Bell Equine Veterinary Clinic

Background: Equine sinonasal disorders are significant diseases whose investigation and treatment have undergone significant changes over the past decade. No large study has described the signalments, pre-referral management, or the clinical and nasal

The healthcare sector contributes significantly to global greenhouse gas (GHG) emissions, with anaesthetic gases being a notable contributor. Implementing sustainable practices in equine anaesthesia, such as low-flow anaesthesia, offers potential benefits. To audit oxygen and isoflurane usage in five equine hospitals, their associated GHG emissions, and the impact of anaesthesia training on mitigating these emissions. Multi-centre clinical audit. This audit covered two periods: study period one (1 June-30 September 2022) and study period two (1 June-30 September 2023). After period one, an anaesthesia training programme introduced low-flow techniques. Data collected retrospectively included patient signalment, anaesthetic protocol, and 5-min recordings of fresh gas flow (FGF) and vapouriser settings. GHG emissions (in carbon dioxide equivalents) and costs (in £) were calculated. Statistical analysis used a linear mixed-effects model with a significance level of p-value <0.05. A total of 414 general anaesthetics were audited. Between study period one and two, isoflurane and oxygen usage decreased by 9.6% and 17.9%, respectively, resulting in a 9.6% reduction in GHG emissions (from 14.6 to 13.2 tCO2e). A linear mixed-effects model identified five significant predictors of GHG emissions per case: study period, oxygen usage, anaesthesia duration, average isoflurane vapouriser setting, and the interaction between oxygen usage and study period. Cases in study period two were associated with lower GHG emissions, producing on average 10.4 kgCO2e less per case (p = 0.01), while each additional litre of oxygen consumed increased emissions by 0.12 kgCO2e (p < 0.001). Missing data from FGF and/or vapouriser settings and the minimal variability between hospitals could be perceived as limitations. This audit demonstrates that practising low-flow anaesthesia can effectively reduce the environmental impact of inhalant anaesthetic agents during equine anaesthesia. Wider adoption could improve sustainability, although further research and broader professional engagement are needed.

SummaryBackgroundYoungstock are particularly susceptible to parasitic disease; anthelmintic resistance is an increasing problem.ObjectivesTo investigate the current approaches to testing for parasites and anthelmintic use in foals and adult horses on UK studs.Study DesignCross‐sectional study; online survey.MethodsSurveyMonkey questionnaires (multiple choice, Likert scale and free text questions) distributed via practices, press, social media and snowball sampling. Descriptive and inferential statistics performed in Microsoft Excel and STATA. Statistical differences assessed with Fisher's exact test or Mann–Whitney U test.ResultsThere were 56 usable responses. Experience, faecal egg counts and veterinary advice were considered to be the most important factors in determining anthelmintic choice. The commonest product choices overall were a moxidectin–praziquantel combination, fenbendazole and pyrantel. Timing of anthelmintic treatment for cyathostomins in broodmares was based on faecal egg counts in 58.9%; treatment for tapeworms was based on ELISA results in 10.7%. With respect to foals, 61.8% received anthelmintic treatments regardless of test results; the commonest anthelmintic products used in foals were fenbendazole (56.6%) and pyrantel (47.9%). Anthelmintic resistance on the property was reported by 27.8% of respondents, but there was no association with reported illness.Main LimitationsSmall sample size. Potential selection bias and response bias.ConclusionsOver a quarter of stud owners believed that anthelmintic resistance occurred on their premises. The commonest used anthelmintic product on stud farms was moxidectin–praziquantel combination. The commonest anthelmintic used in foals was fenbendazole. Testing for tapeworms was uncommonly undertaken. Results identify areas where testing for parasites and anthelmintic use on stud farms could be improved.

SummaryBackgroundPancreatitis is a poorly understood condition in the horse. The DGGR‐lipase assay has recently been validated for horses.ObjectivesTo evaluate serum DGGR‐lipase concentrations in equids presented to an equine hospital in the United Kingdom with gastrointestinal disease.Study designProspective descriptive.MethodsBlood samples were obtained by convenience sampling of horses and donkeys presented for evaluation of gastrointestinal disease.ResultsSerum pancreatic (DGGR‐) lipase concentrations were measured in 205 equids with gastrointestinal disease, of which 147 survived, 47 were euthanised and 11 died. The median serum pancreatic lipase concentration in all animals was 17 U/L (IQR 14–27; range 1–3484). The lipase concentration was categorised as normal in 124 animals (60.5%) and elevated in 81 (39.5%). There was a statistically significant difference in the disease category and pancreatic lipase concentration (p &lt; 0.001), with colic cases having higher lipase concentrations than colitis and peritonitis cases. There was strong evidence (p = 0.01) of an association between pain severity and lipase values, with higher lipase concentrations in horses with more severe pain. Of 12 horses with severely increased pancreatic lipase concentration (&gt;200 U/L), 3/12 had spontaneous nasogastric reflux and 6/10 had distended and/or thickened small intestine on abdominal ultrasonography; 7/12 survived to hospital discharge and 5/12 died or were euthanised.Main limitationsWe were unable to confirm the presence of pancreatitis in any of the horses with elevated serum DGGR‐lipase concentrations by post‐mortem examination or histopathology.ConclusionsSome equids with gastrointestinal disease have increased serum pancreatic (DGGR‐) lipase concentrations, especially those with colic. This suggests that a degree of pancreatitis may be present in many colic cases, although this does not indicate causation.

As an equine registered veterinary nurse (RVN), it is essential to understand the fundamental welfare, health, and husbandry requirements for equine patients. This chapter includes information on welfare legislation, housing, nutrition, exercise, grooming, dental care, vaccinations, parasite control, breeds and markings, passports requirements and exports, handling and restraint, transport techniques, and equine behaviour,. The information in this chapter is an important foundation to developing and delivering a high standard of individualised nursing care to equine patients.

Background There are limited data on outcomes and complications of conjunctival pedicle grafts in horses. Objective Document the indications, complications and outcomes of conjunctival pedicle grafts in horses. Study Design Retrospective case series. Methods Review of case records of horses with corneal diseases managed using conjunctival pedicle grafts. History, clinical findings, treatments, complications, and outcomes were recorded. Results 26 horses were treated by conjunctival pedicle grafts over a 16 years period. The indications were deep corneal ulceration (n=9), non-healing superficial corneal ulceration (n=6), corneal stromal abscessation (n=5), corneal laceration (n=3) and keratomalacia (n=3). Short term complications occurred in 12 horses (46%), the commonest being necrosis of the graft (n=6); in 3 cases, the corneal lesion healed following debridement, but in 2 the affected eye required enucleation and one was euthanased. Keratomalacia and ulceration extending beyond the graft occurred in 3 horses, all of which were enucleated. Uveitis occurred in 6 horses (4 cases prior to discharge and 2 after discharge); enucleation was required in 5 of these horses. Phthisis bulbi occurred prior to discharge in one horse and after discharge in another. Two horses had decreased faecal output after surgery (one had caecal impaction). In 6/26 cases (23%) enucleation was required prior to hospital discharge. One horse was euthanased due to post-operative caecal impaction. The short-term success rate was 69%. Two horses (8%) required enucleation after discharge from the hospital and the long-term success rate was 58%. Main Limitations Small number of cases with variety of different diseases of varying severities. Conclusions Conjunctival pedicle grafts were successfully employed to treat several corneal diseases including chronic superficial corneal ulceration, deep corneal ulceration, corneal stromal abscesses, corneal lacerations and keratomalacia. The short-term success rate was 69%. Long-term follow-up indicated a good prognosis for most horses that had a successful short-term outcome.

Geriatric horses have a high prevalence of dental disease, which is a culmination of age-related dental changes and dental disease throughout the life of the horse that may have long-term consequences. Wear abnormalities, diastemata with periodontal disease, pulpitis and endodontic disease, infundibular caries, and equine odontoclastic tooth resorption and hypercementosis become more prevalent with age. Recognition of age-related dental disease at an early stage can help to treat and possibly preserve teeth for longer. With a natural decrease in masticatory efficiency, it is even more important to preserve teeth where possible and prevent any painful dental disease. Regular routine dental examination and maintenance will help to prevent many dental conditions such as wear disorders and possibly secondary diastemata. Successful treatment and management of most dental diseases are possible even in older patients and will ensure that we are able to maintain a high standard of welfare as horses age.

These findings should be used to inform decision-making in equine primary care practice.