Clinical applicability of detomidine and methadone constant rate infusions for surgery in standing horses.

OBJECTIVE: To determine the required rate of a detomidine infusion (loading dose 5 µg kg-1; initial rate 12.5 µg kg-1 hour-1) added to a constant infusion of methadone (0.2 mg kg-1; 0.05 mg kg-1 hour-1) for sedation in standing horses and ponies undergoing elective surgeries with appropriate local anaesthetic techniques. STUDY DESIGN: Prospective, clinical study. ANIMALS: Adult, healthy, client-owned, non-food-producing horses or ponies sedated for elective standing surgeries longer than 45 minutes. METHODS: At baseline (in the stables before administration of sedative agents), at 10 minutes after sedation and every 5 minutes thereafter, ataxia, sedation and surgical condition were evaluated; each scored 0-3. These scores were used to adjust the detomidine administration rate using the Ghent Sedation Algorithm. A 10 cm visual analogue scale (VAS) was used by the main surgeon at the end of the procedure to evaluate the surgical conditions. Heart rate, systolic arterial pressure and respiratory frequency were also recorded at each time point. For statistical analysis, anova for normal, Kruskal-Wallis H-test for non-normal variables, and Mann-Whitney U test for VAS were used. RESULTS: From the 42 horses/ponies included in this study, 28 underwent dental procedures and 14 other types of procedures. Overall, dental procedures required higher mean detomidine rates compared with other types of surgeries (16.9 ± 4.5 versus 9.0 ± 1.9 µg kg-1 hour-1) (p < 0.001). Dental procedures were assigned similar VAS scores, median (range), of 7.8 (5.8-10) with other procedures, 8.7 (2.8-10). Cardiovascular changes were not clinically significant. No signs or behavioural changes of abdominal pain were observed postoperatively. CONCLUSIONS AND CLINICAL RELEVANCE: Satisfactory surgical conditions were achieved using a combination of detomidine and methadone infusions with locoregional anaesthesia, with no adverse effects. Dental procedures required higher detomidine dose rates compared with other surgeries.

Piezoelectric device use in sinus osteotomy for equines is feasible but may extend time to accomplish frontonasal bone flap.

OBJECTIVE: Sinus osteotomy is currently performed in equine surgery with conventional surgical methods, such as trephines and oscillating bone saw, leading to subsequent trauma to the bone during cutting. Piezoelectric devices are now used in maxillofacial surgery in humans as a standard tool as it is less traumatic than the oscillating bone saw and shortens the healing period. The aim of this study was to show that the piezoelectric device can be used for equine sinus surgery, compare its use with the oscillating bone saw, and describe the outcome of cases involving osteotomy performed with a piezoelectric surgical device. ANIMALS: 10 horse specimens for cadaveric study and 11 client-owned equines for clinical evaluation. METHODS: Each cadaveric head underwent a frontonasal bone flap on a randomly assigned side with the piezotome and the oscillating bone saw on the opposite side. Surgical time was recorded for every procedure, and gross examination was performed. A Welch t test was used to compare the surgical time between piezoelectric and oscillating saw use. For the clinical study, animals presented for sinonasal surgery at the hospital from March through October 2023 were included. RESULTS: Osteotomy was possible with the piezotome in all animals. Surgical time was significantly increased when using the piezotome in comparison with the oscillating saw (P < .05). All clinical patients were treated adequately for the sinonasal disorder they were presented for using the piezotome instead of the oscillating saw. No adverse effects nor long-term complications related to its use have been noted, and preservation of the surrounding soft tissues was evident. CLINICAL RELEVANCE: The use of a piezoelectric device in equine surgery is feasible. However, the cadaveric study showed an increased surgical time to perform a frontonasal bone flap.

Diagnosis and Surgical Treatment of Idiopathic Primary Sino-Nasal Obstruction in Miniature Horse Breeds: Long-Term Follow-Up of Seven Cases.

Idiopathic sino-nasal obstruction resulting in retention of large amounts of liquid in the paranasal sinus compartments was diagnosed in seven young (2. 2 ± 0.7 years) miniature-breed horses based on clinical, endoscopic, radiographic, and CT scan examinations. The most prevalent clinical signs included decreased or no airflow from the nostril(s) (7/7) and nasal discharge (6/7). The problem presented bilaterally in six of seven cases. An alternative sino-nasal communication was created through bone flap osteotomy surgery and perforation of the ventromedial floor of the dorsal conchae in all cases, followed by fixation of silicone irrigation tubes/Foley catheters in six of seven cases to keep the newly created ostium patent. This resulted in long-term resolution of the problem with good cosmetic appearance in all animals following a median period of 19 months. Premature loss of fixed tubes was reported in three cases.

Fracture Resistance of Equine Cheek Teeth With and Without Occlusal Fissures: A Standardized ex vivo Model.

Background: Ex vivo fracture models are frequently used in human dentistry to provide insights in the fracture mechanisms of teeth. Equine cheek teeth fractures are an important dental pathology, but there has been no research performed to examine the fracture resistance ex vivo. Objective: To evaluate the fracture resistance of equine cheek teeth and identify anatomical predictors that might influence fracture resistance in healthy teeth. It was further evaluated if the presence of a fissure caused a decrease in fracture resistance. Study design: Ex vivo experimental design. Methods: Individual cheek teeth were subjected to a compression load in a universal testing machine until fracture occurred. Testing was performed in two study groups. A first group of healthy cheek teeth was tested to examine anatomical predictors on fracture resistance. A second group comprised cheek teeth with occlusal fissures and an equal number of age- and size-matched fissure-free teeth as controls. The effect of possible predictors on fracture resistance was investigated by regression analysis. Results: In the first group, fracture resistance was significantly influenced by the location on the tooth where testing was performed in both maxillary (p < 0.001) and mandibular teeth (p < 0.001). Additional significantly associated factors were Triadan number in mandibular (p = 0.009) and the mesiodistal length of the occlusal surface of maxillary teeth (p = 0.01). Experimentally induced crown fractures that extended below the simulated bone level were more frequently associated with pulp horn exposure (p < 0.001). In the second group, significant lower fracture loads were recorded in teeth with fissures (mandibular p = 0.006; maxillary p < 0.001), compared to fissure-free teeth. Main limitations: This ex vivo model does not imitate the in vivo masticatory forces and lacks the shock-absorbing properties of the periodontal ligament. Conclusions: The methodology used in this study provides an ex vivo experimental set-up to test fracture resistance of equine cheek teeth enabling evidence-based research to examine the potentially weakening effects of tooth pathology and its treatments. Crown resistance to fracture differed along the occlusal surface of healthy equine cheek teeth, and the presence of fissures further decreased fracture resistance.

Occlusal Fissures in Equine Cheek Teeth: A Prospective Longitudinal in vivo Study.

Background: It has been suggested that fissures of the occlusal surface of equine cheek teeth may develop into crown fractures. Objectives: To examine the evolution of fissures present on the occlusal surface of cheek teeth. Furthermore, to investigate the presence of a fissure as a risk factor for the development of a subsequent crown fracture. Study Design: Observational longitudinal study. Methods: Bi-annual dental examinations were performed on 36 horses for 3 years. Video-recordings were made to evaluate the evolution of detected fissures. The effect of possible predictors on the development of tooth fractures was investigated by regression analysis. Results: The evolution of 785 fissures (467 type 1a, 271 type 1b, 47 type 2) was recorded. Fissure characteristics were observed to remain unchanged, disappear, become longer, shorter, change in configuration or change in color. Partial crown fractures (22 maxillary, 50 mandibular) were recorded in 52 cheek teeth in 22/36 horses. Fifty-nine of these fractures evolved from previously observed fissures (24 type 1a, 29 type 1b, 6 type 2). All fissure types proved to be a significant risk factor for the development of a crown fracture (p < 0.001), with the highest odds for type 2 fissures (OR = 14.27; 95% CI = 4.88-41.71). Other significant risk factors were the time of follow-up (p < 0.001), mandibular teeth (p < 0.001) and the lingual side of a tooth (p < 0.001). All fractures were non-complicated. Main Limitations: Some horses were prematurely lost for follow-up, which perhaps influenced the results. A longer follow-up period would have also allowed an evaluation of the risk for pulp disease on the long term subsequent to partial crown fractures. Conclusions: The presence of a fissure of any type, mandibular cheek teeth, the lingual side of cheek teeth, and time of follow-up proved to be significant risk factors for development of a cheek tooth crown fracture. Type 2 fissures showed the highest odds followed by type 1b fissures. The observed partial crown fractures demonstrated a low clinical impact whereby no tooth showed signs of development of endodontal disease.

Dental disease in alpacas. Part 2: Risk factors associated with diastemata, periodontitis, occlusal pulp exposure, wear abnormalities, and malpositioned teeth.

BACKGROUND: Dental disorders, of which tooth root abscesses are best documented, are highly prevalent in alpacas. Identification of risk factors can be valuable for prevention of dental disorders in this species. HYPOTHESIS/OBJECTIVES: To identify risk factors associated with wear abnormalities, malpositioning, diastemata, periodontal disease (PD), and occlusal pulp exposure at the level of the cheek teeth. ANIMALS: Two hundred twenty-eight alpacas (Vicugna pacos) from 25 farms. METHODS: Cross-sectional study. Dental examinations were performed on sedated animals. Risk factors were determined by clinical examination and interview. Multivariable logistic regression was used to identify risk factors for wear abnormalities, malpositioned teeth, diastemata, PD, and occlusal pulp exposure. RESULTS: Mandibular swelling was significantly associated with PD (odds ratio [OR], 11.37; 95% confidence interval [CI], 3.27-48.81; P < .001). Nearly 73% of included animals with mandibular swelling concurrently had PD. For every increase in herd size of 1 animal, the risk for PD increased by 2% (95% CI, 1-4%; P = .01). The association between severe stages of PD and body condition score (BCS) indicates a painful situation, impairing animal welfare (P < .001). For each 1-day increase in interval between pasture cleanings, the odds of finding pulp exposure for a single animal was estimated to increase by 1% (95% CI, 0-2%; P = .05). CONCLUSION AND CLINICAL IMPORTANCE: Simple management tools such as measuring BCS, palpating the mandible for bony swellings, removing feces from pasture on a regular basis and decreasing herd size might help identify animals at risk for dental disorders or prevent their development.

Dental disease in alpacas. Part 1: Prevalence of dental disorders and their mutual relationships.

BACKGROUND: Dental disease is a troublesome health concern in alpacas. Specifically, the occurrence of tooth root abscesses has been described in veterinary literature. Nevertheless, no objective prevalence data are available for dental disorders in alpacas. HYPOTHESIS/OBJECTIVES: To determine the prevalence of dental disorders in alpaca herds in Belgium and the Netherlands. To study the associations between the different dental disorders encountered in alpacas. ANIMALS: A total of 228 alpacas (Vicugna pacos) originating from 25 farms. METHODS: This is a cross-sectional study. Dental disorders were diagnosed by dental examination of sedated animals using a dental mirror or a portable rigid oroscope. RESULTS: At the animal level, 82% (n = 187) had dental disorders of which 74.6, 41.7, and 3.9% were cheek teeth, incisor disorders, and canine disorders, respectively. At the level of the cheek teeth, diastemata (43.1%) were most common, followed by wear abnormalities (WA; 39.6%) and periodontal disease (PD; 33.3%). A significant association was detected between the presence of diastemata and PD (odds ratio [OR], 13.1; 95% confidence interval [CI], 6.6-27.7; P < .001). Pulp exposure was significantly associated with the presence of diastemata (OR, 11.8; 95% CI, 3.8-51.5; P < .001), PD (OR, 8.2; 95% CI, 3.1-25.3; P < .001) and WA (OR, 2.9; 95% CI, 1.2-7.4; P = .002). CONCLUSION AND CLINICAL IMPORTANCE: Dental disorders are highly prevalent in alpacas in Belgium and the Netherlands. Several dental disorders in alpacas had significant associations. To prevent the development of advanced stages of dental disease, routine dental examinations are advised to allow early detection and prompt treatment.