Costs and complications of equine castration: a UK practice-based study comparing 'standing nonsutured' and 'recumbent sutured' techniques.

REASONS FOR PERFORMING STUDY: Clinicians are often asked to guide owners and trainers over the relative advantages and disadvantages of equine castration performed in either the standing horse with an open unsutured scrotal wound with healing by second intention, or a recumbent horse under general anaesthesia in aseptic conditions, with sutured scrotal skin allowing primary wound closure. OBJECTIVES: To identify types and frequency of complications following the 2 differing approaches, and to compare the financial cost associated with each procedure, based on practice charges. METHODS: Veterinary expenses of 217 horses castrated by a Newmarket equine veterinary practice over an 18-month period were analysed. Of these, Group 1 (n = 121) were castrated standing and nonsutured by one of 2 ambulatory clinicians and Group 2 (n = 96) castrated in recumbency, in aseptic equine hospital conditions. RESULTS: Group 1 had a complication prevalence of 22% with no mortalities, and Group 2 a significantly lower complication prevalence of 6% (P = 0.001) with a mortality rate of 1%. The financial cost of Group 1, without complications, was approximately one-third of the cost of uncomplicated Group 2. However, the cost of Group 1 with complications increased to approximately two-thirds of the cost of an uncomplicated Group 2 castration. CONCLUSIONS: Even though the complication prevalence for Group 1 castrations leaving an open scrotal wound was significantly higher than for a recumbent horse with a sutured scrotal wound in a hospital, the average cost of Group 1 was still less, even taking into account the additional follow-up costs associated with treating such complications. POTENTIAL RELEVANCE: This report provides a benchmark for the outcome of 2 methods of castration based on a database obtained from particular circumstances within the practice involved. Further studies are required to corroborate and take into account future development in surgical and anaesthetic techniques.

A study of ten cases of focal peritarsal infection as a cause of severe lameness in the thoroughbred racehorse: clinical signs, differential diagnosis, treatment and outcome.

The differential diagnoses of tarsal joint infection, fracture and peritarsal focal infection are of particular importance in practice. The objective of the present report is to provide additional clinical data to assist in the understanding of one of these conditions. The haematological parameters, clinical signs, treatment and outcome of 10 cases of severe lameness associated with peritarsal infection are reviewed. All horses had a significant rise in rectal temperature. The majority of cases (6/10) had haematological changes consistent with acute bacterial infection on the day of first examination. In the remaining cases these changes were not apparent on a blood sample taken on the first examination, but became so after 24 h. Nine out of 10 cases made a complete recovery on a regimen of i.v. antibiotic therapy, in conjunction with administration of nonsteroidal anti-inflammatory drugs and repeated forced exercise. One case developed osteomyelitis of the third and fourth metatarsal bones, but made a full recovery in due course. It is concluded that, in the majority of cases, prompt treatment with antibiotic therapy, analgesics and forced exercise results in complete resolution of the condition.

Wedge-shaped conformation of the dorsolateral aspect of the third tarsal bone in the Thoroughbred racehorse is associated with development of slab fractures in this site.

Anecdotal evidence suggested that many cases of third tarsal bone (T3) fracture encountered clinically were associated with an abnormal shape to this bone. The radiographs of 10 normal horses and 10 horses affected with slab fracture of T3 were therefore examined to ascertain if any pre-existent radiological abnormality was present in cases of fracture. Measurement of the maximum and minimum width between the proximal and distal articular surfaces of the dorsolateral aspect of this bone was carried out on a standardised dorso-50 degrees medial-palmarolateral radiographic projection of the tarsus of each horse. To avoid artefacts produced by possible image magnification, ratios of these values were used for comparison between horses. The results showed that wedge shaped conformation of T3, in which the articular surfaces of the bone converge and then diverge again on the dorsolateral aspect, was over-represented in the population of horses sustaining T3 fracture when compared to controls. This information may be important in making judgements on the suitability of horses during prepurchase examination for racing.

Fracture of the wing of the ilium, adjacent to the sacroiliac joint, in thoroughbred racehorses.

During a two year period, sagittal fractures of the wing of the ilium were diagnosed in 10 Thoroughbred horses. All were spontaneous fractures sustained during normal exercise in training and racing, with no history of inciting trauma. When ultrasound scans of the surface of the pelvis were performed, the fracture was clearly visible as a discontinuity of the sacral wing of the ilium. In 3 horses, an irregular contour suggestive of periosteal callus was seen in the vicinity of the acute fracture. All horses examined by gamma scintigraphy had a focal increase in uptake of isotope just lateral to the tuber sacrale. Nine of the horses were treated conservatively by rest. The other horse had bilateral fractures and was subjected to euthanasia at the time of the injury. Six horses returned to full training, and 2 subsequently won, without recurrence of lameness.

The efficacy of dantrolene sodium in controlling exertional rhabdomyolysis in the Thoroughbred racehorse.

REASONS FOR PERFORMING STUDY: Dantrolene sodium (Dantrium) has been used extensively for the treatment of myopathies in man and anecdotal evidence suggests it is of clinical benefit in the control of exercise-induced rhabdomyolysis (ER) in racehorses, although data to support this are currently lacking. OBJECTIVES: To investigate the efficacy of oral dantrolene sodium in controlling ER in a randomised, double-blind, placebo-controlled crossover trial involving 77 Thoroughbred racehorses in Newmarket, UK. METHODS: Horses were treated on 2 occasions 1 week apart, with treatment days coinciding with a return to exercise following 2 days box rest on each occasion. For the first treatment, each horse was randomly selected to receive either 800 mg dantrolene sodium or a colour-matched placebo administered orally 1 h before exercise. This was followed by crossover to the other treatment on the second occasion, with each horse thereby acting as its own control. Degree of ER was assessed using rising serum creatine kinase (CK) levels, by subtracting pre-exercise blood CK levels from those measured in 6 h post exercise blood samples. For each horse, the difference in change between pre- and post exercise CK values between placebo and dantrolene treatments was calculated, with positive values indicating a greater rise with placebo than with dantrolene sodium treatment. RESULTS: The overall mean difference for all horses was +104.8 iu/l and the null hypothesis, that there was no true difference in non-normally distributed post exercise rises in CK values between placebo and dantrolene treatments, was rejected (P = 0.0013) using the nonparametric Wilcoxon signed rank test. Additionally, no horses given dantrolene sodium showed clinical signs of ER, whereas 3 horses given the placebo developed ER following exercise. The incidence of ER in the study was 4% (3/77). CONCLUSIONS: The results confirmed that oral administration of dantrolene sodium, 1 h before exercise, had a statistically significant effect on reducing the difference between pre- and post exercise plasma CK levels compared with a placebo in the same animals, and preventing clinical ER in susceptible individuals. POTENTIAL RELEVANCE: This study suggested that dantrolene sodium is of use in controlling ER in the Thoroughbred racehorse. Further investigation into pre- and post exercise myoplasmic calcium levels and the repeat of the study late in the season when horses receive a much higher energy ration and more strenuous exercise would appear to be warranted.

Can a pelvic fracture in a horse be detected by probe scintigraphy?

Pelvic fracture is a relatively common spontaneous fracture in thoroughbred racehorses. Its diagnosis can be difficult, and radiography in the acute phase carries the risks associated with anaesthesia and recumbency. This paper describes the use of a hand-held probe for point counting after the injection of technetium-99m in the investigation of four cases of pelvic fracture. The level of increased uptake of radioactivity was lower (40 to 61 per cent increase) than for distal limb bone fractures.

An improved method for the scintigraphic detection of acute bone damage to the equine pelvis by probe point counting.

A fracture of the pelvis in a horse can be detected scintigraphically by probe point counting. However, the pelvis is covered by a large and variable muscle mass, and is close to the urinary bladder, both of which can introduce errors. This paper describes an improved technique which uses a larger set of sampling points and analyses the data with a small computer to construct a three dimensional graph of the gamma-ray output across the pelvis, thus helping to improve the interpretation of the data. The scintigraphic plot from a normal horse, three cases of fracture (confirmed by radiography, ultrasound imaging or post mortem examination) and examples of the artefacts produced by isotope in the bladder and by marked muscle wasting are presented.

The use of radionuclide bone scanning in the diagnosis of tibial 'stress' fractures in the horse: a review of five cases.

Five horses, all two year old Thoroughbreds, presented with acute onset hindlimb lameness following moderate to fast exercise. The use of a hand-held scintillation detector after Tc99 MDP injection greatly aided the diagnosis of tibial stress fractures in these horses. Radiological findings were subtle, involving only periosteal new bone and callus at the fracture site. In two cases this took several weeks to develop but in three others was present at the onset of lameness, indicating insidious pre-fracture bone pathology. The site of the most obvious radiological signs was constant in all five cases, being the proximal lateral tibia some 8 to 9 cm from the femoro-tibial joint surface. The diagnosis of five cases of tibial fracture in one racing season suggests that this condition has been underdiagnosed in the past in this clinic, prior to the availability of bone scanning.