Retrospective Analysis of the Use of Tiludronate in Equine Practice: Safety on 1804 Horses, Efficacy on 343 Horses.

The objective of this retrospective study was to assess the safety and efficacy of a slow IV administration of 1mg/kg tiludronate in a large number of horses. Each horse that received at least one tiludronate-based treatment between 2006 and August 2019 at Virginia Equine Imaging or Fairfield Equine was included in the study. Concomitant medical treatments, preliminary nonsteroidal anti-inflammatory drug injection and potential side effects were recorded after each administration. Horses for which follow-up was available over 1 year were subject to clinical evolution assessment via lameness grade evolution and performance data when available. Collected data suggest excellent tolerance to tiludronate with only 0.9% of the 2,497 injections (1,804 horses) inducing potential side effects, mild colics being the most frequent. Clinical follow-up was available over more than 1 year for 343 horses. Most horses (>80%) presented an initial lameness score over 1.5/5, approximately half of the population was sound by 30 days and remained so after a year. Mean lameness score improved by more than one grade during the follow-up period compared to initial examination. Performance data were available for 129 horses. One year after treatment, 89 (69%) horses were still competing, 73 (82%) of them at a better or similar level. These data suggest good efficacy of tiludronate over a year after treatment. Despite limitations inherent to any field study, this is the first retrospective study of the use of bisphosphonates in horses combining a large group with long-term follow-ups.

A retrospective view of concussion in American football, 1900-1959: What was suggested then we now know.

While published work and media attention about football-related concussion in the USA have increased exponentially in the past few years, these injuries have in fact been written about for over a century. In this work, we undertook a selective review of the PubMed database of the published reports on concussion in football prior to 1960, with attention to the definitions used, physician attitudes, epidemiology, return to play criteria and recommendations and concerns related to long-term outcomes. Search inclusion criteria were English language, publication between the years 1900 and 1959 and studies written by healthcare professionals treating football-related injuries. Twenty-six studies met the inclusion criteria for this review, and the findings are grouped by topic area and detailed chronologically. Early sports medicine physicians struggled with many of the same issues faced today by clinicians such as honest reporting of symptoms by athletes, lack of uniform diagnosis and treatment and ambiguity over maximum 'safe' number of lifetime concussions.

Magnetic resonance imaging findings of desmopathy of the collateral ligaments of the equine distal interphalangeal joint.

We report the use of a low-field magnetic resonance (MR) imaging system for the detection of desmopathy of the collateral ligament of the distal interphalangeal joint and the long-term outcome. Twenty horses were studied and their medical records and MR images were reviewed retrospectively. Long-term follow-up information was obtained by telephonic questionnaires of owners, trainers, or referring veterinarians. Desmopathy of the medial collateral ligament (80%) and enthesopathy of the affected collateral ligament (80%) were common MR imaging features. Treatment consisted of stall rest followed by a rehabilitation period. Additional treatments included shoeing, extracorporeal shock wave therapy, application of a half limb or foot cast, and medication of the distal interphalangeal joint. Twelve (60%) horses returned to their previous level of exercise and maintained their previous level, whereas eight horses had a poor outcome. Low-field MR imaging in the standing patient can be used to detect collateral ligament desmopathy of the distal interphalangeal joint without a need for general anesthesia.