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.

Clinical significance and prognosis of deep digital flexor tendinopathy assessed over time using MRI.

Deep digital flexor (DDF) tendinopathy is one of the most frequent causes of foot lameness and the prognosis is guarded. The progress of lesion healing may be followed by magnetic resonance (MR) imaging to formulate a prognosis and to adapt the rehabilitation program. We assessed the correlation of outcome with total tendon damage and temporal resolution of MR abnormalities. Images from 34 horses with DDF tendinopathy that had undergone at least two low-field standing MR examinations of the foot (mean 2.5 ± 1.3 times) were reviewed. No horse having a T1-GRE hyperintense lesion over 30 mm in length or over 10% tendon cross-sectional area returned to its previous activity level. Horses with concomitant lesions had worse outcome than horses with DDF tendinopathy only (P = 0.005). In all horses including those with excellent outcome, the lesion persisted, even mildly, in T1-GRE and PD images. Horses with tendon lesion resolution on STIR-FSE and T2-FSE images on recheck examination had a better outcome (P = 0.0004 and P = 0.002, respectively), and all horses that returned to their previous level of performance had complete resolution of signal hyperintensity on the STIR-FSE sequence. Although rehabilitation remains multifactorial, characteristics of DDF tendinopathy and concomitant lesions on first and recheck MR examinations allow refining the prognosis.

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.