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Summary: Background: The increasing popularity of objective gait analysis makes application in prepurchase examinations (PPE) a logical next step. Therefore, there is a need to have more understanding of asymmetry during a PPE in horses described on clinical evaluation as subtly lame. Objectives: The objective of this study is to objectively compare asymmetry in horses raising minor vet concerns in a PPE and in horses raising major vet concerns with that found in horses presented with subtle single‐limb lameness, and to investigate the effect of age/discipline on the clinicians' interpretation of asymmetry on the classification of minor vet concerns in a PPE. Study Design: Clinical case‐series. Methods: Horses presented for PPE (n = 98) or subjectively evaluated as single limb low‐grade (1–2/5) lame (n = 24, 13 forelimb lame, 11 hindlimb lame), from the patient population of a single clinic, were enrolled in the study provided that owners were willing to participate. Horses undergoing PPE were assigned a classification of having minor vet concerns (n = 84) or major vet concerns (n = 14) based on findings during the dynamic‐orthopaedic part of the PPE. Lame horses were only included if pain‐related lameness was confirmed by an objective improvement after diagnostic analgesia exceeding daily variation determined for equine symmetry parameters using optical motion capture. Clinical evaluation was performed by six different clinicians, each with ≥8 years of equine orthopaedic experience. Vertical movement symmetry was measured using optical motion capture, simultaneously with the orthopaedic examination. Data were analysed using previously described parameters and mixed model analysis and least squares means were used to calculate differences between groups. Results: There was no effect of age or discipline on the levels of asymmetry within PPE horses raising minor vet concerns. MinDiff and RUD of the head discriminated between forelimb lame and PPE horses raising minor vet concerns; MinDiff, MaxDiff, RUD of the Pelvis, HHDswing and HHDstance did so for hindlimb lameness. Two lameness patterns differentiated both forelimb and hindlimb lame from PPE horses with minor vet concerns: RUD Poll + MinDiff Withers – RUD Pelvis and RUD Pelvis + RUD Poll − MinDiff Withers. Correcting for vertical range of motion enabled differentiation of PPE horses with minor vet concerns from PPE horses with major vet concerns. Main Limitations: Objective data only based on trot on soft surface, limited number of PPE horses with major vet concerns. Conclusions: Combinations of kinematic parameters discriminate between PPE horses with minor vet concerns and subtly lame horses, though overlap exists. [ABSTRACT FROM AUTHOR]

This randomised controlled trial evaluates the necessity of preoperative antimicrobial prophylaxis in equine clean, elective orthopaedic surgery. 75 horses undergoing clean orthopaedic surgery were randomly assigned to either a treated or a control group. Treated horses received 10mg/kg amoxicillin and 6.6mg/kg gentamicin once 30 to 45 minutes prior to first incision. The horses remained in the clinic for at least six days. During the first three days after surgery, rectal body temperatures were measured twice and on day four and five once daily. Surgical incisions received score points for exudation, swelling, skin temperature, and dehiscence. A two-factorial ANOVA was used to test for statistically significant differences between groups and over time. For pairwise comparisons between groups or time points, Fisher’s exact test and the (exact) Wilcoxon-Mann-Whitney-test were used. 59/75 horses (78.7%) were included in statistical analysis. Significantly higher scores for swelling (p=0.002), and skin temperature (p=0.007) were observed in treated patients (n=28), which caused the total score to be significantly higher in treated horses, too (p=0.002). In both groups, body temperatures were significantly higher in the evening of the day of surgery (p<0.0001). On the third day after surgery, temperatures in the morning were significantly higher than in the evening (p=0.007). All other statistical comparisons revealed no significant differences. After the seven-day observation period, one control horse (day 8 postoperatively) and one horse (day 9 postoperatively) in the treated group, that was excluded from statistical analysis due to additional gentamicin administration directly after the operation, developed septic arthritis in the operated joint. Preoperatively administered amoxicillin in combination with gentamicin failed to reduce reactions at incision sites after elective surgical orthopaedic procedures. The routine administration of preoperative antimicrobial prophylaxis in clean, elective orthopaedic surgery in horses lacks scientific data to prove a beneficial effect. Antibiotic administration before or after these procedures should be based on an individual risk-benefit assessment. [ABSTRACT FROM AUTHOR]

Several studies report that there is no association between septic arthritis after arthroscopy or the development of post-operative complications and perioperative antimicrobial prophylaxis and low rates for septic arthritis after arthroscopy without perioperative antimicrobial prophylaxis. The following prospective randomised study examined the development of post-surgical complications in these types of surgery with /without perioperative antimicrobial prophylaxis. 75 horses underwent elective orthopaedic surgery and were randomly assigned to either a treated or a control group. As prae-operative antimicrobial prophylaxis, treated horses received antibiotics as a single-shot (6.6 mg/kg gentamicin, 10 mg/kg amoxicillin) 30 to 45 minutes prior to surgery. Controls received neither antibiotic nor placebo. The horses stayed at the clinic for at least five days after surgery. The rectal body temperature was measured in the mornings, at day 0-3 also in the evenings. Bandages were changed at day 1, 3 and 5 and score points for exudation (0, 1 or 3), swelling (0-3), skin temperature (0-3), and dehiscence (0-3) assigned. Differences between treated and control horses were detected with a two way ANOVA with repeated measures. Fisher's exact test and the Wilcoxon-Mann- Whitney-test were used as post-hoc tests. 59/75 horses (78.7%) were considered for statistical analysis. Reasons for drop out were unrelated to group assignment. Treated horses had a significantly higher total score than control patients for swelling and skin temperature. For exudation and dehiscence, there was no significant difference. Also, there were no significant differences between the groups in body temperature. At day 8 and 9 respectively, one control and one treated (dropped out, additional gentamicin) horse developed septic arthritis. As wound infections after clean elective orthopaedic surgery are rare, patients should be monitored carefully for at least 20 days especially after arthroscopy. Nonetheless, the single-shot praeoperative administration of antibiotics failed to reduce wound scores and eliminate postoperative fever in this study. A routine, praeoperative application of antimicrobials in these type of surgeries seems unnecessary. The administration of pre-/post-operative antibiotics in equine clean elective surgery requires an individual risk/benefit assessment including surgical and postoperative findings. [ABSTRACT FROM AUTHOR]

Background: High-power laser therapy gained popularity recently as a regenerative treatment for tendinitis and desmitis in the horse. However, studies evaluating the effects of laser therapy on tissue repair at the histological level in large mammals are lacking., Objectives: To evaluate the effects of high-power laser therapy on suspensory desmitis healing, using a model of suspensory ligament branch injury., Study Design: In vivo experiments., Methods: Standardised lesions were surgically induced in all four lateral suspensory branches of 12 healthy Warmblood horses. Laser therapy (class 4, 15W) was applied daily on two of four induced lesions for four consecutive weeks. Horses were randomly assigned to either short-term study (horses were sacrificed after 4 weeks) or long-term study (6 months). Suspensory ligament samples were scored after staining with haematoxylin-eosin and immunostaining for collagen 1- collagen 3- and factor VIII., Results: In the short-term study, significantly better (lower) scores for variation in density (17% above cut-off score in treated lesions vs. 31% above cut-off score in controls, P = .03), shape of nuclei (54% vs 92%, P = .02), fibre alignment (32% vs 75%, P = .003) and fibre structure (38% vs 71%, P = .02) were found in laser-treated lesions when compared to controls. Collagen 3 expression was significantly higher (32% vs 19%, P = .006) in control lesions. In both short- and long-term studies combined, parameters lesion size (44% vs 56%, P = .02) and shape of nuclei (53% vs 84%, P = .05) scored significantly better in treated lesions. Long-term, significantly better (lower) scores were found in the laser-treated group for lesion size (15% vs 45%, P = .008) and a higher percentage above cut-off score for density of the nuclei (27% vs 9%, P = .02), compared to controls., Main Limitations: The model of suspensory branch injury is not an exact representation of clinical overstrain lesions., Conclusions: These results suggest that high-power laser therapy enables better lesion healing than conservative treatment., (© 2022 EVJ Ltd.)

High-power laser therapy is often used as a treatment for human sport injuries but controlled standardized studies on its efficacy are lacking. The technique has also been introduced in the equine field and recently promising results were reported in a retrospective study focusing on 150 sporthorses suffering from tendinopathy and desmopathy of the SDFT, DDFT, suspensory ligament, and suspensory branches. The goal of the present study was to evaluate the effect of high-power laser in a standardized lesion model in horses. Lesions were created in all lateral suspensory branches of 12 warmblood horses. In each horse, 2 of the 4 lesioned branches were treated daily with a multi-frequency high-power laser for 4 weeks. Color Doppler ultrasonography was performed during and after the treatment period. Six horses were euthanized 4 weeks post-surgery (short-term) and 6 were further rehabilitated until 6 months and then euthanized (long-term). High-field MRI evaluation was performed on all cadaver limbs. On ultrasound, transverse size of the lesion was significantly smaller after 2- and 3 months ( p = 0.026 and p = 0.015) in the treated branches. The expected post-surgery enlargement of the lesion circumference and cross-sectional area (CSA) over time, was significantly lower in the short-term laser treated group ( p = 0.016 and p = 0.010). Treated lesions showed a significantly increased Doppler signal during treatment ( p < 0.001) compared with control. On MRI, in the short and long-term group, the CSA of the lesions was significantly smaller ( p = 0.002), and the mean signal significantly lower in the treatment groups ( p = 0.006). This standardized controlled study shows that multi-frequency high-power laser therapy significantly improves healing of a suspensory branch ligament lesion., (Copyright © 2020 Pluim, Martens, Vanderperren, van Weeren, Oosterlinck, Dewulf, Kichouh, Van Thielen, Koene, Luciani, Plancke and Delesalle.)