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Background: Emergency laparotomies in donkeys are infrequently performed and there is limited literature on the subject., Objectives: To determine findings and associated outcomes of exploratory laparotomies in donkeys., Study Design: Descriptive retrospective study., Methods: Donkeys undergoing emergency exploratory laparotomy for investigation and treatment of colic at seven UK referral hospitals between 2005-2017 were included. Data were retrieved from available hospital records. Descriptive statistics and inferential statistical analysis of outcomes of interest was performed in three steps., Results: Thirty-three cases fulfilled the inclusion criteria. Clinical signs on presentation were available for 32 donkeys, of which 53.1% (17/32) presented for investigation of colic while in 46.9% (15/32) the presenting complaint was non-specific. Primary lesion location included small intestine (42.4%, 14/33), large colon (39.3%, 13/33), caecum (6.1%, 2/33), stomach (6.1%, 2/33) and 6.1% (2/33) had multiple abnormal findings without a clear primary lesion. Overall survival to discharge was 54.5% (18/33). Five donkeys (15.2%, 5/33) were euthanased at surgery and of those recovering from general anaesthesia a further 35.7% (10/28) were euthanased or died prior to discharge. Six donkeys (21.4%, 6/28) required a second laparotomy of which 4 (66.7%, 4/6) survived. Post-operative complications occurred in 82.1% (23/28) of cases and included hyperlipaemia (42.9%, 12/28), incisional complications (21.4%, 6/28), ileus (21.4%, 6/28) and persistent colic (17.9%, 5/28). When adjusted for other complications, donkeys with primary gastric lesions were less likely to have presented with severe colic compared with those with primary small intestinal lesions (OR: 0.07, 95% CI 0.01-0.95, p = 0.05). Only age was positively associated with death prior to discharge (OR: 1.18, 95% CI 1.03-1.36, p = 0.02)., Main Limitations: Small sample size and retrospective design., Conclusion: Donkeys with abdominal lesions may present with a range of signs often not including colic. Surgical findings were diverse and survival to discharge appears to be lower than in horses., (© 2022 EVJ Ltd.)

Current consensus defines mild-moderate equine asthma (mEA; previously inflammatory airway disease) by a hierarchy of indicators of lung pathology: cough, poor performance, increased tracheobronchial mucus, inflammatory bronchoalveolar lavage (BAL) cytology and pulmonary dysfunction. Exclusion criteria include fever, systemic disease, or increased resting respiratory effort. The aim of this review was to inform future research by identifying gaps, strengths and weaknesses in the current body of evidence supporting this consensus-proposed definition. Objectives were to critique evidence supporting the inclusion of each diagnostic indicator in the case definition, by summarising and evaluating evidence for its association with higher-level indicators of lung inflammation. Searches of three databases identified 2275 articles relating to mEA or its diagnostic indicators, from which 298 full-text articles were screened and 45 reviewed in full. Studies (n = 44) had been performed worldwide in clinics, hospitals, racetracks, yards or research herds, in 6092 horses. Studies were predominantly opportunistic observational (n = 13/44: 29.5%) or cross-sectional (n = 11/44; 25%). The median number of horses per study was 74. Where breed and use were reported most were Thoroughbreds (58.2%; 2730/4688) and racehorses (72.8%; n = 3960/5439). Domains rated as high risk of bias in almost 50% of articles were 'study power' and 'masking'. Heterogeneity in clinical and laboratory measures precluded meta-analysis. Evidence was more consistent for certain pairwise relationships (e.g., between cough and tracheobronchial mucus) than others (e.g., BAL cytology and lung function). Findings highlight the need for increased standardisation of diagnostic methods and reporting to facilitate future systematic review and meta-analysis., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Aims: To examine prescribed psychotropic medicine use on a given day in Australia (25 September 2018; World Pharmacists Day), with a focus on psychotropic polypharmacy., Methods: We used a 10% sample of individual-level nationwide dispensing claims to examine psychotropic medicine use on a given day. We estimated the prevalence of psychotropic medicine use in all ages stratified by age and sex. We also calculated the observed vs expected (had medicines been randomly combined) prevalence of psychotropic combinations used. We focused on combinations of clinical significance as well combinations of psychotropics with medicines prescribed to manage cardiovascular risk and disease., Results: Serotonin reuptake inhibitors, serotonin-noradrenalin reuptake inhibitors/noradrenaline reuptake inhibitors, tricyclic antidepressants and gabapentinoids dominated psychotropic use. The use of any psychotropic as a proportion of people in the Australian population increased with age, peaking at the 85-89 year age group and declining thereafter. Combinations of medicines from the same subclass generally occurred at lower than expected frequencies. However, combinations including atypical antipsychotics occurred more frequently than expected; e.g. 7.4× with anticonvulsants and 2.2× with other atypical antipsychotics. This was also the case for combinations of sedatives, e.g. anxiolytic with hypnotic benzodiazepines (3.8×). Lipid-lowering drugs and antidiabetic medicines were combined with psychotropics at frequencies close to those expected had they been randomly combined., Conclusion: Psychotropic use in older adults and certain psychotropic combinations that are not well supported with evidence remain prevalent and greater consideration of the drivers of this potentially inappropriate prescribing is required., (© 2020 The British Pharmacological Society.)

Background: Arthroscopy has been advocated as the treatment of choice for dorsal osteochondral chip fracture of the metacarpo/metatarsophalangeal (MCP/MTP) joint. However, there is no published research on racing performance outcomes of horses with this pathology managed nonsurgically., Objectives: To compare racing career outcomes of Thoroughbred racehorses with nonsurgically (non-SX) or surgically (SX) managed MCP/MTP dorsal osteochondral chip fracture alongside a cohort of horses with no dorsal osteochondral chip fracture (unexposed)., Study Design: Retrospective cohort study conducted between 2006 and 2014., Methods: Radiographs of Thoroughbred racehorses were reviewed to identify MCP/MTP dorsal osteochondral chip fractures. Unexposed horses under the care of the same practice were recruited randomly from training records. Racing outcomes were analysed using survival analysis and logistic, linear and negative binomial regression techniques., Results: Dorsal osteochondral chip fractures were identified in 98 (70 non-SX, 28 SX) horses and compared with 648 unexposed horses. There was no significant difference among non-SX, SX, and unexposed horses in respect of total career starts, or likelihood of ever winning, placing, or earning money in a race (P > .05). SX horses had a significantly higher rate of wins/start than non-SX horses (rate ratio 1.6, CI 1.1-2.4, P = .02) and unexposed horses (rate ratio 1.9, CI 1.3-2.8, P = .001). Total career earnings for the SX horses were 4.1 times that of the unexposed horses (95% CI 1.2-14.5, P = .03), although total career earnings did not differ significantly between non-SX and unexposed horses (P = .8)., Main Limitations: Retrospective observational study where management technique was not randomised or blinded. Small number of surgically managed horses and potential selection bias for surgical management., Conclusions: Nonsurgical management of this injury appears to be a valid management choice given that it was not associated with significant effects on racing career performance relative to a large unexposed cohort in this study population., (© 2020 EVJ Ltd.)

Purpose: To describe Australians' prescribed medicine use on a typical day (September 25, 2018)., Methods: We conducted a cross-sectional study using nationally representative dispensing claims data using the Australian Government Department of Human Services random 10% sample of all Australians eligible for prescription medicines subsidised through the Australian Pharmaceutical Benefits Scheme (PBS). Our main outcome measures were the number and proportion of people using at least one prescribed medicine and the specific medicine groups and classes on the day. We estimated the proportion of Australians using these medicines using the mid-year Australian population as the denominator. We quantified multiple medicine use by calculating the number and proportion of people experiencing polypharmacy (the use of 5 or more unique medicines) and hyper-polypharmacy (the use of 10 or more unique medicines)., Results: We found that 9.0 million Australians used at least one PBS medicine on September 25, 2018; equating to 27.5 million medicines in use across Australia. "Cardiovascular system", "nervous system" and "alimentary tract and metabolism" medicines comprised the top three medicine groups. Over 1.8 million people experienced polypharmacy on the day, accounting for 13.6 million dispensed medicines. 1 022 590 (45%) people aged ≥70 years old experienced polypharmacy and 188 930 (8%) experienced hyper-polypharmacy., Conclusions: Rates of polypharmacy were high, particularly in the people most susceptible to polypharmacy-related harm. Strategies to optimise the risk-benefit ratio of medicines and to reduce polypharmacy through "choosing wisely" and "de-prescribing" in this age group are needed. Australia's national data provides a benchmark to inform global medicine utilisation practices., (© 2020 John Wiley & Sons Ltd.)

Background: Previous studies investigating factors associated with survival following endoscopic treatment of contamination/sepsis of the calcaneal bursa are limited., Objectives: To investigate the factors associated with survival in horses with contamination/sepsis of the calcaneal bursae treated endoscopically and to describe the bacterial isolates involved in the synovial infections., Study Design: Retrospective analysis of clinical records., Methods: Medical records from 128 horses with contamination/sepsis of the calcaneal bursae treated by endoscopic lavage at seven equine hospitals were reviewed. A follow-up questionnaire was used to determine survival and return to athletic performance. Descriptive statistics and Cox proportional hazards survival models were used to determine factors associated with survival., Results: Horses underwent one (n = 107), two (n = 19), or three (n = 2) surgeries. Survival to hospital discharge was 84.4%. Univariable survival analysis revealed that administration of systemic antimicrobials prior to referral was associated with reduced mortality (hazard ratio, [HR] 0.41, 95% CI 0.18-0.91, P = 0.03). Increased mortality was associated with bone fracture/osteomyelitis (HR 2.43, 95% CI 1.12-5.26, P = 0.03), tendon involvement (≥30% cross sectional area) (HR 3.78 95% CI 1.78-8.04, P = 0.001), duration of general anaesthesia (HR 1.01, 95% CI 1.00-1.02, P = 0.04), post-operative synoviocentesis (HR 3.18, 95% CI 1.36-7.43, P = 0.006) and post-operative wound dehiscence (HR 2.5, 95% CI 1.08-5.65, P = 0.04). Multivariable Cox proportional hazards model revealed reduced mortality after systemic antimicrobial administration prior to referral (HR 0.25, 95% CI 0.11-0.60, P = 0.002) and increased mortality with tendinous involvement (≥30% cross-sectional area) (HR 7.92, 95% CI 3.31-19.92, P<0.001). At follow-up (median 30 months, range 0.25-13 years, n = 70) 87.1% horses were alive, 7.1% had been euthanised due to the calcaneal injury and 5.7% had been euthanised for unrelated reasons. From 57 horses with athletic performance follow-up, 91.2% returned to the same/higher level of exercise, 5.3% to a lower level and 3.5% were retired due to persistent lameness of the affected limb., Main Limitations: Retrospective study and incomplete follow-up., Conclusion: Endoscopic treatment of contamination/sepsis of the calcaneal bursae has an 84% survival rate to hospital discharge. Tendinous involvement reduced survival whilst systemic antimicrobials administration prior to referral improved survival., (© 2019 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.)

Background: Arthroscopy is considered the treatment of choice for dorsal osteochondral chip fractures of the metacarpo/metatarsophalangeal (MCP/MTP) joints in the racehorse; however, there is no published research on non-surgical management of this injury., Objectives: To compare clinical features, intra-articular medication use and return to racing in Thoroughbred racehorses with non-surgically (non-SX) or surgically (SX) managed MCP/MTP dorsal chip fracture., Study Design: Retrospective observational study conducted between 2006 and 2014., Methods: Radiographs of Thoroughbred racehorses were reviewed to identify MCP/MTP dorsal osteochondral chip fractures. Clinical and intra-articular medication data were obtained from veterinary records, and return to racing data from a public online resource., Results: A total of 98 MCP/MTP horses with dorsal chip fractures were identified (70 non-SX, 28 SX). Median age was 2 years (range 2-7 years). Osteochondral chip fractures predominantly involved the forelimbs (n = 92, 93.9%) and the majority were considered by the treating clinician to be clinically active (n = 85, 86.7%). Significantly more SX horses had a reported ongoing problem associated with the affected joint than non-SX horses (P = 0.002), however there was no significant difference between non-SX and SX horses in the number of intra-articular medications of affected joint per month of follow-up (P = 0.22). The proportion of horses racing post-diagnosis was not significantly different between non-SX (55/70; 78.6%, 95% CI 69.0, 88.2%) and SX horses (24/28; 85.7%, 95% CI 72.8, 98.73%) (P = 0.57). Median time to first start following diagnosis for non-SX (106 days, range 1-326) was significantly shorter than for SX horses (203 days, range 9-559) (P = 0.002)., Main Limitations: Management technique was not randomised or blinded, with few surgically managed horses., Conclusions: The results contribute to the current evidence base used to guide management of osteochondral chip fractures of the MCP/MTP joints in the racehorse, and indicate that non-surgical management may be a valid treatment option for some injuries., (© 2019 EVJ Ltd.)

Euthanasia is a complex topic, with animal owners using multiple factors to shape their decision-making process. Previous epidemiological studies have described causes of equine mortality in specific populations, but there is limited evidence regarding factors contributing specifically to equine euthanasia in Great Britain (GB). This observational study used a prospective cohort design: the objectives were to describe owner-reported reasons for euthanasia, estimate the rate of euthanasia and identify associated factors in horses/ponies enrolled in a web-based epidemiological study of laminitis in GB. Self-selected horse/pony owners submitted regular management and health data over 29 months and reported dates and reasons for euthanasia during this period. The overall incidence of euthanasia was estimated and associated factors were identified using multivariable Cox regression modelling, adjusted for age, with variables retained in the final model if P ≤ 0.05. Data were available for 1070 horses/ponies contributing 1093 horse-years at risk (HYAR), with 80 owner-reported euthanasias. The incidence of euthanasia was 7.3 euthanasias per 100 HYAR (95 % confidence interval [CI] 5.9, 9.1). The most frequently reported health reasons contributing to euthanasia were laminitis-related consequences (25.0 % ; CI 16.8, 35.5 %), colic (21.3 % ; CI 13.7, 31.4 %), non-laminitic lameness (20.0 % ; CI 12.7, 30.1 %) and age-related deterioration, including owner-perceived compromised quality of life (20.0 % ; CI 12.7, 30.1 %). Health-related factors associated with significantly higher rates of euthanasia were colic (hazard ratio [HR] 26.4; CI 12.5, 55.8), pituitary pars intermedia dysfunction (HR 3.0; CI 1.7, 5.4) and lameness due to navicular syndrome (HR 5.9; CI 1.8, 20.0), soft tissue injury (HR 6.5; CI 2.7, 15.6) or laminitis (HR 2.7; CI 1.3, 5.7). Further factors included being pure bred (HR 1.7; CI 1.0, 2.8), female (HR 1.7; CI 1.0, 2.9), having poor owner-perceived hoof quality (HR 2.4; CI 1.1, 5.2), being entirely stabled (HR 5.0; HR 2.1, 12.0), being on loan or under temporary care of the study participant (HR 2.3; CI 1.2, 4.4) and participating in affiliated or professional competitions (HR 5.9; CI 2.4, 14.8). Euthanasia rates were significantly higher in the first two study years compared to the third (P < 0.001). Animals whose owners used the study's custom-designed weight tracker tool had significantly lower rates of euthanasia (HR 0.6; CI 0.3, 0.95). This study has identified a number of, arguably preventable, health-related factors associated with higher rates of euthanasia. Data on owners' decision-making process regarding euthanasia, including emotive and financial impacts, were not recorded but are important contributors to euthanasia that require better understanding., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Aim: To describe the epidemiology of veterinary pharmaceutical-related exposures based on telephone calls to Australia's largest poisons information centre. Methods: A retrospective analysis of exposures to pharmaceutical products intended for animal use, managed by the New South Wales Poison Information Centre (NSWPIC, Australia's largest poisons information centre) from 2014 to 2016 inclusive, was conducted. Case narratives were reviewed and coded for exposure-related circumstances and intended species. Descriptive statistics were generated and forest plots were produced to visualise the perceived severity of products. Results: From 2014 through 2016 NSWPIC received 2655 calls regarding exposure to veterinary pharmaceutical products: 11.72 human exposures to veterinary pharmaceuticals per 1000 PIC initial contact exposure calls (CI: 10.95-12.49) per year. The vast majority of exposures were with products intended for companion animals, particularly of the class "antiparasitic products, insecticides and repellents", with the most common individual specified product being pimobendan, a phosphodiesterase inhibitor used as a cardiac inotrope and vasodilator in dogs. Immunologicals presented the greatest perceived severity, with livestock vaccinations eliciting substantial proportions of symptomatic exposures and those receiving hospitalisation. Exploratory behaviour, such as accessing packaging, was a common source of exposure within toddlers and children in particular. Conclusions: This overview of all exposures to veterinary pharmaceutical products has identified high-risk groups to target interventions to reduce the incidence of future exposures. The pet-owning population and those personnel administering immunologicals to livestock represent a substantial cohort of individuals at risk of harm during, and in the immediate time following, administration of veterinary pharmaceutical products to animals. It is important to review risk management plans for veterinary pharmaceutical products to ensure product safety is as stringent as human equivalents. The legislative requirements concerning child-resistant packaging and the scheduling of livestock vaccines require reconsideration.

Background: There are few observational studies regarding the potentially serious complication of synovial sepsis following intrasynovial medication in general equine practice. Quantification of risk is fundamental to fully inform decision-making and owner consent prior to undertaking procedures., Objectives: To describe the occurrence of synovial sepsis following intrasynovial injections in a large ambulatory equine practice between 2006-2011., Study Design: Retrospective cohort study., Methods: Medication records were cross-referenced against synovial cytology submissions and hospital admissions for synovial sepsis. The occurrence of synovial sepsis within strata of interest, including horse age, sex and product used were described as proportions with corresponding 95% confidence intervals, and measures of attributable risks., Results: In the study period, 9456 intrasynovial medications were performed in 4331 sessions. The most frequently used medications were: corticosteroids (3869/4331, 89.3% [95% CI 88.4, 90.3%]), hyaluronate (3617/4331, 83.5% [95% CI 82.4, 84.6%]) and amikacin sulphate (4044/4331, 93.4% [95% CI 92.6, 94.1%]). Overall four horses developed post medication synovial sepsis (0.04% [95% CI 0.0, 0.08%] of all medications), two of these cases were given polysulphated glycosaminoglycans and hyaluronate (2/14, 14.3% [95% CI 0.0, 32.6%]), two were given triamcinolone acetonide (2/3592, 0.1% [95% CI 0.0, 0.1%]), and hyaluronate (2/3617, 0.06% [95% CI 0.0, 0.1%]). One of these cases had received concurrent medication with amikacin sulphate (1/4044, 0.02% [95% CI 0.0, 0.1%]). All four cases returned to racing following joint lavage., Main Limitations: Due to the low frequency of cases multivariable statistical analysis was not performed. Although the study was conducted in an ambulatory setting, the population included a high number of racehorses, limiting application to the general horse population., Conclusions: The frequency of synovial sepsis in this population of horses was 0.04%. These data may be helpful in informing clients regarding the potential risks of adverse complications resulting from intrasynovial medication., (© 2018 EVJ Ltd.)

Objectives: To assess the numbers of paracetamol overdose-related hospital admissions and deaths in Australia since 2007-08, and the overdose size of intentional paracetamol overdoses since 2004., Design, Setting: Retrospective analysis of data on paracetamol-related exposures, hospital admissions, and deaths from the Australian Institute of Health and Welfare National Hospital Morbidity Database (NHMD; 2007-08 to 2016-17), the New South Wales Poisons Information Centre (NSWPIC; 2004-2017), and the National Coronial Information System (NCIS; 2007-08 to 2016-17)., Participants: People who took overdoses of paracetamol in single ingredient preparations., Main Outcome Measures: Annual numbers of reported paracetamol-related poisonings, hospital admissions, and deaths; number of tablets taken in overdoses., Results: The NHMD included 95 668 admissions with paracetamol poisoning diagnoses (2007-08 to 2016-17); the annual number of cases increased by 44.3% during the study period (3.8% per year; 95% CI, 3.2-4.6%). Toxic liver disease was documented for 1816 of these patients; the annual number increased by 108% during the study period (7.7% per year; 95% CI, 6.0-9.5%). The NSWPIC database included 22 997 reports of intentional overdose with paracetamol (2004-2017); the annual number increased by 77.0% during the study period (3.3% per year; 95% CI, 2.5-4.2%). The median number of tablets taken increased from 15 (IQR, 10-24) in 2004 to 20 (IQR, 10-35) in 2017. Modified release paracetamol ingestion report numbers increased 38% between 2004 and 2017 (95% CI, 30-47%). 126 in-hospital deaths were recorded in the NHMD, and 205 deaths (in-hospital and out of hospital) in the NCIS, with no temporal trends., Conclusions: The frequency of paracetamol overdose-related hospital admissions has increased in Australia since 2004, and the rise is associated with greater numbers of liver injury diagnoses. Overdose size and the proportion of overdoses involving modified release paracetamol have each also increased., (© 2019 AMPCo Pty Ltd.)

Background: Previous robust epidemiological studies of equine laminitis have utilised only veterinary-diagnosed episodes of disease, potentially underestimating true disease frequency., Objectives: To estimate the incidence of, and describe clinical signs associated with, owner-reported active laminitis in horses/ponies, using both veterinary-diagnosed and nonveterinary-diagnosed episodes., Study Design: Prospective cohort., Methods: Data were collected from horse/pony owners in Great Britain between August 2014 and December 2016 using a web-based application. The incidence of owner-reported laminitis was estimated using both first incident and repeat episodes reported during the study period via a previously validated laminitis reporting form. Owner-reported clinical signs present in these episodes were recorded., Results: A total of 1070 horses/ponies contributed 1068 horse-years at risk (HYAR) and 123 active laminitis episodes were reported in 97 animals. Sixty-two of these episodes (50.4%, 95% confidence interval [CI] 41.6, 59.2%) were veterinary-diagnosed and 75.3% (CI 66.7, 83.8%; n = 73) of horses/ponies reported to have laminitis during the study had a previous laminitis history. Overall owner-reported first episode incidence was 9.6 episodes (CI 7.8, 11.7)/100 HYAR, whereas incidence including repeat episodes was 11.5 episodes (CI 9.7, 13.7)/100 HYAR. Laminitis occurred throughout the year with no significant differences between seasonal incidence estimates. Incidence was highest in Connemara and New Forest and lowest in Draught and Cob breed categories. The most prevalent owner-reported clinical signs (≥70%) were difficulty turning and a short/stilted or lame walk. Laminitis was reported in all limbs, however; both forelimbs were most commonly affected (62.9%, CI 54.1, 71.7%; n = 73/116)., Main Limitations: Self-selection enrolment of participants may limit generalisability of the findings., Conclusions: Laminitis remains a considerable year-round welfare issue of horses and ponies, with frequency estimates utilising owner-reported data more representative of the true impact of the disease. The clinical signs reported by horse/pony owners were reflective of those previously described by veterinary surgeons., (© 2018 EVJ Ltd.)

Aims: We aim to calculate 2 metrics of relative lethal toxicity; the fatal toxicity index (FTI; number of deaths per year of a daily dose) and the case fatality (CF; number of deaths per overdose) with a focus on opioids, antidepressants, antipsychotics, benzodiazepines and illicit drugs., Methods: This descriptive cohort study used the Australian National Coronial Information System (NCIS) to identify a population of individuals with drug-associated deaths in the Greater Newcastle Hunter Area between January 2002 and December 2016. This was combined with Australian medicine dispensing data and corresponding data from the Hunter Area Toxicology Service to calculate FTI and CF., Results: There were 444 drug-related deaths and 21,296 overdoses during the study period. FTI and CF were well correlated (Spearman's rho 0.64, P < .001). Of the classes of interest, opioids had the highest FTI (40.3 95% confidence interval [CI] 35.2-45.4 deaths per 100 years of use at the defined daily dose or deaths/DDD/100 years) and CF (12.4% 95%CI 11.0-13.9). Fentanyl, methadone and morphine had the highest relative fatal toxicity within this class. Tricyclic antidepressants had the highest relative fatal toxicity of all antidepressants (FTI 14.5 95%CI 9.7-19.3 deaths/DDD/100 years and CF 7.1% [95%CI 4.8-9.3]) and benzodiazepines appeared to be more associated with multiple agent deaths than single. Of the illicit drugs, heroin had the highest CF (26.4%, 95%CI 19.1-33.7)., Conclusion: Knowledge of relative lethal toxicity is useful to prescribers and medicines and public health policy makers in restricting access to more toxic drugs and may also assist coroners in determining cause of death., (© 2019 The British Pharmacological Society.)

Despite their implication in the pathogenesis of lower airway inflammation, limited baseline data exists for airborne particulates in Thoroughbred racehorse stalls in the United Kingdom. This study documents airborne particulate size and concentrations in Newmarket training yards using a nephelometer (DustTrak DRX 8534, TSI). Each stall was sampled on a summer and winter day at three time points (morning, midday and evening). Minimum, mean and maximum/min ranges were calculated for the fraction of particulates with an aerodynamic diameter smaller than 2.5 μm (particulate matter (PM) 2.5) and 10 μm (PM10). Comparisons were made using Wilcoxon signed-rank test. Average particulate concentration ranges were 0.02-0.27 (summer) mg/m 3 , 0.01-0.37 (winter) mg/m 3 for PM2.5 and 0.02-0.39 (summer) mg/m 3 , 0.02-0.60 (winter) mg/m 3 for PM10. Statistically significant effects of season and time of day were established, resulting in implications for future studies investigating the effect of yard variables on airborne particulates., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The barriers to opioid use in some countries necessitate the need to identify suitable alternatives or adjuncts for pain relief. The gabapentinoids (gabapentin and pregabalin) are approved for the management of persistent pain in adults, but not in children. Searches were conducted in Embase, Medline, Scopus, and Web of Science up until November 2017, for randomized controlled trials that investigated the analgesic effects of gabapentin or pregabalin in children and adolescents <18 years of age. A total of 7 publications were identified, 5 regarding gabapentin as prophylactic postsurgical pain relief for either adenotonsillectomy (n = 3) or scoliosis surgery (n = 2), and 1 for gabapentin treatment of chronic regional pain syndrome/neuropathic pain. One study investigated the efficacy of pregabalin as a treatment for fibromyalgia. Based on the studies' primary outcomes alone, neither of the chronic pain studies involving gabapentin and pregabalin showed significant efficacy compared with amitriptyline or placebo, respectively. Two of the prophylactic gabapentin studies for adenotonsillectomy and idiopathic scoliosis surgery reported significantly fewer children requiring analgesia and lower opioid requirement, respectively, compared with placebo. Two of the identified clinical trials (conducted by the same first author) on the efficacy of gabapentin for prophylactic postadenotonsillectomy pain relief were omitted from narrative synthesis due to clear evidence of fabricated data. Overall, this review identified a paucity of evidence for the analgesic effect and safety of gabapentinoids in children. We also suggest audit of any current evidence-based practice and clinical guidelines that have cited the research studies with fabricated data.

Background: Equine laminitis is a complex disease that manifests as pain and lameness in the feet, often with debilitating consequences. There is a paucity of data that accounts for the multifactorial nature of laminitis and considers time-varying covariates that may be associated with disease development; particularly those that are modifiable and present potential interventions. A previous case-control study identified a number of novel, modifiable factors associated with laminitis which warranted further investigation and corroboration. The aim of this study was to identify factors associated with equine laminitis in horses/ponies in Great Britain (GB) using a prospective, web-based cohort study design, with particular interest in evaluating modifiable factors previously identified in the case-control study., Results: Self-selected horse/pony owners in GB submitted initial baseline and follow-up health and management questionnaires for 1070 horses/ponies between August 2014 and December 2016. The enrolled horses/ponies contributed 1068 horse-years at risk with a median of 38 days between questionnaire submissions. Owners reported 123 owner-recognised and/or veterinary-diagnosed episodes of active laminitis using a previously-validated laminitis reporting form. Multivariable Cox regression modelling identified 16 risk/protective factors associated with laminitis development. In keeping with the previous case-control study, a prior history of laminitis (particularly non-veterinary-diagnosed episodes), soreness after shoeing/trimming and weight gain were associated with higher rates of laminitis. There is now strong evidence that these risk factors should be used to guide future recommendations in disease prevention. Factors with some prior evidence of association included breed, steroidal anti-inflammatory administration, transport and worming. The modifiable factors amongst these should be the focus of future laminitis studies. The remainder of the identified factors relating to health, turnout and grazing management and feeding are novel, and require further investigation to explore their relationship with laminitis and their applicability as potential interventions., Conclusions: This study has demonstrated a temporal relationship between a number of horse- and management-level factors and laminitis, identifying potential interventions and important risk groups for which these interventions would be of particular importance. These results serve as a sound evidence-base towards the development of strategic recommendations for the horse/pony-owning population to reduce the rate of laminitis in GB.

Background: Tracheal wash sample neutrophilia is common in lower airway inflammation of various causes; however, relevance of cytomorphological features to culture of bacterial pathogens has not been established., Objectives: To investigate whether the presence of nondegenerate or degenerate neutrophils in tracheal washes is associated with culture of bacteria and, if so, whether this is influenced by age or temporal factors., Study Design: Cross-sectional study., Methods: Tracheal wash samples submitted to Rossdales LLP from 1/1/2013 to 31/7/2015 were evaluated using set criteria. Neutrophilia and degenerate neutrophilia (graded ≥2/4 on Rossdales cytological scale [0-4]) were analysed in relation to bacterial isolates considered potentially pathogenic in respiratory disease. Statistical analyses included multivariable logistic regression to identify associations between two separate outcomes: 1) the presence of neutrophilia compared with no neutrophilia and 2) the presence of degenerate neutrophilia compared with nondegenerate neutrophilia and four independent variables., Results: Sufficient data for inclusion in the multivariable model for nondegenerate neutrophilia were available from 1100 horses. Culture of potentially pathogenic bacteria was associated with increased odds of degenerate neutrophilia compared with samples with negative culture (OR 4.5, 95% CI 3.1, 6.4, P-value<0.001). Horses over 9 years old had lower odds of having degenerate neutrophilia than those aged 1-3 years (OR 0.6, 95% CI 0.4, 0.9, P-value<0.02). In the spring/summer, horses had reduced odds of a degenerate neutrophilia compared with winter (OR 0.4, 95% CI 0.3, 0.7, P-value <0.001)., Main Limitations: The study relied on routine laboratory submissions, with no control over sample collection or submitted clinical history., Conclusions: Cytological evaluation of tracheal washes should include cytomorphological features of the neutrophil response. The presence of degenerate neutrophils, especially in young horses, indicates added value of culture and sensitivity for antimicrobial therapeutics. The absence of degenerate changes, in combination with clinical factors, can help support diagnosis of a nonseptic cause of airway neutrophilia., (© 2018 EVJ Ltd.)

Background: There is a need for investigation of associations between intrasynovial medication and fracture risk in racehorses., Objectives: To document the proportion and type of fracture occurring following intrasynovial medication., Study Design: Retrospective longitudinal study., Methods: Review of clinical records from all Thoroughbred flat racehorses receiving intrasynovial medication under the care of a first-opinion veterinary practice between 2006 and 2011. Fractures pre- and post-medication were categorised by location, type, and severity; analysis of fractures sustained within 56-days of medication was undertaken. Survival analyses using Cox proportional hazards models were conducted for associations between medication used (corticosteroid vs. non-corticosteroid), age at first medication, sex and total number of medications and fracture., Results: A total of 1488 horses received intrasynovial medication during the period of study; 8692 synovial spaces were medicated in 3925 sessions. There were 96 fractures that occurred within 56-days of medication, of which 44 were classified as 'serious' (44/1488; 3.0% total population, 95% CI 2.1, 3.8%) and 11 (11/1488, 0.7%, 95% CI 0.3, 1.2%) were euthanased due to severity of injury. Fifty-four of 96 cases (56.4%, 95% CI 46.3, 66.2%) returned to racing. Targeted imaging of the subsequent injury site was undertaken prior to injury in only 7 (7/96, 7.3%) horses that injured post-medication. Horses that had received ≥3 previous intrasynovial medication sessions had an increased hazard of sustaining a fracture within 56 days (HR 2.31, 95% CI 1.51, 3.54, P<0.001) compared with those receiving ≤3 medication sessions, adjusted for each increasing year of age (HR 0.67, 95% CI 0.53, 0.86, P = 0.001)., Main Limitations: Absence of an unexposed cohort of nonmedicated racehorses., Conclusions: Serious musculoskeletal injury following intrasynovial medication occurred in 3% (44/1488) horses. Reduction in injury rates may be possible through greater use of premedication diagnostic imaging., (© 2018 EVJ Ltd.)

Background: Racing performance is often used as a measurable outcome variable in research studies investigating clinical diagnoses or interventions. However, the use of many different performance measures largely precludes conduct of meaningful comparative studies and, to date, those being used have not been collated., Objectives: To systematically review the veterinary scientific literature for the use of racing performance as a measurable outcome variable in clinical studies of racehorses, collate and identify those most popular, and identify their advantages and disadvantages., Study Design: Systematic literature search., Methods: The search criteria "((racing AND performance) AND (horses OR equidae))" were adapted for both MEDLINE and CAB Abstracts databases. Data were collected in standardised recording forms for binary, categorical and quantitative measures, and the use of performance indices., Results: In total, 217 studies that described racing performance were identified, contributing 117 different performance measures. No one performance measure was used in all studies, despite 90.3% using more than one variable. Data regarding race starts and earnings were used most commonly, with 88.0% and 54.4% of studies including at least one measure of starts and earnings, respectively. Seventeen variables were used 10 times or more, with the top five comprising: 'return to racing', 'number of starts', 'days to first start', 'earnings per period of time' and 'earnings per start'., Main Limitations: The search strategies may not have identified all relevant papers, introducing bias to the review., Conclusions: Performance indices have been developed to improve assessment of interventions; however, they are not widely adopted in the scientific literature. Use of the two most commonly identified measures, whether the horse returned to racing and number of starts over a defined period of time, would best facilitate future systematic reviews and meta-analyses in advance of the development of a gold-standard measure of race performance outcome., (© 2017 EVJ Ltd.)

Background: Use of owner-reported data could further epidemiological knowledge of equine laminitis. However, owner recognition of laminitis has not previously been assessed., Objectives: The primary objective was to establish whether cases of owner-suspected laminitis would be confirmed as laminitis by the attending veterinary surgeon. Secondary objectives were to compare owner- and veterinary-reported information from veterinary-confirmed cases of equine laminitis., Study Design: Cross-sectional study., Methods: Twenty-five British veterinary practices were invited to submit laminitis reporting forms (LRFs) for active laminitis cases attended between January 2014 and October 2015; detailing 27 clinical signs, 5 underlying conditions and 7 risk factors associated with laminitis. Owners were invited to independently complete a modified LRF if reason for the veterinary visit was suspicion of laminitis. Differences between paired veterinary and owner LRFs, and between cases where owners did and did not recognise laminitis, were assessed using McNemar's and Fisher's Exact tests, respectively., Results: Veterinary LRFs were received for 93 veterinary-diagnosed laminitis cases. All 51 owner-suspected cases were confirmed by veterinary diagnosis, with the remaining 42 (45.2%) not recognised as laminitis by owners. Undefined lameness, foot abscesses, colic and stiffness were common reasons for owner-requested veterinary visits in owner-unrecognised cases. 'Divergent growth rings' (prevalence difference: +27.3%, P = 0.01) and 'breed type' (prevalence difference: +21.2%, P = 0.04) were more commonly reported by veterinary surgeons in owner-recognised compared to owner-unrecognised cases. 'Difficulty turning', 'shifting weight' and risk factor 'body condition' were more frequently reported by veterinary surgeons whilst 'increased hoof temperature' was reported more frequently by owners., Main Limitations: The limited clinical data restricted statistical inferences regarding the secondary objectives., Conclusions: All owner-suspected laminitis cases were confirmed upon veterinary examination, showing validity for the inclusion of owner-reported cases in future epidemiological studies. However, failure of laminitis recognition by owners highlights further need for evidence-based education to ensure early disease detection., (© 2017 EVJ Ltd.)

Monitoring racehorse fatality and associated jockey falls provides benchmarks for intervention strategies. The aims of this study were to describe the incidence of and reasons for fatalities in Thoroughbred horses during flat races in the Australian Capital Territory and New South Wales (NSW), Australia, and to describe reported jockey falls and injuries associated with racehorse fatalities. A cohort study identified all racehorse fatalities reported through Racing NSW for the 2009-2010 to 2013-2014 racing seasons. Risks of racehorse fatality, fatal musculoskeletal injury, spontaneous death (as distinct from euthanasia) and racehorse fatality associated jockey falls and injuries were calculated using Poisson regression. A total of 167 horse fatalities were reported, with an overall incidence of 0.59 deaths/1000 starts. Forty-nine reasons for horse fatality were reported, although post-mortem examinations were conducted on only 52/165 (31.5%) horses. Musculoskeletal injury accounted for 144/167 (86.2%) fatalities, with an incidence of 0.52/1000 starts. Fractures comprised 96/167 (57.5%) fatalities, with the fetlock or proximal sesamoid bones being the most common fracture location, comprising 36/96 (37.5%) fractures. Only 22/166 (13.3%) racehorse fatalities were due to spontaneous death, representing an incidence of 0.08/1000 starts. A total of 50 racehorse fatality associated jockey falls were reported (incidence of 0.18/1000 starts), with 32 reported jockey injuries (incidence of 0.12/1000 starts). Most racehorse fatality associated jockey injuries occurred to the limbs (17/32, 53.1%), particularly the upper limb. The estimates for both horse fatality and associated jockey injury were comparable with previous estimates from other jurisdictions internationally., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Reasons for Performing Study: We hypothesised that the apparent geographical distribution of equine grass sickness (EGS) is partly attributable to suboptimal levels of soil macro- and trace elements in fields where EGS occurs. If proven, altering levels of particular elements could be used to reduce the risk of EGS., Objectives: To determine whether the geographical distribution of EGS cases in eastern Scotland is associated with the presence or absence of particular environmental chemical elements., Study Design: Retrospective time-matched case-control study., Methods: This study used data for 455 geo-referenced EGS cases and 910 time-matched controls in eastern Scotland, and geo-referenced environmental geochemical data from the British Geological Survey Geochemical Baseline Survey of the Environment stream sediment (G-BASE) and the James Hutton Institute, National Soil Inventory of Scotland (NSIS) datasets., Results: Multivariable statistical analyses identified clusters of three main elements associated with cases from (i) the G-BASE dataset - higher environmental Ti and lower Zn, and (ii) the NSIS dataset - higher environmental Ti and lower Cr. There was also some evidence from univariable analyses for lower Al, Cd, Cu, Ni and Pb and higher Ca, K, Mo, Na and Se environmental concentrations being associated with a case. Results were complicated by a high degree of correlation between most geochemical elements., Conclusions: The work presented here would appear to reflect soil- not horse-level risk factors for EGS, but due to the complexity of the correlations between elements, further work is required to determine whether these associations reflect causality, and consequently whether interventions to alter concentrations of particular elements in soil, or in grazing horses, could potentially reduce the risk of EGS. The effect of chemical elements on the growth of those soil microorganisms implicated in EGS aetiology also warrants further study., (© 2015 The The Authors Equine Veterinary Journal © 2015 EVJ Ltd.)

Objective: To document the clinical presentation, diagnosis, and surgical treatment of mineralization of the equine palmar/plantar annular ligament (PAL)., Study Design: Retrospective study., Animals: Ponies (n=7)., Methods: Case records from 2 referral hospitals were examined to identify cases with lameness associated with PAL mineralization treated surgically. Follow-up information was obtained from the owners by telephone questionnaire., Results: Duration of lameness before referral ranged from 5 weeks to 6 months, and degree of lameness from grade 1 to 5 out of 10. In 3 cases, records noted obvious pain when pressure was applied over the PAL. Pain resulting in lameness was localized to this area and all cases were treated surgically, although the extent of resected tissue varied among cases. Histological examination of resected tissue (4 cases) revealed fibrocartilaginous and/or osseous metaplasia. Following surgery, 6 of the 7 ponies became sound., Conclusion: Based on this limited case series, surgical treatment for mineralization of the PAL offers a favorable success rate without severe complications where conservative methods have failed., (© Copyright 2016 by The American College of Veterinary Surgeons.)

Reasons for Performing Study: Laser resection for the treatment of sarcoids is an established part of equine practice; however, few studies have provided long-term follow-up results. Additionally, many previous reports have evaluated several treatments concurrently or have not been able to provide a definitive histological diagnosis of sarcoid., Objectives: To establish the success rate following laser resection as a sole treatment for histologically confirmed sarcoids and evaluate risk factors for recurrence., Study Design: Retrospective time-to-event analysis., Methods: Horses included had laser surgery to remove at least one sarcoid between 1 July 2005 and 1 September 2012. No previous known/concurrent veterinary treatment was administered. Diagnosis was confirmed by histology in all cases. Clinical data were retrieved from the hospital database. Follow-up information was obtained by telephone questionnaire., Results: Ninety-nine horses, with a total of 235 sarcoids, were included in the analysis; 82 (83%) had no recurrence of the sarcoid removed and 71 (72%) had no occurrence of any sarcoids following surgery. Horses with sarcoids on the head and neck and those with verrucose sarcoids were at increased risk of recurrence (hazard ratios of 1.61 and 4.03, and 95% confidence intervals of 1.02-2.56 and 1.11-14.7, respectively)., Conclusions: Laser resection of sarcoids in the horse has a positive post operative prognosis. Further work is required to fully evaluate risk factors for recurrence fully., (© 2015 EVJ Ltd.)

The objective of this cross-sectional study was to compare the prevalence of selected clinical signs in laminitis cases and non-laminitic but lame controls to evaluate their capability to discriminate laminitis from other causes of lameness. Participating veterinary practitioners completed a checklist of laminitis-associated clinical signs identified by literature review. Cases were defined as horses/ponies with veterinary-diagnosed, clinically apparent laminitis; controls were horses/ponies with any lameness other than laminitis. Associations were tested by logistic regression with adjusted odds ratios (ORs) and 95% confidence intervals, with veterinary practice as an a priori fixed effect. Multivariable analysis using graphical classification tree-based statistical models linked laminitis prevalence with specific combinations of clinical signs. Data were collected for 588 cases and 201 controls. Five clinical signs had a difference in prevalence of greater than +50 per cent: 'reluctance to walk' (OR 4.4), 'short, stilted gait at walk' (OR 9.4), 'difficulty turning' (OR 16.9), 'shifting weight' (OR 17.7) and 'increased digital pulse' (OR 13.2) (all P<0.001). 'Bilateral forelimb lameness' was the best discriminator; 92 per cent of animals with this clinical sign had laminitis (OR 40.5, P<0.001). If, in addition, horses/ponies had an 'increased digital pulse', 99 per cent were identified as laminitis. 'Presence of a flat/convex sole' also significantly enhanced clinical diagnosis discrimination (OR 15.5, P<0.001). This is the first epidemiological laminitis study to use decision-tree analysis, providing the first evidence base for evaluating clinical signs to differentially diagnose laminitis from other causes of lameness. Improved evaluation of the clinical signs displayed by laminitic animals examined by first-opinion practitioners will lead to equine welfare improvements., (British Veterinary Association.)

Objective: To describe a technique of canaliculosinostomy into the caudal maxillary sinus to alleviate epiphora secondary to nasolacrimal duct obstruction and to report the long-term outcome in 5 horses., Study Design: Case series., Animals: Five client-owned horses., Methods: Case records of all horses presented for chronic epiphora to a single equine hospital that underwent surgical treatment were reviewed. All included horses had a Jones test or dacryocystography to confirm nasolacrimal duct obstruction. All horses were anesthetized and canaliculosinostomy was created from the medial canthus of the eye into the caudal maxillary sinus using a Steinmann pin and Jacob's chuck. A Foley catheter was placed normograde through the stoma. The inflated bulb held the Foley in place in the sinus, while the proximal end was pulled through the upper eyelid and sutured to the skin on the head. The Foley catheter was maintained in place for 3 weeks and then removed under sedation., Results: Five horses were included. There were no intraoperative difficulties or complications. One horse dislodged the Foley catheter 3 days postoperatively. No other postoperative complications occurred. Followup was available for all horses. One horse was euthanatized for unrelated reasons 10 weeks postoperative at which time epiphora was resolved. The remaining 4 horses had resolution of epiphora at followup (24-46 months postoperative)., Conclusion: This report describes a simple technique for canaliculosinostomy into the caudal maxillary sinus and long-term outcome in 4 of 5 horses, all of which had resolution of epiphora. This technique can be used to resolve epiphora of various etiologies., (© Copyright 2015 by The American College of Veterinary Surgeons.)

Reasons for Performing the Study: Few data are available on the prevalence of obesity in the general equine population of Great Britain (GB), and its associated risk factors., Objectives: To estimate the prevalence of owner-reported obesity in veterinary-registered horses and ponies in GB, and identify factors associated with obesity., Study Design: A cross-sectional survey of horse/pony owners in GB was undertaken using a postal questionnaire., Methods: Thirty veterinary practices randomly selected horse/pony owners to complete a self-administered postal questionnaire. Owners estimated body condition score using a modified Carroll and Huntington method (1-6 scale), and animals were classified as obese if they were scored as either 5 (fat) or 6 (very fat). Factors associated with obesity were assessed using logistic regression analysis., Results: Prevalence of obesity was 31.2% (n = 247/792; 95% confidence interval [CI] 27.9-34.2%). Factors associated with increased odds of obesity were breed (P<0.001), ease of maintaining weight (P<0.001) and primary use (P = 0.002). Compared to Thoroughbreds, draught-type (odds ratio [OR] 7.3; 95% CI 3.1-17.1), cob-type (OR 5.6; 95% CI 2.5-12.5), native (OR 3.2; 95% CI 1.8-5.78) and Welsh breeds (OR 3.5; 95% CI 1.9-6.2) were more likely to be obese. Animals described as 'good doers' were more likely to be obese than those described as readily maintaining normal weight (OR 3.7; 95% CI 2.6-5.3). Compared to competition animals, animals used for pleasure riding (OR 2.5; 95% CI 1.4-4.4) and nonridden animals (OR 2.9; 95% CI 1.5-5.5) were more likely to be obese., Conclusions: Identification of at-risk breeds and other horse- and management-level risk factors for obesity will enable optimal targeting of owner education regarding management strategies to reduce the frequency of equine obesity., (© 2014 EVJ Ltd.)

The electronic patient records of all equine patients of Rossdales Equine Practice between January 1, 2005 and November 1, 2013 were reviewed to determine the number of cases of supporting limb laminitis (SLL) in a large equine practice and referral hospital setting in the UK and to discuss the implications for future epidemiological studies. The clinical notes were searched electronically for a combination of 'laminitis AND (contralateral OR supporting OR overload OR weight bearing)'. The prevalence of SLL within each identified denominator population and the corresponding 95% CI were calculated. SLL developed in nine horses, one donkey and one pony. Thoroughbreds were the most commonly affected breed (72.7 per cent, CI 46.4 to 99.1 per cent), aged 2-14 years (median six years), and only mares (n=9) and stallions (n=2) were represented. SLL was not restricted to horses that were non-weightbearing lame, it developed within 4-100 days after injury (median 14.5 days) and occurred most commonly in a forelimb (54.6 per cent, CI 25.1 to 84.0 per cent). During the same time frame, a total of 65,327 horses were registered with Rossdales Equine Practice, resulting in an overall practice prevalence of SLL of 0.02 per cent (CI 0.01 to 0.03 per cent). Future epidemiological studies to investigate risk factors for SLL prevention will, therefore, be a logistical challenge., (British Veterinary Association.)

The objective of this study was to systematically review the efficacy of topically applied insecticide treatments of dogs (impregnated collars, spot-ons), and prophylactic medications to prevent natural Leishmania infantum (L. infantum) infection in dogs. Randomised controlled trials (RCT), non-randomised clinical trials, cohort studies and case-control studies that investigated preventive efficacy for natural L. infantum infection in dogs were eligible for inclusion. Two review authors independently assessed each study against the inclusion criteria, independently extracted relevant data from all included studies and assessed the risk of methodological shortcomings in each individual study. The odds ratio (OR) and absolute risk reduction (ARR) for dichotomous outcomes and mean difference for continuous outcomes were calculated. Meta-analysis was not performed due to heterogeneity of the studies identified. The search yielded 937 articles, from which 84 full text articles were selected for second stage screening. Eleven eligible studies were included; four on collars (two RCTs), three on spot-ons (two RCTs - one looking at two different dosing regimens), three on prophylactic medications (all RCTs) and one on both collars and spot-ons summarised in this paper. All of the studies were considered to be at a high risk of methodological shortcomings, with the exception of one spot-on study which was considered to be at an unclear risk of methodological shortcomings. Deltamethrin collars, 65% permethrin, 10% imidacloprid with 50% permethrin spot-ons and domperidone prophylactic medication tended to significantly reduce the proportion of dogs infected with L. infantum based on either parasitological or serological evidence., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Canine leishmaniosis (CanL) is an important zoonotic disease; however, the efficacy of available vaccines for the prevention of naturally-occurring Leishmania infantum (L. infantum) infection in dogs remains unclear. The objective of this review was to determine the efficacy of currently available vaccines to prevent naturally-occurring L. infantum infection in dogs. Four bibliographic databases (CAB Direct 2011, Web of Science 2011, U.S. National Library of Medicine 2011 and Literatura Latino Americana e do Caribe em Ciências da Saúde) were searched along with eight sets of conference proceedings and the International Veterinary Information Service (IVIS) database, from 1980 to November 2012. Randomised controlled trials (RCTs), non-randomised clinical trials (NRCTs), cohort studies and case-control studies that investigated vaccine efficacy for natural L. infantum infection in dogs were eligible for inclusion. Two review authors independently assessed each study against the inclusion criteria, independently extracted relevant data from all included studies and assessed the risk of methodological shortcomings in each individual study. The odds ratio (OR) and absolute risk reduction (ARR) for dichotomous outcomes and mean difference for continuous outcomes were calculated. Meta-analysis was not performed due to heterogeneity of the studies identified. The search was conducted for all mitigations for CanL and yielded the title and abstract of 937 articles, from which 84 articles were screened based on full text. Twelve studies on vaccinations (five RCTs, seven NRCTs) were identified. Ten studies were at a high risk of methodological shortcomings, whilst two were at an unclear risk. The use of 200 μg ALM protein, Leishmune(®), CaniLeish(®), LiESAp with MDP, and ALM with BCG tended to significantly reduce the proportion of dogs infected with L. infantum based on either parasitological or serological evidence. The use of lyophilized protein vaccine significantly increased the proportion of dogs infected with L. infantum based on either parasitological or serological evidence. There is peer-reviewed evidence that control measures are effective in preventing CanL with the results suggesting that between 6 and 54% of infections could be prevented with vaccination. However, this evidence is based on a small number of RCTs, all of which are either at high or unclear risk of methodological shortcomings. Well-designed, adequately powered and properly reported randomised clinical trials are needed to clearly establish efficacy of vaccines as CanL control measures., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Reasons for Performing Study: Equine grass sickness (EGS) remains a frequently fatal disease of equids in Britain. Since previous investigations of signalment- and meteorology-related risk factors for EGS have yielded some conflicting data, further investigation is warranted., Objectives: To identify signalment- and meteorology-related risk factors for EGS in Scotland., Study Design: Retrospective time-matched case-control study., Methods: This study was undertaken using data for 455 EGS cases and 910 time-matched controls that were referred to the Royal (Dick) School of Veterinary Studies, and average UK Meteorological Office weather station meteorological values from the month of admission of the animal, from the 3, 6 and 12 months prior to admission, and for the entire 1990-2006 period., Results and Conclusion: Signalment-related risk factors associated with an increased risk of EGS were native Scottish pure breeds compared with crossbreeds (odds ratio [OR] = 3.56, 95% confidence interval [CI] 2.43-5.43) and animals living on premises located further north within the study region (OR = 1.08, 95% CI 1.06-1.10). There was a decreased risk of EGS in animals aged 11-20 years compared with animals 2-10 years (OR = 0.32, 95% CI 0.22-0.45), non-native Scottish pure breeds compared with crossbreeds (OR = 0.71, 95% CI 0.54-0.94), and stallions compared with mares (OR = 0.43, 95% CI 0.22-0.86). Meteorology-related risk factors associated with an increased risk of EGS were (if Ordnance Survey northing is excluded) more sun hours (OR>1.43) and more frost days (OR>1.13), while there was a decreased risk of EGS with higher average maximum temperature (OR<0.83)., Potential Relevance: The signalment-related risk factors will help owners identify high-risk animals, thereby allowing them to prioritise management strategies. The identification of meteorological risk factors may assist studies on the aetiology of EGS., (© 2013 EVJ Ltd.)

Reasons for Performing Study: A previous systematic review highlighted a lack of good evidence regarding the frequency of equine laminitis in Great Britain., Objectives: To estimate the frequency of veterinary-diagnosed active laminitis in the general horse population of Great Britain and to describe the clinical signs present in cases., Study Design: Prospective cohort study., Methods: Data on active episodes of equine laminitis were collected from veterinary practitioners., Results: The prevalence of veterinary-diagnosed active laminitis was 0.47% (95% confidence interval [CI] 0.42-0.52%) for the veterinary-attended population and 0.49% (95% CI 0.43-0.55%) for the veterinary-registered population, suggesting that active episodes of laminitis accounted for nearly one in 200 equine visits and occurred in nearly one in 200 horses registered with veterinary practices. The incidence of veterinary-diagnosed active laminitis was 0.5 cases per 100 horse-years at risk (95% CI 0.44-0.57). Laminitis occurred in all limbs, but most commonly affected the forelimbs bilaterally (53.5%, 95% CI 49.4-57.7%) and was most severe in the front feet. The most common clinical signs were increased digital pulses, difficulty turning and a short, stilted gait at walk., Conclusions and Potential Relevance: The frequency of veterinary-diagnosed active laminitis was considerably lower than previously published estimates, which is probably due to differences in geographical setting, study period, case definition, study design and study populations., (© 2013 EVJ Ltd.)

Laminitis is a highly debilitating disease of the foot known to have a complex and multifactorial aetiology of metabolic, inflammatory, traumatic or vascular origin. The disease has major welfare implications due to unrelenting pain associated with degenerative changes, which often necessitate euthanasia on welfare grounds. Despite this, there have been few high-quality studies investigating risk factors for equine laminitis, and only a limited number of risk factors have been previously investigated. The aim of this study was to conduct a case-control study of risk factors for active episodes of veterinary-diagnosed laminitis in horses and ponies attended by veterinary practitioners in Great Britain, based on multivariable statistical analyses. Questionnaires were received for 1010 animals, comprising 191 laminitis cases and 819 controls. Factors associated with an increased risk of laminitis were weight gain in the previous 3 months, summer and winter months compared to spring, new access to grass in the previous 4 weeks, box rest in the previous week, owner-reported history of laminitis, lameness or foot-soreness after shoeing/trimming, existing endocrinopathic (pituitary pars intermedia dysfunction and equine metabolic syndrome) disease and increasing time since the last anthelmintic treatment. Factors associated with a decreased risk of laminitis were increasing height (cm), feeding of additional supplements in the previous week and transportation in the previous week. Novel associated factors were identified that may aid in the management and prevention of the disease in the veterinary-registered equine population., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

This study aimed to describe the provision of preventive health care and owner-reported disease prevalence in horses and ponies within Great Britain (GB), and to assess geographical variations in health care provision. A cross-sectional survey was conducted, using a postal questionnaire administered to a random sample of veterinary-registered owners of horses and ponies in GB (n=797). The majority of animals received regular preventive health care: 95.6% had regular hoof care; 71.3% were vaccinated for both influenza and tetanus and median time since last anthelmintic administration was 8.7 weeks. Thirty-one percent of owners indicated their animal was overweight/obese. A new health problem within the previous 7 days was reported for 7.4% of animals, 59.3% of which were veterinary-diagnosed. Thirty-two percent of animals were reported to have a long-term/recurrent condition, of which osteoarthritis (13.9%) was the most prevalent. Obesity, musculoskeletal disorders, and dermatological conditions were the most prevalent conditions affecting veterinary-registered horses/ponies., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

The objectives of this study were to describe the demographic characteristics and management practices undertaken by owners of horses/ponies within GB and assess seasonal and geographical variations in management practices. A cross-sectional study was conducted, surveying a random sample of veterinary-registered owners in GB, using a self-administered postal questionnaire. A total of 797 useable responses were received. Only 4.0% of animals were stabled 24h/day, this proportion being greater in winter compared to other seasons (p<0.001). Shavings (45.7%) and straw (35.3%) were the most frequently used bedding. Ninety-two percent of animals had access to pasture (median 91 h/week). The majority of animals received forage (82.6%) and concentrate/supplementary feeding (86.1%). Retired/companion animals and ponies received supplementary feed less frequently and most animals were used for pleasure riding (60.6%). Seasonal and regional differences in management practices were identified, of relevance to practitioners and researchers in the investigation and management of disease conditions., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Objective: To review the clinical use of a lipid-free, ready-made amino acid and glucose parenteral nutrition (PN) solution in dogs., Design: Retrospective study of dogs from 2006 to 2012 that received this form of PN., Setting: University veterinary teaching hospital., Animals: Seventy dogs presented to the hospital for treatment of various diseases in which PN was used as part of patient management. Dogs were administered PN at the discretion of the primary clinician., Intervention: A lipid-free, ready-made solution containing amino acid (59 g/L) and dextrose (100 g/L) was administered intravenously as a constant rate infusion to provide nutritional support., Measurements and Main Results: PN was provided for a median of 2.2 days (range 0.5-9.5 days) in the 70 dogs, totaling 168 days of PN. The PN provided a median of 5.5 g/100 kcal of protein (range 1-9.5 g/100 kcal) and a median of 2.2 mg/kg of bodyweight per minute (range 0.8-5.2 mg/kg/min) of glucose, which reflected a median of 57% of the resting energy requirement (range 9-100%). Metabolic complications developed in 43 of 67 dogs where these data were recorded, but the development of hyperkalemia was the only complication associated with a poor outcome (eg, death or euthanasia). Mechanical complications were seen in 28 dogs, and all but one of these occurred when PN was delivered through peripheral catheters. Septic complications were confirmed in 5 dogs., Conclusions: This form of PN is suitable for clinical use and can provide both protein and calories to ill dogs. It was, however, associated with a high rate of complications and requires careful patient monitoring., (© Veterinary Emergency and Critical Care Society 2013.)

Epidemiological studies into the risk factors for naturally-occurring equine laminitis are limited. There are a small number of such studies, although the results are inconsistent and remain disputed. The reasons for the conflicting results remain unclear. The aim of this review was to critically evaluate previous research in order to identify publications which provide the best evidence of risk factors for naturally-occurring equine laminitis. A systematic review of English language publications was conducted using MEDLINE (1950-2010), CAB Direct (1910-2010) and IVIS (1997-2010). Additional publications were included by searching bibliographies. Search terms included laminitis, equine, risk factors and epidemiology. Publications which compared a case population to a control population and made inferences about parameters as risk factors for naturally-occurring equine laminitis were included. Information was extracted using predefined data fields, including 18 study quality indicators. In total, 17 publications were fully appraised. Six were considered to provide the most reliable information about risk factors for naturally-occurring laminitis. Information on signalment was well researched and there was good evidence for an association with chronic laminitis and increasing age. There remain inconsistent results for many other horse-level risk factors including gender, breed and bodyweight. Previous publications estimating risk factors for equine laminitis were of reasonable quality, although they were limited in the number and scope of the risk factors studied. High-quality, evidence-based studies are needed to identify further risk factors and to establish consensus over previously identified risk factors for different equine populations., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Reasons for Performing Study: Equine grass sickness (EGS) remains a frequently fatal disease of equids in Great Britain (GB). The first nationwide surveillance scheme for EGS was developed to obtain information on the occurrence of EGS and to help facilitate future proposed intervention studies, such as vaccine trials., Objectives: To collect both retrospective and prospective data on cases of EGS occurring in GB since 2000 and to assess potential risk factors for categories of EGS and survival after chronic EGS., Methods: Prospective data were collected using a nationwide surveillance scheme for EGS that was developed and initiated in 2007. Data were collected by means of postal and online questionnaires documenting both retrospective premises-level and prospective case-level information. Data on outcomes of EGS category and survival after chronic grass sickness (CGS) were analysed using univariable logistic regression., Results: Descriptive data for 1410 EGS cases occurring in GB in the decade between the beginning of 2000 and the end of 2009 are presented. Univariable logistic regression analyses identified that CGS cases in Scotland were significantly more likely to survive than those occurring elsewhere in GB. There was no relationship between case details and the category of EGS or the outcome among CGS cases., Conclusions: EGS affected equids throughout England, Scotland and Wales. Although an overall average of 141 cases were reported to the nationwide surveillance scheme annually, this number of cases was not consistent between years. Around 50% of CGS cases survived, although regional differences in survival rates existed, probably due to variation in expertise of care and/or disease severity., Potential Relevance: This study provides information on the spatiotemporal occurrence of EGS in GB during the last decade. Data from the nationwide surveillance scheme can be used in developing protocols for future intervention studies such as Clostridium botulinum vaccine trials., (© 2011 EVJ Ltd.)

Equine laminitis is a highly debilitating disease of the foot. Despite its perceived importance, epidemiological characteristics are poorly understood and the true frequency of the disease remains unclear. The objective of this study was to retrospectively assess previous research to identify publications which provide the best evidence of the frequency of naturally-occurring equine laminitis. A systematic review of English language publications was conducted using MEDLINE (1950-2010), CAB Direct (1910-2010) and IVIS (1997-2010). Additional publications were included by searching bibliographies. Search terms included laminitis, equine, frequency, prevalence and incidence. Studies that allowed frequency estimations to be made for naturally-occurring equine laminitis were included. Information was extracted using predefined data fields, including 13 study quality indicators. Sixty-nine publications were appraised. Ten were considered to provide the most reliable information, estimating the frequency of equine laminitis ranging from 1.5% to 34%. Previous publications estimating laminitis frequency were generally poor quality. Laminitis frequency varied across publications however the publications included in this review focussed on many of the different underlying laminitis aetiologies and comparison of the frequencies between groups would be inappropriate. High-quality evidence-based studies are needed to estimate the true disease frequency in different equine populations., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Detailed knowledge of horse populations can better facilitate effective control of equine diseases. Preliminary studies were undertaken to ascertain the type of information held on the UK's National Equine Database (NED) and to determine the geographical resolution at which mandatorily recorded owner addresses might be a suitable proxy for predicting horse locations. Results indicated that relatively few UK passport-issuing organisations requested details of where horses were kept in addition to owner address details. Examination of data on 1440 horses held on an Animal Health Trust syndromic surveillance database showed that 90% of them were kept within 10 km of their owners. While owner location may provide an indication of where most horses are kept, further work is also needed to evaluate the usefulness of NED as an epidemiological resource in future equine disease control measures., (© 2010 EVJ Ltd.)

Laminitis poses a threat to all horses, and is widely considered as being one of the most important diseases of horses and a global equine welfare problem. The effects of laminitis lead to debilitation, development of pronounced digital pain, and great suffering in the afflicted animal. The precise pathophysiological processes that result in laminitic pain are poorly defined, and hence the delivery of effective palliative care is clinically challenging. Knowledge and understanding of pain states in other animal species may further aid the elucidation of equine laminitic pain mechanisms, guide the search for treatable causes of this multifactorial problem, and thereby help achieve enhanced therapeutic and palliative care. However, parallels drawn from pain states in other animals must consider species differences in both anatomy and physiology, and the specific nature of the laminitic disease process., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Equine grass sickness (EGS) is recognized as a debilitating and predominantly fatal neurodegenerative disease affecting grazing equids. The gastrointestinal tract is the most severely affected body system, resulting in the main clinical signs of colic (acute grass sickness), weight loss, or dysphagia (chronic grass sickness). EGS predominantly occurs within Great Britain, although it is also recognized in regions of mainland Europe, and mainly affects young horses with access to pasture in the springtime. There is strong evidence of an association between EGS and the type C toxins produced by the bacterium Clostridium botulinum. This article covers the clinical aspects, epidemiology, and global distribution of EGS, along with comparisons with botulism and developments in disease prevention.