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1.
Reasons for performing study: Medications are frequently employed to treat intra‐articular (IA) problems in the performance horse. Actual usage of the different IA medications in horses is not available. Objectives: To determine the most common usage of these medications, members of the American Association of Equine Practitioners (AAEP) were surveyed. Methods: An email link to an online survey was electronically sent to 6305 AAEP members and the responses tabulated and analysed with a logistic regression model. Results: A total of 831 survey responses were submitted and tabulated. Eighty per cent of the respondents indicated that they see 100% equine cases in their practice. The majority of respondents (77%) use triamcinolone acetonide (TA) to treat high motion joints and 73% use methylprednisolone acetate (MPA) to treat low motion joints. Veterinarians treating the Western performance and Sport horse were significantly more likely to use TA in high motion joints compared to MPA (P = 0.0201 and P<0.0001, respectively). Triamcinolone acetonide use compared to MPA in high motion joints by racehorse veterinarians was significantly lower compared to other veterinarians (P<0.0001). Polysulphated glycosaminoglycan (Adequan) and hyaluronate sodium (Legend) were the most commonly used disease modifying products (63 and 57% of respondents, respectively). Sport horse practitioners were significantly more likely than race or show horse veterinarians to utilise IRAP products (P = 0.0035 and P = 0.04, respectively). Respondents who had been in practice for more than 10 years were significantly less likely to use antimicrobials in their joint injections compared to those in practice for less than 10 years (P<0.0001). Conclusions: Significant differences existed in usage of medications related to primary discipline treated and years practicing. Potential relevance: The results of this study aid in defining the current usage of different joint therapy medications within equine practice. This knowledge can guide further research as well as education.  相似文献   

2.
In the first edition of this journal, Barbara Weaver wrote a review titled ‘Equine Anaesthesia’, stating that, at that time, it was quickly becoming accepted practice that many horses were being anaesthetised ‘by essentially similar procedures, i.e. premedication, induction and then maintenance by controlled inhalation’. To celebrate the 50th anniversary of the first edition of this journal, this review covers the development of understanding and practice of inhalational anaesthesia and controlled ventilation in horses over the last 50 years. We review how the perceived benefits of halothane led to its widespread use, but subsequently better understanding of halothane's effects led to changes in equine anaesthetic practice and the utilisation of different inhalation agents (e.g. isoflurane and sevoflurane). We discuss how more recently, better understanding of the effects of the ‘newer’ inhalation agents’ effects has led to yet more changes in equine anaesthetic practice, and while, further new inhalation agents are unlikely to appear in the near future, further enhancements to anaesthetic practice may still lead to improved outcomes. We review advances in our understanding of the anatomy and pathophysiology of the equine lung as well of the effects of anaesthesia on lung function and how these predispose to some of the common problems of gas exchange and ventilation during anaesthesia. We identify the aims of optimal mechanical ventilation for anaesthetic management and whether the various methods of ventilatory support during equine anaesthesia achieve them. We also highlight that further developments in equipment and optimal ventilator modes are likely in the near future.  相似文献   

3.
ABSTRACT

Equine dentistry is a rapidly developing clinical specialty. It has benefitted from key advances in anatomical and physiological research, development of equipment and instrumentation, utilisation of standing sedation and anaesthesia protocols, a change towards minimally invasive surgical techniques, and the introduction of restorative and endodontic techniques translated from techniques used in human and canine dentistry. Anatomical research has provided further insight into the endodontic system of incisors and cheek teeth and how it changes throughout development with age. Studies of the periodontium have demonstrated a rich vascular supply and repair capacity. Routine dental visits are increasingly being performed utilising sedation and clinical instruments for routine examinations. Equipment has become more efficient, battery-operated and miniaturised giving benefits to both equine dental maintenance work and advanced techniques, assisting the transition to minimally invasive techniques, and the development of endodontic and restorative dentistry. Diagnosis has also benefitted from advances in equipment such as patient-side digital radiography systems, high definition oroscopy, and small diameter flexible fibrescopes that are capable of visualising inside a pulp canal. Dental units combining endodontic high- and low-speed drills, suction and air or water flush are becoming increasingly used and adapted for equine use. Sedative combinations and standing anaesthesia protocols have meant that revisions of traditional techniques, as well as novel techniques, can be performed with almost no requirement for general anaesthesia. Equine dentistry can only continue to advance in this way if there is early identification of dental disease through clinical oral examinations, leading to a system based on prophylaxis, as in human dentistry. This necessitates a change in attitude of the public and industry in general to a proactive approach, with early intervention based on examination and diagnostic findings of practitioners and not necessarily based on the clinical signs displayed by the patient.  相似文献   

4.
OBJECTIVE: To determine the fatality rate of horses undergoing general anaesthesia at a private equine referral practice using a limited number of anaesthetic protocols. METHODS: A retrospective analysis of records (n = 17 961) from all horses undergoing general anaesthesia for surgical procedures from 1997 to 2001 at Rood and Riddle Equine Hospital, Lexington, Kentucky, USA. Results were reported as percentage of the population, and as crude mortality rates for each procedure (deaths per 1000). RESULTS: The prevalence of equine fatalities directly related to anaesthesia was 0.12% (n = 21) and this rose to 0.24% (n = 42) with the inclusion of horses killed or dying within 7 days post general anaesthesia. Causes of death directly related to anaesthesia were cardiac arrest (n = 10), fracture in recovery stall (n = 8), neuropathy and myopathy necessitating euthanasia (n = 3). Crude mortality rates per procedure were < or =7 deaths per 1000 cases, except arthrodesis/osteotomy cases were 66.7 deaths per 1000 cases. CONCLUSIONS: The anaesthetic fatality rate at this practice is lower than has been reported previously. CLINICAL RELEVANCE: Familiarity with an anaesthetic protocol in combination with reduced anaesthetic time, emergencies of shorter duration between diagnosis and surgery, and adequate preoperative examination appear to minimize the risks associated with general anaesthesia in horses.  相似文献   

5.
Objective The aim of this study was to define and evaluate a combined inhalation?intravenous anaesthetic protocol for use in equine anaesthesia. Study design Prospective, randomized clinical trial. Animals Twenty‐eight horses (body mass 522 ± 82; 330–700 kg [mean ± SD; range]) with a mean age of 6 ± 4 years (range: 2–18 years) presented to the university hospital for various surgical procedures requiring general anaesthesia. Materials and methods Animals were randomly allocated to one of two treatment groups. Anaesthesia was maintained in 14 horses with halothane alone (H group). The mean end‐tidal halothane concentration was 1.24%. In the second group (n = 14) anaesthesia was maintained with both halothane (end‐tidal concentration 0.61%) and a continuous infusion of a ketamine–guaiphenesin mixture (HKG group). The two techniques were compared in terms of qualitative differences and cardiopulmonary effects. Results The stability of anaesthesia was significantly greater in group HKG and the need for dobutamine to maintain blood pressure was significantly less. Recovery times and quality were acceptable in all cases. There were no significant differences between the groups. Conclusions The infusion of ketamine and guaiphenesin in horses receiving low inspired concentrations of halothane provides suitable surgical anaesthesia and lowers the risk of hypotension. Clinical relevance The anaesthetic technique described in this study is a useful and practical alternative to inhalation anaesthesia using halothane alone.  相似文献   

6.
Reason for performing study: Current use of acepromazine in the anaesthetic management of male horses and ponies and associated risks are largely unknown. Objectives: To explore anaesthetic acepromazine use and related adverse effects in the male horse. Methods: Of 8533 anaesthetised horses and ponies medical records of male animals treated perianaesthetically with acepromazine were reviewed. Demographic data, time and dose of acepromazine administration, co‐administered drugs, quality of induction and recovery from anaesthesia, arterial blood pressures, and occurrence of penile dysfunction were recorded. Practising ACVA and ECVAA diplomates were polled on the use of acepromazine and its effects on blood pressure and penile dysfunction in the equine. Results: Of all animals, 12% females and 11% males (n = 575 including 42% stallions) received perianaesthetic acepromazine, predominantly for premedication. Anaesthetic induction was smooth in 566 animals. Lowest mean arterial pressures averaged 65 ± 9 mmHg. Recovery was good or very good in 70% of all animals and 74% stood after 1–2 attempts. In 14 horses (2.4%; 7 stallions, 7 geldings), penile prolapse occurred for 0.5–4 h and in one stallion (0.2%) for >12 but <18 h post recovery. Most surveyed anaesthesiologists use acepromazine in stallions (occasionally 63%; frequently 17%) but more frequently in geldings (occasionally 34%; frequently 59%) and mares (occasionally 38%; frequently 59%), primarily for premedication with other sedatives and analgesics. Persistent intraoperative hypotension was not frequently reported. Only 5% of surveyed anaesthesiologists recall penile prolapse post acepromazine administration lasting for >12 h and only one recalls 3 cases of irreversible penile prolapse in 20 years of anaesthesia practice. Conclusions and potential relevance: The extremely low risk of permanent penile dysfunction (≤1 in 10,000 cases) does not justify more restricted use of acepromazine in the intact male vs. geldings and mares.  相似文献   

7.
Melanoma is a common neoplasm in horses, with a high rate of incidence in the perineum and ventral tail. Surgical excision is often recommended to remove such masses and can be achieved in the standing horse either via local infiltration of local anaesthetic, or via epidural administration of a local anaesthetic and/or an adrenergic α2 receptor agonist. The clinical records of all horses with tail and/or perineal melanomas that received epidural anaesthesia at a single equine hospital, over a 7-year period, were reviewed to determine the drugs administered and complications associated with the epidural injection. Twenty-five cases were identified, five of which received epidural anaesthesia on two occasions. Epidural anaesthesia was insufficient to allow surgical melanoma excision in two horses; repeated epidural injection allowed sufficient loss of sensation in one of these horses and additional regional infiltration of local anaesthetic allowed completion of surgery in the other. Three horses developed significant ataxia associated with epidural anaesthesia, two of which became recumbent. Both recumbent horses were placed under general anaesthesia, and in one of these, rope-assisted anaesthetic recovery resulted in additional complications associated with facial nerve paresis, fractured ribs and a fracture of the first coccygeal vertebra, with associated neurological dysfunction of the rectum, anus, tail and surrounding skin.  相似文献   

8.
This report documents the feasibility and clinical information provided by a new method for spirometric monitoring adapted for equine anaesthesia. Monitoring of ventilatory function was done with continuous spirometry during general anaesthesia of client‐owned horses presented for various diagnostic and surgical procedures. An anaesthetic monitor with a spirometry unit for human anaesthesia was used. To allow the measurement of large tidal volumes, a remodelled larger version of the pitot tube‐ based flow sensor was used. This technology provided reliable spirometric data even during prolonged anaesthesia when water condensation accumulated in the anaesthetic circuit and the sensor. In addition to flow and volume measurement and respiratory gas analysis, the continuous display of flow‐volume and pressure‐volume loops offered visually recognisable information about compliance, airway resistance and integrity of the circuit. Continuous spirometry with this monitoring system was helpful in evaluating the efficacy of spontaneous ventilation, in adjusting intermittent positive pressure ventilation and detecting technical faults in the anaesthetic apparatus and connection with the patient. This adapted spirometry method represents a practical and reliable measuring system for use during equine anaesthesia. The variety of information provides an opportunity to optimise anaesthetic management in this species.  相似文献   

9.
The use of antimicrobials in veterinary medicine is under great scrutiny with the emergence of antimicrobial resistance in the human population. Equine veterinarians rely on antimicrobials as an essential tool for the treatment of infections in horses, but there is much criticism of some use, particularly prophylaxis. While the appropriate use of antimicrobials can be justified in equine medicine, the misuse cannot. The definition of appropriate use is complex and involves the indication for therapy, antimicrobial selection, dosing regimen and timing and route of administration, duration of therapy and modification of therapy based on microbial susceptibility and clinical response. The aim of this article is to provide guidance on these factors to assist equine veterinarians in determining what constitutes appropriate antimicrobial use in horses.  相似文献   

10.
Equine nutrition plays a critical role in equine health. The veterinarian is an expected major source of equine nutrition information, yet little evidence exists to evaluate this assumed role, particularly from the veterinarian’s perspective. The aim of this study was to investigate the knowledge and confidence levels and practices and perceptions regarding equine nutrition by surveying equine clinicians in Georgia, USA. A sample representative of a cross-section of equine veterinarians participated in the survey: response rate was 20%. Veterinarians reported that although their level of equine nutrition knowledge had improved since graduation, their confidence levels varied when giving nutritional advice on a number of prevalent nutritional-related conditions. Their confidence level in giving nutritional advice on colic was the highest and on hyperkalemic periodic paralysis the lowest. The majority of veterinarians had not taken any recent equine nutrition continuing education, mainly owing to lack of courses available; however, the majority expressed an interest in taking future courses, particularly if offered online. Although the veterinary profession was considered to be an important source of equine nutrition information, almost one-quarter of veterinarians offered no equine nutrition counseling to their clients. More than two-thirds of veterinarians reported having no access to a referral equine nutrition service, but would be likely to use one if it were available. The results of this survey reveal equine nutrition perceptions and practices from an equine clinician perspective. Several areas of concern are highlighted, questioning the quality, responsibility, and provision of equine nutrition in Georgia, USA, and are suggestive of a far more wide-reaching problem, requiring further research.  相似文献   

11.
REASONS FOR PERFORMING STUDY: Approximately 1 in 100 horses suffer unexpectedly from anaesthetic-related death. Identification and use of the safest anaesthetic drugs should support this aim. Experimental evidence has suggested that isoflurane should be a safer maintenance agent in equine anaesthesia than halothane. HYPOTHESIS: The death rate would be reduced in horses being maintained with isoflurane compared to halothane. METHODS: A multicentre randomised controlled trial was undertaken to compare the effects of isoflurane and halothane for maintenance of equine anaesthesia for all types of operation. Data were analysed from 8242 horses in which anaesthesia was maintained with either halothane or isoflurane using mixed effects logistic regression models. RESULTS: No overall benefit of either drug was detected. However, although not part of the primary hypothesis, data showed that the overall death rate was significantly reduced in horses age 2-5 years with isoflurane and that death from cardiac arrest was also reduced with isoflurane, particularly in high risk cases. CONCLUSIONS AND POTENTIAL RELEVANCE: Halothane remains an acceptable anaesthetic for maintenance of anaesthesia in horses, but isoflurane may be safer in the young horse and in high risk cases.  相似文献   

12.
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13.
OBJECTIVE: To ascertain anaesthetic practices currently for dogs and cats in Australia. METHODS: A questionnaire was distributed to 4,800 veterinarians throughout Australia, seeking data on numbers of dogs and cats anaesthetised per week; drug preferences for anaesthetic premedication, induction and maintenance; use of tracheal intubation, supplemental nitrous oxide and anaesthetic antagonists; and types of vaporisers, breathing systems and anaesthetic monitoring devices used or available. Additional questions concerned proportions of different animal types seen in the practice, and the respondent's university and year of graduation. RESULTS: The response rate was 19%; 95% of respondents graduated from Australian universities, about half since 1985. Most responses (79%) came from mainly small animal practices. On average 16 dogs and 12 cats were anaesthetised each week. Premedication was used more often in dogs than cats, with acepromazine and atropine most favoured in both species. For anaesthetic induction, thiopentone was most preferred in dogs and alphaxalone/alphadolone in cats. Inhaled agents, especially halothane, were preferred for maintenance in both species. Most respondents usually employed tracheal intubation when using inhalational anaesthetic maintenance, but intubation rates were lower during injectable anaesthetic maintenance and a minority of respondents provided supplemental O2. Nitrous oxide was administered regularly by 13% of respondents. The agents most frequently used to speed recovery from anaesthesia were doxapram and yohimbine. The most widely used vaporisers were the Fluotec Mark III and the Stephens machine. Most (95%) respondents used a rebreathing circuit for large dogs and a non-rebreathing system was used for small dogs by 68% of respondents. Most respondents (93%) indicated some form of aid was available to monitor general anaesthesia: the three most mentioned were an apnoea alarm, oesophageal stethoscope and electrocardiogram. CONCLUSION: Diverse approaches were evident, but there appeared to be less variation in anaesthetising dogs: premedication was more frequent and less varied in type, while thiobarbituates dominated for induction and inhalants for maintenance. Injectable maintenance techniques had substantial use in cats, but little in dogs. Evident disparity between vaporisers available and circuits used suggested either confusion in terminology or incorrect use of some vaporisers in-circuit. While most respondents used monitoring equipment or a dedicated observer to invigilate anaesthesia, the common reliance on apnoea alarms is of concern, because of unproven reliability and accuracy.  相似文献   

14.
Objectives To document the equine perioperative mortality rate and to highlight any factor associated with an increased risk of death up to 7 days after anaesthesia. Study design A prospective observational epidemiological multicentre study. Methods Data were recorded from all equidae undergoing general anaesthesia in 62 clinics. Power calculations indicated that 45 000 cases were required to detect the significance of important variables. Details of each horse, operation, anaesthetic agents and clinic personnel were recorded. Outcome at 7 days was recorded as: alive, put to sleep (PTS) or dead. Data were analysed by a standard multilevel logistic regression approach, considering the effects of clustering at the level of clinic. Results Data were collected from 41 824 cases over 6 years. A total of 39 025 (93.3%) were alive on day 7 and 785 were dead giving an overall death rate of 1.9% (95% CI: 1.8–2.0) and 2014 (4.8%) were PTS. About 5846 horses undergoing emergency abdominal surgeries (‘colics’) were excluded from subsequent analyses. A total of 35 107 ‘noncolic’ horses were alive at 7 days and 328 dead giving a death rate for noncolics of 0.9% (95% CI: 0.8–1.0). Five hundred and forty‐three (1.5%) noncolic horses classified PTS were excluded from further analyses. There were 109 (33%) deaths from cardiac arrest or post‐operative cardiovascular collapse, with 107 (32%) from fractures and myopathies. Fracture repair, out of hours surgery, and age below 1 month was associated with increased risk of dying whereas the use of acepromazine and intravenous anaesthetic agent maintenance of anaesthesia was associated with reduced risk. Conclusions A number of potential contributors to the high risk of anaesthetic‐related mortality have been identified. Further investigation of the underlying mechanism for their apparent harmful effects and development of alternative techniques is merited.  相似文献   

15.
This is the first of a series of capsule reviews published by the World Small Animal Veterinary Association ‐ Global Pain Council (WSAVA‐GPC). Each of these short articles provides a brisk assessment of the scientific evidence in specific aspects of pain management, including analgesic techniques, recommendations and controversies surrounding their use. In this first capsule review, the scientific evidence available on the long‐term use of non‐steroidal anti‐inflammatory drugs in cats with concomitant chronic pain and chronic kidney disease is discussed.  相似文献   

16.
Reasons for performing study: Previous studies have suggested that agreement between equine veterinarians subjectively evaluating lameness in horses is low. These studies were limited to small numbers of horses, evaluating movement on the treadmill or to evaluating previously‐recorded videotape. Objectives: To estimate agreement between equine practitioners performing lameness evaluations in horses in the live, over ground setting. Methods: 131 mature horses were evaluated for lameness by 2–5 clinicians (mean 3.2) with a weighted‐average of 18.7 years of experience. Clinicians graded each limb using the AAEP lameness scale by first watching the horse trot in a straight line only and then after full lameness evaluation. Agreement was estimated by calculation of Fleiss' (κ). Evaluators agreed if they picked the same limb as lame or not lame regardless of the severity of perceived lameness. Results: After only evaluating the horse trot in a straight line clinicians agreed whether a limb was lame or not 76.6% of the time (κ= 0.44). After full lameness evaluation clinicians agreed whether a limb was lame or not 72.9% of the time (κ= 0.45). Agreement on forelimb lameness was slightly higher than on hindlimb lameness. When the mean AAEP lameness score was >1.5 clinicians agreed whether or not a limb was lame 93.1% of the time (κ= 0.86), but when the mean score was ≤1.5 they agreed 61.9% (κ= 0.23) of the time. When given the task of picking whether or not the horse was lame and picking the worst limb after full lameness evaluation, clinicians agreed 51.6% (κ= 0.37) of the time. Conclusions: For horses with mild lameness subjective evaluation of lameness is not very reliable. Potential relevance: A search for and the development of more objective and reliable methods of lameness evaluation is justified and should be encouraged and supported.  相似文献   

17.
Summary

An equine model of acute non‐immune inflammation has been developed to facilitate studies of the inflammatory process and the actions of novel anti‐inflammatory drugs. Five polyester sponge strips soaked in sterile 2% carrageenin solution were placed in subcutaneous pouches prepared under local anaesthesia in the necks of conscious ponies. Serial removal of the strips and harvesting of the exudate enabled studies to be made of the cellular, biochemical and mediator aspects of the localised, acute inflammation, and the heat generated by the lesion was monitored by infra‐red thermometry. Maximal concentrations of the eicosanoids 6‐keto‐prostaglandin F1α, thromboxane B2 and leukotriene B, occurred at 9 h, whereas leukocyte numbers, lactate dehydrogenase (LDH) and total protein concentrations were greatest at 24 h. Lesional skin temperature was increased by approximately 4°C throughout the 24 h period. The novel anti‐inflammatory agent BW540C, administered orally at a dose‐rate of 20 mg/kg, did not affect leukocyte infiltration or the concentrations of protein, LDH and eicosanoids in exudate but serum thromboxane B2 levels were reduced. Skin temperature rises were greater in drug‐treated animals.

It is concluded that higher doses of BW540C will be required for a clinically useful anti‐inflammatory action in horses.  相似文献   

18.
This Case Report describes a 5‐year‐old Standardbred gelding that was referred to the Equine Hospital of ONIRIS Veterinary School of Nantes, France for a surgical procedure under general anaesthesia. Anaesthesia was induced and maintained intravenously and the horse was placed in left lateral recumbency with a padded halter. On post operative Day 1, a post anaesthetic distal facial nerve branch paresis was diagnosed based on clinical signs. The horse was discharged on post operative Day 2 with medical treatment based on anti‐inflammatory drug administration locally and systemically. The horse was re‐examined 2 weeks after the surgery; the left partial facial paralysis was still present and associated with amyotrophy of the muscles supplied by the buccal branches of the facial nerve. In accordance with the owner, the horse was hospitalised to start an electrostimulation treatment. The horse was treated every day for the first 4 days, then every 2 or 3 days during the following 3 weeks, for a total of 11 sessions. At the end of the second week of treatment, the horse was able to normally prehend the food and atrophy seemed reduced. The horse was discharged from hospitalisation at the end of the third week of treatment with specific recommendations. One month after discharge from the hospital just a slight asymmetry could be noticed at rest. Six months later, the training season began and the horse was able to perform. Facial paralysis due to nerve compression is a well‐known complication of anaesthesia. Gradual recovery of function over the weeks of treatment suggests that electroacupuncture may promote recovery and may hasten time of recovery.  相似文献   

19.
The equine practitioner is in a position to make day‐to‐day decisions regarding antimicrobial drug (AMD) use for their patients as well as to educate their clients regarding judicious use. General guidelines regarding judicious use of AMDs in equine patients have been developed by the American Association of Equine Practitioners. Detailed guidelines for AMD use in specific equine diseases supported by clinical trials and results of surveillance studies focused on resistance among equine bacterial pathogens are lacking. Studies that could lead to detailed and justifiable use recommendations would allow the equine practitioner to make more informed decisions regarding when to use AMDs, which drugs should be used and how they should be used (e.g. dose, route and duration).  相似文献   

20.
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