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Objective: In the context of a study of Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH), elderly Icelandic horses were examined in their originating country. The subject of this survey was the impact of dental treatment and keeping and feeding management on the health of the rostral oral cavity., Animals: A total of 170 horses (aged ≥ 15) located in different areas of Northwest, West, and South Iceland., Methods: The horse owners completed a questionnaire about keeping, feeding, and preventative dental care. The horses were clinically examined with particular attention to gingival and dental disorders of the rostral mouth, such as gingivitis, fistula, gingiva retraction, enlargement of the roots and dental calculus as well as integrity of incisors, bite angle, and tooth mobility., Results: Most of the horses were kept on pasture all year with little supplementary feeding. The frequency of dental treatment in Iceland was low. Only a few horses were affected by tooth loss, gingivitis, gingival recession, and incisor calculus. Calculus occurred more frequently and more severely in canines than in incisors. The findings did not depend on the location of the horse., Clinical Relevance: Assuming that the remarkable health of the rostral oral cavity in elderly Icelandic horses was not caused by preventive dental care, it is likely that it was due to living conditions in Iceland. Continuity, intensity of chewing, and nativeness of forage might promote the health of incisors and tissue surrounding the tooth even in elderly horses.

Objective: To compare anamnestic factors in Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH) in affected and nonaffected horses to detect risk factors for horses developing EOTRH., Animals: A total of 154 Icelandic horses, aged 15 years and older, examined at 22 locations in Lower Saxony, Germany. The investigations took place from October 2020 to December 2021., Methods: Anamnestic data were collected using an owner-completed questionnaire. Horses underwent a thorough physical examination and CBC. The rostral oral cavity was clinically examined, and intraoral radiographs of the incisors were taken. Clinical and radiographic findings were scored. Based on the results, the study population was separated into "EOTRH-affected" and "EOTRH-healthy" horses. Both groups were compared to identify differences within the anamnestic factors. In case of inconclusive findings, some horses were classified as "suspicious"., Results: The diagnosis of EOTRH was made in 72.2% (109/151) of horses. The risk of contracting the disease increased with the age of the horse (P = .004). In addition, there was a predisposition for male animals (P = .032). Feeding, keeping, and dental treatments showed no significant influence, while place of birth seemed to influence horses developing EOTRH (P = .017)., Clinical Relevance: The results highlight how widespread EOTRH is among the German Icelandic horse population and the need for raising awareness of EOTRH, as many horses were not suspected of having EOTRH beforehand. Moreover, numerous etiological propositions exist, but, to date, no studies have investigated their relevance.

Background: In clinical practice, early diagnosis of Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH) and other resorptive incisor diseases is difficult to achieve. The radiographic appearance of subtle pathological changes has not been described in detail and might be confused with age-related changes., Objectives: The study was performed to define typical radiographic signs of early incisor lesions and to evaluate the reliability of the radiographic findings., Study Design: Descriptive and comparative study using post mortem clinical, radiographic, macroscopic and µCT examination., Methods: The incisor region of 20 cadaveric horse heads, divided into three different age groups, was examined visually and by palpation. Intraoral radiographs were taken. After extraction, each incisor was macroscopically evaluated. Micro-computed tomography (µCT) scans were obtained. These scans were processed with Scry (v6.0, Kuchel & Sautter GbR) to obtain surface meshes which then were transferred to Meshlab (ISTI-CNR, version 2016.12). Attached tissues were virtually removed and surface curvature was computed to visualise and evaluate the quantity of unevenness (roughness) of the teeth's surface. Scoring systems for each diagnostic modality were developed. Scores were compared to describe and evaluate the radiographic appearance of early incisor lesions., Results: The prevalence and severity of incisor lesions increased with age. Early, subtle lesions develop on the palatal/lingual side of incisors. While radiographically detected lesions were confirmed macroscopically and on the µCT scans, numerous teeth which were radiographically classified as healthy displayed lesions by macroscopic inspection (13.7%) and µCT analysis (58.1%)., Main Limitations: Cadavers were studied and dental history was unknown., Conclusions: The detection of early and subtle incisor lesions indicating first signs of EOTRH on dorsoventral intraoral radiographs is limited due to the typical localisation of the lesions on the palatal/lingual side of the incisors., (© 2022 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.)

The objective of this study was to compare effects of butorphanol (BUT) or buprenorphine (BUP), in combination with detomidine and diazepam, on the sedation quality, surgical conditions, and postoperative pain control after cheek tooth extraction in horses, randomly allocated to 2 treatment groups (BUT: n = 20; BUP: n = 20). A bolus of detomidine (15 μg/kg, IV) was followed by either BUP (7.5 μg/kg, IV) or BUT (0.05 mg/kg, IV). After 20 min, diazepam (0.01 mg/kg, IV) was administered and sedation was maintained with a detomidine IV infusion (20 μg/kg/h), with rate adjusted based on scores to 5 variables. All horses received a nerve block (maxillary or mandibular), and gingival infiltration with mepivacaine. Sedation quality was assessed by the surgeon from 1 (excellent) to 10 (surgery not feasible). A pain scoring system (EQUUS-FAP) was used to assess postoperative pain. Serum cortisol concentrations and locomotor activity (pedometers) were measured. Horses in BUP and BUT required a median detomidine infusion rate of 30.2 μg/kg/h (20 to 74.4 μg/kg/h) and 32.2 μg/kg/h (20 to 48.1 μg/kg/h), respectively ( P = 0.22). Horses in the BUP group had better sedation quality ( P < 0.05) during surgery and higher step counts ( P < 0.001) postoperatively. Buprenorphine combined with detomidine provided a more reliable sedation than butorphanol. However, the EQUUS-FAP pain scale became unreliable because of BUP-induced excitement behavior., (Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.)

The objective of this study was to determine whether the assessment of cytological features of secretions from the paranasal sinuses represents a useful diagnostic tool in equine sinusitis to distinguish between different etiologies. Secretion samples from 50 horses with sinusitis and 10 healthy horses were taken transendoscopically from the drainage angle of the nasomaxillary aperture using a Swing Tip catheter. An additional direct sample from the caudal maxillary sinus was taken from all healthy horses after trephination. A direct sample was obtained from the affected sinus in 19 diseased horses after osteotomy. Samples were smeared on microscope slides and dyed using "Pappenheim stain" for cytological evaluation. Smears from horses with sinusitis (primary n = 14, dental n = 28, cyst n = 2, progressive ethmoidal hematoma [PEH] n = 2, traumatic n = 2, malignant neoplasia n = 2) were dominated by moderate to high numbers of neutrophilic granulocytes and moderate numbers of different epithelial cells, whereas samples from healthy sinuses revealed almost exclusively epithelial cells. Smears in dental-related sinusitis tended to contain more lytic cellular material than in other conditions. Horses with dental sinusitis also showed a higher intracellular and extracellular bacterial burden than horses with other underlying etiologies and healthy horses. The absence of bacteria in light microscopy did not exclude the evidence of pathogenic bacteria from bacterial culture in every case. Case numbers were too small to evaluate the diagnostic value for neoplastic conditions or PEH. In conclusion, cytological examination of secretions from the paranasal sinuses can provide an additional but limited ancillary diagnostic value in equine sinusitis., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Paranasal sinus cysts (PSC) are a common cause of equine secondary sinusitis. The outcome and associated complications have not been frequently reported., Objectives: To review the associated clinical signs, associated morbidities and outcomes of horses treated for PSC., Study Design: Retrospective multicentre case series., Methods: Retrospective analysis of case records and telephone follow up survey., Results: Subjects were 37 horses 1-24 years old that were presented with nasal discharge (n = 31), facial swelling (n = 25) and epiphora (n = 19). Radiography and computed tomography allowed identification of the cyst-induced changes including concomitant tissue destruction (n = 31), leading among other things to local nerve damage causing headshaking (n = 6) and unilateral blindness (n = 1). Radiographic changes to adjacent dental apices were present in 10 horses. Horses over 10 years old showed more of the named associated problems. Post-operative complications included surgical site infection (SSI) (n = 11), nasofrontal suture periostitis (n = 6) and sequestration (n = 1) following removal of the PSC via osteotomy. The long-term response to treatment was available for 28 cases with 22 horses (78.6%) fully cured, 4 (14.3%) partially cured and 2 (7.1%) not responding to treatment. In 7 horses (18.9%) there was recurrence of the cyst post-operatively., Main Limitations: Due to the study being a multicentre retrospective case series with collection of data over an extended period, there may be inconsistency in data recording and absence of reporting of some findings., Conclusions: Overall, the diagnosis and treatment of sinus cysts is relatively straightforward and carries a good prognosis. In long-standing cases complications secondary to the expansive growth of cysts will dramatically affect the prognosis for full recovery due to pressure-induced changes to facial bones, cheek teeth and nerves. These secondary complications mainly occurring in older horses may be due to a combination of a relatively longer period of affection and the inflexibility of older horses' bones. Cyst recurrence following treatment can occur in up to 19% of cases., (© 2018 EVJ Ltd.)

Overjet is defined as the projection of the maxillary incisors labial to their antagonists in a horizontal direction. This malocclusion in horses can lead to incorrect dental wear and is aesthetically undesirable. Whether lengthening of the maxilla or shortening of the mandible causes the condition has not yet been determined. Therefore, a measurement technique was developed to investigate the correlations between skull bone measurements in overjet-affected individuals. The position of the incisors in 650 Warmblood foals born in a private German stud was examined at two weeks of age, revealing the prevalence of overjet to be 2 per cent. Five measurements were made on each foal's head and comparisons with a second set of measurements that were made later in the foals first year showed a change in the presence or degree of overjet over time. Nine of 13 foals diagnosed with measurable overjet at the beginning of the study resolved spontaneously. Thirteen foals had no evidence of overjet at birth, of which four developed the condition during the first year of life. The methods used for measuring longitudinal changes in different skull bones and for the assessment of malocclusion in foals affected with overjet were considered effective., Competing Interests: Competing interests: None declared., (© British Veterinary Association 2018. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Diagnostics in equine sinusitis can be challenging and often require a combination of different imaging tools to ascertain its underlying aetiology. The bacterial flora of healthy and diseased paranasal sinuses, respectively, has only sporadically been assessed in horses. The objectives of this study were to determine whether assessment of microbiological features of secretions from the paranasal sinuses displays a useful diagnostic tool in equine sinusitis to distinguish between different aetiologies. Secretion samples from 50 horses with sinusitis and from 10 healthy horses were taken transendoscopically from the drainage angle of the nasomaxillary aperture using a guidable Swing Tip catheter. Bacteria found in healthy and diseased equine sinuses were compared. Endoscopic samples in all healthy and 19 diseased horses were compared with samples taken directly from the affected sinus after trephination., Results: Eleven of the 14 horses with primary sinusitis revealed growth of Streptococcus equi ssp. zooepidemicus, with three samples yielding pure cultures. Anaerobes were found in 15 out of 26 samples from horses with dental sinusitis. Healthy sinuses revealed mainly α-haemolytic streptococci and coagulase-negative staphylococci or showed no growth. Enterobacteriaceae were found more frequently in secondary sinusitis. There were significant differences in the bacterial composition and diversity (P < 0.05) between primary sinusitis, dental sinusitis and healthy controls. The correlation between endoscopic and trephination samples was satisfying., Conclusions: Microbiological examination of secretions from horses with sinusitis collected transendoscopically can help to distinguish between primary and dental sinusitis. Therefore, it may display a feasible ancillary diagnostic tool, but does not replace a meticulous examination procedure including diagnostic imaging.

Background: Transient bacteraemia can occur during tooth extraction in humans, and dogs and can lead to severe infectious sequelae. Several case reports describe distant site infections following equine tooth extraction, but the occurrence of bacteraemia during dental surgery has not been evaluated in the horse., Objectives: To determine if transient bacteraemia occurs during tooth extraction in horses, describe isolated organisms and compare these with those found in the diseased teeth., Study Design: Prospective, observational study., Methods: Blood was collected aseptically for blood culture before, during and after oral extraction of incisor, canine or cheek teeth from 20 adult horses undergoing dental extraction that had not received antimicrobial agents for at least 4 weeks prior to surgery. Bacteria found in blood cultures were compared with those found in swab samples obtained from the extracted teeth., Results: Eighteen of 20 horses had positive blood cultures at one or more time points. Streptococcus spp., Actinomyces spp., Fusobacterium spp. and Prevotella spp. were most commonly found. Bacterial genera isolated from swab samples of extracted teeth largely corresponded with those identified in blood cultures., Main Limitations: This study was limited by its use of only conventional bacterial culture, the lack of statistical analysis to explore associations between gingiva score and the occurrence of bacteraemia, and the lack of an age-matched control group of horses not undergoing exodontia., Conclusions: Transient bacteraemia of oral origin commonly occurs during dental extraction in horses. As none of the horses developed complications associated with bacteraemia during the observation period after surgery, the significance of this bacteraemia remains uncertain. The Summary is available in Chinese - see Supporting Information., (© 2016 EVJ Ltd.)

Objective: To report meningoencephalitis as a complication after paranasal sinus surgery in 5 horses., Study Design: Case series., Animals: Adult horses (n = 5)., Methods: Medical records (2005-2010) of 5 horses that developed neurologic signs after sinus surgery were reviewed to identify potential risk factors, cause(s), or common pathways for infection., Results: Underlying diseases were primary (n = 1) and secondary sinusitis (4) because of apical dental infection (1), sinus cyst (2), or masses in the ethmoturbinate region (2). Horses were treated by conventional surgical approaches and aftercare including repeated sinus lavage. Four horses had undulating pyrexia postoperatively despite antimicrobial therapy. All horses developed neurologic signs, eventually unresponsive to treatment. Suppurative meningoencephalitis was diagnosed macro- and/or microscopically on necropsy in all horses., Conclusion: Meningitis is a rare but fatal complication after sinus surgery in horses., (© Copyright 2014 by The American College of Veterinary Surgeons.)

The article summarizes the relevant clinical pathological assessment of horses with acute colic. A minimal laboratory evaluation should include the patient's haematocrit (or packed cell volume), total protein, and lactate concentration in the blood. Haematocrit and total protein provide an indication of the severity of dehydration (haematocrit < 0.45 l/l is evidence of no to mild dehydration whereas > 0.5 l/l points to a severe dehydration). The degree of dehydration is often associated with the severity of the colic. Additionally, the blood lactate concentration rises with increasing intestinal compromise with a concentration of > 4 mmol/l indicating a guarded prognosis. However, it is crucial to assess laboratory values only in the context of the clinical findings. If an abdominocentesis is performed, the leukocyte count and the protein and lactate concentrations offer valuable information regarding the type of colic, the severity of the lesion, further therapy, and prognosis of the colic. Reddish discolouration of peritoneal fluid may be a sign of a strangulating obstruction. Transcutaneous abdominal ultrasonography may provide a crucial insight into the colic cause and severity in a relatively short time, even for inexperienced examiners. In regards to small intestinal lesions, dilated small intestinal loops can often be imaged ultrasonographically before they can be palpated transrectally. The occurrence of free peritoneal fluid and dilated small intestine as well as the evaluation of the intestinal wall and the extent of the gastric wall, allow a better management of the acute colic patient. In ponies and foals, radiography as a further diagnostic imaging modality of the abdomen is of great value. It can help to visualise sand impactions, meconium impactions, or gastrointestinal atresia in the neonate.

The article provides hands-on advice and scientific background information regarding the management of the equine acute colic patient. It summarizes essential information on the patient's history, clinical examination, and legal aspects. The scope of the history is based on the clinical appearance of the patient. In horses with violent and barely controllable signs of pain, it is limited to colic-associated information such as onset, course and severity of colic signs, and the last time of defecation, as well as prior therapeutic intervention. In these patients, the clinical examination is focussed primarily on the assessment of cardiovascular parameters, rectal temperature, and the patient's behaviour. The nasogastric intubation is an essential part of the examination of a horse with colic to prevent a gastric rupture due to gastric distension. Transrectal palpation is equally important and should always be performed unless there are important reasons to object to this procedure. In most cases, a thorough patient history and clinical examination of an acute colic patient allows the examining veterinarian to make a tentative diagnosis and a prognostic evaluation. This helps with the decision to start a conservative or a surgical therapy. Due to the existing obligatory documentation requirement and the duty to inform patient owners, it is of utmost importance to promptly document one's findings, therapeutic measures, consultations, and information of the patient owner in written form. This supports further therapy and it can also be of relevance in a potentially resulting lawsuit.

Background Sinusitis is a common disease in the horse. In human medicine it is described, that obstruction of the sinonasal communication plays a major role in the development of sinusitis. To get spatial sense of the equine specific communication ways between the nasal cavity and the paranasal sinuses, heads of 19 horses, aged 2 to 26 years, were using threedimensional (3D) reformatted renderings of CT-datasets. Three-dimensional models were generated following manual and semi-automated segmentation. Before segmentation, the two-dimensional (2D) CT-images were verified against corresponding frozen sections of cadaveric heads. Results Three-dimensional analysis of the paranasal sinuses showed the bilateral existence of seven sinus compartments: rostral maxillary sinus, ventral conchal sinus, caudal maxillary sinus, dorsal conchal sinus, frontal sinus, sphenopalatine sinus and middle conchal sinus. The maxillary septum divides these seven compartments into two sinus systems: a rostral paranasal sinus system composed of the rostral maxillary sinus and the ventral conchal sinus and a caudal paranasal sinus system which comprises all other sinuses. The generated 3D models revealed a typically configuration of the sinonasal communication ways. The sinonasal communication started within the middle nasal meatus at the nasomaxillary aperture (Apertura nasomaxillaris), which opens in a common sinonasal channel (Canalis sinunasalis communis). This common sinonasal channel ramifies into a rostral sinonasal channel (Canalis sinunasalis rostralis) and a caudo-lateral sinonasal channel (Canalis sinunasalis caudalis). The rostral sinonasal channel ventilated the rostral paranasal sinus system, the caudo-lateral sinonasal channel opened into the caudal paranasal sinus system. The rostral sinonasal channel was connected to the rostral paranasal sinuses in various ways. Whereas, the caudal channel showed less anatomical variations and was in all cases connected to the caudal maxillary sinus. Volumetric measurements of the sinonasal channels showed no statistically significant differences (P < 0.05) between the right and left side of the head. Conclusions Under physiologic conditions both paranasal sinus systems are connected to the nasal cavity by equine specific sinonasal channels. To resolve sinus disease it is aimed to maintain or even reconstruct the normal anatomy of the sinonasal communication by surgical intervention. Therefore, the presented 3D analyses may provide a useful basis. [ABSTRACT FROM AUTHOR]