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Summary: A 5‐year‐old gelding used for showing was presented for surgical repair of a full‐thickness 15 mm diameter defect in the right pinna, which had occurred as a delayed complication following laser excision of a sarcoid. The defect had resulted in progressive deformity of the ear, and the horse was considered at risk of further injury if the defect became entrapped on a fixed object. Two artificial dermis meshes were inserted to encourage the formation of granulation tissue across the defect, and a commercially available skin expander was implanted adjacent to the site. Eighteen days later, a second surgery was performed to remove the skin expander and to mobilise a local rotational skin flap to close the defect. Both surgeries were performed under standing sedation and local anaesthesia. The site healed well, avoiding further potential trauma to the ear and deformity due to tissue contracture at the site, although some deformation of the lateral aspect of the cartilage remained. [ABSTRACT FROM AUTHOR]

Summary: Critical appraisal skills enabling assessment of the validity and importance of evidence are essential for clinicians to make informed decisions regarding what new information should be incorporated into their clinical practice. This review highlights key points to consider in a critical review concentrating on common study designs used in the equine literature. [ABSTRACT FROM AUTHOR]

Summary: An 18‐month‐old Welsh Cob was referred to a university teaching hospital for investigation of abnormal respiratory noise at rest. Video‐endoscopy revealed persistent displacement of the soft palate with bilateral 2–3 cm diameter raised areas on either side of the midline. Neither trans‐nasal nor oral approaches allowed sufficient visualisation of the caudal soft palate for diagnosis or treatment. Latero‐lateral radiographs showed a blunted, thickened caudal edge of the soft palate consistent with a palatal cyst. Two palatal cysts were thermally ablated with a transendoscopic diode laser via temporary tracheotomy. The horse recovered uneventfully and resolution of the displacement was evident on follow‐up endoscopy 11 months later. This report documents a novel surgical approach to the caudal aspect of the soft palate. [ABSTRACT FROM AUTHOR]

Summary: Background: There is limited information about bacterial isolates that are present on the equine midline incision during and following exploratory laparotomy. Objectives: To investigate the bacterial species cultured from the ventral midline pre‐, intra‐ and post‐ laparotomy, whether particular bacterial isolates are associated with the development of surgical site infections (SSIs) and to report the antimicrobial resistance phenotypes of these isolates. Study design: Prospective cohort study. Methods: The ventral midline of 31 horses undergoing exploratory laparotomy was sampled for bacterial culture at set time‐points pre, intra and post‐operatively. Inclusion criteria were that horses must have undergone exploratory laparotomy within 90 min of the initial colic examination upon hospital admission and must not have been placed in a stable prior to surgery. SSI was defined as any purulent or serous discharge from the laparotomy incision of >24 h duration. Results: Seven horses (22.6%) developed a SSI. None of the variables tested were associated with the altered risk of SSI. The prevalence of a positive bacterial culture from the incision increased progressively over time and a variety of bacteria were isolated. A positive intra‐operative culture was not a predictor of SSI; and when a SSI did occur, it was due to a different bacterial isolate. MRSA and ESBL‐producers were identified in the post‐operative period in one and four different horses respectively, but none of these developed a SSI. Main limitations: Sampling was limited to hospitalisation and no culture results were available for horses developing SSI following hospital discharge. Conclusions: A variety of bacterial species may be isolated from equine laparotomy incisions peri‐operatively without development of SSI. SSI does not appear to be solely related to bacterial contamination of the incision peri‐operatively and other mechanisms such as bacteraemia merit further investigation. [ABSTRACT FROM AUTHOR]

It has been 21 years since the adoption of clinical audit by our profession was first suggested in the literature (Mosedale [17]) and 19 years since an editorial in this journal introduced two thought-provoking articles on the subject (Rossdale and Mair [25]). Colic surgery has been identified as a discipline well-suited to clinical audit (Mair and White [13]). Despite significant improvements in treatment and outcomes for horses undergoing colic surgery, mortality, and complication rates remain relatively high (Mair [12]; Salem I et al i . 14 Mair, T.S. and White, N.A. (2008) The creation of an international audit and database of equine colic surgery: Survey of attitudes of surgeons. [Extracted from the article]

Summary: Five horses with a primary surgical lesion of the small (descending) colon were diagnosed with eosinophilic colitis based on visual and histopathological examination. These were evident as visibly striking, hyperaemic, focal lesions of the small colon, with serosal petechiation, oedema and marked thickening of the intestinal wall at the site. Areas of focal necrosis were also evident. The gross appearance of the lesions were considered to be sufficiently severe in all cases to merit resection, due to concerns about intestinal necrosis and septic peritonitis. An inability to fully exteriorise the affected portion of intestine to perform a resection and anastomosis necessitated intraoperative euthanasia of one horse. A total of three horses survived to hospital discharge. Eosinophilic colitis lesions are a rare cause of severe small colon disease, but should be considered in cases with similar visual characteristics. [ABSTRACT FROM AUTHOR]

Reasons for performing study Relaparotomy may be required to investigate and manage complications that occur following surgical management of colic. Objectives To report factors associated with survival following relaparotomy. Study design Retrospective cohort study. Methods Records of horses that had undergone exploratory laparotomy for treatment of colic over a 10-year period (2002-2012) and had undergone relaparotomy <8 weeks following the initial surgery were reviewed. Descriptive data were generated and association with survival time was modelled using Cox proportional hazards models. Results Relaparotomy was performed in 96 horses at <8 weeks following initial surgery at a median of 4 days. This represented 6.3% of horses that underwent laparotomy during the study period (n = 1531). Relaparotomy was most frequently undertaken based on signs of persistent post-operative colic (76%; n = 73). Short-term survival for horses undergoing relaparotomy due to persistent colic was 53%, incisional dehiscence 50%, post-operative reflux 37%, haemoperitoneum 17% and septic peritonitis 0%. Median survival was 6 days for all horses undergoing relaparotomy and 778 days for those that recovered following anaesthesia. Nonsurvival was associated with increased packed cell volume at 24 h following initial laparotomy (hazard ratio [ HR] 1.06, 95% confidence interval [ CI] 1.04-1.10, P = 0.009), peritonitis as a reason for undertaking relaparotomy ( HR 4.41, 95% CI 1.43-13.6, P = 0.01) and adhesions found at relaparotomy ( HR 1.77, 95% CI 1.03-3.04, P = 0.04). Increased likelihood of survival was associated with colic signs being the reason for performing relaparotomy ( HR 0.48, 95% CI 0.26-0.88, P = 0.02) and small intestinal distension found at relaparotomy ( HR 0.53, 95% CI 0.29-0.96, P = 0.04). Conclusions This study has provided information about survival rates and risk factors for survival in horses undergoing relaparotomy that can assist clinicians and owners when determining whether to perform relaparotomy and in predicting the likely surgical outcome. [ABSTRACT FROM AUTHOR]

Reasons for performing study Colic is an important health problem in managed horse populations. Currently, there is limited information about colic prevalence and risk factors for colic in working horse populations. Objectives To determine the prevalence of, and risk factors for, colic in a working horse population in Egypt and to describe management practices in this working horse population. Study design Cross-sectional survey. Methods Owners of 350 working horses were interviewed. Data about their horses, management and colic episodes in the preceding 12 months were collected. Dental examination was conducted on 342 horses and blood samples (n = 100) were collected for immunodiagnosis of tapeworm ( Anoplocephala perfoliata) infection. Multivariable logistic regression analysis was used to identify risk factors for a history of colic in the preceding 12 months. Results The 12-month prevalence of colic was 54.6%. Severe and moderate tapeworm infection intensity was identified in 3% and 26% of horses tested, respectively. Horses that had severe dental disease (odds ratio [ OR] 6.8, 95% confidence interval [ CI] 1.9-24.3, P<0.001), that displayed stereotypic behaviour ( OR 2.0, 95% CI 1.15-3.5, P = 0.013), were fed ground corn during the 'dry season' ( OR 1.65, 95% CI 1.03-2.6, P = 0.035) or that had received an anthelmintic in the previous 6 months ( OR 2.1, 95% CI 1.3-3.3, P = 0.003) were more likely to have a history of colic in the preceding 12 months. Horses fed on rice bran during the 'green season' ( OR 0.47, 95% CI 0.26-0.9, P = 0.015) and that displayed geophagia/coprophagia ( OR 0.19, 95% CI 0.05-0.73, P = 0.001) were less likely to have a history of colic. Conclusions Colic is common in this working horse population and this study has identified factors associated with altered likelihood of colic. The study provides important information that may be used to inform future prospective studies investigating colic in working horse populations and to assist development of preventive healthcare strategies. The Summary is available in Chinese - see Supporting information [ABSTRACT FROM AUTHOR]

Reasons for performing study Oro-dental disease can have a significant impact on equine welfare. Objectives To determine the prevalence of oro-dental disease and to identify risk factors for oro-dental disorders and poor body condition scores ( BCS) in a working horse population in Egypt. Study design Cross-sectional survey. Methods Oro-dental examination was performed on 450 working horses in 2 Egyptian provinces. Horse and management historical data were collected and horses were assigned to no/mild, moderate and severe dental disease categories based on findings on examination. Multivariable logistic regression and generalised additive models were used to identify risk factors for oral mucosal injuries and very poor/poor BCS, and to explore the relationship between age and different oro-dental disorders. Results Oro-dental disease was common, with 45.3% and 8.4% of horses considered to have moderate and severe oro-dental disease, respectively. None of these horses had previously undergone any form of proper dental examination and treatment by trained personnel. Oral mucosal injuries (64.2%) and sharp enamel points (79.8%) were most common. Oral mucosal injuries were significantly associated with increasing age (odds ratio ( OR) 1.1, 95% confidence interval ( CI) 1.01-1.1, P = 0.03), focal dental overgrowths ( OR 2.4, 95% CI 1.4-4.0, P = 0.002) and sharp enamel points ( OR 6.3, 95% CI 3.5-11.0, P<0.001). Very poor and poor BCS were significantly associated with severe dental disease ( OR 2.6, 95% CI 1.2-5.8, P = 0.02), horses aged 16-30 years ( OR 3.5, 95% CI 1.7-7.0, P = 0.001), height ( OR 0.9, 95% CI 0.9-0.97, P = 0.001) and packed cell volume ( OR 0.9, 95% CI 0.85-0.95, P<0.001). Conclusions There is a need for education of working horse-owners in Egypt about the importance of oro-dental disease and for greater availability of veterinarians with suitable training and equipment to perform dental prophylaxis and treatment. Even simple dental prophylaxis could have a significant impact on the health and welfare of this population of working horses. [ABSTRACT FROM AUTHOR]

Reasons for performing study Surgical site infection ( SSI) is an important cause of post operative morbidity following laparotomy. Objectives To investigate risk factors for SSI, including effect of season and surgery performed outside normal working hours, and to report bacterial isolates and antimicrobial resistance patterns. Study design Retrospective cohort study. Methods Data were obtained from horses that had undergone exploratory laparotomy over a 3-year period (2010-2013) in a UK hospital population. SSI was defined as any purulent or serous discharge from the laparotomy incision of >24 h duration that developed during hospitalisation. Multivariable logistic regression was used to identify associations between pre-, intra- and post operative variables and altered likelihood of SSI. Results Surgical site infection developed in 73/287 (25.4%) horses during hospitalisation. Horses of greater bodyweight (odds ratio [ OR] 1.002, 95% confidence interval [ CI] 1.0002-1.005, P = 0.03), increased packed cell volume (≥48%) on admission ( OR 3.03, 95% CI 1.32-6.94, P = 0.01), small intestinal resection ( OR 2.27, 95% CI 1.15-4.46, P = 0.02) and post operative colic ( OR 2.86, 95% CI 1.41-5.79, P = 0.003) were significantly associated with increased likelihood of SSI in a multivariable model. SSI was also significantly more likely to occur during winter ( OR 3.84, 95% CI 1.38-10.70, P = 0.01) and summer ( OR 5.63, 95% CI 2.07-15.3, P = 0.001) months in the model. Three-layer closure of the incision was protective ( OR 0.31, 95% CI 0.16-0.58, P<0.001) compared to 2-layer closure. There was no effect of surgery being performed outside normal working hours (P = 0.5). The most common bacterial isolates were Escherichia coli (59.5%) , Enterococcus spp. (42.4%) and Staphylococcus spp. (25.4%). Penicillin resistant isolates accounted for 92% (96/104) of isolates while 18% (21/119) of isolates were gentamicin resistant. Conclusions Laparotomy during winter and summer months was associated with increased likelihood of SSI but there was no effect of surgery performed outside normal working hours. This information assists in identifying horses at high risk of SSI and informing development of preventive strategies. [ABSTRACT FROM AUTHOR]

Changes in management of the surgical colic patient over the last 30 years have resulted in considerable improvement in post operative survival rates. However, post operative complications remain common and these impact negatively on horse welfare, probability of survival, return to previous use and the costs of treatment. Multiple studies have investigated risk factors for post operative complications following surgical management of colic and interventions that might be effective in reducing the likelihood of these occurring. The findings from these studies are frequently contradictory and the evidence for many interventions is lacking or inconclusive. This review discusses the current available evidence and identifies areas where further studies are necessary and factors that should be taken into consideration in study design. [ABSTRACT FROM AUTHOR]

Reasons for performing study Recurrent colic occurs frequently in the general horse population but little evidence exists about what factors place horses at greater risk of recurrent colic. Objectives To quantify time-varying and non time-varying risk factors for recurrent colic among horses attended by first-opinion veterinary surgeons in northwest England. Study design Nested case-control study. Methods A nested case-control study was conducted on data from a prospective longitudinal cohort study of 127 horses recruited subsequent to an episode of medical colic. Data were collected on management and recurrent colic episodes at 4-monthly intervals by telephone questionnaires. All recurrent colic episodes were selected as cases; controls were unmatched and randomly selected from all horse-time at risk. Data relating to the 30 days prior to the date of colic or control selection were used to determine exposure status. Multivariable logistic regression analyses were used to determine risk factors for recurrent colic. Results In total, 59 cases and 177 controls were included. The final model showed that horses that displayed crib-biting/windsucking (odds ratio [ OR] 10.1, 95% confidence interval [ CI] 2.5-41.0) or weaving behaviour ( OR 3.9, 95% CI 1.5-10.1) had an increased risk of recurrence of colic. Increasing time at pasture reduced the risk of recurrence ( OR 0.99, 95% CI 0.99-1.0). A significant interaction was found suggesting that the risk associated with crib-biting/windsucking may be modified by feeding fruit/vegetables; however, further research is required before recommendations for feeding practices can be made. Conclusions This study suggests that sufficient access to pasture may be an important means of reducing recurrent colic risk. The behavioural risk factors highlight individuals who may be at increased risk of recurrent colic and whose colic prevention strategies should be carefully managed. [ABSTRACT FROM AUTHOR]