Quality of equine veterinary care. Part 2: Client satisfaction in equine top sports medicine in The Netherlands

The aim of this study was to evaluate systematically the quality of equine veterinary top sports medicine in The Netherlands and the degree to which the expectations in the field are met. Focus was on structure, process and outcome of care. The structure of care is generally satisfactory but there is insufficient transfer of applicable scientific knowledge to the equine community and a lack of regular checks by team vets. The process of care is hampered by the failure in communication between the veterinary and paraveterinary members of a team. For continuation of the excellent international results of Dutch riders and drivers a more collaborative approach, abandoning the often secretive character of equine medicine in relation to sport horses, is necessary.     

How riding may affect welfare: What the equine veterinarian needs to know

Veterinarians generally focus on keeping the performance horse in work but they need to be mindful of ways in which the work itself may jeopardise the animal's welfare and health. Elements of a horse's work may expose it to the risk of injury but insults to wellbeing, which are far more common and far more sustained, although less overt, also deserve consideration. A good example is the way in which chronic physiological stress responses arising from inhumane training techniques may compromise immunity and tissue repair. This article explores the physiological and musculoskeletal insults that can result from ridden work, alongside the gear and training paradigms that can compromise welfare. It also considers issues relating to the use of pharmaceuticals in the ridden horse. With stress reduction as a primary focus, it emerges that veterinarians are uniquely placed to comment on the somatic effects of psychological stressors, including the social and ethological challenges resulting from the work required of the so‐called elite equine athlete. Whether the profession will step up to meet this significant challenge is also discussed.     

A review of approaches to assessing equine welfare

Veterinary surgeons are required to assess an animal's welfare in a range of different circumstances in the course of their daily work. These assessments may relate to the long‐term welfare of an individual animal under their care, or the current welfare of a population of animals that are unfamiliar to them as individuals. The welfare assessment made may subsequently have implications for the treatment that an animal receives or for the decision of whether or not an animal should remain in its current home. Yet welfare assessment is not straightforward. Here we review the challenges that welfare assessment presents and review the tools currently available to meet them. Lastly, we look towards the future of equine welfare assessment, with examples of current research to develop tools and optimise welfare assessment.     

Management and environmental factors involved in equine influenza outbreaks in Ireland 2007-2010

Reasons for performing study: Outbreaks of equine influenza (EI) in endemic populations continue to cause economic loss despite widespread vaccination. Hypothesis: To identify the key management and environmental factors that determine the risk of horses contracting EI in an endemic country and to identify control strategies. Methods: Real time‐polymerase chain reaction (RT‐PCR), virus isolation and haemagglutination inhibition were carried out on nasopharyngeal swabs and clotted blood samples collected from horses and ponies showing signs of respiratory disease. On premises where a diagnosis of EI was confirmed, the attending veterinary surgeon was asked to participate in an epidemiological investigation. Results: Between June 2007 and January 2010, EI outbreaks were diagnosed on 28 premises located in 13 of the 32 counties of Ireland. Veterinary advice was sought on average more than 5 days after the first clinical signs were observed. The majority of diagnoses were made by RT‐PCR. Data from 404 horses on 16 premises were used in the epidemiological analysis. In 15 premises, EI was identified following movement of horses. Housing type, teaser stallions or fomites/personnel contributed to virus spread. Vaccination status, number of years vaccination, time since last vaccination and age influenced disease expression. Isolation and vaccination were effective control measures on the premises where they were implemented. Conclusions: Preventative measures include: isolation, clinical monitoring, serological testing and vaccination of new arrivals, booster vaccination of horses at 6 monthly intervals, maintenance of effective boundaries between equine premises and avoidance of stabling in single air spaces. Control measures include: prompt isolation of suspected cases, rapid diagnosis by RT‐PCR, booster vaccination of cohorts and implementation of biosecurity measures to avoid transmission by fomites and personnel. Potential relevance: Implementation of these preventative and control measures should reduce the economic losses associated with outbreaks of EI.     

Review of two viral agents of economic importance to the equine industry (equine herpesvirus-1, and equine arteritis virus)

Equine herpesvirus type-1 (EHV-1) and equine arteritis virus (EAV) are infectious agents that cause serious health risks to horse populations and are disbursed worldwide, which can lead to significant financial losses. In addition to being responsible for abortion and neonatal death, these viruses are associated with respiratory illness. Although previous research and reviews have been written on these viruses, both viruses still affect horse populations around the world and the vaccines currently available are not completely protective, especially against EHV-1 and equine herpes myeloencephalopathy (EHM). Moreover, EAV is considered a threat to the $102 billion equine industry in the United States. As a result, these viruses represent a huge threat to the horse industry and efforts geared towards preventing the outbreak of the disease are strongly encouraged. For this reason, updates about these viruses are necessary and require more and more discussion on the nature and characteristics of these viruses to know how to overcome them. Prevention and control of abortion and neonatal foal death caused by each of the two viruses depend on appropriate management strategies coupled with prophylactic vaccination. This review presents the latest detailed information on EHV-1 and EAV from several aspects such as transmission, clinical signs, pathogenesis, latest developments on the treatment of the diseases, vaccination, and finally challenges and future perspectives. The information presented herein will be useful in understanding EHV-1 and EAV and formulating policies that can help to limit the spread of these viruses within horse populations.     

Evaluation of current equine welfare issues in Ireland: Causes,desirability, feasibility and means of raising standards

Reasons for performing study: Significant potential threats to the health and welfare of horses exist in Ireland when supply exceeds demand and the identification system for horses is not yet robust. Objectives: To secure engagement with stakeholder groups and determine their perception of equine welfare in Ireland and encourage the development of inclusive, rather than imposed, policy solutions. Methods: A 3 round, web‐based Policy Delphi incorporating novel vignette methodology was conducted from November 2007–March 2008 to canvass opinion (in both quantitative and qualitative forms) on the perceived most significant equine welfare issues. Vignettes (narratives depicting potential compromise to equine welfare) were employed. Quantitative data were collected in the form of scoring on a 9 point Likert scale with labelled end‐points, qualitative information as text subsequently analysed for themes. Results: All 44 respondents completed all rounds. Major equine welfare issues were identified as welfare of horses during the disposal process and at unregulated gatherings. Assessed quantitatively on a 9 point Likert scale (0 = minimal; 8 = maximal), respondents scored the desirability and feasibility of improving standards, median 8 and 6, respectively, for both issues identified. Basic themes identified in respondents' quotes as reasons to raise equine welfare standards were ideological, protection of animal welfare, safe‐guarding the reputation of the equine industry and safety (of people, horses and environment). Themes for reasons for low standards were societal norms, fiscal pressures, indolence, indifference and ignorance. Themes underpinning potential means for achieving meaningful change (solutions) were legislation, enforcement, education/training, fiscal remedies, increasing awareness and a combination of these. Conclusions: Mechanisms aimed at raising standards must be based on an understanding of motivational drivers for currently low standards. Potential relevance: The challenge is to translate the findings and this heightened awareness into meaningful change to the benefit of horses and those who care for them.     

Assessment of quality of life in equine patients

Reasons for performing study: Assessing patients' quality of life (QOL) is a core part of clinical decision making. Various methodologies for assessing patients' QOL have been developed in human medicine and small animal veterinary disciplines. In contrast, the lack of aids for QOL assessment in equine veterinary practice leaves practitioners reliant on subjective assessments of QOL, which may be prone to avoidable errors. Objectives: This paper suggests pragmatic ways in which QOL may be enhanced, while remaining appropriate for the time, financial and owner‐based constraints within equine practice. Methods: Through interdisciplinary research, this paper identifies, adapts and applies insights from several areas of research and practical experience in order to develop an overarching approach to making QOL‐based decisions in clinical cases. Results: The paper identifies 6 steps involved in QOL‐based decision making and provides examples of how these steps may be practically applied. These include deciding what each clinician feels is important; deciding how to evaluate it, including taking owners' views into consideration; making decisions about each case and achieving the desired clinical outcomes. Conclusions: Practitioners can draw their own conclusions on how they may improve QOL assessment in practice and may usefully share these with colleagues. Reporting cases and sharing practical examples of QOL tools used on the ground are vital to the development of this field and appropriate methodologies. Potential relevance: Improvements in QOL assessment are relevant to all areas of equine veterinary practice, and several areas of research. Further research may develop QOL assessment in practice, but more important are the personal improvements that each practitioner may achieve. See also correspondence by Grove     

Ultrasound-guided injections of the equine head and neck: review and expert opinion

Ultrasound-guided injections can be used for a wide variety of conditions in the horse, including both diagnostic and therapeutic applications. Benefits of ultrasound guidance include more accurate deposition of injectate compared with blind approaches. Improved identification of vital structures, including nerves and blood vessels, allows their avoidance and thus reduces procedure-associated complications. Validation of such ultrasound-guided techniques has shown that they can be easily learnt by inexperienced veterinarians, assuming a proper knowledge of the sonographic anatomy. In many cases they can be employed in the field with a high level of accuracy, using widely available equipment, and with complete adherence to the sterility principles. Many ultrasound-guided injection techniques of the axial skeleton in the horse have been described in past years, enabling the equine veterinarian to perform more accurate treatments of specific anatomical areas. The goal of this review is to discuss diagnostic and therapeutic ultrasound-guided injection techniques of the skull and cervical spine in the horse, including those for the retrobulbar space, maxillary and inferior alveolar nerves, atlanto-occipital and atlanto-axial junctions, and cervical articular process joints, as well as the 1st cervical nerve, the C2 and C3 nerve plexus, and the 6th, 7th, and 8th cervical nerve roots.     

Equine viral arteritis: A respiratory and reproductive disease of significant economic importance to the equine industry

Equine arteritis virus is the causative agent of equine viral arteritis, a respiratory and reproductive disease that affects the members of the family Equidae. The virus was first isolated from the lung of an aborted fetus after an extensive outbreak of respiratory disease and abortion on a Standardbred breeding farm near Bucyrus, Ohio, in 1953. Since then, periodic outbreaks of equine viral arteritis have been reported in a number of countries around the world. This disease may result in significant economic loss to the equine industry due to the occurrence of abortion in pregnant mares, neonatal mortality, and establishment of the carrier state in stallions. This article provides an extensive review on equine arteritis virus, epidemiology, disease, pathogenesis, and prevention and control measures.     

The equine gastrosplenic ligament: Anatomy and clinical considerations

A gelding was referred for colic and inguinal wound evaluation. Abdominal ultrasound showed distended, oedematous and immotile small intestine abaxial to the spleen. An exploratory laparotomy revealed jejunal incarceration through a rent in the gastrosplenic ligament (GSL). The rent in the GSL was opened and surgical correction (resection and anastomosis of nonviable jejunum) performed. The GSL was left open. The horse recovered uneventfully and one year after surgery no further episodes of colic have been observed.     

A comparative study of the application of two horse welfare assessment protocols

Two assessment protocols for horse welfare were compared: the Swedish official protocol (OP) and a newly developed horse welfare assessment protocol (HWAP). The protocols differ in composition: the HWAP contains 20 animal-based (35.7%), 28 resource-based (50.0%) and 8 management-based (14.3%) measures whereas the OP has 4 animal-based (8.9%), 21-resource-based (46.7%), 16-management-based (35.6%) and 4-uncategorized measures (8.9%). The HWAP detected more welfare issues than the OP for 11 out of 12 welfare criteria. The OP took less time to assess (2–4?h) compared to the HWAP (3?h 20?min to 8?h 40?min). The added level of detail and more animal-based measures means that the HWAP provides a more thorough assessment of welfare of the individual animal than the OP.     

Detection of clade 2 equine influenza virus in an adult horse recently imported to the USA

A 4‐year‐old Warmblood mare presented to the William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California at Davis with bilateral mucoid nasal discharge and pyrexia. The mare had recently been imported from Germany, arriving at a quarantine holding facility 72 h prior to presentation. Based on clinical presentation and culture results of tracheal fluid, the mare was diagnosed with bacterial bronchopneumonia secondary to equine influenza. The equine influenza virus (EIV) identified in the imported mare displayed 99.1% nucleotide homology of the HA1 gene to the prototype Florida sublineage clade 2 isolate A/equine/Richmond/1/2007 (H3N8). This case illustrates the risk of introducing a clade 2 EIV in North America.