Crib‐biting in US horses: Breed predispositions and owner perceptions of aetiology

Reasons for performing study: Crib‐biting is an equine stereotypy that may result in diseases such as colic. Certain breeds and management factors have been associated. Objectives: To determine: breed prevalence of crib‐biting in US horses; the likelihood that one horse learns to crib‐bite from another; and owner perceptions of causal factors. Methods: An initial postal survey queried the number and breed of crib‐biting horses and if a horse began after being exposed to a horse with this habit. In a follow‐up survey, a volunteer subset of owners was asked the number of affected and nonaffected horses of each breed and the extent of conspecific contact. The likelihood of crib‐biting given breed and extent of contact was quantified using odds ratio (OR) and significance of the association was assessed using the Chi‐squared test. Results: Overall prevalence was 4.4%. Thoroughbreds were the breed most affected (13.3%). Approximately half of owners believed environmental factors predominantly cause the condition (54.4%) and crib‐biting is learned by observation (48.8%). However, only 1.0% of horses became affected after being exposed to a crib‐biter. The majority (86%) of horses was turned out in the same pasture with other horses and extent of contact with conspecifics was not statistically related to risk. Conclusion: This is the first study to report breed prevalence for crib‐biting in US horses. Thoroughbreds were the breed more likely to be affected. More owners believed either environmental conditions were a predominant cause or a combination of genetic and environmental factors contributes to the behaviour. Only a small number of horses reportedly began to crib‐bite after being exposed to an affected individual, but approximately half of owners considered it to be a learned behaviour; most owners did not isolate affected horses. Potential relevance: Genetic predisposition, not just intensive management conditions and surroundings, may be a factor in the high crib‐biting prevalence in some breeds, and warrants further investigation. Little evidence exists to suggest horses learn the behaviour from other horses, and isolation may cause unnecessary stress.     

Are horses that undergo an exploratory laparotomy for correction of a right dorsal displacement of the large colon predisposed to post operative colic,compared to other forms of large colon displacement?

Reason for performing study: It is a clinical impression that horses diagnosed with a right dorsal displacement (RDD) of the large colon, are more likely to suffer from recurrent episodes of colic post operatively, compared to other forms of nonstrangulating large colon displacement. Objectives: To investigate whether the type of nonstrangulating large colon displacement identified at exploratory laparotomy would influence long‐term outcome. Hypothesis: Horses identified with a RDD of the large colon at exploratory laparotomy would be more likely to experience recurrent episodes of post operative colic than other types of displacement. Materials and methods: Medical records for horses undergoing an exploratory laparotomy, from 2000–2008, for a nonstrangulating large colon displacement were reviewed. Data retrieved included: subject details, previous medical history, details of current episodes of colic, results of preoperative examination, surgical findings and procedures, post operative management and complications. Follow‐up information was obtained by reference to computerised clinical records and by telephone questionnaire administered to the horse's owner or carer, and included details of any colic episodes exhibited by the horse after discharge and whether a repeat celiotomy had been required to resolve the colic episodes. Results: There were 165 surgeries identified, in 154 horses. It was found that those horses with RDD were significantly more likely to experience recurrent episodes of colic requiring veterinary intervention post operatively compared to other types of displacement. Clinical relevance: Long‐term prognosis and likelihood of post operative complications is an important consideration for both owners and veterinarians.     

Survival of horses following strangulating large colon volvulus

Reasons for performing study: The pattern of long‐term survival and specific factors associated with long‐term survival have not previously been evaluated in horses with a strangulating large colon volvulus (LCV). Objectives: To provide data on the long‐term survival of horses with LCV and to identify pre‐, intra‐ and post operative variables associated with survival. Methods: Clinical data and long‐term follow‐up information were obtained from 116 horses with a strangulating LCV (≥360°) undergoing general anaesthesia. Two multivariable Cox proportional hazards models for post operative survival time were developed: Model 1 included all horses and evaluated preoperative variables and Model 2 included horses that survived anaesthesia and evaluated pre‐, intra‐ and post operative variables. Results: The study population comprised 116 horses. Eighty‐nine (76.7%) survived general anaesthesia. Of these, the percentage that survived until discharge, to one year and to 2 years was 70.7%, 48.3% and 33.7%, respectively. Median survival time for horses that survived general anaesthesia was 365 days. In Model 1 increased preoperative packed cell volume (PCV) was significantly associated with reduced post operative survival (hazard ratio [HR] 1.08, 95% confidence interval [CI] 1.05–1.11). However, this effect changed over time. In Model 2 abnormal serosal colour intraoperatively (HR 3.61, 95% CI 1.55–8.44), increased heart rate at 48 h post surgery (HR 1.04, 95% CI 1.02–1.06), and colic during post operative hospitalisation (HR 2.63, 95% CI 1.00–6.95), were all significantly associated with reduced post operative survival. Conclusions: Survival time in horses with a LCV was associated with preoperative PCV, serosal colour, heart rate at 48 h post operatively and colic during post operative hospitalisation. Potential relevance: This study provides evidence‐based information on the long‐term survival of horses with LCV and identifies parameters that may assist decision‐making by clinicians and owners.     

Nutritional considerations for horses with colitis. Part 1: Nutrients and enteral nutrition

The equine colon is the primary site of fibre digestion and water absorption. It is therefore not surprising that colitis and associated colonic dysfunction can result in severe nutritional derangements, which can be exacerbated by reduced feed intake in affected horses. Dietary management of colitis is important for optimum recovery. In broad terms, it should prioritise provision of nutrients to horses that otherwise have reduced appetites. In some forms, such as right dorsal colitis, as well as those with chronicity, nutritional recommendations include restricting or eliminating long‐stem roughage from the diet and feeding a complete pelleted diet. Voluntary enteral nutrition is preferred, but horses that are not ingesting enough to meet the minimum recommended requirements as outlined, should be fed via nasogastric tube (if tolerated – no reflux, no ileus and no colic present; faecal output present). Parenteral nutrition may be necessary in some cases, as some colitis cases do not tolerate enteral feeding for reasons such as colic, intestinal dysmotility or abdominal distension. Timing and constitution of nutritional intervention is vital and should be tailored to the individual patient to prevent further complications of the disease process.     

Aortic rupture and aorto‐pulmonary fistulation in the Friesian horse: Characterisation of the clinical and gross post mortem findings in 24 cases

Reasons for performing study: In horses, aortic sinus of Valsalva aneurysms or tears in the aortic root are well‐recognised conditions in breeding stallions, often leading to sudden death. A more uncommon form of aortic rupture, located proximal to the ligamentum arteriosum has been reported in 3 Friesian horses. Objectives: The purpose of this study was to phenotypically characterise aortic rupture and aorto‐pulmonary fistulation in Friesian horses in terms of clinical and post mortem data based on 24 cases. Methods: Friesian horses that were diagnosed with aortic rupture and aorto‐pulmonary fistulation over a period of 13 years (1997–2010) at the Department of Equine Sciences of Utrecht University (n = 15) and Wolvega Equine Hospital (n = 9), were included in this study. Case history, results of clinical examination and gross post mortem findings were screened and analysed. Results: Some cases were found dead without prior symptoms, but in several cases signs such as recurrent colic, peripheral oedema and sustained tachycardia were present for several weeks prior to cardiac failure. Clinical examination during hospitalisation revealed increased rectal temperature, peripheral oedema and increased jugular pulse with a bounding arterial pulse. In the majority of horses an aortic rupture of the aortic arch near the ligamentum arteriosum, concurrent with a circumferential cuff of perivascular haemorrhage and aorto‐pulmonary fistulation, was found at post mortem examination. Conclusions: Aorto‐pulmonary fistulation in conjunction with aortic rupture is more common in Friesians than previously estimated. In some cases findings demonstrate a progressive pathology rather than acute cardiac failure and sudden death. An appropriate approach is necessary during post mortem examination of the heart in order not to overlook the diagnosis. Potential relevance: Equine practitioners should realise that in Friesian horses presented with a history of recurrent false colic, coughing, sustained tachycardia and/or peripheral oedema, aortic rupture and aorto‐pulmonary fistulation should be included in the differential diagnosis.     

Non-strangulating intestinal infarction in horses in the UK: A review of 15 cases

The clinicopathological features of 15 horses diagnosed with non-strangulating intestinal infarction (NSII) based on identification of focal areas of intestinal necrosis without mesenteric strangulation were reviewed. The mean age at presentation was 16.3 years, median 13 years, and there was no age, sex, or breed predilection. The major presenting clinical signs included: acute colic ≤ 24 h duration in nine horses; diarrhoea, depression, and inappetence in four horses; and low-grade chronic or recurrent colic, depression, and inappetence in two horses. One horse presented with both acute colic and diarrhoea. Predisposing diseases included colitis or typhlocolitis in five horses and an initial strangulating small intestinal obstruction in three horses, but in seven horses no underlying or predisposing disease was identified. Four cases were managed medically and 11/15 were managed surgically. The most useful diagnostic test was exploratory celiotomy and the only successful treatment was complete resection of the necrotic intestine. Prognosis for survival was poor with a survival rate of only 1/15 (7%). Among the 15 horses, both single and multiple NSII lesions were seen, and they occurred in both the small intestine and large intestines. There was no evidence of Strongylus vulgaris infestation in any of the affected horses.     

Owner assessment in judging the efficacy of airway disease treatment

Reasons for performing study: Efficacy of medications for recurrent airway obstruction is typically tested using clinical, cytological and lung function examinations of severely affected animals. These trials are technically challenging and may not adequately reflect the spectrum of disease and owner complaints encountered in clinical practice. Objective: To determine if owners of horses with chronic airway disease are better able to detect drug efficacy than a veterinarian who clinically examines horses infrequently. Method: In a double‐blinded randomised controlled trial, owners and a veterinarian compared the efficacy of dexamethasone (0.1 mg/kg bwt per os, q. 24 h, for 3 weeks; n = 9) to placebo (n = 8) in horses with chronic airway disease. Before and after treatment, owners scored performance, breathing effort, coughing and nasal discharge using a visual analogue scale (VAS). The clinician recorded vital parameters, respiratory distress, auscultation findings, cough and nasal discharge, airway mucus score, bronchoalveolar lavage fluid (BALF) cytology and arterial blood gases. Results: The VAS score improved significantly in dexamethasone‐ but not placebo‐treated horses. In contrast, the clinician failed to differentiate between dexamethasone‐ and placebo‐treated animals based on clinical observations, BALF cytology or endoscopic mucus score. Respiratory rate (RR) and arterial oxygen pressure (PaO₂) improved with dexamethasone but not placebo. Conclusions and clinical relevance: In the design of clinical trials of airway disease treatments, more emphasis should be placed on owner‐assessed VAS than on clinical, cytological and endoscopic observations made during brief examinations by a veterinarian. Quantifiable indicators reflecting lung function such as RR and PaO₂ provide a good assessment of drug efficacy.     

Evaluation of dietary and management risk factors for enterolithiasis among horses in California

Enteroliths are intestinal calculi that result in intestinal obstruction and colic in horses. Equine enterolithiasis occurs worldwide, but the disease is particularly prevalent in some geographic locations, including California. The objectives of this study were to evaluate dietary and environmental risk factors for the disease. This was accomplished through a case–control study by comparing horses with colic from enterolithiasis presenting to the University of California, Davis VMTH, to horses with colic of other causes. Data were collected on 61 horses with enterolithiasis and 75 controls via evaluation of patient records and questionnaires completed by owners at the time of admission. Following multiple logistic regression analysis, the following factors were found to be significantly associated with enterolithiasis: feeding ⩾50% of the diet as alfalfa; feeding <50% of the diet as oat hay; feeding <50% of the diet as grass hay; and lack of daily access to pasture grazing.     

Nutritional and clinicopathological effects of post operative parenteral nutrition following small intestinal resection and anastomosis in the mature horse

REASONS FOR PERFORMING STUDY: There is an absence of data describing the nutritional requirements and nutritional status of horses following surgery for colic; furthermore, the potential effect of parenteral nutrition (PN) on improving nutritional status in such cases is unknown. HYPOTHESIS: Post operative colic cases suffer from a potentially detrimental negative energy balance and the PN formulation developed in this study would lead to clinicopathologically detectable improvements in the subjects' nutritional status. METHODS: Several clinicopathological variables, some known to be associated with nutritional status, were compared in 2 groups of horses in the post operative period following colic surgery; Group N (n = 15) were treated with PN and Group C (n = 15) were starved routinely. RESULTS: Group N had significantly lower serum concentrations of triglycerides, total bilirubin, albumin and urea and significantly higher serum concentrations of glucose and insulin compared with Group C in the post operative period. CONCLUSIONS: The control group of horses demonstrated significant clinicopathological evidence of starvation and the described PN protocol resulted in a demonstrably improved nutritional status in the treated horses. POTENTIAL RELEVANCE: Further study is required to investigate clinical benefits and possible harmful side effects of post operative parenteral nutrition before the technique can be advocated for widespread use in practice.     

Colic in geriatric compared to mature nongeriatric horses. Part 1: Retrospective review of clinical and laboratory data

Reason for performing study: It is the impression of some surgeons that geriatric horses have a lower survival rate compared to mature nongeriatric horses following colic surgery. One possible reason for this is that geriatric horses may be more critically ill at admission and have more severe disease than mature nongeriatric horses. Objective: To compare admission historical, physical examination and laboratory data for geriatric and mature nongeriatric horses referred for signs of colic. Methods: Medical records of horses admitted with a presenting complaint of colic between 2000 and 2006 were reviewed. Geriatric horses ≥16 years (n = 300) and mature nongeriatric horses 4–15 years (n = 300). Information obtained included duration of colic prior to admission, admission level of pain, heart rate, intestinal borborygmi, packed cell volume (PCV), plasma creatinine and blood lactate concentrations and peritoneal fluid total protein. Data were analysed using a Chi‐squared test or an analysis of variance. Level of significance was P<0.05. Results: There was no difference between geriatric and mature horses in the duration of colic prior to admission or in admission heart rate, PCV, or plasma creatinine or blood lactate concentrations. However, geriatric horses were more likely to be moderately painful and less likely to be bright and alert than mature horses; and less likely to have normal intestinal borborygmi than mature horses. Peritoneal fluid total protein concentration was higher in geriatric than mature horses. Conclusions and potential relevance: Geriatric horses presenting with signs of colic had a similar admission cardiovascular status based on heart rate, PCV, and plasma creatinine and blood lactate concentration to mature horses. Geriatric horses, however, may have different causes of colic, which may be more serious than mature horses based on pain, lack of intestinal borborygmi and peritoneal fluid total protein concentration.     

Prevalence of Clostridium perfringens in faeces and ileal contents from grass sickness affected horses: Comparisons with 3 control populations

Reasons for performing study: While previous studies have demonstrated an association between equine grass sickness (EGS) and the presence of Clostridium botulinum within ileal contents and faeces, no such associations with other intestinal‐derived anaerobic bacteria have been extensively investigated. Hypothesis: The prevalence of C. perfringens in the ileal contents and faeces of EGS horses is greater than control horses; the detection of C. perfringens in faeces by ELISA could be diagnostically beneficial in a clinical setting. Methods: The prevalence of C. perfringens in faeces from EGS horses and healthy grazing control horses was determined by both selective culture and ELISA to permit both validation of the ELISA and inter‐group comparisons. Additionally, the prevalence of C. perfringens (ELISA) in ileal contents from EGS horses was compared with that for control horses with nongastrointestinal disease. Finally, the prevalence of C. perfringens (ELISA) in faeces from EGS cases was compared with that from both horses with which they shared pasture at the time of disease onset and non‐EGS colic horses. Results: When compared with culture, the ELISA had a sensitivity and specificity of 86 and 98%, respectively. The prevalence of C. perfringens in faeces as determined by both culture and ELISA was significantly higher (P<0.001) for EGS horses (7/9 and 15/37, respectively) than for healthy grazing controls (0/60 and 1/74, respectively). The prevalence of C. perfringens in ileal contents from EGS horses (5/10) was greater than that for horses with nongastrointestinal disease (1/12) at a level that approached significance (P = 0.056). EGS cases had a significantly greater prevalence of C. perfringens in faeces (15/37) than co‐grazing horses (1/18) and colic (1/16) horses. The specificity (93%) and PPV (94%) of the detection of C. perfringens by ELISA on faecal samples in relation to disease status (EGS compared with colic horses) was good. Sensitivity (41%) and NPV (39%) were poor. Conclusions and potential relevance: The use of a commercial ELISA to detect faecal C. perfringens may be diagnostically beneficial when differentiating EGS cases from colic cases, although further work is required to fully evaluate its potential.     

Colic Surgery in Horses: A Retrospective Study Into Short- and Long-Term Survival Rate,Complications and Rehabilitation toward Sporting Activity

Colic surgery in horses impacts both short-term well-being of horses due to possible surgical and anesthetic complications and also long-term return to a sporting career. In this retrospective study, survival and complication rates, as well as functional outcome and behavioral problems in horses that underwent colic surgery were studied. Data from 283 horses that underwent colic surgery at a veterinary teaching hospital were analyzed. Furthermore, owners were contacted and requested to fill out a questionnaire concerning the first year of rehabilitation. Of 283 horses that underwent colic surgery, 167 (59%) were discharged home. After discharge from hospital, 34 horses (12%) were lost to follow-up. Of the remaining 133 horses, 128 were still alive after 1 year (96.2%), while 5 horses were euthanized due to recurrent colic. Of the horses that did not survive the hospitalization period 73 horses (25.8%) were euthanized intraoperatively and 36 horses (12.7%) during intensive care unit (ICU) stay. Survival of horses entering the ICU up to discharge from hospital was 79.5%. During rehabilitation, 49 horses (59.8%) that returned home experienced one or more recurrences of colic. Fifty-two horses (63.4%) that returned home reached at least preoperative level of performance. Altered behavior and gait-related problems during specific elements of riding (for instance during collecting, lateral bending, etc.) were reported in up to 46.2% of horses. Improving veterinary aftercare in collaboration with other disciplines (e.g., physiotherapy and saddle fitting) during rehabilitation could be a means to further improve athletic performance and welfare after recovery from colic surgery.     

Evaluation of dietary and management risk factors for enterolithiasis among horses in California

Enteroliths are intestinal calculi that result in intestinal obstruction and colic in horses. Equine enterolithiasis occurs worldwide, but the disease is particularly prevalent in some geographic locations, including California. The objectives of this study were to evaluate dietary and environmental risk factors for the disease. This was accomplished through a case–control study by comparing horses with colic from enterolithiasis presenting to the University of California, Davis VMTH, to horses with colic of other causes. Data were collected on 61 horses with enterolithiasis and 75 controls via evaluation of patient records and questionnaires completed by owners at the time of admission. Following multiple logistic regression analysis, the following factors were found to be significantly associated with enterolithiasis: feeding 50% of the diet as alfalfa; feeding <50% of the diet as oat hay; feeding <50% of the diet as grass hay; and lack of daily access to pasture grazing.     

Primary gastric impaction in horses: A retrospective study of 20 cases (2005–2008)

Primary gastric impaction is an uncommon condition. Furthermore, the factors associated with gastric impaction and the optimal method of treatment are not clear. The aim of this article is to describe the clinical findings, treatment and outcome of horses with a primary gastric impaction. Medical records of horses that presented with a primary gastric impaction between 2005 and 2008 were reviewed and 20 horses with a primary gastric impaction identified. Diagnosis of a primary gastric impaction was made if the horse had been fasted for a minimum of 16 h, a concretion of ingesta precluded visualisation of the margo plicatus and there was no evidence of concurrent intestinal pathology. Thirteen of 20 (65%) horses were presented on an emergency basis. The most common complaint was inappetence (50%) followed by acute colic (35%) and recurrent colic (35%). On initial examination for colic, all horses had a normal heart rate and 7 of 20 (35%) had decreased gastrointestinal borborygmi. All horses were treated with enteral fluid therapy. The median dose of fluids administered per day was 5 doses (range 1–8 doses) of 2–10 l of isotonic electrolyte solution. The median length of treatment until resolution was 2 days (range 1–5 days). Eighteen of 20 (90%) horses survived to discharge. Primary gastric impaction appears to be a condition with clinical signs of inappetence and mild abdominal discomfort. This is the largest group of horses reported that were treated with enteral fluid therapy for a gastric impaction and it was concluded that enteral fluid therapy was of value in this study.     

Fecal Sand Clearance Is Enhanced with a Product Combining Probiotics, Prebiotics, and Psyllium in Clinically Normal Horses

Consumption of sand and dirt by horses can cause chronic diarrhea, weight loss, and colic caused by irritation and obstruction of the gastrointestinal tract. Prevention has been primarily focused on changes in management to reduce the intake of sand resulting from feeding on the ground. Studies regarding the use of psyllium for the prevention of sand accumulation in clinically normal horses have not been published. A nutritional supplement combining probiotics, prebiotics, and psyllium was hypothesized to increase fecal sand output in clinically normal horses in a natural environment. A measured volume of feces was collected daily from eight clinically normal horses and screened for sand 1 week before and during 35 days of treatment with a supplement combining probiotics, prebiotics, and psyllium. Sand was isolated from feces using a flotation decanting method and was expressed in milligrams sand per gram of feces. Fecal sand output increased significantly (P < .01) by day 4 of supplementation and remained significantly increased through day 31 of the feeding trial. Daily supplementation with a probiotic, prebiotic, and psyllium supplement demonstrated enhanced fecal sand clearance in clinically normal horses. These results suggest that this product may be an effective prophylactic treatment for sand enteropathy and sand colic in which management alone is not sufficient to prevent intestinal sand accumulation. Further studies are needed to confirm the utility of this product in clearing sand from horses with naturally occurring sand impactions and enteropathy.     

Comparison of owner-reported health problems with veterinary assessment of geriatric horses in the United Kingdom

Reasons for performing study: Previous studies suggest that owners underestimate or incorrectly recognise or report health problems in geriatric horses. However, few studies have directly compared owner‐reported and veterinary assessed disease. Objectives: To compare the findings of veterinary clinical examination of geriatric horses with owner‐reported clinical signs and disease. Methods: A total of 200 horses aged ≥15 years were randomly selected to receive a veterinary examination, from responses to a cross‐sectional postal questionnaire survey. Veterinary examinations were performed within 2 months of questionnaire return, and agreement between owner‐reported data and veterinary clinical findings was assessed. Results: Owners under‐reported many clinical signs and disease conditions detected on veterinary clinical examination. For example, dental abnormalities (detected in 95.4% of horses, reported by 24.5% of owners); cardiac murmurs (detected in 20% of horses, reported by 0.5% of owners); lameness (present in 50% of horses, reported by 23% of owners) and hoof abnormalities (detected in 80% of horses, reported by 27% of owners). Agreement between owner‐reported and veterinary assessed respiratory disease (Kappa 0.02–0.2), body condition score (Kappa 0.24) and coat abnormalities (Kappa 0.42) was poor, fair and moderate, respectively. Range of motion (ROM) of the tarsal and metacarpophalangeal joints was lower in horses with owner‐reported osteoarthritis (P = 0.005 and <0.001, respectively). Conclusions and potential relevance: The low prevalence and relatively poor agreement of owner‐reported disease compared to that detected on veterinary examination suggests inaccurate or under‐recognition, or inaccurate reporting of health problems by owners of geriatric horses, which could lead to a delay in presentation for veterinary treatment. Increased veterinary involvement and improved owner education in the care of geriatric horses should facilitate earlier identification of disease, particularly that which is not readily detectable by owners, and aid management of health and welfare problems.     

A farm-based prospective study of equine colic incidence and associated risk factors

Abdominal pain (colic) in the horse is one of the most acute problems facing equine practitioners. Several causes and risk factors are associated with colic. The current study evaluated the incidence and associated risk factors of colic during a 1-year evaluation in horse farms of Kerman, Iran. The study investigated age, sex, breed, anthelmintic control program, and nutritional status of 128 horses of four breeds on six farms that took part in the study. The mean incidence density rate of colic in the horse population was 8.6% (11/128) in a year. Crossbred horses had more chance of developing colic (P < .05). Horses between the ages of 2 and 10 years also had more risk of developing colic (P < .05). There was no significant difference between sexes (P < .05), and nutritional factors were the most associated risk factors in the cases under study.