Current Use of Equine Laparoscopy in Urogenital Disorders: A Scoping Review of the Literature from 2000 to 2021

Background: Laparoscopic surgery replaced traditional invasive techniques for the treatment of common urogenital disorders in equids. The aim of this review is to evaluate applications and the development of urogenital laparoscopy from 2001 to 2021. (2) Methods: A scoping review of literature was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines for scoping reviews on three databases (NCBI-PubMed, Web of Science-Thompson Reuters, and SciVerse Scopus). (3) Results: A total of 452 papers were identified. After duplicate removal and title screening, 181 papers underwent abstract screening. Of these, 160 + 10 papers (cited by others) were assessed for eligibility according to the PICOs. A total of 132 papers were considered eligible. Most of the research was focused on ovaries and testes, followed by urinary bladder and general articles about laparoscopy in horses. We identified 43 original studies (33%, RCT, NoRCT, and experimental trials), 39 case series/retrospective studies (29%), 37 case reports (28%), and 13 reviews (10%, narrative or systematic). (4) Conclusions: Gonadal disorders were the most investigated. Hand-Assisted Laparoscopic Surgery (HALS) and laparoscopic-assisted surgery represent valuable options for more challenging conditions (uterine and urinary bladder disorders)

Elastosonographic features of the metacarpophalangeal joint capsule in horses

Background: Capsulitis leads to the release of inflammatory mediators in the joint, causing capsular fibrosis and osteoarthritis (OA). Strain elastosonography (SE) measures the elasticity of tissue by evaluating its strain in operator-dependent deformation. The aims of the study were to assess the feasibility, repeatability, and reproducibility of SE for imaging the distal attachment of the joint capsule (DJC) of metacarpophalangeal joints in sound horses (Group S) and in horses with metacarpophalangeal OA (Group P) and to evaluate differences in the elastosonographic patterns of these horses. After a whole lameness examination, fore fetlock DJCs were assigned to Group S and Group P and were thereafter examined by two operators using SE. Qualitative (i.e., colour grading score) and semi-quantitative (i.e., elasticity index (EI) and strain ratio (SR)) methods were used to evaluate the elastograms. The inter-rater reliability (IRR), intraclass correlation coefficient (intra-CC) and interclass correlation coefficient (inter-CC) were used to compare colour grading scores and the repeatability and reproducibility of EI and SR outcomes. The same parameters were compared between groups. P < 0.05 indicated a significant finding. Results: Forty-one horses were included: 11 were in Group S and 30 were in Group P (16 with bilateral OA, 8 with left OA and 6 with right OA). IRR outcomes ranged from good to excellent. For transverse and longitudinal ultrasound scans, the colour grading score of Group S was significantly higher than the metacarpophalangeal DJCs of Group P. Both Inter-CC and intra-CC were higher in Group S than in Group P, with values always > 0.8. Significative differences in EI and SR were detected between groups and between Group S and the affected limb of Group P; values were lower in Group S than in Group P. Conclusions: SE can be a useful technique for evaluating DJCs, with good repeatability and reproducibility. DJCs appear softer in sound horses

2D-SWE of the Metacarpophalangeal Joint Capsule in Horses

(1) Two-dimensional shear wave elastography (2D-SWE) employs an ultrasound impulse to produce transversely oriented shear waves, which travel through the surrounding tissue according to the stiffness of the tissue itself. The study aimed to assess the reliability of 2D-SWE for evaluating the elastosonographic appearance of the distal attachment of the fetlock joint capsule (DJC) in sound horses and in horses with osteoarthritis (OA) (2). According to a thorough evaluation of metacarpophalangeal joint (MCPJ), adult horses were divided in a sound Group (H) and in OA Group (P). Thereafter, a 2D-SWE of MCPJs was performed. Shear wave velocity (m/sec) and Young's modulus (kPa) were calculated independently by two operators at each selected ROI. Statistical analysis was performed with R software. (3) Results: 2D-SWE had good-excellent inter-CC and intra-CC in both groups. Differences in m/s and kPa between Groups H and P were found in transverse scans with lower values in Group P. No correlation with age or DJC thickness was found. (4) Conclusions: 2D-SWE was repeatable and reproducible. In Group H, DJC was statistically stiffer than in Group P only in transverse scan. The technique showed poor sensitivity and specificity in differentiating fetlocks affected by OA

Segmental Posthetomy in a Four Stallions Case Series

Segmental posthetomy, also referred to as circumcision, reefing or posthioplasty, consists of removing a circumferential segment of the internal preputial lamina (internal preputial fold) followed by end-to-end anastomosis of skin edges. The purpose of this case series is to describe the successful outcome of segmental posthetomy for treating different diseases involving the internal or/and external preputial fold, while restoring the normal telescopic function. In this paper, we report the first case of complete degloving injury of the equine penis in the literature (case 1) and describe three different common lesions of the equine prepuce/penis (preputial scar tissue in case 2, preputial sarcoid in case 3 and penile/preputial wound in case 4). The amount of prepuce (safe minimums) that can be removed from a stallion without disrupting the proper telescopic function of the internal/external preputial fold and normal copulatory ability, has not been established. In this case series, all Equidae stallions maintained the telescopic function after preputial surgical resection. However, the surgeon must carefully evaluate every single case, especially when performing the Adam’s procedure

COHORT RETROSPECTIVE STUDY ON DIAGNOSIS AND OUTCOME OF COLIC SYNDROME IN HORSES: PRELIMINARY DATA

Colic syndrome enrolles several disorders mainly involving the gastrointestinal apparatus and is a common cause of morbidity and mortality [1,2]. Several parameters are considered as predictor factors for the outcome, due to the multifactorial nature of the disorder and variability in horse population [3-6]. Aim of the study was to describe the characteristics, the clinical findings, diagnosis, treatment, and short term survival of horses referred for colic syndrome to the Veterinary Teaching Hospital of Teramo from 2005 to 2022. Collected data included patient signalment (age, gender, body weight, breed), time (morning, afternoon, night) and season of referral, type of treatment (medical, surgical), PCV, Total Protein, euthanasia, survival to discharge. Statistical analysis was carried out with R [7]. Frequency distribution of all discrete variables was provided as well as media, standard deviation (SD) for normally distributed continuous variables, median and interquartile range (IQR) for not-normally distributed continuous variables. One-hundred and fifty-seven horses were included (median age 10 years, IQR 7-13; body weight 550 kg, IQR 407-650). Thoroughbreds, Standardbreds, American and Spanish breeds were represented, as well as Frisian and Italian draft horses. Sixty-two were females (39.5%), 42/157 males (27%), 43/157 geldings (27.5%), 10/157 cases were unidentified (6%). Seventy-three were surgically (46,5%) and 81/157 conservativelly treated (51,5%), 3/157 cases were unidentified (2%). Thirty-nine were euthanized (25%), 5 died spontaneously, 106/157 survived to discharge (67%). In 7 cases the information was lost. When we considered as the outcome variable “survival to discharge”, only the explanatory variable”surgery” differed between the two groups. So a subdataset was considered involving only horses that were surgically treated. Horses receiving surgery were not different in age and body weight from those medically treated (t- test, p>0.05). Hour and season of referral were statistically different between survived and not-survived horses (Fischer exact test, p<0.05), with more survived horses referred in the afternoon and night, compared to the morning, and less survived horses refererred during winter compared to the other seasons. PCV was statistically lower in discharged horses (38.89% vs 48.17%), and time to standing after surgery shorter (58.61 vs 85.87) (t-test, p<0.05). In discharged horses recovery score was better, and not-ischemic lesions were more represented (38 vs 19)(Fischer exact test, p<0.05). No difference in discharge rate was observed according to the site of the lesion [large intestine 45/73 (61.64%), small intestine 22/73 (30.14%) or other sites 2/173(2.74%)], or to the administration of lidocaine after surgery (Fischer exact test, p>0.05). Overall success rate (survival to discharge) of this observational study was in accordance with previous data, with the most common diagnosis being large colon disorders. Differently, we did not observe a higher rate of survival with this disorder compared to others. Hour and season of referral varied among survived and not-survived horses. A more extensive analysis involving an univariate and multivariate logistic regression model involving physical parameter at referral may be of use to highlight odd ratio for survival and help the clinician in the evaluation of prognosis in case of exploratory laparotomy

Retrospective Study on Risk Factors and Short-Term Outcome of Horses Referred for Colic from 2016 to 2022

SIMPLE SUMMARY: Colic syndrome is the most common out-of-hours call for equine practitioners. In most cases, medical treatment at home is effective for the resolution of the disorders. In 20% of cases, hospital intensive care is required. Several factors have been addressed as predisposing to the disorder. Cardiovascular and hemodynamic variables are the most reliable indicators of the severity of the condition and, thus, are important prognostic factors. The aim of the study was to highlight the predisposing factors and best prognostic clinical signs for discharge in a cohort of horses referred for colic syndrome. Medical records from 2016 to 2022 were examined. One hundred and fifty-seven horses were included in the study. Month and time of admission were the main predisposing factors. Cardiovascular variables (heart rate on admission and after 3–6 h, packed cell volume, capillary refill time, and mucosal membranes) and the presence of gastric reflux were negatively associated with discharge as well as time to standing after surgery. The results from this retrospective study may help the clinician in evaluating prognosis, deciding on the best treatment, and adequately informing the owner of the rates of success. ABSTRACT: (1) Background: colic syndrome is a multifactorial life-threatening condition in equids. Awareness of predisposing and prognostic indicators is useful to adequately inform the owner of the outcome and plan the best treatment. The aim of the study was to identify the variables associated with short-term survival in a cohort of horses referred for colic to a veterinary teaching hospital; (2) Methods: medical records of horses referred for colic from 2016 to 2022 were retrospectively reviewed. Univariate and multivariate regression models were built to assess the odds ratios of discharge from the hospital, both on the whole sample and in those patients undergoing surgery; (3) Conclusions: Month, time of admission, cardiovascular variables (heart rate on admission and after 3–6 h, packed cell volume, capillary refill time, and mucosal membranes), and presence of gastric reflux were significantly associated with discharge in the univariate regression in all horses and in those surgically treated. In the multivariate regression model, heart rate, packed cell volume, and capillary refill time showed significant association with the outcome in the whole sample. Although comparison between this study and previous studies is difficult due to the number and type of variables included, cardiovascular variables and markers of hypovolemia were also shown to be associated with outcome