An update on the treatment of cutaneous tumours

Cutaneous tumours continue to present a significant clinical challenge in equine practice. There are a large number of treatment options and selecting the appropriate modality requires careful consideration of a number of factors. While sarcoids are the most commonly diagnosed cutaneous tumour, their clinical appearance can have considerable overlap with other types of lesion, so biopsy should be performed where the diagnosis is uncertain. New treatment options for sarcoids include electrosurgery, electrochemotherapy and novel intralesional treatments. Melanomas still have relatively limited treatment options beyond surgical resection, but there are now limited data to support the use of a xenogenic DNA vaccination protocol. Squamous cell carcinomas are generally best treated via surgical excision, but a novel intralesional treatment may prove to be a useful option for further treatment.

Autumn de-worming

Autumn is traditionally a time when most horses are de-wormed with one or more products that are effective against tapeworms and both adult and larval roundworms. However, the increasing prevalence of resistance and availability of diagnostics should prompt scrutiny of whether blanket de-worming at this time of year is appropriate. If management is good and horses are at low-risk of clinical disease, then there may be no need to use anthelmintics. Serology provides a means of assessing exposure to both cyathostomins and tapeworms, but it has its limitations and does not provide a validated means of assessing the risk of parasitic disease. The results of serology, results of faecal worm egg counts performed in the population through the preceding grazing season, and knowledge of management practices in the population should all be considered when assessing whether the risk of the disease to the individual is such that it must take priority over the ever-increasing threat of resistance in the equine population.

Equine obesity and the role of the veterinary nurse

Equine obesity is defined as a medical disease in which excess body fat has accumulated to such an extent that it has an adverse effect on the general health of the horse. Obesity is a cause for concern, with one-third of the equine population in the UK being regarded as obese, although owner recognition of obesity in horses is an inherent problem, with many underestimating the body condition or weight of their horse. This is further complicated by the fact that with larger framed horses, or horses that are already overweight, assessing body condition is more difficult. There are a number of ways to assess body condition and the most practical means of regular assessment is body condition scoring, although this is regarded as subjective. As with many diseases and disorders, the cause of obesity is multifactorial. However, the most common reason for a horse to become obese is overfeeding, coupled with a lack of exercise. Obesity can be addressed with client education and veterinary nurses can provide advice on weight management programmes. However, these need to be tailored to the individual horse and owners need to recognise that they are entering into a long-term commitment.

Advanced equine diagnostics – developments in computed tomography

Advancement in veterinary imaging technologies to assess pathology in the horses has been greatly improved since the development of computed tomography in the 1970s. These technical innovations have enabled faster acquisition times, lower patient doses of radiation and easier care of the patient during scanning. A wide range of computed tomography scanners are now available to the veterinary market, from companies providing second hand refurbished scanners, to those tailoring computed tomography scanners to the veterinary market. In turn, this makes the price of purchase, or rental, much more feasible to the industry. The financial implications of purchasing a scanner need to be reviewed to ensure viability, as well as identifying maintenance costs, space, specialist staffing and case load. However, even with access to advanced imaging devices such as computed tomography, imaging the equine patient comes with its own complexities and limitations. Owing to their size and anatomy, passing the relevant structures through the gantry can be difficult in itself, often requiring the administration of general anaesthetic to acquire suitable images, which comes with its own set of risks and additional costs. Therefore, there is an ongoing need to further develop the skills and abilities needed for standing computed tomography.

EquineReview

Introduction: This month's Equine Review presents papers on a large prospective European study of the efficacy and safety of the glucocorticoid prodrug ciclesonide, changes in the faecal microbiota of horses hospitalised for colic and the comparison of chlorhexidine and alcohol-based antisepsis of the equine distal limb.

The role of nutrition and feeding in equine weight management

Increasing awareness of the prevalence of overweight and obese horses has shed light on to the importance of appropriate nutrition and feed management within weight loss programmes. The review presents a basic approach to weight loss programme design and appropriate feeding and shows that while there is sufficient information upon which to base weight loss programmes, the findings of recent research into compliance and communication is likely to improve future success. Further education for livery yards and establishments is also a pivotal piece of the weight loss puzzle. There is still ground with regard to the most appropriate conserved forage, and a shift in responsibilities and mindset when it comes to forage analysis may be required. Ultimately, success may lie in a multidisciplinary team approach to weight recognition and management, and the development of a framework for fostering and maintaining communication across paraprofessionals and owners is an essential first step.

Chronic kidney disease in adult horses: causes, diagnosis and management

Chronic kidney disease is a rare disease in horses, unlike humans and companion animals where it is frequently encountered. There are multiple causes, although, since the disease typically presents late in the disease process, the instigating factor is often not ascertained. Clinical signs most commonly include weight loss, ventral oedema and polyuria-polydipsia. There is a need for more sensitive markers of renal damage or dysfunction so that the disease can be detected earlier in its course. Serum symmetric dimethylarginine and neutrophil gelatinase-associated lipocalin are potential biomarkers that are being investigated in this regard. Currently, once the diagnosis has been made, treatment is supportive only, with no options to halt the progression of the disease. Although this is a terminal condition, horses can be maintained with an adequate quality of life for several years after diagnosis in some cases.

Nursing a horse with strangles

Strangles can be an extremely debilitating and unpleasant experience for an infected horse. Diligent nursing care is important as the disease runs its course, to maximise the chances of a full and straightforward recovery. Veterinary nurses can play a critical role in strangles outbreaks by ensuring horses are in a comfortable environment within quarantine, are encouraged to eat and drink, benefit from careful abscess management and are monitored closely. Nurses also provide essential support for vets during procedures such as guttural pouch endoscopy, as well as helping to maintain strict biosecurity protocols to prevent further spread of disease.