Sara Nannarone

Perioperative lidocaine is widely used in horses with acute abdomen for its analgesic, prokinetic, anti-inflammatory, and anti-endotoxic effects, although evidence of its visceral analgesic efficacy remains inconclusive. Given the potential of alternative routes of administration for local anaesthetics, this prospective, randomised, unblinded clinical trial evaluated whether intraperitoneal (IP) lidocaine improves early postoperative recovery, including recovery from anaesthesia and the first 24 h after laparotomy for colic. A Multifactorial Numerical Rating Composite Pain Scale for equines was used for pain assessment. Covariates including aetiology, times of surgery, anaesthesia and recovery, and eventual postoperative constant rate infusion (CRI) of lidocaine were further analysed. Fifty-four horses were enrolled and equally distributed between two groups differing from the IP administration of 2 mg/kg lidocaine (group L) or not (group C) at the end of laparotomy. Postoperative lidocaine CRI (p = 0.007), higher ASA status (p = 0.005), longer recovery time (p = 0.0012), and large intestinal disease compared with small intestinal disease (p = 0.006) were significantly associated with higher pain scores, particularly within the first 24 h. No horse showed signs of toxicity. Although group L demonstrated a trend toward faster pain reduction, IP lidocaine did not significantly improve early postoperative pain outcomes. Postoperative ‘lidocaine CRI’ was associated with more severe cases, questioning its analgesic efficacy. Further research is warranted to optimise safe and effective protocols.

Left dorsal displacement of the large colon (LDDLC) is a common cause of colic in horses and it is frequently associated with recurrent episodes, with significant implications for horse management, athletic performance, and owner satisfaction. Laparoscopic nephrosplenic space (NSS) ablation is a preventive surgical technique aimed at reducing recurrence in horses with a history of medically or surgically treated LDDLC. This retrospective study evaluated 48 horses that underwent laparoscopic NSS ablation in two Italian Veterinary Teaching Hospitals between 2016 and 2024. Short-term outcomes, including immediate postoperative complications and discharge status, were assessed. Long-term follow-up data were collected via owner questionnaires, focusing on survival, recurrence of colic, post-surgical complications, return to athletic or breeding activity, and owner satisfaction. Most horses were discharged without complications (91.7%), while postoperative colic occurred in 8.3%. Kaplan–Meier estimated one-year post-discharge survival was 83.3%, and 81.3% of horses were alive at last follow-up (range 0.7 months to 8.8 years). Post-discharge complications were reported in 31.2% of horses, most commonly recurrent LDDLC. Return to preoperative athletic or breeding activity was reported in 70.8% of cases, and owner satisfaction was high (83.3%). Time-to-event analysis indicated markedly reduced survival in horses requiring laparotomy during follow-up. Bayesian logistic models suggested lower mortality and fewer post-discharge complications in horses with prior colic surgery, whereas a history of recurrent colic and laparotomy during follow-up was associated with higher mortality and complications. These results indicate that laparoscopic NSS ablation is an effective and safe procedure for long-term management of horses at risk of LDDLC, allowing a high rate of survival, functional recovery, and owner satisfaction, despite the persistence of occasional colic episodes.

Bacterial contamination of the surgical site in horses is a major risk factor for the development of surgical site infections (SSIs), which increase morbidity, mortality, the hospitalisation period, antibiotic use, and management costs. While contamination is a prerequisite for infection, its progression to clinical infection depends on additional factors that compromise host defences. The present study, conducted at the Veterinary Teaching Hospital of the University of Perugia over an 11-month period, investigated bacterial contamination in 70 surgeries (53 clean and 17 clean-contaminated) at the end of the procedure. To exclude pre-existing contamination, a sterile swab was collected after surgical scrub, and only cases that entered surgery with a sterile operative field were considered. A swab, biopsy, and fine-needle aspiration from the wound margins were then performed at the end of the surgery to conduct a qualitative assessment of the bacterial contamination of the surgical sites. Risk factors for surgical field contamination were analysed separately for clean and clean-contaminated procedures. Specifically, for clean-contaminated surgeries, the presence of emergency conditions, surgery duration, and intra-operative complications were evaluated. For clean surgeries, risk factors included the type of operating room, surgical duration, tissue involved, use of local anaesthetics, and placement of surgical drapes. The results revealed bacterial contamination rates of 49.1% in clean surgeries and 41.2% in clean-contaminated surgeries. Coagulase-negative staphylococci were the most frequently isolated bacteria, followed by Burkholderia cepacia, Bacillus sp., and Stenotrophomonas maltophilia. A statistical analysis showed no significant results on the predictive factors of the contamination evaluated. However, the observed trends suggest the importance of further investigating these risk factors in a larger sample size. These results emphasise the importance of effective prophylactic measures to limit surgical site contamination. Future research will focus on optimising pre-operative and intra-operative prophylaxis strategies to reduce bacterial contamination to sub-pathogenic levels, thereby enhancing post-operative outcomes.

The aim of this study was to compare three different anesthetic protocols administered intramuscularly (IM) in cats undergoing elective ovariectomy, while evaluating the quality of sedation, antinociceptive, isoflurane-sparing effect, and analgesia in the intra-operative and post-operative phases. A total of 71 female cats were sedated IM with alfaxalone (3 mg/kg) combined with either butorphanol (0.3 mg/kg), methadone (0.3 mg/kg), or pethidine (5 mg/kg). During surgery, vital parameters were constantly monitored; at the end of the procedure, the quality of recovery was assessed through a specific form and each cat was scored for perceived pain using the UNESP-Botucatu scale for 5 days, and rescue analgesia was provided with buprenorphine IM when indicated. Moreover, differences between two different post-operative resting regimens (hospital kennels vs. home) were also assessed. A significant difference emerged for the amount of IM dexmedetomidine required to achieve an adequate level of sedation for intravenous catheterization, highlighting a greater need in the pethidine group (p = 0.021). There was no significant difference between opioid groups for the requirement of intra-operative rescue analgesia, and the clinical parameters were kept within physiological ranges regardless of the opioid used in premedication. Lastly, differences between the UNESP-Botucatu scores were detected from day 3 to day 5 post-operatively, with lower scores in cats with home resting regimens compared to the hospitalized animals, likely due to the presence of an unfamiliar condition and the absence of a cat-friendly environment.

Summary: This case report discusses the clinical signs, diagnostic findings, treatment and outcome of a 6‐year‐old Italian Warmblood gelding referred for evaluation of a chronic unilateral ocular mucopurulent discharge that had been ongoing for several months. Dacryocystorhinography and computed tomography dacryocystography (CT‐DCG) allowed the identification of a neoformation associated with tooth 206 connected to a cystic lesion occupying the ipsilateral ventral nasal concha. It is likely that both lesions caused stenosis of the nasolacrimal duct and secondary recurrent ocular discharge. Once the 206 tooth had been surgically removed, a histological diagnosis of nodular hypercementosis associated with a small cystic lesion was made. In this case, CT‐DCG was extremely important in identifying the source of the ocular discharge and guiding the surgical planning for tooth removal. A follow‐up telephone conversation with the owner 6 months postoperatively reported that the horse had not shown further ocular discharge.

Small colon impaction can result in accumulation of ingesta, gas, and fluid orally to the impaction site in horses. Large colon tympany, which is caused by ingesta fermentation, can be a predisposing factor for intestinal displacement. The aim of this study is to report the history, clinical, and surgical findings of horses and ponies referred for abdominal pain not responsive to drugs where a right dorsal displacement (RDD) or large colon volvulus (LCV), together with a small colon faecalith (SCF), were diagnosed during surgery. This study included a total of five horses and five ponies. Based on clinical features, ultrasonographic examination, and rectal palpation, an initial suspected diagnosis of RDD, LCV or severe large colon and caecum distension was made in all clinical cases. Due to the lack of response to medical treatment or worsening of colic symptoms, surgery was performed in all horses: diagnosis of RDD or LCV was made and a SCF was incidentally detected in all cases. While exploratory laparotomy was carried out in all the patients for the presence of a large colon issue, it was probably subsequent to an obstruction of the small colon caused by the presence of an SCF, which is generally difficult to diagnose. This study reported the presence of SCF as a possible cause of secondary RDD or LCV in horses and ponies that, to the authors’ knowledge, has never been reported.

The aim of this study was to retrospectively report outcomes resulting from the approach to the maxillary nerve block (MNB) through the infraorbital canal, in terms of needles selection, drawbacks or side effects during or after block execution, and analgesic efficacy leading to clinical and cardiovascular stability during surgery. Anesthetic records of 15 horses undergoing orofacial surgery in standing analgo-sedation (STA, n = 6) and in general anesthesia (GEN, n = 9) were retrieved and analyzed. Horses in group STA required surgery for dental extraction, nasal polyp resection and maxillary/frontal sinusitis. Horses in group GEN underwent surgery for fronto-maxillary, nasal and dental diseases. Size 19 and 20 G Tuohy needles were used in adult horses weighing 350–600 kg, while size 21 and 22 G were used in younger horses or ponies. None of the horses in both groups showed complications related to the block and physiological parameters were stable and within normal ranges during surgery; overall, an adequate anesthetic/sedation depth was achieved. Our results confirm the in vivo applicability of the MNB approached within the infraorbital canal, which had been described only on cadaveric specimens. The retrograde technique resulted in a valid and easy approach to the maxillary nerve that avoids damage to periorbital structures and side effects reported with traditional techniques.

While butorphanol is the most commonly used opioid in horses, methadone is not licensed in most countries. Our aim was to compare the effects of both drugs, combined with romifidine, regarding the quality of sedation and induction in horses undergoing elective surgery. Results indicate the suitability of both methadone and butorphanol in this patient population. Animals were scored 10 min after intravenous injection of sedatives. Despite lower overall sedation (OS) score in horses receiving methadone (p = 0.002), the quality and time of induction and intubation remained unchanged. None of the horses had the lowest OS score (no sedation), nor the highest score for ataxia (horse falling). Methadone induced a tendency for minor noise reaction yet minor head lowering scores, the latter being probably the most influencing parameter when scoring OS. Measured physiological parameters decreased in both groups, with greater bradycardia recorded after methadone (p = 0.017), including a higher incidence of atrioventricular blocks that resolved during general anaesthesia. The quality of induction was good–excellent in most of the animals. While comparisons between the degree of antinociception were beyond the scope of this study, analgesic potency might influence the choice when considering opioids as pre-anaesthetic drugs in combination with romifidine before surgery in equines.