Objective—To describe the clinical use of regional limb perfusion with antimicrobials (A-RLP), complications, and outcome in a large series of patients. Design—Retrospective case series. Animals—174 horses. Procedures—Medical records of horses treated with A-RLP between 1999 and 2009 were reviewed. Signalment, primary complaint, horse use, etiology, duration of clinical signs, previous treatment, structures involved, concurrent conditions, A-RLP characteristics, additional treatments, complications, and outcome were recorded. At long-term follow-up, 2 outcomes were investigated: survival rate and return to previous use at the same or higher level. Univariate and multivariate logistic regression analyses were conducted. Results—Group 1 (96 horses) included septic synovitis. Group 2 (50 horses) included extrasynovial lacerations (23 horses) and fresh, minimally contaminated intrasynovial lacerations without evidence of established synovial infection (27 horses). Group 3 (28 horses) included miscellaneous other conditions. Only minor complications were reported in 12.26% of horses that received IV (n = 155) and 33% of horses that received intraosseous (27) A-RLP. Horses with septic synovitis had a lower survival rate (53.43%) than did horses with lacerations (91.89%). Within group 2, no significant differences in short- or long-term outcomes were found between horses with extrasynovial and fresh, minimally contaminated intrasynovial lacerations. For the horses returning to previous use, 80% of horses with septic synovitis and 72.72% of horses with lacerations were performing at the same or higher level at the time of follow-up. Conclusions and Clinical Relevance—The results of the present study indicated that A-RLP is a safe technique with minimal adverse effects. The IV route presented fewer complications than intraosseous injection. Horses with infection of synovial structures had a lower survival rate than did those with acute, minimally contaminated intrasynovial lacerations. The latter had a similar prognosis for horses with extrasynovial lacerations treated with A-RLP.

Allogeneic CB-MSCs reduced synovial fluid cell populations and stimulated mild self-limiting inflammation in the synovitis model. Continued evaluation of the effects of i.a. CB-MSC therapy on synovitis in horses is needed to evaluate anti- and proinflammatory properties of CB-MSCs. Immediate interests are dose, timing of treatment, and treatment frequency.

OBJECTIVE To explore referring equine veterinarians' expectations of equine veterinary referral centers and specialists. DESIGN Qualitative, focus group interview-based study. SAMPLE 6 focus groups comprised of equine practitioners with experience in referral of clients and patients to equine specialists or referral centers (48 referring veterinarians [rDVMs]). PROCEDURES Focus group sessions were conducted independently and followed a standardized discussion guide consisting of open-ended questions and follow-up probes. Discussions were recorded, and thematic analysis was performed on the content. RESULTS The overarching theme of participants' discussions was that specialists and referral centers are an extension of the care that rDVMs provide to their clients and patients. The 5 areas that participants described as important to this expectation were rDVM-client relationships, rDVM involvement during referral care, collegial rDVM-specialist relationships, communication between rDVMs and specialists, and the boundaries of referral care. Participating practitioners wanted to be involved during the referral process, which was seen as being facilitated by having a collegial relationship with the specialist and through effective communication during the course of referral care. CONCLUSIONS AND CLINICAL RELEVANCE Relationships and communications between rDVMs and specialists are important aspects of equine veterinary medicine. Both rDVMs and specialists are likely to benefit from pursuing opportunities to further their relationship by using up-front communication to establish clear role expectations and clear processes for sharing information.

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Although a definite time frame for resolution of digital flexor tendon sheath distension was not determined, we recommend waiting more than 3 days between intrasynovial anaesthesia of the digital flexor tendon sheath and evaluation with MRI.