@article{ruff_zetterstrom_boone_hofmeister_smith_epstein_blikslager_fogle_burke_2023, title={Retrospective analysis of postoperative complications following surgical treatment of ileal impaction in horses managed with manual decompression compared to jejunal enterotomy}, volume={10}, ISSN={["2297-1769"]}, DOI={10.3389/fvets.2023.1156678}, abstractNote={Objective The objective of this study was to compare the occurrence of post-operative complications and survival to discharge in horses with ileal impactions resolved by manual decompression compared with jejunal enterotomy. Animals A total of 121 client-owned horses undergoing surgical correction of an ileal impaction at three teaching hospitals. Materials and methods Data from the medical records of horses undergoing surgical correction of an ileal impaction was retrospectively collected. Post-operative complications, survival to discharge, or post-operative reflux present were evaluated as dependent variables and pre-operative PCV, surgery duration, pre-operative reflux, and type of surgery were evaluated as independent variables. Type of surgery was divided into manual decompression (n = 88) and jejunal enterotomy (n = 33). Results There were no significant differences in development of minor complications, development of major complications, presence of post-operative reflux, amount of post-operative reflux, and survival to discharge between horses that were treated with manual decompression and those treated with distal jejunal enterotomy. Pre-operative PCV and surgery duration were significant predictors of survival to discharge. Conclusions and clinical relevance This study showed that there are no significant differences in post-operative complications and survival to discharge in horses undergoing distal jejunal enterotomy versus manual decompression for correction of ileal impaction. Pre-operative PCV and duration of surgery were found to be the only predictive factors of survival to discharge. Based on these findings, distal jejunal enterotomy should be considered earlier in horses with moderate to severe ileal impactions identified at surgery.}, journal={FRONTIERS IN VETERINARY SCIENCE}, author={Ruff, Jennifer and Zetterstrom, Sandra and Boone, Lindsey and Hofmeister, Erik and Smith, Caitlin and Epstein, Kira and Blikslager, Anthony and Fogle, Callie and Burke, Megan}, year={2023}, month={Apr} }
 @article{murillo_ramaker_burke_walker_negrao watanabe_2023, title={Severe unilateral nephrolithiasis and recurrent colic in a horse}, volume={1}, ISSN={["2052-6121"]}, url={http://dx.doi.org/10.1002/vrc2.567}, DOI={10.1002/vrc2.567}, abstractNote={Abstract Urolithiasis is an uncommon disorder reported in horses. Calculi located in the kidneys and ureters are often underdiagnosed. Associated clinical signs include weight loss, anorexia, haematuria, dysuria, colic and polyuria/polydipsia. A 26‐year‐old Thoroughbred gelding was referred for evaluation of an acute colic episode of 5‐hour duration. Haematologic analysis revealed increased serum creatine kinase and creatinine concentrations. Abdominocentesis yielded serosanguineous, mildly cloudy fluid with a lactate of 9.6 mmol/L (<2 mmol/L). Exploratory laparotomy was recommended. Surgical intervention was declined, and the horse was humanely euthanased. Limited postmortem evaluation was performed. A 3.633 kg nephrolith measuring 23.6 × 16.2 × 8.9 cm was completely effacing the left kidney. Crystallography and infrared spectroscopy (attenuated total reflection and Fourier transform infrared) revealed a 100% calcium carbonate nephrolith. Carbonate calcium calculi are the most common subtype in horses. Nephrolithiasis should be considered as a differential diagnosis for colic and haematologic evidence of azotaemia in horses.}, journal={VETERINARY RECORD CASE REPORTS}, publisher={Wiley}, author={Murillo, Daniel Felipe Barrantes and Ramaker, Erica and Burke, Megan and Walker, Ryan and Negrao Watanabe, Tatiane Terumi}, year={2023}, month={Jan} }
 @article{sheats_burke_robertson_fiebrandt_fogle_2021, title={Development and Formative Evaluation of a Low-Fidelity Equine Castration Model for Veterinary Education}, volume={8}, ISSN={["2297-1769"]}, url={https://europepmc.org/articles/PMC8476848}, DOI={10.3389/fvets.2021.689243}, abstractNote={Entrustable Professional Activities (EPAs) are units of activity that early-stage professionals perform in the workplace that necessitate simultaneous integration of multiple competencies. EPA #6 requires students to perform a common surgical procedure on a stable patient, including pre-operative and post-operative management. Castration is one of the most common surgeries performed by equine primary care practitioners and is considered an “entry-level competency” for veterinary graduates entering equine private practice, however, to our knowledge there are no equine castration models available for veterinary student education. Therefore, we developed an inexpensive, low-fidelity model of equine field castration and evaluated it using a mixed-methods approach. Two different groups of students, with or without model experience, completed surveys before and after live horse castration. Students who used the model also completed model specific surveys. Videos of the students completing the model were evaluated by at least two different equine veterinary faculty using a 15-point rubric, and inter-rater reliability of the rubric was determined. After completing the model, students reflected on strengths and weaknesses of their performance. From our student survey results, we determined that student attitudes toward the model were mostly positive. Interestingly, there were several student attitudes toward the model that became significantly more favorable after live horse castration. Prior to live horse castration, there was no significant difference in confidence in model vs. no-model groups. Following live horse castration, students who used the model had higher confidence in procedure preparation and hand-ties than students who did not use the model, but they had lower scores for confidence during patient recovery. When reflecting on model castration, students most commonly cited preparation and surgical description as strengths, and ligature placement and hand-ties as weaknesses. Experts provided several suggestions to improve the model, including incorporation of emasculators and the need for better model stabilization. Our findings suggest that both students and veterinary educators feel that this low-fidelity model has educational value. Rubric performance metrics were favorable, but additional steps are needed to improve grading consistency among educators. Future research will determine whether student performance on the model is predictive of competence score during live-horse castration.}, journal={FRONTIERS IN VETERINARY SCIENCE}, author={Sheats, M. Katie and Burke, Megan J. and Robertson, James B. and Fiebrandt, Katherine E. and Fogle, Callie A.}, year={2021}, month={Sep} }
 @article{ziegler_fogle_burke_blikslager_2019, title={Letter to the Editor: Bias in statistics or bias in equine veterinary medicine?}, volume={51}, ISSN={0425-1644 2042-3306}, url={http://dx.doi.org/10.1111/evj.13081}, DOI={10.1111/evj.13081}, abstractNote={• We agree that using the word “trend” to suggest data is “close to significance” is incorrect. However, the authors were careful not to use the term trend in this manner. Our discussion in the article proposes that validating a trend towards improved survival in horses treated with firocoxib would require additional studies with greater numbers of horses and likely modification of the study design to include preoperative drug randomisation. The suggestion by Dr Freeman that changes are unlikely no matter how many horses are assessed simply implies bias, rather than a true understanding of statistical power. Furthermore, the discussion regarding sCD14 values, which were significantly higher in patients on flunixin meglumine as compared to firocoxib (P = 0.044), is incoherent.}, number={3}, journal={Equine Veterinary Journal}, publisher={Wiley}, author={Ziegler, A. L. and Fogle, C. A. and Burke, M. and Blikslager, A. T.}, year={2019}, month={Feb}, pages={423–423} }
 @article{burke_blikslager_2018, title={Advances in Diagnostics and Treatments in Horses with Acute Colic and Postoperative Ileus}, volume={34}, ISSN={0749-0739}, url={http://dx.doi.org/10.1016/j.cveq.2017.11.006}, DOI={10.1016/j.cveq.2017.11.006}, abstractNote={Differentiating between medical and surgical causes of colic is one of the primary goals of the colic workup, because early surgical intervention improves prognosis in horses requiring surgery. Despite the increasing availability of advanced diagnostics (hematologic analyses, abdominal ultrasound imaging, etc), the most accurate indicators of the need for surgery remain the presence of moderate to severe signs of abdominal pain, recurrence of pain after appropriate analgesic therapy, and the absence of intestinal borborygmi. Investigation of novel biomarkers, which may help to differentiate surgical lesions from those that can be managed medically, continues to be an active area of research.}, number={1}, journal={Veterinary Clinics of North America: Equine Practice}, publisher={Elsevier BV}, author={Burke, Megan and Blikslager, Anthony}, year={2018}, month={Apr}, pages={81–96} }
 @article{burke_tomlinson_blikslager_johnson_dallap-schaer_2018, title={Evaluation of digital cryotherapy using a commercially available sleeve style ice boot in healthy horses and horses receiving i.v. endotoxin}, volume={50}, ISSN={["2042-3306"]}, url={https://doi.org/10.1111/evj.12842}, DOI={10.1111/evj.12842}, abstractNote={BACKGROUND
Continuous digital cryotherapy experimentally prevents development and reduces severity of sepsis-associated laminitis. A sleeve style ice boot where ice is in direct contact with the skin, and water drains from the boot is being used clinically for distal limb cryotherapy. The degree of cooling achieved by this boot is unknown.


OBJECTIVES
Evaluate skin and lamellar cooling after application of the ice sleeve in healthy horses, and the same horses during an endotoxaemia model.


STUDY DESIGN
Prospective study, crossover design.


METHODS
In eight healthy horses thermocouples were inserted into dorsal lamellae of both front feet, and under skin on both metacarpi. One forelimb received cryotherapy using sleeve style ice boot, with contralateral limb as control. Temperature was recorded on data logging devices at 5 min intervals during each cryotherapy session. Day 1: temperature data was collected for healthy horses. Day 2: data was collected for the same horses during i.v. administration of endotoxin.


RESULTS
In healthy and endotoxaemic horses, the sleeve style ice boot significantly decreased mean skin (7.2°C and 5.8°C respectively) and lamellar (10.8°C and 9.6°C respectively) temperatures compared with control limbs (P<0.001). Skin and lamellar temperatures in endotoxaemic horses undergoing cryotherapy were significantly colder than in healthy horses (P = 0.01).


MAIN LIMITATIONS
Order of treatment not randomised.


CONCLUSIONS
The boot caused significant decreases in lamellar temperatures compared with untreated control limbs in all horses. Endotoxaemic horses had significantly colder lamellae and skin than healthy horses. This study is the first to show that a sleeve style boot, where ice does not cover the hoof, can cause significant decreases in lamellar temperatures through cooling of blood as it travels to the foot.}, number={6}, journal={EQUINE VETERINARY JOURNAL}, author={Burke, M. J. and Tomlinson, J. E. and Blikslager, A. T. and Johnson, A. L. and Dallap-Schaer, B. L.}, year={2018}, month={Nov}, pages={848–853} }
 @article{ziegler_freeman_fogle_burke_davis_cook_southwood_blikslager_2018, title={Multicentre, blinded, randomised clinical trial comparing the use of flunixin meglumine with firocoxib in horses with small intestinal strangulating obstruction}, volume={51}, ISSN={0425-1644 2042-3306}, url={http://dx.doi.org/10.1111/evj.13013}, DOI={10.1111/evj.13013}, abstractNote={BACKGROUND
Small intestinal strangulating obstruction (SISO) is associated with endotoxaemia which leads to an increased risk of death. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat signs of endotoxaemia by inhibiting cyclo-oxygenases (COX). COX-1 is expressed constitutively and promotes gut barrier function, whereas COX-2 is inducible and contributes to the signs of endotoxaemia. In preclinical SISO trials, intestinal barrier recovery was more complete with reductions in endotoxin permeability in horses treated with COX-2 selective NSAIDs as compared with horses treated with flunixin meglumine.


OBJECTIVES
We hypothesised that treatment of post-surgical SISO horses with firocoxib (COX-2 selective) would reduce the signs of endotoxaemia to a greater extent than flunixin meglumine (nonselective COX inhibitor) while continuing to provide similar levels of pain control.


STUDY DESIGN
Blinded randomised clinical trial.


METHODS
In addition to clinical monitoring, preoperative and 12-, 24- and 48-h post-operative plasma samples were assessed for prostaglandin E2 (PGE2 ), thromboxane B2 (TXB2 ), TNF⍺ and soluble CD14 (sCD14).


RESULTS
In 56 recruited SISO horses, either flunixin meglumine (1.1 mg/kg, i.v., q12h) or firocoxib (0.3 mg/kg, i.v. loading dose; 0.1 mg/kg, i.v., q24h) was given in the post-operative period in three university hospitals from 2015 to 2017. COX-2 selectivity was confirmed by a relative lack of inhibition of the COX-1 prostanoid TXB2 by firocoxib and significant inhibition by flunixin meglumine (P = 0.014). Both drugs inhibited the COX-2 prostanoid PGE2 . There were no significant differences in pain scores between groups (P = 0.2). However, there was a 3.23-fold increased risk (P = 0.04) of increased plasma sCD14 in horses treated with flunixin meglumine, a validated biomarker of equine endotoxaemia.


MAIN LIMITATIONS
Horses were all treated with flunixin meglumine prior to referral. In addition, many horses were treated with lidocaine, which has been shown to mitigate the deleterious effects of flunixin meglumine.


CONCLUSIONS
In SISO cases, firocoxib reduced a biomarker of endotoxaemia as compared with flunixin meglumine while continuing to provide similar levels of pain control.}, number={3}, journal={Equine Veterinary Journal}, publisher={Wiley}, author={Ziegler, A. L. and Freeman, C. K. and Fogle, C. A. and Burke, M. J. and Davis, J. L. and Cook, V. L. and Southwood, L. L. and Blikslager, A. T.}, year={2018}, month={Sep}, pages={329–335} }
 @article{burke_soma_boston_rudy_schaer_2017, title={Evaluation of the analgesic and pharmacokinetic properties of transdermally administered fentanyl in goats.}, url={https://doi.org/10.1111/vec.12644}, DOI={10.1111/vec.12644}, abstractNote={OBJECTIVE
Evaluate the analgesic properties and pharmacokinetics of transdermal fentanyl patches (TFPs) in goats.


DESIGN
Prospective, randomized study.


SETTING
Preclinical Testing Facility at a University Teaching Hospital.


ANIMALS
Thirty-four adult female Boer-cross goats.


INTERVENTIONS
Goats underwent surgery as part of a concurrent orthopedic research study. Twelve hours prior to surgery, each goat received a TFP (target dosage of 2.5 μg/kg/h), or a placebo patch with analgesia provided by buprenorphine (0.01 mg/kg, IM, q 6 h). Patches were removed after 72 hours. Blood was sampled at specified intervals, up to 84 hours following TFP placement. Plasma concentrations of fentanyl (FEN) were determined using liquid chromatography-mass spectrometry. Postoperative pain assessments were performed by two independent blinded observers.


MEASUREMENTS AND MAIN RESULTS
TFPs were applied at a mean (± standard deviation, SD) dose of 2.54 ± 0.36 μg/kg/h. No adverse events occurred. Pain scores between TFP and BUP groups were not significantly different at any time point. Mean plasma FEN concentration (± SD) 2 hours following patch application was 1.06 ± 0.85 ng/mL, and remained above 0.5 ng/mL for 40 hours. Maximum mean plasma FEN concentration (Cmax ) was 1.84 (ranging from 0.81 to 3.35) ng/mL with average time to maximum concentration (Tmax ) of 12 hours after patch application.


CONCLUSIONS
TFP resulted in consistent FEN absorption and plasma concentrations within the human and ovine therapeutic ranges. Pain scores for goats administered TFP were not different than those administered buprenorphine. Ease of administration, duration of analgesia, and decreased dosing frequency make TFPs an attractive option for pain management in goats.}, journal={Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)}, author={Burke, MJ and Soma, LR and Boston, RC and Rudy, JA and Schaer, Thomas}, year={2017}, month={Sep} }
 @article{burke_parente_2016, title={Prosthetic Mesh for Obliteration of the Nephrosplenic Space in Horses: 26 Clinical Cases}, volume={45}, ISSN={["1532-950X"]}, url={https://doi.org/10.1111/vsu.12434}, DOI={10.1111/vsu.12434}, abstractNote={OBJECTIVE
To report surgical complications, occurrence of post-obliteration colic, long term outcome, and return to previous function for horses treated with prosthetic mesh obliteration of the nephrosplenic space.


STUDY DESIGN
Retrospective study.


ANIMALS
Horses (n = 26) having nephrosplenic space obliteration using prosthetic mesh.


METHODS
Horses undergoing mesh obliteration between January 2006 and May 2013 were included. A Proxplast™ mesh was secured to the nephrosplenic space with titanium helical coils in standing horses using laparoscopic technique. Perioperative data were obtained from the medical record and by telephone followup. Tests of proportion were used to compare the study population to the hospital colic population. Occurrence of colic within 1 year of obliteration was compared between horses where the diagnosis was confirmed at laparotomy and those diagnosed by abdominal palpation per rectum using a Fisher's exact test.


RESULTS
All 26 horses undergoing mesh obliteration during the study period survived to discharge. Long term followup was available for 25 horses, with 23 returning to their previous level of function, and 21 alive at the time of followup. Cause of death was not associated with the surgical procedure in any case. Geldings and Warmbloods were overrepresented compared to the hospital colic population. Ten horses (38%) demonstrated colic after mesh obliteration. All 10 horses were examined by a veterinarian and none were diagnosed with recurrence of nephrosplenic entrapment.


CONCLUSION
Mesh obliteration of the nephrosplenic space is an effective alternative to suture closure for preventing nephrosplenic entrapment of the large colon in horses. No complications related to mesh obliteration were reported in our study population.}, number={2}, journal={VETERINARY SURGERY}, author={Burke, Megan J. and Parente, Eric J.}, year={2016}, month={Feb}, pages={201–207} }
 @article{mackinnon_southwood_burke_palmer_2013, title={Colic in equine neonates: 137 cases (2000-2010).}, url={https://doi.org/10.2460/javma.243.11.1586}, DOI={10.2460/javma.243.11.1586}, abstractNote={OBJECTIVE
To document causes of colic in equine neonates, evaluate clinical features of neonates managed medically versus surgically, determine short- and long-term survival rates for neonates with specific medical and surgical lesions, and assess ability of patients to achieve intended use.


DESIGN
Retrospective case series.


ANIMALS
137 client-owned equine neonates (< 30 days old) with a history of colic or signs of colic within 1 hour after hospital admission examined between 2000 and 2010.


PROCEDURES
Signalment, history, results of physical examination, laboratory data, ancillary diagnostic tests, details of treatment, primary diagnosis, concurrent diseases and short-term survival rate were obtained from the medical records. Long-term follow-up information was obtained through phone survey.


RESULTS
137 neonates with colic were included. The majority (122 [89%]) of neonates were managed medically. The 3 most common diagnoses associated with colic were enterocolitis (37 [27%]), meconium-associated colic (27 [20%]), and transient medical colic (26 [19%]). The most common reason for surgery was small intestinal strangulating obstruction, and these neonates were more likely to have severe, continuous pain and were less responsive to analgesics. Concurrent diseases were common (87 [64%]) but did not significantly impact survival rate. Short-term survival rate was not significantly different between medically (75%) and surgically (73%) managed neonates. Long-term survival rate was excellent (66/71 [93%]) for horses that survived to hospital discharge. Most neonates surviving to maturity were used as intended (49/59 [83%]).


CONCLUSIONS AND CLINICAL RELEVANCE
Most neonates examined for signs of colic can be managed medically. Short-term survival rate in medically and surgically treated neonates was good. Long-term survival rate of foals discharged from the hospital was excellent, with most achieving intended use.}, journal={Journal of the American Veterinary Medical Association}, author={Mackinnon, MC and Southwood, LL and Burke, MJ and Palmer, JE}, year={2013}, month={Dec} }