Introduction Equine glandular gastric disease (EGGD) is a common condition causing signs of gastric pain although lesions are highly variable in their appearance. The only definitive method to diagnose EGGD ante‐mortem is gastroscopy. The current recommended method for describing these lesions is the European College of Equine Internal Medicine (ECEIM) guidelines; however, repeatability between users is variable. This study aimed to validate the reliability of lesion descriptions using ECEIM consensus guidelines, using four blinded equine internal medicine diplomates. Methods Ninety‐two horses with EGGD with pre‐ and post‐treatment gastroscopy images were identified using the electronic record at a UK equine hospital between 2012 and 2019. Eight horses were excluded due to non‐diagnostic images. Four blinded observers used the recommended grading system to describe images and outcomes. Intraclass correlation coefficients and Krippendorff's alpha were used to determine reliability and agreement, respectively. Results Intraclass correlation coefficient for severity was 0.782 (95% confidence interval [CI] 0.722–0.832), for distribution was 0.671 (95% CI 0.540–0.763), for the descriptor raised was 0.635 (95% CI 0.479–0.741), fibrinosuppurative was 0.745 (95% CI 0.651–0.812), haemorrhagic was 0.648 (95% CI 0.513–0.744), hyperaemic was 0.389 (95% CI 0.232–0.522) and for outcome was 0.677 (95% CI 0.559–0.770). Krippendorff's alpha for severity was 0.466 (95% CI 0.466–0.418), for distribution was 0.304 (95% CI 0.234–0.374), for the descriptor raised was 0.268 (95% CI 0.207–0.329), fibrinosuppurative was 0.406 (95% CI 0.347–0.463), haemorrhagic was 0.287 (95% CI 0.229–0.344), hyperaemic was 0.112 (95% CI 0.034–0.188) and for outcome was 0.315 (95% CI 0.218–0.408). There was moderate reliability determined between observers using intra‐class correlation coefficients and unacceptable agreement determined between observers using Krippendorff's alpha. Discussion These results suggest that the current grading system is not comparable between observers, indicating the need to review the grading system or define more robust criteria.

BackgroundTeaching and learning how to perform examination of the ocular fundus is challenging. Smartphones can support to enhance students’ confidence and experience.MethodsFollowing an optional year-4 ophthalmoscopy practical using hand-held ophthalmoscopes, students completed a questionnaire using a visual analogue scale (VAS) investigating if students felt smartphone use aided learning and if student’s self-assessed confidence in visualising the ocular fundus had improved. VAS scores were compared using the Wilcoxon signed rank test (significance: P<0.05).ResultsAll 30 year-4 students attending the practical participated to the study. Confidence in performing direct ophthalmoscopy significantly increased after the practical. Confidence after the practical was 65.3 (±19.8) per cent compared with before the practical when confidence was 20.1 (±15.6) per cent (P<0.001). The perceived usefulness of traditional teaching was 62.3 (±23.8) per cent. The perceived usefulness of the teaching with the smartphone was 91.1 (±8.6) per cent. While students found both methods useful, they perceived the use of the smartphone to be significantly more useful (P<0.001). Free-text comments on the use of the smartphone were all positive and included ‘useful’, ‘fun’ and ‘good teaching tool’.ConclusionsThis study shows that students positively received the use of the smartphone, which can be a useful tool to teach the equine ocular examination to undergraduate veterinary students.

Background: There is currently a lack of evidence surrounding the factors that contribute towards a clinician's decision to discontinue non-steroidal anti-inflammatory drug (NSAID) administration during the post-operative period following equine colic surgery, as well as the drugs and dosages commonly administered to these patients.Objectives: To survey clinicians involved in the care of colic patients as to their use of NSAIDs and to investigate the factors associated with the decision to discontinue their administration.Study design: An online questionnaire was created using Jisc Online Surveys, designed to record information about the use of NSAIDs by equine clinicians who regularly manage post-operative colic patients. Methods:The questionnaire was distributed to boarded equine veterinarians from the

<p><strong>PICO question</strong></p><p>In three day event horses, does biannual routine influenza vaccination compared to annual routine influenza vaccination reduce performance levels?</p><p><strong>Clinical bottom line</strong><strong><br /> </strong></p><p>There is no evidence that biannual equine influenza vaccination compared to annual booster vaccination in three day event horses is associated with reduced performance.</p><p>A group of five studies published over an 11 year period from one were evaluated. In adult warmblood horses there is weak evidence that exercise in the 28 day period post booster vaccination for equine influenza and equine herpes virus 1 and 4 (EHV1&amp;4), is associated with changes in physical and clinical pathophysiological parameters including total red blood cell (RBC) count, neutrophil and lymphocyte count, fibrinogen concentration and serum proteins. These changes occurred at variable time points in the 14 days post exercise and values were not outside the published reference ranges for the reporting laboratories where published. Athletic performance of the horses was not evaluated.</p><p>No recommendations for equine influenza vaccination protocols in three day event horses can be made from the evidence.</p><p> </p><p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" /></p>

Background Equine glandular gastric disease (EGGD) is a common condition of the horse. Misoprostol is reported to be superior to oral omeprazole and sucralfate for treatment. Long‐acting intramuscular injectable omeprazole (LAIOMEP) is a novel treatment shown to be effective in a small population. Objectives This study aimed to determine LAIOMEP efficacy compared to misoprostol and oral omeprazole and identify characteristics that predict treatment outcome. Methods All horses that underwent gastroscopy between 2012 and 2019 were reviewed. Lesions were characterised by 4 blinded observers, all of whom are diplomates in equine internal medicine, using established descriptors from the ECEIM consensus statement and subjective severity. Treatment outcome was ranked as worsened, improved or healed. Consensus lesion type, lesion severity and treatment choice were compared to outcome and data screened using univariate analysis (chi‐squared) to determine whether each predicted outcome. Lesion types where univariate analysis predicted a trend ( p <0.2) were included in a multiple‐regression analysis to identify predictors of outcome irrespective of treatment. Results Only severity significantly predicted final outcome ( p = 0.025) with severe lesions being more likely to improve. Treatment choice did not significantly predict outcome. Overall healing rate was 29% (24 horses), and 43% (44 horses) improved. Treatment healing rates were 23% (10), 12% (7) and 27% (7) for LAIOMEP, misoprostol and oral omeprazole, respectively, with improvement in 69% (14), 76% (21) and 61% (9). 64% of the latter group received sucralfate. Worsening occurred in 7% (6). Treatment length varied with a median of 4 weeks (range 4–20 weeks). Conclusions This study showed poorer therapy outcome compared to previous studies. The only initial lesion descriptor to predict outcome was severity and treatment choice did not affect outcome.