Summary The objectives of this study were to compare horses’ gaits in hand and when ridden; to assess static and dynamic saddle fit for each horse and rider; to apply the Ridden Horse Pain Ethogram (RHpE) and relate the findings to gait abnormalities consistent with musculoskeletal pain, rider position and balance and saddle fit; and to document noseband use and its relationship with mouth opening during ridden exercise. Data were acquired prospectively from a convenience sample of horses believed by their owners to be working comfortably. All assessments were subjective. Gait in hand and when ridden were evaluated independently, by two assessors, and compared using McNemar’s test. Static tack fit and noseband type were recorded. Movement of the saddle during ridden exercise, rider position, balance and size relative to the saddle was documented. RHpE scores were based on assessment of video recordings. Multivariable Poisson regression analysis was used to determine factors which influenced the RHpE scores. Of 148 horses, 28.4% were lame in hand, whereas 62.2% were lame ridden (P<0.001). Sixty per cent of horses showed gait abnormalities in canter. The median RHpE score was 8/24 (interquartile range 5, 9; range 0, 15). There was a positive association between lameness and the RHpE score (P<0.001). Riding School horses had higher RHpE scores compared with General Purpose horses (P = 0.001). Saddles with tight tree points (P = 0.001) and riders seated at the back of the saddle rather than the middle (P = 0.001) were associated with higher RHpE scores. Horses wearing crank cavesson compared with cavesson nosebands had higher RHpE scores (P = 0.006). There was no difference in mouth opening, as defined by the RHpE, in horses with a noseband with the potential to restrict mouth opening, compared with a correctly fitted cavesson noseband, or no noseband. It was concluded that lameness or gait abnormalities in canter may be missed unless horses are assessed ridden.
Such behaviours may be exhibited in anticipation of musculoskeletal pain during ridden exercise, which may be associated with ill-fitting tack in some horses.• Owners need to be made aware that these behaviours are not normal and may be a manifestation of underlying problems.
Proximal suspensory desmopathy (PSD) is a common cause of hindlimb lameness in sports horses; anecdotally there is an association with straight hock conformation. The objective of this prospective observational study is to describe hindlimb conformation in horses with and without bilateral PSD. Horses examined over one year with a definitive diagnosis for lameness (based on clinical assessment, response to diagnostic anaesthesia, radiography, ultrasonography AE MRI or scintigraphy), were included (n = 193). Markers were placed on predefined landmarks. Lateral photographs were acquired from the left and right sides with the horse standing squarely, using standardised techniques, with each metatarsus perpendicular to the ground, aligned to the tuber ischii marker. Before data acquisition, repeatability studies for marker placement, horse positioning and angle measurements were performed. The tarsal and metatarsophalangeal angles were measured using Image Measurement. Orthopaedic diagnosis, breed, work discipline, weight, height and age were recorded. Z-tests, Fisher's exact tests, Chi-squared tests and multivariable logistic regression were used to determine the associations between diagnosis, tarsal angles and possible confounding variables. Mann Whitney U tests were used to evaluate the relationship between metatarsophalangeal joint angle and suspensory ligament injury. Horses with PSD had larger tarsal angles than controls (P = 0.003). The proportions of Warmblood-type horses and dressage horses with PSD were different to those of other breeds and work disciplines (P = 0.001, 0.02 respectively). A final logistic regression model demonstrated a significant effect of mean tarsal angle on outcome when breed and weight-height product were accounted for. There was a an 11% increase in the odds of PSD for every degree increase in tarsal angle (CI 1.006-1.223, P = 0.04). There was no association between suspensory ligament injury and metatarsophalangeal joint angle. Assessment of tarsal angles at prepurchase examinations and prior to surgical treatment of PSD may be advisable.
Learning theories are abstract descriptions which help us make sense of educational practice. Multiple theories can inform our understanding of a single concept, in this case: veterinary workplace clinical training (WCT), which occurs just prior to students' graduation as competent veterinary surgeons. The competency movement has strongly influenced reforms in veterinary education and is considered important. In reflection of this, the term “preparedness” is operationalised here as a measure of the likelihood that the veterinary student is going to be a competent learner and participant during WCT. Preparedness itself is therefore important because it directly impacts performance. Workplace clinical training is explored through the lenses of cognitivist, social constructivist and socio-culturalist learning theories and used to inform student preparedness characteristics (“tools”) in terms of their behaviours, personal attributes, knowledge and skills, and awarenesses to optimise learning and participation. These form a new conceptual framework—the “Preparedness Toolkit.”
Background The success of workplace clinical training (WCT) is important given that veterinary students are licensed to work independently upon graduation. Considering this, it is perhaps surprising that there is limited published work describing what it means to be prepared for this educational experience, particularly given that the transition to WCT can be stressful for students. This paper reports the results of a qualitative study aiming to generate a rich understanding of veterinary student preparedness for WCT using emic, or insider, perspectives of key stakeholders. Methods From a constructivist standpoint, homogenous online group interviews were held with final year veterinary students, recent student alumni, clinical supervisors, faculty, and academic educationalists to discuss what it means to be prepared for WCT. The data was analysed using a template analysis approach. Results A three-tier taxonomy to describe preparedness for WCT was constructed from the data. At the topmost level, there were seven themes to illuminate different aspects of preparedness: students should be prepared 1) for the transition to learning and working in a clinical and professional environment, 2) for self-directed and experiential learning whilst working, 3) with a growth mindset, 4) with intrinsic motivation and enthusiasm for learning and working, 5) for communication, consultation and clinical reasoning, 6) with the knowledge for work, and 7) with the practical competence and confidence for work. Conclusions This study provides a deeper understanding of the tools we can provide, and the attributes we can nurture in, senior veterinary students to facilitate their learning and working during WCT. This improved understanding is a necessary precursor to refining pedagogical support and curriculum design within veterinary schools.
Background: There is a lack of understanding of the pathological and/or physiological nature of lumbosacral region pain.Objectives: To describe the gross variations of the osseous and soft tissues of the lumbosacral region and report the histological findings of sections of nerve tissue in affected and control horses. Study design:Descriptive post-mortem case series.Methods: All horses had undergone full clinical and gait assessment, including ridden exercise. Horses with a substantial response to infiltration of local anaesthetic solution around the sacroiliac joint regions were included in the affected group (n = 27).Horses for which the source(s) of pain was confirmed by diagnostic anaesthesia to be distant to the lumbosacral region were included in the control group (n = 5). The pelvic regions were isolated and the soft tissues were assessed grossly. Sections of the lumbosacral plexus and cranial gluteal, sciatic and obturator nerves were examined histologically. The osseous specimens were evaluated for anatomical variants and abnormalities. Data were analysed using descriptive statistics.Results: Gross discolouration of the sciatic or obturator nerves was observed in 7 (26%) affected and no control horses. Grade 3/3 histological abnormality scores were assigned in 22% of nerve sections from affected horses compared with 3% from control horses.Several osseous variants (bifid sacral spinous processes, straight-shaped sacroiliac joint surface, short arrow-shaped sacral alae, left-right asymmetry of sacral alae, sacral curvature, absence of the fourth to fifth and ankylosis of the fifth to sixth lumbar articular process joints, left-right asymmetry of caudocranial position of the fourth to fifth and lumbar-sacral articular process joints) and abnormalities (sacroiliac enthesopathy, extra ventral sacroiliac joint surface, lumbosacral symphyseal periarticular modelling, lumbosacral intertransverse joint pitting lesions) were more frequently observed in affected horses. Main limitations:Both control and affected horses may have had preclinical abnormalities.Conclusions: Lumbosacral region pain may reflect the presence of a number of pathological changes. Neural pain may play an important role in some horses.
Summary Background Reasons for abnormal behaviour during tacking‐up and mounting are poorly documented. Objectives To relate behavioural abnormalities during tacking‐up or mounting to epaxial muscle hypertonicity or pain, girth region hypersensitivity, ill‐fitting tack, rider position and balance, or equine musculoskeletal pain. Study design Prospective observational study; convenience sample of 193 horses. Methods The behaviour of horses in a stable or tied up was observed for ≥8 min before systematic palpation of the thoracolumbosacral and girth regions. Owners were asked to tack‐up and mount using their normal regime. A purpose‐designed protocol for assessment of behaviour during tacking‐up and mounting was applied. Lameness was evaluated in‐hand and during ridden exercise. Static and dynamic saddle‐fit were assessed. A static saddle‐fit score was the sum of any saddle‐fit abnormality. Rider position in the saddle, balance and size relative to the saddle were evaluated during ridden exercise. Multivariable negative binomial regression modelling was used to assess the relationship between the sum of tacking‐up and mounting behaviours and horse, rider and tack‐fit variables. Results Riding School horses comprised only 12% of the sample population, but had higher rates of abnormal behaviours during both tacking‐up (P<0.0001) and mounting (P = 0.007) compared with General Purpose horses. The rate of abnormal behaviour during tacking‐up for horses with moderate or severe lameness was 1.4 times higher (P = 0.02) than for nonlame horses. Horses with lameness in‐hand or ridden had 1.5 times higher rates of abnormal behaviour during mounting than nonlame horses. Tight tree points (P = 0.03) and epaxial muscle pain (P<0.001) were associated with higher behaviour scores during tacking‐up. Higher static saddle‐fit scores were associated with higher behaviour scores during mounting. Main limitations Oral examination was not performed. Conclusions The display of many behaviours during tacking‐up or mounting is likely to reflect lameness or tack‐associated discomfort. Owners must be better educated to recognise these behaviours.
The public health implications of the Covid-19 pandemic have caused unprecedented and unexpected challenges for veterinary schools worldwide. They are grappling with a wide range of issues to ensure that students can be trained and assessed appropriately, despite the international, national, and local restrictions placed on them. Moving the delivery of knowledge content largely online will have had a positive and/or negative impact on veterinary student learning gain which is yet to be clarified. Workplace learning is particularly problematic in the current climate, which is concerning for graduates who need to develop, and then demonstrate, practical core competences. Means to optimise the learning outcomes in a hybrid model of curriculum delivery are suggested. Specific approaches could include the use of video, group discussion, simulation and role play, peer to peer and interprofessional education.
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