2022 AAEP Agreement: Handling MFC SCLs

There are examples of out-of-the-box thinking throughout San Antonio, Texas, as well as at the 2022 AAEP Convention, where María Isabel Calero, DVM, presented a practical solution to a common problem in equine medicine: retarded IUD transcondylar placement for the treatment of MFC SCLs. iStock/Sean Pavone

Huh, who would have thought?

Part V: “Out of the Box” Edition

In this latest installment of Who’d Have Thought 2022, I present four San Antonio-specific examples of how you can think outside the box to solve various problems.

Remember the Alamo by proxy

The Alamo, as we discussed in the first part of this series, the home of the Texas Revolution of 1836, is a major tourist attraction in San Antonio. Historians have gone to great lengths in the upkeep of the church and long house, numerous statutes, history fence, and more. Since there could be various reasons why you can’t visit the Alamo IRL (in real life), you can see a 63-square-foot miniature replica of the Alamo made from 50,000 Legos. This plastic masterpiece is a creative way to save people from walking 100 meters to the actual Alamo (maybe due to bad weather?). Notice in this image a close-up of the actual Alamo’s reflection through the entrance to the Crockett Building where the Lego structure is located.

Protect property in public places

What’s the best way to beautify the neighborhood, celebrate the season, and keep personal belongings safe from theft and damage? This sassy barrier should do the trick!

Giving purpose to San Fernando Cathedral

I stumbled upon a Van Gogh-style immersive experience at Main Plaza in the heart of San Antonio. It’s a so-called light show saga Viewed on San Fernando Cathedral. The exhibit depicts the discovery, settlement, and development of San Antonio. Fun and worthwhile, yes, but perhaps an odd solution to the problem, “Hey, what should we do with the oldest continuously operating cathedral in the United States?”

At the 2022 AAEP Conference, María Isabel Calero, DVM, of Alamo Pintado Equine Medical Center in California presented a practical solution to a common problem in equine medicine: transcondylar delayed IUD placement for the treatment of medial subchondral femoral cysts (MFC SCLs). It’s clearly a more pressing problem than the above examples but still requires outside-the-box thinking.

Calero and colleagues report in their proceedings summary that SCLs occur in 1.7-3.6% of Thoroughbreds and 10-13.6% of Quarterhorses. Transcondylar lag screws are already being used clinically. However, long-term data are not available to fully assess effectiveness or make clinical recommendations. Moreover, there are no head-to-head comparisons between other techniques, such as exercise restriction, synovial and intralesional steroid injections, arthrotomy with cyst debridement, and endoscopic cystectomy.

Calero et al. Retrospective data from 58 quarter horses (but 69 stifles, as some horses were affected bilaterally) were reviewed. They were 1-7 years old with MFC SCLs who were treated with delay screws through the center of the lesion.

Results

A successful outcome was the horses returning to their previous activity level, performing as intended, or the horses not performing but performing normally on the recheck tests. The treatment was successful on 46 out of 58 horsepower and 57 out of 69 throttles.

There was a successful outcome in 100% of horses 5 years of age or older.

“This shows that even older horses diagnosed with MFC SCLs have a chance of a successful outcome,” said Calero.

The study followed horses from less than a year to seven years old. Reported good long-term results. For example, the treatment was 100% successful in the six horses at a 5-year follow-up, according to the study authors.

“Even the highest-scoring horses (on a scale of 1-5) had successful results,” Calero said.

She added, “For the 10 horses that underwent follow-up radiology, an average reduction of 47% in cyst size and a minimum of 22% was observed. This indicates that cyst size reduction can be achieved using this technique.”

A study on last-minute claudication at the 2022 AAEP Annual Conference

I was inspired by the quality and quantity of continuing education offered by AAEP. So, I decided to conduct my impromptu study at the 2022 conference. It was a prospective observational study of nearly 3,000 equine practitioners and paraprofessionals. The study rated lameness according to the AAEP lameness scale from 0-5.

The main finding was that 65.5% of the general population was frail.

The results identified at least 5 cases of claudication of the fifth degree and about 1568 cases of claudication of the first degree. Primarily noticed these instances revolve around coffee stations. Although not the most prevalent, a significant proportion of the observed lameness cases were of grades 2, 3 and 4 (n = 398). Includes 125 class 4 scores.

The limitations of the study were: it was conducted by a single observer over the course of only five days; Subjects in walking other than walking were not examined; No flexion tests were performed; Diagnostic analgesia was considered unethical in this setting. All subjects were lost to follow-up.

As Laurie Bidwell, DVM, pointed out in her presentation Perform horse pain management“Horses shouldn’t be in pain. It should be our job to avoid injury to horses. If we see occupational soreness, we need to manage it. I don’t call it pain management. I call it performance management.”

Treatment of Occupational Pain in Equine Veterinary Medicine in the 2022 AAEP Convention

The message of this unpublished study is that equine veterinarians need to address their professional pain. We’ve seen the impact of chronic pain on horses. We need to defend our physical and mental health to avoid the same outcome. The AAEP Wellness website contains valuable resources on physical and mental health. These resources can help us achieve and maintain healthy lifestyles for longer, more productive careers and personal lives.

Yoga is another great way to gently soothe sore muscles and make time for a mindfulness practice. This year’s AAEP Wellness Program was sparse, due to a lack of interest. Help restore yoga in 2023 by contacting AAEP today!

Brought to you by ADM Cellarator Advantage

Exercise demands are stressors on a horse’s performance. Hard work can overwhelm the body’s natural ability to deal with oxidative stress, which can damage muscle proteins, lipids and DNA, release pro-inflammatory cytokines that lead to muscle pain, and damage the mitochondrial membrane which reduces energy production. Cellarator Advantage RECOVERY+ by ADM Animal Nutrition™ is designed to help the performance horse resist the stress of exercise. To learn more, go to go.adm.com/recovery and come visit the ADM experts at AAEP, Booth #17095.

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