Controversies in Equine Medicine and Surgery

Preface
A n d N o w f o r So m e t h i n g
C o m p l e t e l y D i ff e r e n t : S o m e
Controversies in Equine Medicine,
S u r g e r y, a n d R e p r o d u c t i o n

Robert J. MacKay, BVSc (Dist), PhD

Editor

It has been an honor and privilege to be able to recruit distinguished authors from
among multiple disciplines to contribute to this issue and to superintend their manu-
scripts through to publication. The process has been an unusual challenge as this issue
is not primarily a series of state-of-the-art reviews, as is the usual custom. Rather, with
the help and advice of consulting editor, Tom Divers, I have for each article selected an
element of a topic that is controversial, not universally agreed upon, or otherwise un-
clear. The purpose is to analyze the available evidence through the lens of each au-
thor’s special expertise in order to provide some definition and clarity to the topic or
at least explode a few myths. The first 6 articles are about effectiveness of certain treat-
ments; the next one deals with diagnosis; then 2 articles make arguments as to the
importance (or not) of the particular topic, and the final 2 articles explore controversial
aspects of pathophysiology.
I hope some of the questions addressed in these articles will resonate with readers.
Thumbnail questions are summarized here in the order they appear in the table of con-
tents. Sarcoid is the most common cutaneous tumor of equids, but many treatments
lack rationale or evidence of effectiveness. Have molecular and technical innovations
led to progress in treatment? Knottenbelt. Head shakers are easy to diagnose but
notoriously difficult to treat. Will some version of transcutaneous electrical nerve stim-
ulation (TENS) provide a reliable and long-term solution? Pickles. Following small intes-
tinal surgery, it is common practice to infuse lidocaine to prevent or treat ileus. Is
postoperative ileus an important problem, and, if so, is lidocaine effective therapy?
Freeman. Extraction of retained fetal membranes is not straightforward. Is there a

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simple and effective way to do it? Burden, Meijer, Pozor, and Macpherson. Interbody
vertebral fusion is a well-established but lightly used treatment for wobblers that is
performed now much as it was in the 1980s. Is there anything new on the horizon?
Pezzanite and Easley. Grayness and melanomas of horses are genetically linked. Is
there an effective way to manage these tumors? MacKay. Seasonally adjusted refer-
ence ranges, effects of stress and feeding on results, stimulations versus constitutive
values: Can endocrine disorders be reliably diagnosed? McFarlane. There is now a
wealth of epidemiologic analyses relating to exercise-induced pulmonary hemorrhage
(EIPH). Are conclusions based on these data definitive, and is there consensus on the
clinical consequences of EIPH? Crispe. News of scary-sounding hepatitis viruses has
burst onto the scene, but are these viruses a serious threat? Tomlinson, Van de Walle,
Divers. Theories as to the cause or causes of dummy foals seem to have dichotomized
into perinatal deprivation versus endocrine immaturity. Can these both be right, and, if
so, what is the relationship between the 2 theories? Toribio. Most readers have seen
sophisticated diagrams showing networks of mediators and events underlying each of
the laminitis types, namely, sepsis-associated, endocrinopathic, and (to a lesser
extent) supporting limb. Do these networks overlap, and are there implications for pre-
vention and treatment? Van Eps and Burns.
Finally, I would like to thank all the authors for their excellent contributions, and Tom
Divers and the staff at Elsevier for their help in putting this issue together.

Robert J. MacKay, BVSc (Dist), PhD

Large Animal Clinical Sciences
University of Florida
PO Box 100136
Gainesville, FL 32610, USA
E-mail address:
mackayr@ufl.edu