Vetnews | Julie 2024 12 « BACK TO CONTENTS Perioperative inflammatory reaction, inflammation resolution and wound healing: the effects of Tr14 Melanie Christiane Wergin Heel GmbH, Baden- Baden, Germany After any trauma an inflammatory reaction is initiated and only after resolution of the inflammation the tissue can start to heal. The trauma can either be a blunt trauma such as a strain or sprain, or it can be a trauma with tissue disruption causing an open wound. Especially in open wounds a fast wound closure is essential to prevent bacterial infection, a feared complication. A well-orchestrated wound healing can thereby avoid antibiotic over usage by preventing bacterial infection. In horses, it is well known that there is a high risk of complications after wounding or surgery. Even standard procedures such as castration of stallions have a risk of post-surgical complications. Castration induces an acute phase response (APR) and an exuberant inflammatory response. Serum Amyloid-A (SAA) is a well-studied major acute phase protein (APP) that can be used to monitor the acute APR. SAA has been shown to be a good marker for the development of post-surgical complications. A randomized, double-blinded study in stallions, monitored before and after castration, demonstrated that the natural medicinal product Tr14 seemed to have proresolving effects, shown by a lowered amplitude and duration of the SAA increase. Tr14 had also significantly lower wound healing complications compared to a NSAID group, and Tr14 had no kidney associated side effects, making Tr14 a valuable and well tolerated treatment option to reduce the APR induced by castration. This presentation will give an overview on the efficacy of Tr14, focusing on recent research in mice and horses covering preclinical and clinical aspects. The preclinical studies will give insights in the mode of action of Tr14, showing the beneficial effect on inflammation resolution and wound healing. Diagnostic analgesia: the distal limb Erin K Contino Colorado State University, Colorado, USA Before embarking on diagnostic analgesia (aka diagnostic blocking) it is important to understand that lameness needs to be repeatable and/or consistent enough to reliably be able to detect a difference after blocking. Thus, it can be beneficial to determine the scenario in which the horse is most lame and then subject that horse to that exact scenario after each block. It should also be recognized that some horses that are not visibly lame may have a behavioural oddity in hand or under saddle that can be diminished with diagnostic blocking. Another important concept to keep in mind is that diagnostic blocking is not as specific as once believed. It is becoming increasingly clear that diagnostic analgesia can desensitize remote structures and the foot is no exception. Typically, diagnostic blocking is performed from the bottom up, meaning that one would start blocking as distal as possible. In the foot, this usually means starting with a palmar digital (PD) nerve block which blocks the palmar third of the foot and the sole. A PD nerve block can variably block the distal interphalangeal joint and in some cases, can even block as high as the metacarpo-/ metatarso-phalangeal joint! A recent study showed that diffusion from a PD nerve block is lessened with use of a tourniquet around the pastern region. Moving proximally, some practitioners elect to perform a ‘pastern ring block’ but most often an abaxial and/or basisesamoid nerve block is placed next. This block will reliably desensitize the remainder of the foot, including the distal interphalangeal and proximal interphalangeal joint. Intra-articular analgesia is typically considered more specific than perineural blocks but can also desensitize unintended structures. In the foot, the distal interphalangeal joint is the most commonly blocked structure but does also desensitize the navicular bursa. Interestingly, blocking the navicular bursa does not tend to desensitize the distal interphalangeal joint. Anatomically, the digital tendon sheath also extends into the foot so is another synovial structure that could block certain structures that extend into the foot. 39th World Veterinary Association Congress, Cape Town, 16-19 April 2024 (Continued)
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