Peri-anaesthetic complications in 1798 equids undergoing high-field elective orthopaedic MRI at a tertiary referral hospital.
Authors: Manning Heath, Sampson Sarah
Journal: Equine veterinary journal
Summary
# Editorial Summary: Peri-anaesthetic Complications in Equine Orthopaedic MRI Whether systemically healthy horses, mules, and donkeys genuinely require antimicrobial prophylaxis during elective orthopaedic MRI under general anaesthesia remains contentious in equine practice, particularly given the potential for unnecessary medication to cause adverse effects. Heath and Sampson examined 1655 cases across an 11-year period at a tertiary referral centre, comparing complication rates in animals that received no peri-anaesthetic antimicrobial cover against established clinical expectations. Only 25 animals (1.5%) experienced post-operative complications; post-anaesthetic fever occurred in 11 cases (0.7%), with just four progressing to pneumonia and one showing respiratory herpesvirus infection, whilst transient femoral neuropathy and mild self-resolving colic each affected seven animals (0.4%), and notably, no deaths or euthanasias resulted from anaesthetic-related complications. These findings suggest that prophylactic antimicrobials may be unnecessary in fit, healthy performance and sport horses undergoing routine orthopaedic MRI, potentially reducing unnecessary antibiotic exposure and associated risks such as dysbiosis and antimicrobial resistance. Whilst the retrospective design and incomplete records limit definitive conclusions, the low complication rate provides reassurance for practitioners considering omitting antimicrobial prophylaxis in this specific low-risk scenario—though individual risk stratification remains important for systemically compromised or elderly animals.
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Practical Takeaways
- •Peri-anaesthetic antimicrobial prophylaxis appears unnecessary for healthy horses, mules, and donkeys undergoing elective orthopaedic MRI, reducing unnecessary antibiotic use and associated risks
- •Expect post-anaesthetic complications in fewer than 2% of cases, with fever being most common but rarely progressing to serious respiratory infection
- •Monitor for transient neurological and gastrointestinal complications post-anaesthesia, which typically resolve with conservative management in systemically healthy patients
Key Findings
- •Only 1.5% (25/1655) of equids undergoing elective orthopaedic MRI without peri-anaesthetic antimicrobial prophylaxis experienced complications
- •Post-anaesthetic fever occurred in 0.7% of cases, with only 0.2% progressing to pneumonia
- •Transient femoral neuropathy and mild colic each occurred in 0.4% of cases and resolved with medical management
- •No horses died or required euthanasia, suggesting elective MRI under general anaesthesia without prophylactic antibiotics is safe for systemically healthy equids