To start off the next section, Prof. Debra Archer from Liverpool illustrated the microbial changes within the equine intestine which occur seasonally as well as due to various disorders and pointed out the future potential of using this knowledge for prevention. However, she took a sceptical position towards the prebiotics which are currently on the market as there is too little scientific evidence for their benefit as yet. Furthermore, she promoted careful use of antibiotics as these have marked effects on the intestinal flora. She also presented methods of preventing incisional infections after abdominal surgery. The two presentations by Cornélie Westermann from Utrecht also focussed on prevention, first of atypical myopathy by avoiding the ingestion of sycamore and then by reducing dust in the stable in order to prevent pulmonary disease. Dr. Andy Durham from Liphook Equine Hospital in Britain reflected on the numerous possible causes and resulting diagnostic challenges of pyrexia as well as on the relevance of moderately elevated liver values in healthy horses, which may be overrated as they can also be influenced by other factors, e.g. exercise or gastric ulcers.
After the lunch offered by Tiermedizin Hochmoor in celebration of their 50th anniversary, Prof. Michael Schramme from Lyon University provided the veterinarians with practical treatment options for traumatic injuries of the hoof wall and pointed out the important positive impact of cast immobilisation on the outcome. Dr. Francesca Beccati from Perugia und Dr. Ina Lorenz addressed the diagnostics of cervical vertebrae using x-ray and the relatively novel standing CT. The latter requires further development but nonetheless offers an interesting perspective for the diagnosis of changes in this area. Afterwards, the French colleague Dr. Fabrice Rossignol showed impressive techniques for the surgical fixation of cervical vertebrae fractures beforeDr. David Lichtenberg, Hochmoor, presented a study on the significance of radiographic findings in the area of the thoracic and lumbar spine of unridden young horses. In his second presentation, Prof. Schramme reflected on stem cell therapy and pointed out that next to still insufficient scientific evidence, there is no legal basis for veterinarians for the use of stem cells unless these have been acquired and processed by the veterinarian him-/herself.
On the occasion of the 50th anniversary of the Tiermedizin Hochmoor, a section with historical references concluded the first conference day. Firstly, Dr. Niels Henrik Huskamp presented an overview of the development of equine medicine since the 1960s, before Prof. Norbert Kopf from Vienna, companion of the founder of the hospital Dr. Bernhard Huskamp, gave a very personal and entertaining review of the development of ileus surgery, in which Dr. Huskamp Sen. and the Tiermedizin Hochmoor played a leading role in the 1970s. After Prof. Michael Röcken had presented an outlook into the future of equine surgery which he sees in technology complementing human potential with limitations due to rising costs, the first conference day ended with a sociable champagne reception.
On Saturday, laminitis was the first topic on the programme, with Dr. Eberhard Schüle stressing the importance of due diligence in diagnosis and treatment of this disease and particularly the necessity of taking x-rays to correctly assess the progression of disease. Prof. Karsten Feige from Hanover clearly illustrated the pathogenesis and diagnostics of laminitis due to endocrinological disorders, before Gerhard Assmann from Opfenbach critically reflected on the principles of treatment of acute and chronic laminitis in comparison between Germany and the Anglo-American literature. He also pointed out the important role of Dr. Bernhard Huskamp, who 30 years ago, after years of practical experiments with his own patients, called for frog support and the removal of load from the dorsal hoof wall by applying so-called „laminitis casts“, especially in the acute phase of the disease. In his well-illustrated presentation on diagnosis and treatment of keratoma, Prof. Christopher Lischer from Berlin University also addressed the likelihood of recurrence which can be assessed by histological examination of resected tissue. This was followed by a lively debate on the treatment of laminitis with the practitioners, but also among the speakers, which once more highlighted the relevance of this topic in practice. Dr. Matthias Rettig’s presentation with results on the influence of mild sedation on the motion sequence of lame horses may facilitate practitioners’ decision to use mild sedation during diagnostic anaesthesia. Dr. Mark Meijer from Utrecht also sparked great interest among the participants with his strikingly easy and low-risk method for the treatment of Retentio secundinarum using water infusion into the umbilical vessels.
During the second section, Dr. Anne Schreier, Dr. Saskia Walther and Dr. Leendert-Jan Hoflandcompared the systems of equine insurance in Great Britain, Germany and the Netherlands and Dr. Daniel Meister stressed the significance of a fair cooperation between veterinarians and insurance companies, which is essential for the system to work. During the following panel discussion, there was a lively exchange of ideas, especially since there were also some representatives from insurance companies in the audience. A higher proportion of insured horses also in Germany (78% in Great Britain) would certainly offer some advantages for veterinarians, such as billing a solvent partner with the insurance company. However, there are also risks involved, especially since clients are often not aware of the coverage of their insurance. In this context, the GOT (German scale of charges and fees for vets) was also criticized as it was considered out of date and thought to hamper consistent billing. Experts presented the prospect of a rise in GOT rates, however the GOT may have to be abolished medium-term due to EU regulations.
After lunch, Dr. Michael Stettner’s presentation on the most common issues regarding pharmacy management and inspection may have caused a few practitioners to critically assess their pharmacy management as mistakes are easily made during everyday practice. Then, Dr. Kathrin Mählmann, Dr. Stefan Tietje and Stefan Lumpe once again focused on some orthopaedic topics (endoscopy of the navicular bursa, fetlock joint) before Dr. Willy Neumann, Hochmoor, presented new surgical techniques for the treatment of corneal lesions using tissue glue, corneal transplants and corneal cross-linking which were met with great interest by the participants.
The last section addressed the judgement of the Federal Supreme Court of Germany and its implications for veterinarians as well as the classification of radiographic findings according to the Radiography Guidelines which always sparks controversial discussions. Dr. Schüle promised a reviewed version of the Radiography Guidelines in the near future. Lawyer Dr. Burkhard Oexmann first provided an insight into current jurisdiction, where he pointed out that in terms of informing, documentation and evidence, equine practitioners are meanwhile equated to human doctors which leads to his call for drawing up a catalogue of veterinary treatment rules. He illustrated the legal risks which veterinarians currently expose themselves to when they issue a pre-purchase examination report (contract to produce a work) due to the classification of radiographic findings according to the Radiography Guidelines. Afterwards, Prof. Röcken, Gießen University, compared the aims and the actual results of the introduction of the Radiography Guidelines for pre-purchase examinations. On the one hand, quality of radiographs and their assessment has improved during the past 20 years due to provision of defined criteria. However, he also pointed out the difficulty of classifications in the field of orthopaedics, as issues are often quite complex. He thus postulated that the radiographic classifications should be abolished without substitution, in which about 70% of attendees agreed with him during a spontaneous vote. However, there were also different opinions among the colleagues, who argued in favour of maintaining the assessment of radiographs according to Radiography Guidelines. This was subject to intensive discussion, notably there were repeated calls for placing higher emphasis on clinical examination during pre-purchase examinations instead of focusing on the radiography classifications which in the end are not very conclusive in terms of the horse’s future health. Overall, the topic of radiographic classification remains controversial and there are high expectations as to what news the pending review of the Radiography Guidelines might bring.
With this up-to-date discussion, the XXII. Tagung über Pferdekrankheiten came to an end. We hope that once again our participants were content and could take home a lot of valuable stimuli for their work.
We thank our speakers for their willingness to share their knowledge with all of us employing time and effort, and of course also our participants whom we hope to welcome again at the XXIII. Tagung über Pferdekrankheiten on 15 and 16 March 2019.