Factors Affecting Complication Rates with Subpalpebral Lavage Catheter Use in Horses

Abstract

Reasons for performing study Subpalpebral lavage ( SPL ) systems are commonly used to facilitate treatment of ophthalmic conditions in the horse, are placed in differing positions and are associated with various complications. Objectives To evaluate differences in complication rates between SPL placement in the upper vs. lower eyelid and factors associated with development of complications. Study design Retrospective, clinical study. Methods Clinical records from the Royal Veterinary College (2000–2013) were evaluated. Data collated included age, breed, sex, clinician, training, ophthalmic condition, pharmacological agents administered, catheter position, duration of placement, where the catheter was managed (hospital/home) and any complications observed. Data was initially interrogated using chi‐squared tests and then binary logistic regression models built to evaluate these factors. Results Data was obtained from 135 horses aged 6 days to 30 years. Duration of SPL was 3–60 days (median 8; IQR 7–15). Complication rates were lowest for medicine residents (10%), when compared with interns (42%), medicine clinicians (27%) and surgeons (16%). There was no difference in complication rate between SPL management at home (15.4%) compared with the hospital (16.1%; P = 0.94). Position of catheter placement was influenced by stage of training (P = 0.04; boarded clinicians were more likely to place in lower eyelid) and associated with duration of treatment (P = 0.03; longer treatment times with SPL s in upper eyelid). Complications were associated with catheter position (P = 0.03; upper 12.8%; lower 22.2%), antimicrobial administration (P = 0.008; 13.2% when used; 25.0% when not) and plasma administration (P = 0.004; 30.4% when used; 13.0% when not). Conclusions Subpalpebral lavage placement in the upper eyelid was associated with fewer complications. Use of antimicrobials appeared protective against complications and plasma should only be administered when indicated as it was associated with increased complications. Ethical animal research: This project was reviewed by the University of Nottingham Ethics and Welfare Committee. Explicit owner informed consent for inclusion of animals in this study was not stated. Source of funding: None. Competing interests: None declared.