Risk factors associated with cast complications in horses: 398 cases (1997–2006)

John C. Janicek, Scott R. McClure, Timothy B. Lescun, Stefan Witte, Loren Schultz, Carly R. Whittal, Canaan Whitfield-Cargile
January 1, 2013
Journal of the American Veterinary Medical Association

Objective—To determine the frequency of and risk factors for complications associated with casts in horses.

Design—Multicenter retrospective case series

Animals—398 horses with a half-limb or full-limb cast treated at 1 of 4 hospitals

Procedures—Data collected from medical records included age, breed, sex, injury, limb affected, time from injury to hospital admission, surgical procedure performed, type of cast (bandage cast [BC; fiberglass tape applied over a bandage] or traditional cast [TC; fiberglass tape applied over polyurethane resin-impregnated foam]), limb position in cast (flexed, neutral, or extended), and complications. Risk factors for cast complications were identified via multiple logistic regression.

Results—Cast complications were detected in 197 of 398 (49%) horses (18/53 [34%] horses with a BC and 179/345 [52%] horses with a TC). Of the 197 horses with complications, 152 (77%) had clinical signs of complications prior to cast removal; the most common clinical signs were increased lameness severity and visibly detectable soft tissue damage Cast sores were the most common complication (179/398 [45%] horses). Casts broke for 20 (5%) horses. Three (0.8%) horses developed a bone fracture attributable to casting Median time to detection of complications was 12 days and 8 days for horses with TCs and BCs, respectively. Complications developed in 71%, 48%, and 47% of horses with the casted limb in a flexed, neutral, and extended position, respectively. For horses with TCs, hospital, limb position in the cast, and sex were significant risk factors for development of cast complications.

Conclusions and Clinical Relevance—Results indicated that 49% of horses with a cast developed cast complications.