Peri-anaesthetic complications in 1798 equids undergoing high-field elective orthopaedic MRI at a tertiary referral hospital

Background: Antimicrobial prophylaxis for elective orthopaedic magnetic resonance imaging (MRI) in equids is a topic of debate among practitioners and can have negative detrimental effects on patients if used unnecessarily. Objectives: To describe the complications with elective orthopaedic MRI of horses, mules, and donkeys under general anaesthesia without the use of peri-anaesthetic antimicrobial prophylaxis at a single large tertiary referral centre. We hypothesised that horses, mules, and donkeys undergoing general anaesthesia for elective orthopaedic MRI, without antimicrobial prophylaxis, will not be at increased risk of complications, including increased risk of infectious respiratory disease. Study design: Retrospective cross-sectional study. Methods: This retrospective study of 1798 systemically healthy equids that underwent elective orthopaedic MRI under general anaesthesia without peri-anaesthetic antimicrobial prophylaxis between January 2009 and May 2020. Results: A total of 1655 MRIs were included in the study, with 25 (1.5%) horses having complications. The most common complication was post-anaesthetic fever in 11 (0.7%) horses, of which 4 (0.2%) horses went on to develop pneumonia and one horse was diagnosed with equine herpesvirus (respiratory). Seven (0.4%) horses developed transient post-anaesthetic femoral neuropathy and 7 (0.4%) horses had mild post-anaesthetic colic that resolved with initial medical management. No horses were euthanised or died in this study. Main limitations: The retrospective nature of the study led to non-randomised case selection, and some records were incomplete. Conclusions: These findings suggest that peri-anaesthetic antimicrobial prophylaxis may not be necessary for performance and sport horses undergoing general anaesthesia for elective orthopaedic MRI.