Journal watch1 April 2026
Author(s): C.J. Morales and L.R.R. Costa
Published in: Veterinary Clinics of North America: Equine Practice
Date: July 2025
DOI: https://doi.org/10.1111/vec.70001
Type of access: Requires membership/payment (click for full article)
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Our summary
The aim of this review article was to describe the possible complications for common equine diagnostic procedures. For each procedure, the authors explore common complications by covering causes, prevention tactics, clinical signs and treatment options, while also documenting rarer reported complications.
The review starts by considering gastrointestinal procedures including nasogastric intubation, gastroscopy, abdominocentesis, transrectal palpitations, rectal biopsy, and liver biopsy. The first three procedures have minimal rates of complications if executed with proper technique. A table with guidance on stopping epistaxis is provided. For rectal biopsies and liver biopsies, the section offers information on the management and prognosis of rectal tears, and treatment options for haemorrhage.
The respiratory procedures evaluated by the article are bronchoalveolar lavage, transtracheal wash, guttural pouch lavage, and lung biopsy. Minimal complications are reported for the first three procedures. Regarding lung biopsy, the authors recommend that the procedure should always be performed in hospital settings due to the risk of complications such as pulmonary haemorrhage, and provide suggestions for diminishing complication rates. The article also highlights that the risk of severe complications is increased when a manual Tru-Cut needle is used as opposed to an automated biopsy needle.
The neurologic diagnostic procedures covered were cerebrospinal fluid (CSF) collection and myelography. The article compares the possible complications for three approaches to CSF: atlanto-occipital taps, ultrasound-guided C1-C2 cervical taps, and lumbosacral taps. For myelography, the article discusses the reported 32% rate of complications, including seizures and worsening of neurological signs, leading to newer techniques such as standing computed tomography being considered preferable.
The urologic diagnostic procedures covered were urethral catheterisation, cystourethroscopy, and renal biopsy. The first two procedures have minimal associated complications when performed correctly. The authors identify haemorrhage as a potential complication for renal biopsies, with intraabdominal haemorrhage being the most common complication and haemorrhage caused by the inadvertent puncture of the renal artery also being a risk.
Limitations include the lack of an explicit methodology section and explicit grading of the evidence.
Take home
This article provides guidance on possible complications associated with equine diagnostic procedures in order to help practitioners in assessing the risk of these procedures and preparing for different scenarios. It also highlights haemorrhage as a common complication across procedures and stresses the importance of performing more complication-prone procedures such as lung biopsies in hospital settings.
The following may also be of interest
McMaster, M. et al. (2015) Equine rectal tears. Equine Veterinary Education, 27 (4), pp. 209-208. https://doi.org/10.1111/eve.12266
Byrne, C.A. (2025) Challenges and complications of prolonged nasogastric intubation in equine patients. Equine Veterinary Education, 37 (2), pp. 65–67. https://doi.org/10.1111/eve.14066
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