Evaluation of Risk Factors Associated with Cast Complications in Horses: 398 Cases (1997-2006)

Cast complications occur in 50% of cases. Bandage casts have fewer complications, and casting the limb flexed increases complications. Authors’ addresses: Department of Veterinary Medicine and Surgery, University of Missouri, 900 East Campus Drive, Columbia, MO 76227 (Janicek and Whittal); Department of Veterinary Clinical Sciences, Iowa State University, 1600 South 16th Street, Ames, IA 50011-1250 (McClure); Department of Veterinary Clinical Sciences, Purdue University, 625 Harrison Street, West Lafayette, IN 47907 (Lescun); and Department of Large Animal Medicine, University of Georgia, 501 DW Brooks Drive, Athens, GA 30602 (Witte and Whitfield). e-mail: jcjanicek@ yahoo.com.

1. Introduction

Complications associated with casting are recognized. Limited data are available about incidence and risk factors of cast complications. The objective of this study was to identify complications and risk factors for cast complications.

2. Materials and Methods

This study was a multicenter retrospective case series involving 398 horses with half- or full-limb casts. Medical records were reviewed, and data, including signalment, initial problem, limb affected, reason for casting, type of cast, limb position, and complications were recorded. Multiple logistic regression was used to assess associations between variables and incidence of complications. 

3. Results

In 49.5% of horses, a cast complication occurred. Complications occurred in 34% of bandage casts and 52% of traditional casts. Of 197 horses with complications, 77% exhibited clinical signs, most commonly increased lameness and visible sores. Cast sores were the most common complication (45%); 5% of the casts broke, and 0.7% of horses developed a secondary fracture. The median time to complications being noted was 12 days for traditional casts and 8 days for bandage casts. Limbs cast in a flexed position had complications 71% of the time compared with neutral (48%) and extended (47%) positions. Institution (0.014), cast type (0.001), and limb position (0.016) were found to be significant factors for developing complications.

4. Discussion

Results indicate that nearly one-half of all equine patients requiring cast application will encounter some type of cast complication. Limbs cast in a flexed position had complications 71% of the time compared with neutral (48%) and extended (47%) positions. Cast complications occur in 50% of the cases. Bandage casts have fewer complications, and casting the limb flexed increases complications.