Dermoid cysts formation is a complication of wound pinch grafting in a horse: A case report.

OBJECTIVES: To describe dermoid cyst formation as an uncommon complication of the pinch grafting technique in horses. STUDY DESIGN: Case report. ANIMAL: A 8 year old Arabian gelding. METHODS: Clinical presentation, imaging, treatment, and histopathology records were reviewed. The horse originally presented due to delayed healing of a laceration to the distal aspect of the metatarsus. The wound was treated initially with debridement and it was allowed to fill with healthy granulation tissue prior to pinch grafting. Two months after grafting, the horse started to show self-mutilation behavior targeting the wound site. Ultrasonographic examination revealed the presence of cystic lesions in the subcutaneous tissue in the wound bed and adjacent to the long digital extensor tendon. RESULTS: Treatment involved surgical excision of the cysts, which resulted in a resolution of the self-mutilation episodes. The specimens were submitted for histopathological investigation, which revealed findings compatible with dermoid cyst formation, suspected to be secondary to the skin-grafting procedure. CONCLUSION: Dermoid cysts formation should be considered as a potential differential diagnosis for skin graft complications in horses.

Allogeneic chondrogenic-induced mesenchymal stem cells for the treatment of tarsometatarsal lameness in horses.

OBJECTIVE: To assess the efficacy of commercial intra-articular blood-derived allogeneic-induced mesenchymal stem cells (CIMSCs) to treat tarsometatarsal lameness in horses. STUDY DESIGN: This was a retrospective cohort study. ANIMALS: Records from 167 adult light breed horses with bilateral tarsometatarsal lameness. METHODS: Horses with tarsometatarsal lameness were retrospectively selected from medical records. Diagnosis followed subjective graded lameness assessment before and after intra-articular analgesia, with graded radiographic tarsal examination. Horses were excluded if they were diagnosed or treated for any other concurrent lameness conditions during the study. Time to last follow-up and time of recurrence of lameness was recorded at veterinary re-assessment. RESULTS: A total of 67 horses were recruited to the CIMSC-treated group and 100 to the corticosteroid (CS)-treated group. Median age was 9 years, with no difference in signalment, use or radiographic grade between groups. First re-examination was 38 days (95% CI: 38-49), with no difference between groups, CIMSC 42 (35-45), control 34 (25-42). Median follow-up was 438 days for CIMSC, 546 for controls. Symptoms of lameness recurred in 86/100 controls compared to 17/67 (25%) CIMSC. Median time to lameness recurring in CIMSC was 336 days (95% CI: 239-400), control 90 days (95% CI: 80-108), p < .0001. Cox proportional hazard ratio for treatment was 8.35, 95% CI: 4.67 to 14.92, p < .0001. CONCLUSIONS: Lameness was abolished in all treated horses. It recurred significantly less often, and later, in CIMSC-treated horses. CLINICAL SIGNIFICANCE: Intra-articular CIMSC treatment results in prolonged soundness in horses with tarsometatarsal lameness.

Administration safety of medical-grade honey (MGH) in septic synovial structures in horses: 3 cases.

The objective of this study was to investigate the postoperative use of intrasynovial honey as an antimicrobial after treatment for synovial sepsis in horses. One colt and 2 mares were presented with acute lameness, with or without an associated wound. All 3 cases were initially managed with surgical endoscopic or tenoscopic debridement and lavage for treatment of different synovial structures. Collection of synovial fluid was consistent with synovial sepsis and this was diagnosed in each case. All horses subsequently underwent arthroscopic lavage under general anesthetic and intraarticular or intrathecal medical-grade honey (MGH) was then instilled. All 3 cases recovered well and were free from lameness at all gaits. Although there is extensive research about the antimicrobial properties of honey and growing interest in the biocompatibility of honey in joints with the use of honey hydrogels in human medicine, the research in veterinary medicine is lacking. There are studies describing the antimicrobial properties of honey in healing wounds in horses, but there are no published studies describing the use of honey within a synovial structure. Further research is necessary to assess the biocompatibility of honey in equine articular cartilage. In the cases described in this article, the use of honey demonstrated a safe adjunctive therapy after conventional surgical treatment for septic arthritis.

L'objectif de cette étude était d'étudier l'utilisation postopératoire du miel intrasynovial comme antimicrobien après le traitement d'une infection synoviale chez les chevaux. Un poulain et deux juments ont été présentés avec une boiterie aiguë, avec ou sans plaie associée. Les trois cas ont été initialement pris en charge par un débridement chirurgical endoscopique ou ténoscopique et un lavage pour le traitement de différentes structures synoviales. La collecte de liquide synovial était compatible avec une infection synoviale et celle-ci a été diagnostiquée dans chaque cas. Tous les chevaux ont ensuite subi un lavage arthroscopique sous anesthésie générale et du miel de qualité médicale (MGH) intra-articulaire ou intrathécal a ensuite été instillé. Les trois cas se sont bien rétablis et étaient exempts de boiterie à toutes les allures. Bien qu'il existe des recherches approfondies sur les propriétés antimicrobiennes du miel et un intérêt croissant pour la biocompatibilité du miel dans les articulations avec l'utilisation d'hydrogels de miel en médecine humaine, la recherche en médecine vétérinaire fait défaut. Il existe des études décrivant les propriétés antimicrobiennes du miel dans la cicatrisation des plaies chez les chevaux, mais aucune étude publiée ne décrit l'utilisation du miel dans une structure synoviale. Des recherches supplémentaires sont nécessaires pour évaluer la biocompatibilité du miel dans le cartilage articulaire équin. Dans les cas décrits dans cet article, l'utilisation du miel a démontré une thérapie d'appoint sûre après le traitement chirurgical conventionnel de l'arthrite septique.(Traduit par Docteur Serge Messier).

Radiographic abnormalities of the thoracolumbar spinous processes do not differ between yearling and trained Thoroughbred horses without perceived back pain.

OBJECTIVE: The purpose of this prospective study was to investigate the prevalence and severity of radiographic abnormalities of the interspinous spaces (ISSs) in the thoracolumbar vertebral column of unbroken yearlings and to compare these findings with a group of older trained Thoroughbred horses without perceived back pain. ANIMALS: Yearlings (n = 47) and trained horses (55); 102 total. PROCEDURES: Each horse underwent a digital radiographic study of the thoracolumbar vertebral column (T7-L3) and each space graded for narrowing of the ISSs, increased opacity, radiolucency, and modeling of the cranial and caudal margins of 2 contiguous dorsal spinous processes (DSPs). This generated both an individual anatomical space score for each space and a total score for each horse for subsequent comparison. Statistical analysis of the results was then undertaken. RESULTS: Narrowing and impingement were detected in a third of the examined ISSs, while DSP increased opacity, radiolucencies, and modeling were found in over half of the yearlings. The median total score per horse was 33 (0 to 96) in the yearlings and 30 (0 to 101) in trained horses, indicating no significant difference in radiographic abnormalities (P = .91). Likewise, the median total score per anatomical space was 112 (25 to 259) and 127.5 (24 to 284) in the yearlings and trained horses (P = .83). No differences were found between the groups for number of radiographic abnormalities, scores, and total score. CLINICAL RELEVANCE: This study reported the incidence of DSP radiographic abnormalities in Thoroughbred horses. The absence of difference in occurrence between yearlings and older horses supported a developmental rather than acquired etiology.

Benefits of cyanoacrylate mesh closure following exploratory laparotomy in horses.

BACKGROUND: Skin closure of laparotomy incisions using topical 2-octyl cyanoacrylate (2-OCA) mesh provides a secure bactericidal barrier in humans, which may reduce the risk of postoperative incisional complications. However, the benefits of using this mesh have not been objectively assessed in horses. METHODS: From 2009 to 2020, three methods of skin closure were used following laparotomy for acute colic, including metallic staples (MS), suture (ST) and cyanoacrylate mesh (DP). The closure method was not randomised. Owners were contacted 3 months or more after the surgery to record any postoperative complications that occurred. For each method of closure, the rates of surgical site infection (SSI) and herniation were recorded, as well as surgical time and treatment costs, including those for incisional complications. Chi-square testing and logistic regression modelling were used to assess differences between the groups. RESULTS: A total of 110 horses were recruited (45 in the DP group, 49 in the MS group and 16 in the ST group) The overall rate of SSI was 15.5%, with rates of 8.9%, 18.4% and 25% for the DP, MS and ST groups, respectively (p = 0.23). In addition, incisional hernias developed in 21.8% of cases, with 8.9%, 34.7% and 18.8% of horses in the DP, MS and ST groups, respectively, being affected (p = 0.009). The median total treatment cost did not differ significantly between groups (p = 0.47). LIMITATION: This was a retrospective study with non-randomised choice of closure method. CONCLUSIONS: No significant differences in the rate of SSI or overall cost wwere demonstrated between treatment groups. However, MS was associated with a higher rate of hernia formation than DP or ST. Despite increased capital cost, 2-OCA proved to be a safe skin closure method in horses and was no more expensive than DP or ST by the time visits to remove sutures/staples and treat infections were factored in.

Treatment of subchondral lucencies in the medial proximal radius with a bone screw in 8 horses.

OBJECTIVE: To describe the results of screw placement through subchondral lucencies (SCL) of the proximal radius in 8 horses. STUDY DESIGN: Retrospective clinical study. ANIMALS: Horses with cubital SCL causing lameness (n=8). METHODS: Medical record review and clinical follow-up. RESULTS: Eight horses with SCL in the proximal radius causing lameness were treated with a screw placed across the lucency. The horses range in age from 1 to 20 years. In 4 of 8 horses, the lameness had been intermittently severe (apparent at the walk). Lameness was isolated to the cubital joint by intra-articular anesthesia in 5 horses and diagnosed radiographically in all 8. All horses had a 4.5 mm cortical bone screw placed from medial to lateral (6 lag, 2 neutral) across the SCL using fluoroscopic or radiographic control. Postoperative care included stall confinement with hand walking for 30-60 days, followed by an additional 30-60 days of pasture turnout. Radiographic SCL healing (reduction in SCL size) was demonstrated at 3-4 months after surgery in all horses, and 7/8 horses (87.5%) were used as intended (4 performance, 3 pasture turn-out) within 6 months. Lameness in the remaining horse improved initially (dressage) but returned. CONCLUSIONS: A screw placed through the SCL of the proximal-medial radius was effective in reducing or resolving lameness associated with the elbow joint in 7/8 horses (88%). Screw placement in the proximal radius should be considered for horses with lameness caused by an SCL when a quick return to exercise is desired or conservative therapy is ineffective.

A controlled study evaluating a novel surgical treatment for kissing spines in standing sedated horses.

OBJECTIVE: To compare the results of a novel minimally invasive surgical technique with intralesional corticosteroid medication, as treatment for overriding dorsal spinous processes (ORDSP) in horses. STUDY DESIGN: Retrospective controlled clinical case series. ANIMALS: Horses (n = 68) with ORDSP. METHODS: ORDSP was diagnosed based on history, clinical, and radiographic examination. All narrowed spaces were treated. Horses undergoing medical treatment had methylprednisolone acetate injected directly in the affected space under radiographic control. Surgical cases had interspinous ligament desmotomy (ISLD) using Mayo scissors; supraspinous ligaments were left intact. All horses had the same controlled exercise plan and returned to work 3-6 weeks after treatment. RESULTS: Methylprednisolone was administered in 1-7 spaces in 38 cases, compared with ISLD in 3-8 spaces in 37 cases. Thirty-four horses (89%) treated medically initially resolved signs of back compared with 35 horses (95%) treated surgically. From these, back pain recurred in 19 medical cases and in none of the surgical cases. Horses having ISLD were 24 times more likely to experience long-term resolution of signs of back pain (OR 24; 95%CI: 5-115; P = < .0001). Repeat radiographs in 19 surgical cases indicated that interspinous spaces widened significantly postoperatively (P = < .0001). CONCLUSIONS: This surgical technique allowed horses with back pain and radiographic ORDSP to return to work without further clinical signs of back pain and to show radiographic evidence of improvement.

Repulsion of maxillary and mandibular cheek teeth in standing horses.

OBJECTIVE: To report the technique and results of cheek teeth repulsion in standing, sedated horses. STUDY DESIGN: Case series. ANIMALS: Horses (n = 12), ponies (6). METHODS: Medical records (2006-2009) of horses that had cheek tooth repulsion while standing were reviewed. Inclusion criteria included: maxillary or mandibular cheek tooth disease diagnosed by clinical and radiographic examination where attempted oral extraction failed necessitating repulsion. Horses were sedated and a local nerve block performed. Intraoperative radiographs facilitated instrument positioning and ensured repulsion of all dental remnants. Alveolar cavities were packed postoperatively and secondary dental sinusitis treated with lavage. RESULTS: Median horse age was 7 years (range, 1-30 years). Maxillary (n = 15) and mandibular (5) cheek teeth were removed successfully. One horse was euthanatized 1 week after tooth removal because of concurrent liver disease and 10 horses (59%) had resolution of discharge after the 1st treatment; 41% of extractions required follow-up medical or surgical treatment to resolve signs [6/12 maxillary sinusitis and 1/5 persistent mandibular drainage]. CONCLUSIONS: Standing repulsion of diseased and fractured cheek teeth is an effective means of resolving clinical signs of dental disease when oral extraction fails. Chronic sinus involvement increased the risk of postextraction surgical treatment for sinusitis.

Computed tomography to identify preoperative guidelines for internal fixation of the distal sesamoid bone in horses: an in vitro study.

OBJECTIVE: To assess the reliability of computed tomography (CT) to identify the direction of implant insertion for cortical screws along the longitudinal axis of intact (nonfractured) distal sesamoid bones. STUDY DESIGN: In vitro study. SAMPLE POPULATION: Cadaveric paired equine forelimbs (n=16). METHODS: Insertion of a cortical screw in lag fashion along the longitudinal axis of intact (nonfractured) distal sesamoid bones was evaluated in 2 groups (3.5 and 4.5 mm) of 8 paired limbs. In each group, the direction of the distal sesamoid bone was determined by CT (Equine XTC 3000 pQCT scanner). Screw placement was verified by specimen dissection. Implant direction was considered satisfactory if the entire screw length was within the distal sesamoid bone and not damaging the articular or flexural surfaces. RESULTS: In our sample and according to our criteria, the proportion of satisfactory direction of screws was 0.63 (5/8) for 4.5 mm implants, and 0.87 (7/8) for 3.5 mm implants. CONCLUSIONS: CT is a useful imaging modality to identify anatomic landmarks for insertion of a 3.5 mm cortical screw in the distal sesamoid bone.