Bilateral ovarian adenocarcinoma in a mare causing haemoperitoneum and colic.

CASE HISTORY: A 13-year-old Thoroughbred mare was presented with a history of mild colic over 3 days. This colic had acutely exacerbated and was unresponsive to analgesic treatment, and was referred to Massey University Veterinary Teaching Hospital. CLINICAL FINDINGS: On examination the heart rate was 100 beats per minute, and mucous membranes were pale and tacky. A large mass was detected on transrectal palpation in the caudal abdomen to the left of midline. Explorative laparotomy revealed severe haemoperitoneum and several masses that were associated with the reproductive tract. The mare was then subject to euthanasia. On post-mortem examination, adjacent and attached to each ovary were soft, lobulated dark red masses up to 200 mm in diameter. Similar masses were present in the omentum and on the peritoneal surface of the diaphragm and the serosa of the spleen and liver. Histopathology revealed that the neoplastic component of the masses comprised proliferating cuboidal to columnar cells forming disorganised acini and cords separated by dense collagenous stroma. Immunohistochemistry showed the neoplastic cells were positive for cytokeratin AE1/AE3 and vimentin, but negative for cytokeratin 7 and inhibin α. DIAGNOSIS: Bilateral ovarian adenocarcinoma with transcoelomic metastasis and terminal decompensation due to rupture of a neoplastic mass and consequent haemoperitoneum. CLINICAL RELEVANCE: To the authors' knowledge, bilateral ovarian adenocarcinoma has not been previously reported in a horse. Ovarian adenocarcinoma should be considered when horses present with haemoperitoneum and colic. Further research is required on the immunohistochemical differentiation of adenocarcinoma of ovarian and intestinal origin in the horse.

Investigation into the morphology of the third metacarpal bone in the horse.

AIMS: To describe key morphological attributes of the third metacarpal bone (Mc3) of horses and to determine whether or not the symmetry of the Mc3 varied significantly between limbs of the same horse. METHODS: Ten pairs of metacarpi were collected from slaughter facilities. The age and breed of the horses were recorded. Fixed points and axes that could be easily reproduced between bones were identified on high-quality photographic images of each bone. Using image analysis, three angles were measured. Angle gamma measured the rotation around the long axis of the diaphysis of Mc3, angle delta the angle between the dorsal long axis of the cannon bone and the surface of the condyle of Mc3, and angle theta the angle between the surface of the condyle and the long axis of the sagittal ridge of the condyle of Mc3. These angles represent some of the characteristic morphologic relationships within the equine Mc3. RESULTS: The coefficient of variation for angles gamma, delta and theta and were 1.2%, 0.2% and 0.5%, respectively. Angle gamma was larger in the left compared with the right limb (p=0.041). Angles delta and theta were larger in the right compared with the left limb (p=0.001 and p=0.003, respectively). There was a single outlier in a left limb for angle gamma. When this was excluded from the analysis, angle gamma in the left limb was still larger than in the right limb. Angle delta was consistently greater than 90° in 19/20 metacarpi. CONCLUSIONS: There were significant morphological differences in the Mc3 between the left and right limbs of the 10 horses examined. These findings provide some reliable reference data for future investigation. Further work is required to document these differences in a larger population of horses and to determine whether the morphology of the Mc3 is influenced by age or other factors such as use of the animal.

Multi-drug-resistant Enterococcus spp. as a cause of non-responsive septic synovitis in three horses.

CASE HISTORY: Three Thoroughbred horses, a 6-week-old filly (Case 1), a 15-year-old broodmare (Case 2) and a yearling filly (Case 3), sustained synovial sepsis secondary to trauma. CLINICAL FINDINGS: Case 1 presented with a heel bulb laceration communicating with the distal interphalangeal joint. Arthroscopic lavage was performed and treatment commenced using systemic and local broad spectrum antimicrobial drugs. A pure growth of multi-drug-resistant (MDR) Enterococcus gallinarum was cultured from samples of synovium and joint fluid. Antimicrobial treatment was changed according to the susceptibility results. Response to treatment was poor and despite repeat arthroscopic lavage and intra-osseous regional perfusion of antimicrobials the filly was subject to euthanasia 24 days after the initial injury. Post-mortem examination confirmed septic synovitis, cartilage degeneration and osteomyelitis. Case 2 sustained a full thickness wound to the carpus which was sharply debrided and closed. The wound dehisced with effusion within the tendon sheath. Drainage was established and treatment included systemic broad spectrum antimicrobials, topical lavage with povodine-iodine and manuka honey infusion. A mixed infection including MDR Enterococcus faecalis was cultured from the synovial fluid. Antebrachiocarpal joint effusion developed 21 days after initial injury and joint sepsis was confirmed. Arthroscopic lavage and tendon sheath debridement were performed, followed by treatment with systemic and local antimicrobials. The mare improved and was discharged. Three months later lameness recurred and corticosteroids were administered intra-articularly. The mare became non-weight bearing lame and was subject to euthanasia. Post-mortem examination confirmed joint sepsis of the antebrachiocarpal and intercarpal joint. Case 3 presented with a complete articular open fracture of the tibial crest. Under general anaesthesia the fracture was stabilised and the wounds debrided and closed. Systemic broad-spectrum antimicrobials were administered. Six days later the wound dehisced and a bone fragment was removed. Three weeks post-surgery the wound deteriorated with a purulent discharge. Culture of the discharge revealed a mixed bacterial infection, including a MDR Enterococcus faecalis. Femoropatellar joint involvement was confirmed, and treatment included joint lavage, local and systemic antibiosis, and manuka honey instilled into the wound. The filly initially improved, and then deteriorated such that euthanasia was performed. DIAGNOSIS: All three cases had synovial sepsis with MDR Enterococcus spp. CLINICAL RELEVANCE: Increased awareness of MDR pathogens in equine wound infections is essential. Prompt diagnostic testing, appropriate therapy, infection control strategies and on-going monitoring and management are vital to limit the clinical impact of these organisms.

Granulosa theca cell tumour in a pregnant mare: concentrations of inhibin and testosterone in serum before and after surgery.

CASE HISTORY: A 14-year-old Thoroughbred mare was presented for evaluation of a rapidly enlarging ovary at 73 days gestation. The mare's owner reported behavioural changes in the mare since she returned from stud, notably aggression towards other horses. CLINICAL FINDINGS: Transrectal palpation and ultrasonography of the reproductive tract revealed a viable pregnancy, an enlarged, multiloculated right ovary, and a normal-sized left ovary with a corpus luteum present. Concentrations of inhibin and testosterone in serum were 13.8 ng/mL and 1,150 pg/mL, respectively, being markedly higher than reference ranges. Concentration of progesterone was 4.5 ng/mL, consistent with the presence of functional luteal tissue. A presumptive diagnosis of a granulosa theca cell tumour (GTCT) was made, and the ovary was surgically removed. Histopathological examination of the removed ovary confirmed a benign GTCT. At 31 days after surgery concentrations of inhibin in serum had decreased 18-fold, and testosterone had decreased 10-fold. Pregnancy was reconfirmed at 115 days gestation by rectal palpation and transrectal ultrasonography. DIAGNOSIS: Granulosa theca cell tumour associated with elevated concentrations of inhibin and testosterone in serum. CLINICAL RELEVANCE: While ovarian enlargement and aggressive behaviour may be considered normal in some pregnant mares, a GTCT should be included as a differential diagnosis. Measurement of concentrations of inhibin and testosterone in serum are useful to support a presumptive diagnosis of GTCT in mares.

Neurectomy of the deep branch of the lateral plantar nerve can cause neurogenic atrophy of the muscle fibres in the proximal part of the suspensory ligament (M. interosseous III).

Neurectomy of the deep branch of the right lateral plantar nerve was performed on a single healthy mature horse. Six weeks after surgery, the horse was subjected to euthanasia and both hind suspensory ligaments harvested. The cross sectional area of the muscular part of the proximal part of the suspensory ligament was measured and assessed for morphological abnormalities in a blinded fashion. There was a clear difference in cross sectional area of the muscular part between treated and control ligament and there was profound neurogenic atrophy of the muscular fibres in the treated ligament.

Arthrodesis of the talocalcaneal joint for the treatment of two horses with talocalcaneal osteoarthritis.

Two horses with lameness due to tolocalcaneal osteoarthritis that failed to respond to conservative management were treated by tolocalcaneal arthrodesis using cortex screws placed in lag fashion. The affected joint of one horse was arthrodesed by compressing and stabilizing the medial facet of the joint with three screws. In the second horse, the medial and lateral facets of the affected tolocalcaneal joint were each compressed and stabilized with two screws. The lameness of both horses improved markedly following surgery.

Characterization of glutathione amide reductase from Chromatium gracile. Identification of a novel thiol peroxidase (Prx/Grx) fueled by glutathione amide redox cycling.

Among the Chromatiaceae, the glutathione derivative gamma-l-glutamyl-l-cysteinylglycine amide, or glutathione amide, was reported to be present in facultative aerobic as well as in strictly anaerobic species. The gene (garB) encoding the central enzyme in glutathione amide cycling, glutathione amide reductase (GAR), has been isolated from Chromatium gracile, and its genomic organization has been examined. The garB gene is immediately preceded by an open reading frame encoding a novel 27.5-kDa chimeric enzyme composed of one N-terminal peroxiredoxin-like domain followed by a glutaredoxin-like C terminus. The 27.5-kDa enzyme was established in vitro to be a glutathione amide-dependent peroxidase, being the first example of a prokaryotic low molecular mass thiol-dependent peroxidase. Amino acid sequence alignment of GAR with the functionally homologous glutathione and trypanothione reductases emphasizes the conservation of the catalytically important redox-active disulfide and of regions involved in binding the FAD prosthetic group and the substrates glutathione amide disulfide and NADH. By establishing Michaelis constants of 97 and 13.2 microm for glutathione amide disulfide and NADH, respectively (in contrast to K(m) values of 6.9 mm for glutathione disulfide and 1.98 mm for NADPH), the exclusive substrate specificities of GAR have been documented. Specificity for the amidated disulfide cofactor partly can be explained by the substitution of Arg-37, shown by x-ray crystallographic data of the human glutathione reductase to hydrogen-bond one of the glutathione glycyl carboxylates, by the negatively charged Glu-21. On the other hand, the preference for the unusual electron donor, to some extent, has to rely on the substitution of the basic residues Arg-218, His-219, and Arg-224, which have been shown to interact in the human enzyme with the NADPH 2'-phosphate group, by Leu-197, Glu-198, and Phe-203. We suggest GAR to be the newest member of the class I flavoprotein disulfide reductase family of oxidoreductases.

[A clinical observation as example and proof of functional adaptation of bone through longitudinal growth]. / Eine klinische Beobachtung als Beispiel und Beweis für funktionelle Anpassung des Knochens durch Längenwachstum

The history of the case and findings and follow-up in radiographs when submitted to analysis of the mechanical forces, are an example and proof for : 1. the fact that, in compression forces overlayed by flexion forces, the tension on the pressure aspect of flexion is always larger than on the extension side, since on the flexion side it is the sun of, on the extension side the difference between, the two tensions which are active. 2. Ossification and bone absorption are steered by the amount of tension and will be the greater, the more the tensions exceed or fall short of the "required" tensions which maintain the balance between ossification and bone absorption during the continuous restructuring of bone. 3. In epiphyseal cartilage which physiologically is purely subject to pressure, longitudinal growth will increase when flexion forces overlay on the pressure side where tensions are greatest. This will automatically exclude the overlaying flexion forces.