Management of Subchondral Lucencies of the Medial Aspect of the Equine Antebrachiocarpal Joint.

The objective of this study is to describe the management and outcomes of eight horses with subchondral lucencies (SCLs) of the medial aspect of the antebrachiocarpal (ABC) joint. The medical records and radiographs of the carpi of 8 horses with SCLs of the medial aspect of the ABC joint were reviewed. Follow-up clinical information was obtained for 6-60 months (the median duration of 14 months). Treatment was successful if radiographic healing was apparent or lameness was reduced or eliminated. Four horses had SCLs in the distomedial radius (DMR) and four in the proximal aspect of the radiocarpal bone (RCB). Lameness was present in all horses with DMR SCLs and in one horse with an RCB SCL. Treatments included restriction of exercise (n = 3), intra-articular administration of corticosteroids (n = 2), or placement of a screw across the SCL (n = 3). Exercise restriction alone was successful in three nonlame horses younger than one year with proximal RCB SCL and intra-articular corticosteroid administration in the ABC joint in two horses aged 2 years or younger with DMR SCLs. A yearling with a large proximal RCB SCL and two horses aged 5 years or older with DMR SCLs were successfully treated with screw placement across the SCL. Exercise restrictions and intra-articular administration of corticosteroids were successful in management of DMR SCLs in five horses. Placing a screw across the SCL of three horses resulted in resolution of lameness and substantial improvement of the radiographic appearance of the lesion in the RCB or DMR.

Subchondral lucencies of the proximal tibia in 17 horses.

OBJECTIVE: To describe subchondral lucencies (SCL) in the equine proximal tibia, several treatment options, and clinical outcomes. STUDY DESIGN: Retrospective study. ANIMALS: Seventeen horses with proximal tibial SCL. METHODS: Medical record and radiograph review. Follow-up was obtained via examination and radiography when possible and by telephone and race records when required. The median duration of follow-up was 20 months (range, 0-48). RESULTS: Proximal tibial SCL were associated with lameness in 14 of 17 horses. Subchondral lucencies were primary in 11 horses and secondary to an ipsilateral medial femoral condyle SCL in six horses. One foal with a primary SCL was euthanized because of osteomyelitis. Six horses ≤1 year old with primary SCL were managed with exercise restrictions only; SCL in three horses without lameness decreased in size, whereas three horses with lameness did not improve. One young horse treated with surgical debridement failed to improve and was euthanized. Lameness resolved in three horses with primary tibial SCL treated with screw fixation. Screw fixation of secondary SCL in five horses led to a reduction in SCL size and degree of lameness. CONCLUSION: Primary tibial SCL healed with rest in 3 non-lame young horses with small SCL, but was not successful in lame horses with larger SC. Radiographic size and associated lameness improved or resolved with screw fixation in primary and secondary proximal tibial SCL. CLINICAL SIGNIFICANCE: Primary tibial SCL that did not cause lameness healed with conservative management, but persistent primary and secondary tibial SCL required screw fixation to reduce lameness.

Nocardia arthritidis infection in the distal metaphysis of the metatarsal III and IV bone of a heifer.

CASE DESCRIPTION: A 19-month-old 536.4-kg (1,180-lb) Brown Swiss heifer was referred for evaluation of a firm swelling over the distal aspect of the right metatarsal region and chronic lameness in the right hind limb. CLINICAL FINDINGS: Examination of radiographs of the right metatarsophalangeal joints revealed an expansile, smoothly marginated, cyst-like lesion within the distal metaphysis of the metatarsal III and IV bone. Differential diagnoses included bone abscess, bone cyst, aneurysmal bone cyst, neoplasia, osteomyelitis, and metabolic bone disease. Aerobic microbial culture of the aspirate yielded moderate growth of branching, gram-positive, rod-shaped bacteria, which were presumptively identified as Nocardia spp. The isolate was subsequently identified as Nocardia arthritidis by 16S rRNA gene sequence analysis. TREATMENT AND OUTCOME: The lesion was surgically debrided, lavaged, and bandaged. Exercise was restricted, and systemic and local administration of antimicrobials was instituted. After a communication between the abscess and the metatarsophalangeal joints was iatrogenically created, the extralabel use of aminoglycosides was initiated. The heifer had noticeable clinical improvement within 2 weeks after initial evaluation and reportedly had no evidence of lameness and minimal external blemishes 3 months after the second evaluation. CLINICAL RELEVANCE: To our knowledge, this is the first report on the diagnosis and management of a long-bone abscess attributable to N arthritidis infection in cattle. Complications encountered during treatment and the decision to engage in extralabel use of antimicrobial agents in the heifer described here may serve as a guide for food animal practitioners faced with the treatment of valuable cattle.

Primary mandibular hemangiosarcoma in a bull.

Disseminated pulmonary and subcutaneous-muscular hemangiosarcoma at the left hemimandible was diagnosed postmortem in a 2-year-old Jersey bull that presented with a 7-day history of facial swelling from suspected traumatic injury. Hemangiosarcoma is uncommon in cattle and has never been reported to affect the bones of the skull.

Molecular identification of Phialophora oxyspora as the cause of mycetoma in a horse.

CASE DESCRIPTION: An 18-year-old mare was evaluated for an oral mass that developed after extraction of a broken incisor. CLINICAL FINDINGS: An ulcerated, firm, darkly pigmented, approximately 5-cm-diameter spherical mass involved the gingiva lateral and dorsal to the right first to third maxillary incisors. Osteolysis of the roots of the first and second right maxillary incisors and periosteal proliferation of the adjacent premaxilla margins were apparent on radiographs. Histologic examination of the mass revealed multiple coalescing and ramifying foci of abscess formation, each containing a well-defined, discrete, black mass (2 to 7 mm in diameter). Myriad fungal hyphae enmeshed in a black, granular, cementlike material were within each of the black structures. Mycetoma was the histologic diagnosis. The causative agent could not be identified via culture because of lack of distinguishing characteristics. Fungal DNA was isolated from frozen fungal cultures and paraffin sections. The D1/D2 domains of the large subunit P gene rDNA were amplified and sequenced. The sequences of the D1/D2 domains of both isolates were 96% homologous with those of Phialophora oxyspora. TREATMENT AND OUTCOME: The mass was surgically excised, the local area curetted, and the wound allowed to heal by second intention. Postoperative treatment consisted of administration of phenylbutazone and IV administration of sodium iodide followed by oral administration of potassium iodide. There was no evidence of recurrence 1 year later. CLINICAL RELEVANCE: Mycetomata should be a differential diagnosis for equine gingival masses. Identification of the fungal agent can be critical for selection of optimal treatments. Molecular methods may permit definitive identification when standard phenotypic-based identification criteria are inconclusive.