External transcutaneous ultrasound technique in the equine cricoarytenoideus dorsalis muscle: Assessment of muscle size and echogenicity with resting endoscopy.

BACKGROUND: Recent studies have assessed the cricoarytenoideus dorsalis muscle (CAD) using transoesophageal ultrasonography in equine recurrent laryngeal neuropathy (RLN). We assessed the CAD using the external transcutaneous ultrasound technique, which may constitute an easier method in horses. OBJECTIVES: To evaluate ultrasonographic imaging of the left cricoarytenoideus dorsalis muscle (LCAD) and right cricoarytenoideus dorsalis muscle (RCAD) as a diagnostic tool for RLN using the transcutaneous ultrasound technique. STUDY DESIGN: Cross-sectional study. METHODS: The axial plane thickness, cross-sectional area and echogenicity of the LCAD and RCAD were measured using transcutaneous ultrasonography in 164 horses. Assessments of LCAD were compared with those of RCAD. The LCAD:RCAD ratios in thickness and area were compared between control horses (resting grades 1 and 2) and horses with resting laryngeal grades 3 and 4 using the Havemeyer 4-point grading system with subgrades. RESULTS: The LCAD:RCAD ratios for thickness and area were 0.69 and 0.66 in horses with resting grades 3 and 4 respectively; LCAD was more hyperechogenic than RCAD in resting grades 3 and 4. LCAD:RCAD ratios for thickness and area in grades 3.II, 3.III and 4 were significantly lower than those in control horses. Thickness and area of the LCAD were negatively correlated with resting laryngeal grade MAIN LIMITATIONS: Overground endoscopy was not performed in this study. There were some differences in methodology: measurement of the physical thickness of the LCAD and clipping of hair at the laryngeal region were only performed in horses that underwent laryngoplasty. CONCLUSIONS: Results of ultrasonographic assessments of the CAD using transcutaneous ultrasonography were similar to those obtained by transoesophageal ultrasonography. This technique enables a simple, noninvasive, direct and easy examination. Assessment of the CAD using transcutaneous ultrasonography may be a useful technique and a potential option for determining whether to perform nerve graft or laryngoplasty.

Transcutaneous Ultrasonography Is a Feasible Method for Characterizing the Cricoarytenoideus Dorsalis Muscle in Horses.

Assessment of the cricoarytenoideus dorsalis muscle (CAD) in horses using a transesophageal ultrasound, computed tomography, or magnetic resonance imaging is available in a limited number of hospitals. This study assessed the ease of ultrasonographic imaging of the CAD using an external transcutaneous technique in horses. After confirmation of the CAD in the cadavers, ultrasonography in twenty live horses was carried out using a transcutaneous approach. In live horses, ultrasonographic imaging of the CAD was possible by pushing the larynx from the opposite side with the other hand. It is believed that the results of this study may be beneficial in the examination of recurrent laryngeal neuropathy.

Factors affecting the prognosis for uterine torsion: the effect of treatment based on measurements of serum progesterone and estradiol concentrations after surgery.

This is a retrospective study of uterine torsion (UT) in seven mares. In two cases, serum progesterone and estradiol concentrations were also investigated. The mare and foal/fetus survival rate was 57% (4/7). Four cases presented with clockwise torsion, and two cases presented with counterclockwise torsion. The direction was undetermined in one case. The degree of torsion varied. Correction of torsion was performed by ventral midline celiotomy in all cases. In the two cases with measured hormone levels, elevated levels of P4 were decreased through medication. All mares discharged from the hospital with a live fetus were able to carry a live fetus. Early diagnosis and treatment of UT increases the possibility of helping mares and foals in cases with acute UT.

Epidural anesthesia during hysterectomy diminishes postoperative pain and urinary cortisol release.

PURPOSE: To examine the hypothesis that epidural anesthesia throughout lower abdominal surgery would depress both postoperative pain and cortisol release. METHODS: Forty adult patients undergoing abdominal total hysterectomy were studied. The patients were randomly assigned to two groups. Group G received general anesthesia alone (sevoflurane 1.5%-2.5%); group E received a combination of epidural anesthesia (1.5% mepivacaine) with a light plane of general anesthesia (sevoflurane<0.5%). Postoperative analgesia was obtained epidurally by patient-controlled analgesia. Postoperative pain at rest and during movement was assessed by a visual analogue scale (VAS) at 2, 24, and 48 h following surgery. The plasma concentration and urinary excretion of cortisol were measured during the perioperative period. RESULTS: VAS values were lower in group E than in group G during movement at 24h (4.6±0.5vs 6.1±0.4 cm). Urinary cortisol excretion on the first postoperative day was less in group E than in group G (192±34vs 480±120µg). CONCLUSIONS: Epidural blockade prior to surgical stimuli and throughout lower abdominal surgery reduces the postoperative dynamic pain and stress response.