Clinical investigations of halothane and isoflurane for induction and maintenance of foal anesthesia.

Fifty-eight foals were divided into two groups for study of aspects of the clinical anesthetic management of foals and to characterize effects of halothane (n = 30) and isoflurane (n = 28) in foals. There were no significant differences (P greater than 0.05) in the demographics of the two groups. Results of hemograms and biochemical analysis of venous blood samples before and after anesthesia were either not influenced or only mildly (clinically unimportant) affected by either agent. Like adult horses, foals have an increased PaCO2 when anesthetized with inhaled anesthetics. We could detect no difference in the magnitude of increase in PaCO2 with either anesthetic. Anesthetic induction and recovery was most rapid with isoflurane. The quality of induction and recovery was similarly acceptable with either agent. Heart rate during isoflurane was not significantly different from conscious conditions but during halothane, heart rate was significantly less than control except at 91-120 min when statistical significance was not detected. These results support the clinical impression that foals can be safely and reliably anesthetized with either agent.

Ulceration in the proximal portion of the urethra as a cause of hematuria in horses: four cases (1978-1985).

Sudden onset of hematuria was associated with mucosal ulceration of the proximal portion of the urethra in 1 stallion and 3 geldings. Hematuria was observed characteristically and consistently at the end of urination. Mucosal ulceration was identified endoscopically in the proximal portion of the urethra at the level of the ischial arch. Biopsy of an ulcerated area of the proximal urethra in one gelding revealed transitional cell carcinoma. Treatment regimens varied from systemic antimicrobial and/or vasoactive therapy to diversion of urinary flow via a temporary perineal urethrostomy. Hematuria resolved in 14 to 24 days (average, 20 days) after treatment was begun, except in one gelding that died of undetermined causes during an initial examination. In the 3 remaining horses, hematuria had not recurred for up to 9 years (average, 1 year).

Keratomas in horses: seven cases (1975-1986).

The diagnosis of keratoma in 7 horses and their treatment and outcome were evaluated. Horses were 2 to 20 years old, of various breeds, and were intact or castrated males. All were lame, and 6 horses had had previous injuries of the affected hoof that had not responded to prior treatments. Only 1 hoof was affected in each horse. Keratomas were beneath the hoof wall (6 horses) or sole (1 horse). Radiographically, a circular or semicircular defect with a discrete margin was present in the distal portion of the third phalanx in 3 horses. Grossly, keratomas were firm solitary masses (1.5 to 5 cm diameter); gray, tan, or yellow; and oval or conical. Keratomas were excised from beneath the hoof wall by removing a section of hoof wall (5 horses) or by undermining the wall beginning at its junction with the sole (1 horse). A keratoma beneath the sole in 1 horse was excised by excavating the sole to the level of the palmar surface of the third phalanx. Keratoma was verified microscopically by the presence of characteristic rings of squamous epithelial cells with abundant keratin. Purulent exudate and inflammatory infiltrate often were present concurrently, reflecting an associated localized infection. Aftercare included daily application of an antiseptic iodine solution and foot bandages, and shoeing with a treatment plate several weeks after surgery. Hoof and sole defects healed completely between 6 months and 1 year. By 1 year after surgery, 6 horses were sound, and keratoma had not recurred.

Epiglottic entrapment. A transnasal surgical approach to divide the aryepiglottic fold axially in the standing horse.

Transnasal, axial division of the aryepiglottic fold was performed to correct entrapment of the epiglottis in 20 sedated, standing horses, using a hooked bistoury and topical anesthesia. Presenting complaints included decreased exercise tolerance or loss of racing performance, abnormal respiratory noise, and coughing. The surgical procedure was technically easy to perform with a minimum of instrumentation. The horses were rested an average of 18 days before race training or riding was resumed. Evaluation of racing records or contact with owners indicated that most affected horses competed successfully after transnasal surgical correction of the entrapment.

In vitro comparison of three fixation methods for humeral fracture repair in adult horses.

The stiffness, load to failure, and bending moments of adult intact equine humeri and humeri repaired with 3 fixation techniques were determined in vitro. Bones were tested in axial compression (30 pairs), mediolateral 3-point bending (15 pairs), and caudocranial 3-point bending (15 pairs). An oblique osteotomy of 1 humerus of each pair was performed to simulate the long spiral oblique fractures that occur clinically in horses. Bones were repaired in 3 ways: group 1--nylon band cerclage fixation (20 bones); group 2--multiple intramedullary pinning (20 bones); and group 3--nylon band cerclage fixation and multiple intramedullary pinning (20 bones). Intact bones were significantly (P less than 0.05) stronger than repaired bones in each testing mode. Bones repaired with bands only were significantly less stiff in bending than were bones repaired with pins only or with pins and bands. In compression, only specimens repaired with pins and bands were significantly stiffer than were bones repaired with bands only. Bones repaired with bands only required significantly less load to failure in compression and in caudocranial bending than did bones repaired with pins only or with pins and bands. Bones repaired with pins only deformed through the full displacement of the actuator (5 cm), and pins deformed plastically. Bones repaired with pins and bands were stiffer and had higher bending moments than did bones repaired with pins only, but the differences were not significant.

Incomplete palmar fracture of the proximal extremity of the third metacarpal bone in horses: ten cases (1981-1986).

In 4 adult horses, simple, nondisplaced, incomplete fracture of the proximal extremity of the third metacarpal bone (MC3) was identified radiographically only on the dorsopalmar projection. Lameness was slight to moderate. Although nerve blocks of the foot and fetlock did not alter the lameness, high palmar regional nerve block improved the gait in 1 of the 2 horses on which it was performed. Pain on palpation or swollen distal accessory (inferior check) ligament, flexor tendons, and suspensory ligament were not found in any horse. The fracture was localized to the palmar surface of the proximal extremity of the MC3 on the basis of the intense uptake of radiopharmaceutical (99MTc-labeled sodium medronate) observed in that area during the soft tissue and delayed bone phases of a nuclear scintigraphic examination (nuclear scan) performed concurrently with radiography. Of 4 horses evaluated 6 months after the initial diagnosis, 3 had medullary sclerosis without radiographic evidence of fracture; results of follow-up nuclear scintigraphy performed in one of these horses at the same time were normal. Incomplete fracture also was suspected in another 6 adult horses with clinical lameness referable to the proximal extremity of the MC3. Although a fracture line could not be seen radiographically, trabecular hypertrophy and/or medullary sclerosis of the proximal extremity of the MC3 were detected on the dorsopalmar projection. Further, during nuclear scintigraphy, an intense uptake of the radiopharmaceutical was observed on the palmar aspect of the proximal extremity of the MC3 in all 6 horses.(ABSTRACT TRUNCATED AT 250 WORDS)

Genital neoplasms treated by en bloc resection and penile retroversion in horses: 10 cases (1977-1986).

The medical records of 10 horses with invasive neoplasms of the penis, prepuce, and/or superficial inguinal lymph nodes in which treatment involved en bloc resection and penile retroversion were reviewed. All were geldings and ranged in age from 12 to 25 years (mean, 19 years). Evaluation of biopsy specimens obtained before surgery confirmed lymphosarcoma in 1 horse and squamous cell carcinoma in 9 horses. Typical history included swelling, ulceration, and abscessation of the penis and prepuce and large superficial inguinal lymph nodes. Complications after surgery included dehiscence of the urethrostomy site (4 horses), dehiscence of the ventral skin incision (1 horse), urine scalding of 1 hind limb (1 horse), cystitis (1 horse), severe hemorrhage (1 horse), and diarrhea (1 horse). One horse was euthanatized during hospitalization, because of severe dehydration secondary to diarrhea. At necropsy, firm nodules were scattered in the pulmonary parenchyma, myocardium, thyroid gland, parathyroid glands, cranial mediastinum, kidneys, and hilar lymph nodes. Microscopic examination of the nodules revealed undifferentiated carcinoma. Nine horses were discharged from the hospital between 1 and 5 weeks after surgery. The mean follow-up interval was 27 months (range, 6 to 96 months). Eight horses had no evidence of recurrence. One horse had recurrence of neoplasm at 6 months and was euthanatized 12 months later.

Small intestinal adenocarcinoma in a horse.

A 21-year-old mare was evaluated for intermittent episodes of apparent abdominal pain of 6 month's duration. Abdominal palpation per rectum revealed distended small intestine in the caudal portion of the abdomen. Ventral midline celiotomy revealed a mass in the midjejunal region. The mass was resected, and a side-to-side anastomosis performed. The histologic diagnosis was tubular adenocarcinoma of the small intestine. The mare was still alive 13 months after surgery.

Surgical management of proximal splint bone fractures in the horse.

Fractures of Metacarpal and Metatarsal II and IV (the splint bones) were treated in 283 horses over an 11 year period. In 21 cases the proximal portion of the fractured bone was stabilized with metallic implants. One or more cortical bone screws were used in 11 horses, and bone plates were applied in 11 horses. One horse received both treatments. Complications of screw fixation included bone failure, implant failure, radiographic lucency around the screws, and proliferative new bone at the ostectomy site. Only two of the horses treated with screw fixation returned to their intended use. Complications of plate fixation included partial fixation failure (backing out of screws), wound drainage, and proliferative bony response around the plate. Six of the 11 horses treated by plate fixation returned to their intended use. The authors recommend consideration of plate fixation techniques for repair of fractures in the proximal third of the splint bone.

Enteroliths in horses.

Many cases of enteroliths were reported in the nineteenth century but the number greatly decreased in the early twentieth century. However, in recent years the number of cases in certain parts of the United States such as California has greatly increased. The reasons for the increase are obscure. The intake of nitrogen, magnesium and phosphorus (the primary components of enteroliths) from water and food is likely to be a factor. Arabians may be more likely to develop enteroliths than horses of other breeds. A nidus such as a small stone is needed because a nidus has been found in every enterolith that has been examined. Further studies in which the effect of mineral intake and form of the mineral on enterolith formation are needed. Studies of enterolith formation in the past have all been retrospective. Models for the development of enteroliths are needed.

Cellulitis associated with coagulase-positive staphylococci in racehorses: nine cases (1975-1984).

Nine Thoroughbred racehorses were admitted with cellulitis (of one or more limbs) associated with coagulase-positive staphylococci. The right hindlimb was affected in 4 horses, the right forelimb in 2, the left hindlimb in 1, and both hindlimbs in 2. Typical abnormalities included high values for rectal temperature (9 horses) and heart rate (5 horses), hyperfibrinogenemia (7 horses), leukocytosis (7 horses), and neutrophilia (6 horses). The staphylococcal isolants were speciated in 3 horses and classified as Staphylococcus aureus. Complications included skin loss (5 horses), laminitis of the affected limb (2 horses), laminitis of the contralateral limb (4 horses), osteomyelitis and sequestrum formation (2 horses), and bacteremia (1 horse). Five horses were euthanatized because of the severity of the complications, ie, laminitis in 4 horses and severe skin loss in 1 horse. The remaining 4 horses were discharged from the clinic. At follow-up evaluation (mean, 16.7 months), the swelling in 3 of the horses had completely resolved. One horse returned to racing; of 2 used for pleasure riding, one was mildly lame. The remaining horse was not lame, but was used for breeding because of persistent swelling of the affected limb.

Palatal myositis in horses with dorsal displacement of the soft palate.

The histologic and histochemical features of palatine muscles from 53 horses were studied; 25 of the horses were racehorses that had upper airway obstruction associated with dorsal displacement of the soft palate and 28 of the horses did not have any respiratory disorders and served as controls. Pathologic features observed included myonecrosis, phagocytosis, mononuclear cell infiltration of perimysial connective tissue, alkaline phosphatase-positive myofibers, and myofibers with cytoarchitectural changes that included irregular staining of the intermyofibrillar sarcoplasm and sarcoplasmic masses. These histopathologic features were judged to be indicative of myositis. Those features were found in both control horses and horses with dorsal displacement of the soft palate; however, their prevalence was higher in horses with dorsal displacement of the soft palate. For the control horses as well as the horses with dorsal displacement of the soft palate, the inflammatory changes were more prevalent in older horses. The finding of myositis suggests that palatal muscle weakness may contribute to the development of dorsal displacement of the soft palate; however, the myositis might have been secondary to trauma associated with displacement of the soft palate. We could not distinguish between these 2 possibilities. A large number of horses with dorsal displacement of the soft palate also had concurrent pharyngeal lymphoid hyperplasia. Extension of the mucosal inflammatory changes associated with pharyngeal lymphoid hyperplasia into the underlying palatine muscle might have accounted for the myositis.

Radiographic assessment of epiglottic length and pharyngeal and laryngeal diameters in the Thoroughbred.

A lateral radiograph of the pharyngeal region provides a technique for identifying pharyngeal disorders, including entrapment of the epiglottic cartilage and dorsal displacement of the soft palate. Epiglottic cartilage length, predicted from radiographs by measurement from the body of the thyroid cartilage to the tip of the epiglottis (thyroepiglottic length), was well correlated to actual length at postmortem examination (r2 = 0.98). Thyroepiglottic length, corrected for magnification, was 8.76 +/- 0.44 cm in 24 healthy Thoroughbreds. Nine Thoroughbreds with entrapment of the epiglottic cartilage and 6 with dorsal displacement of the soft palate had significantly short thyroepiglottic lengths--6.59 +/- 0.33 cm and 6.43 +/- 0.40 cm, respectively. The nasopharyngeal diameter of the Thoroughbreds with dorsal displacement of the soft palate was significantly less than the nasopharyngeal diameter of healthy Thoroughbreds. There was no significant difference between healthy and abnormal Thoroughbreds for pharyngoepiglottic, laryngeal, or tracheal measurements as determined from the lateral radiographs. The head should be placed in a normal resting position to obtain the pharyngeal radiograph. Maximum dorsiflexion of the head significantly increased the pharyngoepiglottic distance, whereas maximum ventriflexion significantly decreased this distance. The nasopharyngeal diameter during dorsiflexion was significantly greater than during ventriflexion. This investigation documented that a lateral pharyngeal radiograph provides important diagnostic information for evaluating suspected pharyngeal disorders in Thoroughbreds with airway obstruction of the cranial part of the respiratory tract.

Surgical management of uterine torsion in the mare: a review of 26 cases.

Uterine torsion was diagnosed in 26 mares of various breeds. The mean duration of gestation was 9.6 months. The most common clinical history was intermittent unresponsive colic of varying duration. Diagnosis of uterine torsion was confirmed by rectal palpation, and surgical correction was achieved in most cases by standing flank laparotomy and manual repositioning of the gravid uterus. Recumbent laparotomy was used only if the mare was intractable, the uterus was ruptured, or hysterotomy was indicated. Of 20 foals determined to be alive during surgery, 14 (70%) were subsequently born alive.

Exercise-induced pulmonary hemorrhage in racing thoroughbreds: a preliminary study.

Of 235 Thoroughbred racehorses examined with a flexible fiberoptic endoscope within 2 hours of racing to determine the frequency of exercise-induced pulmonary hemorrhage (EIPH), 103 (43.8%) had various degrees of hemorrhage in the tracheal lumen. Two of these horses (0.8%) subsequently had blood flow from the nostrils. Blood seemed to originate from the lung. Statistical analysis of frequency data for 191 horses which finished in 1st, 2nd, and 3rd places did not show any relationship between EIPH and horse's age, sex, or finishing position. However, a trend toward an increased frequency of EIPH with age was shown, by a greater proportion of horses 5 years and older having EIPH. This trend is thought to reflect the chronicity of the pulmonary lesions and an inability of the lung to repair damaged regions while training and racing continued. The efficacy of furosemide for the treatment of EIPH was questioned, since 30 of 56 furosemide-treated horses which were examined had evidence of pulmonary hemorrhage. Nineteen (8%) horses had visible functional abnormalities of the upper respiratory tract.