DYNAMIC SONOGRAPHY OF THE EQUINE METACARPO(TARSO)PHALANGEAL DIGITAL FLEXOR TENDON SHEATH.

Palmar/plantar annular desmitis is a common disease that may be associated with adhesions and structures affecting the flexor tendons, which requires tenoscopy to diagnose. The purpose of this descriptive study was to develop a dynamic sonographic technique for evaluating the motion of normal equine flexor tendons in relation to the palmar/plantar annular ligament and to compare findings with horses previously diagnosed with palmar/plantar annular desmitis. Ten healthy adult horses were examined prospectively and the images of four horses diagnosed with palmar/plantar annular desmitis were retrospectively evaluated. Dynamic sonography was performed at the level of the metacarpo/metatarsophalangeal joint by maximally extending and flexing the interphalangeal joints. Palmar/plantar annular ligament thickness (mm), size of any gap between the flexor tendons, and subjectively increased angulation of the long linear echoes of the superficial digital flexor tendon were measured. The presence of gliding motion between the palmar/plantar annular ligament and superficial digital flexor tendon was determined by consensus. Twenty-eight healthy control limbs (16 hind/12 fore) and four with palmar/plantar annular desmitis (3 hind/1 fore) were evaluated. Controls had unrestricted gliding motion between the palmar/plantar annular ligament and flexor tendons and zero to 13° of angulation of the long linear echoes. The four affected horses had restricted gliding motion and between 20-35° angulation of the long linear echoes. Dynamic ultrasound is a feasible technique for detecting restricted flexor tendon and palmar/plantar annular ligament gliding motion, as well as subjectively increased angulation of the long linear echoes of the flexor tendon in affected horses compared with controls and warrants further investigation.

Endoscopic, transoral, reduction of epiglottic entrapment via wire snare technique.

OBJECTIVE: To describe the use of a wire snare technique for epiglottic entrapment. STUDY DESIGN: Case series. ANIMALS: Eight adult horses. METHODS: Under general anesthesia, a modified mouth gag was placed in the oropharynx. An endoscope was passed through the gag until there was adequate visualization of the entrapped epiglottis. The entrapping mucosa was grasped with bronchoesophageal forceps and pulled rostrally, releasing the epiglottis. A custom snare was passed down the bronchoesophageal forceps to encircle the redundant subepiglottic mucosa. Tension was applied to the entrapping mucosa via the forceps as the obstetric wire was tightened at the base and the redundant mucosa (aryepiglottic fold) was excised. RESULTS: The procedure was performed on 8 adult thoroughbred horses. Re-evaluation by endoscopy did not show entrapment in any horse and no horse developed complications or has had problems with performance. CONCLUSIONS: This technique is a minimally invasive, competitively priced and straightforward method for resection of entrapping subepiglottic mucosa in adult horses.