Congenital defects of the soft palate in 15 mature horses.

REASONS FOR PERFORMING STUDY: Horses, usually foals, with a congenital defect of the soft palate have been reported infrequently, and most reports describe a surgical procedure to repair the defect. Results of conservative management have not been previously reported. OBJECTIVE: To describe 15 horses affected with soft palate defects that were presented for examination when mature. STUDY DESIGN: Retrospective case series. METHODS: Clinical records from horses identified as having been diagnosed with a soft palate defect when older than one year were reviewed retrospectively. Follow-up was obtained wherever possible. RESULTS: Nasal discharge, occasional coughing and abnormal respiratory noise at exercise were the most common reasons for presentation. Only one yearling had mild symptoms of aspiration pneumonia. Many were able to perform at least low-intensity ridden activities and 2 Thoroughbreds raced successfully without surgical treatment. Surgical correction was attempted in 3 horses but was only partially successful in 2. The other horses were not treated surgically and no deterioration in severity of clinical signs was reported in the long term. The prevalence of survival in this case series was 100%. CONCLUSIONS AND POTENTIAL RELEVANCE: This case series shows that some foals may survive to maturity with substantial congenital defects of the soft palate without displaying severe clinical signs. Given the published high incidence of morbidity and mortality associated with surgical treatment, this case series suggests that a reasonable alternative is to manage such cases conservatively, provided that they are not suffering from severe pneumonia or ill thrift and that their welfare is not compromised.

Right dorsal displacement of the large colon as a cause of surgical colic in three foals in New Zealand.

CASE HISTORY: Over a 3-year period between July 2008 and July 2011, 10 exploratory laparotomies were performed on foals in a Waikato referral facility in New Zealand. CLINICAL FINDINGS: Right dorsal displacement of the large colon (RDDLC) was identified during four exploratory laparotomies in three foals that presented for mild-to-moderate colic that was non-responsive to medical management. One foal required a repeat laparotomy 7 weeks post initial surgery, and RDDLC was again diagnosed. DIAGNOSIS: Right dorsal displacement of the large colon in foals. CLINICAL RELEVANCE: Further investigation may identify risk factors or management practices contributing to this condition. This is an important and uncommonly reported cause of surgical colic in foals, that is also important to consider in non-responsive medical colic cases that do not appear to be associated with severe pain, but may still require prompt surgical intervention to avoid a strangulating obstruction. The incidence of the condition in one Waikato referral facility appears higher than what could be expected based on the current literature.

Quantitative evaluation of subchondral bone injury of the plantaro-lateral condyles of the third metatarsal bone in Thoroughbred horses identified using nuclear scintigraphy: 48 cases.

REASONS FOR PERFORMING STUDY: Increased radio-isotope uptake (IRU) in the subchondral bone of the plantaro-lateral condyle of the third metatarsus (MTIII) is a commonly reported scintigraphic finding and potential cause of lameness in UK Thoroughbred racehorses in training and has not been fully documented. OBJECTIVES: To characterise lameness attributable to IRU of the subchondral bone of MTIII, compare the scintigraphic findings of these horses with a normal population and evaluate the use of scintigraphy as an indicator of prognosis. HYPOTHESIS: IRU will be in significantly higher in horses with subchondral bone injury and will be related to prognosis and future racing performance. METHODS: Data were analysed from 48 horses in which subchondral bone injury of the plantaro-lateral condyle of MTIII had been diagnosed using nuclear scintigraphy and that met the inclusion criteria. Data recorded included age, sex, trainer, racing discipline, lameness assessment, treatment regimes, radiographic and scintigraphic findings, response to diagnostic analgesia where performed and racing performance pre- and post diagnosis. Region of interest (ROI) counts were obtained for the plantar condyle and the mid diaphysis from the latero-medial view, the ratio calculated and then compared with a control group of clinically unaffected horses. RESULTS: The mean condyle mid-diaphysis ROI ratio was significantly (P<0.001) higher in the affected population and with positively correlation (P = 0.024) with the level of lameness. The presence of radiographic findings had no significant effect on the ROI ratio. CONCLUSION: Subchondral bone injury of the plantar lateral condyles of MTIII is a significant cause of lameness in UK Thoroughbred racehorses. Nuclear scintigraphy is a useful diagnostic imaging modality in the detection of affected horses but is a poor indicator of prognosis for the condition. POTENTIAL RELEVANCE: Better understanding of the clinical manifestations, diagnosis of and prognosis for subchondral bone injury will benefit the Thoroughbred industry in the UK.

The use of race winnings, ratings and a performance index to assess the effect of thermocautery of the soft palate for treatment of horses with suspected intermittent dorsal displacement. A case-control study in 110 racing Thoroughbreds.

REASONS FOR PERFORMING THE STUDY: There have been no reports of the efficacy of thermocautery of the soft palate (TSP) assessed objectively as a treatment of intermittent dorsal displacement of the soft palate (DDSP). OBJECTIVE: To compare: racing performance of horses that underwent thermocautery of the soft palate with matched controls; and 'Racing Post ratings' (RPR) with prize money won (RE) and a performance index (PI) for each of the horses in the study. HYPOTHESIS: Thermocautery of the soft palate has no beneficial effect on racing performance and the 3 measures of performance are significantly related. METHODS: The inclusion criteria were fulfilled by 110 horses and each was matched with 2 controls. Changes in performance were compared statistically. RPR, RE and PI were analysed using a regression model. RESULTS: The percentage of horses that improved in performance following the procedure was 28-51% for the 3 measures of performance, compared to 21-53% for the matched controls. There was no significant effect of the procedure on the changes in RPR or RE. There was a significant effect of the procedure on the change in PI (P=0.015) with more treated horses achieving an improved PI and fewer acquiring a worse PI than matched control horses. The measures of performance showed significant correlation. CONCLUSIONS: Thermocautery of the soft palate alone may not be the most efficacious treatment of DDSP. POTENTIAL RELEVANCE: Production of a reliable measure of racehorse performance may be possible.

Tenoscopic surgery for treatment of lacerations of the digital flexor tendon sheath.

REASONS FOR PERFORMING STUDY: Lacerations to the digital flexor tendon sheath (DFTS) are a common injury in the horse, but little information is available in the literature regarding prognostic indicators. OBJECTIVE: To ascertain whether laceration of the DFTS carried a better prognosis if treated by tenoscopic lavage, debridement and repair within 36 h of the original injury. METHODS: A retrospective analysis of 39 horses treated surgically for lacerations to the DFTS was performed over a 3 year period. The injury-to-surgery interval was recorded as <36 or >36 h. The structures damaged by the injury were also recorded, as well as age, sex, use and outcome. RESULTS: Sixteen horses had laceration and contamination of the DFTS alone, of which 15 (94%) returned to their original or intended use. Sixteen horses had lacerations involving the superficial digital flexor tendon, of which 12 (75%) made a full recovery. Six horses had lacerations to both superficial and deep digital flexor tendons, 5 were subjected to euthanasia intraoperatively and one is paddock sound. Treatment within 36 h of initial laceration carried a significantly better prognosis for return to intended athletic use (25 of 28 horses allowed to recover from anaesthesia) than treatment after 36 h (2 of 5 P = 0.03; Fisher's Exact Test). CONCLUSIONS: If sepsis is treated early using tenoscopic visualisation, lavage and repositol antibiotics, the limiting factor in return to athletic function is tendon damage. POTENTIAL RELEVANCE: This study supports anecdotal evidence that early treatment of synovial sepsis improves the prognosis for return to intended use. It also provides information on prognostic indicators including extent of damage to collateral structures.