Duration of disease influences survival to discharge of Thoroughbred mares with surgically treated large colon volvulus.

REASONS FOR PERFORMING STUDY: Large colon volvulus results in strangulating obstruction requiring surgical treatment. Duration of this disease prior to surgical treatment is likely to influence survival directly. OBJECTIVES: The primary objective of this study was to evaluate the influence of duration of large colon volvulus on patient survival to discharge. Relationships between other factors and survival following large colon volvulus were also examined. STUDY DESIGN: Retrospective case analysis. METHODS: Medical records of Thoroughbred mares aged ≥2 years undergoing surgical treatment for large colon volvulus between 1 March 1986 and 28 February 2011 were reviewed. Multivariable logistic regression was used to identify influence of duration and other factors on survival to discharge. RESULTS: Within the study period, 1039 surgeries were performed to correct large colon volvulus in 896 Thoroughbred mares. Median duration of colic signs prior to admission was 2 h (interquartile range [IQR] 1-4 h). Median time from admission to anaesthetic induction was 25 min (IQR 15-45 min). Median surgical time was 70 min (IQR 55-85 min). Primary surgical treatment was simple correction of the large colon volvulus followed by replacement of the colon. The overall survival to discharge was 88%. The final model identified risk factors significantly associated with survival and included colic duration prior to admission, packed cell volume at admission, surgery length, duration of hypotension while under anaesthesia, heart rate 48 h post operatively, post operative manure consistency and days hospitalised. CONCLUSIONS: Duration of colic prior to admission was statistically associated with patient survival to discharge. Other factors significantly associated with survival in mares with large colon volvulus were related to disease severity and degree of colonic compromise. Mares with large colon volvulus have a good prognosis for recovery with early referral and prompt surgical treatment.

Factors influencing foaling rate following colic surgery in pregnant Thoroughbred mares in Central Kentucky.

REASONS FOR PERFORMING STUDY: Clinical experience has suggested that foaling rates following colic surgery in the pregnant mare are influenced by days of gestation. This premise has not been supported in previous studies. We also aimed to determine the effects of other potential influencing factors. OBJECTIVE: To determine the influence of age of gestation on foaling rates in pregnant mares following colic surgery and evaluate the relationships between other factors and foaling rates. METHODS: Medical records of Thoroughbred mares, which had colic surgery performed from 1993 to 2007 at the Rood and Riddle Equine Hospital, were reviewed. Mares identified in the record as pregnant or bred within the previous 15 days were included in this study. Age of the mare, date of surgery, gestational age, duration of colic at admission, packed cell volume at admission, surgical diagnosis, duration of general anaesthesia, intraoperative hypotension, intraoperative hypoxaemia and post operative signs of endotoxaemia were recorded. A mare was considered to have a live foal if that foal was registered with the North American Jockey Club. RESULTS: Of the 228 mares, where pregnancy had been confirmed, 152 (66.7%) had a live foal registered after surgery. Mares bred <40 days before surgery had a lower foaling rate compared with mares undergoing surgery ≥40 days after breeding: 48.7% vs. 69.8% (odds ratio [OR] = 0.41 [95% confidence interval (CI) 0.20-0.83], P = 0.012). Foaling rate was also influenced by mare's age (P = 0.008) and duration of colic signs before surgery (P = 0.03). CONCLUSIONS: The prognosis for a live foal after colic surgery in the pregnant Thoroughbred mare is significantly better if the mare is ≤15 years of age and ≥40 days of gestation. POTENTIAL RELEVANCE: The results of this study are useful for clinicians offering a prognosis for a live foal following colic surgery in pregnant mares.

Complications after two transphyseal bridging techniques for treatment of angular limb deformities of the distal radius in 568 Thoroughbred yearlings.

REASONS FOR PERFORMING STUDY: Surgical correction of carpal angular limb deformities by growth retardation is commonly undertaken with a screws and tension band wire loop technique (S&W) or a single transphyseal screw (STS). This study compares complications after S&W and STS bridging in the distal radius of Thoroughbred yearlings. OBJECTIVE: To compare the prevalence of complications serious enough to require follow-up radiographs following either S&W or STS surgery for growth manipulation in the distal radius of Thoroughbred yearlings. METHODS: Medical records and radiographs from Thoroughbred yearlings (age range 261-457 days) treated for carpal angular limb deformities at a single hospital over 2 years were reviewed. Each of the techniques was used exclusively during a single year. The complication threshold criterion for inclusion was the need for nonroutine radiographs of the operated site anytime after implant insertion or removal. RESULTS: Of 568 horses, 253 received S&W and 315 received STS. Horses were of similar age at the time of surgery for STS and S&W. Single transphyseal screws were left in place for a significantly shorter amount of time (16 days). Sex, the limb(s) treated and medial vs. lateral placement were not significantly different between techniques. Complications included physitis post implant removal, metaphyseal collapse post implant removal, infection, overcorrection and seroma formation severe enough to require radiography. Physitis and metaphyseal collapse occurred significantly more frequently with STS compared with S&W. Infection, overcorrection and seromas were not significantly different between techniques. CONCLUSION: The STS and S&W techniques are both viable treatment options for correction of carpal angular limb deformities. However, horses treated with the STS technique have a significantly increased risk of developing physitis or metaphyseal collapse. POTENTIAL RELEVANCE: Horses treated with STS bridging have a significantly increased risk of developing the post correction complications of moderate to severe physitis and metaphyseal collapse compared with horses treated with S&W bridging.

Size and geometry of apical sesamoid fracture fragments as a determinant of prognosis in Thoroughbred racehorses.

REASON FOR PERFORMING STUDY: Analysis was performed to examine a method for refining the preoperative prognosis for horses that had surgery to remove apical fractures of the proximal sesamoid bones (PSBs). OBJECTIVES: To determine if: 1) there was a difference in size or configuration of apical fractures between the different anatomical locations of the PSBs, which have been shown to affect the prognosis; and 2) the size or configuration could predict the prognosis for racehorses with these fractures. METHODS: The study included 110 weanlings and yearlings and 56 training racehorses that underwent surgery to remove apical PSB fractures. Radiographs of the fractures were used for measurement of the abaxial and axial proportion and the abaxial to axial ratio, and race records were used to determine average earnings per start (AEPS) and total post operative starts. Analysis of variance and regression statistics were used to compare the fragment sizes between the specific PSBs on each of the limbs and compare size and configuration of the fractures to prognosis. RESULTS: There was a significantly larger abaxial to axial ratio (more transverse fracture) for the forelimb medial sesamoids than for all other sesamoids in untrained racehorses (P = 0.03). There were no other significant differences in size. There was no relationship between fracture size or configuration and AEPS nor total post operative starts. CONCLUSIONS: Apical fractures in weanlings and yearlings tend to be more transverse in the forelimb medial PSBs than the other PSBs. Apical fracture size and geometry does not determine prognosis for apical sesamoid fractures. POTENTIAL RELEVANCE: Horses that undergo surgery to remove larger apical fractures of the PSBs do not have a worse outcome than those horses with smaller fractures.

Management and assessment of prognosis after gastrocnemius disruption in Thoroughbred foals: 28 cases (1993-2007).

REASONS FOR PERFORMING STUDY: Few studies have evaluated the athletic prognosis of foals affected by gastrocnemius disruption. OBJECTIVE: To examine the diagnosis and management of gastrocnemius disruption in Thoroughbred (TB) foals, determine short-term survival rate and assess future racing performance. The hypothesis was that Thoroughbred foals with gastrocnemius disruption are able to perform as racehorses comparably to their age matched maternal siblings. METHODS: The medical records of foals diagnosed with gastrocnemius muscle disruption were reviewed. Information on training and racing was acquired from published works and race records. Paired t tests were utilised to compare performance variables of affected racehorses to their maternal siblings in starts, earnings and earnings/start for their 2- and 3-year-old racing seasons. Fisher's exact tests were employed to determine the association between sex, limb affected, age on admission, degree of caudal reciprocal apparatus dysfunction, concurrent disease, antibiotic therapy, complications, abscess formation and likelihood of entering training or starting a race. RESULTS: Sample size was too small to detect significant differences in performance variables between affected horses and controls. Of 28 foals, 17 (61%) presented with concomitant illness; foals without concurrent disease were more likely to achieve race training or start a race (P = 0.04); 23 (82%) were short-term survivors defined as survival to discharge. Of these 23 survivors, 7 were aged <2 years at the time of the study. Eighty-one percent (13/16) of the survivors that were of racing age were in training or had started a race. CONCLUSIONS: In this population, 82% of TB foals affected with gastrocnemius disruption were able to achieve training or start a race. Foals presenting for gastrocnemius disruption have a high prevalence of concurrent disease processes. POTENTIAL RELEVANCE: The assessment of athletic prognosis and treatment complications provides useful information to clinicians treating gastrocnemius muscle disruption in foals and making recommendations to clientele.

Racing performance after arthroscopic removal of apical sesamoid fracture fragments in Thoroughbred horses age < 2 years: 151 cases (1989--2002).

REASONS FOR PERFORMING STUDY: Studies on arthroscopic removal of apical proximal sesamoid fracture fragments in Thoroughbred (TB) horses age > or = 2 years have reported a high success rate. However, there are no reports documenting the racing prognosis of TB horses that undergo such surgery as weanlings or yearlings. OBJECTIVES: To describe the incidence of apical proximal sesamoid fractures in immature TB horses, age < 2 years and determine probability and quality of racing performance after arthroscopic removal of such fractures in 151 TB weanlings and yearlings. METHODS: The medical records of TB horses age < 2 years that underwent arthroscopic surgery for removal of apical proximal sesamoid fracture fragments were reviewed. Follow-up information was obtained from race records. Student's t tests were used to compare performance variables of operated racehorses to that of their maternal siblings. RESULTS: Ninety-two percent (139/151) of fractures occurred in the hindlimbs and 8% (11/151) in the forelimbs (fracture of both fore- and hindlimb, n = 1). Horses with forelimb fractures had a greatly reduced probability of racing (55%) compared to those with hindlimb fractures (86%). Overall, 84% of the horses raced post operatively and had performance records similar to that of their maternal siblings, 78% (787/1006) of which raced. CONCLUSIONS: Arthroscopic removal of apical proximal sesamoid fracture fragments in TB weanlings and yearlings carries an excellent prognosis for racing in horses with hindlimb fractures and a reduced prognosis in those with forelimb fractures. Medial fractures of the forelimb carry the worst prognosis. POTENTIAL RELEVANCE: The determination of prognosis increases knowledge on apical sesamoid bone fractures and potential for arthroscopic restoration of the ability to race; and enables the value of yearlings for subsequent sale to be established.

Racing performance after arthroscopic removal of apical sesamoid fracture fragments in Thoroughbred horses age > or = 2 years: 84 cases (1989-2002).

REASONS FOR PERFORMING STUDY: Studies have shown that surgical removal of apical fracture fragments in Standardbred racehorses carries the best prognosis for return to racing performance, but there are no reports involving mature Thoroughbred (TB) racehorses. OBJECTIVES: To describe the incidence of apical proximal sesamoid fractures in TB racehorses and determine probability and quality of racing performance after arthroscopic removal of such fractures in TB racehorses age > or = 2 years. METHODS: Medical records and pre- and post operative race records of TB racehorses age > or = 2 years that underwent arthroscopic surgery for removal of apical proximal sesamoid fracture fragments were reviewed. RESULTS: Sixty-four percent of fractures occurred in the hindlimbs and 36% in the forelimbs. Horses with forelimb fractures had a reduced probability of return to racing (67%) compared to those with hindlimb fractures (83%), but the majority (77%) of treated horses recovered to return to race post operatively. Horses with medial forelimb fractures raced at only a 47% rate; those with suspensory desmitis at 63%. Unlike Standardbreds, there was no difference in probability of racing post operatively between horses that had, and had not, raced preoperatively. CONCLUSIONS: Data show that arthroscopic removal of apical proximal sesamoid fracture fragments is successful at restoring ability to race in skeletally mature TB horses without evidence of severe suspensory ligament damage. Prognosis for return to racing is excellent (83%) in horses with hindlimb fractures and good (67%) in those with forelimb fractures. Medial fractures of the forelimb have the worst prognosis. POTENTIAL RELEVANCE: The determination of prognosis for differing sites in TB racehorses should increase knowledge of apical proximal sesamoid bone fractures and improve communication from veterinarian to owner, and trainer, on the potential for arthroscopic restoration of the ability to race.

In vitro biomechanical properties of 2 compression fixation methods for midbody proximal sesamoid bone fractures in horses.

OBJECTIVE: To evaluate 2 methods of midbody proximal sesamoid bone repair--fixation by a screw placed in lag fashion and circumferential wire fixation--by comparing yield load and the adjacent soft-tissue strain during monotonic loading. STUDY DESIGN: Experimental study. SAMPLE POPULATION: 10 paired equine cadaver forelimbs from race-trained horses. METHODS: A transverse midbody osteotomy of the medial proximal sesamoid bone (PSB) was created. The osteotomy was repaired with a 4.5-mm cortex bone screw placed in lag fashion or a 1.25-mm circumferential wire. The limbs were instrumented with differential variable reluctance transducers placed in the suspensory apparatus and distal sesamoidean ligaments. The limbs were tested in axial compression in a single cycle until failure. RESULTS: The cortex bone screw repairs had a mean yield load of 2,908.2 N; 1 limb did not fail when tested to 5,000 N. All circumferential wire repairs failed with a mean yield load of 3,406.3 N. There was no statistical difference in mean yield load between the 2 repair methods. The maximum strain generated in the soft tissues attached to the proximal sesamoid bones was not significantly different between repair groups. CONCLUSIONS: All repaired limbs were able to withstand loads equal to those reportedly applied to the suspensory apparatus in vivo during walking. CLINICAL RELEVANCE: Each repair technique should have adequate yield strength for repair of midbody fractures of the PSB immediately after surgery.

Long-term outcome of horses with a slab fracture of the central or third tarsal bone treated conservatively: 25 cases (1976-1993).

OBJECTIVE: To determine clinical features of horses with a slab fracture of the central or third tarsal bone and to report outcome of horses in which treatment did not include surgery. DESIGN: Retrospective study. ANIMALS: 25 horses (14 Standardbreds, 6 Thoroughbreds, 5 Quarter Horses). PROCEDURE: Medical records of horses with a slab fracture of the central (n = 9) or third (16) tarsal bone were reviewed. Only horses for which treatment consisted of confinement to a stall were included in this study. Clinical features and radiographic findings were recorded and summarized. Outcome was determined for racing breeds by obtaining official lifetime race results. Outcome for Quarter Horses was determined by phone survey of the owners. RESULTS: 16 (64%) horses had a successful outcome. Ten of 14 (71%) Standardbreds and 2 of 6 Thoroughbreds returned to racing and started at least 5 races after injury. Four of 5 Quarter Horses for which follow-up information was available successfully returned to their previous activity. Sex, age, limb affected, or gait was not associated with final outcome. Percentage of racehorses with central tarsal bone fractures that had a successful outcome (2/7) was significantly less than percentage with third tarsal bone fractures that did (10/13). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that enforced rest without surgical fixation can be an effective therapeutic option for horses with a slab fracture of the central or third tarsal bone, even if athletic function is expected.

Biodegradable drug delivery systems for gentamicin release and treatment of synovial membrane infection.

OBJECTIVE: This study investigated two biodegradable drug delivery systems (BDDS) for elution of gentamicin and elimination of synovial membrane infection. STUDY DESIGN: The effect of BDDS on control and infected synovial explants was determined. ANIMALS OR SAMPLE POPULATION: Synovial explants from four adult equine cadavers. METHODS: First, BDDS were placed in phosphate buffered saline for 14 days. Eluent was tested for gentamicin concentration (G) and bioactivity. Second, synovial explants were divided into four groups (n = 14/group): Group 1 (control); Group 2 (infected control) 405 cfu Staphylococcus aureus added at 6 hours; Group 3 (antibiotic BDDS [Ab-BDDS]) Ab-BDDS added at 24 hours; Group 4 (infected Ab-BDDS) 405 cfu S. aureus added at 6 hours, Ab-BDDS added at 24 hours. Both types of Ab-BDDS were used (n = 7/type/group). Explants were incubated in standard medium for 4 days. Medium was cultured and analyzed for (G) and hyaluronic acid concentration (HA). Explants were analyzed for viability and morphologic changes. RESULTS: The Ab-BDDS released >500 microg/mL of active gentamicin for 10 days. In Group 3, infection was eliminated within 24 hours, but histologic scores did not return to normal. Viability was significantly reduced by infection, but if eliminated, viability tended to return to normal. In Group 3, the Ab-BDDS had no significant effect on viability or (HA). Histopathologic scores were significantly higher for infected synovium. Infection, even if treated, significantly reduced (HA). CONCLUSIONS: Both Ab-BDDS eliminated infection within 24 hours. However, synovial morphology, viability and function did not return to normal. CLINICAL RELEVANCE: The Ab-BDDS may be useful for treatment of synovial membrane infection.

Apical fracture of the proximal sesamoid bone in standardbred horses: 43 cases (1990-1996).

OBJECTIVE: To determine whether fracture fragment dimensions, suspensory ligament damage, and racing status at the time of injury were associated with outcome in Standardbred horses with apical fracture of the proximal sesamoid bone. DESIGN: Retrospective study. ANIMALS: 43 Standardbred racehorses. PROCEDURE: Medical records, racing records, and radiographs were reviewed, and ultrasonographic findings were scored. Measurements of the fractured portion of the proximal sesamoid bone were made. RESULTS: Seventy-four percent (32/43) of horses were pacers, and 26% (11/43) were trotters. Statistical differences between trotters and pacers regarding ability to start, number of starts, or amount of money earned after injury were not detected. Females earned significantly more money per start after injury than males. Eighty-six percent (37/43) of fractures involved hind limbs and 14% (6/43) involved forelimbs. Horses with forelimb injuries earned less money per start. Severity of suspensory ligament damage did not affect postinjury racing performance. A higher proportion of horses that had raced before injury returned to racing after surgery than horses that had not raced before injury, although a significant difference between these groups was not detected. Eighty-eight percent of horses that raced before injury raced after injury. Fifty-six percent of horses that did not race before injury raced after injury. Fracture fragment dimensions did not affect outcome. CLINICAL IMPLICATIONS: Dimensions of the apical fracture fragment of the proximal sesamoid bone in Standardbred horses and degree of suspensory ligament damage did not affect outcome. Prognosis for return to racing soundness is good in horses that had raced before injury and fair in horses that had not raced before injury.

Biochemical, histochemical, and immunohistochemical characterization of distal tibial osteochondrosis in horses.

OBJECTIVE: To compare the biochemical, histochemical, and immunohistochemical profiles of articular cartilage from horses with naturally acquired distal tibial osteochondrosis (OC) with cartilage from a similar location in clinically normal horses. ANIMALS: 9 affected horses (group 1, 16 OC lesions) and 4 control horses (group 2, 8 normal osteochondral specimens). PROCEDURE: OC specimens were collected during arthroscopic removal of the fragment, and control specimens were collected by aseptic osteotomy. Uronic acid, total protein, total glycosaminoglycan (GAG), chondroitin sulfate (CS), and keratan sulfate (KS) contents were determined. Histomorphologic, histochemical, and immunohistochemical examinations were performed on specimens after snap freezing at -80 C and cryosectioning. Monoclonal antibodies (MAB) 3B3 and 5D4 were applied for location of epitopes of CS and KS, respectively. RESULTS: OC lesions had significantly lower quantity of uronic acid, total GAG, and CS, compared with normal cartilage. OC cartilage had significantly less intense staining with toluidine blue, along with irregular cellularity and tidemark characteristics, compared with normal cartilage. Monoclonal antibodies 3B3 and 5D4 stained OC cartilage, whereas MAB 5D4 did not stain control cartilage. Additionally, MAB 3B3 and 5D4 stained the fibrous tissue that was found firmly attached to the OC lesion located between the parent distal portion of the tibia and OC fragment. CONCLUSION: OC cartilage lesions of the distal intermediate ridge of the tibia in horses are biochemically, histochemically, and immunohistochemically distinct from normal cartilage from the same location. Results may reflect the inability of the chondrocyte of the developing joint to alter matrix components that would allow proper maturation and differentiation into bone.

Tibial stress fractures in racing standardbreds: 13 cases (1989-1993).

OBJECTIVE: To determine clinical signs, radiographic and scintigraphic findings, and performance outcome of racing Standardbreds with tibial stress fractures. DESIGN: Retrospective case series. ANIMALS: 13 racing Standardbreds with tibial stress fractures. PROCEDURE: Information concerning clinical signs, diagnostic evaluation, and recommendations was obtained by review of the medical records. Performance information before and after diagnosis of the fracture was collected from racing records, and follow-up information was obtained from the owners or trainers by use of a telephone questionnaire. RESULTS: Horses with tibial stress fractures were moderately lame, and diagnosis was made by nuclear scintigraphy and radiography. Fractures were more likely to occur in 2-year-old horses than in older horses. The fracture location was unique for Standardbreds; 11 of 13 developed stress fractures in the mid-diaphysis of the tibia, whereas fractures in Thoroughbreds are usually in the proximal caudal or caudolateral cortex. Fractures occurred in young horses that had raced or were in advanced race training. All horses were treated with rest alone, and 10 of 13 horses raced after injury. The horses that raced after injury were able to return to a level of performance that was equal to or better than the level raced before injury. 8 of 10 horses established a lifetime-best winning time after injury. CLINICAL IMPLICATIONS: Tibial stress fractures are a cause of lameness in young racing Standardbreds. Diagnosis is aided by nuclear scintigraphy. The prognosis for return to previous level of performance after a tibial stress fracture is good.

Plasma, urine, and synovial fluid disposition of methylprednisolone acetate and isoflupredone acetate after intra-articular administration in horses.

OBJECTIVE--To document plasma, urine, and synovial fluid disposition of 2 common intra-articularly administered steroid preparations, methylprednisolone acetate (MPA) and isoflupredone acetate (IPA). DESIGN--Descriptive investigation. SAMPLE POPULATION--100 mg of MPA or 4 mg of IPA was administered to 2 groups of 4 healthy sound radiographically normal female horses. PROCEDURE--Blood samples were collected at time 0 (before) and 2, 4, 6, 8, 10, 12, 24, 36, 48, 72, and 96 hours after administration of the designated steroid. Complete urine collection for measurement of designated steroid was accomplished by use of occluding 28-F balloon catheters. Synovial fluid samples were aseptically aspirated from the injected and contralateral uninjected tarsocrural joint at time 0 and 8, 24, 48, 240, and 672 hours after administration of the designated steroid. All samples were screened by ELISA to detect parent drug or metabolite equivalent, with a sensitivity of 2.5 ng/ml for MPA and 0.1 ng/ml for IPA. If drug was detected by ELISA in the plasma or synovial fluid, the samples were further quantified and specified, using HPLC with a lower limit of quantification (10 ng/ml). RESULTS--Between 2 and 12 hours after administration, plasma contained < 10 ng of MPA or IPA/ml (parent drug or metabolite equivalent), as intermittently detected by ELISA. Parent drug or metabolite equivalent was detected in the urine for 24 and 72 hours after injection of IPA and MPA, respectively. Synovial fluid from the contralateral joint contained no detectable MPA or IPA at any sample collection time. Median half-life for MPA, as detected by HPLC, was 10.3 hours (range, 6.1 to 10.6) in the synovial space. Median half-life for methylprednisolone, as detected by HPLC, was 10.4 (range, 9.9 to 32.1) hours. CONCLUSIONS--Both steroids appeared to be rapidly hydrolyzed to their respective ester forms, as detected by HPLC. The ELISA appeared to be a useful screening tool for detection of corticosteroids in this variety of body fluids.

Fracture of the distal sesamoid bone in horses: 17 cases (1982-1992).

Medical records of 17 horses in which a distal sesamoid bone fracture was diagnosed between 1982 and 1992 were reviewed. There were 8 Standardbreds, 6 Quarter Horses, 2 Thoroughbreds, and 1 Arabian. Mean age was 4.7 years. A forelimb was affected in 15 horses, and a hind limb was affected in 2. All horses were lame, and most were grade III/V lame at the trot. In all horses, the diagnosis was confirmed by means of radiography. Five horses were treated with stall rest alone; 5 underwent neurectomy; 4 were treated with stall rest and corrective shoeing; and 1 was treated with stall rest and external coaptation. The other 2 horses were euthanatized. Two Quarter Horses, 1 treated with stall rest and corrective shoeing and the other treated with stall rest and external coaptation, returned to use as halter horses, and 2 Standardbreds treated with stall rest alone returned to racing, but at a lower level than they had raced prior to injury. One horse that underwent neurectomy could be used for pleasure riding. Long-term rest may be important in achieving a successful outcome. Pleasure horses would appear to have a better prognosis for return to use after a distal sesamoid bone fracture than do performance horses.

Endoscopic examination and treatment of paranasal sinus disease in 16 horses.

Sixteen horses with suspected paranasal sinus disease had endoscopic examination of the paranasal sinuses with a 4.0 mm arthroscope either while standing and sedated (14 horses) or under general anesthesia (two horses). Endoscopic diagnosis included sinusitis (four horses), sinus cyst (three horses), hemorrhage (three horses), neoplasia (three horses), and tooth root abnormalities (two horses). No abnormalities were detected in one horse. Endoscopic findings concurred with the radiographic findings in 13 horses (81%). Samples of sinus contents for bacteriologic (eight horses) and histologic examinations (five horses) were obtained using sinus endoscopy. Diagnostic sinus endoscopy was combined with debridement, lavage, and suction as a therapeutic technique in 10 horses. In three horses, sinus exploration was performed after diagnostic endoscopy confirmed sinus disease, whereas in three horses, further therapy was not recommended after sinus endoscopy. Clinical signs of sinus disease resolved in 11 horses (69%) overall and in eight of 10 horses (80%) with sinusitis, cyst formation, or hemorrhage using endoscopic techniques alone. Mild, local subcutaneous emphysema occurred at the portal sites in all horses, but healing occurred without additional complications. Iatrogenic damage to sinus structures occurred in one horse. Sinus endoscopy was useful in the diagnosis and management of paranasal sinus disease and avoided the need for exploratory sinusotomy in some horses.

Disseminated Halicephalobus deletrix infection in a horse.

A 13-year-old Quarter Horse gelding was referred for evaluation of a draining tract and fracture of the right hemimandible of 4 weeks' duration. Two days prior to admission, the horse had developed pigmenturia. Radiography of the mandible revealed a fracture of the vertical ramus of the right hemimandible, loss of the right lower second premolar, and osteomyelitis involving an extensive portion of the hemimandible. Ultrasonography of the left kidney revealed loss of normal renal architecture. Histologic examination of tissue obtained from the right hemimandible revealed granulomatous osteomyelitis and multiple metazoan parasites identified as Halicephalobus deletrix. The horse was treated with antimicrobial and deworming agents, and the mandible was surgically debrided. The horse became atactic 8 days after surgery and was euthanatized. Necropsy identified parasitic migration in the right hemimandible, kidneys, and CNS.

Changes in fluid composition on the serosal surface of jejunum and small colon subjected to venous strangulation obstruction in ponies.

In 6 anesthetized ponies, 3 segments of jejunum and 3 segments of small colon were isolated from the peritoneal cavity in plastic bags filled with Hanks' balanced salt solution. One jejunal and 1 small colon segment were subjected to venous strangulation obstruction for 3 hours (VSO-3), venous strangulation obstruction for 6 hours (VSO-6), or a 6-hour sham procedure to control for changes induced by isolation in a plastic bag. Additional segments of jejunum and colon that were not placed in bags served as controls for histologic examination and collagenase measurements. Samples of fluid surrounding the intestine were obtained for chemical analyses, nucleated cell count, aerobic and anaerobic bacteriologic culture, and measurement of collagenase activity. Full-thickness tissue samples were obtained for histologic examination and measurement of collagenase content. Bacteria did not cross the intestinal wall after 3 and 6 hours of VSO, despite severe mucosal lesions in these segments. At 6 hours, PO2 was significantly less and PCO2 was significantly (P < 0.05) greater in the fluid surrounding the VSO-6 jejunal segments, compared with the sham jejunal segments. The pH was significantly (P < 0.05) less in fluid surrounding VSO-6 small colon segments, compared with the sham colon segments at 6 hours. For jejunum and small colon, phosphate and lactate concentrations were significantly (P < 0.05) greater in VSO-6 fluid than in the corresponding sham fluids at 6 hours. Fibrin formed around all VSO segments, although fibrinogen was not detected in the surrounding fluid, indicating possible rapid conversion of fibrinogen to fibrin.(ABSTRACT TRUNCATED AT 250 WORDS)

Ocular lymphangiosarcoma in a cow.

Ocular lymphangiosarcoma was diagnosed in a Holstein cow with a progressively enlarging limbal mass. The cow was treated by exenteration. The cow survived for 2 years without clinical signs of recurrence. Lymphangiosarcoma is a vascular neoplasm that rarely has been reported in domestic animals. In other species, it has a high rate of metastasis and is associated with poor long-term survival.

Intraluminal hemorrhage from small intestinal ulceration in two cows.

Two adult Holstein cows were admitted with signs of acute gastrointestinal hemorrhage. Abomasal ulceration was diagnosed tentatively in both cows, but was later ruled out in 1 cow that had an abomasotomy performed through a right paramedian approach. Both cows failed to respond to treatment of blood loss and hypovolemic shock and became recumbent; one cow died and the other was euthanatized. Post-mortem examination determined the source of hemorrhage in both cows to be ulcerated small intestine with severe intraluminal hemorrhage. The cause of ulceration was undetermined. Small intestinal hemorrhage should be considered in cattle with signs of acute gastrointestinal hemorrhage.