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Abstract

Objective—To determine whether CT provides unique information about the treatment or prognosis for horses with ethmoid hematoma (EH).

Design—Retrospective case series.

Animals—16 horses with EH.

Procedures—Horses with a diagnosis of EH that had undergone a diagnostic CT study were included. Clinical features, treatment, outcome, radiographic and CT images, and histologic specimens were reviewed.

Results—CT provided new diagnostic information that affected treatment in 10 of 16 horses. Bilateral disease occurred in 8 of 16 horses and was undetected in 5 horses prior to CT. Paranasal sinus involvement occurred in all horses, but was incompletely defined prior to CT in 7 of 16 horses. The sphenopalatine sinus was affected in 6 of 16 horses as detected on CT; 4 of 6 of these were bilaterally affected. Medical and surgical treatments were performed. Six of 10 horses had a successful outcome, with recurrence in 4 of 10. Five of 6 patients in which treatment addressed all lesion sites identified by CT had a successful outcome. Bilateral disease did not confer a poor prognosis when all affected sites were treated. Sphenopalatine sinus involvement may have been associated with recurrence.

Conclusions and Clinical Relevance—CT provided anatomic information that may facilitate effective treatment of horses with EH, particularly in patients with bilateral disease and paranasal sinus involvement. Computed tomography is recommended for patients in which the lesion cannot be viewed endoscopically, when sinus involvement or multifocal disease are suspected, or when the lesion has been unresponsive to treatment.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To test the hypothesis that postanesthetic sedation with romifidine would dose-dependently improve recovery quality of recovery from isoflurane anesthesia in horses more than postanesthetic sedation with xylazine.

Design—Prospective, randomized, blinded clinical trial.

Animals—101 healthy adult horses examined at the University of California-Davis Veterinary Medical Teaching Hospital from 2007 to 2009.

Procedures—Horses were sedated with xylazine, and anesthesia was induced with guaifenesin, diazepam, and ketamine via a standardized drug protocol. Anesthesia for surgical or diagnostic procedures was maintained with isoflurane in oxygen for 1 to 4 hours. At the end of anesthesia, horses were moved to a padded stall for recovery. Once the breathing circuit was disconnected and the patient was spontaneously breathing, either xylazine (100 or 200 μg/kg [45 or 91 μg/lb]) or romifidine (10 or 20 μg/kg [4.5 or 9.1 μg/lb]) was administered IV. Objective patient, surgical, and anesthesia data were recorded. Subjective visual analog scale (VAS) scores of recovery quality were assigned by a single individual who was unaware of the treatment received. A stepwise linear regression model was used to correlate patient and procedure factors with the VAS score.

Results—Painful procedures, longer anesthesia times, and the Arabian horse breed were associated with poorer VAS scores. Adjustment for these factors revealed an improved VAS recovery score associated with the use of a romifidine dose of 20 μg/kg.

Conclusions and Clinical Relevance—In healthy adult horses anesthetized with isoflurane for > 1 hour, the results of this study supported the use of 20 μg of romifidine/kg, IV, rather than lower romifidine doses or xylazine, for postanesthetic sedation to improve recovery quality.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To define the reference range for laminar blood flow (BF) and vascular permeability (VPM) in horses without laminitis by use of dynamic contrast-enhanced computed tomography (CT).

Animals—9 adult horses that were not lame and had no abnormalities of the laminae or phalanges detectable via radiographic examination.

Procedures—Each horse was anesthetized by use of a routine protocol. Horses were placed in right or left lateral recumbency with the dependent forelimb in the CT gantry; only 1 limb of each horse was scanned. Serial 10-mm collimated transverse CT images were acquired at the same location every other second for 90 seconds during infusion of ionic, iodinated contrast medium. Custom software was used to estimate BF, VPM, and fractional vascular volume (FVV) in the dorsal, dorsomedial, and dorsolateral laminar regions.

Results—Among the 9 horses' forelimbs, mean ± SD dorsal laminar BF was 0.43 ± 0.21 mL•min−1•mL−1. Mean dorsomedial and dorsolateral laminar BFs were 0.26 ± 0.16 mL•min−1•mL−1 and 0.24 ± 0.16 mL•min−1•mL−1, respectively. Mean dorsal laminar VPM was 0.09 ± 0.03 mL•min−1•mL−1. Mean dorsomedial and dorsolateral laminar VPMs were 0.16 ± 0.06 mL•min−1•mL−1 and 0.12 ± 0.06 mL•min−1•mL−1, respectively. Mean dorsal laminar FVV was 0.63 ± 0.20 and dorsomedial and dorsolateral laminar FVV were 0.37 ± 0.14 and 0.34 ± 0.17, respectively.

Conclusions and Clinical Relevance—In horses, laminar BF, VPM, and FVV can be non-invasively measured by use of dynamic contrast-enhanced CT.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To evaluate use of a diode laser to induce tendinopathy in the superficial digital flexor tendon (SDFT) of horses.

Animals—4 equine cadavers and 5 adult horses.

Procedures—Cadaveric SDFT samples were exposed to a diode laser at various energy settings to determine an appropriate energy for use in in vivo experiments; lesion size was assessed histologically. In vivo experiments involved laser energy induction of lesions in the SDFT (2 preliminary horses [0, 25, 75, and 87.5 J] and 3 study horses [0 and 125 J]) and assessment of lesions. Study duration was 21 days, and lesions were assessed clinically and via ultrasonography, MRI, and histologic evaluation.

Results—Lesion induction in cadaveric tissues resulted in a spherical cavitated core with surrounding tissue coagulation. Lesion size had a linear relationship (R 2 = 0.9) with the energy administered. Size of in vivo lesions in preliminary horses indicated that larger lesions were required. In study horses, lesions induced with 125 J were ultrasonographically and histologically larger than were control lesions. At proximal and distal locations, pooled (preliminary and study horses) ultrasonographically assessed lesions were discrete and variable in size (mean ± SEM lesion percentage for control lesions, 8.5 ± 3%; for laser lesions, 12.2 ± 1.7%). Ultrasonography and MRI measurements were associated (R 2 > 0.84) with cross-sectional area measurements.

Conclusions and Clinical Relevance—In vivo diode laser–induced lesions did not reflect cadaveric lesions in repeatable size. Further research is required before diode lasers can reliably be used for inducing tendinopathy.

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE

Mesenchymal stromal (stem) cells (MSCs) have been studied to treat many common orthopedic injuries in horses. However, there is limited information available on when and how to use this treatment effectively. The aim of this retrospective study is to report case features, treatment protocols, and clinical outcomes in horses treated with MSCs.

ANIMALS

65 horses presenting with tendinous, ligamentous, and articular injuries, and treated with MSCs prepared by a single laboratory between 2016 and 2019. Outcome information was available for 26 horses.

PROCEDURES

Signalment, clinical signs, diagnostic methods, treatment protocol features (prior and concurrent therapies, cell origin, dose, application site and number), and effective outcomes were analyzed. The analysis was focused on comparing the effect of different MSC treatment protocols (eg, autologous vs allogeneic) on outcome rather than the effectiveness of MSC treatment.

RESULTS

MSC treatment resulted in 59.1% (clinical lameness) to 76.9% (imaging structure) improvement in horses with diverse ages, breeds, sex, and lesions. The use of other therapeutic methods before MSC application (eg, anti-inflammatories, shockwave, laser, icing, resting, bandage and stack wrap, intra-articular injections, and/or surgical debridement) was shown to be statistically more effective compared to MSCs used as the primary therapeutic procedure (P < .05). Autologous versus allogeneic treatment outcomes were not significantly different.

CLINICAL RELEVANCE

A prospective MSC treatment study with standardization and controls to evaluate the different features of MSC treatment protocols is needed. The various case presentations and treatment protocols evaluated can be used to inform practitioners who are currently using MSCs in clinical practice.

Open access
in American Journal of Veterinary Research

Objective

To determine the benefits of reducing the interval between surgical cytoreduction and intratumoral administration of cisplatin.

Design

Randomized clinical study.

Animals

70 horses with 89 incompletely resected T2- and T3-stage sarcoids (n = 64) and squamous cell carcinomas (25).

Procedure

Horses were given 4 intratumoral treatments of cisplatin at 2-week intervals. The first treatment was given at the time of, or immediately after, surgical resection for horses treated in accordance with the perioperative protocol (group 1). Horses in group 2 were treated with cisplatin after the skin healed following surgical resection in accordance with the postoperative protocol.

Results

A difference was not found in duration of overall local tumor control between the 2 groups. Patterns of treatment failures and interval to failure differed between the 2 groups. Length of the surgical scar was the only factor that affected prognosis; an increase in length was associated with a poorer prognosis. A detrimental effect of postoperative treatment was only found in tumors with a high tumor proliferative fraction. Local reactions were similar for the 2 treatment groups, and chronic reactions were not observed.

Conclusions and Clinical Relevance

Intratumoral administration of cisplatin is beneficial for treatment of cutaneous tumors in horses. Tumor repopulation during the interval between surgery and intratumoral administration of cisplatin decreases treatment efficacy. These results provide evidence of rapid tumor repopulation following surgical resection without a lag period for tumors with a high proliferation index. When tumor proliferation index is not known, it may be prudent to use the perioperative protocol. (J Am Vet Med Assoc 1999;215:1655–1660)

Free access
in Journal of the American Veterinary Medical Association

Objective

To document natural bacterial flora on the ventral aspect of the equine abdomen, to compare 2 preparation techniques, and to identify potential risk factors that may contribute to incisional drainage.

Design

Prospective study.

Animals

53 horses undergoing exploratory celiotomy.

Procedure

Group-1 horses (n = 26) were prepared with povidone-iodine and alcohol. Group-2 horses (27) were prepared with a film-forming iodophor complex. Numbers of bacterial colony-forming units (CFU) were measured before and after surgical scrub, following skin closure, and after recovery from general anesthesia. Swab specimens to identify normal skin bacterial flora and potential pathogens were obtained by swabbing a 4 X 4-cm area. Variables that might affect incisional drainage were also investigated.

Results

For both techniques, there was a significant reduction in bacterial numbers after skin preparation. Incisional drainage was observed in 14 (26%) horses (8 group-1 and 6 group-2 horses). Preexisting dermatitis, poor intraoperative drape adherence, high number of bacterial CFU obtained after recovery from anesthesia, and high number of CFU obtained from the surgery room environment were the main risk factors associated with subsequent incisional drainage. Bacillus spp, nonhemolytic Staphylococcus spp, Micrococcus spp, Corynebacterium spp, Streptomyces spp, other nonenteric genera, and non-hemolytic Streptococcus spp were the most common isolates obtained before surgical scrub.

Conclusions and Clinical Relevance

Both skin preparation techniques were equally effective in reducing numbers of bacterial CFU by 99%, and a significant difference was not found in incisional drainage rate between groups. Protection of the wound during recovery from anesthesia and the immediate postoperative period may reduce incisional drainage after abdominal surgery in horses. (J Am Vet Med Assoc 1999;215:963–969)

Free access
in Journal of the American Veterinary Medical Association

Abstract

Objectives

To provide an accurate and detailed description of the laparoscopic anatomy of the abdomen of horses positioned in dorsal recumbency and to compare those observations with laparoscopic anatomy of standing horses. The effects of laparoscopy and positional changes on arterial blood pressure and blood gas values also were investigated.

Design

Descriptive anatomic study.

Sample Population

Laparoscopy was performed on 6 horses (2 mares, 2 geldings, and 2 stallions) to record the normal laparoscopic anatomy of the abdomen in dorsal recumbency.

Procedure

Feed was withheld from all horses for 36 hours. Horses, under general anesthesia, were examined in horizontal and inclined positions (head-up and head-down). Intermittent positive-pressure ventilation was used, arterial blood pressure was continuously monitored, and samples for arterial blood gas measurements were taken at intervals.

Results

The main structures of diagnostic relevance observed in the caudal region of the abdomen were the urinary bladder, mesorchium and ductus deferens (left and right), left and right vaginal rings, insertion of the pre-pubic tendon, random segments of jejunum and descending colon, pelvic flexure of the ascending colon, body of the cecum, and cecocolic fold. The main structures observed in the cranial region of the abdomen were ventral surface of the diaphragm, falciform ligament and round ligaments of the liver, ventral portion of the left lateral, left medial, quadrate, and right lateral lobes of the liver, spleen, right and left ventral colons, sternal flexure of the ascending colon, apex of the cecum, and stomach.

Conclusions

Alterations in cardiovascular and respiratory function in response to pneumoperitoneum and various positional changes indicated the need for continuous and throrough anesthetic monitoring and support. Comparison of anatomic observations made in dorsally recumbent, inclined horses with those reported for standing horses should enable practitioners to make patient positioning decisions that best suit access to specific visceral structures. Development of special instrumentation for manipulation of the viscera in horses, particularly the intestinal tract, would increase the diagnostic and therapeutic capabilities of laparoscopy during dorsal recumbency. (Am J Vet Res 1996;57:923–931)

Free access
in American Journal of Veterinary Research

Summary

The signalment, clinical and laboratory findings of surgical conditions, treatment, and outcome of 102 cases of descending colon disease in horses were reviewed. Abnormal conditions were categorized as enteroliths, impactions, strangulating lipomas, fecaliths, foreign body obstruction, volvulus, nephrosplenic entrapment, and other conditions. Eleven breed categories of horses were seen during this period. Arabians, ponies, and American miniature horses were more predisposed to descending colon disease than other breeds (P < 0.05). Female horses and animals >15 years old were more likely to be affected with descending colon disease, whereas horses <5 years old were less likely to be affected (P < 0.05). More specifically, Arabians, Quarter Horses, and Thoroughbreds >10 years old were breeds that were overrepresented when compared with the hospital population (P < 0.05). Enteroliths were most commonly seen in horses between 5 and 10 years old (P < 0.05) and were not seen in horses <2 years old. Enteroliths had a tendency to develop more commonly in Arabians and in female horses. Impactions affected horses >15 years old (P < 0.05) and had a greater tendency to affect ponies and American miniature horses. Female horses were more commonly affected by impaction than were males. Strangulating lipomas were commonly seen in horses >15 years old (P < 0.05) and more specifically female Quarter Horses (P < 0.05). Fecaliths tended to be a disease of horses <1 year old or >15years old and affected males more commonly than females. Ponies, American miniature horses, mixed-breed horses, and mustangs were the breeds most commonly affected. Surgical conditions were categorized as vascular (16%) or nonvascular (84%) conditions. Vascular conditions included strangulating lipomas (6%) and other conditions (10%). Nonvascular conditions included enteroliths (40%), impactions (25%), fecaliths (13%), and other conditions (6%). Horses with vascular lesions were older than horses with nonvascular conditions (P < 0.05). Peritoneal fluid values were high for all surgical conditions of the descending colon. Nucleated cell count and total protein concentration in peritoneal fluid retrieved from horses with vascular lesions were higher than in horses with nonvascular lesions (P < 0.01). Palpation per rectum revealed abnormal findings more commonly in horses with vascular compromise (P < 0.05). Of those horses taken to surgery, 91% were recovered from anesthesia and discharged; 90% of horses, for which the condition was monitored to at least 6 months after surgery, were alive. All horses that were medically treated were alive at least 6 months after discharge.

Free access
in Journal of the American Veterinary Medical Association