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Abstract

Objective—To evaluate records of racehorses with palmar carpal osteochondral fragments and determine whether the fragments were indicators of the severity of pathologic joint changes or prognosis.

Design—Retrospective case series.

Animals—31 racehorses.

Procedures—Medical records, radiographs, and videos of arthroscopic procedures were reviewed. Information gathered included signalment; location, number, and size of the primary lesion; number and size of palmar carpal fragments; and details pertaining to surgical procedures. Outcome variables were obtained from race records.

Results—31 horses met the selection criteria. Multiple palmar fragments were diagnosed in 58% of horses; small fragments (< 3 mm in diameter) were most common (52% of horses). Fifty-two percent of the horses returned to racing, 48% returned to racing and earned money, and 32% had at least 5 more starts. Horses with multiple fragments had significantly less earnings per start and lower performance index values after surgery than those with 1 fragment. Horses with palmar fragments < 3 mm in diameter were significantly less likely to return to racing and have 5 starts or to win money after surgery than horses with larger fragments.

Conclusions and Clinical Relevance—Palmar carpal osteochondral fragments can be used as an indicator of clinically important joint pathology and as a prognostic indicator in racehorses. Horses with multiple small fragments were less likely to successfully return to racing than horses with only dorsally located carpal fragments or horses with 1 or 2 large palmar fragments. When possible, removal of palmar carpal osteochondral fragments should be considered.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine the effect of colic surgery on return to function in Thoroughbred racehorses, identify clinical variables associated with successful return to racing, and compare racing performance between horses undergoing colic surgery and an untreated cohort.

Design—Retrospective cohort study.

Animals—59 Thoroughbred racehorses 2 to 5 years of age that underwent colic surgery and survived to hospital discharge and 90 untreated Thoroughbred racehorses equivalent in class.

Procedures—Medical records of patients evaluated for colic between January 1996 and July 2009 were reviewed, and horses with a Jockey Club Information Systems record were included. Physical examination and laboratory findings on hospital admission, lesion location and type, duration of surgery, duration of hospitalization, and any postoperative complications were recorded. The untreated cohort comprised 2 untreated horses randomly selected from runners in each treated horse's last race immediately prior to the date of colic surgery. Records were obtained from the Jockey Club Information Systems in April 2011. Only horses that raced at least once before and after surgery were included in the performance analysis. Number of starts, earnings per start, and total earnings were determined from race records for all horses. Quarterly earnings and number of starts for 12 quarters following the date of surgery were compared between treated and untreated horses via a Wilcoxon rank sum test. Longevity of racing was assessed by means of survival analysis. Poisson regression was used to compare rates of return to racing and active quarters aggregated across the first 12 quarters after surgery and for the available follow-up period for treated and untreated horses.

Results—45 of 59 (76%) horses that raced prior to surgery returned to racing. Return to racing was significantly associated with admission heart rate and blood lactate concentration. From quarters 3 to 12, treated and untreated horses had slight differences in the number of starts but no difference in earnings per quarter. Treated and untreated horses had no difference in total number of quarters raced, number of starts, or earnings after surgery. Treated horses had higher earnings per start, compared with untreated horses.

Conclusions and Clinical Relevance—In the present study, racing Thoroughbreds that underwent colic surgery and successfully returned to racing had no differences in performance variables, compared with their untreated cohorts.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To describe gastrointestinal histologic findings for horses with recurrent colic and evaluate possible associations between initial clinical signs, biopsy method, histologic diagnosis, and outcome 1 year after hospital discharge.

DESIGN Retrospective case series.

ANIMALS 66 horses with a history of recurrent colic for which gastrointestinal specimens had been submitted for histologic examination.

PROCEDURES Histologic diagnosis was categorized as inflammatory, neoplastic, ischemic, other, and undiagnosed. Relationships among initial clinical features, biopsy method, histologic diagnosis, and outcome 1 year after hospital discharge (ie, alive vs dead and persistent recurrent colic [yes vs no]) and between corticosteroid treatment and outcome were investigated. Odds ratios and hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated.

RESULTS Inflammatory disease (36/66 [55%]) was the most common histologic diagnosis. Horses undergoing rectal biopsy alone were significantly (OR, 14.4; 95% Cl, 2.7 to 76.1) more likely to not have a histologic diagnosis than were horses in which other biopsy methods were used. In multivariable modelling, persistence of recurrent colic (HR, 15.2; 95% Cl, 1.9 to 121.2) and a history of weight loss (HR, 4.9; 95% Cl, 1.4 to 16.5) were significantly associated with outcome (alive vs dead) 1 year after surgery. Corticosteroid treatment was not significantly associated with either outcome.

CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that a high proportion (36/66 [55%]) of horses with recurrent colic had inflammatory gastrointestinal disease. Use of rectal biopsy alone to obtain biopsy specimens was more likely to result in no histologic diagnosis. Use of corticosteroids in horses with inflammatory gastrointestinal disease was not associated with outcome but warrants further investigation.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine the outcome of horses with basal fractures of the proximal sesamoid bone from which a fracture fragment involving a portion of the base of the bone was removed arthroscopically and to determine whether fragment size was associated with outcome.

Design—Retrospective study.

Animals—26 horses.

Procedure—Dorsopalmar and axial-abaxial lengths of the fracture fragment were measured on the dorsopalmar and mediolateral radiographic views, respectively, and percentage of the base of the sesamoid bone involved was estimated. Fractures were classified as grade 1 (≤ 25% of the base involved) or grade 2 (> 25% but < 100% of the base involved). Outcome was classified as successful if the horse started at least 2 races or unsuccessful if the horse started only 1 race or failed to return to racing.

Results—There were 24 racehorses and 2 nonracehorses. Twelve (50%) of the racehorses returned to racing and started at least 2 races. Eight of 14 horses with grade-1 fractures and 4 of 10 horses with grade- 2 fractures had a successful outcome. Ten of 16 horses without associated articular disease had successful outcomes, compared with 2 of 8 horses with associated articular disease. However, fragment size and presence of associated articular disease were not significantly associated with outcome.

Conclusions and Clinical Relevance—Horses with basal fractures of the proximal sesamoid bone from which a fracture fragment involving a portion of the base of the bone is removed arthroscopically have a fair prognosis for return to racing. (J Am Vet Med Assoc 2000;217:236–240)

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine historical, physical, and microbiologic findings in horses with limb cellulitis and identify factors associated with short- and long-term outcome.

Design—Retrospective case series.

Animals—44 horses with limb cellulitis.

Procedures—Information obtained from medical records included use, history, affected limb, diagnostic procedures, treatment, and short-term outcome. Long-term follow-up information was obtained by means of a telephone survey.

Results—Twenty-four horses had primary cellulitis, and 18 of the 24 (75%) had a hind limb affected. Results of microbiologic culture were positive for all 20 horses with primary cellulitis from which specimens were obtained, with coagulase-positive Staphylococcus spp recovered from 12 of the 20. Short-term survival rate was 67% (16/24) for horses with primary cellulitis; 7 of the 9 horses available for long-term follow-up were being used for their intended use, and 4 had had a recurrence. Results of microbiologic culture were positive for 13 of the 16 (81%) horses with secondary cellulitis from which specimens were obtained. Short-term survival rate for horses with secondary cellulitis was 90% (18/20). Eleven of the 17 horses available for long-term follow-up were being used for their intended use; 2 had had a recurrence.

Conclusions and Clinical Relevance—Results suggested that cellulitis can be a life-threatening condition in horses. Horses that were febrile at admission or that developed laminitis were significantly less likely to survive. The prognosis for return to function was guarded, and recurrence was a potential concern.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate the use of serum concentrations of biochemical markers of bone metabolism (osteocalcin [OC], bone-specific alkaline phosphatase [BS-ALP], and deoxypyridinoline [DPYR]) to compare healing in infected versus noninfected fractures and in fractures with normal repair versus delayed (nonunion) repair in rabbits.

Animals—32 female 9- to 10-month-old New Zealand White rabbits.

Procedure—A femoral fracture defect was made in each rabbit. Rabbits were assigned to the following groups: the bone morphogenetic-2 gene treatment group with either noninfected nonunion or infected (ie, inoculation of defects with Staphylococcus aureus) nonunion fractures or the luciferase (control) gene treatment group with either noninfected nonunion or infected nonunion fractures. Serum samples were obtained before surgery (time 0) and 4, 8, 12, and 16 weeks after surgery. Callus formation and lysis grades were evaluated radiographically at 16 weeks.

Results—Serum OC and BS-ALP concentrations decreased from time 0 at 4 weeks, peaked at 8 weeks, and then decreased. Serum DPYR concentration peaked at 4 weeks and then decreased, independent of gene treatment group or fracture infection status. Compared with rabbits with noninfected fractures, those with infected fractures had lower serum OC and BS-ALP concentrations at 4 weeks, higher serum OC concentrations at 16 weeks, and higher serum DPYR concentrations at 4, 8, and 16 weeks. Combined serum OC, BS-ALP, and DPYR concentrations provided an accuracy of 96% for prediction of fracture infection status at 4 weeks.

Conclusions and Clinical Relevance—Measurement of multiple serum biochemical markers of bone metabolism could be useful for clinical evaluation of fracture healing and early diagnosis of osteomyelitis. ( J Am Vet Med Assoc 2003;64:727–735)

Full access
in American Journal of Veterinary Research

Abstract

Case Description—6 female alpacas, ranging in age from < 1 day to > 2 years, were examined because of primary owner complaints related to urogenital malformation.

Clinical Findings—In all instances, the vulva was totally to subtotally imperforate. One neonate had failure of passive transfer of immunity and mild azotemia at the time of initial examination. No additional urogenital malformations were detected in any of the alpacas.

Treatment and Outcome—Vulvoplasty performed via local anesthesia was successful in all alpacas. The neonate with failure of passive transfer received a plasma transfusion. Postsurgical wound management was limited to topically applied medications.

Clinical Relevance—Congenital vulvar deformity in alpacas may result in interference with urine outflow. Neonates with a completely imperforate vulva may be brought to veterinarians for examination on an emergency basis. Less severely affected alpacas may be examined later in life with owner complaints ranging from stranguria or dysuria to urogenital malformation. No other primary abnormalities of the urogenital tract in alpacas have been reported, to the authors' knowledge. Vulvoplasty, performed with local anesthesia, resolves obstructed urine flow. Because it is possible that this condition is heritable, affected alpacas, and possibly their sires and dams, should not be used for breeding.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate the use of hydrothermal ablation of articular cartilage for arthrodesis in horses through investigation of the effects of joint lavage with physiologic saline (0.9% NaCl) solution (80°C) for various treatment times on chondrocyte viability in the articular cartilage of the metacarpophalangeal and metatarsophalangeal joints of cadaveric horse limbs.

Sample Population—7 pairs of metacarpophalangeal and 8 pairs of metatarsophalangeal joints from 8 Thoroughbreds.

Procedure—The horses were euthanatized for reasons unrelated to musculoskeletal disease. On a random basis, 1 joint of each pair underwent intra-articular lavage for 5, 10, or 15 minutes with heated saline solution (80°C); the other joint underwent sham treatment of similar duration with saline solution at 22°C (control). Cartilage samples from the distal articular surface of metacarpus III (or metatarsus III), the proximal surface of the proximal phalanx, and the lateral and medial proximal sesamoid bones were assessed for chondrocyte viability via confocal microscopy and viability staining following enzymatic digestion.

Results—Compared with the control joints, findings of both viability assays indicated that the percentage of sites containing viable chondrocytes in heat-treated joints was decreased. Treatment hazard ratios of 0.048 (confocal microscopy) and 0.2 (digestion assay) were estimated. Histologically, periarticular soft tissues had minimal detrimental effects after heat treatment.

Conclusions and Clinical Relevance—Ex vivo intraarticular lavage with saline solution at 80°C resulted in the death of almost all articular chondrocytes in the joint. This technique may be a satisfactory method for extensive cartilage ablation when performing arthrodesis by minimally invasive techniques. (Am J Vet Res 2005;66:36–42)

Full access
in American Journal of Veterinary Research

Abstract

Objective—To evaluate use of technetium Tc 99m disodium hydroxymethylene diphosphonate (99m-Tc- HDP) for assessing fracture healing and 99m-Tc-HDP and technetium Tc 99m ciprofloxacin (99m-Tc-CIPRO) for early diagnosis of osteomyelitis in rabbits.

Animals—32 skeletally mature New Zealand White rabbits.

Procedure—A femoral fracture defect stabilized with bone plates and cortical screws was used. Scintigraphy was performed 4, 8, 12, and 16 weeks after surgery. The 99m-Tc-CIPRO scan was performed 48 hours after the 99m-Tc-HDP scan. The uptake ratio of the experimental limb to the normal limb was calculated by use of multiple regions of interest. Results of radiography performed to determine external callus and lysis grade and percentage defect ossification at 16 weeks were compared with scintigraphy results.

Results—Infected fractures had a higher uptake ratio for 99m-Tc-HDP and 99m-Tc-CIPRO than noninfected fractures. Infected fractures could be differentiated from noninfected fractures late in healing by use of 99m-Tc-HDP. Although 99m-Tc-CIPRO was better than 99m-Tc-HDP for identifying infection, there was a high incidence of false positive and negative results with 99m-Tc-CIPRO. There was an association between 99m-Tc-HDP uptake ratio and callus formation and a good correlation between 99m-Tc-HDP uptake ratio and defect ossification after 4 weeks.

Conclusions and Clinical Relevance—99m-Tc-HDP and 99m-Tc-CIPRO may be useful for diagnosing osteomyelitis late in fracture healing; however, false positive and false negative results occur. Technetium Tc 99m disodium hydroxymethylene diphosphonate may be useful for evaluating fracture healing. ( Am J Vet Res 2003;64:736–745)

Full access
in American Journal of Veterinary Research

Abstract

Objective—To document causes of colic in equine neonates, evaluate clinical features of neonates managed medically versus surgically, determine short- and long-term survival rates for neonates with specific medical and surgical lesions, and assess ability of patients to achieve intended use.

Design—Retrospective case series.

Animals—137 client-owned equine neonates (< 30 days old) with a history of colic or signs of colic within 1 hour after hospital admission examined between 2000 and 2010.

Procedures—Signalment, history, results of physical examination, laboratory data, ancillary diagnostic tests, details of treatment, primary diagnosis, concurrent diseases and short-term survival rate were obtained from the medical records. Long-term follow-up information was obtained through phone survey.

Results—137 neonates with colic were included. The majority (122 [89%]) of neonates were managed medically. The 3 most common diagnoses associated with colic were enterocolitis (37 [27%]), meconium-associated colic (27 [20%]), and transient medical colic (26 [19%]). The most common reason for surgery was small intestinal strangulating obstruction, and these neonates were more likely to have severe, continuous pain and were less responsive to analgesics. Concurrent diseases were common (87 [64%]) but did not significantly impact survival rate. Short-term survival rate was not significantly different between medically (75%) and surgically (73%) managed neonates. Long-term survival rate was excellent (66/71 [93%]) for horses that survived to hospital discharge. Most neonates surviving to maturity were used as intended (49/59 [83%]).

Conclusions and Clinical Relevance—Most neonates examined for signs of colic can be managed medically. Short-term survival rate in medically and surgically treated neonates was good. Long-term survival rate of foals discharged from the hospital was excellent, with most achieving intended use.

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in Journal of the American Veterinary Medical Association