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Case Description—A 7-year-old Quarter Horse gelding was evaluated because of sudden onset of severe left forelimb lameness of 4 days' duration.
Clinical Findings—Clinical evaluation and diagnostic perineural analgesia localized the lameness to the distal portion of the left forelimb. Radiography revealed a transverse fracture of the distal phalanx of the left forelimb.
Treatment and Outcome—The horse was treated conservatively with stall rest and stabilization of the hoof with fiberglass cast material and an elevated heel support. These treatments improved the lameness considerably. Over the following 4 months, the horse was exercised at an increasing level; external coaptation of the hoof was removed, and the horse was gradually shod in a flat shoe. At 6 months after injury, the horse had no signs of lameness when working at its previous performance level, but it was euthanized for reasons unrelated to orthopedic disease. Radiographically, the fracture was unapparent; however, results of magnetic resonance imaging and histologic examination of the cadaveric limb confirmed the presence of tissue changes consistent with a healing fracture.
Clinical Relevance—Conservative management of transverse fractures of the distal phalanx of a forelimb may be effective and enable affected horses to be returned to their intended use.
Case Description—A 2-year-old 38.9-kg (85.58-lb) sexually intact male German Shepherd Dog was examined because of a 4-month history of severe nasal swelling and nasal mucosa congestion. The signs were slowly progressive.
Clinical Findings—Physical examination revealed that the dorsal aspect of the dog's nose was swollen and hard. Mucous membranes in both nostrils were hyperemic and edematous. Diagnostic investigation revealed severe nasal osteolysis and pyogranulomatous rhinitis and nasopharyngitis attributable to blastomycosis.
Treatment and Outcome—Oral administration of itraconazole was initiated (5 mg/kg [2.27 mg/lb], q 12 h for 5 days and then q 24 h). After a treatment period of 3 months, the nose had regained its normal appearance. After 5 months of treatment, the Blastomyces infection was eliminated as confirmed by results of rhinoscopy and biopsy specimen examination. No relapse was evident within 1 year after discontinuation of treatment.
Clinical Relevance—In dogs, nasal and nasopharyngeal blastomycosis can result in severe osteolysis of the nasal bone. Resolution of disease can be achieved with oral administration of itraconazole for a period of at least 5 months.