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Objectives

To determine radiation exposure to personnel during fluoroscopic imaging of limbs of horses with a portable unit and to determine distance from the c-arm at which radioprotective clothing is not required.

Design

Repeated-measures cohort study.

Sample Population

Part 1, 1 forelimb and 1 hind limb from each of 5 equine cadavers; parts 2 and 3, personnel involved during imaging of limbs of 5 and 9 horses, respectively.

Procedure

Radiation exposure rates were mapped around the suspended c-arm of a portable fluoroscopy unit during imaging of various joints of equine cadaver limbs. During similar examinations in live horses, exposure rates to the fluoroscopist and assistant were measured. Mean duration for fluoroscopy of various joints was determined by observing an experienced fluoroscopist. Exposure to fluoroscopists and assistants per examination and per annum was estimated.

Results

Radiation exposure rates were dependent on distance and direction relative to the c-arm and consistently highest on the tube side of the unit. Exposure was significantly greater than background amounts until approximately 4.7 m from the c-arm. During examination of live horses, exposure was highest to the fluoroscopist's hand nearest the tube. Typically, exposure to the fluoroscopist and assistant during carpal examination was 25 to 40 times greater than that for comparable radiographic examination. Annual exposure for fluoroscopists was more than twice the recommended maximum permissible dose.

Conclusions and Clinical Relevance

Fluoroscopic imaging of limbs of horses represents a major source of radiation exposure. Annual maximum permissible doses of radiation will be rapidly exceeded if required radioprotective clothing is not worn. (J Am Vet Med Assoc 1999;215:372–379)

Free access
in Journal of the American Veterinary Medical Association

SUMMARY

Lameness examinations and radiography of the distal phalanx and associated soft-tissue structures of the front feet of 103 Thoroughbred racehorses, 4 to 9 years old, were performed to determine normal radiographic appearance and morphometry. Of 103 horses examined, 41 were used in the study that were without clinical signs of foot problems or lameness, had raced at least twice prior to radiography, and had raced at least twice more in the 6 months after radiography.

Lateromedial and dorsoproximal-palmarodistal radiographic views of each front distal phalanx were used to measure 28 bone and soft-tissue structures, and to evaluate 14 radiographic findings. Significant differences were not observed between left and right digits for any radiographic determination.

Mean thickness of the soft tissues dorsal to the distal phalanx, which provides an evaluation of the epidermal laminae, was 14.6 ± 1.0 mm when measured adjacent to the distal aspect of the distal phalanx. Most horses had straight, smooth hoof walls that were parallel to the dorsal cortex of the distal phalanx. The mean degree of palmar rotation of the distal phalanx was −0.5 ± 1.3, and none was rotated more than 4°.

The dorsal cortex was smooth and straight, without bone deposition or reaction in either digit for only 5 of the 41 horses. Active bone formation was seen unilaterally along the middle portion of the dorsal cortex in 7 horses, and along the distal portion of the dorsal cortex in 4 of the phalanges from 3 horses. New bone formation along the distal dorsal cortex was often accompanied by resorption of the palmar cortex. For 26 of the 31 horses without active bone deposition, smooth inactive bone formation along the midportion of the dorsal cortex was identified in 1 or both distal phalanges.

Bone at the solar margin of the distal phalanx was uniformly dense and finely trabeculated, without evidence of resorption or fractures. Severe irregularity of the solar margin was not found in any digit, and the margin of both phalanges was smooth in 8 horses. Various degrees of solar margin irregularity were observed in the other 33 horses.

The mean number of vascular canals within the distal phalanx was 8.4 ± 1.7, and the diameter of the largest canal was 3.4 ± 0.6 mm. A mean number of 2.0 ± 1.2 vascular canals was oriented parallel to the radiographic beam on the dorsoproximal-palmarodistal view, and these were termed end-on vessels, because they were visualized as radiolucent dots ≥ 1 mm in diameter in the central portion of the distal phalanx.

Racing performance of horses with subtle radiographic signs of laminitis (palmar rotation, hoof wall curvature or undulations, palmar cortical resorption, distal dorsal cortical bone deposition) was poorer than that of horses without these signs. These findings are suggestive of a subclinical laminitis condition, which may influence performance without causing overt clinical signs.

Free access
in American Journal of Veterinary Research

Summary

Radiography and soft tissue- and bone-phase scintigraphy were performed on 14 clinically normal horses and 35 horses in which definite, probable, or possible navicular disease had been diagnosed. The specificity of radiography and scintigraphy in revealing signs of navicular disease were nearly equal; however, the sensitivity of scintigraphy appeared to be greater than that of radiography. The greatest sensitivity and specificity were achieved when the results of radiography and scintigraphy were evaluated together. Differences in sensitivity were greatest when scintigraphy revealed lesions not detected by radiography. Although a diagnosis of navicular disease was sometimes made when only soft tissue-phase or only bone-phase scintigraphy revealed lesions, results obtained during the 2 phases generally were similar. It was concluded that scintigraphy can be a valuable aid in diagnosing navicular disease in horses, especially when radiographic findings do not support clinical findings.

Free access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To identify and characterize motilin receptors in equine duodenum, jejunum, cecum, and large colon and to determine whether erythromycin lactobionate competes with porcine motilin for binding to these receptors.

Sample Population—Specimens of various segments of the intestinal tracts of 4 adult horses euthanatized for reasons unrelated to gastrointestinal tract disease.

Procedure—Cellular membranes were prepared from smooth muscle tissues of the duodenum, jejunum, pelvic flexure, and cecum. Affinity and distribution of motilin binding on membrane preparations were determined by use of 125I-labeled synthetic porcine motilin. Displacement studies were used to investigate competition between 125I-labeled synthetic porcine motilin and erythromycin lactobionate for binding to motilin receptors in various segments of bowel.

Results—Affinity of 125I-labeled synthetic porcine motilin for the equine motilin receptor was estimated to be 6.1nM. A significantly higher number of motilin receptors was found in the duodenum than in the pelvic flexure and cecum. The jejunum had a significantly higher number of motilin receptors than the cecum. Erythromycin lactobionate displacement of 125I-labeled porcine motilin from the equine motilin receptor did not differ significantly among various segments of bowel.

Conclusions and Clinical Relevance—Motilin receptors were found in the duodenum, jejunum, pelvic flexure, and cecum of horses. The highest number of motilin receptors was in the duodenum, and it decreased in more distal segments of bowel. Erythromycin lactobionate competed with motilin binding in the equine gastrointestinal tract. This suggests that 1 of the prokinetic actions of erythromycin in horses is likely to be secondary to binding on motilin receptors. (Am J Vet Res 2002;63:1545–1550)

Full access
in American Journal of Veterinary Research

Abstract

Objective—To determine whether a single contusive impact injury to the palmar aspect of the metacarpus would progress to post-traumatic osteoarthritis or palmar osteochondral disease in horses.

Animals—12 horses.

Procedures—In each horse, an impact injury was created on the palmar aspect of the medial metacarpal condyle of 1 randomly chosen limb with an impactor device under arthroscopic and fluoroscopic guidance. The opposite limb was sham operated as a control. A low to moderate amount of forced exercise was instituted, and horses were evaluated clinically via lameness examinations weekly for 5 months, then biweekly until endpoint, with synovial fluid analysis performed at 0, 1, 2, 3, 4, 6, 8, and 10 months and radiography at baseline and endpoint. Macroscopic examination, micro-CT, and sample collection for cartilage viability and sulfated glycosaminoglycan content, histologic evaluation, immunohistochemical analysis, and fluorochrome analysis were performed following euthanasia at 1 (3 horses), 4 (4), and 8 to 10 (5) months after surgery.

Results—There was variability in impact lesion location, depth, and area on macroscopic inspection, but on histologic evaluation, cartilage defects were less variable. Mean sulfated glycosaminoglycan concentration from cartilage at the impact site was significantly lower than that at a similar site in control limbs. Higher concentrations of cartilage oligomeric matrix protein were observed in synovial fluid from impact-injured joints.

Conclusions and Clinical Relevance—The impact injury method caused mild focal osteoarthritic lesions in the metacarpophalangeal joint, but did not progress to palmar osteochondral disease at this site. Repeated injury is probably required for the development of palmar osteochondral disease.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To determine effects of extracorporeal shock wave therapy (ESWT) on healing of wounds in the distal portion of the forelimb in horses.

Animals—6 horses.

Procedures—Five 6.25-cm2 superficial wounds were created over both third metacarpi of 6 horses. Forelimbs were randomly assigned to treatment (ESWT and bandage) or control (bandage only) groups. In treated limbs, each wound was treated with 625 shock wave pulses from an unfocused electrohydraulic shock wave generator. In control limbs, each wound received sham treatment. Wound appearance was recorded weekly as inflamed or healthy and scored for the amount of protruding granulation tissue. Standardized digital photographs were used to determine the area of neoepithelialization and absolute wound area. Biopsy was performed on 1 wound on each limb every week for 6 weeks to evaluate epithelialization, fibroplasia, neovascularization, and inflammation. Immunohistochemical staining for A smooth muscle actin was used to label myofibroblasts.

Results—Control wounds were 1.9 times as likely to appear inflamed, compared with treated wounds. Control wounds had significantly higher scores for exuberant granulation tissue. Treatment did not affect wound size or area of neoepithelialization. No significant difference was found for any of the histologic or immunohistochemical variables between groups.

Conclusions and Clinical Relevance—Treatment with ESWT did not accelerate healing of equine distal limb wounds, but treated wounds had less exuberant granulation tissue and appeared healthier than controls. Therefore, ESWT may be useful to prevent exuberant granulation tissue formation and chronic inflammation of such wounds, but further studies are necessary before recommending ESWT for clinical application.

Full access
in American Journal of Veterinary Research