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  • Author or Editor: Eric J. Parente x
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Abstract

Objective—To identify history, clinical signs, endoscopic findings, treatment, and outcome of mature (> 8 years old) nonracehorses with epiglottic abnormalities.

Design—Retrospective case series.

Animals—23 horses with an epiglottic abnormality.

Procedures—Medical records of horses examined between 1990 and 2009 because of an epiglottic abnormality were reviewed to obtain information on signalment, history, clinical signs, clinical examination findings, upper airway endoscopic findings, diagnosis, surgical procedure, clinical management, postoperative care, and outcome.

Results—Mean ± SD age was 16 ± 6 years (range, 9 to 30 years). Sixteen of the 23 (70%) horses had a primary complaint of a chronic cough. Thirteen (57%) horses had epiglottic entrapment, 7 (30%) had a subepiglottic granuloma, and 3 (13%) had a subepiglottic cyst. All 23 horses were treated surgically, with 1 (4%) requiring further surgical treatment. Follow-up examinations and conversations with owners indicated resolution of the primary complaint in 17 of the 23 (74%) horses, with 4 (24%) requiring prolonged medical treatment because of postoperative subepiglottic inflammation. Of the 6 horses without complete resolution, 4 (67%) had signs of recurrent airway obstruction and 2 (33%) developed persistent dorsal displacement of the soft palate following laryngotomy and subepiglottic membrane resection.

Conclusions and Clinical Relevance—Results suggested that coughing is a common complaint in mature nonracehorses with epiglottic abnormalities. Therefore, upper airway endoscopy is recommended in the evaluation of older horses with a cough. Surgical treatment can be beneficial in most horses, with some requiring further postoperative medical treatment.

Full access
in Journal of the American Veterinary Medical Association

Objective

To evaluate laryngeal function by means of videoendoscopy during high-speed treadmill exercise in racehorses with grade-III left laryngeal hemiparesis at rest and to determine outcome of treatment.

Design

Retrospective study.

Animals

26 racehorses.

Procedure

Videoendoscopy of the larynx was performed while horses were at rest and exercising on a treadmill. Horses were classified as having grade-III A, -IIIB, or -IIIC laryngeal hemiparesis on the basis of the degree of arytenoid cartilage abduction maintained during exercise. Postoperative racing performance was determined by evaluating race records and conducting telephone surveys.

Results

20 (77%) horses had grade-IIIC laryngeal hemiparesis (ie, severe dynamic laryngeal collapse during exercise). Eighteen underwent surgery, and racing performance was improved in 9. Five (19%) horses had grade-IIIB laryngeal hemiparesis (ie, left arytenoid cartilage and vocal fold were maintained in an incompletely abducted position during exercise). Four underwent surgery, and racing performance was improved in 1. One (4%) horse had grade-IIIA laryngeal hemiparesis (ie, full abduction of arytenoid cartilage during exercise); surgery was not performed.

Clinical Implications

Videoendoscopy is useful in determining dynamic laryngeal function in racehorses with grade-III laryngeal hemiparesis at rest. (J Am Vet Med Assoc 1998; 212:399-403)

Free access
in Journal of the American Veterinary Medical Association

Abstract

Case Description—An 8-year-old multiparous Thoroughbred broodmare was admitted for evaluation of a rectal tear sustained during parturition.

Clinical Findings—On initial evaluation, the mare had mild signs of abdominal discomfort. A full-thickness rectal tear located 30 cm cranial to the anus and extending approximately 15 cm longitudinally along the surface of the small colon between the 4 and 6 o'clock positions, when viewed from behind, was diagnosed on examination per rectum.

Treatment and Outcome—Laparoscopic evaluation of the abdomen was performed to assess the tear and extent of peritoneal contamination. A hand-assisted repair via a flank incision was performed. The tear was closed in a single-layer, simple continuous pattern with size-0 polydioxanone with a handheld needle holder. Subsequently, a ventral midline celiotomy was performed, and intestinal contents were evacuated via a pelvic flexure enterotomy and a typhlotomy. Following surgery, the mare was managed with IV fluid therapy, partial parenteral nutrition, antimicrobials, and NSAIDs for 5 to 7 days before being gradually reintroduced to a complete pelleted feed and alfalfa hay. Prior to discharge, examination per rectum revealed no stricture formation associated with repair. The mare was discharged from the hospital and performed successfully as a broodmare, with the delivery of a live foal 1 year after surgery.

Clinical Relevance—Successful repair with an excellent outcome was achieved in this mare. Hand-assisted laparoscopic repair should be considered as a possible treatment option in horses with grade IV rectal tears.

Full access
in Journal of the American Veterinary Medical Association

Summary:

Medical records of 57 horses admitted between 1980 and 1991 because of basal sesamoidean fractures were evaluated. Radiographic measurements of fragment size and fracture characteristics were recorded to determine their relationship to outcome. A successful outcome was assessed on the basis of the ability to return to racing, ability to race more than one time, and ability to finish first, second, or third. Any change in racing class also was assessed.

There was a significant (P < 0.001) overrepresentation of Thoroughbreds, compared with other breeds in the hospital population. Fractures of the forelimbs accounted for 50 of the 57 fractures, and the right front medial sesamoid was affected significantly (P < 0.0001) more frequently than other proximal sesamoids.

Fifty-nine percent of the horses returned to race at least 1 time regardless of treatment, and 41% finished first, second, or third. Horses with smaller fragments (shorter dorsopalmar length) tended to do better than horses with larger fragments. Horses without comminuted fractures tended to do better than horses with comminuted fractures, and horses with fragments only mildly (< 3 mm) displaced had significantly (P < 0.05) better outcomes than did horses with severe displacement of fragments. Only 19% of the horses with moderate (> 3 mm) displacement of fragments raced more than once, whereas 63% of horses with mild displacement of fragments returned to race more than once.

Seventy-three percent of the horses that had the fragment removed surgically returned to race, and 57% dropped in class. Only 48% of the horses that did not have the fragment removed returned to race, and 87% dropped in class. Mean time for return to racing was 8.6 months for horses that had the fragment removed, and 6.5 months for those that did not.

Free access
in Journal of the American Veterinary Medical Association

Objective

To evaluate results of cytologic examination of specimens obtained by means of tracheal washes (TW) in 42 horses with a history of poor performance.

Design

Cross-sectional case series.

Animals

42 horses with a history of poor performance.

Procedure

A TW was performed via endoscopy before and after horses exercised on a high-speed treadmill, and specimens were evaluated microscopically and graded.

Results

Ten (24%) horses were considered to be clinically normal before and after exercise. Pulmonary hemorrhage was diagnosed in 8 (19%) horses. One horse had evidence of exercise-induced pulmonary hemorrhage (EIPH) before exercise and pulmonary hemorrhage and allergic or inflammatory airway disease (IAD) after exercise. Five (12%) horses had IAD, and 1 had IAD and pulmonary hemorrhage after exercise. Seven (17%) horses had evidence of EIPH and IAD in both specimens. Four (10%) horses with EIPH had an increase in the proportion of hemosiderophages in the specimen obtained after exercise. Specimens obtained before exercise in 6 (14%) horses were not representative of the respiratory tract and could not be compared with specimens obtained after exercise.

Clinical Implications

Interpretation of TW specimens obtained before and after exercise differed for only 5 of 36 (14%) horses. Specimens obtained after exercise were more likely to reveal airway disease. All specimens obtained after exercise adequately represented the respiratory tract, whereas 6 specimens obtained before exercise did not. Specimens obtained after exercise contained more airway secretions and had less cytologic evidence of pharyngeal contamination. Therefore, we recommend that TW samples be obtained after exercise in horses. (J Am Vet Med Assoc 1999;214:673–677)

Free access
in Journal of the American Veterinary Medical Association

Abstract

Case Description—3 racehorses were evaluated because of poor performance or abnormal noise originating from the upper portion of the respiratory tract.

Clinical Findings—During maximal exercise, initial dynamic videoendoscopy of the upper respiratory tract revealed complete arytenoid cartilage abduction in 2 horses and incomplete but adequate abduction of the left arytenoid cartilage in 1 horse. Subsequent exercising endoscopic evaluation revealed severe dynamic collapse of the left arytenoid cartilage and vocal fold in all 3 horses.

Treatment and Outcome—2 horses were treated with prosthetic left laryngoplasty and raced successfully. One horse was retired from racing.

Clinical Relevance—Idiopathic laryngeal hemiplegia can be a progressive disease. Successive dynamic videoendoscopic upper airway evaluations were used to confirm progression of left laryngeal hemiplegia in these 3 horses. Videoendoscopy of the upper respiratory tract during exercise should be considered as part of the clinical evaluation of horses with signs of upper respiratory tract dysfunction.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Case Description—A 1-day-old Standardbred foal with a history of extreme respiratory distress after birth consistent with upper airway obstruction was evaluated. A temporary tracheostomy tube was placed by the referring veterinarian.

Clinical Findings—On initial examination, there was evidence of hypoxic-ischemic syndrome, secondary to perinatal asphyxia. Endoscopy revealed obstruction of both nares at the level of the choanae; a diagnosis of bilateral choanal atresia was made.

Treatment and Outcome—The foal was anesthetized and underwent transendoscopic laser fenestration of the buccopharyngeal membranes. Three weeks after surgery, cicatricial narrowing of the choanae was apparent and further transendoscopic ablation was performed. Recurrent stenosis necessitated revision surgeries involving a combination of laser ablation with topical administration of mitomycin and, subsequently, a combination of radial incisions into the stenotic tissue and repeated bougienage with a cuffed endotracheal tube. The degree of stenosis decreased, and at 1 year of age, the horse was an appropriate size for its age, had choanae that were almost maximally open (> 85%), and had entered training. Mild stenosis was still evident when the horse was reexamined the following year, although there was no evidence of exercise intolerance or respiratory compromise.

Clinical Relevance—Bilateral choanal atresia in a foal can be successfully treated via transendoscopic fenestration of the buccopharyngeal membranes, enabling the horse to subsequently participate in athletic activities. Secondary problems resulting from initial asphyxia and recurrent stenosis at the surgical site can be overcome but may require prolonged and extensive treatment.

Full access
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Summary

Keratan sulfate (ks) is a glycosaminoglycan, distribution of which is confined mostly to hyaline cartilage. As such, it is a putative marker of hyaline cartilage catabolism. In experiment 1, a focal osteochondral defect was made arthroscopically in 1 radial carpal bone of 2 ponies, and in 2 other ponies, chymopapain was injected into the radiocarpal joint to induce cartilage catabolism. Sequential and concurrent plasma and synovial fluid concentrations of ks were measured, up to 13 months after induction of cartilage injury, to determine whether changes in ks concentrations reflected cartilage catabolism. In experiment 2, a large, bilateral osteochondral defect was made in the radial carpal bones of 18 ponies, which were subsequently given postoperative exercise and/or injected intra-articularly with 250 mg of polysulfated glycosaminoglycan (PSGAG). Medication was given at surgery, then weekly for 4 weeks. Blood samples were collected and synovial fluid was aspirated before surgery, when medication was given, and at postmortem examination (postoperative week 17). The ks concentration was measured in these fluids to determine whether changes in ks concentration indicated an effect of joint treatment.

In experiment 1, the concentration of ks in synovial fluid was highest 1 day after joint injury, and the concentration in plasma peaked 2 days after joint injury. For ponies receiving chymopapain intra-articularly (generalized cartilage catabolism), a fivefold increase over baseline was observed in the concentration of ks in plasma (peak mean, 1.2 μg/ml), and a tenfold increase over baseline in synovial fluid (peak mean, 2.0 mg/ml) was observed. On average, these maxima were threefold higher than values in fluids of ponies with osteochondral defects (focal cartilage disease).

In experiment 2, nonexercised ponies had lower ks concentration (as a percentage of the preoperative concentration) in synovial fluid than did exercised ponies at all postoperative times, and at postoperative week 17, this effect was significant (P < 0.05). This may be related to decreased turnover of ks in articular cartilage attributable to stall confinement and late increase in turnover related to exercise. Seventeen weeks after surgery, synovial fluid from exercised, medicated ponies had significantly (P < 0.05) higher ks content than did fluid from exercised, nonmedicated ponies. This indicated that exercise, when combined with medication, may increase ks release from articular cartilage. Synovial fluid from medicated joints of nonexercised ponies had significantly (P < 0.05) lower ks concentration than did synovial fluid from nonmedicated joints of nonexercised ponies. This indicated that, in nonexercised joints, medication with PSGAG may have decreased either release of ks from the articular cartilage into the synovial fluid or inhibited synthesis of ks. Concentration of ks in synovial fluid was not related clearly to the development of osteoarthritis in these ponies. Exercise or medication did not affect plasma ks concentration, and synovial fluid and plasma ks concentrations were not correlated. Data indicated that ks concentration in plasma and synovial fluid may be increased in acute, marked, generalized articular cartilage catabolism and that ks turnover in cartilage of joints with large osteochondral defects was affected by intra-articular PSGAG and postoperative exercise.

Free access
in American Journal of Veterinary Research