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- Author or Editor: Gary M. Baxter x
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Abstract
Objective—To determine whether high plasma fibrinogen concentration (≥ 900 mg/dL) is a valid indicator of physeal or epiphyseal osteomyelitis in foals.
Design—Retrospective case series.
Animals—17 foals with physeal or epiphyseal osteomyelitis with or without septic arthritis, 17 foals with septic arthritis alone, 20 foals with non–Rhodococcus equi pneumonia, and 22 healthy foals.
Procedures—Medical records were reviewed for information regarding signalment and total WBC count, segmented neutrophil count, and plasma fibrinogen concentration measured when foals were initially evaluated at the hospital. Whether the foals survived to discharge from the hospital was also determined.
Results—Foals with physeal or epiphyseal osteomyelitis had higher plasma fibrinogen concentrations than did foals in the other 3 groups. Sixteen of 17 affected foals had values ≥ 900 mg/dL. The positive predictive and negative predictive values for plasma fibrinogen concentrations between 900 and 1,500 mg/dL as an indicator of osteomyelitis were 84.2% and 98.2%, respectively. Fibrinogen concentrations of 200 to 400 mg/dL and 500 to 800 mg/dL were associated with foals not having physeal osteomyelitis. Having septic arthritis alone or non–R equi pneumonia was significantly associated with a plasma fibrinogen concentration between 500 and 800 mg/dL; however, the positive predictive value of this range as an indicator of those diseases was low. Foals with osteomyelitis had greater total WBC and segmented neutrophil counts than did foals with septic arthritis alone.
Conclusions and Clinical Relevance—A plasma fibrinogen concentration of ≥ 900 mg/dL may be useful as an indicator of physeal or epiphyseal osteomyelitis in foals.
Abstract
Objective—To compare the effects of 2 approaches and 2 injection volumes on diffusion of mepivacaine hydrochloride for local analgesia of the deep branch of the lateral plantar nerve (DBLPN) in horses.
Design—Experimental study.
Animals—16 adult horses.
Procedures—Either 2 mL (low volume) or 8 mL (high volume) of mepivacaine hydrochloride-iohexol (50:50 mixture) was injected by means of 1 of 2 techniques to produce analgesia of the DBLPN. For technique 1, the needle was inserted 15 mm distal to the head of the fourth metatarsal bone and directed perpendicular to the limb. For technique 2, the needle was inserted 20 mm distal to the head of the fourth metatarsal bone and was directed in a proximodorsal direction. Lateromedial radiographs were obtained before and 5, 15, 30, and 60 minutes after injection. Radiographs were evaluated to determine the proximal and distal extent of diffusion of the contrast solution and presumably anesthetic agent and whether contrast agent appeared to be present in the tarsal sheath or tarsometatarsal joint.
Results—A high degree of variability in contrast solution diffusion was noted among injections. High-volume injections diffused significantly further proximally and distally than did low-volume injections. Contrast agent was documented within the tarsal sheath in 5 of 32 (16%) injections and within the tarsometatarsal joint in 2 of 32 (6%) injections. No significant difference was found for risk of inadvertent tarsal sheath or tarsometatarsal joint injection between the 2 techniques or the 2 volumes of anesthetic used. Mepivacaine diffused significantly further distally with technique 1 than with technique 2 but diffused significantly further proximally with technique 2 than with technique 1. For both techniques, diffusion in the distal but not the proximal direction significantly increased over time.
Conclusions and Clinical Relevance—Results indicated that the proximal and distal diffusion of the mepivacaine-iohexol solution was quite variable following either DBLPN nerve block technique.
Objective
To obtain information from specialists in equine surgery as to prevalence of, predisposing factors for, and methods to prevent postoperative adhesion formation in horses undergoing abdominal surgery.
Design
Survey.
Procedure
Surveys were mailed to 196 diplomates of the American College of Veterinary Surgeons involved in equine practice.
Results
60 (31%) surveys were returned. Most respondents (55/60) routinely informed clients of the risk of postoperative adhesion formation in horses with small intestinal lesions. When asked after which procedures they routinely used measures to prevent adhesions, 56 of 60 (93%) indicated that they did after small intestinal resection and anastomosis and 56 of 60 (93%) indicated that they did after any abdominal surgery in foals. The 4 methods most frequently listed when respondents were asked which methods were effective at preventing adhesion formation were meticulous surgical technique, administration of antibiotics and nonsteroidal anti-inflammatory drugs, intraoperative peritoneal lavage, and methods that prevent abdominal contamination. Most respondents (50/60) thought that at least some horses with colic secondary to adhesion formation could be managed medically. Fifty-four (90%) respondents indicated that they were successful less than half of the time when treating horses with adhesions severe enough to require additional surgery.
Conclusion
In general, respondents thought that less than 15% of horses undergoing abdominal surgery would develop adhesions, but that horses with small intestinal disease and foals were most prone to develop adhesions. Meticulous surgical technique was thought to be the most important factor in preventing adhesions, and many prevention regimens reported to be effective in the literature were not commonly used in practice. (J Am Vet Med Assoc 1997;211:1573–1576)
Summary
Medical records of 50 horses with extensor tendon lacerations affecting 53 limbs over 7 years (1982 to 1988) were reviewed to determine the clinical features and prognosis for athletic soundness after treatment. Mean and median ages were 4.8 and 3 years, respectively. Eighty-nine percent of the injuries involved the hind limbs, with approximately equal distribution between the right and left limbs. Hind limb lacerations involved the long digital extensor tendon (28 limbs), lateral digital extensor tendon (3 limbs), or both tendons (16 limbs). Forelimb lacerations involved the common digital extensor tendon (2 limbs), lateral digital extensor tendon (1 limb), or both tendons (3 limbs). Joint involvement was found in 6 cases. Wound management varied according to wound characteristics, financial constraints of owners, and clinician preference. External coaptation consisted of a 3-layered cotton bandage in 33 limbs, splint and cotton bandage in 12 limbs, fiberglass or plaster-of-Paris cast in 5 limbs, and no form of coaptation in 3 limbs.
Follow-up information for 40 cases at least 1 year after injury revealed that 29 (73%) horses had returned to athletic soundness, 7 (18%) horses were pasture sound, 3 horses were chronically lame, and 1 horse was euthanatized during treatment because of wound sepsis. Depending on the hind limb tendons involved, return to athletic soundness ranged from 62% (long digital and lateral digital extensor tendons lacerated) to 80% (long digital extensor tendon lacerated) The small number of forelimb lacerations precluded any comparative data. Five of 6 horses with joint involvement returned to athletic soundness. Complications during treatment included wound sepsis/cellulitis, bone sequestra/osteitis of the third metatarsus, and exuberant granulation tissue.
Abstract
Objective—To determine the clinical applications, short and long-term survival, and complications of using transfixation pin casts for treatment of comminuted phalangeal fractures in adult horses.
Design—Retrospective case series.
Animals—20 horses.
Procedures—Medical records were reviewed to obtain information regarding signalment, fracture location, treatment methods, complications, and short-term survival (discharge from hospital). Long-term follow-up information was obtained via contact with owners or trainers.
Results—12 fractures were in a hind limb, and 8 were in a forelimb. Fourteen fractures occurred in a middle phalanx, and 6 occurred in a proximal phalanx. Eleven fractures were treated with internal fixation combined with transfixation pin casts, and 9 fractures were treated with transfixation pin casts alone. Transfixation pin casts were maintained for a mean of 52 days (median, 49 days; range, 1 to 131 days). Fourteen (70%) horses were discharged from the hospital, whereas 6 (30%) were euthanized during the treatment period. Reasons for euthanasia included secondary fracture of the third metacarpal or metatarsal bone, avascularity of the distal aspect of the limb associated with an open fracture, and displacement of the fracture after transfixation pin cast removal. A significantly greater number of horses was discharged from the hospital when the transfixation pin cast was maintained for > 40 days, compared with those in which the transfixation pin cast was maintained for < 40 days.
Conclusions and Clinical Relevance—Results suggested that horses should be maintained in a transfixation pin cast for a minimum of 40 days, as this was associated with an increase in short-term survival without an increased risk of catastrophic failure.
