Objective—To determine long-term effects of transendoscopic, laser-assisted ventriculocordectomy (LAVC) on airway noise and performance in horses with naturally occurring left laryngeal hemiplegia.
Design—Retrospective case series.
Animals—22 horses with left laryngeal hemiplegia treated by means of LAVC.
Procedures—Medical records were reviewed and initial complaint, intended use of the horse, duration of abnormal airway noise, preoperative performance level, endoscopic findings, surgical procedure, postoperative treatment, and complications were recorded. Follow-up telephone interviews with owners and trainers were conducted to determine time for return to intended use, level of postoperative performance, and percentage reduction in airway noise.
Results—All horses were examined because of excessive airway noise; 10 (45%) had concurrent exercise intolerance. Left ventriculocordectomy was performed in all 22 horses; bilateral ventriculocordectomy (right ventriculocordectomy was done 1 year later) was performed in 1 horse (5%). Complications occurred in 3 (14%) horses. Twenty (91%) horses returned to their intended use. Excessive airway noise was eliminated after surgery in 18 (82%) horses; exercise intolerance improved postoperatively in 8 of 10 horses. Three racing Thoroughbreds returned to racing; 1 additional racehorse returned to racing but required a laryngoplasty 1 year later to continue racing.
Conclusions and Clinical Relevance—Results suggested that LAVC was an effective procedure for elimination of excessive airway noise and improvement of performance in horses with left laryngeal hemiplegia.
Case Description—A 6-month-old male Bactrian camel was examined because of a 3-week history of lameness of the left hind limb.
Clinical Findings—Lameness was initially detected in the left hind limb but resolved and was detected in the right hind limb during treatment. Lameness increased during periods of rapid growth. Radiography revealed multiple small opacities of the medullary cavity of several long bones throughout treatment. Core bone biopsies of lesions in the tibiae revealed lamellar bone with areas of loose connective tissue, osteoblasts in the medullary cavity, and periosteal new bone formation, all which were consistent with panosteitis.
Treatment and Outcome—Palliative treatment was attempted with epidural and transdermal administration of analgesics. Flunixin meglumine was administered PO, which coincided with an abrupt increase in serum creatinine concentration. Performance of multiple diagnostic bone biopsies led to remission of clinical signs of pain.
Clinical Relevance—Panosteitis should be a differential diagnosis for shifting limb lameness in young camels. Bone biopsies can be useful for diagnosis of panosteitis and possible relief of pain associated with the disease. Bactrian camels may be susceptible to the renal toxicity of flunixin meglumine, especially when dehydrated.
Objective—To compare isolated limb retrograde venous injection (ILRVI) and isolated limb infusion (ILI) for delivery of amikacin to the synovial fluid of the distal interphalangeal and metacarpophalangeal joints and to evaluate the efficacy of use of an Esmarch tourniquet in standing horses.
Animals—6 healthy adult horses.
Procedures—Horses were randomly assigned in a crossover design. In ILRVI, the injection consisted of 1 g of amikacin diluted to a total volume of 60 mL administered during a 3-minute period. In ILI, the infusion consisted of 1 g of amikacin diluted to 40 mL administered during a 3-minute period followed by administration of boluses of diluent (82 mL total) to maintain vascular pressure. During ILI, the infusate and blood were circulated from the venous to the arterial circulation in 5-mL aliquots. Synovial fluid and serum samples were obtained to determine maximum amikacin concentrations and tourniquet leakage, respectively.
Results—Both techniques yielded synovial concentrations of amikacin > 10 times the minimum inhibitory concentration (MIC) for 90% of isolates (80 μg/mL) and > 10 times the MIC breakpoint (160 μg/mL) of amikacin-susceptible bacteria reported to cause septic arthritis in horses. These values were attained for both joints for both techniques. Esmarch tourniquets prevented detectable loss of amikacin to the systemic circulation for both techniques.
Conclusions and Clinical Relevance—Both techniques reliably achieved synovial fluid concentrations of amikacin consistent with concentration-dependent killing for bacteria commonly encountered in horses with septic arthritis. Esmarch tourniquets were effective for both delivery techniques in standing horses.
Objective—To determine the effect of meloxicam and flunixin meglumine on recovery of ischemia-injured equine jejunum.
Procedures—Horses received butorphanol tartrate; were treated IV with saline (0.9% NaCl) solution (SS; 12 mL; n = 6), flunixin meglumine (1.1 mg/kg; 6), or meloxicam (0.6 mg/kg; 6) 1 hour before ischemia was induced for 2 hours in a portion of jejunum; and were allowed to recover for 18 hours. Flunixin and SS treatments were repeated after 12 hours; all 3 treatments were administered immediately prior to euthanasia. Selected clinical variables, postoperative pain scores, and meloxicam pharmacokinetic data were evaluated. After euthanasia, assessment of epithelial barrier function, histologic evaluation, and western blot analysis of ischemia-injured and control jejunal mucosa samples from the 3 groups were performed.
Results—Meloxicam- or flunixin-treated horses had improved postoperative pain scores and clinical variables, compared with SS-treated horses. Recovery of transepithelial barrier function in ischemia-injured jejunum was inhibited by flunixin but permitted similarly by meloxicam and SS treatments. Eighteen hours after cessation of ischemia, numbers of neutrophils in ischemia-injured tissue were higher in horses treated with meloxicam or flu-nixin than SS. Plasma meloxicam concentrations were similar to those reported previously, but clearance was slower. Changes in expression of proteins associated with inflammatory responses to ischemic injury and with different drug treatments occurred, suggesting cy-clooxygenase-independent effects.
Conclusions and Clinical Relevance—Although further assessment is needed, these data have suggested that IV administration of meloxicam may be a useful alternative to flunixin meglumine for postoperative treatment of horses with colic.
Objective—To determine the outcome of and prognostic
indicators for dogs and cats with pneumoperitoneum
and no history of penetrating trauma.
Animals—43 dogs and 11 cats.
Procedure—Medical records of dogs and cats with
radiographic evidence of pneumoperitoneum and no
history of penetrating trauma were reviewed.
Information collected included signalment, previous
medical problems, initial complaint, duration of illness,
physical examination findings, radiographic findings,
laboratory abnormalities, abdominocentesis
results, bacterial culture results, concurrent diseases,
hospitalization time, and outcome. Abdominal radiographs
were reviewed, and radiographic severity of
pneumoperitoneum was classified. For those animals
that underwent exploratory laparotomy, time from
admission to surgery and results of histologic examination
of biopsy specimens were recorded.
Results—24 (44%) animals survived and were discharged
from the hospital, but none of the variables
examined was associated with whether animals survived.
Rupture of the gastrointestinal tract was the
cause of pneumoperitoneum in 40 animals. However,
cause and location of gastrointestinal tract rupture
was not associated with whether animals survived.
Twenty-three of 40 (58%) animals that underwent
exploratory laparotomy survived, compared with only
1 of 14 animals that did not undergo surgery.
Conclusions and Clinical Relevance—Results suggest
that pneumoperitoneum in dogs and cats without
any history of penetrating trauma is most commonly
associated with rupture of the gastrointestinal tract
and requires immediate surgical intervention. Even
when appropriate treatment is instituted, the shortterm
prognosis is only fair. (J Am Vet Med Assoc
Objective—To determine clinical signs, diagnostic
findings, and outcome for horses with desmitis of the
straight sesamoidean ligament (SSL) near its insertion
on the middle phalanx.
Procedure—Medical records were reviewed, and
information on signalment, history, clinical signs, diagnostic
findings, and treatment was obtained. Followup
information was obtained through telephone conversations
Results—In all horses, the diagnosis was made by
use of high-resolution ultrasonography. Seven horses
had moderate lameness on initial examination; lameness
was exacerbated in 6 horses following flexion of
the distal limb joints. The cause of lameness could
not be determined on the basis of clinical signs, and
diagnostic local anesthesia was necessary to localize
the source of lameness to the distal portion of the
limb. Five horses had forelimb involvement (1 bilateral),
and 4 had hind limb involvement (1 bilateral).
Treatment consisted primarily of a 6-month rest and
rehabilitation program. Six of the 9 horses were able
to return to their intended use.
Conclusions and Clinical Relevance—Results suggest
that injury to the SSL proximal to its insertion on
the middle phalanx should be considered as a possible
cause of lameness in horses, particularly performance
horses, with lameness localized to the distal
portion of the forelimb or hind limb that do not have
any radiographic abnormalities. High-resolution ultrasonography
was necessary to make the diagnosis.
Horses with an acute injury appeared to have a reasonable
chance of responding to treatment and
returning to their intended use. (J Am Vet Med Assoc 2003;222:973–977)
Objective—To determine whether administration of
Crandell-Rees feline kidney (CRFK) cell lysates or vaccines
against feline viral rhinotracheitis, calicivirus,
and panleukopenia (FVRCP vaccines) that likely contain
CRFK cell proteins induces antibodies against
CRFK cell or feline renal cell (FRC) lysates in cats.
Animals—14 eight-week-old cats.
Procedure—Before and after the study, renal biopsy
specimens were obtained from each cat for histologic
evaluation. Each of 4 FVRCP vaccines was administered
to 2 cats at weeks 0, 3, 6, and 50. Between
weeks 0 and 50, another 3 pairs of cats received 11
CRFK cell lysate inoculations SC (10, 50, or 50 µg
mixed with alum). Clinicopathologic evaluations and
ELISAs to detect serum antibodies against CRFK cell
or FRC lysates were performed at intervals.
Results—Cats had no antibodies against CRFK cell
or FRC lysates initially. All cats administered CRFK
cell lysate had detectable antibodies against CRFK
cell or FRC lysates on multiple occasions. Of 6 cats
vaccinated parenterally, 5 had detectable antibodies
against CRFK cell lysate at least once, but all 6 had
detectable antibodies against FRC lysate on multiple
occasions. Cats administered an intranasal-intraocular
vaccine did not develop detectable antibodies
against either lysate. Important clinicopathologic or
histologic abnormalities were not detected during
Conclusions and Clinical Relevance—Parenteral
administration of vaccines containing viruses likely
grown on CRFK cells induced antibodies against
CRFK cell and FRC lysates in cats. Hypersensitization
with CRFK cell proteins did not result in renal disease
in cats during the 56-week study. (Am J Vet Res 2005;66:506–511)