Objective—To determine clinical history, structures
involved, treatment, and outcome of lacerations of
the heel bulb and proximal phalangeal region (pastern)
Procedures—Medical records of horses with lacerations
of the heel bulb and pastern were reviewed, and
follow-up information was obtained.
Results—75 horses were Quarter Horses. Most
horses were not treated with antimicrobial drugs prior
to referral. Mean ± SD time from injury to referral was
24 ± 45 hours (range, 1 to 168 hours). Lacerations
were most frequently caused by contact with wire or
metal objects. In 17 horses, lacerations involved synovial
structures; the distal interphalangeal joint was
most commonly affected. One horse was euthanatized
after initial examination. Wound treatment consisted
of cleansing, lavage, debridement, lavage of
affected synovial structures, suturing of fresh
wounds, and application of a foot bandage or cast.
Fifty-six horses were treated with systemically administered
antimicrobial drugs. Follow-up information
was collected for 61 horses. Fifty-one horses returned
to their intended use and had no further complications;
10 horses had complications associated with
the wound, and of those horses, 5 were euthanatized
and 1 horse died from an unrelated cause. Horses
with lacerations that involved synovial structures had
worse outcomes than horses with lacerations that did
not involve synovial structures.
Conclusions and Clinical Relevance—Horses that
sustain heel bulb lacerations can successfully return
to their intended use. Involvement of the distal interphalangeal
joint is associated with poor prognosis.
(J Am Vet Med Assoc 2005;226:418–423)
Case Description—A 4-month-old Missouri Fox Trotter colt was examined for a 5-week history of head tilt after treatment for suspected pulmonary Rhodococcus equi infection.
Clinical Findings—Computed tomography revealed osteolysis of the occipital, temporal, and caudal portion of the parietal bones of the left side of the cranium. A soft tissue mass compressing the occipital region of the cerebral cortex and cerebellum was associated with the osteolytic bone.
Treatment and Outcome—A rostrotentorial-suboccipital craniectomy approach was performed to remove fragmented occipital bone, debulk the intracranial mass, and obtain tissue samples for histologic examination and bacterial culture. All neurologic deficits improved substantially within 3 days after surgery. Bacterial culture of the resected soft tissue and bone fragments yielded R equi.
Clinical Relevance—Intracranial surgery in veterinary medicine has been limited to dogs and cats; however, in select cases, extrapolation of surgical techniques used in humans and small animals can assist with intracranial procedures in horses.
Objective—To determine the frequency of and risk factors for complications associated with casts in horses.
Design—Multicenter retrospective case series
Animals—398 horses with a half-limb or full-limb cast treated at 1 of 4 hospitals
Procedures—Data collected from medical records included age, breed, sex, injury, limb affected, time from injury to hospital admission, surgical procedure performed, type of cast (bandage cast [BC; fiberglass tape applied over a bandage] or traditional cast [TC; fiberglass tape applied over polyurethane resin-impregnated foam]), limb position in cast (flexed, neutral, or extended), and complications. Risk factors for cast complications were identified via multiple logistic regression.
Results—Cast complications were detected in 197 of 398 (49%) horses (18/53 [34%] horses with a BC and 179/345 [52%] horses with a TC). Of the 197 horses with complications, 152 (77%) had clinical signs of complications prior to cast removal; the most common clinical signs were increased lameness severity and visibly detectable soft tissue damage Cast sores were the most common complication (179/398 [45%] horses). Casts broke for 20 (5%) horses. Three (0.8%) horses developed a bone fracture attributable to casting Median time to detection of complications was 12 days and 8 days for horses with TCs and BCs, respectively. Complications developed in 71%, 48%, and 47% of horses with the casted limb in a flexed, neutral, and extended position, respectively. For horses with TCs, hospital, limb position in the cast, and sex were significant risk factors for development of cast complications.
Conclusions and Clinical Relevance—Results indicated that 49% of horses with a cast developed cast complications.