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- Author or Editor: Larry D. Galuppo x
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Abstract
Objective—To determine whether iatrogenic hemarthrosis of the metacarpophalangeal joint could be used as a model for temporary reversible joint pain in horses.
Animals—8 adult horses.
Procedure—Each horse was evaluated on a treadmill before and after injection of 1 metacarpophalangeal joint with 10 mL of autogenous blood. Horses were evaluated subjectively and objectively by use of a computerized force measurement system at intervals until lameness abated. The mean force difference between injected and noninjected limbs at all time periods after injection was compared with the difference between limbs at baseline. From each horse, synovial fluid samples collected before and 24 hours and 30 days after injection were analyzed for total protein concentration and cell type and number. Venous blood samples were collected before and 6 and 24 hours after injection for assessment of plasma cortisol concentration.
Results—For 24 hours after injection, the mean force difference between injected and noninjected limbs was significantly increased over baseline. The greatest force difference was detected after 2 and 4 hours. Baseline and 24-hour force data were not significantly different. Compared with baseline values, synovial fluid protein concentration and nucleated cell and RBC counts were increased significantly at 24 hours after injection but were not different at 30 days after injection. No significant changes in plasma cortisol concentration were detected at any time point.
Conclusions and Clinical Relevance—In horses, iatrogenic hemarthrosis of the metacarpophalangeal joint appears to induce temporary reversible lameness with a mild to moderate degree of synovitis. (Am J Vet Res 2005;66:1084–1089)
Abstract
Objective—To compare variables for screw insertion, pushout strength, and failure modes for a headless tapered compression screw inserted in standard and oversize holes in a simulated lateral condylar fracture model.
Sample Population—6 pairs of third metacarpal bones from horse cadavers.
Procedure—Simulated lateral condylar fractures were created, reduced, and stabilized with a headless tapered compression screw by use of a standard or oversize hole. Torque, work, and time for drilling, tapping, and screw insertion were measured during site preparation and screw implantation. Axial load and displacement were measured during screw pushout. Effects of drill hole size on variables for screw insertion and screw pushout were assessed by use of Wilcoxon tests.
Results—Drill time was 59% greater for oversize holes than for standard holes. Variables for tapping (mean maximum torque, total work, positive work, and time) were 42%, 70%, 73%, and 58% less, respectively, for oversize holes, compared with standard holes. Variables for screw pushout testing (mean yield load, failure load, failure displacement, and failure energy) were 40%, 40%, 47%, and 71% less, respectively, for oversize holes, compared with standard holes. Screws could not be completely inserted in 1 standard and 2 oversize holes.
Conclusions and Clinical Relevance—Enlarging the diameter of the drill hole facilitated tapping but decreased overall holding strength of screws. Therefore, holes with a standard diameter are recommended for implantation of variable pitch screws whenever possible. During implantation, care should be taken to ensure that screw threads follow tapped bone threads.
Abstract
OBJECTIVE To describe the use of CT in the diagnosis of and presurgical planning for equids with keratomas treated by hoof wall resection and determine postoperative complications and outcome.
DESIGN Retrospective case series.
ANIMALS 29 horses and 3 mules with keratomas treated by partial or complete hoof wall resection following CT imaging of the distal portion of the affected extremity from 2005 through 2016.
PROCEDURES For each equid, physical examination and lameness evaluation were performed, followed by imaging of the distal portion of the affected extremity. A tentative diagnosis of keratoma was made given results of clinical, radiographic, and CT examination, with the definitive diagnosis made on histologic examination. After CT imaging, each equid was treated with hoof wall resection.
RESULTS CT allowed accurate identification of the size and location of 35 keratomas in 33 feet. Thirty equids underwent partial and 2 underwent complete hoof wall resection for keratoma removal. Complications developed in 4 of 31 (13%) equids and included excessive granulation tissue formation at the surgical site (n = 1), excessive granulation tissue formation and worsening lameness (1), incomplete keratoma removal with suspected regrowth (1), and incomplete healing of the surgical site with distal interphalangeal joint sepsis secondary to repeated debridement of abnormal tissue (1). Twenty-eight of 31 (90%) equids returned to their previous activity level.
CONCLUSIONS AND CLINICAL RELEVANCE Preoperative CT examination of the feet was useful in the diagnosis of and surgical planning for keratomas in equids. A low complication rate was achieved with the described techniques.
Abstract
OBJECTIVE
To determine the median time to maximum concentration (tmax) of amikacin in the synovial fluid of the tarsocrural joint following IV regional limb perfusion (IVRLP) of the drug in a saphenous vein of horses.
ANIMALS
7 healthy adult horses.
PROCEDURES
With each horse sedated and restrained in a standing position, a 10-cm-wide Esmarch tourniquet was applied to a randomly selected hind limb 10 cm proximal to the point of the tarsus. Amikacin sulfate (2 g diluted with saline [0.9% NaCl] solution to a volume of 60 mL) was instilled in the saphenous vein over 3 minutes with a peristaltic pump. Tarsocrural synovial fluid samples were collected at 5, 10, 15, 20, 25, and 30 minutes after completion of IVRLP. The tourniquet was removed after collection of the last sample. Amikacin concentration was quantified by a fluorescence polarization immunoassay. Median maximum amikacin concentration and tmax were determined.
RESULTS
1 horse was excluded from analysis because an insufficient volume of synovial fluid for evaluation was obtained at multiple times. The median maximum synovial fluid amikacin concentration was 450.5 μg/mL (range, 304.7 to 930.7 μg/mL), and median tmax was 25 minutes (range, 20 to 30 minutes). All horses had synovial fluid amikacin concentrations ≥ 160 μg/mL (therapeutic concentration for common equine pathogens) at 20 minutes after IVRLP.
CONCLUSIONS AND CLINICAL RELEVANCE
Results suggested that, in healthy horses, maintaining the tourniquet for 20 minutes after IVRLP of amikacin in a saphenous vein was sufficient to achieve therapeutic concentrations of amikacin in the tarsocrural joint.
Abstract
Objective—To develop an objective, accurate method for quantifying forelimb ground reaction forces in horses by adapting a human in-shoe pressure measurement system and determine the reliability of the system for shod and unshod horses.
Animals—6 adult Thoroughbreds.
Procedure—Horses were instrumented with a human in-shoe pressure measurement system and evaluated at a trot (3 m/s) on a motorized treadmill. Maximum force, stance time, and peak contact area were evaluated for shod and unshod horses. Three trials were performed for shod and unshod horses, and differences in the measured values were examined with a mixed model ANOVA for repeated measures. Sensor accuracy was evaluated by correlating measured variables to clinically observed lameness and by a variance component analysis.
Results—4 of 6 horses were determined to be lame in a forelimb on the basis of clinical examination and measured values from the system. No significant differences were observed between shod and unshod horses for maximum force and stance time. A significant decrease in peak contact area was observed for shod and unshod horses at each successive trial. Maximum force measurements provided the highest correlation for detecting lameness ( r = 0.91, shod horses; r = 1.0, unshod horses). A variance component analysis revealed that 3 trials provided a variance of 35.35 kg for maximum force (± 5.78% accuracy), 0.007 seconds for stance time (± 2.5% accuracy), and 8.58 cm2 for peak contact area (± 11.95% accuracy).
Conclusions and Clinical Relevance—The in-shoe pressure measurement system provides an accurate, objective, and effective method to evaluate lameness in horses. ( Am J Vet Res 2001;62:23–28)
Abstract
OBJECTIVE To evaluate the use of a laparoscopic specimen retrieval pouch for removal of intact or fragmented cystic calculi from standing horses.
DESIGN Retrospective case series.
ANIMALS 8 horses (5 geldings and 3 mares) with cystic calculi.
PROCEDURES Physical examination and cystoscopic, ultrasonographic, and hematologic evaluations of urinary tract function were performed for each horse. A diagnosis of cystic calculus was made on the basis of results of cystoscopy and ultrasonography. Concurrent urolithiasis or other urinary tract abnormalities identified during preoperative evaluation were recorded. Horses were sedated and placed in standing stocks, and the perineum was aseptically prepared. Direct access to the urinary bladder was gained in geldings via perineal urethrotomy or in mares by a transurethral approach. Calculi were visualized endoscopically, manipulated into the retrieval pouch, and removed intact or fragmented (for larger calculi).
RESULTS For 4 geldings and 1 mare, fragmentation was necessary to facilitate calculus removal. Mean duration of surgery was 125 minutes, and trauma to the urinary bladder and urethra was limited to areas of hyperemia and submucosal petechiation. No postoperative complications were encountered for any horse. When lithotripsy was required, the retrieval pouch provided an effective means of stabilizing calculi and containing the fragments for removal.
CONCLUSIONS AND CLINICAL RELEVANCE Use of the laparoscopic specimen retrieval pouch was an effective, minimally traumatic method for retrieving cystic calculi from standing horses. The pouch protected the urinary bladder and urethra from trauma during calculus removal and allowed for stabilization, containment, and fragmentation of calculi when necessary.
Abstract
Laparoscopy was performed on 6 horses (2 mares, 2 geldings, 2 stallions) to determine the normal laparoscopic anatomy of the equine abdomen. After withholding feed for 36 hours, horses were examined from the left and right paralumbar fossae, and the visceral anatomic structures were recorded by videotape and photography. One mare developed emphysema located subcutaneously at the primary laparoscopic portal; otherwise, there were no complications. The anatomic structures of diagnostic importance that were observed in the left half of the abdomen were the hepatic duct; left lateral and quadrate lobes of the liver; stomach; spleen; left kidney with the associated nephrosplenic ligament; segments of jejunum, descending colon, and ascending colon; left side of the male and female reproductive tracts; urinary bladder; vaginal ring; and mesorchium. Important structures observed in the right side of the abdomen were portions of the common hepatic duct; left lateral, quadrate, and right lobes of the liver; caudate process of the liver; stomach; duodenum; right dorsal colon, epiploic foramen; omental bursa; right kidney; base of the cecum; segments of jejunum, descending colon, and ascending colon; urinary bladder; right half of the male and female reproductive tracts; and rectum.
Abstract
Objective—To define the reference range for laminar blood flow (BF) and vascular permeability (VPM) in horses without laminitis by use of dynamic contrast-enhanced computed tomography (CT).
Animals—9 adult horses that were not lame and had no abnormalities of the laminae or phalanges detectable via radiographic examination.
Procedures—Each horse was anesthetized by use of a routine protocol. Horses were placed in right or left lateral recumbency with the dependent forelimb in the CT gantry; only 1 limb of each horse was scanned. Serial 10-mm collimated transverse CT images were acquired at the same location every other second for 90 seconds during infusion of ionic, iodinated contrast medium. Custom software was used to estimate BF, VPM, and fractional vascular volume (FVV) in the dorsal, dorsomedial, and dorsolateral laminar regions.
Results—Among the 9 horses' forelimbs, mean ± SD dorsal laminar BF was 0.43 ± 0.21 mL•min−1•mL−1. Mean dorsomedial and dorsolateral laminar BFs were 0.26 ± 0.16 mL•min−1•mL−1 and 0.24 ± 0.16 mL•min−1•mL−1, respectively. Mean dorsal laminar VPM was 0.09 ± 0.03 mL•min−1•mL−1. Mean dorsomedial and dorsolateral laminar VPMs were 0.16 ± 0.06 mL•min−1•mL−1 and 0.12 ± 0.06 mL•min−1•mL−1, respectively. Mean dorsal laminar FVV was 0.63 ± 0.20 and dorsomedial and dorsolateral laminar FVV were 0.37 ± 0.14 and 0.34 ± 0.17, respectively.
Conclusions and Clinical Relevance—In horses, laminar BF, VPM, and FVV can be non-invasively measured by use of dynamic contrast-enhanced CT.
Abstract
Objective—To evaluate use of a diode laser to induce tendinopathy in the superficial digital flexor tendon (SDFT) of horses.
Animals—4 equine cadavers and 5 adult horses.
Procedures—Cadaveric SDFT samples were exposed to a diode laser at various energy settings to determine an appropriate energy for use in in vivo experiments; lesion size was assessed histologically. In vivo experiments involved laser energy induction of lesions in the SDFT (2 preliminary horses [0, 25, 75, and 87.5 J] and 3 study horses [0 and 125 J]) and assessment of lesions. Study duration was 21 days, and lesions were assessed clinically and via ultrasonography, MRI, and histologic evaluation.
Results—Lesion induction in cadaveric tissues resulted in a spherical cavitated core with surrounding tissue coagulation. Lesion size had a linear relationship (R 2 = 0.9) with the energy administered. Size of in vivo lesions in preliminary horses indicated that larger lesions were required. In study horses, lesions induced with 125 J were ultrasonographically and histologically larger than were control lesions. At proximal and distal locations, pooled (preliminary and study horses) ultrasonographically assessed lesions were discrete and variable in size (mean ± SEM lesion percentage for control lesions, 8.5 ± 3%; for laser lesions, 12.2 ± 1.7%). Ultrasonography and MRI measurements were associated (R 2 > 0.84) with cross-sectional area measurements.
Conclusions and Clinical Relevance—In vivo diode laser–induced lesions did not reflect cadaveric lesions in repeatable size. Further research is required before diode lasers can reliably be used for inducing tendinopathy.
