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Case Description—A 4-year-old Arabian-cross mare was examined because of a 48-hour history of pyrexia, lethargy, and signs of abdominal discomfort.
Clinical Findings—On initial evaluation, the horse was in good body condition, but febrile, tachycardic, tachypneic, and icteric and had signs of colic. Findings on CBC and serum biochemical analysis indicated marked systemic inflammation and hepatocellular damage. Serial abdominal ultrasonographic examinations revealed progressive, localized hepatic parenchymal abnormalities in the left ventral aspect of the abdomen in proximity to the left liver lobes, and eventual identification of an irregularly marginated, hyperechoic walled region of heterogenous echogenicity consistent with an encapsulated hepatic abscess.
Treatment and Outcome—Medical treatment was initiated with administration of doxycycline and flunixin meglumine. After 7 days, the horse's clinical signs and hematologic values improved. After 14 days, the horse was discharged from the hospital and prescribed continuation of doxycycline treatment for 14 days. One week following hospital discharge, the horse was reevaluated for recurrent signs of colic and pyrexia. The horse was sedated, and the region overlying the caudal aspect of the seventh rib was desensitized with an inverted L nerve block by local infiltration with 2% lidocaine. While the horse was standing and sedated, drainage of an encapsulated intra-abdominal abscess was followed by rib resection and removal of a portion of necrotic left lateral liver lobe. The development of a pneumothorax following rib resection represented the only major surgical complication. Twelve months later, the horse was clinically normal and had returned to its previous level of performance.
Clinical Relevance—Rib resection in standing sedated horses, together with appropriate medical management, should be considered an option for removal of well-encapsulated cranially located intra-abdominal abscesses that are adherent to the ventrolateral aspect of the body wall in horses.
Objective—To assess the safety and efficacy of alcohol-facilitated ankylosis of the distal intertarsal (DIT) and tarsometatarsal (TMT) joints in horses with osteoarthritis (bone spavin).
Design—Prospective clinical trial.
Animals—21 horses with DIT or TMT joint-associated hind limb lameness and 5 nonlame horses.
Procedures—11 horses (group 1) underwent lameness, force-plate, and radiographic examinations; following intra-articular analgesia, lameness and force-plate examinations were repeated. Nonlame horses were used for force-plate data acquisition only. Following localization of lameness to the DIT and TMT joints, contrast arthrographic evaluation was performed; when communication with the tibiotarsal joint was not evident or suspected, 70% ethyl alcohol (3 mL) was injected. Group 1 horses underwent lameness, force-plate, and radiographic examinations every 3 months for 1 year. Ten other horses (group 2) underwent lameness and radiographic examinations followed by joint injection with alcohol; follow-up information was obtained from owners or via clinical examination.
Results—Significant postinjection reduction in lameness (after 3 days to 3 months) was evident for all treated horses. Twelve months after injection, 10 of 11 group 1 horses were not lame; lameness grade was 0.5 in 1 horse. Follow-up information was available for 9 of 10 group 2 horses; 7 were not lame, and 2 remained mildly lame (1 had a concurrent problem in the injected limb, and the other had DIT joint collapse that precluded needle entry).
Conclusions and Clinical Relevance—Intra-articular alcohol injection in horses with bone spavin resulted in a rapid (usually within 3 months) reduction in lameness and joint space collapse.