Case Description—An 18-year-old mare was evaluated for an oral mass that developed after extraction of a broken incisor.
Clinical Findings—An ulcerated, firm, darkly pigmented, approximately 5-cm-diameter spherical mass involved the gingiva lateral and dorsal to the right first to third maxillary incisors. Osteolysis of the roots of the first and second right maxillary incisors and periosteal proliferation of the adjacent premaxilla margins were apparent on radiographs. Histologic examination of the mass revealed multiple coalescing and ramifying foci of abscess formation, each containing a well-defined, discrete, black mass (2 to 7 mm in diameter). Myriad fungal hyphae enmeshed in a black, granular, cementlike material were within each of the black structures. Mycetoma was the histologic diagnosis. The causative agent could not be identified via culture because of lack of distinguishing characteristics. Fungal DNA was isolated from frozen fungal cultures and paraffin sections. The D1/D2 domains of the large subunit P gene rDNA were amplified and sequenced. The sequences of the D1/D2 domains of both isolates were 96% homologous with those of Phialophora oxyspora.
Treatment and Outcome—The mass was surgically excised, the local area curetted, and the wound allowed to heal by second intention. Postoperative treatment consisted of administration of phenylbutazone and IV administration of sodium iodide followed by oral administration of potassium iodide. There was no evidence of recurrence 1 year later.
Clinical Relevance—Mycetomata should be a differential diagnosis for equine gingival masses. Identification of the fungal agent can be critical for selection of optimal treatments. Molecular methods may permit definitive identification when standard phenotypic-based identification criteria are inconclusive.
Case Description—A 19-month-old 536.4-kg (1,180-lb) Brown Swiss heifer was referred for evaluation of a firm swelling over the distal aspect of the right metatarsal region and chronic lameness in the right hind limb.
Clinical Findings—Examination of radiographs of the right metatarsophalangeal joints revealed an expansile, smoothly marginated, cyst-like lesion within the distal metaphysis of the metatarsal III and IV bone. Differential diagnoses included bone abscess, bone cyst, aneurysmal bone cyst, neoplasia, osteomyelitis, and metabolic bone disease. Aerobic microbial culture of the aspirate yielded moderate growth of branching, gram-positive, rod-shaped bacteria, which were presumptively identified as Nocardia spp. The isolate was subsequently identified as Nocardia arthritidis by 16S rRNA gene sequence analysis.
Treatment and Outcome—The lesion was surgically debrided, lavaged, and bandaged. Exercise was restricted, and systemic and local administration of antimicrobials was instituted. After a communication between the abscess and the metatarsophalangeal joints was iatrogenically created, the extralabel use of aminoglycosides was initiated. The heifer had noticeable clinical improvement within 2 weeks after initial evaluation and reportedly had no evidence of lameness and minimal external blemishes 3 months after the second evaluation.
Clinical Relevance—To our knowledge, this is the first report on the diagnosis and management of a long-bone abscess attributable to N arthritidis infection in cattle. Complications encountered during treatment and the decision to engage in extralabel use of antimicrobial agents in the heifer described here may serve as a guide for food animal practitioners faced with the treatment of valuable cattle.
Objective—To describe signalment; surgical findings; short-, medium-, and long-term outcome; and recurrence rate for cattle undergoing celiotomy because of jejunal hemorrhage syndrome (JHS) and to analyze risk factors associated with outcome and recurrence.
Design—Retrospective case series.
Animals—31 dairy cattle with JHS.
Procedures—Medical records were analyzed. Follow-up information was obtained from owners of cattle surviving until discharge.
Results—18 of 31 (58%) cattle undergoing celiotomy survived to initial discharge. Fifteen (48%) and 13 (42%) were alive 6 and 12 months after discharge, respectively. All 5 deaths within 12 months after discharge were attributed to JHS recurrence. Survival time was 12 to 85 months for the 13 long-term survivors. Six of 7 that died > 12 months after celiotomy did so for reasons unrelated to JHS. Recurrence rate among short-term survivors was 7 of 18; 1 of these survived long-term. A significant proportion of affected cattle were Brown Swiss, compared with proportions for other breeds. Manual massage of the bowel to break down clots was associated with a significantly higher short-term survival rate than was en-terectomy or enterotomy. Medium- and long-term survival rate was higher in cattle referred 24 to 48 hours after onset of signs. Length of obstructing blood clots was not associated with outcome. Other factors were not significantly associated with recurrence.
Conclusions and Clinical Relevance—Survival rates were higher than those in other reports. Prompt celiotomy and resolution by use of manual massage were associated with higher survival rates. In this population, JHS recurred in 7 of 18 short-term survivors.