Objective—To evaluate equids with enostosis-like lesions (ELLs) and document the clinical and epidemiological features of this disease.
Design—Retrospective case series.
Animals—79 equids with a scintigraphic diagnosis of at least 1 ELL on ≥ 1 occasion.
Procedures—Medical records of 4,992 equids that underwent bone scintigraphy between March 1997 and March 2009 were reviewed; 78 horses and 1 pony had a scintigraphic diagnosis of an ELL. For those equids, signalment; physical, scintigraphic, radiographic, and lameness examination results; and outcome were reviewed.
Results—Of the 79 equids, 4 (5.1%) had anatomically distinct ELLs on 2 (n = 3) or 4 (1) separate occasions that caused lameness in different limbs. Thus, there were 85 ELL-related admissions to the hospital. Overall, 157 ELLs were detected. Among all equids undergoing scintigraphic examination, Thoroughbreds were more commonly and Standardbreds were less commonly affected. Older animals were more likely to have ELLs. Lameness was directly attributed to scintigraphically evident ELLs in 42 of the 85 (49.4%) admissions. The tibia (62/157 [39.5%]) and the radius (46/157 [29.3%]) were most commonly affected. The ELLs located in the humerus caused more severe lameness than did ELLs in other anatomic locations. Lameness severity was associated with radiopharmaceutical uptake intensity. Among racehorses, those with 1 ELL were more likely to return to racing than were those with multiple ELLs detected in 1 scintigraphic examination; mean interval from diagnosis to first start was 184 days.
Conclusions and Clinical Relevance—Results of this retrospective evaluation of a large group of equids with ELLs have provided a better understanding of this disease process.
Objective—To identify scintigraphic abnormalities in
the pelvic region of horses examined because of hind
limb lameness or poor performance and determine
the clinical relevance of areas of abnormal radiopharmaceutical
uptake (ARU) in these horses.
Procedure—Medical records were reviewed, and
information on signalment, history, admitting complaints,
physical examination findings, and results of
lameness examinations was recorded. Clinical relevance
of areas of ARU was determined by comparison
with results of other diagnostic tests. For horses
with clinically relevant areas of ARU, follow-up information
was obtained through telephone interviews
with owners and trainers and analysis of race records.
Results—Areas of ARU were identified in the tuber
coxae (25 horses), ischiatic tuber (9), hip joint (10),
third trochanter (10), ilium (5), sacral tuber region (22),
greater trochanter (1), cranial femoral cortex (1), skeletal
muscle surrounding the pelvis (34), or multiple
areas (11). In 44 horses, areas of ARU were associated
with the primary cause of lameness; in 51, areas
of ARU were not associated with the primary cause
of lameness; and in 33, the primary cause of lameness
was not determined. Thirty-six of the 44 horses
with clinically relevant areas of ARU were available for
follow-up; 15 (42%) had a good outcome.
Conclusions and Clinical Relevance—Results suggest
that pelvic scintigraphy may be useful in identifying
abnormalities in horses with hind limb lameness
or poor performance. (J Am Vet Med Assoc 2004;224:
Objective—To determine features of postoperative
wound infection caused by Actinobacillus spp in horses
undergoing clean, elective surgery and to evaluate
bacterial susceptibility profiles of bacteria isolated.
Procedure—Data were retrieved from medical
records and the microbiology laboratory database.
Results—1,604 horses underwent clean, elective
surgical procedures during the study period. Of these,
23 (1.43%) had postoperative wound infections, and
Actinobacillus spp was isolated from 10 of these 23
(43%). Surgical procedures in these 10 horses included
laryngoplasty with ventriculocordectomy (n = 3),
arthroscopy (3), desmotomy of the accessory ligament
of the superficial digital flexor tendon (2),
removal of laryngoplasty prostheses (1), and hygroma
resection (1). Seven horses survived, and 3 were
euthanatized. All 10 Actinobacillus isolates were
resistant to penicillin, and 6 were resistant to
trimethoprim-sulfamethoxazole. All isolates were susceptible
to ceftiofur and gentamicin. During the 5-year
period of the study, Actinobacillus organisms were
isolated from 35 of 513 (6.8%) samples from the general
hospital population submitted for bacterial culture
and antimicrobial susceptibility testing.
Conclusions and Clinical Relevance—During the
study period, Actinobacillus spp was isolated from a
higher than expected percentage of horses that
developed postoperative wound infections after
clean, elective surgery. Susceptibility profiles for
these isolates were different from typical susceptibility
profiles for Actinobacillus isolates, suggesting that
a pattern of resistance may be emerging. (J Am Vet Med Assoc 2002;221:1306–1310)
Objective—To report the outcome of surgical treatment
of comminuted fractures of the proximal phalanx
Procedure—Medical records and radiographs were
reviewed to obtain information regarding signalment,
fracture classification, and treatment. Follow-up information
was obtained by telephone conversation or
evaluation of production records.
Results—Thirty-eight horses had moderately comminuted
fractures of the proximal phalanx. Two horses were
euthanatized immediately. Fractures of the proximal phalanx
in 36 horses were repaired with open reduction and
internal fixation with a successful outcome in 33 (92%)
horses. Reconstruction of the fracture was performed in
most horses by use of a long curved incision, transection
of the collateral ligament of the metacarpophalangeal or
metatarsophalangeal joint, and open exposure of the
proximal articular surface of the proximal phalanx.
Twenty-six horses had severely comminuted fractures of
the proximal phalanx. Six horses were euthanatized
immediately. One horse was euthanatized after 9 days of
treatment with a cast alone. Severely comminuted fractures
of the proximal phalanx in 13 horses were treated
with an external skeletal fixation device, and fractures
healed in 8 of those horses. Six horses with severely
comminuted fractures of the proximal phalanx were
treated with transfixation pins incorporated into a fiberglass
cast, and fractures healed in 4 horses.
Conclusions and Clinical Relevance—Moderately
comminuted fractures of the proximal phalanx can be
successfully repaired; however, fractures that are too
severe to permit accurate reconstruction of the fragments
remain difficult to treat and horses have only a
fair prognosis for survival. (J Am Vet Med Assoc 2004;
Objective—To determine whether topical application of 1% diclofenac sodium cream would decrease inflammation at sites of IV regional limb perfusion (IVRLP) in healthy horses.
Animals—6 healthy adult horses (12 forelimbs).
Procedures—Bilateral IVRLP with 2.5 g of amikacin sulfate was performed twice in each horse, with 24 hours between each session. Horses were treated with topical 1% diclofenac liposomal cream (treated limbs) or a placebo cream (control limbs). All injection sites were evaluated before the first IVRLP session and 24 hours after the second session by means of ultrasonographic examination by a trained ultrasonographer who was unaware of the treatment received. Circumferential measurements and subjective visible inflammation scores were recorded by a veterinarian who was also unaware of treatment received.
Results—After IVRLP, control limbs had a significantly greater increase in subcutaneous thickness, compared with treated limbs. Ultrasonographic and visual assessment scores were significantly higher in control versus treated limbs. The mean change in limb circumference was greater, but not significantly so, in control limbs, compared with treated limbs.
Conclusions and Clinical Relevance—Topical application of 1% diclofenac sodium liposomal cream to sites of IVRLP in healthy horses decreased inflammation as judged by visual assessment and ultrasonography. Decreased inflammation may allow extended use of IVRLP and may result in a reduction in pain in treated horses.
Objective—To compare results (ie, return to racing
and earnings per race start) of surgical versus nonsurgical
management of sagittal slab fractures of the
third carpal bone in racehorses.
Animals—32 racehorses (19 Thoroughbreds, 11
Standardbreds, and 2 Arabians).
Procedure—Medical records and radiographs were
reviewed to obtain information regarding signalment
and treatment. Follow-up information was obtained
from race records. Robust regression analysis was
performed to evaluate earnings per start in horses
that raced at least once before and after injury.
Results—22 (69%) horses raced at least once after
treatment of the fracture. All 7 horses treated by
means of interfragmentary compression raced after
treatment, and horses that underwent interfragmentary
compression had significantly higher earnings
per start after the injury than did horses treated without
surgery. Eight of 9 horses treated by means of
arthroscopic debridement of the damaged cartilage
and bone raced after treatment, but only 7 of 16 horses
treated without surgery (ie, stall rest) were able to
return to racing after treatment.
Conclusions and Clinical Relevance—Results suggest
that racehorses with sagittal slab fractures of the
third carpal bone have a favorable prognosis for return
to racing after treatment. Horses treated surgically
were more likely to race after treatment than were
horses treated without surgery. (J Am Vet Med Assoc
Objective—To describe the pool-raft recovery system protocol and to evaluate the clinical outcome inhorses that underwent recovery from general anes-thesia using this system.
Animals—393 horses that underwent recovery fromgeneral anesthesia in the pool-raft system.
Procedure—Anesthetic records were examined fromhorses recovered from anesthesia in the pool-raft sys-tem between January 1984 and December 2000.Complete medical records of horses were examinedwhen available. Information regarding the anestheticand recovery period was recorded. Horses first recov-ered from general anesthesia in the pool-raft and,once awake, were transported to a recovery stall andlowered to the floor in a standing position.
Results—351 horses underwent 1 pool-raft recovery,and 42 horses underwent multiple pool-raft recover-ies. Most horses were recovered from general anes-thesia within the pool-raft system to safeguard repairof a major orthopedic injury. During 471 pool-raftrecoveries, 34 (7%) horses had complications withinthe recovery pool and 62 (13%) had complicationswithin the recovery stall. Deaths resulted from complete failure of internal fixation, pulmonary dysfunc-tion, or a combination of pulmonary dysfunction andfixation failure in 2% (10/471) of horses that under-went pool-raft recoveries.
Conclusions and Clinical Relevance—The pool-raftsystem is a good option for recovery from generalanesthesia. Although not a fail-safe system, itappears to decrease the complications of recoveringhorses in a high-risk category. Potential disadvan-tages of this system are added expense and man-power necessary in building, maintenance, andusage, as well as size limitations of the raft itself. (J Am Vet Med Assoc 2002;221:1014–1018)