Objective—To evaluate outcome after intralesional injection of insulin-like growth factor-I (IGF-I) for treatment of superficial digital flexor (SDF) tendonitis in Thoroughbred racehorses.
Design—Retrospective case series.
Animals—40 Thoroughbred racehorses.
Procedures—Medical records of racehorses with SDF tendonitis treated within 13 weeks after injury by intralesional injection of IGF-I (25 or 50 μg every other day for 4 or 5 treatments) were reviewed. Outcome was determined via analysis of race records, owner follow-up, and examination.
Results—Mean age of the horses was 3.1 years (range, 2 to 7 years), and time from injury to treatment ranged from 8 to 90 days. Mean ± SD approximate lesion length on admission was 15.6 ± 6.0 cm, and mean percentage cross-sectional area of the tendon affected was 26 ± 18%. Twenty-six of the 40 horses underwent desmotomy of the accessory ligament of the SDF tendon. Echolucency was reduced in 23 of 26 horses by the end of the treatment period. Twenty-one of 34 (62%) horses for which race data were available raced at least once after treatment, including 10 (30%) horses that raced between 1 and 4 times and 11 horses (32%) that raced ≥ 5 times. Thirteen of 28 (46%) horses had a recurrence of tendonitis or developed tendonitis elsewhere.
Conclusions and Clinical Relevance—Results suggested that in Thoroughbred racehorses with SDF tendonitis, intralesional injection of IGF-I led to a decrease in ultrasonographic lesion severity, but treated horses had only a moderate prognosis for return to racing.
To describe clinical and CT findings for horses and ponies undergoing intraoral cheek tooth extraction and assess potential associations between these features and outcome of the procedure.
74 horses and 7 ponies.
Medical records were searched to identify horses and ponies that underwent CT and intraoral extraction of ≥ 1 cheek tooth with standing sedation. Signalment and clinical variables were recorded, and CT scans were reviewed. Anatomic location and measurements of affected teeth; abnormalities of the periodontium, pulp, infundibula, roots, and tooth shape; fracture presence and type; presence of sinusitis; and affected sinus cavities were assessed by a surgeon and a radiologist. Intraoral extraction outcome was recorded as successful (complete removal of the tooth in 1 intraoral extraction procedure) or unsuccessful. Univariable and multivariable logistic regression analyses were performed to assess associations between clinical or CT findings and outcome.
89 cheek teeth (80 maxillary and 9 mandibular) were included in the analyses. Sixty of 89 (67%) cheek teeth were extracted successfully (56/80 [70%] maxillary and 4/9 [44%] mandibular cheek teeth). Only presence of a simple fracture (vs no fracture) was associated with outcome on multivariable regression analysis; odds of successful intraoral extraction were significantly lower when this feature was present.
CONCLUSIONS AND CLINICAL RELEVANCE
Most extractions of cheek teeth in the study sample were successful, and results may be useful for practitioners in refining cheek tooth extraction plans for horses and ponies. Further studies are required to assess whether specific CT findings can be used to predict the outcome of intraoral extraction in equids.
Case Description—A 7-year-old 573-kg (1,261 -lb) Swiss Warmblood gelding was evaluated because of signs of acute abdominal pain.
Clinical Findings—Physical examination revealed a markedly distended abdomen with subjectively reduced borborygmi in all abdominal quadrants. A large, gas-distended viscus was present at the pelvic brim preventing complete palpation of the abdomen per rectum. Ultrasonographic evaluation could not be safely performed in the initial evaluation because of severe signs of abdominal pain.
Treatment and Outcome—Ventral midline celiotomy was performed, and right dorsal displacement of the ascending colon was corrected. Progressive signs of abdominal pain after surgery prompted repeat ventral midline celiotomy, and small intestinal incarceration in a large, radial mesojejunal rent was detected. The incarceration was reduced, but the defect was not fully accessible for repair via the celiotomy. Repair of the mesenteric defect was not attempted, and conservative management was planned after surgery; however, signs of colic returned. A standard laparoscopic approach was attempted from both flanks in the standing patient, but the small intestine could not be adequately mobilized for full evaluation of the rent. Hand-assisted laparoscopic surgery (HALS) allowed identification and reduction of jejunal incarceration and repair of the mesenteric rent. Although minor ventral midline incisional complications were encountered, the horse recovered fully.
Clinical Relevance—HALS techniques should be considered for repair of mesenteric rents in horses. In the horse of this report, HALS facilitated identification, evaluation, and repair of a large radial mesenteric rent that was not accessible from a ventral median celiotomy.