To compare the efficacy and duration of action for perineural analgesia with liposomal bupivacaine (LB) versus bupivacaine hydrochloride (BHCl) in a sole-pressure induced model of forelimb lameness in horses.
6 healthy adult research horses.
In 1 randomly assigned forelimb, grade 3/5 lameness was induced by use of a sole-pressure lameness model. Objective lameness (vector sum [VS]) was determined with an inertial sensor system at 0, 1, 6, and 24 hours after lameness induction to evaluate the model. Mechanical nociceptive thresholds (MNTs) and objective lameness (VS and force platform kinetics) were recorded prior to and at 1, 6, 24, 48, and 72 hours after perineural anesthesia of the palmar nerves at the level of the proximal sesamoid bones with LB or BHCl in random order, with a 1-week washout period between crossover treatments. Data analysis was performed with mixed-model ANOVA.
When evaluating the lameness model, there was a decrease in lameness at 24 hours in at least 1 limb of each horse (7/12 limbs); thus, screw length was increased by 1 to 2 mm at each 24-hour interval to maintain lameness. Compared with results at baseline, horses treated with BHCl had significant improvements in median MNT and VS identified at only 1 hour after injection, whereas treatment with LB yielded significantly improved median MNT, VS score, and peak vertical force for up to 24 hours.
In this experimental model of forelimb lameness, LB provided longer analgesia when compared with BHCl and should be further investigated for treatment of pain in horses.
Case Description—A 7-year-old sexually intact male Thoroughbred racehorse was evaluated because of exercise intolerance, respiratory tract noise, and coughing when eating.
Clinical Findings—A persistent dorsal displacement of the soft palate was identified during endoscopic examination of the upper portions of the respiratory tract. Radiography of the pharyngeal and laryngeal regions revealed a hypoplastic epiglottis that was ventral to, and not in contact with, the soft palate. The horse was anesthetized, and an oral endoscopic examination revealed a subepiglottic frenulum that had resulted in the dorsal displacement of the soft palate.
Treatment and Outcome—The frenulum was transected transendoscopically by use of a diode laser. Twenty-four hours following surgery, repeat endoscopic and radiographic examinations revealed that the epiglottis had returned to its correct anatomic position in relation to the soft palate. Four weeks after surgery, endoscopy of the upper portions of the airway revealed recurrence of the dorsal displacement of the soft palate.
Clinical Relevance—A subepiglottic frenulum should be considered as a cause of persistent dorsal displacement of the soft palate in horses. An endoscopic examination of the oropharyngeal region should be performed in horses prior to undertaking any surgical interventions to treat persistent dorsal displacement of the soft palate.
Objective—To determine the incidence of unilaterally castrated horses among horses admitted to the hospital for castration and to compare horses that underwent previous unilateral castration with horses that had cryptorchism.
Design—Retrospective case series.
Animals—16 unilaterally castrated horses and 44 cryptorchid horses.
Procedures—Medical records of horses that were admitted to the veterinary medical teaching hospital for castration, including cryptorchid and unilaterally castrated horses, between January 2002 and December 2006 were reviewed. Medical records of unilaterally castrated horses and cryptorchid horses were examined for age, breed, history, diagnostic procedures, surgical technique of cryptorchidectomy, location of the retained testicle, and cost of surgery.
Results—Of 160 horses admitted for castration, 16 (10%) had undergone previous unilateral castration and 44 (27.5%) had cryptorchidism. Unilaterally castrated horses were significantly older than cryptorchid horses. No significant difference was found in left versus right distribution of testicles. No significant difference was found in abdominal versus inguinal distribution of left-sided testicles. Unilaterally castrated horses had a significantly lower proportion of right inguinal testicles, compared with cryptorchid horses. The cost of diagnosis and management of unilaterally castrated horses was significantly greater than in cryptorchid horses.
Conclusions and Clinical Relevance—Results indicated that the distribution of retained testicles is significantly different in unilaterally castrated horses, compared with cryptorchid horses, which may affect the selection of diagnostic and surgical approaches to unilaterally castrated horses.
To determine the effects of 3 α2-adrenergic receptor agonists (α2-ARAs), alone or in combination with butorphanol tartrate, on objective measurements of lameness in horses.
17 adult polo horses with naturally occurring forelimb or hind limb lameness (or both).
In a crossover design, each horse received each protocol (saline [0.09% NaCl] solution [2 mL, IV] or xylazine hydrochloride [0.33 mg/kg, IV], detomidine hydrochloride [0.007 mg/kg, IV], or romifidine hydrochloride [0.033 mg/kg, IV] alone or in combination with butorphanol [0.007 mg/kg, IV]) in random order, with a washout period (≥ 7 days) between protocols. Horses were assessed immediately prior to (baseline) and 10, 15, 20, 30, and 40 minutes after administration of each protocol for degree of sedation, mechanical nociceptive threshold (MNT), and objective lameness measurements.
Compared with baseline values, sedation scores and MNTs were significantly higher at all evaluated time points following administration of all sedation protocols except xylazine alone; following administration of xylazine alone, sedation scores and MNTs were significantly higher at ≤ 30 minutes and ≤ 20 minutes, respectively. Significant differences in objective forelimb lameness measurements were noted after administration of the 3 α2-ARA-butorphanol combinations. Most significant differences in objective measurements of hind limb lameness were detected after administration of detomidine or romifidine, alone or in combination with butorphanol.
CONCLUSIONS AND CLINICAL RELEVANCE
In the study horses, xylazine alone had the least impact on objective lameness measurements. The administration of α2-ARAs, particularly detomidine or romifidine, alone or in combination with butorphanol, resulted in small but significant effects on objective lameness measurements.
OBJECTIVE To determine the ability of an accelerometer within a commercially available portable media device (PMD) to measure changes in postural stability of standing horses during various stance conditions and to compare these results with data obtained by use of a stationary force platform.
ANIMALS 7 clinically normal horses.
PROCEDURES A PMD was mounted on a surcingle; the surcingle was placed immediately caudal to the highest point of the shoulders (withers). Each horse was examined while standing on a stationary force platform system in a normal square stance, forelimb base-narrow stance, and normal square stance at 5 and 10 minutes after sedation induced by IV administration of xylazine hydrochloride. A minimum of 5 trials were conducted for each stance condition. Ranges of craniocaudal and mediolateral motion as well as SDs were collected for the PMD and force platform system. Analyses were performed with mixed-model ANOVAs, and correlation coefficients were calculated.
RESULTS Stance condition significantly altered craniocaudal accelerations measured by use of the PMD, all craniocaudal and mediolateral displacements of the center of pressure, and velocities measured by use of the stationary force platform. For both the PMD and force platform, SDs were significantly affected by stance condition in both craniocaudal and mediolateral directions. Correlation coefficients between the systems for all variables were low to moderate (r = 0.18 to 0.58).
CONCLUSIONS AND CLINICAL RELEVANCE Body-mounted PMDs should be investigated for use in assessment of postural stability in horses with neuromuscular abnormalities.
Objective—To determine kinematic changes to the hoof of horses at a walk after induction of unilateral, weight-bearing forelimb lameness and to determine whether hoof kinematics return to prelameness (baseline) values after perineural anesthesia.
Animals—6 clinically normal Quarter Horses.
Procedures—For each horse, a sole-pressure model was used to induce 3 grades of lameness in the right forelimb, after which perineural anesthesia was administered to eliminate lameness. Optical kinematics were obtained for both forelimbs with the horse walking before (baseline) and after induction of each grade of lameness and after perineural anesthesia. Linear acceleration profiles were used to identify hoof events, and each stride was divided into hoof-contact, break-over, initial-swing, terminal-swing, and total-swing segments. Kinematic variables were compared within and between limbs for each segment by use of mixed repeated-measures ANOVA.
Results—During the hoof-contact and terminal-swing segments, the hoof of the left (nonlame) forelimb had greater sagittal-plane orientation than did the hoof of the right (lame) forelimb. For the lame limb following lameness induction, the break-over duration and maximum cranial acceleration were increased from baseline. After perineural anesthesia, break-over duration for the lame limb returned to a value similar to that at baseline, and orientation of the hoof during the terminal-swing segment did not differ between the lame and nonlame limbs.
Conclusions and Clinical Relevance—Subclinical unilateral forelimb lameness resulted in significant alterations to hoof kinematics in horses that are walking, and the use of hoof kinematics may be beneficial for the detection of subclinical lameness in horses.
Objective—To determine kinematic changes to the hoof of horses at a trot after induction of unilateral, weight-bearing forelimb lameness and to determine whether hoof kinematics return to prelameness values after perineural anesthesia.
Animals—6 clinically normal Quarter Horses.
Procedures—For each horse, a sole-pressure model was used to induce 3 grades (grades 1, 2, and 3) of lameness in the right forelimb, after which perineural anesthesia was administered to alleviate lameness. Optical kinematics were obtained for both forelimbs with the horse trotting before (baseline) and after induction of each grade of lameness and after perineural anesthesia. Hoof events were identified with linear acceleration profiles, and each stride was divided into hoof-contact, break-over, initial-swing, terminal-swing, and total-swing segments. For each segment, kinematic variables were compared within and between limbs by use of mixed repeated-measures ANOVA.
Results—During hoof-contact, the left (nonlame) forelimb hoof had greater heel-down orientation than did the right (lame) forelimb hoof, and during break-over, the nonlame hoof went through a larger range of motion than did the lame hoof. Maximum cranial acceleration during break-over for the lame hoof was greater, compared with that at baseline or for the nonlame hoof. Following perineural anesthesia, the sagittal plane orientation of the hoof during hoof-contact did not vary between the lame and nonlame limbs; however, interlimb differences in maximum cranial acceleration and angular range of motion during break-over remained.
Conclusions and Clinical Relevance—Results suggested that hoof kinematics may be useful for detection of unilateral, weight-bearing forelimb lameness in horses that are trotting.
OBJECTIVE To determine the effects of altering location of right forelimb and pelvic sensors on kinematic data obtained with a commonly used inertial sensor system during gait analysis of trotting horses.
DESIGN Experimental study.
ANIMALS 12 horses with mild to moderate lameness of at least 1 hind limb, with or without lameness of the forelimbs.
PROCEDURES All horses were examined while trotting on a high-speed treadmill. The right forelimb sensor was tested at 3 anatomic locations in random order: dorsal midline and 2 cm medial and lateral to that midline. During another treadmill session, the pelvic sensor was tested at 5 anatomic locations in random order: dorsal midline, 2 cm to the right and left of midline, and 2 cm cranial and caudal to the tubera sacrale on the midline. Laterality of the pelvic sensor was analyzed in 2 ways: sensor toward the right or left and sensor toward or away from the lame or lamest hind limb. Maximum and minimum differences in head and pelvic motion and vector sum values were ranked and compared with values for the midline location by means of mixed-model ANOVA.
RESULTS Altering the location of the right forelimb sensor by 2 cm medially or laterally had no significant effect on forelimb or hind limb kinematics. However, location of the pelvic sensor had a significant effect on minimum difference in pelvic motion, regardless of whether the data were analyzed by laterality (right vs left) or toward versus away from the lame hind limb.
CONCLUSIONS AND CLINICAL RELEVANCE Results of this study indicated that a 2-cm change in the location of the pelvic sensor during kinematic gait analysis had a significant effect on hind limb kinematic data of the system used. Therefore, placement of this sensor needs to be anatomically accurate.
OBJECTIVE To determine accuracy for a technique of needle redirection at a single craniolateral site for injection of 3 compartments of the equine stifle joint, describe the external needle position, and identify the location of the needle tip within each joint compartment.
SAMPLE 24 equine cadaver stifle joints.
PROCEDURES Stifle joints were placed in a customized stand. After the needle was placed, external needle position was measured and recorded. Each joint compartment (medial and lateral compartments of the femorotibial joint and the femoropatellar joint) was injected with a solution containing iodinated contrast medium, water, and dye. Radiography, assessment of intra-articular location of the needle tip, and gross dissection were performed to determine success of entering each joint compartment. Student t tests and an ANOVA were used to compare mean values.
RESULTS Overall accuracy was 19 of 24 (79.1%), and accuracy for individual joint compartments was at least 21 of 24 (87.5%). Mean depth of needle insertion to access each compartment of the stifle joint was 5.71 cm. Mean angle of insertion (relative to the long axis of the tibia) was 82.1°, 80.3°, and 18.5° for the medial compartment of the femorotibial joint, lateral compartment of the femorotibial joint, and femoropatellar joint, respectively, and 28° medial, 7.3° lateral, and 1.3° lateral for the medial compartment of the femorotibial joint, lateral compartment of the femorotibial joint, and femoropatellar joint, respectively.
CONCLUSIONS AND CLINICAL RELEVANCE Results supported that this was an accurate technique for successful injection of the 3 equine stifle joint compartments.
Objective—To validate an equine inertial measurement unit (IMU) system rigidly attached to a hoof against a 3-D optical kinematics system in horses during walking and trotting.
Animals—5 clinically normal horses.
Procedures—5 swing phases of the hooves of the right forelimb and hind limb were collected via both 3-D optical and IMU systems from 5 horses during walking and trotting. Linear and angular positions, velocities, and accelerations were compared between the 2 systems.
Results—Of the 55 variables compared between the 2 systems, 25 had high correlations (r > 0.8) and 18 had moderate correlations (r > 0.5). Root mean squared errors were lowest in the sagittal plane and orientation (1.1 to 4.4 cm over a range of 1.5 to 1.9 m in the cranial-caudal direction and 2.5° to 3.5° over a range of 88° to 110° rotating around the medial-lateral axis). There were more differences between the 2 systems during small changes in motion, such as in the medial-lateral and proximal-distal directions and in the angular measures around the cranial-caudal and proximal-distal axes.
Conclusions and Clinical Relevance—The equine IMU system may be appropriate for rigid attachment to a hoof of a horse and use in examination of linear and angular motion in the sagittal plane of the hoof during the swing phase while walking and trotting. Although promising in many respects, the IMU system cannot currently be considered clinically useful for lameness evaluation because of limitations in accuracy, attachment method, and lack of stance phase evaluation.