Objective—To characterize ruptures of collateral ligaments (CLs) in metacarpophalangeal and metatarsophalangeal joints in horses.
Design—Retrospective case series.
Animals—17 horses with ruptured CLs.
Procedures—Data were obtained from medical records, including signalment, history, clinical signs, ultrasonographic and radiographic findings, treatment, and outcome. Additional follow-up information was obtained from owners or referring veterinarians.
Results—The lateral CL was ruptured in 11 horses; the medial CL was ruptured in 6 horses. Ultrasonography revealed ipsilateral rupture of the short and long components of the CL in 11 horses and rupture of only 1 component in 6 horses. No biaxial ruptures were detected, but 9 horses had desmitis of the CL on the nonruptured side of the affected joint. All horses were lame (lameness score range, 2/5 to 4/5). Joint instability was palpable in 9 horses; only 4 horses had episodes of joint luxation. Avulsion fractures were identified radiographically in 6 horses and ultrasonographically in another 2 horses. Stress radiography revealed joint instability in 10 horses. Horses were managed by stall confinement, limb immobilization, and gradual return to exercise. Eight horses returned to riding, 2 resumed breeding, 2 were retired, 2 were euthanized, and 3 were doing well 86 to 139 days after injury.
Conclusions and Clinical Relevance—Ultrasonographic examination is indicated in horses with acute lameness and swelling at the metacarpophalangeal or metatarsophalangeal joint, particularly when stress radiography cannot be performed or findings are equivocal. Affected horses can be conservatively managed. Prognosis for athletic use may be better than originally believed.
PROCEDURES Horses were sedated, jugular catheters were placed, and manual restraint was used to ensure proper positioning for the angiography procedure. Two injection techniques (IV and intra-arterial) were performed for each horse 1 week apart. Intravenous injections of 0.25% indocyanine green (ICG; 50 mg) and 10% SF (10 mg/kg) were administered via the jugular catheter. Intra-arterial injections of ICG (1 mg) and SF (1 mg/kg) were administered into the common carotid artery with ultrasound guidance. Angiography was performed by use of an adaptor system comprised of a modified digital single-lens reflex camera, camera adaptor, and lens. Imaging was performed at a rate of 3 images/s for 60 seconds immediately following ICG injection, then at 2, 3, 4, and 5 minutes after injection. The SF was injected 5 minutes thereafter.
RESULTS ASICGA allowed visual identification of the arterial, capillary, and venous phases of angiography. Intra-arterial administration provided superior dye fluorescence, sharper contrast, and faster dye passage than IV administration. Visibility of the iris vasculature was limited with SF, and extravasation of SF was noted. No clinically important adverse events were detected.
CONCLUSIONS AND CLINICAL RELEVANCE ASICGA images were obtainable with both injection techniques; however, visibility of the iris vasculature was better with intra-arterial administration of ICG. The ASICGA technique may serve as a viable ocular imaging modality for horses.