Acute effects of perineural administration of sodium hyaluronate on palmar digital neurectomy sites in horses

Rachel C. Murray From the Department of Clinical Sciences (Murray, Gaughan, DeBowes, Hoskinson) and Department of Pathology (Mosier), College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506.

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Earl M. Gaughan From the Department of Clinical Sciences (Murray, Gaughan, DeBowes, Hoskinson) and Department of Pathology (Mosier), College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506.

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Richard M. DeBowes From the Department of Clinical Sciences (Murray, Gaughan, DeBowes, Hoskinson) and Department of Pathology (Mosier), College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506.

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Derek A. Mosier From the Department of Clinical Sciences (Murray, Gaughan, DeBowes, Hoskinson) and Department of Pathology (Mosier), College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506.

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James J. Hoskinson From the Department of Clinical Sciences (Murray, Gaughan, DeBowes, Hoskinson) and Department of Pathology (Mosier), College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506.

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Summary

Biaxial palmar digital neurectomy of all limbs was performed on 6 mixed-breed castrated adult male horses, using a standard guillotine method. Using a Teflon catheter, 20 mg (2 ml) of sodium hyaluronate (group 1), 2 ml of phosphate-buffered saline solution (group 2), or catheter placement with no infusion (group 3) was applied to 4 (group 1) or 2 (groups 2 and 3) of 8 incisions/horse. Treatments were administered after closure of the neurectomy incision, and the catheter was removed. Horses were evaluated daily for 1 week, then weekly over a 9- week period for evidence of lameness, swelling, and ultrasonographic changes. On week 9, horses were euthanatized and neurectomy sites were removed en bloc for histologic evaluation of axonal regrowth, inflammation, and fibrosis. Neither lameness nor sign of painful neuroma was observed clinically in any of the horses. Neurectomy eliminated cutaneous heel sensation in all limbs for the duration of the study. Swelling was evident at all neurectomy sites. There were no significant differences between treatment sites for measurement of pastern circumference or ultrasonographic evaluation of incisional swelling. Foci of ultrasonographic hyperechogenicity increased over time, but there was no significant difference in hyperechogenicity between treatment groups. Histologic evidence of neuroma formation was observed at all sites. Morphometric assessment of neuroma cross-sectional areas revealed no significant difference between the groups, as did subjective histologic assessment of neuroma density and fibrous tissue content. We conclude that there are no clinical, ultrasonographic, or histologic effects on neuroma formation and fibrosis at sites of palmar digital neurectomy associated with a single perineural administration of sodium hyaluronate or phosphate-buffered saline solution.

Summary

Biaxial palmar digital neurectomy of all limbs was performed on 6 mixed-breed castrated adult male horses, using a standard guillotine method. Using a Teflon catheter, 20 mg (2 ml) of sodium hyaluronate (group 1), 2 ml of phosphate-buffered saline solution (group 2), or catheter placement with no infusion (group 3) was applied to 4 (group 1) or 2 (groups 2 and 3) of 8 incisions/horse. Treatments were administered after closure of the neurectomy incision, and the catheter was removed. Horses were evaluated daily for 1 week, then weekly over a 9- week period for evidence of lameness, swelling, and ultrasonographic changes. On week 9, horses were euthanatized and neurectomy sites were removed en bloc for histologic evaluation of axonal regrowth, inflammation, and fibrosis. Neither lameness nor sign of painful neuroma was observed clinically in any of the horses. Neurectomy eliminated cutaneous heel sensation in all limbs for the duration of the study. Swelling was evident at all neurectomy sites. There were no significant differences between treatment sites for measurement of pastern circumference or ultrasonographic evaluation of incisional swelling. Foci of ultrasonographic hyperechogenicity increased over time, but there was no significant difference in hyperechogenicity between treatment groups. Histologic evidence of neuroma formation was observed at all sites. Morphometric assessment of neuroma cross-sectional areas revealed no significant difference between the groups, as did subjective histologic assessment of neuroma density and fibrous tissue content. We conclude that there are no clinical, ultrasonographic, or histologic effects on neuroma formation and fibrosis at sites of palmar digital neurectomy associated with a single perineural administration of sodium hyaluronate or phosphate-buffered saline solution.

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