Muscle strain injuries of the hindlimb in eight horses: diagnostic imaging,management and outcomes

Objective To describe the clinical presentation, ultrasound findings, management and outcome in horses with muscle tear injuries of the hindlimbs. Design Retrospective case series Procedure Medical records of eight horses were reviewed and information on signalment, history, presenting complaint, physical examination findings and further diagnostic tests were recorded. Diagnosis of muscle injury was determined by the presence of abnormal ultrasound findings, compared with the contralateral limb, and, when required, nuclear scintigraphy. Follow-up information was obtained via telephone interviews with owners, trainers and referring veterinarians. Results Muscle tears causing lameness were identified in the middle gluteal (3), semitendinosus (1), semimembranosus (2) and gracilis (2) muscles. Tears were classified by ultrasound imaging as partial (6) or complete (2). The degree of lameness did not appear to be indicative of the extent of injury or of completion of healing. Long-term follow-up was available for seven horses and the outcome was favourable in six cases. Conclusions and clinical relevance Ultrasonography is useful in the diagnosis and assessment of moderate to severe muscle strain injuries. The prognosis appears to be favourable in most cases, although recurrence of injury and lameness can delay the return to athletic activity and an inferior outcome with persistent gait abnormality may occur.     

Microglia and astrocyte activation in the spinal cord of lame horses

Objective

To determine the microglial and astrocyte response to painful lameness in horses.

Morphometry and abnormalities of the feet of Kaimanawa feral horses in New Zealand

Objective The present study investigated the foot health of the Kaimanawa feral horse population and tested the hypotheses that horses would have a large range of foot morphology and that the incidence of foot abnormality would be significantly high. Procedures Abnormality was defined as a variation from what the two veterinarian assessors considered as optimal morphology and which was considered to impact negatively on the structure and/or function of the foot. Fifteen morphometric variables were measured on four calibrated photographic views of all four feet of 20 adult Kaimanawa feral horses. Four morphometric variables were measured from the lateromedial radiographs of the left forefoot of each horse. In addition, the study identified the incidence of gross abnormality observed on the photographs and radiographs of all 80 feet. Results There was a large variation between horses in the morphometric dimensions, indicating an inconsistent foot type. Mean hoof variables were outside the normal range recommended by veterinarians and hoof care providers; 35% of all feet had a long toe conformation and 15% had a mediolateral imbalance. Abnormalities included lateral (85% of horses) and dorsal (90% of horses) wall flares, presence of laminar rings (80% of horses) and bull-nose tip of the distal phalanx (75% of horses). Both hypotheses were therefore accepted. Conclusions The Kaimanawa feral horse population demonstrated a broad range of foot abnormalities and we propose that one reason for the questionable foot health and conformation is lack of abrasive wearing by the environment. In comparison with other feral horse populations in Australia and America there may be less pressure on the natural selection of the foot of the Kaimanawa horses by the forgiving environment of the Kaimanawa Ranges. Contrary to popular belief, the feral horse foot type should not be used as an ideal model for the domestic horse foot.     

Computed tomographic features of the temporomandibular joint in 10 Jeju horses

BackgroundThe equine temporomandibular joint (TMJ) has a complex anatomical structure that makes diagnosis of TMJ disorders difficult. Computed tomography (CT) is now available in equine medicine; hence, TMJ evaluation has become more convenient.ObjectivesThe objectives of this study were to describe the CT features of the TMJ in Jeju horses and to compare these features with those of Thoroughbreds.MethodsIn this report, the TMJs of 10 Jeju horses (mean age: 4.5 ± 1.9 yr; mean body weight: 282.6 ± 40.3 kg) and 6 Thoroughbreds (mean age: 7.3 ± 1.6 yr; mean body weight: 479.7 ± 44.0 kg) were examined using CT. After CT scanning, the Hounsfield units (HU) and height to width ratio (H:W) of the mandibular condyle were measured.ResultsThe mean H:W in Jeju horses was significantly lower than that in Thoroughbreds. The mean HU in Jeju horses was lower than that in Thoroughbreds; however, the difference was not significant. The most frequent CT finding was an irregular medial margin of the mandibular condyle in both breeds.ConclusionsIn this study, the shape of the mandibular condyle in Jeju horses was flatter than that in Thoroughbreds. This report could be useful in evaluating the TMJ in Jeju horses. Moreover, CT could be a pragmatic choice for the examination of the TMJ in horses.     

Radiographic and scintigraphic evaluation of the third carpal bone of control horses and horses with carpal lameness

We compared the radiographic and scintigraphic findings in the third carpal bone of horses performing different work disciplines and investigated their relationship with lameness. Horses had undergone carpal radiography including acquisition of a dorsoproximal-dorsodistal oblique (DPr-DDiO) image of the distal row of carpal bones and/or scintigraphic examination of the carpi. Cause of lameness, breed, age, and work discipline were recorded. Increased opacity in the third carpal bone was graded, ratio of radiopharmaceutical uptake calculated objectively, and increased radiopharmaceutical uptake graded subjectively. Relationships between radiographic, scintigraphic, and clinical findings were assessed statistically. Increased opacity in the third carpal bone (P = 0.003) and ratio of radiopharmaceutical uptake (P = 0.015) were associated with the work discipline. Increased opacity in the third carpal bone was associated with both increased radiopharmaceutical uptake grade (P = 0.002; rs = 0.59) and ratio of radiopharmaceutical uptake (P = 0.013; rs = 0.46). Increased radiopharmaceutical uptake and increased opacity in the third carpal bone were not always observed concurrently. Lameness related to the middle carpal joint was associated with increased opacity (P < 0.001), ratio of radiopharmaceutical uptake (P = 0.037), and increased radiopharmaceutical uptake grade (P < 0.001). Radiographic and scintigraphic abnormalities were observed in horses performing all disciplines, indicating that high-speed exercise may not be the only factor determining the development of osseous disease in the third carpal bone. Both increased opacity and increased radiopharmaceutical uptake were more likely to be seen in horses with lameness related to the middle carpal joint than in horses with other sources of pain.     

Retrospective investigation of prognostic indicators for adult horses with infection of a synovial structure

Objective To investigate predictors of survival and athletic function in adult horses with infection of a synovial structure. Hypotheses Increasing duration from contamination to referral, bone or tendon involvement and positive microbial culture decreases short‐term survival. Synovitis and/or sepsis at 5 days post‐admission and involvement of Staphylococcus spp. decreases long‐term athletic function. Design Retrospective study. Methods Records over 4 years of adult horses with synovial sepsis were reviewed. A two‐tailed Fisher's exact test, Mann‐Whitney U test or t‐test was used to examine whether variables were predictive of short‐term survival and long‐term athletic function. Results During the study period 75 horses underwent treatment for infection of 93 synovial structures. Short‐term survival was 84% (63/75) and 54% (30/56) of horses returned to athletic function. Of the variables measured at admission, duration from contamination to referral did not affect survival, whereas evidence of bone or tendon involvement decreased survival and athletic function. Of the variables available during treatment, abnormal synovial fluid at 4–6 days post‐admission and positive microbial culture reduced athletic function. Staphylococcal infection was associated with persistent sepsis. Conclusions Of the variables available at presentation, only evidence of bone or tendon involvement negatively affected survival and athletic function. During treatment of synovial sepsis, analysis of synovial fluid at 4–6 days and bacterial culture results have prognostic value.     

Ultrasonographic guided injection of the scapulohumeral joint in horses

Intra‐articular injections of the scapulohumeral joint (SHJ) in horses are difficult to perform because of the thick muscles covering the area and a reduced articular space. Ultrasonographic guidance was demonstrated to be helpful to perform intra‐articular injections. This technique applied to the SHJ can be performed in the field with a portable machine. The joint space is firstly imaged in transverse and proximodistal scans. After aseptic preparation of the shoulder area, the probe is placed to image the SHJ space in transverse section and the needle is inserted cranially in the ultrasound beam. The progression of the needle is followed towards the SHJ space, limiting joint injuries and side effects.     

Traumatic communication of the extensor carpi radialis tendon sheath and antebrachiocarpal joint in two horses

Two horses were examined due to lacerations at the level of the craniodistal antebrachii. Further evaluation of the lacerations revealed communication with the extensor carpi radialis tendon sheath and potentially the antebrachiocarpal joint. Positive contrast arthrography performed via the palmarolateral pouch of the antebrachiocarpal joint was used to diagnose communication with the extensor carpi radialis tendon sheath. Both the joints and tendon sheaths were treated aggressively with surgical debridement and lavage, followed by post operative medical management and rehabilitation. Both horses made a full recovery and are performing in their intended level of use with acceptable cosmetic results. Traumatic communication with the carpal joints should be considered when evaluating lacerations involving the forelimb extensor tendon sheaths.     

Idiopathic infectious arthritis of the coxofemoral joint in a mature horse

The authors are aware of only one previously described case of idiopathic infectious arthritis of the coxofemoral joint in a mature horse. The case described herein presented with clinical signs that localised pain to the proximal limb, subtle increased radiopharmaceutical uptake at the coxofemoral joint and an increase of the major acute phase protein, serum amyloid A in the horse's blood biochemistry. The latter finding led the authors to search initially for an infective process. Ultrasound guided aspiration of the coxofemoral joint yielded infected synovial fluid. Despite the duration of the condition, nonsurgical treatment allowed the horse to return to its previous, relatively modest, level of activity. This case is presented to supplement the single previously published case report of idiopathic adult coxofemoral infectious arthritis in the horse.     

Methicillin-resistant Staphylococcus aureus in a population of horses in Australia

Objective To evaluate if methicillin‐resistant Staphylococcus aureus (MRSA) is present in the horse population in Australia. Design A two‐part retrospective study of laboratory submissions of microbial culture results from horses. Methods Part A: medical records of 216 horses that had MRSA screening performed on nasal swabs collected over a 30‐day period at admission to the Scone Equine Hospital Clovelly Intensive Care Unit were retrieved. Part B: laboratory records from 2004 to 2009 of culture submissions to the Scone Veterinary Laboratory were reviewed and cultures that grew MRSA were identified. The MRSA isolates from Parts A and B were genotyped over an 18‐month period. Results MRSA screening of 216 horses identified eight (3.7%) positive samples. MRSA was isolated from cultures of 80 (0.002%) clinical bacteriology samples over a 6‐year period. Genotypic analysis was performed on 36 isolates. All MRSA characterised had the same pulse field gel electrophoresis pattern (type 1), with eight closely related subtypes identified (subtypes A–F and H) and 66% of isolates classified as subtype D, which multilocus sequence and staphylococcal cassette chromosome mec typing analysis identified as ST612‐MRSA‐IVa, a clonal complex (CC) 8 S. aureus strain. Antimicrobial resistance to more than two classes of antimicrobials was common. Conclusions MRSA was present in a population of horses in Australia. Genotypic analysis of the isolates identified the MRSA strain as CC8 S. aureus. Further research needs to be undertaken to evaluate MRSA infection and colonisation of horses and personnel in Australia.     

Retrospective study of outcome following desmotomy of the accessory ligament of the deep digital flexor tendon for type 1 flexural deformity in Thoroughbreds

Objective Determine the long‐term outcome for Thoroughbreds undergoing desmotomy of the accessory ligament of the deep digital flexor tendon (DAL‐DDFT) for type 1 flexural deformity of the distal interphalangeal joint (DIPJ). Design Retrospective matched cohort study Procedure Medical records were retrieved over a 17‐year period for Thoroughbreds that underwent DAL‐DDFT for type 1 flexural deformity. Long‐term outcome was determined by analysis of race records and comparison with maternal siblings. Comparisons between cases and controls included 2‐year‐old, 3‐year‐old and total career performance data. Results There were 46 cases of DAL‐DDFT. The mean age at surgery was 151 days (median 118, range 2–562); 48% of case horses and 77% of 90 controls started in a race. For case horses that did race, the time to first race, total number of starts and prize money per race were not significantly different to maternal siblings. Age at the time of surgery did not alter the likelihood of starting a race. Conclusion Thoroughbreds undergoing DAL‐DDFT for type 1 flexural deformity of the DIPJ are less likely to race when compared with their maternal siblings. For those that do race, the time to first race, total races and earnings per race are not different from controls. There is no evidence to suggest that age at the time of surgery influences the likelihood of racing.     

Collateral desmitis of the distal interphalangeal joint in conjunction with concurrent ossification of the cartilages of the foot in nine horses

The purpose of this study was to describe the frequency of occurrence of severe ossification of the collateral cartilages (sidebone) coexistent with collateral desmitis of the distal interphalangeal joint (DIPJ) in lame horses. Sidebone was diagnosed and graded on standard radiographs and soft tissue injuries of the foot were diagnosed using standing low‐field magnetic resonance imaging (MRI). Of 15 horses with forelimb lameness and severe sidebone, 9 had evidence of concurrent collateral desmitis of the DIPJ. All 15 horses had damage to other structures (including the deep digital flexor tendon, distal sesamoidean impar ligament, collateral sesamoidean ligament, navicular bone and distal phalanx) within the affected feet as identified on MRI. The clinical and pathophysiological significance of concurrent collateral desmitis of the DIPJ and sidebone is currently uncertain. However, this study shows that injuries to multiple structures within the foot are common and that collateral desmitis of the distal interphalangeal joint is frequently seen in lame horses in conjunction with severe ossification of the collateral cartilages.     

Distal luxation of the patella in a horse

A 19-year-old Thoroughbred gelding presented with sudden onset, non-weight bearing lameness in the right hindlimb. Radiography confirmed distal luxation of the patella, which was replaced into its normal anatomical location under general anaesthesia. There were no pathological sequelae noted on follow-up examination 9 months after the initial injury. To our knowledge, this is a rare manifestation of patellar luxation, only reported once previously in the equine literature.     

Pharmacokinetics of single doses of maropitant citrate in adult horses

The neurokinin‐1 (NK) receptor antagonist, maropitant citrate, mitigates nausea and vomiting in dogs and cats. Nausea is poorly understood and likely under‐recognized in horses. Use of NK‐1 receptor antagonists in horses has not been reported. The purpose of this study was to determine the pharmacokinetic profile of maropitant in seven adult horses after single intravenous (IV; 1 mg/kg) and intragastric (IG; 2 mg/kg) doses. A randomized, crossover design was performed. Serial blood samples were collected after dosing; maropitant concentrations were measured using LC‐MS/MS. Pharmacokinetic parameters were determined using noncompartmental analysis. The mean plasma maropitant concentration 3 min after IV administration was 800 ± 140 ng/ml, elimination half‐life was 10.37 ± 2.07 h, and volume of distribution was 6.54 ± 1.84 L/kg. The maximum concentration following IG administration was 80 ± 40 ng/ml, and elimination half‐life was 9.64 ± 1.27 hr. Oral bioavailability was variable at 13.3 ± 5.3%. Maropitant concentrations achieved after IG administration were comparable to those in small animals. Concentrations after IV administration were lower than in dogs and cats. Elimination half‐life was longer than in dogs and shorter than in cats. This study is the basis for further investigations into using maropitant in horses.     

The pharmacokinetics and antiparasitic activity of ivermectin in Hutsul and Toric horses

The aim of this study was to compare the pharmacokinetics of ivermectin and its antiparasitic activity in two horse breeds. Eight Hutsul and 14 Toric horses were administered ivermectin orally at a dose of 0.2 mg/kg body weight. Blood samples were collected for 96 hr, and faecal samples were collected one day before and on days 14 and 21 after drug administration. Ivermectin concentrations in plasma samples were determined by high‐performance liquid chromatography. Ivermectin concentration was significantly higher in Toric than in Hutsul horses 90 min after ivermectin administration and was maintained at higher level for up to 96 hr. The area under the concentration versus the time curve from 0 to the last sampling point (AUC_0→t) and the maximum plasma concentration (C_max) were significantly higher in Toric than in Hutsul horses (1792.09 ± 246.22 μg × hr/L vs. 716.99 ± 255.81 μg × hr/L and 62.72 ± 17.97 ng/ml vs. 35.34 ± 13.61 ng/ml, respectively). No parasitic eggs were found in the faecal samples collected from both groups of horses on days 14 and 21 after drug administration. The obtained results indicate that although the pharmacokinetics of ivermectin may differ significantly between horse breeds, these differences do not affect the effectiveness of therapy.     

Repair of a type IV Monteggia fracture in a foal

A Monteggia fracture is a humero-radial luxation combined with a fracture of the ulna. It is a rare injury, infrequently reported in the horse. This case report describes the surgical repair of such a fracture in a 4-month-old filly.