Successful surgical management of a medial humeral epicondyle fracture in a Thoroughbred foal

A 2-week-old 75 kg Thoroughbred filly was presented for the investigation of an acute forelimb lameness. Radiographs revealed a fracture of the medial epicondylar physis of the left humerus (Salter–Harris type II fracture). The fragment was removed via arthrotomy under general anaesthesia. Two months post-operatively, the foal was sound and at 2 years had resumed normal turn out. This case report describes a previously unreported surgical treatment for a fracture of the medial epicondylar physis in a foal.     

Computed tomographic diagnosis of a fracture of the floor of the pelvis in a Thoroughbred foal

This case report describes the clinical and diagnostic imaging findings, treatment and outcomes of a 15-day-old Thoroughbred foal referred for the evaluation of severe left hindlimb lameness of 8 days' duration. Radiographic examination of the left hindlimb and transcutaneous ultrasonographic examination of the pelvis were unremarkable. A computed tomographic (CT) examination was performed to investigate the proximal aspect of the limb and the pelvis; CT scans of the thorax were also acquired. In this case, CT images allowed detection of a closed, slightly displaced, oblique wedge-like fracture of the left caudal ramus of the pubis and medial ramus of the ischium, allowing an accurate diagnosis to guide appropriate treatment and prognostication. The foal was treated with anti-inflammatory drugs and box-rest. A follow-up by telephone interview with the trainer 3 years later revealed that the horse is in full athletic activity without any residual gait alteration related to the pelvic fracture.     

Surgical treatment of a large congenital cavernous haemangioma on the thorax of a foal

A 3‐day‐old male foal was presented with a fluctuant 25 × 15 cm mass on the thorax. The mass had increased in size since birth. The mass did not respond to conservative treatment consisting of aspiration of serohaemorrhagic contents and compression bandages, and it was therefore surgically removed when the foal was approximately 2½ weeks. A histopathological diagnosis of cavernous haemangioma was made. Healing progressed without complications despite a large surgical wound left to heal by second intention. Recurrence was not observed during the 1.5‐year follow‐up period.     

Fractures of the scapula

Fractures of the scapula are uncommon and the majority of these involve the supraglenoid tubercle in young horses 2 years of age or less. Scapula fractures of the neck or body are rare. Comminuted scapula fractures have been diagnosed in racing breeds (Thoroughbreds and Quarter Horses) and a review of the literature on the different fracture types and their management is presented in this article. The best prognosis for soundness is given for horses treated surgically. The different techniques for surgical management are described here and comments made with reference to nonsurgical management. A residual gait deficit may persist in some horses because of involvement of the suprascapular nerve at the time of injury, during surgery and follow‐up period, the severity of which depends on the degree of nerve trauma.     

Transplacental infection of a foal with Anaplasma phagocytophilum

This is the first report to document transplacental transmission of Anaplasma phagocytophillum in the horse. A 4-year-old late-term pregnant mare presented for a recent onset of pyrexia due to equine granulocytic anaplasmosis (EGA). She was hospitalised for treatment with oxytetracycline and monitoring of high-risk foaling due to significant thrombocytopenia. Parturition occurred overnight, and the foal was PCR positive for A. phagocytophilum at birth. The foal was slow to stand and nurse, with signs of neonatal encephalopathy and anaplasmosis (thrombocytopenia). Therapy with oxytetracycline resulted in complete clinical recovery of the mare and foal within 5 days. Congenital anaplasmosis should be considered in any foal delivered to a mare suffering from EGA during late-term pregnancy and guide appropriate antimicrobial therapy.     

Treatment of a Periarticular Tibial Fracture in a Foal with a Hybrid External Fixator

Objective— To report repair of a right proximal tibial Salter-Harris type II fracture in a foal with a hybrid external fixator (HEF).
Study Design— Case report.
Animals— A 5-month-old male foal.
Methods— After open surgical reduction, an HEF built with wires, 2 half-rings, 3 half-threaded connecting rods, and Schanz pins was used to stabilize the fracture.
Results— Immediately after surgery, the foal had relatively good weight bearing. The HEF was removed at 60 days after radiographic confirmation of healing.
Conclusions— HEF can be used to stabilize a proximal tibial Salter-Harris type II fracture in a 5-month-old foal.
Clinical Relevance— HEF should be considered as another option for repair of proximal tibial Salter-Harris type II fractures in foals.     

Successful surgical debridement of a cerebral Streptococcus equi equi abscess by parietal bone flap craniotomy in a 2-month-old Warmblood foal

Brain abscesses and intracranial masses have been regularly described in horses. Treatment often is difficult and unrewarding and mortality rate high. This case report describes the successful treatment of a cerebral abscess in a 2-month-old female Warmblood foal with severe neurological signs of acute onset. Computed tomography (CT) revealed a 3 × 4 × 4 cm cerebral mass in the left brain hemisphere with severe cerebral oedema. Craniotomy, using a parietal bone flap technique, allowed the abscess to be sampled, drained and lavaged. Immediately, post-surgery the foal showed significant clinical improvement. Sample culture confirmed Streptococcus equi equi infection. The foal was medically treated for 6 weeks, leading to complete clinical and radiographical recovery. Intracranial surgery in equine medicine is limited. Using a parietal bone flap instead of partial craniectomy to gain access to the cerebrum is a less invasive procedure leading to a better aesthetic result and should be considered for the treatment of cerebral masses in the horse.     

Multiple rib fracture in a neonatal foal using a nylon strand suture repair technique

OBJECTIVES: To report rib fracture repair using the Securos Cranial Cruciate Ligament Repair System (SCCLRS; Securos Veterinary Orthopedics, Charlton, MA) in a neonatal foal. STUDY DESIGN: Case report. ANIMALS: A 1-day-old Standardbred foal with fracture of left ribs 2-9. METHODS: Four days after admission the foal was anesthetized and rib fractures were repaired using open reduction and the SCCLRS. RESULTS: Rib fractures were successfully stabilized and the foal was discharged 7 days postoperatively without further complications. CONCLUSIONS: The SCCLRS provided a straightforward, effective method of rib fracture repair in neonatal foals. CLINICAL RELEVANCE: Effective rib fracture repair in neonatal foals can be achieved with the SCCLRS.     

Aggression to a foal after 4 months of nursing

A 4-month-old male Arabian foal was examined because of a kicking trauma to the right frontal region. The foal had been kicked by its dam when it was seeking the udder the previous day. Radiographic inspection of head and neck showed no defect or bone fracture. Treatment consisting of intravenous administration of hypertonic solution, dexamethasone, and furosemide improved the clinical signs temporarily; however, second head trauma due to falling of the standing foal resulted in deterioration of clinical condition and finally death. At necropsy, epidural, subdural, and subarachnoid hemorrhages, a hematoma at cerebrocerebellar fissure and cerebellar herniation were observed. Continuous assessment of foal rejection-related signs in susceptible mares should be considered until foal weaning.     

Oesophageal ectasia as a cause of dysphagia and milk regurgitation in a neonatal foal

Dysphagia and milk regurgitation are relatively infrequently observed clinical signs in neonatal foals but, when present, can commonly arise from anatomic or functional disorders of the upper airway. Less commonly, milk regurgitation can be caused by anatomic or neuromuscular disorders of the oesophagus. In the report presented here, a neonatal foal was examined for milk regurgitation at 4 days of age and was diagnosed with transient oesophageal ectasia via oesophagoscopy and contrast radiography. Aspiration pneumonia was treated with broad-spectrum antimicrobials and the owner was instructed to intermittently elevate the forelimbs to facilitate passage of milk out of the dilated oesophagus. The milk regurgitation resolved and reassessment of the foal at 6 weeks of age documented the absence of oesophageal ectasia and resolution of aspiration pneumonia. The foal was reported to be healthy and consuming food normally 6 months after initial examination and was in good body condition. This case is unique in that the oesophageal ectasia improved with time; furthermore, other potential causes of dysphagia and milk regurgitation of oesophageal origin in neonatal foals are discussed.     

Surgical management of an extrahepatic portosystemic shunt in a foal: A multidisciplinary problem

A 5‐week‐old American Miniature filly was referred due to intermittent neurological signs of 4 weeks' duration. Clinicopathological findings showed increased ammonia and bile acids in venous blood samples. Abdominal ultrasonography detailed a portosystemic shunt (PSS). The foal underwent laparotomy and operative mesenteric portovenography, which further defined the PSS as extrahepatic portocaval in configuration. The PSS was occluded and intraoperative portovenography confirmed successful shunt occlusion. The foal made a good recovery from surgery and had a successful showing career until she succumbed to colic just over 3 years after surgery.     

Ulnar osteotomy for treatment of cubital subluxation,following locking compression plate osteosynthesis of a radius fracture in a foal

A closed mid‐diaphyseal fracture in a one‐day‐old foal was treated using a 3.5 mm locking compression plate on the cranial aspect of the radius. The foal showed good fracture healing, but a radio‐ulnar synostosis developed despite the absence of transfixation by any implant into the ulna. Four months after surgery the radiographs revealed a cubital subluxation, which was managed by an osteotomy of the ulna at the time of plate removal, allowing the ulna to adjust into a normal position. One year after surgery the foal was clinically sound; the radiographs showed good healing of the osteotomy gap as well as good remodelling of the radius; however, a slight elbow subluxation was present.     

Anatomical and radiographic study of the scapula in juveniles and adults of Tamandua mexicana (Xenarthra: Myrmecophagidae)

Tamandua mexicana is a mammal of the superorder Xenarthra geographically located between Mexico and Peru that remains insufficiently studied. These species are characterized by their movement, resting, and eating of termites and ants in arboreal and terrestrial environments, and therefore, their thoracic limbs have been adapted morphologically to move in these environments. Tamandua mexicana is a species constantly threatened by different causes, and their thoracic limbs can be affected in the scapular and shoulder regions as a result; therefore, specific anatomical knowledge of the scapula allows for better clinical procedures, surgical approaches, radiological diagnosis and muscular reconstructions in extinct species of anteaters. The main objective of this study was to report the anatomical and radiographic features of the scapula in juvenile and adult specimens of T. mexicana. Gross dissections and radiographic study were performed in six cadavers. The scapula had large differences compared with other mammals, such as two spines, a foramen for the suprascapular nerve, a long acromion, a cranial transverse scapular ligament and caudolateral fossa for the origin of the muscles teres major, tensor fasciae antebrachii and subscapular. In juvenile specimens, a scapular cartilage, an acromial cartilage, craniomedial and caudolateral coracoscapular ligaments forming the foramen for the suprascapular nerve, and progressive ossification of those ligaments and the cranial transverse scapular ligament were observed. These findings were corroborated by radiography; therefore, these characteristics change with age. The bony reliefs of the scapula of T. mexicana corroborate the specialization of the shoulder in this species.     

Closed reduction and blind cross-pinning for repair of a proximal tibial fracture in a foal

A 4-day-old foal underwent repair of a proximal metaphyseal fracture of the tibia. After closed reduction, fixation was achieved by use of blind cross-pinning. Thirty-five days after surgery, radiography demonstrated complete healing. The foal was mildly lame 4 months after repair of the fracture. Blind cross-pinning may be considered as a method of repair for certain long bone fractures in small foals.     

Correcting Campylorrhinus Lateralis in a Foal by Bone Distraction: A Case Report

Campylorrhinus lateralis, also known as “wry nose,” is a congenital malformation that mainly affects Thoroughbreds. These horses have a unilateral deviation of the maxillae that may be to one side or the other side, and it causes airway obstruction and dental malocclusion. The choice of treatment is not necessarily operation; however, the treatment of choice, which aims to repair the maxillae deviation, is surgical to improve the horse’s respiratory condition and correct the dental occlusion. There are currently no reports describing the first surgical technique for such deformity described by Valdez et al. The present study describes the case of a 2-month-old foal of the Mangalarga Marchador breed that was diagnosed with wry nose. The foal presented with accentuated maxillae deviation to the right side, malocclusion of the incisor teeth, and respiratory noises. After diagnosis and physical examination, the foal was treated by surgical correction of the deviation. To correct the deviation, the bone distraction technique with unilateral osteotomy of the right maxillae and fixation of the external bone distractor was chosen. After 90 days, the bone distractor was removed; consequently, malocclusion of the incisors was greatly improved, and respiratory noises were eliminated.     

Surgical treatment of a complicated distal tibia epiphyseal Salter–Harris type I fracture in a yearling

This article describes the management of a complicated distal epiphyseal Salter–Harris type I fracture of the left tibia in a yearling horse. Closed reduction and internal fixation was attempted in the first surgery using tension band wires. Due to fracture instability 2 weeks after surgery, a full-limb transfixation pin cast was applied to the tibia and maintained for 7 weeks to prevent further fracture displacement and to achieve axial alignment. The full-limb cast was maintained for a total of 12 weeks, including the time with the transfixation pin cast. Cast sores and tendon laxity resolved without further complications. Ten months after the first surgery, the fracture had radiographically healed, and the horse was sound at the walk and trot in a straight line.     

Aortic rupture causing cardiac tamponade in a 24‐day‐old Friesian colt with concurrent colonic Chlamydiosis and Balantidiasis

A 24‐day‐old Friesian colt died suddenly and a physical examination the morning the foal died showed no abnormalities and serum IgG levels >8.0 g/l. Necropsy examination revealed haemopericardium and a 2 cm transverse tear at the root of the aorta. The foal was also found to have Chlamydophila spp. in the epithelium and Balantidium coli on the mucosal surface of the large colon. An aortic rupture is a novel finding in a foal, colonic Chlamydiosis has not been previously reported in horses and Balantidium coli has not been reported in equids in North America.     

Pulmonary embolism as a complication after abdominal surgery and colitis in a foal

This report describes a fatal pulmonary embolism in a foal, as a sequela of septic thrombophlebitis of the right jugular vein and/or a generalised hypercoagulable state. The foal underwent abdominal surgery and suffered from severe and prolonged colitis. Despite intense supportive care, the colt developed venous thrombophlebitis and subsequently died suddenly 12 days after discharge from the hospital, following an initial improvement. On post‐mortem examination, a large pulmonary embolism was discovered. Pulmonary thromboembolism is a potentially fatal sequelae of thrombus formation. It is difficult to detect and therefore likely to be underdiagnosed.     

Computed tomography assisted diagnosis and treatment of a comminuted fracture of the plantar aspect of the medial trochlear ridge and the proximal tubercle of the talus in a foal

Isolated fractures of the proximal tubercle of the talus and the medial trochlear ridge of the talus have been reported in the equine literature. A comminuted, intra-articular fracture of the plantar medial trochlear ridge and proximal tubercle of the talus has not been previously reported. The current case report describes this unique comminuted fracture in a 6-week-old Thoroughbred foal with acute onset lameness. The diagnosis was achieved by a combination of radiography, ultrasonography and computed tomography (CT) followed by CT arthrography. Surgical removal of the fracture fragments was recommended; the intra-articular fracture fragments were removed under arthroscopic visualisation of the plantar pouch of the tarsocrural joint; due to ligamentous attachments and partial extra-articular nature, the fracture fragment of the proximal tubercle of the talus was removed via an arthrotomy extension of the medial arthroscopy portal. On follow-up examination 12 months post-operatively, the yearling showed no clinical evidence of lameness or radiographic evidence of secondary degenerative joint disease.