Prognostic factors and survival of horses with ocular/adnexal squamous cell carcinoma: 147 cases (1978-1988)

Between January 1978 and December 1988, 147 horses with ocular/adnexal squamous cell carcinoma (SCC) were admitted to the Colorado State University Veterinary Teaching Hospital (CSU-VTH). Diagnosis was confirmed by histologic examination of appropriate tissue specimens. Medical records and communication with owners, referring veterinarians, or both provided information regarding initial examination, treatment at the CSU-VTH, and final outcome. At initial examination, 123 (83.7%) horses had unilateral involvement and 24 (16.3%) horses had bilateral involvement. The nictitating membrane, nasal canthus, or both (28.1%); limbus (27.5%); and eyelid (22.8%) were most commonly affected. In addition to the ocular/adnexal location, SCC was found elsewhere in 14 (9.5%) horses at initial examination. Adequate follow-up (greater than or equal to 4 months) for examination of tumor recurrence and survival analysis was obtained for 125 (85.0%) cases. After treatment at the CSU-VTH, tumor recurred in 30.4% of the cases. Tumor location, multiple vs single tumors at initial diagnosis, and CSU-VTH treatment modality influenced the recurrence of tumors. Survival analysis revealed a good prognosis for horses with ocular/adnexal SCC. Although undefined, a conservative estimate of the median survival time was 47 months. Six factors (treatment prior to referral, tumor location, tumor size, single or multiple tumors, treatment modality at the CSU-VTH, and recurrence or nonrecurrence) were analyzed to determine their relation with survival. Treatment prior to referral, multiple vs single tumors at initial examination, and treatment modality used at the CSU-VTH did not influence survival. Tumor location influenced survival; SCC involving the eyelid or orbit was associated with the poorest prognosis. Tumor stage (maximal dimension) was inversely related with survival.(ABSTRACT TRUNCATED AT 250 WORDS)     

Epidemiologic study of ocular/adnexal squamous cell carcinoma in horses

Proportional hospital accession ratios for equine ocular/adnexal squamous cell carcinoma (SCC) were determined for 14 colleges of veterinary medicine participating in the Veterinary Medical Data Program between January 1978 and December 1986. Comparison of the ratios with their respective geographical, physical data has shown an increased prevalence of SCC with an increase in longitude, altitude, or mean annual solar radiation. In contrast, prevalence of SCC increased with a decrease in latitude. Between January 1978 and December 1988, 147 horses with ocular/adnexal SCC were admitted to the Colorado State University Veterinary Teaching Hospital. Diagnosis was confirmed by histologic examination of appropriate tissue specimens. Medical records provided information regarding month and year of admission and diagnosis, age at diagnosis, breed, gender, and hair color. Comparison with a randomly selected hospital control population revealed an increased prevalence of ocular/adnexal SCC with an increase in age (P less than 0.001). Compared with Quarter Horses, draft breeds (Belgian, Clydesdale, and Shire) and Appaloosas had a significantly (P less than 0.001) greater prevalence of ocular/adnexal SCC. Sexually intact males and females were significantly (P less than 0.001) less likely (5 and 2 times, respectively) to have ocular/adnexal SCC when compared with castrated males. The prevalence of ocular/adnexal SCC was significantly greater for all hair colors when compared with bay, brown, or black (P less than 0.01).     

Cutaneous and ocular habronemiasis in horses: 63 cases (1988-2002)

OBJECTIVE: To describe clinical manifestations of cutaneous and ocular habronemiasis in horses and evaluate outcome of treatment. DESIGN: Retrospective study. ANIMALS: 63 horses. PROCEDURE: The diagnosis was made on the basis of history, clinical signs, and identification of calcified concretions (sulfur granules) in lesions. Histologic examination of biopsy specimens was used to confirm the diagnosis. Case horses were compared with a control population of 12,720 horses examined during the same period. RESULTS: Arabians, gray horses, and horses with diluted coat colors were overrepresented; Thoroughbreds were underrepresented. Lesions were identified most often during the summer and early fall. The medial canthus of the eye, male genitalia, third eyelid, and distal portions of the extremities were the most commonly affected locations. Twenty-five lesions were biopsied, and results of histologic examination were consistent with a diagnosis of habronemiasis. However, nematode larvae were seen in only 11 (44%) biopsy specimens. Treatment consisted of surgical removal (7 horses) or medical treatment (56) consisting of debulking granulation tissue and topical, intralesional, or systemic treatment with corticosteroids. All horses were treated with ivermectin. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that cutaneous and ocular habronemiasis should be considered when examining a horse during the summer months with a proliferative, moist, granulomatous lesion. Treatment should be aimed at decreasing the size of the lesion, reducing inflammation, and preventing recurrence. In general, the prognosis was good, and healing occurred within a few weeks. Fly control and regular deworming with ivermectin are recommended to reduce the incidence of habronemiasis.     

Delayed metastasis of ocular squamous cell carcinoma following treatment in five horses

Identification of regional and/or distant metastasis following treatment and local resolution of primary ocular squamous cell carcinoma (SCC) was observed in 5 horses. In all cases, identification of metastasis occurred at least 18 months following treatment of the primary ocular lesions. In 3 cases, invasion of blood or lymphatic vessels by neoplastic cells was identified in the excisional biopsies of the primary tumour. Two horses developed SCC at 2 or more separate sites. At the time metastases were identified, there was no evidence of local recurrence of the ocular tumour in any of the horses. These cases confirm the importance of long‐term monitoring of horses for metastatic disease following treatment of ocular SCC even in the absence of local recurrence.     

Cutaneous vasculitis in horses: 19 cases (1978-1985)

The medical records of 19 horses with cutaneous vasculitis were reviewed. Most (73.7%) affected horses were between 3 and 10 years old, and there were significantly more mares (14) than stallions or geldings (5) (P less than 0.01). Subcutaneous edema of the limbs, body, and/or head was the predominant clinical sign (18/19 horses; 94.7%). The single most prevalent laboratory abnormality was neutrophilia (greater than 7,000 neutrophils/microliter), which was detected in 10 horses (52.6%). Leukocytoclastic vasculitis was evident in skin biopsy specimens from 12 of 14 horses (85.7%). All horses were treated with corticosteroids and supportive care, and the overall survival rate was 63.1% (12/19). The mean duration of treatment with corticosteroids in surviving horses was 14 (+/- 5.3) days. Of the 7 horses that died, 5 failed to respond to treatment (4 were euthanatized, 1 died), and 2 others had persistent debilitating sequelae (euthanatized). The only significant clinical or laboratory abnormality predictive of poor prognosis was fever (odds ratio, 17.81; P less than 0.05). Seven horses had history of, or were exposed to horses with, abscessed peripheral lymph nodes and likely were suffering from equine purpura hemorrhagica. In spite of histopathologic evidence of hypersensitivity-vasculitis and/or the clinical suspicion that the cause for vasculitis was immune mediated, 7 of 19 horses (36.8%) had no history of bacterial or viral infection nor a history of current drug administration.     

Sternothyrohyoideus myectomy in horses: 17 cases (1984-1985)

Review of medical records of 78 horses admitted to the George D. Widener Hospital for Large Animals with dorsal displacement of the soft palate revealed 94% of these horses to have evidence of an intermittent abnormal "gurgling" respiratory noise at the time of exercise. Sternothyrohyoideus myectomy was used as a primary treatment for 17 of these horses, with a success rate of 58%. Anatomic dissection of 30 horses indicated that the midcervical region is the optimal site for sternothyrohyoideus myectomy to alleviate dorsal displacement of the soft palate.     

Ultrasonographic findings in horses with cholelithiasis: eight cases (1985-1987)

Cholelithiasis and/or obstructive biliary tract disease was diagnosed ultrasonographically in 8 horses, 5 to 15 years old. Ultrasonographic findings revealed greater than normal amount of hepatic parenchyma in the right side of the abdomen in 8 horses and in the left side in 3 horses. The echogenicity of the liver was greater than normal, and thick distended bile ducts were seen in all horses. Choleliths were imaged ultrasonographically in 6 horses. Subsequently, postmortem findings in 6 horses revealed periportal and intralobular fibrosis, moderate bile duct dilatation, proliferation, and cholestasis. One or more choleliths were found in all horses. Ultrasonographic findings accurately depicted the histologic changes in the hepatic parenchyma in horses with cholelithiasis.     

Nasopharyngeal cicatrices in horses: 47 cases (1972-1985)

Nasopharyngeal cicatrices were observed endoscopically in 47 horses examined because of abnormal respiratory noises and/or exercise intolerance. A review of these cases revealed a correlation between cicatrization and age, sex, and the presence of other upper airway abnormalities. The age of affected horses ranged from 6 to 21 years, with a mean age of 12.7 +/- 7.8 (+/- 2 SD) years. Females were affected 2.7 times more frequently than males. Abnormalities commonly observed with a nasopharyngeal cicatrix included chondritis of the arytenoid cartilage, epiglottic deformity, and deformity of the guttural pouch openings. The nasopharyngeal cicatrix was responsible for respiratory obstruction in only 3 horses. Treatment for the cicatrix was not performed on any horse in this series. Generalized nasopharyngeal and laryngeal inflammation were postulated as causes of the cicatrices and associated abnormalities.     

Hepatic abscesses in cats: 14 cases (1985-2002)

In this retrospective study, we describe 14 cats diagnosed with hepatic abscesses. The objective of the study was to report the clinical signs, physical examination findings, clinicopathologic findings, and outcomes in affected cats. These findings were then compared with those previously reported in dogs and humans. Clinical signs were vague and included anorexia, lethargy, and weight loss. Only 23% of cats had fever, whereas 31% were hypothermic. Increases in serum activities of alanine aminotransferase and alkaline phosphatase were found in 45 and 18%, respectively, of the 11 cats that had laboratory work performed. Abdominal ultrasound examinations were performed in 7 cats, and abnormalities were found in 71% of them. Four cats had solitary abscesses, all of which were located in the right liver lobes. The other 10 cats had multifocal small abscesses or microabscesses, and all of these cats had clinical signs suggestive of sepsis. Cytologic evaluation of samples obtained by abdominocentesis indicated septic inflammation in 67% of cats in which peritoneal fluid was analyzed. Hepatic abscess cultures yielded polymicrobial growth in 66% of the cats: Escherichia coli was the most commonly cultured organism. Overall mortality rate was 79%. All survivors underwent exploratory laparotomy for partial hepatectomy to resect the abscess followed by medical management. Hepatic abscesses should be considered in cats with signs consistent with sepsis. More routine use of ultrasonography may aid in earlier diagnosis of hepatic abscesses, potentially improving prognosis and outcome.     

Strangulated umbilical hernias in horses: 13 cases (1974-1985)

The medical records of 13 horses with strangulated umbilical hernias were reviewed. Typical history included increased swelling, warmth, and firmness of the hernial sac. Enterocutaneous fistulas had developed in 2 horses. Four horses had signs of abdominal pain. Surgery was performed on all horses, and the hernia was reduced by an open reduction technique. Incarcerated tissue included omentum (1 horse), jejunum (5), ileum (4), cecum (1), and ventral colon (2). All horses survived and were discharged from the hospital. Follow-up information on 9 horses (5 to 52 months after discharge) revealed no complications in 6 horses. Of the remaining 3 horses, one horse was euthanatized 5 months after discharge because of laminitis. One horse had persistent drainage from the skin incision requiring removal of nonabsorbable suture material 8 months after discharge. One foal required a second surgery because of signs of abdominal pain 17 days after the initial surgery. The foal was euthanatized during surgery because of severe peritonitis secondary to anastomotic leakage.     

Photodynamic therapy for the treatment of periocular squamous cell carcinoma in horses: a pilot study

Objective  Local photodynamic therapy (PDT) is a novel cancer therapy in veterinary ophthalmology. A prospective pilot study seeking to demonstrate proof of principle and safety for the treatment of equine periocular squamous cell carcinoma (PSCC) was therefore conducted. We hypothesized that surgical excision with adjunctive local PDT is an effective and safe treatment for equine PSCC.
Procedures  Nine horses (10 eyes) with PSCC were treated with surgical resection, local infiltration of resulting wound beds with 2-[1-hexyloxyethyl]-2-devinylpyropheophorbide-a (HPPH) and irradiation with 665-nm wavelength diode laser. Regular follow-up ophthalmic examinations were performed.
Results  Surgical resection and PDT yielded disease-free intervals of 25–68 months in our study horses as of January, 2008. These results were obtained following a single treatment in seven horses and two treatments in one horse. In one horse, carcinoma in situ developed 2.5 months after partial surgical excision and PDT, requiring local excision under standing sedation.
Conclusions  Preliminary results suggest that surgical resection and adjunctive local PDT is a safe and effective novel treatment for PSCC in horses. More research is needed before PDT for the treatment of equine PSCC can be adequately compared with other current modalities. Important to future investigations regarding PDT, tumor recurrence rate, length of hospitalization, number of treatment episodes required to effect tumor remission, and total treatment costs should be examined in a controlled manner. Our present results and experiences suggest that this treatment may be useful in the treatment of equine PSCC.     

Surgery alone or in combination with radiation therapy for treatment of intracranial meningiomas in dogs: 31 cases (1989-2002)

OBJECTIVE: To compare, for dogs with intracranial meningiomas, survival times for dogs treated with surgical resection followed by radiation therapy with survival times for dogs treated with surgery alone. DESIGN: Retrospective study. ANIMALS: 31 dogs with intracranial meningiomas. PROCEDURE: Medical records of dogs with histologic confirmation of an intracranial meningioma were reviewed. For each dog, signalment, clinical signs, tumor location, treatment protocol, and survival time were obtained from the medical record and through follow-up telephone interviews. RESULTS: Dogs that underwent tumor resection alone and survived > 1 week after surgery had a median survival time of 7 months (range, 0.5 to 22 months). Dogs that underwent tumor resection followed by radiation therapy had a median survival time of 16.5 months (range, 3 to 58 months). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that in dogs with intracranial meningiomas, use of radiation therapy as a supplement to tumor resection can significantly extend life expectancy.     

Ultrasonographic evaluation of horses with thrombophlebitis of the jugular vein: 46 cases (1985-1988)

Medical records of 46 horses with jugular vein thrombophlebitis that were evaluated ultrasonographically were reviewed. The ultrasonographic appearance of the thrombus within the jugular vein was classified as noncavitating if it had uniform low to medium amplitude echoes, or as cavitating if it was heterogenous with anechoic to hypoechoic areas representing fluid or necrotic areas within the thrombus, and/or hyperechoic areas representing gas. Signs of pain on palpation of the affected vein (P less than 0.001), heat over the vein (P = 0.001), and swelling of the vein (P less than 0.05) were significantly associated with the ultrasonographic detection of a cavitating lesion. Ultrasonography also was useful for selecting a site for aspiration of a specimen for bacteriologic culturing and susceptibility testing.     

Combined keratectomy, strontium-90 irradiation and permanent bulbar conjunctival grafts for corneolimbal squamous cell carcinomas in horses (1990-2002): 38 horses

OBJECTIVE: The purpose of this study was to evaluate the effectiveness of postoperative beta-irradiation with strontium-90 as an adjunctive treatment to superficial keratectomy and permanent bulbar conjunctival graft for removal of equine corneolimbal squamous cell carcinoma (SCC), in decreasing recurrence rate. STUDY: The retrospective case study included 38 horses diagnosed and treated for SCC of the eye that involved the limbus and/or cornea. The patients were treated between 1990 and 2002, with strontium-90 irradiation immediately after corneal and conjunctival graft surgery. Recurrence was defined as the postoperative and postirradiation regrowth of SCC in the same site and globe that was previously treated. RESULTS: The Appaloosa was the most commonly represented breed and horses that had more than one base coat color represented the majority of the cases (53%). The coat colors of white, chestnut/sorrel and gray were the most commonly represented colors of the horses treated. Eight horses (21%) could not be assessed for tumor recurrence due to lack of two or more post-treatment examinations, and another horse was enucleated 6 days postoperatively due to progressive corneal ulceration. Twenty-four horses (63% of the entire study population; 83% of the followed cases) had a mean +/- SD of 1754 +/- 1319 days without tumor recurrence, ranging from 14 days to 5110 days. Five horses (13% of the entire study population; 17% of the assessed horses) had tumor recurrence at a mean +/- SD of 449 +/- 339 days with a range of 29 days to 900 days. For the five recurrences, treatment included local excision (n = 1), enucleation (n = 2), and additional strontium-90 therapy (n = 3). CONCLUSIONS: The combination of superficial keratectomy, beta-irradiation and permanent bulbar conjunctival grafts for limbal, corneal or corneolimbal SCC in horses is effective in at least 83% of the horses. Recurrence occurred in about 17% of the horses. Multiple biannual re-examinations are recommended to observe for tumor recurrence.     

Use of phacofragmentation for cataract removal in horses: 12 cases (1985-1989)

The medical records of 12 horses that had cataracts removed by use of phacofragmentation were reviewed. Cataracts were removed from 16 eyes in horses ranging in age from 2 months to 15 years. Complications after surgery included corneal ulcers in 13 eyes, diffuse corneal edema in 5 eyes, and uncontrollable uveitis in 3 eyes. Follow-up information was obtained in all horses from 1 month to 3.5 years after surgery. Visual results were judged good by owners or veterinarians in 10 of the horses.     

Management of arytenoid chondropathy and failed laryngoplasty in horses: 75 cases (1979-1985)

By use of endoscopy, 75 horses with respiratory noise and/or exercise intolerance were determined to have structural arytenoid cartilage abnormalities (60 primary, 11 after previous laryngeal surgery), or failed left laryngoplasty (4 horses) for laryngeal hemiplegia in which the arytenoid cartilage still appeared normal. Eighty-eight percent of the horses were either Thoroughbred (54 horses; 72%) or Standardbred (12 horses; 16%) racehorses; only 9 horses (12%) had occupations not related to racing. Seventy-six percent of the racehorses were 2 to 4 years old; all non-racehorses were greater than 4 years old. The male:female ratio was approximately 2:1. Of the horses with cartilage abnormalities, 28 had left-sided involvement, 22 had right-sided involvement, and 21 had bilateral involvement. Sixty-two arytenoidectomies were performed, 58 for cartilage abnormalities (22 left, 19 right, 17 bilateral), and 4 for failed left laryngoplasties. Overall, 45% of the Thoroughbred racehorses that returned to racing after arytenoidectomy raced successfully (50% left, 75% right, 22% bilateral); only 20% of the Standardbreds were able to race. Seventy-five percent of non-racehorses were able to return to their previous use. Many horses were retired intentionally after surgery.     

Equine basal cell tumors: 6 cases (1985-1999)

Basal cell tumors are rare benign tumors in horses. Over a 15-year period, 6 horses were diagnosed with basal cell tumors. The tumors were well-circumscribed. freely moveable, firm, raised papules, nodules, or masses that ranged from 0.6 to 5 cm in diameter. Five of the 6 tumors were ulcerated. Based on gross appearance, the tumors were diagnosed as sarcoids, and 1 was diagnosed as a melanoma. The range of age of affected horses was 6-26 years. The tumors were identified clinically 1 week to 3 years before excision. In 4 horses for which information was available, complete surgical excision was curative with no recurrence 4 months to 2 years after removal.     

Cardiac arrhythmias identified in horses with duodenitis/proximal jejunitis: six cases (1985-1988)

During a 3 1/2-year period, cardiac arrhythmias were identified in 6 of 67 horses diagnosed with duodenitis/proximal jejunitis (DPJ). Arrhythmias were detected by auscultation of irregular cardiac rhythm and subsequently were characterized by electrocardiographic evaluation. Arrhythmias included frequent second-degree atrioventricular block, ventricular ectopic depolarizations, and atrioventricular conduction disturbance. In 4 horses, arrhythmias resolved with recovery from the primary problem. One horse died suddenly 66 hours after admission, and another was euthanatized at 72 hours after admission. Clinical and laboratory data from horses with DPJ and cardiac arrhythmias (group 1) were compared with findings for horses with DPJ and without arrhythmias (group 2). Group-1 horses had significantly (P less than 0.05) higher serum bicarbonate concentration and serum creatine kinase activity. Normal sinus rhythm returned in all 4 group-1 horses that recovered from DPJ, suggesting a causal relationship between DPJ and the arrhythmias. Two group-1 horses were necropsied, and both had myocarditis. The cause of these lesions was not determined.     

Effects of corticosteroid treatment on survival time in dogs with chronic hepatitis: 151 cases (1977-1985)

Medical records of 151 dogs with chronic hepatitis were reviewed. Corticosteroid treatment had a statistically significant (P less than 0.005) effect on improving survival time when corticosteroid-treated dogs were compared with untreated dogs. Dogs dying within 1 week of examination represented 37.1% of the cases, and when compared with those living more than 1 week, serum glucose concentration was significantly lower (P less than 0.001); prothrombin time and partial thromboplastin time were significantly longer (P less than 0.001); blood ammonia concentration after oral administration of ammonium chloride was significantly higher (P less than 0.05); and necrosis severity and fibrosis severity were significantly greater (P less than 0.05 and P less than 0.022, respectively). The best predictors of early death were low normal serum glucose concentration (P less than 0.001) and prolonged prothrombin time (P less than 0.030), which was abnormal in 60.0% of dogs dying early. Partial thromboplastin time, which was increased in 92.0% of dogs dying early and in 42.6% of dogs living more than 1 week, was a less reliable predictor. Plasma ammonia concentration after oral administration of NH4Cl was least reliable in predicting early death. In dogs living more than 1 week, hypoalbuminemia was a predictor of shorter survival time (P less than 0.003). Of all the histologic features evaluated, only necrosis severity and fibrosis severity were accurate predictors of early death. The presence of bridging fibrosis was a predictor of shorter survival time in dogs living more than 1 week (P less than 0.0002).