Atrial Fibrillation Associated with Anesthesia in a Standardbred Gelding

A Standardbred gelding was anesthetized on three occasions over a 3 year period. Anesthesia was induced with xylazine and thiamylal on the first occasion, with xylazine, guaifenesin, and thiamylal on the second, and with acepromazine, guaifenesin, and ketamine on the third. Anesthesia was maintained with halothane during each episode. The horse had atrial fibrillation (AF) after induction of anesthesia on the first two occasions. Because arterial blood pressure remained within normal limits during AF and anesthesia, conversion to normal sinus rhythm with quinidine was not attempted. Reversion to normal sinus rhythm occurred within 12 hours of recovery after each of the first two anesthetic episodes. The gelding remained in normal sinus rhythm throughout the third anesthetic period and recovered uneventfully. Potential causes for AF in anesthetized horses are discussed.     

Primary Hyperparathyroidism Associated With Atypical Headshaking Behavior in a Warmblood Gelding

A 14-year-old Zweibrücker Warmblood gelding was presented for evaluation of lethargy and headshaking. The horse had a history of bouts of lameness in different limbs and back problems. It also had many mild colic episodes in the past. Results of repeat laboratory tests had shown persistent hypercalcemia (4.8 mmol/L; reference interval [RI]: 2.0–3.2 mmol/L) for 1.5 years and later on hypophosphatemia (0.4 mmol/L; RI: 0.5–1.3 mmol/L) and mild hypermagnesemia (1.0 mmol/L; RI: 0.5–0.9 mmol/L). Parathyroid hormone (PTH) concentration was within the RI. Other causes of hypercalcemia, such as renal failure, vitamin D toxicosis, and granulomatous disease, and nutritional secondary hyperparathyroidism were ruled out. Furthermore, there was no evidence of neoplastic disease. Parathyroid hormone–related protein was measured but inconclusive. A diagnosis of primary hyperparathyroidism was established on the basis of hypercalcemia, hypophosphatemia, low fractional excretion of calcium, and high fractional excretion of phosphorus in combination with a PTH secretion refractory to high calcium levels. Because of the bad prognosis, the owner decided to euthanize the horse. Results of postmortem examination were unremarkable. Hypercalcemia should always be considered abnormal, and further examinations need to be performed to proof hypercalcemia and subsequently find the cause. The main differential diagnoses are renal insufficiency and humoral hypercalcemia of malignancy, but also rare diseases, such as hyperparathyroidism, have to be taken into account.     

Dermoid Cyst in the Intermandibular Space of a 3-Year-Old Thoroughbred Gelding: A Case Report

Soft tissue swelling located in the intermandibular space is very common in horses and presents a significant diagnostic challenge. Although the possible etiologies of intermandibular swelling are many, dermoid cysts are rarely included within the differential diagnoses list. This may be due to their low prevalence and to the lack of English written literature reporting dermoid cysts in this location in horses. This is the first report describing the clinical signs, diagnosis, and management of a dermoid cyst arising in the intermandibular space of a Thoroughbred horse. In this case, an enlarging soft tissue mass located in the intermandibular space was diagnosed as a dermoid cyst following complete subcutaneous surgical excision and histopathology.     

Serum Thyroid Hormone Concentrations Fluctuate in Cats with Hyperthyroidism

We measured serum thyroxine (T4) and 3,3',5-triiodothyronine (T3) concentrations in hyperthyroid cats (hourly for 10 hours in 14 cats, and daily for 15 days in seven cats) to assess fluctuation in thyroid hormone levels. Over the 10-hour study period the coefficient of variation (CV) for serum T4 and T3 concentrations ranged from 6.4-22.6% (mean = 12.0 +/- 4.8%) and from 9.6-33.1% (mean = 17.5 +/- 6.3%), respectively. During the 15-day study period, CV for serum T4 ranged from 6.6-34.8% (mean = 18.4 +/- 9.3%), while CV for serum T3 ranged from 7.8-31.0% (mean = 20.1 +/- 8.6%). These CV values were significantly higher than the expected intra-assay CVs (T4 assay, 5.1%; T3 assay, 7.7%). In addition, some of the cats with mild hyperthyroidism showed one or more normal serum T4 and T3 values during the course of the respective study periods. There was no specific time during the 10-hour study period at which the cats consistently showed peak serum T4 or T3 concentrations. These results suggest that serum thyroid hormone concentrations are subject to a degree of fluctuation that exceeds the usual assay variation, and that cats with mild hyperthyroidism can, at a given time, exhibit normal serum T4 and T3 values. Therefore, a diagnosis of feline hyperthyroidism should not be excluded on the basis of the finding of a single normal serum T4 or T3 value in a cat with clinical signs and physical examination findings consistent with the disease.     

Presumptive Iatrogenic Microcystin‐Associated Liver Failure and Encephalopathy in a Holsteiner Gelding

An 8‐year‐old Holsteiner gelding was presented for evaluation of anorexia, obtundation, icterus, and mild colic signs of 48 hours duration. History, physical examination, and initial diagnostics were suggestive of hepatic disease and encephalopathy. Microcystin toxicosis was suspected based on historical administration of a cyanobacteria supplement, associated serum biochemistry abnormalities, and characteristic histopathological changes. Microcystin contamination was confirmed in both supplement containers fed to the horse. Fulminant hepatic failure and encephalopathy progressed resulting in euthanasia. Necropsy findings were consistent with microcystin induced liver failure.     

Systemic Granulomatous Disease in a Hungarian Warmblood Gelding

An 8-year-old Hungarian warmblood gelding used for show jumping was evaluated because of poor performance and chronic weight loss. On admission, oral and gastroesophageal ulcerations and malabsorption were detected. Results of thoracic radiography, ultrasonography, bronchoalveolar lavage cytology, and positive polymerase chain reaction for equine herpesvirus 5 raised the possible diagnosis of equine multinodular pulmonary fibrosis. However, abdominal ultrasonography revealed inhomogeneous spleen with many different sized well-demarcated hypoechoic areas, which suggested further differential diagnoses such as tuberculosis, neoplasias, immune mediated diseases, systemic granulomatous disease (SGD), or toxicoses. The horse was euthanized at the owner's request because of the poor condition and possible grave prognosis. Histopathology findings were characteristic of SGD, which is a rare disorder of horses characterized by skin lesions, weight loss, and granulomatous inflammation of multiple organ systems. The lack of skin lesions in this case is an unusual finding. Systemic granulomatous disease is hypothesized to be induced by multiple conventional antigens that are not cleared from affected tissues. Equine herpesvirus 5 might have triggered the granulomatous reactions in this particular case.     

Radioactive Iodine Treatment of a Functional Thyroid Carcinoma Producing Hyperthyroidism in a Dog

Radioactive iodine (131I) was used in the treatment of a 12-year-old female dog with hyperthyroidism resulting from a large, unresectable (and metastatic) thyroid carcinoma associated with signs of severe inspiratory stridor and dyspnea. Hyperthyroidism was diagnosed on the basis of clinical signs (polyuria, polydipsia, polyphagia, weight loss, nervousness) and high basal serum thyroxine (T4) concentrations, as well as thyroid radioiodine kinetic studies that showed a high radioiodine uptake into the thyroid (% thyroid uptake) and markedly increased serum concentrations of protein-bound iodine-131 (PB131I) after 131I tracer injection. Thyroid imaging revealed diffuse radionuclide accumulation by the tumor, which involved both thyroid lobes. The dog was treated with three large doses of radioiodine (131I), ranging from 60 to 75 mCi, given at intervals of 5 to 7 months. The dog became euthyroid, and the size of the tumor decreased by approximately 25% after each 131I treatment, improving the severe inspiratory stridor and dyspnea, but both the hyperthyroid state and breathing difficulty recurred within a few months of each treatment. The dog was euthanatized 5 months after the last treatment because of progressive tracheal compression and pulmonary metastasis.     

Exocrine Pancreatic Adenocarcinoma and Associated Extrahepatic Biliary Obstruction in a Ferret

A 7-year-old neutered, male, fitch ferret presented for weight loss, decreased appetite, reduced bowel movements, and occasional bruxism. Physical examination confirmed weight loss of 340 g over the preceding 7 months. Abnormal clinicopathologic results included lymphopenia, monocytosis, increased alkaline phosphatase, increased alanine transferase, markedly increased total bilirubin, and hypocalcemia. Plasma glucose was normal. After a discussion of diagnostic and therapeutic options, the owner decided to humanely euthanize the patient and consented to cosmetic necropsy. Microscopic examination of submitted tissues revealed an unencapsulated, infiltrative neoplasm that effaced the pancreatic architecture and metastasized to several other organs, including the lung, liver, and jejunum. Based on the cellular morphology, presence of distinctive rosettes, immunonegativity for insulin, and widespread metastasis, the disease diagnosis was exocrine pancreatic adenocarcinoma.     

Conservative Management of a Cervical Vertebral Fracture in a Gelding

The presentation, diagnostic evaluation, treatment, and 5 years follow-up of a 12-year-old Arabian-Saddlebred cross gelding with neck pain and stiffness, attributable to a fracture of the third cervical vertebrae (C3), is described. Initial cervical spinal radiographs revealed a concave defect in the ventral aspect of the cranial end plate of C3. However, both this finding and ultrasonographic imaging of the area were inconclusive for a fracture. Nuclear scintigraphy revealed that the lesion was metabolically active, prompting computed tomographic imaging that revealed a fracture of C3. Sequential radiographs documented progressive fusion of C2-C3 and no neurological deficits developed over the 5 years after the injury. Cervical vertebral injuries in horses can lead to various clinical signs including ataxia, weakness, and neck stiffness or pain. Diagnosis with cervical radiographs alone can be challenging and, in some cases as the horse in this report, multiple imaging modalities may be required to establish a definitive diagnosis. Horses without neurological signs may recover successfully with conservative medical management, which was performed in this case.     

Bilateral Catastrophic Metacarpal Fractures in a Quarter Horse Gelding

A 5 year-old, 450 kg, American Quarter Horse gelding was presented for postmortem examination. The horse had sustained multiple fractures of the metacarpal bones of both fore limbs while being ridden at a canter. Based on the radiographic presence of parasagittal fractures in the condyles of the distal third metacarpus, we theorized that the fractures in this horse likely originated in the metacarpophalangeal joint and propagated into the diaphysis resulting in catastrophic failure. The unique finding in this case is that these injuries occurred in a horse that was not being trained for racing. Owners and trainers should be aware that horses trained for disciplines other than racing can develop condylar fractures similar to racing Thoroughbreds and Quarter Horses.     

Treatment of a Cyst-Like Synovial Hernia Associated with the Digital Flexor Tendon Sheath of a 17-Year-Old Pony

The aim of this study is to describe the successful treatment of a synovial hernia associated with the digital flexor tendon sheath (DFTS) in a 17-year-old pony. The pony presented with left forelimb lameness and multiple unusual swellings of the palmar and plantar aspect of the fetlock. The lameness was isolated to a swelling in close proximity to the DFTS of the left forelimb using diagnostic analgesia, and on diagnostic imaging, the swelling was found to be associated with the DFTS. The hernia resolved after percutaneous drainage and intralesional corticosteroids and atropine and pressure bandaging. Reports of synovial hernias in the horse associated with the DFTS are rare. This difference should be considered when presented with cases exhibiting similar clinical signs.     

Hyperthyroidism associated with a thyroid adenoma in a dog

Hyperthyroidism associated with thyroid adenoma was diagnosed in a dog. Typical clinical signs of hyperthyroidism were resolved with surgical excision of the adenoma. Hyperthyroidism in dogs usually is associated with thyroid carcinoma, which has a poor prognosis. This case emphasizes the importance of obtaining a histologic diagnosis of thyroid tumors in hyperthyroid dogs before giving a prognosis.