Cutaneous fungal granuloma in a horse

This case report describes a 4-year-old-horse with two cutaneous masses on the right crest of the neck. Biopsy revealed chronic nodular pyogranulomatous dermatitis and panniculitis. Giemsa and periodic acid-Schiff stains showed focal spherical, yeast-like organisms. A diagnosis of cutaneous fungal granuloma was made. The size of the masses decreased after oral treatment with fluconazole for 10 days combined with potassium iodide for 30 days, and the remaining masses were excised by laser. Lesions did not recur at the site. Fungal granuloma should be considered as a differential diagnosis in horses with cutaneous or subcutaneous nodules. A definitive diagnosis can only be achieved by histopathological examination or by culture of the affected tissue.     

Polioencephalomalacia in a llama

A 5-year-old, female llama (Lama glama) developed acute, progressive neurological disease, characterized by recumbency, muscle fasciculations, intermittent convulsions/opisthotonos, and absent menace responses. Postmortem histopathologic lesions, limited to the cerebral cortex, consisted of necrosis of the superficial and deep laminae. The clinical disease and microscopic lesions were consistent with polioencephalomalacia.     

A combined frontal and maxillary sinus approach for repulsion of the third maxillary molar in a horse

The 3rd maxillary molar is a difficult tooth to remove by extraction or repulsion. A combined frontal and maxillary approach provides good exposure for repulsion of this tooth, debridement of the sinuses, and placement of an alveolar seal. The improved exposure should minimize operative difficulties and postoperative complications.     

Adenocarcinoma of the frontal sinus with extension to the brain in a horse.

A space-occupying intracranial mass was diagnosed in a horse. The clinical findings included blindness, circling to the right, apprehension, anorexia, weight loss, and leaning against the stall. On ophthalmoscopic examination, the most striking observation was complete bilateral devascularization of the retinas. The horse was euthanatized and necropsied. Necroscopy revealed the mass to occupy the olfactory and frontal areas of the left hemisphere of the brain and part of the left frontal sinus. Microscopically, the mass was an adenocarcinoma and probably arose from the lining epithelium of the sinus or from the subepithelial glands.     

Otitis media in a llama

A 7-month-old female llama was examined because of chronic otitis media and externa of 7 months' duration. Radiographically, the tympanic bullae appeared thicker than normal, and the ventral borders were poorly defined; the left external acoustic meatus (ear canal) appeared to be narrower than the right. The llama was treated with penicillin, and the ear canals were lavaged daily. Contrast radiography was performed on day 15 to determine the shape and size of the ear canals and evaluate the integrity of the tympanic membranes. Contrast medium was visible radiographically in the left tympanic bulla, indicating that the left tympanic membrane was ruptured, but the right tympanic membrane appeared to be intact. The left ear canal was narrower than the right, and the bony ear canals had a well-defined sigmoid shape. The right ear improved with medial treatment alone, but the left ear did not. Therefore, lateral ear canal resection was performed. After surgery, however, exudate was still evident in the left ear canal, and the llama became more lethargic and more reluctant to eat. Lateral bulla osteotomy was attempted, but no purulent material was obtained, and curettage of the bulla resulted in hemorrhage. Because of this and because of the llama's poor physical condition, a decision was made to euthanatize the llama. The sigmoid shape of the bony ear canal and the multicompartmental nature of the tympanic bulla make surgical treatment of otitis media and externa in llamas difficult. Further study of surgical treatments for otitis media in llamas is needed.     

Congenital ichthyosis in a llama

A 1-month-old male cria was examined because of diffuse hyperkeratosis and conjunctivitis that had existed since birth. The mucocutaneous junction of the nostrils as well as the neck, coronary bands, and axillary and inguinal regions were the most severely affected areas. Orthokeratosis involving the epidermis and follicular infundibula was observed on skin biopsy specimens. Electron microscopy revealed 4 to 6 granular layers and inter- and intracellular vacuolation in the stratum corneum; diagnosis of ichthyosis was established.     

Renal teratoma in a llama

Teratomas are neoplasms of embryonal origin in domestic animals and are generally associated with reproductive organs. We report a case of teratoma involving the right kidney in a young llama that presented clinically with signs of mild colic and constipation.     

Ameloblastic odontoma in the mandible of a llama

A 4-year-old llama had an aggressive, multiloculated, expansile bone lesion involving the rostral mandible. The mandibular lesion was imaged using radiography and computed tomography. Antemortem diagnosis of an ossifying fibroma was made histologically. Postmortem findings showed the lesion to be limited to the mandible. Final diagnosis was ameloblastic odontoma.     

Ossifying fibroma in a llama.

A 4.5-year-old llama was admitted for evaluation of a firm mass rostral and ventral to the medial canthus of the left eye. Mucopurulent nasal discharge and absence of airflow through the left nostril were noted. Radiographs of the skull revealed a sharply demarcated soft tissue mass with faint mineralization. Endoscopy of the nasal passages revealed a mucosa-covered mass originating in the area of the second premolar, extending to the edge of the soft palate, and obstructing the airway. Examination of the oral cavity revealed a missing second molar and a mass protruding 2-cm from the empty alveolus. An ossifying fibroma, a previously unreported tumor in llamas, was diagnosed at postmortem examination.     

Entomophthoramycosis conidiobolae in a llama.

A 9-year-old female llama was evaluated for chronic dermatosis involving the external nares. The condition had been diagnosed as a fungal infection. Examination of punch biopsy specimens confirmed the diagnosis of Conidiobolus coronatus. Because of the chronicity of the disease and history of ineffective drug treatment, excision of infected tissue was attempted. Permanent nasal openings were created by suturing the nasal mucosa to the skin after debulking of infected tissue. Excision of most of the infected tissue enabled the llama to breathe easily for 3 years. Because C coronatus does not usually induce deep infections, it may continue to remain dormant in this llama.     

Suspected tolazoline toxicosis in a llama

Clinical signs of tolazoline toxicosis developed in a 4-year-old llama that received 2 doses of tolazoline hydrochloride to reverse xylazine-induced sedation. The full first dose (4.3 mg/kg [2.0 mg/lb] of body weight) was erroneously injected i.v., and the second dose was administered half i.v., half i.m. 45 minutes later, because the llama became weak and recumbent. Signs of anxiety, hyperesthesia, profuse salivation, and tachypnea were the first detectable clinical signs of tolazoline toxicosis. Convulsions, hypotension, gastrointestinal tract hypermotility, and diarrhea also developed. The llama was treated successfully with i.v. administration of diazepam, phenylephrine, and lactated Ringer's solution supplemented with potassium chloride and oxygen administered via nasal insufflation. We suggest that the maximum dose of tolazoline administered at any one time to llamas not exceed 2 mg/kg (0.91 mg/lb). Furthermore, tolazoline should be administered slowly i.v. or i.m. to reduce the risk of adverse reactions.