Pneumonia in a Paso-Fino mare

A 5-year-old Paso-Fino mare was presented for severe respiratory distress. The mare had foaled 2 months prior to presentation. The horse was in poor body condition with a dull hair coat. A mild fever was noted during physical examination and increased bronchovesicular sounds were auscultated. Thoracic radiographs showed an interstitial pattern and an alveolar infiltrate with distinct air bronchograms. Moderate purulent inflammation with increased mucus was observed in tracheal wash fluid, but no infectious agents were identified. A bronchoalveolar lavage (BAL) contained a large amount of mucus and reactive mononuclear phagocytes with variable numbers of intracellular fungal organisms morphologically consistent with Pneumocystis carinii. The mare had undetectable levels of immunoglobulin M (IgM) and decreased IgG levels in the serum. Immunophenotyping revealed decreased expression of major histocompatability complex (MHC) class II molecules. Moderate to marked hyperplasia of type II epithelial cells was present throughout histologic sections of lung, but the fungal organisms were not observed. A culture system has not been developed for diagnosis of P carinii infection. Instead, diagnosis of P carinii pneumonia is achieved by microscopic identification of characteristic morphologic features of the pathogen. Cytologic examination of BAL fluid is the preferred method used to diagnose human infection with P carinii. In humans, the diagnostic sensitivity of cytology is significantly higher than the sensitivity of histopathologic examination of lung biopsies. The difference in sensitivity between BAL cytology and lung histopathology may also apply to the diagnosis of P carinii pneumonia in horses. (MacNeill AL, Alleman AR, Franklin RP, Long M, Giguère S, Uhl E, López-Martinez A, Wilkerson M. Pneumonia in a Paso-Fino mare [ Pneumocystis carinii pneumonia].     

Thecoma in a mare

A 4-year-old crossbred Thoroughbred mare was referred to the University of Tehran Veterinary Medical Teaching Hospital for evaluation of a mass in the pelvic cavity. The mare had been partially anorectic and pyrexic. On clinical examination, the mare was thin and depressed, with body temperature of 38°C, a pulse rate of 38 beats/minute, and a respiratory rate of 10 breaths/minute. Palpation per rectum revealed a large, smooth and tense mass in the anterior part of the pelvic cavity. Ultrasound examination confirmed the presence of a soft tissue mass with a thick wall. The inner surface of the mass had a villous-like appearance. The stroma of the mass was mottled, with accumulation of speckled and hypoechoic to slightly hyperechoic fluid. Hormone assays revealed low serum concentration of testosterone. Serum progesterone concentration indicated that active luteal tissue and serum estradiol concentration was 24 pg/ml. On histological examination, the sections from the tumor were composed of oval- or spindle-shaped cells loosely arranged in diffuse sheets or irregularly interlacing fascicles. On the basis of these histological findings, the large tumor mass of the left ovary was considered to be a thecoma. To our knowledge, the details of the clinical, ultrasonographic, endocrinologic, and histologic findings of this tumor in the mare have not been described in the veterinary literature.     

Pyogenic granuloma of the cornea in a pony: Uncommon complication of corneal wound healing

A 6-year-old miniature Shetland pony mare was referred for evaluation of a left corneal mass, which developed from the healing tissue of a corneal traumatic ulceration that had occurred 4 weeks previously. On gross examination, a spherical, smooth-surfaced, and pink-colored lesion of about 1 cm in diameter was protruding from the left palpebral fissure. Ophthalmic examination revealed that it was attached to the scar tissue of the cornea, and that one corpora nigra was adherent to the posterior face of corneal wounded area, without sign of uveitis. The remainder of the ophthalmic examination was unremarkable. The mass was excised, and cryotherapy was used as an adjunctive therapy. Histopathology of the resected mass was consistent with a pyogenic granuloma on the basis of radially oriented proliferating capillaries, embedded in immature granulation tissue containing an infiltrate of neutrophils, plasma cells and eosinophils. There were no histological features of malignancy. 2 months after surgery, the ventral part of the fibrotic corneal scar was slightly raised by a pink tissue, suggesting possible recurrence of the initial lesion. A second cryotherapy was performed over the leukoma area. No recurrence has been noted for a follow-up period of more than 25 months. Pyogenic granuloma is a benign proliferative fibrovascular response that typically develops after trauma or surgery. Corneal involvement is rare in humans, and to the authors' knowledge has never been documented in veterinary ophthalmology.     

Murray Valley encephalomyelitis in a horse

A 5-year-old Thoroughbred mare presented with signs of severe pain and was taken to exploratory laparotomy based on suspicion of an acute abdominal lesion. A mild gastrointestinal lesion was discovered, but was considered disproportional to the severity of signs displayed. The mare was later euthanased because of intractable pain. Comprehensive postmortem examination, including polymerase chain reaction testing of central nervous system tissue samples, allowed a definitive diagnosis of Murray Valley encephalomyelitis to be made. This case demonstrates the variability of clinical presentations in horses infected with Murray Valley encephalitis virus.     

Direct approach to the nasal cavity through a bone flap for the treatment of a large nasal cyst

A 21‐year‐old Warmblood mare was referred to the Equine Department, Vetsuisse Faculty, University of Zurich, because of recurrent unilateral nasal discharge 3 months after partial removal of a large cyst from the left maxillary and frontal sinuses. Endoscopic, radiographic and computed tomographic examinations showed that the remnant of the cyst, which originally had extended from the left maxillary and frontal sinuses into the left nasal cavity, had expanded and was obliterating the left middle nasal meatus. A direct surgical approach to the cyst through the left nasal and maxillary bones rostral to the facial crest was chosen, which allowed evaluation and removal of the entire cyst. Endoscopic examination 3 days post operatively showed no remnants of the cyst, and the mare was discharged in good health. Re‐examination one year later showed no recurrence of the cyst.     

Treatment using cannabidiol in a horse with mechanical allodynia

A 4-year-old Quarter Horse mare was seen in the field by Colorado State University's Equine Sports Medicine Service for a 5-week history of marked sensitivity to touch near the withers/shoulder region. On examination, the mare showed a marked adverse response to light touch over the caudal neck and withers region. Diagnostic imaging of the caudal neck, withers and shoulder region showed no significant abnormalities. Vital parameters, complete blood count and chemistry profile were also within normal limits, as was a reproductive ultrasound examination. The mare received dexamethasone, gabapentin, magnesium/vitamin E, prednisolone and aquapuncture with no improvement in clinical signs. The mare was then started on pure crystalline cannabidiol (250 mg by mouth twice daily), which resolved the clinical signs after 2 days.     

A Case of Marie's Disease in a Broodmare

An 8-year-old Thoroughbred mare presented with acute bilateral epistaxis. The mare showed no clinical signs other than cough and profuse bilateral epistaxis. Antibiotic therapy was instituted and a transtracheal wash was collected. Large numbers of inflammatory neutrophils and gram-positive cocci were reported in the tracheal wash. The antibiotic therapy was continued for 7 days at which time the mare appeared clinically normal. The mare was successfully bred and was confirmed pregnant. She was referred to a hospital when the epistaxis recurred. She was treated with another antibiotic, and thoracic radiographs were also taken which revealed a space occupying lesion. The mare foaled a live foal. She developed bilateral thickening of her limbs. The swellings were of boney consistency and affected all four legs, particularly the forelimbs. A diagnosis of pulmonary hypertrophic osteopathy was made. The mare was again sent for further investigation. The thoracic mass had increased in size from the first examination. A biopsy was collected by endoscopy which confirmed a neoplastic process. After deterioration in her condition, the mare was euthanized on humane grounds. An autopsy report revealed that the mare had approximately 80% of the left lung replaced by neoplastic tissue. The right lung contained many small nodular masses. There was an associated cardiomegaly. In this case, the development of periosteal proliferation in multiple metaphyses was secondary to an intrathoracic neoplastic mass.     

A Case of Bronchioloalveolar Carcinoma in a Mare

A case of pulmonary carcinoma in a 23-year-old Quarterhorse mare is described. On physical examination, depression, poor body condition, tachypnea, bilateral serosanguineous nasal discharge and a wide area of reduced breath sounds in association with the right hemithorax were detected. Laboratory evaluation showed leukocytosis with neutrophilia and lymphopenia, hyperfibrinogenemia, hyperprotidemia, hypoalbuminemia, increased beta 2 and gamma globulin fractions, hypoxemia, and normocapnia. Radiography and thoracic ultrasonography revealed a large rounded mass extending from the 9th to the 14th right intercostal space, where neither bronchial nor vascular structures were detectable. Endoscopy showed a large amount of serosanguineous fluid within the tracheal lumen and a mass of reddish soft tissue completely obliterating the right caudal lobar bronchus. Histopathology of the endobronchial mass and of the transthoracic ultrasound-guided biopsy samples was consistent with a primary pulmonary epithelial tumor. Due to worsening of the clinical condition, the mare was euthanized. Postmortem examination confirmed the presence of a large 30-cm mass located in the right caudal pulmonary lobe, characterized by epithelial cells arranged in papillary projections and alveolar structures, findings consistent with bronchioloalveolar carcinoma.     

Disseminated cryptococcosis including osteomyelitis in a horse

A 4-year-old Arab mare was diagnosed with disseminated cryptococcosis, including osteomyelitis of the proximal phalanx of the left hind limb, osteomyelitis with associated soft tissue granuloma of a rib and disseminated, large cryptococcal nodules in the lungs. The lesion in the dorsoproximal aspect of the proximal phalanx had a large area of cortical lysis with spiculated periosteal new bone and extensive soft tissue swelling. The affected rib had a pathological fracture. Cryptococcal osteomyelitis has not been previously reported in horses but should be considered as a differential diagnosis, particularly in endemic regions.     

Surgical resection of a dysgerminoma in a mare

A mare was referred for further evaluation of a mass found in the left caudal abdomen during a routine postpartum reproductive palpation. The mare was clinically normal with no history of health problems. Ultrasonographic examination of the mass confirmed its presence, but the origin of the mass could not be accurately determined. Routine haematology and serum biochemistry results were within normal limits. The mare was initially treated conservatively with antibiotics, but the mass continued to increase in size, so it was surgically excised. The mass involved the left ovary. The mare showed transient abdominal pain after surgery, but developed no other complications and was in foal 7 months later. On histology, the mass was diagnosed as a dysgerminoma, a rare ovarian tumour of germ cell origin.     

Disseminated lymphoma with large granular lymphocyte morphology diagnosed in a horse via abdominal fluid and transtracheal wash cytology

A 22‐year‐old Tennessee Walking Horse mare was presented to the Auburn University Large Animal Teaching Hospital with a 3‐day history of lethargy, anorexia, and mild signs of colic. The mare had a several‐month history of weight loss and refractory cough. Physical examination revealed an increased respiratory rate, and crackles and wheezes were heard on thoracic auscultation. Thoracic ultrasonographic examination showed disseminated, minor, bilateral comet tail‐like lesions on the parietal pleural surfaces. Abdominal ultrasonographic examination was unremarkable. Trans‐rectal palpation revealed a firm small colon impaction with concomitant diarrhea. Laboratory data were characterized by a very pronounced acute inflammatory leukogram with severe neutropenia and significant left shift, evidence of hepatocellular damage/necrosis, cholestasis, and possibly mixed metabolic alkalosis and acidosis. On cytologic evaluation of a peritoneal fluid sample, there were many large granular lymphocytes (LGL). Large numbers of LGL were also observed on cytologic examination of a subsequent transtracheal wash. The final cytologic interpretation was disseminated lymphoma with LGL morphology. Due to worsening of the clinical signs and poor prognosis, the mare was euthanized. On necropsy and in histopathologic examination, disseminated lymphoma with LGL morphology was noted in a mesenteric lymph node, lungs, liver, spleen, kidneys, and right dorsal colon. Lymphoma with LGL morphology is rarely diagnosed in the horse. This report provides unique cytologic findings of a case of disseminated lymphoma with LGL morphology in a horse, confirmed with histopathologic evaluation.     

Dysphagia caused by focal guttural pouch mycosis: mononeuropathy of the pharyngeal ramus of the vagal nerve in a 20-year-old pony mare

A 20-year-old pony mare was presented to the equine hospital with a ten-day history of dysphagia, regurgitation and coughing. An obstruction of the oesophagus was excluded via endoscopy, but the proximal oesophagus appeared to be distended and circular contractions were missing. A guttural pouch endoscopy revealed a single, black-mottled plaque on the pharyngeal ramus of the vagus nerve in the left guttural pouch, causing a local swelling of this nerve. The pharyngeal ramus seemed to be atrophic distal to the lesion. A biopsy was taken from the lesion and histopathological findings proved the reasonable suspicion of a guttural pouch mycosis with a high degree of purulent-necrotic inflammation and invasion of fungal hyphae. There were no signs of neoplasia, such as melanoma. Daily guttural pouch irrigations with a clotrimazole emulsion (20 g Canesten^® Gyn⁴ solved in 500 ml water), led to a good recovery of the mucosa above the nerve. Periodic endoscopic examination of the left guttural pouch showed that local thickening and distal atrophy of this pharyngeal ramus did not improve, neither did the clinical symptoms. Due to progressive weight loss, acute respiratory distress and aspiration pneumonia, the 20-year-old pony mare unfortunately had to be euthanized three weeks after discharge. This case report emphasizes the enormous importance of a single nerve for the realization of the swallowing process. The one-sided loss of function of the pharyngeal branch of the vagal nerve cannot be compensated neither by the remaining ipsilateral nerves nor by the contralateral normal functioning glossopharyngeal and vagal nerves and thus inevitably leads to severe dysphagia.     

Ovarian Fibrothecoma in an Arabian Mare: A Rare Case

The occurrence of ovarian tumors is uncommon in domestic animals. Reports are documented more often in the bitch, mare, and cow. In the mare, granulosa-thecal cell tumor is the most common ovarian neoplasms, and other tumors occur less often. Fibrothecoma is a rare gonadal-stromal tumor of the ovary. There is only one reported case in the veterinary literature. This tumor consists of theca cells and fibrous tissues. The present study describes a rare case of fibrothecoma in a 10-year-old Arabian mare that was presented due to infertility problems. The abnormal left ovary was detected via rectal palpation and ultrasonography. Postoperation study showed a solid tumoral mass that completely replaced the normal ovarian tissues. The tumor was large, firm in consistency, with smooth surface. On the cut surface, the mass was white-gray to yellow with cystic areas containing green gelatinous materials. Microscopic examination revealed the structure was composed of fibroblastic cell producing collagen fibers and theca cells containing lipids. Based on histopathologic features, diagnosis of fibrothecoma was confirmed postoperatively.     

Use of a neodymium:yttrium-aluminum-garnet laser to remove exuberant granulation tissue from the esophagus of a horse

Use of a neodymium:yttrium-aluminum-garnet laser to remove exuberant granulation tissue from the esophagus of a horse A 4-year-old Quarter Horse mare was evaluated because of recurrent esophageal obstruction. Endoscopic examination revealed a proliferative mass in the esophagus approximately 55 cm aborad to the nares. Histologic examination of biopsy specimens revealed diffuse suppurative esophagitis and granulation tissue with no evidence of neoplasia. The mass was excisedand ablated transendoscopically with a neodymium:yttrium-aluminum-garnet laser. During a follow-up examination 2 weeks after the final laser procedure, the mass was no longer apparent, and the esophagus appeared healed. Six months after the final examination, there had been no recurrence of the mass. In this horse, transendoscopic laser excision was efficacious and avoided problems associated with an esophagotomy.     

Hepatic lobe torsion in a horse

A 4-year-old Belgian mare was presented with a 1-week history of fever, suspected of being caused by peritonitis. The mare died before the diagnostic procedures had been completed; postmortem examination revealed torsion of the left medial lobe of the liver, resulting in diffuse necrosis of liver tissue and severe peritoneal effusion.     

Necrotizing mycotic vasculitis with cerebral infarction caused by Aspergillus niger in a horse with acute typholocolitis.

An 18-year-old Morgan mare was presented to the Veterinary Medical Teaching Hospital, University of Illinois, with a 10-day history of watery diarrhea, depression, and dysphagia. On admission, the animal was severely dehydrated, depressed, and unable to swallow and had no clinical signs of diarrhea. The respiratory and heart rate and body temperature were within normal limits. Following fluid therapy, the mare developed severe watery diarrhea and continued to be depressed, incoordinated, and dysphagic. The animal died on the fourth day after admission and was sent to the Laboratories of Veterinary Diagnostic Medicine for necropsy. Gross postmortem findings were consistent with an acute cerebral infarction in the right cerebral hemisphere, an acute necrotizing typhlocolitis, multifocal petechial and ecchymotic hemorrhages, enlarged and congested pars intermedia of the pituitary gland, and marked bilateral adrenocortical hyperplasia with multifocal areas of necrosis and hemorrhage. Histologic evaluation of the affected brain demonstrated an area of coagulative necrosis of the gray matter, with hemorrhage, vasculitis, and thrombosis. There were many fungal hyphae 3.5-6.0 microm, pale basophilic, septate, and occasionally branching at 45 degrees present in the arterial walls and throughout the necrotic tissue. Immunohistochemical analysis revealed Aspergillus niger as the etiologic agent responsible for the mycotic vasculitis and infarction in the brain. Bacteria culture and immunohistochemical staining of the colon and cecum failed to demonstrate specific pathogens.     

Clinicopathological Features of an Equine Ovarian Teratoma

The present study describes the clinicopathological features of a mature cystic ovarian teratoma occurred in a 4 year old, cyclic, nulliparous Andalusian mare. The mass was discovered in the left ovary during a breeding soundness examination, and was hard in consistency and variously echogenic. Laparoscopy was performed to confirm the neoplastic change, followed by a unilateral laparotomic ovariectomy in the standing animal. On the cut surface the teratomatous ovary showed a large cyst filled with hair and sebaceous material and three small cysts containing mucous fluid, surrounded by solid areas where bone and cartilage could be recognized. Exceptionally, functional remnants of the ovary, including small follicles and a diestral corpus luteum were found near the tubal extremity. Histology revealed mature tissues foreign to the ovary including stratified squamous and respiratory epithelia, mucous, sebaceous and sweat glands, muscle fibres, fat and nervous tissue. The appearance of tracheal and lung architecture was occasionally observed.     

Squamous cell carcinoma as a cause of dyspnea and blindness in a horse

An 8-year-old Quarter Horse mare was examined for chronic nasal discharge and obstruction of both nasal passages. A solid mass lesion was identified in the maxillary sinuses, soft palate, nasal and pharyngeal cavities. Palliative surgery was used to debulk the lesion and facilitate nasal airflow. Squamous cell carcinoma was diagnosed from surgical biopsies. Approximately 7-8 weeks after surgery, the mare was observed to be acutely blind. Ophthalmologic examination revealed central origin blindness and active retinitis. The squamous cell carcinoma had reobstructed the nasal passages. Pressure by the expanding tumor deformed the ethmoid and sphenoid bones resulting in compression of the optic tracts. No bony invasion by the tumor was present.     

Bad behavior or a physical problem? Rearing in a Dutch Warmblood mare

Behavior problems in horses are often thought to be due to the horse’s bad attitude, which commonly results in them being punished. However, when these cases are carefully worked up, there may be an underlying physical problem, and pain may play an important role. A 5-year-old Dutch Warmblood mare was presented for rearing and flipping over backward. The mare had been repeatedly examined by an equine veterinarian and a nonveterinarian equine dentist who found no abnormalities. Several different bits were tried, and side reins were used to keep her head down. The mare was whipped every time she reared. None of these measures helped. On presentation to our equine teaching hospital, no abnormalities were detected on routine physical examination. The behavior was observed when the mare was lunged; as soon as a small amount of tension was put on the lunge rein, the mare shook her head horizontally for approximately 1-2 seconds, reared, and flipped over onto her back. Neurological examination revealed that the mare was slow to resume a normal stance when her hind legs were placed in an abnormal position. Dental examination and endoscopy of the upper airways proved unremarkable. Radiography of the atlanto-occipital joint area revealed fractures of the first and second cervical vertebrae and fracture fragments, which are both suggestive for the presence of cervical instability and the possible presence of spinal cord compression. These suggestions were further supported by identification of delayed postural reflexes during neurological examination. The mare was deemed unfit for dressage and was successfully kept for breeding. Horses are frequently punished for “bad behavior.” These behaviors are frequently due to underlying physical problems and not a “nasty” horse. This case highlights the importance of careful history taking and a thorough veterinary examination with the use of further diagnostics (if necessary) when dealing with equine behavior problems.