Epiploic foramen entrapment of the large colon in a 9-month-old Thoroughbred filly

A 9-month-old Thoroughbred filly was presented for colic of a few hours’ duration. Examination revealed tachycardia at 64 beats/min, and a colon displaced to the right with wall oedema on ultrasound. After an hour of intravenous fluid therapy, the filly became restless and exploratory laparotomy was performed. Impaction and incarceration of the large colon up to the caeco-colic fold through the epiploic foramen (EF) were diagnosed. After evacuating the colonic contents through a pelvic flexure enterotomy, the EF entrapment (EFE) was reduced. The large colon appeared congested with a fragile serosa, serosal tear at its antimesenteric aspect, and amotile for the remainder of the surgery. Colon motility resumed as evidenced by ultrasonographic examination on the second day post-surgery, and despite pasty diarrhoea, the filly made a complete and uneventful recovery and was alive at 6 months’ follow-up. Epiploic foramen entrapment of the large colon is very rare but should be included as a differential diagnosis of colon displacements, even in young horses, requiring prompt surgical resolution.     

Successful outcome of a Standardbred filly after conservative treatment for a Salter–Harris type III fracture of the distal femoral condyle

A 10-day-old Standardbred filly sustained a complex Salter–Harris type III fracture of the right, lateral, distal femoral condyle. The lateral condyle was fractured in transverse, sagittal and frontal planes. The filly was treated by restricting it and its dam to a small, level paddock until lameness was no longer apparent. The filly, when weaned at 7 months of age, was turned out to pasture with three other weanlings. The filly entered race training as a 2-year-old, qualified to race as a trotter, was placed second in its first start and won its third race. Conservative treatment should be considered as an option for a young horse with a minimally displaced, Salter–Harris type III fracture of the distal lateral femoral condyle.     

Surgical treatment of a mandibular ameloblastic carcinoma with metastases to the mandibular lymph nodes in a pony

A 4-year-old Connemara filly was presented with a rapidly growing oral mass on the right rostrolateral mandible and a right mandibular lymphadenopathy. Radiographs of the rostral mandible revealed a lytic, infiltrative mass consistent with soft tissue and mineralised material, and displacement of tooth 403. A biopsy showed characteristic histopathological features of an ameloblastic carcinoma. Subsequent FNA of the right abnormally firm and enlarged mandibular lymph node confirmed the metastatic spread. Computed tomography of the head was performed for surgical planning, including sentinel lymph node mapping to rule out other lymph node involvement. An aggressive lesion, consistent with soft tissue of the rostral right mandible was identified with intralesional contrast injection showing drainage of contrast within the right mandibular lymph nodes (Sentinel node). Based on the infiltrative and destructive nature reported in ameloblastic carcinoma in humans, a rostral mandibulectomy was performed, along with complete mandibular lymphadenectomy. The horse recovered uneventfully from surgery. In the early post-operative period marked lymphoedema of the ventral mandibular region was observed, which resolved 4–5 days post-operatively. Optimal cosmesis was maintained post-operatively, and no recurrence has been observed to date – 12 months post-surgery.     

Cardiopulmonary resuscitation in small animal medicine: an update

In December 2005, the American Heart Association published new guidelines for cardiopulmonary cerebral resuscitation (CPCR) in humans for the 1st time in 5 years. Many of the recommendations are based on research conducted in animal species and may be applicable to small animal veterinary patients. One important change that may impact how CPCR is performed in veterinary medicine is the recommendation to avoid administration of excessive ventilatory rates because this maneuver severely decreases myocardial and cerebral perfusion, decreasing the chance of survival. The new guidelines also emphasize the importance of providing well-executed, continuous, uninterrupted chest compressions. Interruption of chest compressions should be avoided and, if necessary, should be minimized to <10 seconds. During defibrillation, immediate resumption of chest compressions for 2 minutes after a single shock, before reassessment of the rhythm by ECG, is recommended. This recommendation replaces previous recommendations for the delivery of 3 defibrillatory shocks in rapid succession. Allowing permissive hypothermia postresuscitation has been found to be beneficial and may increase success rate. Medications utilized in cardiopulmonary resuscitation, including amiodarone, atropine, epinephrine, lidocaine, and vasopressin, along with the indications, effects, routes of administration, and dosages, are discussed. The application of the new guidelines to veterinary medicine as well as a review of cardiopulmonary resuscitation in small animals is provided.     

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.     

Causes of cardiopulmonary arrest, resuscitation management, and functional outcome in dogs and cats surviving cardiopulmonary arrest

Objective: To describe the functional outcome of canine and feline survivors of cardiopulmonary arrest (CPA) and the clinical characteristics surrounding their resuscitation. Design: Retrospective study. Setting: Veterinary teaching hospital. Animals: Client‐owned dogs (15) and cats (3) with CPA. Interventions: None. Measurements and main results: Eighteen animals were identified to have survived to discharge following CPA. Cardiopulmonary arrest was associated with anesthesia with or without pre‐existing disease in 10 animals, cardiovascular collapse in 5 animals, and chronic disease with an imposed stress in 3 animals. All CPAs were witnessed in the hospital. The most common initial rhythm at CPA was asystole (72%). Return of spontaneous circulation (ROSC) was achieved in less than 15 minutes from the onset of cardiopulmonary cerebral resuscitation (CPCR) in all animals. No animals had a recurrence of CPA after the initial CPA. Animals were of a wide range of ages (0.5–16 years) and breeds. Two animals were neurologically abnormal at discharge, one of which was normal at 2 months following CPA. Conclusions: A good functional recovery after CPCR was documented in the small number of CPA survivors presented in this study. This may be due to the reversible nature of their inciting cause of CPA, early detections of CPA (‘witnessed’), and/or the animal's underlying normal health status.     

Reoccurrence of a paranasal osteoma following surgical removal in a 6-month-old Warmblood filly

A 6-month-old Warmblood filly presented for evaluation of a left sided unilateral mucopurulent discharge of 5 weeks' duration. Upper airway endoscopy revealed a large, smooth mass in the region of the ethmoturbinates. Dorso-ventral and lateral radiographs of the head revealed a large osseous mass in the left paranasal area. A biopsy was performed under general anaesthesia and an osteoma was diagnosed. A computed tomography (CT) examination was performed to guide surgical removal. Surgery was performed under general anaesthesia and a large mass was removed ~15 × 9 cm. A CT examination 3 months following surgery revealed three small areas of mineralisation. It was difficult to differentiate if these were areas of regrowth or portions of the original mass that were not entirely removed. A CT examination 8 months later revealed one of the areas had increased moderately in size. A second surgery was performed standing to remove the growth. A final CT 8 months later revealed no further evidence of a bone growth. This report describes the successful removal of an osteoma regrowth following initial surgical removal and, to the best of the authors’ knowledge, is the first to describe the reoccurrence of an osteoma after surgical intervention. It also describes a successful rhinotomy in the standing equine patient. This case highlights the importance of serial follow-up imaging after surgical removal as osteoma regrowth occurred in this case.     

Oxytetracycline associated acute kidney injury in a neonatal foal

A 3-day-old Australian Stock Horse filly presented with fulminant acute kidney injury after receiving 4 g of intravenous oxytetracycline at 24 and 48 h of age for medical management of flexural deformities. The filly’s clinical status initially improved, but worsening azotaemia prompted euthanasia after 55 h of supportive care. Necropsy confirmed proximal tubular necrosis. Nephropathy in association with oxytetracycline administration has been rarely reported. This case describes severe nephropathy in an apparently normal foal and highlights the need for thorough case evaluation prior to use of high-dose oxytetracycline therapy for correction of flexural deformities in foals.     

Occurrence of a vaginal septum in a foal diagnosed with pyometra

A 10-week-old Westphalian filly was presented for vaginal discharge of 14-days' duration. Examination revealed a partial vaginal septum and pyometra. Two Group B streptococcal pathogens (Streptococcus dysgalactiae subspecies equisimilis and Streptococcus equi subspecies zooepidemicus) were isolated from the uterus. Pyometra was successfully treated using endoscopically facilitated removal of intraluminal exudate and locally and systemically administered antimicrobials. The filly was reported to be progressing well at 12 months following treatment with no further evidence of disease. Pyometra has not been previously reported in foals, and vaginal septum is evidently rare in this species. These abnormalities should be considered when young fillies develop purulent vaginal discharge.     

Survey of academic veterinarians' clinical practice in cardiopulmonary–cerebral resuscitation

Objective: To document the clinical practice of cardiopulmonary–cerebral resuscitation (CPCR) among academic veterinarians. Design: Survey. Setting: Eight colleges of veterinary medicine in the United States. Subjects: Two hundred and one academic veterinarians. Interventions: The survey was distributed by hand by the authors into the mailboxes of small animal faculty, residents, and interns. Demographic variables, questions regarding number of cardiopulmonary arrests (CPA) supervised and number successful, do not attempt resuscitation discussions, and Likert‐style questions about client presence during CPCR, appropriateness of CPCR, and CPCR decision‐making were included. Multiple linear regression models were constructed to determine the effect of multiple questions on different target variables of interest. Measurements and main results: Numerous differences were noted based on institution, gender, specialty, and position. Most institutions did not have a standard resuscitation consent form. Most respondents believed the client, house officer, and senior clinician should determine whether to perform resuscitation or not. Quality of life was the most significant determinant of whether to resuscitate or not, followed by long‐term prognosis, then short‐term prognosis. Conclusions: Veterinarians differ in many aspects of their approach to CPA and resuscitation. Creating consensus within the veterinary profession would benefit client service and patient care.     

Multiple extra-pulmonary disorders associated with Rhodococcus equi infection in a 2-month-old foal

A 2-month-old Thoroughbred filly was referred to Hagyard Equine Medical Institute for further evaluation of acute pyrexia and a suspected intra-abdominal abscess based on abdominal ultrasonography performed in the field. Initial examination revealed bilateral uveitis, polysynovitis, a large internal abdominal abscess and pneumonia. A transtracheal wash confirmed the presence of a multi-sensitive strain of Rhodococcus equi. Anaemia and thrombocytopenia were noted during hospitalisation. Results of a Coombs test were consistent with an immune-mediated haemolytic process. Recurrent pyrexia, abdominal discomfort and severe respiratory distress unresponsive to intensive medical support motivated euthanasia followed by necropsy after 30 days of treatment. Overall, six extra-pulmonary disorders were simultaneously diagnosed despite the lack of pulmonary pyogranulomas.     

Jejunal perforation due to porcupine quill ingestion in a horse

An 8-month-old Andalusian filly was treated for jejunal perforations due to ingestion of a porcupine quill. During exploratory laparotomy, 2 separate stapled side-to-side jejunojejunal resection and anastomoses were performed. Post-operative complications after 2 years follow-up included mild incisional herniation following incisional infection and chronic intermittent colic.     

A case of mastitis in a young filly

A 15-week-old Arabian filly was treated for clinical mastitis, which, after 5 days of therapy, responded to procaine penicillin G (I.M.). After 1 month the signs returned, and the filly was re-evaluated for recurring mastitis, signs of systemic illness, and a purulent teat exudation. A β hemolytic streptococcus organism was recovered from the udder exudate. The filly recovered after 11 days of trimethoprim-sulphamethozole (5.4 gm P.O. b.i.d.), stripping the udder and infusing cephapirin sodium (1/2 a tube into each teat orifice b.i.d.), and hot-packing the udder. Her condition was monitored for I year post initial treatment. The current literature dealing with mastitis in the horse is reviewed.     

The impact of MK‐467 on plasma drug concentrations,sedation and cardiopulmonary changes in sheep treated with intramuscular medetomidine and atipamezole for reversal

The effect of MK‐467, a peripheral α₂‐adrenoceptor antagonist, on plasma drug concentrations, sedation and cardiopulmonary changes induced by intramuscular (IM) medetomidine was investigated in eight sheep. Additionally, the interactions with atipamezole (ATI) used for reversal were also evaluated. Each animal was treated four times in a randomized prospective crossover design with 2‐week washout periods. Medetomidine (MED) 30 μg/kg alone or combined in the same syringe with MK‐467 300 μg/kg (MMK) was injected intramuscular, followed by ATI 150 μg/kg (MED + ATI and MMK + ATI) or saline intramuscular 30 min later. Plasma was analysed for drug concentrations, and sedation was subjectively assessed with a visual analogue scale. Systemic haemodynamics and blood gases were measured before treatments and at intervals thereafter. With MK‐467, medetomidine plasma concentrations were threefold higher prior to ATI, which was associated with more profound sedation and shorter onset. No significant differences were observed in early cardiopulmonary changes between treatments. Atipamezole reversed the medetomidine‐related cardiopulmonary changes after both treatments. Sedation scores decreased more rapidly when MK‐467 was included. In this study, MK‐467 appeared to have a pronounced effect on the plasma concentration and central effects of medetomidine, with minor cardiopulmonary improvement.     

Platelet function defect in a thoroughbred filly

A2-year-old Thoroughbred filly presented to the Veterinary Medical Teaching Hospital (VMTH) at the University of California, Davis, for evaluation of a bleeding disorder. The bleeding tendency was 1st noted 3 weeks before presentation on the morning after the horse was pin fired. Prolonged bleeding was noted after intramuscular injection of procaine penicillin G, and the trainer noted blood from the horse's right nostril 2 days before presentation. The filly had been seen by a referral practice, which found a prolonged prothrombin time but no other problems. The horse received an injection of vitamin K intravenously the day before presentation. The current owners purchased the horse ˜1 year before the initial bleeding episode, during which time she had not injured herself or had any intramuscular injections. The filly had received 1 dose PO of a dexamethasone (5 mg) and trichlormethiazide (200 mg) combination^a and 1 or 2 doses of phenylbutazone (unknown amount) but had not received aspirin. The exact dates of administration of these drugs were not known, but they were not within the week before presentation. She had never bled from venipuncture sites     

Expression of Lymphangiogenic Vascular Endothelial Growth Factor Family Members in Bovine Corpus Luteum

The aim of this study was to evaluate mRNA expression, protein concentration and localization of the assumedly important lymphangiogenic factors VEGFC and VEGFD and the receptor FLT4 in bovine corpora lutea (CL) during different physiological stages. In experiment 1, CL were collected in a slaughterhouse and stages (days 1–2, 3–4, 5–7, 8–12, 13–16, >18) of oestrous cycle and month <3, 3–5, 6–7 and >8 of pregnancy. In experiment 2, prostaglandin F2α (PGF)‐induced luteolysis was performed in 30 cows, which were injected with PGF analogue on day 8–12 (mid‐luteal phase), and CL were collected before and 0.5, 2, 4, 12, 24, 48 and 64 h after PGF injection. The mRNA expression was characterized by RT‐qPCR. All three factors were clearly expressed and showed significant changes during different groups and periods examined in both experiments. Protein concentrations of VEGFD and FLT4 measured by ELISA were not detectable in early cyclic CL but increased to higher plateau levels during pregnancy. After PGF‐induced luteolysis FLT4 protein showed an increase within 2–24 h after the injection. FLT4 localization by immunohistochemistry in the cytoplasm of luteal cells was relatively weak in early CL. It increased in late CL and especially in CL during pregnancy. During pregnancy, a positive FLT4 staining in both the nucleus and cytoplasm of lymphatic endothelial cells in peripheral tissue was observed. In conclusion, our results lead to the assumption that lymphangiogenic factors are produced and regulated in CL and may be involved in mechanisms regulating CL function, especially during pregnancy.     

Embryonic Development of Cuban Gar (Atractosteus tristoechus) Under Laboratory Conditions

The embryonic development of Cuban gar (Atractosteus tristoechus) was described under controlled laboratory conditions. During the whole embryogenesis seven periods were defined: the zygote (0–½ h), cleavage (¾–4 h), blastula (5–10 h), gastrula (12–20 h), segmentation (24–40 h), pharyngula (48–66 h) and hatching (72–96 h) periods. The stages were based on morphological features, generally readily identified by examination of the embryo with the dissecting stereomicroscope. Hatching occurred 96 ± 4 h after spawning at 28°C.     

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.