Historical and clinical features of 200 cases of equine sinus disease

The historical and clinical findings in 200 referred cases of equine sinus disease were reviewed retrospectively. Univariable and multivariable analyses were performed to detect significant differences in historical or clinical features between various categories of sinus disease. The causes of sinus disease were classified as subacute primary (less than two months duration) (n=52), chronic primary (more than two months duration) (n=37), dental (n=40), sinus cyst (n=26), traumatic (n=13) or mycotic sinusitis (n=7), sinus neoplasia (n=10), dental-related oromaxillary fistula (n=8) and intrasinus progressive ethmoid haematoma (n=7). The majority of sinus disorders were of chronic duration at the time of referral and most (including 97 per cent of chronic primary sinusitis cases) had not responded to previous antibiotic therapy and/or sinus lavage in some cases. Clinical signs included unilateral nasal discharge in most cases, including purulent or mucopurulent discharge in all horses with primary, dental and mycotic sinusitis. Haemorrhagic nasal discharge was a feature of traumatic sinusitis and intrasinus progressive ethmoid haematomas. Firm facial swellings and nasal airflow obstruction were features of sinus cysts and neoplasms. Ipsilateral lymphadenitis was a more prominent feature of sinus disease with active infections such as primary, dental or mycotic sinusitis.     

Equine dental disease part 4: a long-term study of 400 cases: apical infections of cheek teeth

Of 400 horses referred because of equine dental disease, 162 suffered from primary apical infections of their cheek teeth (CT), including 92 with maxillary CT infections and 70 with mandibular CT infections. Maxillary swellings and sinus tracts were more common (82 and 26% incidence, respectively) with infections of the rostral 3 maxillary CT, than with infections of the caudal 3 maxillary CT (39 and 5% incidence, respectively). Nasal discharge was more commonly present with caudal (95%) than rostral (23%) maxillary CT infections. Mandibular CT apical infections commonly had mandibular swellings (91%) and mandibular sinus tracts (59%) and these infections were closely related to eruption of the affected CT. A variety of treatments, including medical treatment, apical curettage, repulsion and oral extraction of affected teeth were utilised in these cases, with oral extraction appearing to be most satisfactory. Infections of caudal maxillary CT with a secondary paranasal sinusitis were most refractory to treatment, with a complete response to the initial treatment achieved in just 33% of these cases. Most other cases responded fully to their initial treatment. The long-term response to treatment was good in most cases.     

CT FEATURES OF ALVEOLITIS AND SINUSITIS IN HORSES

Sinusitis is a common disorder in horses and may result from trauma, dental diseases, or space-occupying lesions. Radiography can only provide a limited amount of information. Computed tomography (CT) has been documented as an alternative imaging method. Eighteen horses (mostly Warmblood) with signs of chronic sinusitis were examined preoperatively with CT to assist in diagnosis of the underlying cause. There was a group of common CT features in horses with dental disease and sinusitis. The first molar was the most frequently affected maxillary cheek tooth. Hypoattenuation of the cementum, destruction of the enamel, and filling of the infundibular cavity with gas were the most frequent CT findings associated with caries. Gas bubbles within the bulging root area or fragmentation of the root in combination with swelling of the adjacent sinus lining were the most important CT features of dental decay. CT findings associated with sinusitis included excessive thickening of the respiratory epithelium in the rostral maxillary sinus; the caudal maxillary sinus was less often involved. The infraorbital canal, the nasomaxillary duct, and the frontomaxillary aperture were usually involved. The maxillary bone, however, especially the facial crest, was involved in nearly every horse, being characterized by endosteal sclerosis, thickening, periosteal reaction, and deformation leading to facial swelling in chronic infections. CT images allowed identification of involvement of individual teeth more clearly to reveal the diseased one for treatment. Three-dimensional imaging allowed improved understanding of the extent and severity of the pathologic change.     

A review of equine paranasal sinusitis: Medical and surgical treatments

Treatment of the different types of equine sinusitis, in particular those of chronic (>2 months' duration) sinusitis can be difficult, with many such cases not responding to more conservative measures such as rest, antibiotic therapy or sinus lavage. Such refractory cases require further clinical examinations and imaging as outlined in a companion article to achieve confirmation of the cause of the sinusitis. Many sinusitis cases will then require some form of surgical treatment that may include sinusotomy, dental extraction or intrasinus growth removal, that are increasingly being performed by less invasive techniques under standing sedation.     

Radiographic examination of the facial, nasal and paranasal sinus regions of the horse. II. Radiological findings

The radiographic findings in 167 horses subjected to radiography of the facial area, nasal cavity and paranasal sinuses are recorded. Cases were grouped according to clinical diagnosis and the common and disparate radiographic features between and within groups are discussed. Dental disease occurred most frequently and accounted for about 30 per cent of cases, most of which had periapical infection. This disorder presented as two distinct clinical entities in almost equal numbers affected teeth with roots rostral to the maxillary sinus usually produced facial swelling, whereas those with roots within the sinus were generally associated with nasal discharge as a result of secondary sinusitis. In the former group periapical changes could readily be identified on radiographs, but in the latter group affected teeth could be recognised with confidence in only about half the cases. Primary sinusitis was the commonest specific condition recorded and accounted for 32 cases, three of which were mycotic. Using lateral erect projections, comparison of the radiographic features of primary sinusitis and sinusitis secondary to dental disease showed some useful differentiating signs. In four ponies, rhinitis associated with sinusitis led to disruption of the intra-nasal structures but mycotic rhinitis, nasal ulceration and an intra-nasal foreign body produced no radiographic abnormalities. Sixteen cases of suture periostitis were recorded, with varying degrees of new bone formation, and of 13 animals presented for evaluation of trauma, pre-diagnosed fractures were demonstrated in 10 and complications due to sinusitis in three.(ABSTRACT TRUNCATED AT 250 WORDS)     

Histopathological findings in equine sinonasal disorders.

Biopsies collected from 79 referred cases of equine sinonasal disease, including 27 horses with primary sinusitis, 10 with secondary dental sinusitis, 19 with sinus cysts, 11 with progressive ethmoid haematomata (PEH), 4 with false nostril epidermal inclusion cysts, 4 with sinonasal polyps, 3 with sinonasal mycosis and from 2 control animals were examined histologically. Observations were made on epithelial type and integrity, cellular inflammatory response, fibroplasia and presence of potential pathogens. Chronic inflammatory changes including mucosal thickening, ulceration and significant fibroplasia, were found in the sinus mucosa with most sinus disorders, similar to those found in human chronic sinusitis. Bacteria were variably present on sinusitis mucosae but their aetiological significance was unclear. The presence of apparently irreversible changes including fibroplasia in some of these sinusitis cases may explain their poor or delayed response to treatment. Sinus cysts had histological similarities to human mucocoeles. Progressive ethmoid haematomata showed recent and older haemorrhage, as did sinus cysts (and occasionally some chronic sinusitis sections), but support for a common aetiology between sinus cysts and PEH was absent.     

A review of swellings of the frontal region of the equine head

Gross swellings of the equine frontal area are most commonly caused by the poorly understood disorder of nasofrontal suture line periostitis that is usually self‐resolving, sinus cysts that are highly amenable to treatment, sinus tumours that in contrast usually respond poorly to treatment and facial trauma that may later lead to nasofrontal suture line periostitis. Other causes of conchofrontal sinus disease such as intrasinus progressive ethmoid haematoma, primary sinusitis and dental sinusitis seldom cause gross swellings of the overlying bones.     

Peripheral nerve sheath tumour of the equine maxillary sinus

This case report describes an 8‐year‐old Belgian Warmblood mare that was initially diagnosed and treated for a dental sinusitis. Despite removal of the diseased teeth and appropriate treatment, the sinusitis did not resolve. Over time, growth of a peripheral nerve sheath tumour of the left maxillary sinus became apparent, with recurrence after surgical removal. The clinical, radiographic, computed tomography, magnetic resonance imaging and pathological (gross and histological) findings of the first reported peripheral nerve sheath tumour of the equine paranasal region are described and illustrated.     

Pasteurella multocida-associated sinusitis in khaki Campbell ducks (Anas platyrhynchos)

Pasteurella multocida group B, serotype 3, was isolated from sinusitis-affected khaki Campbell ducks. To study the role of P. multocida in sinusitis, commercial khaki Campbell ducks were experimentally infected with P. multocida alone or combined with Escherichia coli. In Expt. 1, experimental ducks were infected with P. multocida intranasally or ocularly. A comparison was done by intranasal inoculation with pooled nasal discharge from the affected ducks or phosphate-buffered saline. The ducks intranasally inoculated with the nasal discharge or P. multocida showed sinusitis. In Expt. 2, E. coli alone or a combination of P. multocida and E. coli was intranasally inoculated into experimental ducks. The ducks intranasally inoculated with the combination of P. multocida and E. coli had sinusitis, the same as found in the field but less severe than that of the field cases. Pasteurella multocida was already present in litter/floor of duck farms. We concluded that P. multocida played a role in induction of sinusitis. However, the sinusitis in ducks may be initiated by poor management, especially in the brooding period of ducks.     

北京鸭传染性窦炎的调查研究——Ⅰ.流行病学调查与病理学研究

1983年以来,北京地区几个商品鸭场陆续发生鸭窦炎。一年四季均可发生,冬春季多发。7～15日龄雏鸭易感性最高,发病率高,死亡率低。病鸭主要表现沉郁,打喷嚏,摇头,窦炎和结膜炎。耐过鸭生长缓慢,出栏期延长。病理剖检以呼吸器官尤其是眶下窦的炎性反应为特征。组织学变化主要表现呼吸道粘膜充血、水肿、出血,大量单核细胞、淋巴细胞浸润以及淋巴滤泡反应。     

A long-term study of 277 cases of equine sinonasal disease. Part 2: treatments and results of treatments

The treatments of 277 horses with equine sinonasal disease (1984-1996), described by Tremaine and Dixon (2001), are reported here. Long-term (median duration 24 months) outcomes of treatment of the more common disorders were good, with 92% of horses with sinonasal mycosis, 84% with primary sinusitis, 82% with sinus cysts, 78% with dental sinusitis and 75% with sinonasal trauma reported to have complete remission of clinical signs. However, only 33% of horses with progressive ethmoidal haematoma (PEH) and 12% with sinonasal neoplasia reported long term remission of clinical signs.     

Infectious sinusitis in turkeys at Ibadan, Nigeria

Thirty out of 70 imported broad-breasted white turkeys with severe sinusitis were both culturally and serologically positive for Mycoplasma gallisepticum. Infectious sinusitis due to M. gallisepticum was therefore diagnosed. A low mortality of 5.7% of the total flock was recorded. This appears to be the first published report on M. gallisepticum isolation in turkeys in Nigeria.     

Use of serial standing computed tomography for diagnosis,treatment and monitoring of a horse with acute myonecrosis of the head

An 11-year-old American Quarter Horse gelding was referred to the JT Vaughan Large Animal Teaching Hospital at Auburn University, College of Veterinary Medicine, for investigation of acute and severe right-sided facial swelling and nasal discharge. Standing computed tomographic (CT) examination of the head identified severe soft tissue swelling surrounding the right mandible, emphysema within the soft tissues tracking along fascial planes and right-sided caudal and rostral maxillary sinusitis. Using CT identification and ultrasound guidance, several targeted fasciotomies were created into the right masseter, cranial cervical musculature, supraorbital space and caudo-medial aspect of the mandible. The right-sided sinusitis was treated by right conchofrontal sinus trephination and lavage. Aerobic and anaerobic cultures obtained from the fasciotomy sites and conchofrontal sinus both yielded Prevotella intermedia and Peptostreptococcus asaccharolyticus. During hospitalisation, serial, standing CT examinations were performed for monitoring case progression and guiding further fasciotomies in the face of continued myonecrosis. Follow-up CT performed at 1 month showed resolution of the emphysema and presence of chronic right ventral conchal sinusitis. The sinusitis was treated by fenestration of the right ventral concha with a diode laser via the nasal passage.     

Bacterial meningitis and encephalitis in ruminants.

The clinical aspects of bacterial meningitis in neonates are described in this article. Specific types of meningitis affecting adult cattle are also described. Other conditions occurring less frequently,such as frontal sinusitis and brain abscess, are discussed.     

Immotile cilia syndrome in two Old English Sheepdog litter-mates

Two Old English Sheepdog litter-mates with chronic respiratory disease since birth had ultrastructural abnormalities of their respiratory tract cilia. The ciliary defects included lack of inner dynein arms, abnormal radial spokes and nexin links, and microtubule doublet displacement. Similar ciliary defects in man result in immotile cilia with the subsequent development of sinusitis, bronchitis or bronchiectasis, male sterility, and, in some cases, situs inversus. Both dogs had sinusitis and bronchiectasis, and one of the dogs also had situs inversus.     

Equine paranasal sinus disease: a long-term study of 200 cases (1997-2009): ancillary diagnostic findings and involvement of the various sinus compartments

Reasons for performing study: There is a lack of objective information on the value of ancillary diagnostic techniques used to investigate equine sinus disease, and also on which sinus compartments are commonly affected in this disorder. Objectives: To record the ancillary diagnostic findings used to investigate equine sinus disease and to document which compartments are affected. Materials and methods: The clinical case records of 200 consecutive cases of sinus disease, including subacute (<2 months' duration) primary (n = 52); chronic (>2 months' duration) primary (n = 37); dental (n = 40); traumatic (n = 13); sinus cyst (n = 26); sinus neoplasia (n = 10); dental related oromaxillary fistula (n = 8); mycotic sinusitis (n = 7) and intra‐sinus progressive ethmoid haematoma (n = 7) were retrospectively examined. Results: Nasal endoscopy showed exudate draining from the sino‐nasal ostia in 88% of cases and a sino‐nasal fistula was present in 15% of cases. Sinoscopy was performed in 79% of cases and was of great diagnostic value. More recently, 22% of cases had fenestration of the ventral conchal bulla performed to allow sinoscopy of the rostral sinus compartments. Radiography was performed in 97% of cases and showed intra‐sinus fluid lines to be common (69% prevalence) in subacute primary sinusitis. Radiographic dental apical changes were not specific to dental sinusitis, e.g. 29% of chronic primary sinusitis cases had radiographic dental changes. Scintigraphy was performed in 20% of cases and was helpful in identifying dental apical changes when radiography was inconclusive. Overall, the caudal maxillary (78% involvement) and rostral maxillary (61%) sinuses were most commonly affected, with the ventral conchal sinus (VCS) (54% involvement) and conchofrontal sinuses (48%) less so. The VCS showed the greatest tendency to contain inspissated pus (present in 46% of all affected VCS). Conclusions: Nasal endoscopy, sinoscopy and skull radiography are of great value in diagnosing the presence and causes of equine sinus disease.     

Use of scintigraphy for diagnosis of equine paranasal sinus disorders

OBJECTIVES: To describe and analyze subjective and objective scintigraphic findings in horses with paranasal sinus disorders. ANIMALS: Horses with suspected disorders of the paranasal sinuses or cheek teeth (n = 48) and control horses (n = 30). METHODS: 99Technetium-methylenediphosphate (99Tc-MDP; 7500 MBq) was administered for scintigraphic examination of the skull. Abnormal patterns of increased radionuclide uptake (IRU) were identified and subjectively described. Scintigrams and radiographs were blindly assessed by 2 clinicians and the accuracy of the imaging modalities was compared. Objective analysis was performed by comparing regions of interest (ROI) drawn over areas of abnormal IRU to the equivalent area on the unaffected side using the Mann-Whitney test. An ROI ratio (affected:non-affected sides) was also calculated for each lesion. RESULTS: Twenty-eight horses were diagnosed with primary (15) or secondary (13) sinusitis. Nine primary sinusitis cases had focal area(s) of moderate or marked IRU in addition to a more diffuse uptake in the affected sinus(es). kappa was marginally higher for scintigraphic assessment of paranasal sinus disorders than for radiographic assessment. There were significant differences in mean counts/pixel in ROI drawn on the affected side compared with the non-affected side. There was considerable overlap between the magnitudes of ROI ratios found with many different disorders. CONCLUSIONS: Scintigraphy can be useful for differentiation of sinusitis of dental origin from other causes of sinusitis. Quantitative analysis of scintigrams is not reliable for identification of particular disorders. CLINICAL RELEVANCE: Focal areas of moderate or marked IRU may be observed with primary sinusitis. Careful 3-dimensional localization of the lesion, along with consideration of other clinical and diagnostic findings should be performed to prevent false-positive diagnoses of periapical infection in such instances.     

Equine paranasal sinus disease: a long-term study of 200 cases (1997-2009): treatments and long-term results of treatments

Reasons for performing study: There is limited objective information available on the treatment and the long‐term response to treatment of the different types of equine sinus disease. Objectives: To document the treatments and long‐term response to these treatments in 200 cases of equine sinus disease (1997–2009). Methods: The treatments of horses affected with subacute primary sinusitis (n = 52); chronic primary sinusitis (n = 37); dental sinusitis (n = 40); sinus cyst (n = 26); traumatic (n = 13); dental‐related oromaxillary fistula (n = 8); sinus neoplasia (n = 10); mycotic sinus disease (n = 7); and intrasinus progressive ethmoid haematoma (n = 7) and the long‐term response to these treatments were retrospectively reviewed. Results: Treatments evolved throughout the study and latterly were as conservative as possible, including sinoscopic lavage and standing sinusotomy, with a maxillary sinusotomy approach preferred for the mainly mature horses treated in this study. Removal of intrasinus inspissated pus, including transendoscopically (by sinusotomy and via existing sinonasal fistulae), was the main treatment for chronic primary sinusitis and sinonasal fistulation was seldom performed latterly. Attempted oral extraction of infected cheek teeth, even if unsuccessful, facilitated subsequent dental repulsion, resulting in few post operative problems. Sinus cyst removal carried an excellent prognosis. Except for cases of sinus neoplasia (only 22% cured), an excellent long‐term response to treatment (91% fully cured, 7% partially cured) was obtained for all other types of sinus disease following a median of one treatment. Conclusions: More conservative treatments, including removal of intrasinus inspissated pus by sinoscopy, pre‐existing sinonasal fistula or sinusotomy, are effective for chronic primary sinus disease. Standing sinusotomy, mainly using a small maxillary site, was suitable for most cases of sinus disease in mature horses.     

Paranasal Sinusitis Complicated by Inspissated Exudate in the Ventral Conchal Sinus

Primary paranasal sinusitis complicated by inspissated exudate within the ventral conchal sinus was diagnosed in five horses. Clinical signs included a unilateral, foul-smelling, mucopurulent nasal exudate of 2 to 7 months' duration. Two of the horses had partial nasal obstruction from distortion of the ventral concha. Radiographs of the skull showed a mass of soft tissue density dorsal to the roots of the superior third and fourth or fourth and fifth cheek teeth. Treatment included bone flap maxillary sinusotomy with exposure of the ventral nasal concha and removal of inspissated exudate. Resolution of the sinusitis occurred in all five horses.     

Respiratory diseases of rabbits.

Respiratory diseases are second only to gastroenteric diseases in importance in rabbits. Pasteurellosis is the primary respiratory disease affecting domestic rabbits, but other bacteria (e.g., Bordetella broniseptica and Staphylococcus spp) are significant opportunistic pathogens. The primary manifestations are upper respiratory disease (e.g., rhinitis, sinusitis, conjunctivitis, and dacryocystitis). Various antimicrobials are effective for treatment.