Osteomyelitis of the atlanto-occipital region as a sequela to a pharyngeal stick injury

An eight-year-old female Belgian shepherd dog was referred for investigation of chronic neck pain. The dog had sustained a pharyngeal injury 12 weeks previously while catching a stick. Radiographs of the cervical spine revealed signs consistent with a septic arthritis of the atlanto-occipital joint and osteomyelitis of both occipital condyles and the atlas. A foreign body was identified ultrasonographically in the retropharyngeal soft tissues, and a stick was surgically removed from a site ventral to the right side of the atlanto-occipital joint. The signs of neck pain started to resolve within a week of surgery.     

Computed tomography as an aid to management of chronic oropharyngeal stick injury in the dog

Objective : To describe the use of computed tomography scanning in the management of dogs with chronic signs after oropharyngeal stick injury. Methods : Dogs with a final diagnosis of chronic oropharyngeal stick injury that underwent a computed tomography scan during their investigation were selected retrospectively from case files at the Royal Veterinary College, London. Results : The six dogs were young (median age 3·1 years) and medium to large breed (19·0 to 42·0 kg). By the time of referral the most common clinical sign was cervical swelling (five dogs). Stick foreign bodies were apparent on the plain computed tomography images in all cases and appeared as well‐demarcated, linear abnormalities. A ventral mid‐line approach was used for foreign body retrieval, and the computed tomography findings corresponded well with the surgical findings, with stick foreign body length ranging from 1 to 7 cm. Closed suction drainage was used in five dogs, for two to four days. Clinical signs fully resolved postoperatively in all cases, although cervical swelling recurred three weeks after surgery in one case. This dog had the smallest foreign body, the greatest number of surgical interventions before referral (three) and the longest disease course before referral (eight months). Clinical Significance : Computed tomography scanning is accurate in identifying the presence and location of chronic stick foreign bodies. Recurrence of disease is possible despite successful retrieval of the wood fragments found by computed tomography scan.     

Oropharyngeal stick injury in a Bengal cat

A 16 month old cat presented with a history of acute onset oral pain and hypersalivation. Oral examination revealed a wooden stick that protruded from the right sublingual region. Lateral cervical radiography showed retro pharyngeal gas lucencies. An 11 cm wooden stick was removed per os and the resulting tract was endoscopically explored. There were no post-operative complications and the cat remains disease free four months after presentation. In contrast to dogs, where oropharyngeal stick injuries are an uncommon albeit well recognised condition, there have been no previous case reports of oropharyngeal stick injuries in the cat. This case report describes the presentation, diagnosis and treatment of an oropharyngeal stick injury in a cat.     

Esophageal obstruction as a sequela to ruptured esophagus in a goat

Granulation tissue as a sequela to ruptured esophagus was diagnosed as the cause of esophageal obstruction and regurgitation in a 3.5-year-old Toggenburg buck. Thoracic radiography was useful in localization of the problem. The condition was successfully treated by removal of the granulation tissue through left-sided thoracotomy.     

Anastomoses of intestinal tract as a sequela to rectal stricture in swine.

Rectal stricture with anastomoses of colon and/or small intestine to a spherical dilatation of the descending colon proximal to the stricture was observed in six swine. In three of these swine, feces bypassed most of the colon in passage from the small intestine to the dilated colon. Rectal stricture with an anastomosis of a loop of colon to the rectal stricture was observed in one pig where feces bypassed much of the stricture.     

Ultrasonographic and magnetic resonance imaging diagnosis of an oropharyngeal wood penetrating injury in a dog

A 5 yr old female intact English setter with a 17 day history of a penetrating oropharyngeal wound was referred for cervical swelling and pain. Physical examination revealed swelling at the left lateral aspect of the cranial cervical region. Pain was elicited upon flexion, extension, and leftward movement of the neck. Neurologic deficits were not identified. Cervical ultrasonography showed a 0.4 cm × 2.3 cm linear, hyperechoic structure in the soft tissues ventrolateral to the first (C1) and second (C2) cervical vertebrae. MRI demonstrated a linear structure 2 cm in length adjacent to the cranial aspect of C2. The foreign material was isointense to hyperintense on precontrast T1-weighted images, isointense on postcontrast T1-weighted images, and hypointense on T2-weighted images relative to adjacent muscle. Abnormalities within the spinal canal were not identified. Upon surgical exploration, a reed foreign body was identified deep to the serratus ventralis muscle. The patient was normal on follow-up evaluations 4 wk postsurgically.     

Imaging characteristics and treatment of a penetrating brain injury caused by an oropharyngeal foreign body in a dog

A 4‐year‐old Border collie was presented with one episode of collapse, altered mentation, and a suspected pharyngeal stick injury. Magnetic resonance imaging (MRI) and computed tomography showed a linear foreign body penetrating the right oropharynx, through the foramen ovale and the brain parenchyma. The foreign body was surgically removed and medical treatment initiated. Complete resolution of clinical signs was noted at recheck 8 weeks later. Repeat MRI showed chronic secondary changes in the brain parenchyma. To the authors' knowledge, this is the first report of the advanced imaging findings and successful treatment of a penetrating oropharyngeal intracranial foreign body in a dog.     

Superficial digital flexor tendon lesions in racehorses as a sequela to muscle fatigue: a preliminary study

REASON FOR PERFORMING STUDY: Racing and training related lesions of the forelimb superficial digital flexor tendon are a common career ending injury to racehorses but aetiology and/or predisposing causes of the injury are not completely understood. OBJECTIVES: Although the injury takes place within the tendon, the lesion must be considered within the context of the function of the complete suspensory system of the distal limb, including the associated muscles. METHODS: Both muscle and tendon function were investigated in vivo using implanted strain gauges in 3 Thoroughbred horses walking, trotting and cantering on a motorised treadmill. These data were combined with assessments of muscle architecture and fibre composition to arrive at an overview of the contribution of each muscle-tendon unit during locomotion. RESULTS: The superficial digital flexor muscle has fatigue-resistant and high force production properties that allow its tendon to store and return elastic energy, predominantly at the trot. As running speed increases, deep digital flexor tendon force increases and it stabilises hyperextension of the fetlock, thus reinforcing the superficial digital flexor in limb load support. The deep digital flexor muscle has fast contracting properties that render it susceptible to fatigue. CONCLUSION: Based on these measurements and supporting evidence from the literature, it is proposed that overloading of the superficial digital flexor tendon results from fatigue of the synergistic, faster contracting deep digital flexor muscle. POTENTIAL RELEVANCE: Future research investigating distal limb system function as a whole should help refine clinical diagnostic procedures and exercise training approaches that will lead to more effective prevention and treatment of digital flexor tendon injuries in equine athletes.     

Pleuropneumonia as a sequela of myelography and general anaesthesia in a Thoroughbred colt

A 3-year-old Thoroughbred colt was presented to the University Veterinary Centre Camden for evaluation of ataxia. The horse was anaesthetised to facilitate cervical radiography and myelographic examination of the spinal cord. Recovery from anaesthesia was uneventful. Five days after general anaesthesia the horse re-presented with pleuropneumonia. It was euthanased 24 hours after presentation on humane grounds. Necropsy revealed severe tracheal erosion over the middle third of the ventral surface of the trachea, pleuropneumonia and narrowing of the cervical cord between C4 and C6. It is postulated that extension and flexion of the neck during myelography resulted in movement of the endotracheal tube cuff, causing the tracheal lesion and predisposing the colt to pleuropneumonia. Severe tracheal lesions and pleuropneumonia have not been reported as sequela of equine myelography, and should be considered as possible complications following repeated cervical manipulation during myelography in the horse.     

Bacterial infective arthritis following a penetrating stick injury of the stifle joint in a dog

An eight-year old, Rottweiler was presented with a chronic non-weight bearing right pelvic limb -lameness and a discharging sinus at the right stifle joint. Fifteen weeks previously a diagnosis of bacterial infective arthritis had been made, presumed attributable to haematogenous spread. Failure to respond to appropriate surgical and medical management resulted in severe joint dysfunction. The poor prognosis for restoration of limb function resulted in limb amputation. Subsequent exploration of the sinus tract and the stifle joint revealed a stick within the craniolateral aspect of the joint. This penetrating stick injury had been responsible for the persistent bacterial infective arthritis.     

Acute injury to the central nervous system

Central nervous system (CNS) trauma is divided into brain and spinal cord injury. A basic understanding of the pathophysiology of CNS trauma helps the practitioner more accurately evaluate, treat, and prognose cases of CNS trauma. The progressive nature of CNS injuries and the contribution of microvascular ischemic are explored.     

Acute intraparenchymal spinal cord injury in a cat due to high-rise syndrome

A 9-year-old spayed female Bengal Red cat was evaluated for high-rise syndrome. The cat had paraplegia of the hind limbs, intact reflexes and pain perception, and hyperesthesia in the caudal thoracic area. Mentation, cranial nerve function, forelimb proprioceptive responses, and spinal reflexes were normal. There were no abnormalities on radiographs or computed tomography scan, but magnetic resonance imaging revealed a hyperintense intraparenchymal spinal cord lesion on T2-weighted and T2 fat saturation images.     

Fistula between the guttural pouches and the dorsal pharyngeal recess as a sequela to guttural pouch mycosis in the horse

An unusual case of a two year old gelding with severe unilateral epistaxis due to guttural pouch mycosis is reported. The lesion had spread to involve the dorso-medial aspects of the right guttural pouch and had formed a fistula between the dorsal pharyngeal recess and both the left and right guttural pouches. The diagnosis, surgical treatment and postoperative management are described.     

Acute onset of pulmonary necrotising arteritis in a dog with a left-to-right patent ductus arteriosus

A 12-week-old, clinically normal Chihuahua was referred for investigation for a continuous heart murmur. Cardiac evaluation revealed an anatomically and haemodynamically typical left-to-right shunting patent ductus arteriosus. The continuous wave Doppler measurement of peak ductal jet velocity of 5.6 m/s was suggestive of a normal pulmonary to systemic arterial pressure ratio. The dog returned 16 days later with right heart failure and severe pulmonary hypertension. Marked reduction in left-to-right shunting was demonstrated and the ductal jet velocity had decreased to 2.5 m/s. Immediate ductus ligation, oxygen therapy before and after the operation, and administration of hydralazine failed to reduce pulmonary hypertension, and the dog was euthanased. Histopathological examination of the lung showed pulmonary necrotising arteritis with acute and chronic arterial lesions. Chronic pulmonary vascular changes related to high flow have been associated with altered nitric oxide and endothelin responses. These changes may be responsible for the acute onset of pulmonary hypertension due to relatively minor vascular insults in some human and veterinary patients with left-to-right shunts. The potential for acute progression supports the recommendations for early ductus ligation and the prognostic importance of detecting pulmonary hypertension presurgically in patent ductus arteriosus patients.