Progressive ethmoidal haematoma in horses

Progressive ethmoidal haematoma was diagnosed in 12 Thoroughbreds, 1 part- Arab and 1 stock horse. Ages ranged from 3 to 18 years and both males and females were affected. Diagnosis was based on history, clinical signs, endoscopic and radiographic findings, and was confirmed histologically in 10 cases. Eleven (78%) of the lesions were unilateral and 3 (22%) were bilateral. Two horses were euthanased on diagnosis, 4 were treated conservatively. Of the latter, 3 were euthanased 6 to 24 months after diagnosis, due to progression of the lesions, while 1 case resolved completely within 13 months. Eight horses were treated by surgical excision of the lesion. Three died in the post-operative period, 3 were euthanased within 48 months after recurrence of the condition, and 2 had no recurrence within 60 and 72 months, respectively.     

Arthroscopic treatment of meniscal cysts in the horse

Reasons for performing study: To describe the clinical symptoms, treatment, and outcome of meniscal cysts in horses. These structures have not been previously described in the literature as a potential cause of lameness in the horse. Hypothesis: Meniscal cysts are an uncommon condition of the femorotibial joint but can be a significant cause of lameness. Symptoms can be resolved by arthroscopic excision. Methods: Records of horses diagnosed with meniscal cysts and treated by cyst excision and meniscal debridement at 2 surgical practices were reviewed. Clinical outcome was determined by repeat veterinary examination and contact with owner. Results: Seven cases of meniscal cyst were treated with arthroscopic cyst excision and meniscal debridement. Five of 7 horses had lameness attributable to femorotibial joint pathology, while the remaining 2 horses had meniscal cysts found incidentally during diagnostic arthroscopy for the treatment of osteochondritis dissecans of the lateral trochlear ridge of the femur. Five of 6 horses with long‐term follow‐up were sound and a 7th horse was improved 11 months after surgery. Conclusions and potential relevance: Meniscal cysts, while uncommon, can be associated with progressive lameness in the horse. Surgical excision of the cysts results in resolution or improvement of symptoms, without evidence of recurrence on follow‐up examination.     

Comparison of surgical and nonsurgical treatment of humeral fractures in horses: 22 cases (1980-1989).

Medical records of 22 horses with humeral fractures were reviewed. The horses were from 2 to 144 months old (mean, 25.8 +/- 37.3 months). Ten horses were treated with stall confinement, 3 were treated surgically, and 9 were euthanatized at the time of diagnosis. Seven of 10 horses treated nonsurgically (stall confinement) were able to be ridden 5 to 12 months after the diagnosis was made (mean, 7.5 +/- 2.6 months). One horse treated nonsurgically was euthanatized 6 months after diagnosis because of laminitis in the contralateral limb. Two horses treated nonsurgically were lost to follow-up evaluation. Two of the 3 horses treated surgically had fractures repaired with Rush pins. The fractured humerus of the third horse was repaired with lag screws. Of the 3 surgically treated horses, 1 was pasture sound 10 months after surgery, but developed varus deviation in the contralateral carpus 6 weeks after repair; 1 horse was euthanatized 2 weeks after surgery because of failure of the implant; and the other horse was sound for riding 10 months after surgery. On the basis of these findings, young horses with humeral fractures that are treated nonsurgically can become sound for riding.     

Ethmoidal hematoma in nine horses

Ethmoidal hematoma was diagnosed in 9 horses by results of physical examination, endoscopy, radiography, and histologic examination of tissues. The horses had stertorous breathing (n = 4) or intermittently sanguineous nasal discharge (n = 7). All horses underwent sinusotomy and extirpation of the lesion. At reexamination 15 to 104 months after surgery (mean, 61 months), 3 horses had recurrence of ethmoidal hematoma, and 1 horse had ethmoidal hematoma involving the contralateral ethmoturbinates. One of the horses with recurrence of ethmoidal hematoma also developed a contralateral lesion; both lesions recurred and additional surgeries were performed.     

Calcified tumours of the paranasal sinuses in three horses

Three horses, a 10-year-old Thoroughbred mare, a 9-year-old Thoroughbred gelding and a 6-year-old Arab gelding, with calcified tumours of the paranasal sinuses, are described. All horses presented with purulent nasal discharges and facial distortion. Exophthalmos, blepharospasm and ocular discharge were also a feature in individual horses. A presumptive diagnosis of a calcified tumour was made on the basis of clinical signs and radiographic and endoscopic findings. The tumours ranged from 15 to 25 cm in diameter. A large frontonasal bone flap was used to expose the tumours, which were cleaved into several pieces with an osteotome and removed. Histological examination of the masses identified cementomas in two cases and an osteoma in the third. Long term follow up from 18 months to 5 years after surgery indicated that there was no recurrence. This case series demonstrates that, although calcified tumours of the paranasal sinuses are rare in horses, they should be considered in the differential diagnosis of purulent nasal discharge, facial swelling and ocular distortion, and are amenable to surgical treatment.     

Anaplastic malignant melanoma of the tail in non‐grey horses

Information regarding signalment, clinical findings, treatment and outcome of 5 previously reported cases of anaplastic malignant melanoma of the tail in non‐grey horses and of 5 additional cases are summarised. Age was recorded for 9 horses and mean age was 16 years, range 8–23 years. Gender was recorded for 8 horses and 6 of these 8 horses were male horses over 14 years of age. The most common coat colour was bay (6 horses). Other coat colours were palomino (one horse), chestnut (one horse) and black (one horse); coat colour of one non‐grey horse was not specified. Follow‐up information was available for 9 horses and only one horse, a palomino, survived more than 10 months following diagnosis and tail amputation. Surgical excision, including tail amputation and medical therapy with oral cimetidine, was not effective in non‐grey, non‐palomino horses. Tumour recurred on tail tissue remaining after amputation in 2 horses, widespread metastases were documented in 4 cases and metastasis was suspected at the time of death or euthanasia in 3 cases, including one case with amputation site regrowth. No subjective histopathological differences were detected in the palomino horse that survived as compared to horses of other coat colours. Findings suggest that anaplastic malignant melanoma of the tail in non‐grey horses is most often a very aggressive neoplasm, but that there are rare exceptions.     

Equine giant cell tumor of soft parts: a series of 21 cases (2000-2007).

In horses, giant-cell tumors of soft parts are rare neoplasms, with the majority of reported cases occurring within the hind limb muscles and soft tissues in older horses. The following article documents 21 cases of equine giant-cell tumors of soft parts clinically examined within the state of Colorado from 2000 to 2007. The majority of cases occurred in male horses aged 10 years or older. Nine (43%) arose within the hind limbs. Key histologic features included numerous multinucleated giant cells and hemosiderin-laden macrophages admixed with a spindle-cell proliferation. The majority demonstrated liposarcomatous change, variable areas of necrosis and hemorrhage, and an intermediate number of mitotic figures. Immunohistochemical results demonstrated 2 distinct cell populations: vimentin-expressing neoplastic mesenchymal cells and CD18 (histiocytic marker) expressing multinucleated giant cells. These results suggest a mesenchymal origin of the neoplasm with possible recruitment of the secondary histiocytic population. Surgical excision was attempted in the majority of horses and was considered clinically complete. A recurrence of the neoplasm was documented in 1 horse and 1 mule. In 18 horses, surgical excision, regardless of margin integrity, appeared successful with no recurrence of disease documented. Unfortunately, 10 of 21 horses were lost to follow-up within approximately 3 months of surgery. Of the 11 remaining horses that were available for follow-up evaluation, there has been no evidence of metastasis. A larger case series with more controlled follow-up is necessary to evaluate malignant potential and the importance of complete surgical excision.     

Neodymium:yttrium-aluminum-garnet laser-assisted excision of progressive ethmoid hematomas in horses: 20 cases (1986-1996)

OBJECTIVE: To describe a technique of contact neodymium:yttrium-aluminum-garnet (Nd:YAG) laser-assisted excision of progressive ethmoid hematoma (PEH) in horses, to determine the recurrence rate of clinical signs of PEH in horses with follow-up time of a minimum of 12 months, and to compare this result with reported results achieved by using conventional techniques. DESIGN: Retrospective study. ANIMALS: 21 horses with 26 PEH. PROCEDURE: Medical records of all horses with PEH treated by Nd:YAG laser excision from December 1986 through August 1996 were analyzed. Twenty-one horses underwent unilateral (18 surgeries) or bilateral (14) frontonasal bone flap with excision of the mass, using an Nd:YAG laser. One horse with bilateral PEH underwent a unilateral bone flap twice, 1 year apart. RESULTS: 1 horse died. Four of 20 horses with followup times of 12 months or longer had recurrence of PEH. The PEH recurrence rate was 20% (5/25 PEH). Three of 6 horses with bilateral lesions had recurrence of PEH. Recurrence rate for horses that had bilateral PEH (3/6 horses) was greater than for horses with unilateral PEH (1/14 horses). CLINICAL IMPLICATIONS: Treatment of PEH by Nd:YAG laser excision through a frontonasal bone flap results in a recurrence rate comparable with that reported for conventional techniques. Horses with bilateral lesions are more likely to have a recurrence of PEH.     

Outcome of superficial keratectomy without conjunctival graft as a surgical technique for immune-mediated keratitis in horses: Four cases

This case report describes four horses with unilateral superficial or mid-stromal immune-mediated keratitis (IMMK) treated with a superficial keratectomy (SK) without a conjunctival graft. In two horses, the surgery was performed under general anaesthesia, and in two horses standing with sedation and local blocks. Results of this report show that SK is a viable treatment option in horses with chronic superficial and/or mid-stromal IMMK that can even be performed in the standing, sedated horse. When sufficient corneal tissue is removed, no recurrence is to be expected in the long-term follow-up (up to 31 months). In two horses, healing occurred without complications. Two horses developed a secondary bacterial infection post-operatively (Enterococcus faecalis and Staphylococcus aureus). In one case, this resulted in a pre-perforating melting corneal ulcer necessitating conjunctival pedicle graft surgery 13 days post keratectomy. In three horses, there was no recurrence of the IMMK with a long-term follow-up of 6–31 months. One case showed recurrence of IMMK in the cornea region surrounding the keratectomy 9 months after surgery.     

Complications associated with left dorsal displacement of the large colon in the horse

Four horses operated on for left dorsal displacement of the large colon (LDDLC) had major intraoperative or postoperative complications. One horse was euthanatized during surgery because of extensive necrosis of the large colon. Three horses that were discharged after surgical correction of LDDLC were readmitted with signs of abdominal pain between 5 weeks and 13 months after surgery. Two horses had recurrence of LDDLC, and the third horse had an omental adhesion attached to and obstructing the pelvic flexure. The displacements were corrected, the adhesion was broken down, and the horses were discharged. One horse was readmitted a third time 16 months after the second surgery and required a third surgical correction of LDDLC.     

Genital neoplasms treated by en bloc resection and penile retroversion in horses: 10 cases (1977-1986)

The medical records of 10 horses with invasive neoplasms of the penis, prepuce, and/or superficial inguinal lymph nodes in which treatment involved en bloc resection and penile retroversion were reviewed. All were geldings and ranged in age from 12 to 25 years (mean, 19 years). Evaluation of biopsy specimens obtained before surgery confirmed lymphosarcoma in 1 horse and squamous cell carcinoma in 9 horses. Typical history included swelling, ulceration, and abscessation of the penis and prepuce and large superficial inguinal lymph nodes. Complications after surgery included dehiscence of the urethrostomy site (4 horses), dehiscence of the ventral skin incision (1 horse), urine scalding of 1 hind limb (1 horse), cystitis (1 horse), severe hemorrhage (1 horse), and diarrhea (1 horse). One horse was euthanatized during hospitalization, because of severe dehydration secondary to diarrhea. At necropsy, firm nodules were scattered in the pulmonary parenchyma, myocardium, thyroid gland, parathyroid glands, cranial mediastinum, kidneys, and hilar lymph nodes. Microscopic examination of the nodules revealed undifferentiated carcinoma. Nine horses were discharged from the hospital between 1 and 5 weeks after surgery. The mean follow-up interval was 27 months (range, 6 to 96 months). Eight horses had no evidence of recurrence. One horse had recurrence of neoplasm at 6 months and was euthanatized 12 months later.     

Ectopic cilium in seven horses

Ectopic cilium was diagnosed by slit-lamp biomicroscopy and treated surgically by transconjunctival excision in seven adult horses. All cases presented with a common history of blepharospasm, ocular discharge and keratitis. Ophthalmic examination revealed a single translucent cilium in the upper eyelid palpebral conjunctiva, emerging approximately 5 mm from the eyelid margin. Corneal ulceration was not observed in any horse. Most horses responded well to transconjunctival surgical excision. There was recurrence of ectopic cilium 6 weeks postoperatively in one horse. Histopathologic examination was performed in two cases and confirmed the diagnosis of ectopic cilium in one horse. This is the first publication of ectopic cilia in horses and emphasizes their importance as etiology for epiphora, blepharospasm and keratitis.     

Fractures of the distal phalanx in horses

Summary. Nineteen cases of fracture of the distal phalanx in horses are reviewed. This represented 1.1% of the total number of horses seen at Murdoch University Veterinary Hospital (MUVH) over a 32-month period. All horses were managed conservatively. Eight horses made a complete recovery. Three are being trained again and are not lame. Four horses made a limited recovery. Two horses are still resting and one horse was killed humanely when it still showed lameness after 2 years. One horse was killed humanely after the fracture was first diagnosed.     

Adjuvant Electrochemotherapy Increases Local Control in a Recurring Equine Anal Melanoma

A 25-year-old gelding sport horse was referred for the treatment of recurring bilateral anal amelanotic melanoma. On physical examination, the horse presented bilateral poorly delimited perianal masses that recurred 2 months after surgical excision. The owner elected the lesions to be treated with surgery combined with electrochemotherapy using the drug cisplatin. The two masses were removed, and the surgical bed was treated with electrochemotherapy. A second session was performed 3 weeks later. The horse remained disease-free for 5 months and then experienced a marginal recurrence in one side. The nodule was re-treated, and the horse remained disease-free for 2 additional months, when it died of abdominal metastases. Electrochemotherapy can be added to the current strategies to palliate recurrent melanomas in horses.     

Primary malignant pulmonary neoplasia in two horses

Although primary malignant pulmonary neoplasia of horses is rarely encountered, this diagnosis was confirmed in 2 horses on the basis of necropsy and histopathologic findings. One horse, with cystic mucinous adenocarcinoma, had respiratory tract and neurologic signs directly attributable to the neoplasm, and a tentative antemortem diagnosis of pulmonary neoplasia was made. The other horse, with anaplastic bronchogenic carcinoma, did not have clinical signs of pulmonary neoplasia.     

Complications associated with anaesthesia for ocular surgery: a retrospective study 1989-1996

This retrospective study was initiated to identify complications of anaesthesia occurring during ocular surgery. Records of 74 horses anaesthetised for eye enucleation, 65 horses anaesthetised for surgery of the eye and adnexa, and 51 horses anaesthetised for splint bone excision were reviewed. Fifty-three percent of the horses anaesthetised for eye enucleation moved during surgery which was significantly more frequent than in the other groups (P = 0.001). The incidence of moving was significantly reduced by use of an anaesthetic gas analyser for monitoring (P = 0.001). Transient hypertension was measured in 6 horses during removal of the eye. One horse experienced a momentary decrease in heart rate from 36 to 26 beats/min at the start of surgery involving a mass on the third eyelid. The incidence of unsatisfactory recovery from anaesthesia involving multiple attempts to stand was significantly greater after ocular surgery than after splint bone excision (P = 0.036). Our conclusions were 1) the oculocardiac reflex was not active in these horses undergoing ocular surgery, 2) increased attention must be paid to provision of analgesia and adequate depth of anaesthesia, which may be facilitated by use of an anaesthetic gas analyser and 3) horses were at greater risk for unsatisfactory recoveries from anaesthesia after ocular surgery.     

Extraperitoneal incisional abscess formation after colic surgery in 3 horses

In this article we report 3 horses that developed an extraperitoneal abscess after colic surgery at the incision site. All 3 horses presented with nonspecific clinical signs and extraperitoneal abscess was diagnosed from ultrasound evaluations and cytological examination of abscess aspirates. One horse developed dehiscence of the incision after drainage of the abscess through the incision. In 2 cases a small standing paramedian incision was performed through which the abscess was drained and lavaged; complete resolution of the abscess and healing of the incision was achieved in both cases. Extraperitoneal abscess is a previously unreported incisional complication after colic surgery in horses. Early and careful ultrasonographic examination of the abdominal incision is required for diagnosis in cases with nonspecific clinical signs. A paramedian incision through the rectus abdominis muscle into the abscess cavity permitted adequate drainage and debridement of the abscess in 2 cases.     

Long-term study of partial arytenoidectomy with primary mucosal closure in 76 Thoroughbred racehorses (1992-2006)

REASON FOR PERFORMING STUDY: The effectiveness and best method to perform a partial arytenoidectomy in racehorses is unclear. This study was performed to evaluate the success of and complications that can occur after a unilateral partial arytenoidectomy with primary mucosal closure in Thoroughbred racehorses. HYPOTHESIS: Partial arytenoidectomy is an effective surgical procedure to return Thoroughbred racehorses, afflicted by arytenoid chondropathy or a failed laryngoplasty, to preoperative levels of performance. METHODS: Seventy-six Thoroughbred racehorses admitted to the New Bolton Centre between 1992 and 2006 were assessed. Information was obtained from the medical records about the horse, laryngeal abnormalities, surgery and other findings during hospitalisation. Racing information was evaluated relative to those independent variables by an analysis of variance with a level of significance of P<0.05. RESULTS: Arytenoid chondropathy was the presenting complaint in 54 horses and failed laryngoplasty in 22 horses. Thirteen horses (17%) underwent a second surgery for laser excision of intralaryngeal granulation tissue at the arytenoidectomy site. Seventy-three horses were discharged from the hospital and racing outcome was evaluated. Sixty horses (82%) raced after surgery and 46 horses (63%) raced 5 or more times after surgery. The median time from surgery to the first start was 6 months. The average earnings/start was not significantly different before and after surgery. There was no association between earnings after surgery and age, gender, location of lesion, type of lesion, duration of tracheal intubation or undergoing a second surgery. CONCLUSIONS AND POTENTIAL RELEVANCE: A Thoroughbred racehorse is likely to race after a unilateral partial arytenoidectomy with primary mucosal closure and return to a preoperative level of performance.     

Surgical thrombectomy in horses with aortoiliac thrombosis: 17 cases

Reasons for performing study: Aortoiliac thrombosis (AIT) is a progressive vascular disease characterised by an exercise‐induced hindlimb lameness. After developing a surgical technique, a follow‐up study was required. Objectives: To assess the surgical results of a surgical thrombectomy in horses with AIT, a chronic arterial occlusive disease of the aorta and its caudal arteries. Methods: Seventeen cases showed the typical signs of AIT and diagnosis was confirmed by Doppler‐ultrasonography. Average age of the horses was 12 years. Seven stallions, 6 mares and 4 geldings were included. Results: The thrombus was located in the left hindlimb (5 cases), the right hindlimb (9 cases) or in both hindlimbs (3 cases). Two cases were operated on both limbs with a few days between surgeries. Nine (53%) horses regained their athletic performance and 2 horses were able to work for at least 30 min without complaint, instead of the initial 5 min prior to surgery. During surgery one horse had to be subjected to euthanasia because the thrombus was too tightly attached to the arterial wall and could not be removed. Two horses were subjected to euthanasia post operatively due to severe myopathy and one due to a femoral fracture during recovery. Two reocclusions of the treated artery occurred 4 months after surgical intervention: one horse was reoperated and, due to the extent of the thrombus and quality of the arterial wall, the horse was subjected to euthanasia; the other horse was subjected to euthanasia without a second surgery. A severe complication was the appearance of AIT in the contralateral limb after surgery as result of occlusion caused by an embolus loosened by the procedure. Post anaesthetic myopathy was seen in 4 (24%) of the cases and could be so severe that euthanasia had to be considered. Conclusion and potential relevance: Surgical intervention by means of a thrombectomy in horses with AIT should be considered; 65% of the horses regained athletic activity and 53% of the operated horses in this study performed at their previous level. Adequate padding, correct positioning, prevention of intraoperative hypotension and keeping surgery time as short as possible, are important parameters to prevent post operative myopathy.     

Tendonitis of the branches of insertion of the superficial digital flexor tendon in horses

Objective To describe clinical findings, ultrasonographic features and outcome of injury to the branches of insertion of the superficial digital flexor (SDF) tendon in horses.
Design Retrospective study of 14 cases.
Procedure Fourteen Thoroughbred horses with tendonitis affecting the branches of insertion of the SDF tendon were examined for lameness, location and amount of swelling, and the presence of other musculoskeletal abnormalities. The flexor tendons were assessed by ultrasonographic examination, and recommendations were made for management of the cases. Outcome was assessed by re-examination of some horses, direct communication with the owner or trainer, and examination of race records.
Results The lateral SDF branch was affected in 10 horses; the medial branch in three, and both branches in one horse. Two horses had concurrent injuries to the SDF tendon in the metacarpal region of the contralateral limb. Ultrasonographic findings included swelling of the affected SDF branch, peritendinous fluid accumulation, disruption of normal fibre alignment on sagittal scan, and variable loss of echogenicity. As healing occurred, there was return of normal echogenicity, but normal fibre alignment did not return completely and apparent adhesions formed between the affected SDF branch and adjacent structures. Seven of 10 horses which returned to their previous use were able to compete without further tendon injury. Recurrence of injury occurred in one case, and another two horses developed tendonitis in the metacarpal region. One horse was retired from racing but was able to compete at dressage without recurrence of injury. Two horses were retired for breeding without returning to training, and one horse was sold and lost to follow up but did not race.
Conclusion The prognosis is fair for return to previous use following injury to the branches of insertion of the SDF tendon in athletic horses.