Stress reactions and stress fractures of the proximal palmar aspect of the third metacarpal bone in horses: 58 cases (1980-1990).

The case records, radiographs, and nuclear bone scans of 58 horses with stress reactions or stress fractures of the proximal palmar aspect of the third metacarpal bone (MC3) were reviewed. There were 47 Standardbreds, 4 Quarter Horses, 3 Thoroughbreds, 2 Arabians, 1 Oldenburg, and 1 Pony of America. Fifty-six of the horses were racehorses or performance horses. The mean and median ages of affected horses were 4 and 3 years, respectively. Lameness ranged from mild to severe. Physical findings were usually subtle and included signs of pain on deep palpation of the proximal palmar aspect of MC3 and slight effusion of the middle carpal joint in some cases. Lameness was commonly improved by high palmar and palmar metacarpal nerve blocks or anesthesia of the middle carpal joint. Fifty-three horses had higher than normal radiopharmaceutical uptake in the proximal palmar aspect of MC3 in the left or right limb. The other 5 horses had higher than normal radiopharmaceutical uptake bilaterally. Fifty-six of the 63 limbs with abnormal bone scans also had abnormal radiographs. Treatment consisted of a variable period of rest (1 to 6 months). Healing was best assessed by follow-up bone scans. Of the 45 horses for which follow-up information was adequate, 29 (64%) returned to their previous level of performance.     

Cholelithiasis in horses: ten cases (1982-1986)

Ten horses with clinical signs consistent with cholelithiasis were evaluated. Fever, icterus, mild intermittent colic, and weight loss were reported. Clinical laboratory abnormalities included leukocytosis, hyper-proteinemia, and hyperfibrinogenemia. Gamma glutamyltransferase and liver isoenzyme of lactate dehydrogenase activities also were high. Choleliths were observed via ultrasonography of the liver in 5 of the 8 horses evaluated, and increased echogenicity of the hepatic parenchyma and dilated bile ducts were observed in all horses. Seven horses were treated medically, 5 of which died or were euthanatized. Three horses were treated surgically, of which only 1 survived. Cholelith composition varied, but cholesterol, calcium bilirubinate, and mixed bile pigments were most commonly observed.     

Computed tomographic diagnosis of incomplete palmar cortical (fatigue) fracture of the third metacarpal bone in two young adult endurance horses

Two young adult endurance horses were presented for investigation of sudden-onset forelimb lameness during competition. Clinical examination revealed a severe forelimb lameness and pain on palpation of the proximal palmar metacarpal area. Initial radiographic survey of the affected forelimb was unremarkable in both cases. A week of box rest resulted in only a mild improvement in the lameness. A second radiographic examination did not reveal any significant abnormalities. In both cases, scintigraphic examination was suggested, but was declined by the owner, and the lameness had significantly improved after local infiltration of 3 mL of anaesthetic solution in the proximal suspensory region. Radiographic and ultrasonographic examinations of the carpus and proximal suspensory region were unremarkable in Case 2. Case 1 had increased thickness of the medial lobe of the proximal aspect of the suspensory ligament. A computed tomographic examination was performed and an incomplete longitudinal (fatigue) fracture of the proximal third metacarpal bone was detected. After 8 months of box rest and rehabilitation, re-examination revealed resolution of the lameness in both cases. Advanced diagnostic imaging should be considered in young endurance horses with severe lameness during competition or training, in which radiographic and ultrasonographic examinations are unremarkable or do not explain the severity of the lameness. Computed tomography imaging is considered a useful diagnostic imaging technique to detect incomplete longitudinal palmar metacarpal cortical (fatigue) fractures due to its ability to provide excellent bone detail.     

Scintigraphic appearance of stress-induced trauma of the dorsal cortex of the third metacarpal bone in racing Thoroughbred horses: 121 cases (1978-1986)

Review of 121 bone scintigrams obtained on racing Thoroughbred horses with clinical histories indicative of forelimb lameness revealed 3 scintigraphic patterns of stress-induced trauma to the dorsal cortex of the third metacarpal bone: (1) focal, intense uptake associated with recent stress fracture; (2) regional uptake of varying intensity or a mixed pattern of uptake associated with chronic stress fracture; and (3) diffuse, mild to moderate uptake associated with periostitis (bucked shins). The latter scintigraphic pattern appeared to be an exaggerated manifestation of the normal remodeling process evident in immature horses (2 to 3 years old). Scintigraphy was most helpful in identifying radiographically occult stress fractures, determining the extent of cortical involvement before surgical intervention in cases of chronic stress fractures, and monitoring the fracture healing process.     

Dorsomedial articular fracture of the proximal aspect of the third metacarpal bone in standardbred racehorses: seven cases (1978-1990).

Seven Standardbred horses, all pacers, with a mean age of 2.9 years (range, 2 to 4 years), had dorsomedial articular fracture of the proximal aspect of the third metacarpal bone. Fracture caused acute, unilateral, severe lameness after training or racing. Lameness was abolished by midcarpal joint anesthesia in 4 horses. Six horses had a palpable bony swelling, which caused signs of pain. Radiography revealed a nondisplaced, articular, oblique fracture extending distad toward the dorsomedial cortex for a mean distance of 28 mm (range, 15 to 40 mm). In all horses, chronic periosteal proliferative changes, seen near the distal aspect of the fracture, corresponded to palpable bony exostoses and were associated with the medial attachment of the extensor carpi radialis tendon. In 1 horse, internal fixation followed by a 6-month rest resulted in a successful outcome. All other horses were given 3 months' rest without surgery and were not lame. Five horses raced successfully and lowered the lifetime race records, 1 horse was sound and trained successfully, but died of colic, and 1 horse was not lame in early training.     

Propagation of a dorsal cortical fracture of the third metacarpal bone in two horses

Seemingly, propagation of a dorsal cortical fracture in the third metacarpal bone developed after continued race performance in 2 horses. Historically, both horses had intermittent lameness that had responded to nonsteroidal anti-inflammatory drugs and brief rest periods. However, lameness in both horses had increased in severity. Radiography revealed a dorsal cortical fracture of the third metacarpal bone, with propagation of the fracture plane proximally. Fractures were incomplete and healed with stall rest in both horses.     

Apical fracture of the proximal sesamoid bone in standardbred horses: 43 cases (1990-1996).

OBJECTIVE: To determine whether fracture fragment dimensions, suspensory ligament damage, and racing status at the time of injury were associated with outcome in Standardbred horses with apical fracture of the proximal sesamoid bone. DESIGN: Retrospective study. ANIMALS: 43 Standardbred racehorses. PROCEDURE: Medical records, racing records, and radiographs were reviewed, and ultrasonographic findings were scored. Measurements of the fractured portion of the proximal sesamoid bone were made. RESULTS: Seventy-four percent (32/43) of horses were pacers, and 26% (11/43) were trotters. Statistical differences between trotters and pacers regarding ability to start, number of starts, or amount of money earned after injury were not detected. Females earned significantly more money per start after injury than males. Eighty-six percent (37/43) of fractures involved hind limbs and 14% (6/43) involved forelimbs. Horses with forelimb injuries earned less money per start. Severity of suspensory ligament damage did not affect postinjury racing performance. A higher proportion of horses that had raced before injury returned to racing after surgery than horses that had not raced before injury, although a significant difference between these groups was not detected. Eighty-eight percent of horses that raced before injury raced after injury. Fifty-six percent of horses that did not race before injury raced after injury. Fracture fragment dimensions did not affect outcome. CLINICAL IMPLICATIONS: Dimensions of the apical fracture fragment of the proximal sesamoid bone in Standardbred horses and degree of suspensory ligament damage did not affect outcome. Prognosis for return to racing soundness is good in horses that had raced before injury and fair in horses that had not raced before injury.     

Pericarditis in horses: six cases (1982-1986)

Records of 6 horses with pericarditis were reviewed. Septic pericarditis was suspected in all horses, based on historic and clinical findings. In horses 1, 2, and 4, cytologic examination of the pericardial effusion revealed acute inflammation with severe neutrophil degeneration. In horses 3 and 5, cytologic examination of pericardial fluid revealed subacute inflammation with degenerated neutrophils, and in horse 6, chronic active inflammation, with well preserved neutrophils. In horses 1 and 3, bacteria were identified on cytologic examination of pericardial fluid. Results of microbiologic cultures of pericardial fluid were positive in horse 3. All horses were treated with broad-spectrum antibiotics. An indwelling pericardial catheter was used to lavage and directly administer antibiotics into the pericardial sac. Horses 1, 4, 5, and 6 survived, horse 2 died of unrelated causes, and horse 3 was euthanatized at the owner's request. Surviving horses returned to athletic performance.     

Keratomas in horses: seven cases (1975-1986)

The diagnosis of keratoma in 7 horses and their treatment and outcome were evaluated. Horses were 2 to 20 years old, of various breeds, and were intact or castrated males. All were lame, and 6 horses had had previous injuries of the affected hoof that had not responded to prior treatments. Only 1 hoof was affected in each horse. Keratomas were beneath the hoof wall (6 horses) or sole (1 horse). Radiographically, a circular or semicircular defect with a discrete margin was present in the distal portion of the third phalanx in 3 horses. Grossly, keratomas were firm solitary masses (1.5 to 5 cm diameter); gray, tan, or yellow; and oval or conical. Keratomas were excised from beneath the hoof wall by removing a section of hoof wall (5 horses) or by undermining the wall beginning at its junction with the sole (1 horse). A keratoma beneath the sole in 1 horse was excised by excavating the sole to the level of the palmar surface of the third phalanx. Keratoma was verified microscopically by the presence of characteristic rings of squamous epithelial cells with abundant keratin. Purulent exudate and inflammatory infiltrate often were present concurrently, reflecting an associated localized infection. Aftercare included daily application of an antiseptic iodine solution and foot bandages, and shoeing with a treatment plate several weeks after surgery. Hoof and sole defects healed completely between 6 months and 1 year. By 1 year after surgery, 6 horses were sound, and keratoma had not recurred.     

Sagittal fractures of the third carpal bone in horses: 12 cases (1977-1985)

Third carpal sagittal fractures were found to be related to racing injuries in 10 of 12 horses. These fractures occurred most commonly on the medial aspect of the bone. A dorsoproximal-dorsodistal view of the carpus was required to visualize the fracture in all cases. Healing of the fracture required periods of rest of up to one year. Conservative management of these fractures resulted in return to function in 7 of 12 horses.     

Subchondral cystic lesions of the proximal extremity of the tibia in horses: 12 cases (1983-2000)

OBJECTIVE: To determine clinical and radiographic features of subchondral cystic lesions (SCL) of the proximal extremity of the tibia in horses that could be used to classify these lesions as being related to osteochondrosis or osteoarthritis and to evaluate results of surgical debridement. DESIGN: Retrospective study. ANIMALS: 12 horses with 14 SCL. PROCEDURE: Medical records and radiographs obtained before and after treatment were reviewed. RESULTS: In 6 young horses (8 lesions), SCL were considered to be related to osteochondrosis; all involved the lateral tibial condyle. The remaining 6 horses were mature and had radiographic evidence of osteoarthritis in addition to SCL. Arthroscopic debridement was performed in 4 horses in which lesions were considered to be a result of osteochondrosis and in 3 horses with osteoarthritis. Three horses in which SCL were considered to be a result of osteochondrosis performed athletically after debridement. Two horses with moderate osteoarthritis returned to work after arthroscopic debridement but at a lower level of athletic performance. One horse with SCL related to osteochondrosis responded to medical treatment and went on to race. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that arthroscopic debridement of SCL is feasible in horses in which lesions involve the cranial portion of the lateral or medial tibial condyle, and that treated horses may be able to perform athletically.     

Disseminated histoplasmosis in cats: 12 cases (1981-1986)

Anemia, weight loss, lethargy, fever, anorexia, and interstitial lung disease were the predominant clinical findings in 12 cats with disseminated histoplasmosis. Some cats were examined because of dysfunction or lesions of bone, eyes, or skin. In most cases, the clinical signs were observed by the owner for 4 weeks or less before seeking veterinary care. Young cats were most commonly affected, with 7 of the 12 cats less than or equal to 1 year old. Identification of Histoplasma organisms in bone marrow aspirates was used to confirm the diagnosis of histoplasmosis in 11 of the 12 cats. Histoplasma infection of multiple organs was found at necropsy. In this study, disseminated histoplasmosis had a higher prevalence in cats than in dogs at the same veterinary medical teaching hospital. Feline disseminated histoplasmosis was not associated with FeLV infection. Treatment was attempted in 7 of the 12 cats.     

Disseminated histoplasmosis in dogs: 12 cases (1981-1986)

Diarrhea, intestinal blood loss, anemia, and lethargy were predominant clinical findings in 12 dogs with disseminated histoplasmosis. Young dogs were affected most commonly, with 6 dogs being 1 to 3 years old. A diagnosis of disseminated histoplasmosis was established on the basis of histologic or cytologic detection of Histoplasma organisms in intestinal or rectal mucosa in 7 dogs, in circulating leukocytes in 5 dogs, in bone marrow in 3 dogs, and in multiple tissues at necropsy in 1 dog (4 dogs had Histoplasma organisms detected in greater than 1 site). Anemia was detected in 10 dogs (PCV less than 20% in 3 dogs), and the anemia was inadequately regenerative or nonregenerative in 7. Hypoalbuminemia was detected in 9 dogs, and serum albumin concentrations were low (less than 1.0 g/dl) in 4 of the 9 dogs. Of 5 dogs treated with ketoconazole, 2 were in remission for greater than or equal to 1 year. Corticosteroid therapy may have exacerbated the disease in 4 dogs. Histoplasma infection of multiple organs was detected in 5 necropsied dogs.     

Ileocecal intussusception in horses: 26 cases (1981-1988)

The case records of 26 horses with ileocecal intussusception over a 7-year period were reviewed to determine clinical features of the disease and response to treatment. The median age of horses with ileocecal intussusception was 1 year and ranged from 2 weeks to 19 years. There was no apparent gender or breed predisposition to this disease. An acute form of ileocecal intussusception was diagnosed in 19 horses with signs of moderate to severe abdominal pain of less than or equal to 24 hours' duration, and a chronic form was diagnosed in 7 horses with signs of intermittent, mild to moderate abdominal pain of more than 3 days' duration. Horses with chronic ileocecal intussusception had a history of weight loss or failure to gain weight, slow growth, poor appetite, low-grade pyrexia, and postprandial signs of abdominal pain. At surgery, the involved segments of intestine (intussusceptum and intussuscipiens) in chronic cases were 2 to 10 cm long, and the ileum and much of the distal portion of the jejunum were flaccid, dilated, and thick walled. In the acute cases, the length of involved intestine ranged from 6 to 457 cm. Whereas only 1 of 7 chronic intussusceptions (14%) could be reduced, 9 of 19 (47%) acute intussusceptions were reducible. Surgical treatment included resection and jejunocecostomy (6 horses), partial resection through a cecotomy and a side-to-side jejunocecostomy (2 horses), and a side-to-side ileocecostomy or jejunocecostomy without resection (12 horses, 7 of which had chronic intussusception). Six horses with acute intussusception were euthanatized before or during surgery.(ABSTRACT TRUNCATED AT 250 WORDS)     

Permanent tracheostomy in Equidae: 47 cases (1981-1986)

Between 1981 and 1986, permanent tracheostomy was performed in 46 ponies and 1 adult Quarter Horse. Tracheostomies of 19 ponies and the horse were examined in June 1986 and evaluated for vertical length of stomal orifice (mean = 25.0 +/- 4.7 mm in the ponies and 55 mm in the horse), degree of tracheal obstruction (0/20), regrowth and apposition of epidermis (3/20), and whether or not stomal airflow occurred with nasal occlusion (20/20). In addition, the animals were evaluated to determine whether dyspnea developed during exercise. Records of 27 ponies were evaluated. Six of the 27 were not dyspneic with exercise at their last routine physical examination. Twenty-one ponies had died or had been euthanatized, but only 5 of these deaths were attributed to complications associated with the respiratory tract; 3 ponies had collapsing tracheas and 2 had chronic obstructive pulmonary disease. The permanent tracheostomy technique provided a functional and cosmetic airway and was associated with a low rate of complications.     

Protozoal encephalomyelitis in horses: 82 cases (1972-1986)

Medical records of 82 horses with clinical signs of neurologic disease and histologic lesions suggestive of protozoal encephalomyelitis were reviewed. The presence of a protozoan parasite in the CNS was not influenced by prior treatment of the horse with corticosteroids. Prior treatment of horses with trimethoprim-sulfonamide alone or in combination with pyrimethamine resulted in a decreased number of horses in which a protozoan parasite was detected in the CNS at necropsy. The mean age of affected horses was 3.62 +/- 2.78 years, with male and Standardbred horses being overrepresented, compared with that of the hospital population of horses that were studied at the same time.     

Heterotopic polyodontia in horses: nine cases (1969-1986)

Nine horses with heterotopic polyodontia, examined at Purdue University since 1969, were treated surgically and had a favorable outcome. Six of the horses had received prior medical or surgical treatment, but without success. An understanding of the congenital nature of the problem contributed to an accurate diagnosis in each case. General anesthesia, aseptic technique, removal of all aberrant tissue, and wound suture for primary healing appeared to be essential for preserving ear function and obtaining an effective treatment.     

Screw fixation of accessory carpal bone fractures in racing Greyhounds: 12 cases (1981-1986)

Fractures of the accessory carpal bone in 12 racing Greyhounds were repaired by use of internal fixation with screws. All dogs had a sprain-avulsion fracture of the distal margin of the articular surface of the accessory carpal bone, where the accessorioulnar ligament inserts (type I). Two dogs had a second avulsion fracture at the proximal margin of the articular surface, where the palmar ulnocarpal ligament inserts (type II), and 2 dogs had a second fracture at the caudal end of the bone at the insertion of the accessoriometacarpal ligaments (type III). Fractures were exposed surgically, using a palmarolateral approach between the fourth and fifth accessoriometacarpal ligaments, and were repaired using 1.5-mm or 2-mm cortical screws. Eight dogs were evaluated radiographically to monitor fracture healing. Union of fractures, with bridging of the fracture gap, usually developed by 5 to 8 weeks after surgery. Follow-up evaluation after surgical repair was possible in 11 dogs; 10 (91%) returned to training or racing, and 5 (45%) of those won 1 or more races.