Incomplete palmar fracture of the proximal extremity of the third metacarpal bone in horses: ten cases (1981-1986)

In 4 adult horses, simple, nondisplaced, incomplete fracture of the proximal extremity of the third metacarpal bone (MC3) was identified radiographically only on the dorsopalmar projection. Lameness was slight to moderate. Although nerve blocks of the foot and fetlock did not alter the lameness, high palmar regional nerve block improved the gait in 1 of the 2 horses on which it was performed. Pain on palpation or swollen distal accessory (inferior check) ligament, flexor tendons, and suspensory ligament were not found in any horse. The fracture was localized to the palmar surface of the proximal extremity of the MC3 on the basis of the intense uptake of radiopharmaceutical (99MTc-labeled sodium medronate) observed in that area during the soft tissue and delayed bone phases of a nuclear scintigraphic examination (nuclear scan) performed concurrently with radiography. Of 4 horses evaluated 6 months after the initial diagnosis, 3 had medullary sclerosis without radiographic evidence of fracture; results of follow-up nuclear scintigraphy performed in one of these horses at the same time were normal. Incomplete fracture also was suspected in another 6 adult horses with clinical lameness referable to the proximal extremity of the MC3. Although a fracture line could not be seen radiographically, trabecular hypertrophy and/or medullary sclerosis of the proximal extremity of the MC3 were detected on the dorsopalmar projection. Further, during nuclear scintigraphy, an intense uptake of the radiopharmaceutical was observed on the palmar aspect of the proximal extremity of the MC3 in all 6 horses.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effect of third carpal slab fracture and repair on racing performance in Thoroughbred horses: 31 cases (1977-1984)

Between 1977 and 1984, 31 Thoroughbred horses (mean age, 2.8 years) were surgically treated for slab fractures of the third carpal bone. All fractures involved the articular surfaces of the intercarpal and the carpometacarpal joints in a frontal plane and had a cuboidal or slab shape. In 20 of the horses, the bone was fractured during racing and in 8 of the horses, the bone was fractured during race training. The right limb was affected more frequently than was the left limb (24 vs 7, P less than 0.05). Twenty-one (67.6%) horses raced at least once after recovery from the surgery. Data were available from 11 claiming horses that had raced at least twice before their injuries and 4 times after recovery. A claiming horse is one that competes where any horse entered is subject to being purchased for the designated amount of the claiming race; therefore, each race tends to automatically attract entrants of similar ability. In this group of 11 horses, claiming value decreased from a mean of $13,900 to a mean of $6,500 (P less than 0.05), and the mean finish position was 5.8 +/- 3.16 before injury and 5.8 +/- 3.30 after recovery. The mean claiming value for horses that had not raced before injury, but had raced after recovery (n = 5) was $8,150.     

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.     

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.     

Surgical treatment of dorsal cortical fractures of the third metacarpal bone in thoroughbred racehorses: 53 cases (1985-1989).

Between January 1985 and May 1989, 53 Thoroughbred horses (mean age 3.2 years) were surgically treated for dorsal cortical fractures of the third metacarpal bone (MC III). All horses were treated with cortical drilling through the fracture line (osteostixis). Diagnosis of the fractures was confirmed by xeroradiography. Lifetime racing records were obtained for all horses. Forty-seven horses returned to racing after surgery (89%). The mean time between surgery and the first race was 6.8 months. Horses had a mean of 10.9 starts before surgery and 16.1 starts after surgery. The mean earnings per start before surgery was $6,459 and after surgery was $5,685. Of the 47 horses that raced after surgery, 70% raced at the same class or improved. Complications related to surgery were seen in 10 horses. Two horses had a second fracture of MC III at the same site, and were again treated by osteostixis, after which both horses returned to competition. Fractured drill bits were left in the MC III of 4 horses. One of these horses had catastrophic failure of MC III. Two horses developed subcutaneous infections and 2 horses had catastrophic failure of MC III in the surgically treated limb. Osteostixis appears to be an effective treatment for returning horses affected with dorsal cortical fractures to racing.     

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.     

Standing repair of an articular dorsal medial oblique fracture of the proximal third metacarpal bone in a racing Standardbred

The third metacarpal bone (McIII) is a common site of long bone fractures in racehorses. However, articular fractures of the dorsomedial aspect of McIII are a rare location of such injuries. This report describes the successful standing surgical repair of an articular fracture of the dorso-medial proximal McIII in a 4-year-old Standardbred racing mare using lag screw fixation.     

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.     

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.     

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.     

Pancreatic abscess in dogs: six cases (1978-1986)

Pancreatic abscess was diagnosed by exploratory celiotomy in 6 dogs. The most common clinical signs included acute onset of lethargy (n = 5), anorexia (n = 6), vomiting (n = 5), and diarrhea (n = 2). Physical examination revealed pain response to abdominal palpation (n = 5), depression (n = 5), icterus (n = 3), fever (n = 3), and cranial abdominal mass (n = 2). Consistent preoperative clinicopathologic abnormalities included leukocytosis with left shift, observance of toxic neutrophils on the blood smear, hyperlipasemia, hyperamylasemia, hyperbilirubinemia, and increased serum alkaline phosphatase activity. In 5 of 6 dogs, abdominal radiography revealed increased soft tissue density in the cranial portion of the abdomen. Ultrasonography performed on 4 dogs confirmed pancreatic mass. In all dogs, exploratory celiotomy revealed a cavitary pancreatic mass that contained sterile, mucopurulent material. Histopathologic diagnoses included acute necrotizing or chronic-active pancreatitis and steatitis. Two dogs were euthanatized at the time of diagnosis, and the remaining 4 were treated by use of pancreatic debridement(s), open abdominal drainage, and intensive administration of fluids and antibiotics. One dog was euthanatized 4 days after surgery, because of progressive pancreatic abscessation. Three dogs recovered and were discharged.     

Results of bone scintigraphy in racing standardbred horses: 64 cases (1992-1994).

OBJECTIVE: To document anatomic patterns of scintigraphic uptake and related orthopedic disease associated with racing activity in Standardbred horses. DESIGN: Retrospective study. ANIMALS: 64 Standardbred horses evaluated for lameness. PROCEDURE: Medical records at the time of discharge were reviewed, and information regarding signalment; history; results of lameness examination, scintigraphy, and radiography; diagnosis; and treatment were obtained. RESULTS: 274 areas of increased radiopharmaceutical uptake were identified. Scintigrams of 218 limbs (106 forelimbs, 112 hind limbs) were available for review. Seventy-three (33%) scintigrams had increased radiopharmaceutical uptake associated with the proximal sesamoids, 46 of 106 (43%) fore-limb scintigrams had increased uptake associated with the third carpal bone, and 33 of 112 (33%) hind limb scintigrams had radiopharmaceutical uptake associated with the small tarsal bones. Forty-three of 218 (20%) scintigrams had increased uptake associated with the distal aspect of the third metacarpal and metatarsal bones. Abnormal scintigraphic uptake was bilateral in 91 of 139 (65%) forelimb locations and 99 of 134 (74%) hind limb locations with increased radiopharmaceutical uptake. The primary scintigraphically identified classifications of disease were exercise-induced bone remodeling, synovitis or arthritis, and soft-tissue avulsion from bone (66, 17, and 6% of areas with increased radiopharmaceutical uptake, respectively). Of 274 areas with increased radiopharmaceutical uptake, 244 (89%) were believed to be clinically important. CONCLUSIONS AND CLINICAL RELEVANCE: Distinctive patterns of increased radiopharmaceutical uptake were identified that suggested Standardbred horses used for racing may have a predilection to develop orthopedic disease at specific sites that are distinct from those in Thoroughbreds used for racing and horses used for jumping activities.     

Fistulous withers in horses: 14 cases (1978-1987)

Over an 8-year period, 14 horses were admitted to the New York State College of Veterinary Medicine for evaluation of fistulous withers. Of the 14 horses, 11 were treated surgically and 3 were not treated. Surgical techniques involved radical excision of the affected soft tissue and spinous processes of affected vertebrae. Recurrence rate was 30%, and these horses required additional surgery to resolve the problem.     

Cutaneous vasculitis in horses: 19 cases (1978-1985)

The medical records of 19 horses with cutaneous vasculitis were reviewed. Most (73.7%) affected horses were between 3 and 10 years old, and there were significantly more mares (14) than stallions or geldings (5) (P less than 0.01). Subcutaneous edema of the limbs, body, and/or head was the predominant clinical sign (18/19 horses; 94.7%). The single most prevalent laboratory abnormality was neutrophilia (greater than 7,000 neutrophils/microliter), which was detected in 10 horses (52.6%). Leukocytoclastic vasculitis was evident in skin biopsy specimens from 12 of 14 horses (85.7%). All horses were treated with corticosteroids and supportive care, and the overall survival rate was 63.1% (12/19). The mean duration of treatment with corticosteroids in surviving horses was 14 (+/- 5.3) days. Of the 7 horses that died, 5 failed to respond to treatment (4 were euthanatized, 1 died), and 2 others had persistent debilitating sequelae (euthanatized). The only significant clinical or laboratory abnormality predictive of poor prognosis was fever (odds ratio, 17.81; P less than 0.05). Seven horses had history of, or were exposed to horses with, abscessed peripheral lymph nodes and likely were suffering from equine purpura hemorrhagica. In spite of histopathologic evidence of hypersensitivity-vasculitis and/or the clinical suspicion that the cause for vasculitis was immune mediated, 7 of 19 horses (36.8%) had no history of bacterial or viral infection nor a history of current drug administration.     

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.