Platelet transfusion in thrombocytopenic horses

Platelet transfusions might be indicated in horses with thrombocytopenia. The need for a transfusion cannot be determined by platelet numbers alone, as primary or co‐existing disease processes, platelet function and age of the recipient also need to be considered. In patients with no co‐morbidities, relevant bleeding is uncommonly observed with platelet counts >10 x 10⁹/l and a therapeutic approach with initiation of treatment when signs of bleeding are observed might be justified.     

Intravenous formalin for treatment of haemorrhage in horses

There is limited information in the literature regarding the clinical use of formalin for the treatment of haemorrhage in horses. This uncontrolled retrospective study summarises 11 cases that were treated with intravenous formalin at the Veterinary Health Center at Kansas State University from 2009 to 2019. The objective of this study was to describe signalment, clinical and laboratory findings, treatment and outcome of horses treated with intravenous formalin for potentially life-threatening haemorrhagic conditions. This study does not attempt to prove efficacy of intravenous formalin, but rather to report its clinical use and the associated details of those cases. Horses ranged in age from 2 to 23 years old. There were nine Quarter Horses, one Thoroughbred and one Appaloosa. Treated conditions included haemoabdomen (4/11), uterine haemorrhage (1/11), epistaxis (3/11), haemorrhage secondary to a mandibular laceration (2/11) and haemothorax (1/11). The most utilised dose was 0.476% formalin (50 mL 10% neutral buffered formalin diluted in 1 L of isotonic fluid). Some horses were also treated with aminocaproic acid, Yunnan Baiyao, whole blood transfusions and surgery. Ten out of the 11 horses survived to discharge with one horse reported by the owner to have died 2 weeks later of an unknown cause.     

Use of reversed periosteal flaps in the repair of large nasocutaneous fistulas in two horses

Head injuries occur frequently in horses and a successful outcome after repair depends upon the severity of the initial trauma, the anatomical structures involved and the extent of tissue loss. Often these injuries involve facial bones and enter into the nasal passages or paranasal sinus system. When these injuries occur in conjunction with substantial tissue loss, the resulting defect may be difficult to close and naso/sinocutaneous fistulae can develop. These defects can be challenging and time consuming to repair and an appropriate reconstructive technique must be selected. We describe the use of reverse periosteal flaps as a technique in repairing large nasocutaneous fistulae in 2 horses after previous attempts to close the defects by other means had failed.     

Autologous blood transfusion following an allogenic transfusion reaction in a case of acute anaemia due to intra‐abdominal bleeding

This report describes the use of an autologous transfusion to temporarily improve the oxygen carrying capacity in a case of haemoabdomen. The horse required multiple blood transfusions but use of allogenic transfusions was hindered by a severe adverse reaction. The blood previously lost into the abdomen was drained and returned to the circulation without observed adverse effects. Autologous blood transfusion is a technique which can be used alone, or in addition to, allogenic blood transfusions in selected cases of acute blood loss in horses.     

Rhinotomy to access lesions within the nasal cavity of two horses

Most lesions that affect the nasal cavity of the horse can be accessed via the nostril or via a frontonasal sinus flap but occasionally, surgical access to the mid‐portion of the nasal cavity is necessary. This case report describes the use of a centrally based, 3‐sided rhinotomy which provided good access to the ipsilateral nasal cavity and allowed for removal of abnormal tissue/foreign material in two horses. The nasal bone flap was preserved and only relatively mild intraoperative haemorrhage occurred which was controlled with nasal packing. Horses recovered well from surgery with an excellent long‐term cosmetic result.     

Use of an external fixator to correct a wry nose in a yearling

Wry nose is a rare condition. The resultant deviation of the nasal septum and maxilla/premaxilla often complicates deglutition and respiration. Traditional treatment consists of internal fixation with pins after an osteotomy and a rib graft. A 17‐month‐old Arab yearling was presented for evaluation of deviation of the maxilla and nasal septum. This deviation was managed using an external fixation device after bilateral osteotomy of the maxilla/premaxilla and reduction of the deviation. Partial resection of the nasal septum by a dorsal approach was also performed. The dental malocclusion and respiratory noise were corrected.     

Cataract phacofragmentation in horses

Cataract surgeries were carried out in fifty-one eyes of 36 horses over a 15-year period. Cataracts were removed using phacofragmentation and aspiration. Useful vision was restored after surgery in 30 horses. One year after surgery 16 of the 19 horses for which follow up information was available were still visual with several still being used as working horses. At 5-6 years after surgery three horses were still visual. The most frequent intraoperative complication was tearing of the posterior lens capsule. The most frequent postoperative problem was superficial corneal ulceration. Four eyes in three horses developed postoperative infectious endophthalmitis resulting in blindness.     

The use of computed tomography to assist orthopaedic surgery in 86 horses (2002–2010)

Imaging‐assisted orthopaedic surgery is becoming part of routine orthopaedic practice in horses and several techniques have been reported. However, there are no published reports describing the use of intraoperative computed tomography (CT) for surgical guidance and immediate post operative control in the horse. This use of CT in equine orthopaedics is currently limited because of the logistic problems associated with availability of CT scans in surgical theatres as well as concerns over radiation safety. The aim of this report was retrospectively to report CT assisted orthopaedic surgical cases in our practice through identifying the types of surgery where it was used, to list the technical problems that were encountered, to describe solutions to these, and to discuss the applications of the technique. All surgical procedures were performed with the assistance of a peripheral quantitative computed tomography (pQCT) scanner. CT assisted orthopaedic surgery in 86 patients during the study period. Reasons for CT included: 1) use of CT at the beginning of the surgical procedure to document the lesion and identify surgical landmarks (n = 75); 2) pre, intra‐ and post operative use of CT in comminuted fractures of the middle or proximal phalanx to guide and control internal fixation (n = 7); and 3) post operative use of CT to monitor the results of the surgical procedure (n = 4). Proper planning in both the draping steps and the use of polyvinyl splints to stabilise the limb allowed for movements of the gantry around the limb. The time required to obtain one slice was not dissimilar to the time that is necessary to take and process a single digital radiograph. The radiation dose with the pQCT described here is <0.5 µSv and its acquisition time should be balanced against radiation risks of conventional CT systems.     

Bee pollen product supplementation to horses in training seems to improve feed intake: A pilot study

The objective of this study was to determine the efficacy of supplementation of Dynamic Trio 50/50, a bee pollen-based product, to improve physical fitness, blood leukocyte profiles, and nutritional variables in exercised horses. Ten Arabian horses underwent a standardised exercise test (SET), then were pair-matched by sex and fitness and randomly assigned to BP (receiving 118 g of Dynamic Trio 50/50 daily) or CO (receiving 73 g of a placebo) for a period of 42 days. A total collection was conducted from days 18 to 21 on six geldings to determine nutrient retention and neutral detergent fibre (NDF) and acid detergent fibre (ADF) digestibility. Horses were exercise conditioned and completed another SET on day 42. V160 and V200 were calculated from SET heart rates (HR). Lactate, glucose, haematocrit (HT) and haemoglobin (HB) concentrations were determined from SET blood samples. Total leukocyte count, and circulating numbers of various leukocytes and IgG, IgM and IgA concentrations were determined in rest and recovery blood samples from both SETs. Geldings on BP (n = 3) ate more feed than CO. BP had less phosphorus excretion, and tended to retain more nitrogen. BP tended to digest more NDF and ADF while having lower NDF digestibility and tending to have lower ADF digestibility. No treatment differences existed for V160 and V200, HR, lactate, HT and HB. There was a trend for lymphocyte counts to be lower in BP than CO on day 42. Dynamic Trio 50/50 supplementation may have a positive effect on performance by helping horses in training meet their potentially increased nutrient demands by increasing feed intake and thus nutrient retention.     

Effect of frusemide on transvascular fluid fluxes across the lung in exercising horses

Reasons for performing study: Frusemide (Fru) is widely prescribed for management of racehorses experiencing EIPH. The effect of Fru in the lung appears to be a reduction in transcapillary pressures and inhibition of the erythrocyte anion exchange, which may lead to attenuation of transpulmonary fluid fluxes during exercise. Hypothesis: Treatment with Fru will attenuate transpulmonary fluid fluxes in horses during high intensity exercise. Methods: In a crossover study, 6 race‐fit Standardbred horses were treated with 250 mg of Fru i.v. (FruTr) or placebo (Con) 4 h before exercise on a high speed treadmill until fatigue. Arterial and central mixed venous blood, as well as CO₂ elimination and O₂ uptake, were sampled. Volume changes across the lung and transvascular fluid fluxes were calculated from changes in haemoglobin, packed cell volume, plasma protein and cardiac output (Q). Results: During exercise, Q increased in both Con and FruTr, with Q being significantly lower in FruTr (mean ± s.e. 301.8 ± 8.5 l/min at fatigue) compared to Con (336.5 ± 15.6 l/min) (P<0.01). At rest frusemide had no effect on erythrocyte (J_ER) and transvascular (J_V‐A) fluid fluxes across the lung. Exercise had a significant effect on J_ER and J_V‐A (P≤0.02). During exercise, J_ER (at fatigue 14.6 ± 2.3 l/min and 11.6 ± 2.2 l/min in Con and FruTr, respectively) and J_V‐A (at fatigue14.9 ± 2.3 l/min and 12.0 ± 2.2 l/min in Con and FruTr, respectively) were not significantly different between Con and FruTr (P = 0.6 and P = 0.8 for J_ER and J_V‐A, respectively). Conclusions and clinical importance: Fru does not have a measurable effect on J_ER and J_V‐A. Cardiac output was reduced in FruTr, suggesting that there were also smaller changes in the capillary recruitment and transvascular transmural hydrostatic pressures; however, this did not effect J_V‐A. Therefore, Fru at the dose of 250 mg does not appear to be an effective treatment for regulating pulmonary transvascular forces during exercise in horses.     

Venous aneurysm of the jugular vein in horses

Venous anomalies of the jugular vein are uncommon in the horse. Jugular venous aneurysms (congenital or pseudoaneurysm) in horses usually present as a compressible asymptomatic cervical mass enlarging on manual congestion of the jugular vein. They can be classified into primary (congenital) and acquired lesions. Primary venous aneurysms are true venous aneurysms because in these lesions the venous wall is intact, whereas false or pseudoaneurysm has a disruption of the inner layers of the venous wall. Two types of jugular vein aneurysm can be identified, fusiform or saccular, the former being the most common in people. Doppler ultrasound imaging confirms the diagnosis. Surgical treatment, aneurysmectomy with venorraphy or venoplasty is indicated in case of progressive aneurysmal expansion. This clinical commentary describes a 4-month-old foal presented with a primary aneurysm of the right jugular vein in the midcervial region. Treatment consisted of partial aneurysmectomy and venorraphy. Four years later, the horse had a patent jugular vein with a normal diameter and was trained without clinical signs of venous distension.     

The effect of three different doses of sodium pentosan polysulphate on haematological and haemostatic variables in adult horses

OBJECTIVE: To evaluate the effects of three different doses of sodium pentosan polysulphate (PPS) on haematological and haemostatic variables in adult horses. DESIGN: Eight adult standardbred horses were used. All horses received a single injection of 0, 3, 6, and 10 mg/kg of PPS at the beginning of each treatment week for 4 weeks so that by the end of the study all horses had received all four doses of PPS. Blood samples were collected at 0, 1, 2, 3, 4, 6, 8, 12, 24, 48, and 168 h after each weekly injection of PPS. Variables measured were packed cell volume, haemoglobin, red blood cell count, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, platelet count, white cell count, neutrophil count, lymphocyte count, eosinophil count, monocyte count, serum protein, fibrinogen, prothrombin time, and activated partial thromboplastin time (PTT). Data were analysed using an ANOVA. Significance was set at P < 0.05. RESULTS: There was a dose-dependent increase in PTT. A significant increase in PTT occurrred in all treatment groups when compared to horses receiving 0 mg/kg in which there was no change over time. The PTT values all returned to baseline by 48 h after treatment. The mean neutrophil count was higher 3 h after treatment when compared to time 0. Horses receiving 3 mg/kg of PPS had a higher lymphocyte count 4 h after injection, and those receiving 6 and 10 mg/kg had higher counts at 3,4,6 and 8 h after injection when compared to time 0. At 8 h after injection horses receiving 6 and 10 mg PPS had higher lymphocyte counts than horses not receiving PPS. CONCLUSIONS: PPS causes a dose-dependent prolongation of PTT in horses. At the dose rates currently recommended for treatment of joint problems in horses this increase was small and remained elevated from baseline for up to 24 h. Based on these findings doses of PPS up to 3 mg/kg should not be administered to horses within 24 h of high stress activities or where physical injury may occur.     

Intraoperative depression of the bulla of the maxillary septum as a method of improving sinus drainage without epistaxis in horses

Current methods of creating sinus drainage and allowing egress of a sinus pack at the end of surgery create significant haemorrhage. Given that haemorrhage is already a concern in some sinus surgeries, the method described allows for a significant reduction in blood loss. The objective was to describe a method of enlarging the nasomaxillary aperture in horses to allow egress of a sinus pack, and subsequent endonasal treatment, without incurring significant haemorrhage. The bulla of the maxillary septum is depressed using a gloved finger (through a sinus flap or trephine hole) or using a long curved Peine instrument under sinoscopic control before fenestration. No major operative or post-operative complications have been encountered. Satisfactory widening of the nasomaxillary aperture has been accomplished in all cases, although at times, when the bulla is under the floor of the dorsal conchal sinus, it can be difficult to compress. It is imperative that this procedure be performed before fenestration. If performed after fenestration, the most rostral edge of the fenestration can be difficult to identify, and this becomes an impediment to widening the nasomaxillary aperture. Enlarging the nasomaxillary aperture with a finger or blunt instrument allows improvements in sinus drainage without the complication of severe epistaxis. Depression of the bulla of the maxillary septum, before surgical fenestration into the rostral maxillary and ventral conchal sinuses, allows opening of the nasomaxillary aperture with minimal haemorrhage. Thereafter, the sinus pack can be egressed via this route, which is also large enough to perform sinus lavage and post-operative treatments endonasally without the risk of disturbing the external surgical site.