Transrectal ultrasonographic examination of the sacroiliac joints of the horse: Abnormal findings and lesions

Transrectal ultrasonography is a useful technique for the assessment of sacroiliac osteoarthrosis because of the ventral localisation of lesions. Comparison between the right and left side is essential. Due to the deep localisation of the sacroiliac joints, other imaging modalities have limitations for diagnosing osteoarthrosis. A grading system from 1 to 4 is suggested in order to classify the severity of lesions based on the shape of the articular margins and architecture of the ventral sacroiliac ligament. Abnormal ultrasonographic findings should be correlated with clinical manifestations.     

Clinical pathology and ultrasonographic findings from a Warmblood gelding with primary,severe, acute pancreatitis

A 24-year-old Warmblood gelding presented with a 6-hour history of recurrent colic signs of increasing severity. Upon presentation, he was mildly painful, tachycardic and tachypnoeic and had decreased borborygmi. Nasogastric intubation resulted in no net reflux and rectal palpation revealed an ascending colon impaction. Percutaneous abdominal ultrasonography revealed dilated, thickened and hypomotile loops of small intestine. Complete blood count revealed leucopenia with neutropenia and an increased packed cell volume. Serum biochemistry revealed hyperproteinaemia, hyperglycaemia, hypocalcaemia, hyperbilirubinaemia, hypercholesterolaemia and elevated liver enzymes. Despite sedation and fluid resuscitation, the gelding became severely colicky. A repeat ultrasound was performed, revealing a moderate amount of free fluid and a mass effect between the liver and right dorsal colon. Abdominocentesis yielded a yellow, turbid fluid containing free-floating white debris with an increased total protein and lactate concentration. Cytology of the fluid revealed necrotic mesothelial cells. The gelding was humanely euthanised due to poor prognosis. Necropsy revealed acute, severe pancreatitis and duodenitis. The mass effect on ultrasonography was retrospectively identified as the pancreas exhibiting a similar architecture to that seen in cases of acute pancreatitis in small animals.     

Diagnosis of lumbosacral intervertebral disc disease and protrusion in a horse using ultrasonographic evaluation and computed tomography

This case report describes the clinical presentation, diagnostic imaging modalities, treatment and post mortem evaluation of lumbosacral intervertebral disc protrusion in a mature Quarter Horse gelding 10 days after initial signs were noted. Grade 3 hindlimb ataxia, conscious proprioceptive deficits, urinary and faecal incontinence were present, which did not improve with anti‐inflammatories, antimicrobial therapy, corticosteroids, antioxidant therapy, cold‐laser therapy or electroacupuncture. Imaging modalities utilised ante mortem were computed radiography, transcutaneous and transrectal ultrasonography. Transrectal ultrasonography yielded findings highly suggestive of lumbosacral intervertebral disc protrusion and due to the lack of improvement and a poor prognosis, the horse was humanely subjected to euthanasia. Post mortem computed tomography, necropsy and histopathological evaluation confirmed lumbosacral intervertebral disc disease and protrusion into the spinal canal with subsequent impingement of the spinal nerve roots. Lumbosacral intervertebral disc protrusion as a clinical disease in the horse has not been previously described and should be included as a differential diagnosis in cases with acute hindlimb ataxia, proprioceptive deficits, and urinary and faecal incontinence.     

Observations on an outbreak of nutritional steatitis (yellow fat disease) in fitch (Mustella putorius furo)

An outbreak of nutritional steatitis in farmed fitch (Mustella putorius furo) caused by feeding high levels of dietary polyunsaturated fat was investigated. The disease affected mainly 13 to 15 week rapidly growing kits; 793 kits were affected and 183 died. The outbreak was quickly controlled by lowering the level of polyunsaturated fat in the diet and administering high doses of vitamin E. Affected animals had severe generalised steatitis characterised grossly by yellow brown granular fat, which histologically consisted of diffusely necrotic adipose tissue heavily infiltrated with macrophages and neutrophils. There were extensive deposits of PAS-positive, fluorescent lipopigment within macrophages and extracellularly throughout the inflamed fat. Affected fitch had normochromic microcytic anaemia, lowered liver iron levels, increased thrombocytes and acute inflammatory leucograms. Skeletal or cardiac myopathy was not observed grossly or histologically in any of the animals examined. The diet contained high levels of polyunsaturated fat (7.7%DM), a high proportion being docosahexaenoic and eicosapentaenoic acids which were derived from the squid component (40%) of the ration. The livers from affected fitch contained correspondingly high levels of polyunsaturated fatty acids. The diet provided 13 mg Vitamin E per fitch daily, which was clearly inadequate considering the high levels of polyunsaturated fat being fed. Liver selenium levels were extremely high as a result of the high selenium levels in the squid portion of the diet.     

European outbreaks of atypical myopathy in grazing equids (2006-2009): spatiotemporal distribution, history and clinical features

Reasons for performing study: Improved understanding of the epidemiology of atypical myopathy (AM) will help to define the environmental factors that permit or support the causal agent(s) to exert toxicity. Objectives: This European survey of AM aimed to describe spatiotemporal distribution, survival, clinical signs, circumstances in which AM develops and its different expressions between countries and over time. Methods: The spatiotemporal distribution, history and clinical features of AM cases reported to the Atypical Myopathy Alert Group from 2006 to 2009 were described. Comparisons of data from the most severely affected countries and from the large outbreaks were made with Fisher's exact and Welch's tests with Bonferroni correction. Results: Of 600 suspected cases, 354 met the diagnostic criteria for confirmed or highly probable AM. The largest outbreaks occurred during the autumns of 2006 and 2009 in Belgium, France and Germany. For the first time, donkeys, zebras and old horses were affected, and clinical signs such as gastrointestinal impaction, diarrhoea, penile prolapse, buccal ulceration and renal dysfunction were observed. Affected horses spent >6 h/day on pastures that almost always contained or were surrounded by trees. The latency period was estimated at up to 4 days. Overall survival rate was 26%. Although differences between countries in affected breeds, body condition, horse management and pasture characteristics were recognised, the common presenting clinical signs and mortality were similar between countries. Conclusions and potential relevance: This study describes new data on case details, history and clinical course of AM that is of preventive, diagnostic and therapeutic value. However, the true impact of the findings of this study on the development of or severity of AM should be tested with case–control studies.     

Caecal intussusception in the horse: Ultrasonographic findings and survival to hospital discharge of 60 cases (2009–2013)

Diagnosis of caecal intussusception can be challenging. Transabdominal ultrasound is often used as a diagnostic tool in equine colic. Differentiation between caecocaecal and caecocolic intussusception might be useful in the decision process before surgery. The aims of this study were: 1) to assess the usefulness of ultrasound for diagnosis of intussusception and differentiation between caecocaecal and caecocolic intussusception; and 2) to determine survival to hospital discharge after surgery. Therefore, a retrospective case series (2009–2013) was performed of all colic cases with caecal intussusception (n = 60) confirmed at surgery or necropsy. In all horses, the intussusception could be visualised using ultrasound at admission. Caecocolic intussusception (n = 46) was much more common than caecocaecal (n = 14) intussusception and correct ultrasonographic differentiation between both types could be made in 92% of the cases. Ten horses (out of 14) diagnosed with caecocaecal intussusception underwent surgery, of which 8/10 (80%) were discharged, one horse (10%) was subjected to euthanasia during and one (10%) after surgery. Of the 28 (out of 46) operated horses with caecocolic intussusception, 17 (61%) survived to discharge, while 7 (25%) and 4 (14%) were subjected to euthanasia during and after surgery, respectively. Of all horses that underwent surgery, in 13/38 (34%) surgical reduction was possible, while 13/38 (34%) needed partial typhlectomy and 4/38 (11%) needed colostomy because of an irreducible intussusception. Survival to discharge after successful surgery was 12/13 (92%) when only reduction was performed, 11/13 (85%) if partial typhlectomy was needed and 2/4 (50%) after colostomy and partial typhlectomy. In conclusion, abdominal ultrasound is a useful tool in the diagnosis and differentiation of caecal intussusception. Survival to hospital discharge after successful surgery is good.     

Transrectal ultrasonographic examination of the sacroiliac joints of the horse: Technique and normal images

Transrectal ultrasonography of the sacroiliac joints is routinely performed for the diagnosis of the cause of low back pain and lack of power in the hindlimbs. As a result of the localisation of these small joints, performing and interpreting ultrasonographic images requires a good anatomical knowledge. This paper describes an ultrasonographic procedure that allows imaging of the ventral aspect of the sacroiliac joints. A complete screening should be done to evaluate the articular margins. Moreover, the shape of sacral and iliac wings can vary among individuals especially depending on the gender.     

Comparison of ultrasonographic findings with clinical activity index (CIBDAI) and diagnosis in dogs with chronic enteropathies.

Intestinal wall thickness is neither a specific nor sensitive ultrasound parameter for detecting intestinal inflammation. We hypothesize that mucosal echogenicity, lymphadenomegaly, and secondary findings of the gastrointestinal tract would be more sensitive and specific markers for detecting and differentiating causes of chronic inflammatory bowel disease in dogs. Fifty-six client-owned dogs with chronic diarrhea and 10 control dogs were examined with two-dimensional, gray-scale ultrasound (time 0, 4, and 10 weeks post therapy) and small intestinal mucosal biopsies were performed at the 0- and 4-week time points. The clinical activity was assessed at each time point using the canine inflammatory bowel disease activity index (CIBDAI). Fifty-one dogs had inflammatory infiltration of the duodenal mucosa and were divided into three groups, food-responsive disease, idiopathic inflammatory bowel disease, and protein-losing enteropathy, based on their response to the different treatments and histology. Two different patterns of increased echogenicity of the mucosa were detected: hyperechoic speckles and hyperechoic striations. A normal, hypoechoic bowel mucosa in dogs with chronic diarrhea had a sensitivity of 80% and a specificity of 81% for the diagnosis of food-responsive disease. Hyperechoic striations had a sensitivity of 75% and a specificity of 96% for dogs with protein-losing enteropathy. Hyperechoic speckles were non-specific for diagnosing inflammatory bowel disease. There was a significant relationship between ultrasound score and CIBDAI at t0, but not following therapy. Mucosal echogenicity may be a better parameter for detecting inflammatory bowel disease than bowel wall thickness in dogs with chronic diarrhea.     

Clinical and ultrasonographic findings in the mammary gland of sheep

AIM: To compare clinical and ultrasonographic findings and assess the value of ultrasonography for evaluating the structure and condition of the teat and teat canal of sheep.

METHODS: The mammary glands of 30 lactating ewes were examined clinically and using ultrasonography. The distance from the teat tip to the ground was measured and diagnostic images of the body of the gland, gland cistern and teat cistern were obtained using an 8.5 MHz frequency ultrasonic transducer. A California mastitis test (CMT) and bacteriological culture were performed on milk samples collected from each half of each udder.

RESULTS: Udder parenchyma and teats were palpably normal in 27/30 (90%) ewes. Milk clots or abnormalities were evident in 4/30 (13%) udders, lesions in the glandular parenchyma and/or teats were evident by palpation in 3/30 (10%), and pathogenic bacteria were cultured from 2/30 (7%). In both of the latter cases, mastitis was diagnosed based on clotted and discoloured appearance of milk and highly positive CMT reactions. Ultrasonographic examination in these udders revealed non-homogenous regions in the glandular tissue and alternating areas of hyperechogenic and hypoechogenic tissue. Overall, highly positive CMT reactions were evident in milk from 14/30 (47%) left halves and 9/30 (30%) right halves (p=0.02). No relationship between teat-to-ground distances and CMT results was evident (p>0.05). Teat canal lengths ranged from 5.7–10.3 mm (mean=8.6; SD=1.3 mm) and the widths from 1.8–3.1 mm (mean=2.3; SD=0.4 mm). Milk sampled from ewes that had long (≥9 mm) or wide (≥2 mm) teat canals was highly positive to the CMT in 75% and 83% of cases, respectively.

CONCLUSIONS: Ultrasonographic measurements of the length and width of the teat canal appeared to correlate with CMT results. The use of ultrasonography in evaluating the health of the udder of small ruminants holds promise for the future.     

Ultrasonographic examination of the tuber calcanei area: Technique and normal ultrasonographic images

Ultrasonographic examination is an essential diagnostic tool that complements radiographic examination in the diagnostic work-up of injury to the tuber calcanei area. Using a plantar approach, the superficial digital flexor tendon, gastrocnemius tendon, the bone surfaces of the two lobes of the tuber calcanei and the gastrocnemius bursa and the calcaneal bursa of the superficial digital flexor tendon (if distended) can be accurately assessed. Using a collateral approach, the tenocalcaneal ligaments of the superficial digital flexor tendon and the branches of the calcaneal tendon of the caudal femoral muscles can be imaged. This paper describes the normal anatomy of the tuber calcanei area and presents the complete ultrasonographic procedure and normal ultrasonographic images of this region.     

Subclinical ultrasonographic abnormalities of the suspensory ligament branch of the athletic horse: A survey of 60 Thoroughbred racehorses

Reasons for performing study: Ultrasonographic (US) abnormalities of the suspensory ligament branch (SLB) have been poorly investigated but can have considerable impact on market value and career path when encountered in athletic horses. There is a need for determination of the prevalence and relationship to clinical injury of these US abnormalities in the Thoroughbred (TB) racehorse. Objectives: To establish the prevalence of, and the repeatability of an US grading system for, subclinical US abnormalities of the forelimb SLB in a population of UK TB flat racehorses. Methods: Ultrasonographic assessment of the forelimb SLBs of 60 TB racehorses free from history and clinical indication of SLB desmopathy in a single UK training yard was performed. Images were viewed independently by 2 blinded observers and graded for US abnormality. Interobserver agreement was assessed using Cohen's kappa statistic with 95% confidence intervals (95% CI). Results: Prevalence of horses with subclinical US abnormality of the forelimb SLB of moderate severity was 6.7%. Medial branches were overrepresented. Inter observer agreement was substantial for US grade (kappa = 0.743; 95% CI 0.652–0.834) and almost perfect for appearance of sesamoid bone at ligament insertion (kappa = 0.817; 95% CI 0.66–0.98). Conclusions: The study reveals that a proportion of TB racehorses in flat training free from history or clinical signs of SLB injury have US abnormalities that could negatively impact on market value and career path. Potential relevance: Clinicians should be aware that US abnormalities of the SLB may not always be related to clinical desmopathy. Further longitudinal studies are required to determine whether such findings are predictive for future injury.     

Traumatic pericarditis in cattle: clinical, radiographic and ultrasonographic findings

Pericarditis is an inflammation of the pericardium with accumulation of serous or fibrinous inflammatory products. In cattle, it is almost always attributable to a reticular foreign body that has penetrated the reticular wall, diaphragm and pericardial sac. The lead signs of pericarditis are tachycardia, muffled heart sounds, asynchronous abnormal heart sounds, distension of the jugular veins and submandibular, brisket and ventral abdominal oedema. The glutaraldehyde test is an important diagnostic tool because it is positive in >90% of affected cattle. Other common laboratory findings are leukocytosis and hyperfibrinogenaemia (indicating inflammation), and elevation of liver enzyme activity (reflecting hepatic congestion). Radiographs of the thorax and reticulum often show a foreign body cranial to the reticulum. In the majority of cases, massive fibrinopurulent adhesions obscure the cardiophrenic angle, cardiac silhouette and ventral diaphragm.Ultrasonography is the method of choice for diagnosis and characterisation of pericardial effusion. Echogenic deposits and strands of fibrin are seen on the epicardium, and the ventricles are compressed by the effusion. Severe pleural effusion is usually evident. In cattle with distension of the jugular veins and tachycardia, the differential diagnosis includes right-sided cardiac insufficiency attributable to other causes. Distension of the jugular veins without signs of right-sided cardiac insufficiency may occur with obstruction or compression of the cranial vena cava. The prognosis is poor, and pericardiocentesis or pericardiotomy are inadequate methods of treatment. Thus, prompt and humane euthanasia is indicated for cattle with traumatic reticuloperitonitis. Because a definitive diagnosis of traumatic reticuloperitonitis is not always possible based on clinical signs alone, radiography and ultrasonography of the thorax and reticulum are indicated in doubtful cases.     

Canine prostate specific esterase (CPSE) as an useful biomarker in preventive screening programme of canine prostate: CPSE threshold value assessment and its correlation with ultrasonographic prostatic abnormalities in asymptomatic dogs

Due to the increased attention that pet‐owners devote to their animals and to the improved veterinary care, investigations regarding methods to early detect prostatic disorders that might affect canine life quality have been performed. Canine prostate specific esterase (CPSE) concentration was reported to be higher in dogs suffering from prostatic diseases. This study aimed to estimate the CPSE threshold as a biomarker to early identify prostatic diseases in asymptomatic dogs. The ultrasonographic examination of the prostate was performed in 19 dogs (6–40 kg; 1–5 years) with no symptoms of prostatic diseases. Dogs were grouped according to the presence (Group A) or absence (Group B) of prostatic disorders at the ultrasound (altered appearance, the presence of cysts or irregular borders). For each dog, a venous blood sample was collected to measure serum CPSE and the ratio between calculated and normal expected prostatic volume was assessed for each dog. The CPSE data were statistically analysed (t test, p < .05), and the CPSE threshold in blood serum between groups was calculated by ROC. In 11 dogs, ultrasonography showed signs of prostatic abnormalities (Group A, 2–5 years), while no signs were detected in eight dogs (Group B, 1–3 years). The calculated/estimated volume ratio resulted greater than 1.5 in Group A dogs. The CPSE was statistically different between groups (p < .0001): higher in Group A (mean = 184.9, SD = 126 ng/ml) than in Group B (38.9 ± 22.1 ng/ml). The cut‐off CPSE threshold was 52.3 ng/ml (ROC, AUC = 0.974, SE 95.6%, SP 89.2%). This study suggests that CPSE serum concentration higher than 50 ng/ml in asymptomatic dogs is associated with ultrasonographic alterations and increased the prostatic size (volume by 1.5 times greater than the normal size). As the onset of prostatic disorders often remains asymptomatic, the rapid assessment of CPSE could be suitable for selecting preventively those animals that would require further accurate evaluation.     

Treatment of a second carpal bone fracture by removal under ultrasonographic guidance in a horse

OBJECTIVE: To report an unusual 2nd carpal bone (C2) slab fracture and its treatment, using an ultrasonographically assisted, minimally invasive arthrotomy technique, for fragment removal. STUDY DESIGN: Case report. ANIMALS: An 11-year-old crossbred Warmblood gelding. METHODS: A bone fragment, spanning the height of C2, identified on the palmaromedial aspect of C2 was demarcated intraoperatively using ultrasonographically guided needles and removed by arthrotomy. RESULTS: Fracture fragment removal was achieved using a small, ultrasonographically guided arthrotomy. The horse has become sound after treatment and returned to the previous level of pleasure riding activity. CONCLUSIONS: Perioperative ultrasonography was used to delineate and facilitate removal of an unusual slab fragment of C2, through a minimally sized arthrotomy. Despite the presence of pancarpal osteoarthritis and partial involvement of the medial collateral ligament, the prognosis appeared to be satisfactory for this pleasure riding horse. CLINICAL RELEVANCE: Ultrasonographic guidance may be used to optimize the approach to C2 articular bony fragments that may not be observed using arthroscopy.     

Dietary conjugated linoleic acids increase intramuscular fat deposition and decrease subcutaneous fat deposition in Yellow Breed × Simmental cattle

This study was conducted to estimate the effect of dietary conjugated linoleic acids (CLA) on intramuscular and subcutaneous fat deposition in Yellow Breed × Simmental cattle. The experiment was conducted for 60 days. The results showed that the average backfat thickness, (testicles + kidney + pelvic) fat percentage and subcutaneous fat percentage in dietary CLA were significantly lower than in the control group, while intramuscular the fat percentage was significantly higher. Compared to the control group, the Longissimus muscle enzyme activities of lipoprotein lipase (LPL), fatty acid synthase (FAS) and acetyl‐coenzyme A carboxylase (ACC) in dietary CLA and the subcutaneous fat enzyme activities of LPL, hormone‐sensitive lipase (HSL) and carnitine palmitoyltransferase‐1 (CPT‐1) were significantly increased. Similarly, compared to the control group, the Longissimus muscle sterol regulatory element binding protein 1 (SREBP‐1), FAS, stearoyl‐coenzyme A desaturase (SCD), ACC, peroxisome proliferator‐activated receptor γ (PPARγ), heart fatty‐acid binding protein (H‐FABP) and LPL gene expression in dietary CLA were significant increased, as were the subcutaneous fat of PPARγ, H‐FABP, LPL, CPT‐1 and HSL in dietary CLA. These results indicated that dietary CLA increases IMF deposition mainly by the up‐regulation of lipogenic gene expression, while decreasing subcutaneous fat deposition mainly by the up‐regulation of lipolytic gene expression.