Suture exostosis causing obstruction of the nasolacrimal duct in three horses

CASE HISTORY Three horses were presented with facial swelling and epiphora.

CLINICAL FINDINGS: All horses had facial swellings and radiographic findings consistent with exostosis at the lacrimomaxillary suture, and ipsilateral epiphora. Positive contrast dacryocystorhinography demonstrated that the site of obstruction of the nasolacrimal duct was located where the duct traverses the lacrimomaxillary suture.

DIAGNOSIS: Lacrimomaxillary suture exostosis.

CLINICAL RELEVANCE: Lacrimomaxillary suture exostosis should be considered as a differential diagnosis in cases of epiphora in horses. Dacryocystorhinography, preferably retrograde and normograde, may be used as an aid to diagnosis.     

Use of magnetic resonance imaging identify suspensory desmitis and adhesions between exostoses of the second metacarpal bone and the suspensory ligament in four horses

Four horses were examined because of chronic forelimb lameness. In all horses, the cause of the lameness was localized to the metacarpus by means of physical examination and diagnostic anesthesia, and radiography of the affected limb revealed a small exostosis of the second metacarpal bone. Magnetic resonance imaging revealed suspensory desmitis in the region of this exostosis in all 4 horses. In addition, an abnormal area of low signal intensity, suggestive of an adhesion, was seen between the exostosis and the suspensory ligament. In all horses, an adhesion between the suspensory ligament and the exostosis on the second metacarpal bone was identified and transected at surgery, and the exostosis and distal portion of the second metacarpal bone were removed. All horses were able to return to their previous athletic use following a 6-month rest and rehabilitation program for treatment of the suspensory desmitis. Findings in these horses suggest that adhesions between the suspensory ligament and an exostosis of the second metacarpal bone may be a cause of chronic or recurrent forelimb lameness in horses.     

Urethrotomy of the glans penis in three male dogs with urolithiasis

Three intact male dogs with stranguria and haematuria caused by uroliths in the penile urethra underwent urethrotomy using a novel surgical approach directly over the caudal part of the os penis because conservative procedures to resolve the obstructions had failed. Haemorrhage was minimal, and the incisions healed rapidly by second intention. Complications did not occur during the 6‐month follow‐up period. Urethrotomy directly over the os penis is straightforward, associated with few complications and holds promise for the removal of urinary calculi in the penile urethra.     

Proximal hindlimb flexion in the horse: Effect on movement symmetry and implications for defining soundness

Reasons for performing the study: Flexion tests are a common tool during the prepurchase and clinical lameness examination, yet studies quantifying the effect of flexion, apart from distal forelimb flexion in sound horses, are sparse. Objectives: To investigate the effect of proximal hindlimb flexion on perceivable and measurable changes in movement symmetry in horses with objective movement symmetry falling within the margins of ‘sound’. Methods: Thirteen horses, selected based on objective movement symmetry, were instrumented with inertial sensors on left and right tuber coxae and over the os sacrum. Vertical movement symmetry was quantified at trot before and after proximal hindlimb flexion, with a repeat of flexion after 5 min. Video recordings of the horses were assessed visually. Results: Proximal hindlimb flexion introduced additive changes in movement symmetry to the individual baseline movement, with a tendency towards smaller effects with increasing stride number. The main systematic effect was a decrease in upward movement of the os sacrum following mid‐stance of the flexed limb and an increase in upward movement following mid‐stance of the nonflexed limb, also manifesting in a ‘hip hike’ of the flexed limb; these findings reflected increased movement asymmetry following flexion. Depending on individual baseline asymmetry, flexion can also increase movement symmetry. Conclusions: Proximal hindlimb flexion can exacerbate subtle asymmetry when performed carefully. Variation in measured symmetry following flexion within and between horses showed that the individual response to flexion is highly variable. Potential relevance: Proximal hindlimb flexion may elevate the asymmetry of a slightly lame limb above the threshold for visibility, thus assisting in the clinical gait examination. Further work is needed to examine the causes for a positive response to flexion and possible differences between sound and lame horses as well as horses of different athletic disciplines.     

Human head lice and pubic lice reveal the presence of several Acinetobacter species in Algiers,Algeria

There are two majorspecies of medically important lice that parasitize humans: Phthirus pubis, found in pubic hair, and Pediculus humanus. Pediculus humanus consists of two eco types that live in specific niches on the human host: body lice (Pediculus humanus humanus), found on the human body and clothing, and head lice (Pediculus humanus capitis), found on the scalp. To date, only body lice are known to be vectors of human disease; however, it has recently been reported that the DNA of several bacterial agents has been detected in head lice, raising questions about their role in the transmission of pathogens. This issue caught our attention, in addition to the fact that the pathogenic bacteria associated with P. pubis and P. humanus capitis have never been investigated in Algeria. To investigate this,molecular techniques (real-time PCR) were used to screen for the presence of Acinetobacter spp., Bartonella spp., Borrelia spp. and Rickettsia prowazekii DNA from P. humanus capitis (64 lice) collected from schoolchildren,and P. pubis (4 lice),collected from one adultman living in Algiers. Positive samples for Acinetobacter spp.were identified by sequencing therpoBgene. Conventional PCR targeting the partial Cytb gene was used to determine the phylogenetic clade of the collected lice. Of the 64 samples collected, Acinetobacter spp. DNA was detected in 17/64 (27%) of head lice, identified as: A. baumannii (14%), A. johnsonii (11%) and A. variabilis (2%). Of the four P. pubissamples, 2(50%) were positive for A. johnsonii. The phylogenetic tree based on the Cytb gene revealed that P. humanus capitis were grouped into clades A and B. In this study, we report andidentify for the first time Acinetobacter spp.in Algerian P. pubis and P. humanus capitis. The detection of the genus Acinetobacter in lice should not be underestimated, especially in P. humanus capitis, which is distributed worldwide. However, additional epidemiological data are required to determine if human lice may act as an environmental reservoir and are actively involved in the propagation of these bacteria to humans.     

Conservative management of cystorrhexis in four adult horses

Rupture of the urinary bladder is rare in adult horses with various standing or recumbent surgical repair techniques historically reported as the treatments of choice. This case series describes the successful conservative management of cystorrhexis in 4 adult horses. Conservative management is therefore a potentially viable treatment option which forgoes the risks of general anaesthesia and may reduce the post operative complications associated with surgery of the bladder.     

Laser treatment of urethral defects in geldings and stallions used as the primary treatment or in combination with a temporary subischial incision: Eight cases (2003–2011)

Two geldings with haematuria and 6 stallions with haemospermia presented for evaluation between 2003 and 2011 to the Iowa State University Lloyd Veterinary Medical Center. Both geldings presented for haemorrhage at the end of urination. All stallions presented for evaluation of infertility following natural service or artificial insemination that was related to haemospermia. Urethroscopy identified a urethral defect in all 8 horses. Both geldings possessed a urethral rent. One stallion possessed a urethral varicosity while the remaining 5 possessed a urethral rent. Two geldings and 2 stallions received only laser treatment. The remaining 4 stallions received concurrent laser treatment with a temporary subischial incision (TSI) into the corpus spongiosum penis. All 6 stallions received 8 weeks of sexual rest after the completion of the surgical/laser treatment. Laser treatment alone was successful in resolving haematuria in one of 2 geldings. In the stallion group, all 4 horses with a urethral rent receiving laser treatment concurrent with a TSI resolved haemospermia. Of the remaining stallions, one with a urethral varicosity resolved clinical signs with only laser treatment and one stallion with a urethral rent received only laser treatment and haemospermia recurred. We conclude that laser treatment of a urethral rent in geldings can result in resolution of haematuria. Laser treatment used in combination with a TSI may result in improved success when compared to surgery alone. Laser treatment alone can result in resolution of a urethral varicosity.     

Ultrasonographic assessment of the superficial digital flexor tendons of National Hunt racehorses in training over two racing seasons

Reasons for performing study: It is important to ascertain the prevalence of superficial digital flexor tendon (SDFT) injuries and to improve methods of predicting injury in National Hunt (NH) racehorses. Objectives: To establish: 1) the prevalence of SDFT tendinopathy in NH horses; 2) whether routine ultrasonography can be used to predict SDFT injuries; 3) whether previous tendinopathy predisposes to reinjury; 4) a normal range for the SDFT cross‐sectional area (CSA); and 5) the effects of gender, age, background (ex‐flat or exstore), limb, training and rest periods on SDFT CSA. Methods: Routine ultrasound assessment of the palmar metacarpal soft tissues of 263 NH racehorses was performed on up to 6 occasions over 2 NH racing seasons. Results: The prevalence of SDFT pathology detected using ultrasonography was 24% (n = 148), with a nonsignificant variation between yards of 10–40%. No changes in SDFT CSA or ultrasonographic appearance were detected prior to injury. Older horses had a significantly higher prevalence of SDFT pathology compared to younger horses, and horses with tendinopathy were more likely to suffer an acute injury compared to horses with no evidence of pathology. A reference range for normal CSA measurements was established as 77–139 mm² at level 4, from 142 horses with no ultrasonographic evidence of SDFT pathology. The CSA of normal horses did not vary significantly with age, limb or over 2 racing seasons, but did with sex and background. Conclusions: The study confirms that SDFT tendinopathy is common in NH horses, with substantial variation between training yards. Ultrasonography at 3 month intervals did not seem to predict acute SDFT injuries. Potential relevance: Variation in the prevalence of tendinopathy between yards suggests that training methods may influence injury rate. It was not possible to predict injury using routine ultrasonography and therefore other methods must be identified. A normal reference range for SDFT CSA is provided.     

Pathology of gastritis and gastric ulceration in the horse. Part 1: Range of lesions present in 21 mature individuals

Reasons for performing study: Gastric ulceration is now widely recognised as an important disease in high performance horses. Little is known about gastric histopathology in healthy or diseased animals; a comprehensive assessment would enhance interpretation of gross findings through assessment of their accuracy and allow for identification of lesion variety and pathogenesis in different anatomical regions of the stomach. Objectives: To investigate the true extent and variety of gastric lesions in a mixed population of mature horses at post mortem. Methods: Stomachs were removed from a mixed population of 21 horses at post mortem. Mucosal abnormalities were recorded in photographic and written form. Representative samples from all gross lesions were taken for histopathology and processed routinely. Special stains including Gram, PAS and Warthin Starry, were used when appropriate. Pathological classification of lesion type using both gross and histological appearances was performed. Results: Classification of lesions within the squamous region included hyperkeratosis, punctate scars, diffuse erosions/ulcerations and margo injuria; and within the glandular region, hyperaemia, focal erosions and ulcerations. Glandular metaplasia was recognised for the first time in the equine stomach. No Helicobacter‐like organisms were detected in association with lesion development. Conclusions and potential relevance: This study used gross and histological examination to highlight the large variety of naturally occurring gastric lesions in a mixed population of horses. Analysis of the pathogenesis of lesion development is now possible. Further research regarding the range of pathology in larger, more diverse groups of horses is required.     

Equine laminitis model: Cryotherapy reduces the severity of lesions evaluated seven days after induction with oligofructose

Reasons for performing study: A previous preliminary study demonstrated the potential of distal limb cryotherapy (DLC) for preventing laminitis. Clinically, DLC must be effective for periods longer than 48 h and the preventive effect must extend beyond its discontinuation. Objectives: To evaluate the effect of DLC, applied during the developmental phase of induced laminitis, on the severity of clinical laminitis and lamellar histopathology 7 days after dosing. Methods: Eighteen normal Standardbred horses were divided into 3 groups of 6. Continuous cryotherapy was applied for 72 h to the distal limbs of the first group. The second and third groups were administered laminitis inducing doses of oligofructose and 72 h of cryotherapy applied (immediately after dosing) to the second group. After clinical assessment all horses were subjected to euthanasia 7 days after dosing and hoof lamellar tissues were harvested and analysed. Results: In the laminitis induced horses clinical lameness and laminitis histopathology was significantly reduced in horses that underwent 72 h of DLC compared with untreated controls. Cryotherapy alone produced no significant lameness or other ill effect. Conclusions: Continuous, medium‐ to long‐term (72 h) cryotherapy applied to the distal limbs of horses safely and effectively ameliorates the clinical signs and pathology of acute laminitis. Potential relevance: Pre‐emptive distal limb cryotherapy is a practical method of ameliorating laminitis in ill horses at risk of developing the disease.     

Comparative plasma and milk dispositions,faecal excretion and efficacy of per os ivermectin and pour‐on eprinomectin in horses

The horse milk gains increasing interest as a food product for sensitive consumers, such as children with food allergies or elderly people. We investigated the plasma and milk disposition, faecal excretion and efficacy of per os ivermectin (IVM) and pour‐on eprinomectin (EPM) in horses. Ten mares were divided into two groups. The equine paste formulation of IVM and bovine pour‐on formulation of EPM were administered orally and topically at dosage of 0.2 and 0.5 mg/kg bodyweight. Blood, milk and faecal samples were analysed using high‐performance liquid chromatography. The plasma concentration and persistence of IVM were significantly greater and longer compared with those of EPM. Surprisingly, EPM displayed a much higher disposition rate into milk (AUC_milk/plasma: 0.48) than IVM (AUC_milk/plasma: 0.19). IVM exhibited significantly higher faecal excretion (AUC_faeces: 7148.54 ng·d/g) but shorter faecal persistence (MRT_faeces: 1.17 days) compared with EPM (AUC_faeces: 42.43 ng·d/g and MRT_faeces: 3.29 days). Faecal strongyle egg counts (EPG) were performed before and at weekly intervals after treatment. IVM reduced the EPG by 96–100% for up to 8 weeks, whereas the reduction in the EPM group varied from 78 to 99%. In conclusion, due to the relatively low excretion in milk, EPM and IVM may be used safely in lactating mares if their milk is used for human consumption. Nevertheless, much lower plasma and faecal availabilities of EPM could result in subtherapeutic concentrations, which may increase the risk of drug resistance in nematodes after pour‐on EPM administration compared with per os IVM.     

Evidence of the development of ‘domain‐restricted’ expertise in the recognition of asymmetric motion characteristics of hindlimb lameness in the horse

Reasons for performing study: Visual assessment of horses' movements is subjective, affected by bias and dependent on the level of experience of the assessor. However, to date there are no data available on the ability of the human visual system to recognise (a)symmetry in moving objects. Objectives: To investigate, using visual lameness assessment, the limits of human perception and the ability of experienced and nonexperienced individuals to detect asymmetry in 2 moving objects simulating hindlimb lameness in the horse. Methods: Twelve experienced individuals (equine and small animal clinicians), and 24 nonexperienced individuals (undergraduate veterinary students) were presented with computer simulations showing 2 ‘tuber coxae markers’ created using data from both lame and nonperceptibly lame horses, as well as artificial data based on a sine wave. Individuals were asked to classify as symmetrical or asymmetrical, and then rank based on the grade of perceived asymmetry. Repeatability and learning effect were evaluated by repeating the tests on a subset of subjects. Results: The threshold for detection of movement asymmetry was found to be approximately 25% difference in amplitude between the 2 moving objects for all individuals. There was no significant difference between experienced and nonexperienced individuals in the ability to detect asymmetry in the simulations based on artificial data. However, the percentage of correct answers was higher for experienced compared to nonexperienced individuals for simulations based on data from real lame horses. Conclusions: There was a significant difference between experienced and nonexperienced individuals in the ability to identify asymmetric movement based on the pattern seen in a lame horse, as opposed to an artificial pattern for which all individuals showed similar performance. Potential relevance: The study provides the basis for the development of computer simulations that could aid in training veterinarians in the diagnosis of lameness and, even, the objective assessment of expertise in this field.     

Determination of tear break-up time reference values and ocular tolerance of tetracaine hydrochloride eyedops in healthy horses

Reasons for performing study: Tetracaine hydrochloride (THCl) has been reported to cause irritation in dogs. In man, some topical anaesthetics have been shown to disrupt the tear film. Tear break‐up time (TBUT) is a useful test allowing an assessment of the quality of the precorneal tear film. Only one TBUT value has been reported in horses with no information on the technique used. Objectives: To provide a method for performing the TBUT in horses and to report any side effects of a single application of THCl in clinically normal horses, particularly on the stability of the tear film. Methods: In Study 1, one drop of 0.5 or 1% THCl was applied to one eye of 20 horses divided in 2 groups. Treated eyes were assessed for the development of side effects 2.5 and 5 min after treatment. In Study 2, the TBUT was measured in both eyes of 2 groups of 10 horses, before and 2.5 and 5 min after, instillation of one drop of either 0.5 or 1% THCl. Results: No animals developed any ocular side effect after instillation. Basal TBUT was 8.3 ± 1.3 s. TBUT decreased from baseline 5 and 2.5 min after application of one drop of 0.5% THCl and one drop of 1% THCl, respectively. Conclusions: A technique to measure the TBUT in healthy horses is described and normal range values that could be used as a reference were obtained. Potential relevance: THCl is well tolerated in horses but lowers the TBUT.     

Review of the epidemiology and infection control aspects of nosocomial Salmonella infections in hospitalised horses

Outbreaks of nosocomial Salmonella infections in hospitalised horses can occur when surveillance and infection control protocols are not in place, or not well structured and enforced. The aim of this article is to present a review of published studies that have contributed to the literature of the epidemiology and infection control aspects of nosocomial Salmonella infections in hospitalised horses. The review highlights important elements that must be taken into consideration during the formulation, implementation and evaluation of a hospital surveillance and infection control programme designed to reduce the risk of an outbreak of nosocomial Salmonella infection in hospitalised horses.     

Effect of body weight on the pharmacokinetics of flunixin meglumine in miniature horses and quarter horses

In most species, large variations in body size necessitate dose adjustments based on an allometric function of body weight. Despite the substantial disparity in body size between miniature horses and light‐breed horses, there are no studies investigating appropriate dosing of any veterinary drug in miniature horses. The purpose of this study was to determine whether miniature horses should receive a different dosage of flunixin meglumine than that used typically in light‐breed horses. A standard dose of flunixin meglumine was administered intravenously to eight horses of each breed, and three‐compartmental analysis was used to compare pharmacokinetic parameters between breed groups. The total body clearance of flunixin was 0.97 ± 0.30 mL/min/kg in miniature horses and 1.04 ± 0.27 mL/min/kg in quarter horses. There were no significant differences between miniature horses and quarter horses in total body clearance, the terminal elimination rate, area under the plasma concentration versus time curve, apparent volume of distribution at steady‐state or the volume of the central compartment for flunixin (P > 0.05). Therefore, flunixin meglumine may be administered to miniature horses at the same dosage as is used in light‐breed horses.     

The range and prevalence of pathological abnormalities associated with lameness in working horses from developing countries

Reasons for performing study: Lameness is highly prevalent in working horses, but published reports on the associated pathological abnormalities are lacking. With over 42 million horses in developing countries and the majority used for work, lameness has major welfare implications. Objectives: To describe the range and prevalence of pathological abnormalities associated with lameness in working horses. Methods: A standard lameness assessment was adapted for field use in working equids. Data on pathological abnormalities and pain responses in the feet, limbs and spine were collected through observation, palpation, manipulations and gait assessment in working horses from India (n = 110) and Pakistan (n = 117). Lameness at the walk was scored on a scale of 0–4 (sound‐nonweightbearing). Results: All horses examined were lame. Overall, 98% showed a gait abnormality in all 4 limbs and 87% had at least one limb scoring 3 or 4 on the lameness scale. Multiple pathological abnormalities within each limb were associated with lameness, with similar results in both countries. Chronic foot pathology was seen in every horse; 94% horses showed signs of chronic joint disease; 83% had digital flexor tendonitis in at least one limb. Lameness and pathological abnormalities were associated with specific pain responses in the feet, limbs and spine. Conclusions: The extremely high prevalence of multilimb lameness and its association with pain is of great concern. The multiple pathological abnormalities present in working horses makes lameness complex to address. Potential relevance: The results of this detailed study of lameness should facilitate the identification of risk factors and the implementation of interventions to reduce the prevalence of lameness in working equids.     

Solitary osteochondroma of the radius in three horses

Osteochondroma of the distal portion of the radius was diagnosed in 3 horses with a history of lameness and distention of the common tendon sheath of the superficial and deep digital flexor tendons at the level of the carpal canal. In 2 horses, the exostosis was removed through an incision at the caudal border of the lateral digital extensor muscle above the carpal ligament.     

Studies on the Parietal Region of the Cervid Skull III. On the Occurrence of an Interparietal in Cervus

The occurrence of an os interparietale was studied in two transparent preparations of fetal red deer (Cervus elaphus) heads and in 14 dried skulls of fetal to early postnatal individuals from four Cervus species (C. elaphus, C. nippon, C. duvauceli and C. eldi). In 14 of the 16 specimens, an interparietal was present as either a paired or single bone. In only a neonate red deer and a 5-week-old sika deer this skull element was missing. We therefore conclude that an os interparietale, developing from paired centres of ossification, is normally present in Cervus species. This clearly distinguishes them from the fallow deer, where an interparietal is missing (Kierdorf and Kierdorf, 1992b). Our findings thus support the view that the fallow deer should be considered a distinct genus Dama instead of being included within Cervus.     

Aortic rupture and aorto‐pulmonary fistulation in the Friesian horse: Characterisation of the clinical and gross post mortem findings in 24 cases

Reasons for performing study: In horses, aortic sinus of Valsalva aneurysms or tears in the aortic root are well‐recognised conditions in breeding stallions, often leading to sudden death. A more uncommon form of aortic rupture, located proximal to the ligamentum arteriosum has been reported in 3 Friesian horses. Objectives: The purpose of this study was to phenotypically characterise aortic rupture and aorto‐pulmonary fistulation in Friesian horses in terms of clinical and post mortem data based on 24 cases. Methods: Friesian horses that were diagnosed with aortic rupture and aorto‐pulmonary fistulation over a period of 13 years (1997–2010) at the Department of Equine Sciences of Utrecht University (n = 15) and Wolvega Equine Hospital (n = 9), were included in this study. Case history, results of clinical examination and gross post mortem findings were screened and analysed. Results: Some cases were found dead without prior symptoms, but in several cases signs such as recurrent colic, peripheral oedema and sustained tachycardia were present for several weeks prior to cardiac failure. Clinical examination during hospitalisation revealed increased rectal temperature, peripheral oedema and increased jugular pulse with a bounding arterial pulse. In the majority of horses an aortic rupture of the aortic arch near the ligamentum arteriosum, concurrent with a circumferential cuff of perivascular haemorrhage and aorto‐pulmonary fistulation, was found at post mortem examination. Conclusions: Aorto‐pulmonary fistulation in conjunction with aortic rupture is more common in Friesians than previously estimated. In some cases findings demonstrate a progressive pathology rather than acute cardiac failure and sudden death. An appropriate approach is necessary during post mortem examination of the heart in order not to overlook the diagnosis. Potential relevance: Equine practitioners should realise that in Friesian horses presented with a history of recurrent false colic, coughing, sustained tachycardia and/or peripheral oedema, aortic rupture and aorto‐pulmonary fistulation should be included in the differential diagnosis.     

Nuclear scintigraphic assessment of the thoracolumbar synovial intervertebral articulations

Reasons for performing study: The results of nuclear scintigraphic examination of the thoracolumbar synovial intervertebral articulations (facet joints) have to date been poorly documented. Objectives: To establish an objective scintigraphic grading system for the facet joints; to investigate the relationship between the presence or absence of clinical signs of back pain and increased radiopharmaceutical uptake (IRU); and to compare the results of scintigraphy and radiography. Methods: Nuclear scintigraphic images of the 13th thoracic (T13) to first lumbar (L1) vertebrae were graded subjectively (visual assessment of the image) and objectively (using region of interest analysis) from 31 clinically normal horses in full work (Group N) and 65 horses with clinical evidence of thoracolumbar region pain and osteoarthritis of ≥1 facet joint (Group B). Sensitivity and specificity of IRU for detection of back pain and radiographic abnormalities were assessed. A Spearman correlation was performed to test for an association between the grade of IRU and the classification of radiographic abnormality. Results: The objective scintigraphic grades were matched by 96.7% of subjective grades. IRU was seen more commonly in Group B (61.5%) than in Group N (25.8%), and moderate or intense IRU was only seen in Group B. The strongest association between radiographic abnormalities and scintigraphy was seen in horses with intense IRU. Conclusions: Moderate or intense IRU in a facet joint is more likely to be seen in horses with back pain than in clinically normal horses. Potential relevance: Nuclear scintigraphy is a potentially useful tool in the evaluation of a horse with thoracolumbar region pain.