Suspected swainsonine poisoning in a Belgian horse

The case of a horse with acute symptoms of excitement, exaggerated fright reactions and trembling is presented. In addition to these cerebral symptoms, mild cerebellar ataxia and a renal tubular lesion were diagnosed. Suspected swainsonine poisoning was confirmed by the presence of the toxin (154 ng/ml) in the serum sample taken immediately after admission. A good recovery was seen after fluid therapy with supplementation of potassium, a dopamine drip and administration of diazepam. The effects of the toxin, by inhibiting the lysosomal enzyme α‐mannosidase and mimicking the genetic mannosidosis, are discussed.     

Primary ossifying fibroma of the proximal phalanx in a horse

A primary ossifying fibroma was found at necropsy in a 5-year-old Welsh pony cross mare that was humanely subjected to euthanasia for an intractable severe left hindlimb lameness. Antemortem radiographs of the left hind pastern were characterised by articular, subchondral and cortical areas of lysis. Primary ossifying fibroma is a rare lesion of the distal limb but should be considered when there is extensive lysis extending into the medulla and proximal cortical bone.     

Congenital unilateral facial nerve paralysis in a Warmblood filly

A 17-month-old Warmblood filly was referred to our clinic for evaluation of congenital facial nerve (FN) paralysis. Clinical examination revealed a right-sided facial paralysis with mild masticatory muscle atrophy, mild dysphagia and exposure keratitis. Apart from the FN deficits, neurological examination of the remaining cranial nerves showed no abnormalities. Magnetic resonance imaging (MRI) examination using a 3.0 Tesla scanner showed that in comparison to the left FN, the intracranial section of the right FN between the pons and internal acoustic canal was thinner, whereas it appeared indistinct and thickened within the internal acoustic canal and facial canal. Signs of meningitis or encephalitis were not present on MRI. Cerebrospinal fluid analysis showed mild pleocytosis. The owner of the filly requested euthanasia due to the guarded prognosis. At necropsy, the intracranial section of the right FN was macroscopically thinner than the left side and within the facial canal, a 5 mm tissue stump could be identified with an absent extracranial part of the right FN. Histological examination of the brain stem showed different architecture of the left and right motor nuclei of the FN: in the left nucleus, motor neurons of a normal size and well stainable Nissl bodies were present, whereas in the right nucleus, neurons with Nissl bodies were decreased in number and size. Further, a cytoplasmic rich cell population with a nucleus size compatible with normal neurons was present. These cells were suspected to be atrophic neurons. The tissue stump within the facial canal was histologically identified as connective tissue. Unilateral malformation of the FN has not previously been described in the horse. This filly showed a right-sided, intracranial hypoplasia accompanied by an extracranial aplasia of the FN causing complete, congenital facial nerve paralysis, which corresponded to a difference in the architecture of the affected motor nucleus of the FN.     

Surgical repair of fractures of the lateral and medial tibial malleoli in a yearling Arabian filly

A yearling Arabian filly presented with a history of acute hindlimb lameness, marked tarsocrural effusion and associated soft tissue swelling and was diagnosed with fractures of both the lateral and medial malleoli of the distal aspect of the tibia. The fractures were repaired using a combination of cortical bone screws placed in lag fashion and a tension band wire. A full limb cast bandage was placed for recovery from general anaesthesia and the early post operative period. Despite radiographic development of osteoarthritis, 21 months after surgery the filly was clinically sound and racing successfully.     

Genetic parameters for chronic progressive lymphedema in Belgian Draught Horses

Genetic parameters for chronic progressive lymphedema (CPL)‐associated traits in Belgian Draught Horses were estimated, using a multitrait animal model. Clinical scores of CPL in the four limbs/horse (CPL_clin), skinfold thickness and hair samples (hair diameter) were studied. Due to CPL_clin uncertainty in younger horses (progressive CPL character), a restricted data set (D_3+) was formed, excluding records from horses under 3 years from the complete data set (D_full). Age, gender, coat colour and limb hair pigmentation were included as fixed, permanent environment and date of recording as random effects. Higher CPL_clin certainty (D_3+) increased heritability coefficients of, and genetic correlations between traits, with CPL_clin heritabilities (SE) for the respective data sets: 0.11 (0.06) and 0.26 (0.05). A large proportion of the CPL_clin variance was attributed to the permanent environmental effect in D_full, but less in D_3+. Date of recording explained a proportion of variance from 0.09 ± 0.03 to 0.61 ± 0.08. Additive genetic correlations between CPL_clin and both skinfold thickness and hair diameter showed the latter two traits cannot be used as a direct diagnostic aid for CPL. Due to the relatively low heritability of CPL_clin, selection should focus on estimated breeding values (from repeated clinical examinations) to reduce CPL occurrence in the Belgian Draught Horse.     

Surgical reconstruction of a severely comminuted mandibular fracture in a horse

A Palomino gelding presented for evaluation of a mandibular fracture and physical examination revealed swelling and excoriation of the skin over the ventral mandible. Upon further examination, malalignment of the incisors was appreciated in addition to instability and crepitance of both the rostral aspect and vertical ramus of the mandible. Radiographic examination revealed a comminuted fracture within the interdental space and fractures of both vertical ramii of the mandible. Under general anaesthesia via tracheotomy intubation, the fractures of the vertical ramii were reduced and compression plating techniques used along the caudal‐lateral border of both ramii for stabilisation. Intraoral tension band wires were used for repair of the interdental space fracture. A type II external skeletal fixator using Steinmann pins and polymethyl methacrylate connecting bars was applied to increase stability. The horse was maintained on broad spectrum antibiotics and phenylbutazone and discharged following 6 days of hospitalisation. Radiographs were taken 10 weeks after surgery and revealed evidence of adequate healing. On follow‐up 20 months later, the horse was reported to have no difficulties eating and was maintaining its bodyweight. This case is unique due to the severity of the mandibular fracture. The authors are unaware of any previous reports of such a severely comminuted mandibular fracture and its successful reconstruction employing multiple surgical techniques.     

Advanced imaging of an incomplete fracture and exostosis of the third metacarpal bone in a young Warmblood horse

A 5-year-old Hanoverian gelding with acute moderate right forelimb lameness underwent nuclear scintigraphy, which identified marked increase in radiopharmaceutical uptake of the proximomedial aspect of the right metacarpus. Ultrasonography and radiography identified sclerosis and exostosis of the proximomedial aspect of the metacarpal bone III in-between the suspensory ligament and the second metacarpal bone, and presence of a suspected fracture. The owner requested euthanasia of the gelding, and post-mortem computed tomography and magnetic resonance imaging identified marked bone sclerosis and thickening of the palmar cortex of the metacarpal III (McIII), presence of an incomplete fracture in the palmar cortex of McIII and expansive exostosis from McIII extending in a palmar direction between the suspensory ligament and the second metacarpal bone. Histopathological examination confirmed the imaging findings of sclerosis and led to final diagnosis of a fracture of the palmar cortex of the McIII associated with an exostosis encroaching the medial aspect of the suspensory ligament. No abnormalities were present in the suspensory ligament or metacarpal bone II (McII).     

Presumed primary ocular lymphangiosarcoma with metastasis in a miniature horse

A 7‐year‐old, 153.0‐kg American Miniature mare presented for evaluation of keratoconjunctivitis of the right eye (OD). A superior palpebral conjunctival mass and stromal keratitis were diagnosed. The incisional biopsy diagnosis was a presumptive corneal hemangiosarcoma. Transpalpebral enucleation was performed, and histopathologic evaluation confirmed angiosarcoma of the conjunctiva, cornea, and extraocular muscles. The horse developed progressive epistaxis and orbital swelling following surgery. A systemic workup was performed 3 months after enucleation, revealing regrowth within the orbit and marked cranial cervical lymphomegaly, suggestive of metastasis. Humane euthanasia was performed, and necropsy confirmed a locally invasive periorbital tumor with metastasis to the submandibular tissue, submandibular lymph node, and thoracic inlet. Histopathologic evaluation of necropsy specimens revealed polygonal to spindle neoplastic cells lining neoplastic vascular channels lacking erythrocytes. Immunohistochemically, the neoplastic cells labeled strongly positive for PROX‐1, vimentin, CD‐31, VEGF, weakly positive for factor VIII‐related antigen, and negative for collagen IV. Based on the clinical, histological, and immunohistochemical features of this tumor, a primary ocular lymphangiosarcoma with metastasis was diagnosed.     

Gait abnormalities and ridden horse behaviour in a convenience sample of the United Kingdom ridden sports horse and leisure horse population

The objectives of this study were to compare horses’ gaits in hand and when ridden; to assess static and dynamic saddle fit for each horse and rider; to apply the Ridden Horse Pain Ethogram (RHpE) and relate the findings to gait abnormalities consistent with musculoskeletal pain, rider position and balance and saddle fit; and to document noseband use and its relationship with mouth opening during ridden exercise. Data were acquired prospectively from a convenience sample of horses believed by their owners to be working comfortably. All assessments were subjective. Gait in hand and when ridden were evaluated independently, by two assessors, and compared using McNemar’s test. Static tack fit and noseband type were recorded. Movement of the saddle during ridden exercise, rider position, balance and size relative to the saddle was documented. RHpE scores were based on assessment of video recordings. Multivariable Poisson regression analysis was used to determine factors which influenced the RHpE scores. Of 148 horses, 28.4% were lame in hand, whereas 62.2% were lame ridden (P<0.001). Sixty per cent of horses showed gait abnormalities in canter. The median RHpE score was 8/24 (interquartile range 5, 9; range 0, 15). There was a positive association between lameness and the RHpE score (P<0.001). Riding School horses had higher RHpE scores compared with General Purpose horses (P = 0.001). Saddles with tight tree points (P = 0.001) and riders seated at the back of the saddle rather than the middle (P = 0.001) were associated with higher RHpE scores. Horses wearing crank cavesson compared with cavesson nosebands had higher RHpE scores (P = 0.006). There was no difference in mouth opening, as defined by the RHpE, in horses with a noseband with the potential to restrict mouth opening, compared with a correctly fitted cavesson noseband, or no noseband. It was concluded that lameness or gait abnormalities in canter may be missed unless horses are assessed ridden.     

T cell rich,B cell lymphoma in the small colon of a yearling horse

A one‐year‐old, Thoroughbred colt presented for evaluation due to a one month history of fever of unknown origin and progressive weight loss. On initial presentation, the horse was febrile and showed signs localised to the respiratory tract. These included bilaterally increased bronchovesicular sounds and a moderate, diffuse interstitial pattern on thoracic radiographs. A transtracheal wash yielded mucopurulent debris, culture of which grew small numbers of Staphylococcus epidermidis and Aspergillus spp. The horse was discharged with a diagnosis of bronchointerstitial pneumonia and placed on antibiotic therapy. Ten days after initial presentation, he developed abdominal pain that was unresponsive to on‐farm treatment. The horse was febrile, displayed increased respiratory rate and effort, and showed moderate signs of abdominal pain. On rectal examination, a firm, 8–10 cm mass was palpated on midline. The colt was admitted to the hospital and scheduled for exploratory laparotomy, but died a short time later before surgery could be performed. This report describes the clinical, diagnostic and histopathological findings of a case of alimentary lymphoma in a yearling colt.     

Management of rostral mandibular fractures in the young horse

Rostral mandibular fractures in the young horse can, in the majority of cases, be managed satisfactorily in the field. A technique for the field assessment and repair of such injuries is described here.     

Severe hindlimb lameness and pathological femur fracture in a horse secondary to haemangiosarcoma

An 18‐year‐old Warmblood stallion was presented for an acute onset nonweightbearing right hindlimb lameness following a mild lameness of 2 weeks' duration. Severe swelling was present in the right femoral area. Despite extensive diagnostic procedures, no definitive diagnosis could be made. Packed red cell volume was persistently low. The horse improved with supportive treatment and was discharged at the owner's request. The horse presented 4 days later for bleeding from a previously made incision on the lateral femoral area. Due to deterioration of his condition, the stallion was subjected to euthanasia. Diagnosis of disseminated haemangiosarcoma, affecting primarily the hindlimb musculature and leading to pathological fracture of the femur was made at necropsy and subsequent histopathology.     

Congenital odontogenic keratocyst in a filly

This report describes a congenital odontogenic keratocyst in the left mandible of a filly. A definitive diagnosis was only made after histopathological examination. Mandibular cysts of odontogenic and osteogenic origin have been reported in the past but a case of a keratocyst has not been previously reported in the horse.     

Urinothorax in a Quarter Horse filly

An 18 h old Quarter Horse filly, while being treated for diarrhoea, was evaluated for a distended abdomen and electrolyte abnormalities. Peritoneal and pleural fluid was detected by ultrasound and a presumptive diagnosis of a ruptured bladder was made. Intravenous fluid therapy was instituted to correct the electrolyte abnormalities prior to surgical repair of the bladder tear. Anaesthetic complications included hypoxaemia and decreased compliance secondary to the pleural effusion; therefore, a thoracocentesis was performed. Analysis of the pleural fluid revealed a pleural fluid to serum creatinine ratio of >1.0, indicative of urinothorax. The filly recovered from anaesthesia and was discharged on systemic antimicrobials. Urinothorax should be considered in cases of uroperitoneum with concurrent pleural effusion. Early detection may decrease patient morbidity and anaesthetic complications.     

Multiple skeletal metastases from a penile squamous cell carcinoma in a horse

A 21‐year‐old gelding with ventral abdominal and preputial oedema was evaluated for right hindlimb lameness. Partial phallectomy had been performed 3 years prior for treatment of squamous cell carcinoma. Regional analgesia did not localise the source of lameness and nuclear scintigraphy was recommended. The results of the scan revealed severe increased radiopharmaceutical uptake in the proximal femur. Radiographic and ultrasound examinations were inconclusive. The horse was discharged with recommendations of stall confinement and a 2 week course of nonsteroidal anti‐inflammatory drugs. Four weeks later the horse presented for an inability to elevate his neck and persistent hindlimb lameness. The owner elected humane euthanasia. Post mortem examination revealed metastatic squamous cell carcinoma in the proximal femur and fifth cervical vertebrae consistent with metastasis from the penile squamous cell carcinoma. To the authors’ knowledge, multiple site bone metastasis of squamous cell carcinoma has not been reported previously in the horse.     

Traumatic neuroma of the medial palmar nerve as a possible cause of a severe gait abnormality in a Warmblood riding horse

This paper describes the history, examination and clinical findings in a riding horse with a gait abnormality. The lesion was localised to the carpal area of one of the forelimbs, but could not be properly characterised until post mortem examination, when a diagnosis of a traumatic neuroma of the medial palmar nerve could be reached. Thus, the most plausible explanation for the gait abnormality of the horse was found in the peripheral nervous system.     

Diagnosis and treatment of carpometacarpal desmopathy in a horse

A 9‐year‐old Warmblood gelding underwent magnetic resonance (MR) imaging of the carpal and proximal metacarpal regions for evaluation of prolonged right forelimb lameness. Magnetic resonance findings were indicative of desmopathy of the right lateral carpometacarpal ligament and the interosseous ligament between the third and fourth metacarpal bones. Based on the MR findings and lack of response to conservative therapy, surgery using a drilling technique was performed to facilitate fusion of the right carpometacarpal joint. After surgery and a 6‐month rest and rehabilitation programme, the horse returned to soundness. This case report describes a unique combination of lateral carpal/proximal metacarpal soft tissue injuries that resulted in prolonged lameness and were treated with facilitated arthrodesis of the carpometacarpal joint. These soft tissue injuries should be considered as a differential diagnosis in horses with lameness localised to the proximal metacarpal/distal carpal region.