Uterine prolapse in a mare leading to metritis,systemic inflammatory response syndrome,septic shock and death

This Case Report describes severe complications associated with uterine prolapse in a mare. A 6‐year‐old Trakehner mare was examined for depression, moderate pain and vaginal discharge 3 days after correction of a uterine prolapse. The clinical examination and haematology revealed that the mare had an infection with systemic inflammatory response syndrome and shock. Due to the uncontrollable, persistent pain, an exploratory celiotomy was performed which revealed severe metritis. During anaesthesia, the mare developed severe cardiovascular compromise and died in recovery. In previously reported cases of uterine prolapse in the mare, the authors warn of uterine injury, broad ligament haemorrhage, metritis, endotoxaemia and laminitis but often have a successful outcome with conventional therapy. This case describes a mare that developed severe complications and death after uterine prolapse. Mares with uterine prolapse require appropriate treatment and vigilant monitoring post treatment to prevent life threatening complications.     

Leiomyoma of the uterus of a mare

A mare was presented for diagnosis and treatment of infertility of three seasons duration. Examination revealed a uterine tumor. The tumor was removed surgically and diagnosed histopathologically as a leiomyoma. The mare conceived and successfully foaled after the surgery.     

Ovarian teratoma and endometritis in a mare

An 8-year-old Arabian mare was admitted for a large ovarian anovulatory follicle. A clinical diagnosis of ovarian tumor and endometritis was established. Histological examinations revealed an ovarian teratoma and a grade II endometritis. Three months after unilateral ovariectomy, the mare was confirmed pregnant and eventually gave birth uneventfully.     

Small intestinal adenocarcinoma in a horse

A 21-year-old mare was evaluated for intermittent episodes of apparent abdominal pain of 6 month's duration. Abdominal palpation per rectum revealed distended small intestine in the caudal portion of the abdomen. Ventral midline celiotomy revealed a mass in the midjejunal region. The mass was resected, and a side-to-side anastomosis performed. The histologic diagnosis was tubular adenocarcinoma of the small intestine. The mare was still alive 13 months after surgery.     

Ileocecocolic intussusception as a sequel to jejunocecostomy in a mare

An excessively long ileal stump, the result of a previous jejunocecostomy, had intussuscepted into the cecum and subsequently obstructed the cecocolic orifice of a 12-year-old Quarter Horse mare. Clinical signs were dehydration, ileus, and endotoxemia. The diagnosis was made at necropsy.     

Abortion of a mummified fetus associated with short uterine body in a mare

A mummified fetus was aborted at 284 days of gestation from a Quarter Horse mare with a history of consecutive abortions. The abortion occurred 12 days after administration of supplemental progestogen had been discontinued. Results of a breeding soundness evaluation revealed that this mare had a short uterine body. Other abnormalities were not discovered. This condition may have been responsible for repeated abortions in this mare, and may represent a cause of fetal mummification other than twin pregnancy in mares.     

Continuous Urethral Spasm Responsive to Acepromazine in a Mare

A Standardbred mare presented with a 3-year history of stranguria and pollakiuria. Urethral spasm was detected by transrectal and digital examination. Ancillary diagnostic tests revealed no abnormal findings. The mare recovered after a 1-month treatment with acepromazine. Similar cases and responses to treatment have not been reported before in horses.     

Treatment of a poorly differentiated sarcoma in the oropharynx of a horse

A 10-year-old Thoroughbred mare was referred to Tennessee Equine Hospital for evaluation and treatment of a subepiglottic mass. Physical and laboratory examinations revealed no other abnormalities. The tumour was excised through a laryngotomy site using transendoscopic laser and sharp excision. Histological evaluation revealed a poorly differentiated sarcoma with features of a leiomyosarcoma, a rarely identified neoplasm in the oropharynx of the horse. The mare developed intermittent dorsal displacement of the soft palate (iDDSP) after surgery but was able to resume full training. There was no evidence of regrowth 8 months post-operatively.     

Necrotizing mycotic vasculitis with cerebral infarction caused by Aspergillus niger in a horse with acute typholocolitis.

An 18-year-old Morgan mare was presented to the Veterinary Medical Teaching Hospital, University of Illinois, with a 10-day history of watery diarrhea, depression, and dysphagia. On admission, the animal was severely dehydrated, depressed, and unable to swallow and had no clinical signs of diarrhea. The respiratory and heart rate and body temperature were within normal limits. Following fluid therapy, the mare developed severe watery diarrhea and continued to be depressed, incoordinated, and dysphagic. The animal died on the fourth day after admission and was sent to the Laboratories of Veterinary Diagnostic Medicine for necropsy. Gross postmortem findings were consistent with an acute cerebral infarction in the right cerebral hemisphere, an acute necrotizing typhlocolitis, multifocal petechial and ecchymotic hemorrhages, enlarged and congested pars intermedia of the pituitary gland, and marked bilateral adrenocortical hyperplasia with multifocal areas of necrosis and hemorrhage. Histologic evaluation of the affected brain demonstrated an area of coagulative necrosis of the gray matter, with hemorrhage, vasculitis, and thrombosis. There were many fungal hyphae 3.5-6.0 microm, pale basophilic, septate, and occasionally branching at 45 degrees present in the arterial walls and throughout the necrotic tissue. Immunohistochemical analysis revealed Aspergillus niger as the etiologic agent responsible for the mycotic vasculitis and infarction in the brain. Bacteria culture and immunohistochemical staining of the colon and cecum failed to demonstrate specific pathogens.     

Progression of mycosis of the auditory tube diverticulum (guttural pouch) after arterial occlusion in a horse with contralateral temporohyoid osteoarthropathy

CASE DESCRIPTION: A 6-year-old Appaloosa mare was examined because of inappetance, difficulty eating, and swelling and mucopurulent discharge in the right eye. CLINICAL FINDINGS: Results of a CBC and serum bio-chemical analysis revealed no important findings. Ophthalmologic examination revealed scarring and ulceration of the superficial layers of the cornea. Endoscopic examination of the upper portion of the respiratory tract and auditory tube diverticula (guttural pouches) revealed abnormal thickness of the right stylohyoid bone and a plaque suggestive of mycotic growth on the left internal carotid artery. Radiographic examination revealed right-sided otitis media. Temporohyoid osteoarthropathy in the right guttural pouch and mycosis in the left guttural pouch were diagnosed. TREATMENT AND OUTCOME: Ceratohyoidectomy of the right stylohyoid bone was performed, and the left internal carotid artery was occluded via placement of stainless steel spring embolization coils. The mare regained the ability to eat without difficulty and improved clinically for approximately 4 weeks. However, the mare returned to the medical center 53 days after surgery with left-sided Horner syndrome, atrophy of the right side of the tongue, and a 3-week history of dysphagia and weight loss. Endoscopic evaluation revealed progression of mycotic growth in the left guttural pouch. The mare was euthanatized. CLINICAL RELEVANCE: Although the mycotic lesion in the left guttural pouch was an incidental finding at the time of initial examination, the lesion progressed to cause dysphagia and Horner syndrome after occlusion of the left internal carotid artery, a treatment that is typically associated with resolution of guttural pouch mycosis. Arterial occlusion is not necessarily a reliable method of resolving guttural pouch mycosis.     

Successful reduction of a monozygotic equine twin pregnancy via transabdominal ultrasound‐guided cardiac puncture

In horses, twin pregnancy is pathological and represents a potentially life‐threatening condition to the mare and foal. Twinning occurs in approximately 2% of pregnancies. Of these, the majority of cases are dizygotic twins, resulting from 2 ovulations and monozygotic twins are rare. A 12‐year‐old Quarter Horse mare was presented for breeding management with shipped cooled semen and embryo transfer. Seven days post ovulation, a single late morula/early blastocyst was recovered and transferred immediately to a recipient mare. Thirty‐six days after transfer, transrectal ultrasound examination revealed the presence of 2 embryos. A transcutaneous reduction of one of the fetuses was performed successfully at 128 days of gestation. This report is the first to describe a successful reduction of monozygotic twins by transcutaneous ultrasound‐guided cardiac puncture.     

Chronic intermittent colic in a mare attributed to uterine marbles

A 13‐year‐old Quarter Horse mare presented for evaluation of chronic intermittent colic. Following extensive diagnostics, abdominal radiographs revealed two round, radiopaque objects in the caudal abdomen. Palpation per rectum and transrectal ultrasonography of the reproductive tract confirmed that the round objects were uterine marbles. Dinoprost tromethamine (Lutalyse, 5 mg i.m. q. 24 h for 2 days) was administered to bring the mare into oestrus, and both uterine marbles were manually removed from the uterus following digital dilation of the relaxed cervix. Follow‐up with the owner 12 months after discharge revealed that the mare had shown no further signs of abdominal discomfort since having the uterine marbles removed. To the authors' knowledge, this is the first published report of chronic intermittent colic attributed to uterine marbles in a mare.     

Pleural effusion secondary to thoracic metastatic mammary adenocarcinoma in a mare

A 17-year-old Quarter Horse mare was examined nearly 3 years after excision and cryotherapy of a papillary mammary gland adenocarcinoma. The mare had been used for pleasure riding since surgery, but had recently developed progressive dyspnea. The mare had clinical evidence of pleural effusion, but died before further clinical examination and treatment were instituted. Necropsy revealed deep mammary masses with similar nodules in the deep inguinal, renal, and mediastinal lymph nodes and in the lungs, pericardium, visceral and parietal pleurae, and left ovary. The masses were identified as papillary mammary gland adenocarcinoma. Large volumes of free pleural and peritoneal fluid were detected. The pleural fluid contained similar neoplastic cells that could have been readily detected by exfoliative cytologic examination had the mare survived.     

Osteoma of paranasal sinuses in a horse with inspiratory dyspnoea

We describe a case of osteoma in the frontal and maxillary sinuses of a 3-year-old Arabian mare, presented due to an inspiratory dyspnoea. The mare underwent two surgical procedures in order to excise the tumour. Twelve months after admission the mare was healthy with no signs of respiratory abnormalities. Sinus radiographs and endoscopy repeated at that time revealed some regrowth of the tumour in the maxillary sinus, however, twenty-two months following surgery the mare did not show clinical signs of upper airway disease.     

A Case of Marie's Disease in a Broodmare

An 8-year-old Thoroughbred mare presented with acute bilateral epistaxis. The mare showed no clinical signs other than cough and profuse bilateral epistaxis. Antibiotic therapy was instituted and a transtracheal wash was collected. Large numbers of inflammatory neutrophils and gram-positive cocci were reported in the tracheal wash. The antibiotic therapy was continued for 7 days at which time the mare appeared clinically normal. The mare was successfully bred and was confirmed pregnant. She was referred to a hospital when the epistaxis recurred. She was treated with another antibiotic, and thoracic radiographs were also taken which revealed a space occupying lesion. The mare foaled a live foal. She developed bilateral thickening of her limbs. The swellings were of boney consistency and affected all four legs, particularly the forelimbs. A diagnosis of pulmonary hypertrophic osteopathy was made. The mare was again sent for further investigation. The thoracic mass had increased in size from the first examination. A biopsy was collected by endoscopy which confirmed a neoplastic process. After deterioration in her condition, the mare was euthanized on humane grounds. An autopsy report revealed that the mare had approximately 80% of the left lung replaced by neoplastic tissue. The right lung contained many small nodular masses. There was an associated cardiomegaly. In this case, the development of periosteal proliferation in multiple metaphyses was secondary to an intrathoracic neoplastic mass.     

Standing repair of a proximal,incomplete, articular fracture of the third metatarsal bone

A 5-year-old National Hunt Thoroughbred mare presented with sudden onset left hindlimb lameness after race training on the gallops. Clinical examination revealed a marked painful reaction over the proximal metatarsal region but no other obvious abnormalities were detected. Survey radiographs at the yard did not reveal any abnormalities. Nuclear scintigraphic examination 3 days after injury revealed focal marked increased radiopharmaceutical uptake in the proximal metatarsal region. Subsequent radiography revealed an incomplete, articular fracture of the proximal left third metatarsal bone. Repair of the fracture using 3 × 4.5 mm cortical screws placed in lag fashion was performed under standing sedation following perineural analgesia. Follow-up radiographs demonstrated progressive healing of the fracture. The mare returned to race training 8 months after the fracture was repaired and raced successfully 12 months post injury.     

Pelvic lymphoma as a cause of urethral compression in a mare

A 6-year-old mare was presented for evaluation of dysuria and pollakiuria. A pelvic mass, which caused obstruction of urinary outflow, was identified. Evidence of renal failure was also present. Due to poor prognosis the mare was euthanized. A postmortem examination revealed a pelvic lymphoma that surrounded and compressed the urethra.     

Pythiosis with bone lesions in a pregnant mare

A 9-year-old pregnant mare was referred for evaluation of a nonhealing wound of 8 weeks' duration on the lateral aspect of the left forelimb. A soft tissue mass encircled the proximal two thirds of the metacarpus; radiography revealed a moderate periosteal reaction affecting metacarpal bone i.v. Histologic and immunohistochemical examinations revealed eosinophilic granulomatous inflammation and Pythium sp in the soft tissues. The mare was treated for 12 days with antimicrobials, medicated wound dressings, debridement, and i.v. administration of sodium iodide; radiography revealed progression of the bone lesions. The mare was treated by regional arterial perfusion with miconazole and excision of affected soft tissues and the distal two thirds of metacarpal bone i.v. The mare recovered without complications and gave birth to a healthy foal. Regional perfusion of antifungal agents provides high concentrations in soft and osseous tissues and permits use of low dosages of agents administered by other routes, which reduces cost, adverse effects, and teratogenic effects.     

Elevated Serum Anti-Müllerian Hormone in an Arabian Mare with Granulosa Cell Tumor

Anti-Müllerian hormone (AMH), produced by granulosa cells, has been reported to be elevated in mares with granulosa cell tumor. A 13-year-old Arabian mare was referred after 3 years of infertility. Rectal and ultrasonographic examination revealed enlargement and multicystic appearance of the left ovary. The mare had substantially higher concentration of AMH (21.6 ng/mL) compared with normal cyclic mares (n = 5; 0.36 ± 0.02 ng/mL). Testosterone (50 pg/mL) concentration was also elevated, but progesterone concentration (0.4 ng/mL) was lowered. Accordingly, the mare was presumptively diagnosed with granulosa-theca cell tumor and a left ovariectomy implemented using ventral midline approach under general anesthesia. Histopathological examination confirmed the diagnosis of granulosa-theca cell tumor. Serum concentrations of AMH decreased to 2 ng/mL and 0.5 ng/mL 2 and 4 weeks after tumor removal, respectively. In conclusion, the current report presents confirmatory evidence that evaluation of serum AMH could be useful for diagnosis of granulosa cell tumor in mare.     

Omental fibrosarcoma in a horse

A 13-year-old Thoroughbred mare had a 2-week history of weight loss and intermittent fever. Examination of abdominal and pleural fluid revealed peritonitis and pleuritis. Ultrasonography of the ventral abdominal midline revealed an intra-abdominal mass. Exploratory celiotomy was performed, but the mass was not surgically excisable. The mare was euthanatized and necropsied. Histologically, the mass was determined to be a fibrosarcoma of omental origin.