Septic Arthritis of the Distal Interphalangeal Joint in 12 Horses

The medical records of 12 horses with septic arthritis of a distal interphalangeal joint were reviewed to determine clinical features and response to treatment. Sepsis was caused by trauma or an injection that resulted in an open or contaminated distal interphalangeal joint. All horses were severely lame. Treatment included broad-spectrum parenterally administered antimicrobial drugs (ten horses), percutaneous through-and-through joint lavage (eight horses), indwelling drains (three horses), immobilization of the limb in a cast (three horses), intraarticular injection of sodium hyaluronate (one horse), intraarticular injection of antimicrobial drugs (five horses), curettage of the distal phalanx (one horse), and cancellous bone grafting to promote fusion (one horse). Five horses were euthanatized. Ankylosis of the affected joint developed in five horses, four of which are pasture sound. Two horses treated medically are sound although one underwent subsequent palmar digital neurectomy for treatment of navicular syndrome.     

Partial Arytenoidectomy in Horses

Unilateral partial arytenoidectomy was performed in 22 horses. Six horses had arytenoid chondritis, 14 horses had idiopathic laryngeal hemiplegia (11 of which had been treated unsuccessfully by insertion of a laryngeal abductor muscle prosthesis), and two horses had laryngeal hemiplegia resulting from perivascular injection of an irritant drug. After surgery, eight horses (36%) developed a nasal discharge of food and/or water that was of clinical significance in only two of them. The operation resulted in marked improvement in exercise tolerance in all 20 horses tested, although two could not work because of severe exercise-associated coughing. Mild inspiratory stertor was present in eight horses and was excessive in one. It was concluded that the high incidence of problems related to swallowing rendered the method unacceptable. Modification of partial arytenoidectomy by silicon augmentation produced improvement in one horse.     

Diaphragmatic Hernia Repair in Three Young Horses

Objective- This clinical report describes surgical correction of diaphragmatic hernia in three young horses.
Study Design- Retrospective investigation of medical records and subsequent racing performance.
Animals- Three young horses with diaphragmatic hernia.
Results- Three young horses with signs of abdominal pain had diaphragmatic hernia causing small intestinal strangulation. The strangulated small intestine was resected and an end-to-end jejuno-jejunal (two horses) or a side-to-side jejuno-cecal anastomosis (one horse) was performed. Diaphragmatic hernias were closed with a continuous suture pattern. All horses recovered and raced. No difference in race records was found between the subject horses and their siblings. One subject horse died of colic at 5 years of age, but the cause of the colic was undetermined. The remaining two horses are in use as broodmares and have produced multiple foals without recurrence of signs of diaphragmatic hernia
Conclusions- Diaphragmatic hernias can be repaired in horses. These horses can achieve race records similar to their siblings and can produce foals without recurrence of signs of diaphragmatic hernia.     

Treatment of Mycotic Rhinitis With Itraconazole in Three Horses

Itraconazole, a third-generation azole, was evaluated for treatment of resistant nasal mycotic infections in horses. Two horses with Aspergillus spp nasal granulomas and 1 horse with Conidiobolus coronatus nasal infection were treated with itraconazole (3 mg/kg PO bid). One of the horses with nasal aspergillosis was also treated by surgical resection of the nasal septum. The treatment time for the horses ranged from 3 to 4.5 months. No adverse effects were noted in any of the horses during the treatment period. Peak and trough serum itraconazole concentrations were < 0.5 μg/mL in all 3 horses. Itraconazole (3 mg/kg PO bid) appears to be effective in the treatment of nasal Aspergillus spp infections in horses because the fungal infection was eliminated in both horses. One horse still had excessive nasal sounds during exercise and was retired from training, whereas the other horse returned to normal. The nasal C. coronatus infection appeared resistant to itraconazole treatment in the affected horse because the granulomas were still present after 4.5 months of treatment.     

Endoscopically Assisted Annular Ligament Release in Horses

An endoscopically assisted technique for internally dividing the palmar or plantar annular ligament was developed in six cadaver limb specimens and two anesthetized horses. Under arthroscopic view, a slotted cannula was inserted into the digital sheath through a stab wound proximal to the annular ligament and advanced through the fetlock canal superficial to the flexor tendons with the slot oriented toward the fibers of the annular ligament. Division of the annular ligament by 90-degree tipped open and guarded blades was observed and verified by direct arthroscopic view. At necropsy, complete division of the annular ligament without iatrogenic damage to the neurovascular structures was confirmed by dissection. Annular ligament division was performed in seven horses with complex tenosynovitis conditions. Tenoscopic examination and removal of tendon and digital sheath adhesions, masses, and bands was followed by endoscopically assisted annular ligament transection. At follow-up, five horses were sound athletes without recurrent digital sheath problems, one horse had residual lameness, and one horse was still convalescing.     

Hemothorax in 2 Horses

This report documents the successful conservative medical management of hemothorax in 2 horses. Hemothorax occurred after a lung biopsy procedure (horse 1) and strenuous exercise on a treadmill (horse 2). The horses had tachypnea, tachycardia, nostril flaring, hemoptysis, and pawing. Hemothorax was suspected based upon absence of auscultable ventral lung sounds; development of cool extremities and pale, tacky mucous membranes; the ultrasonographic appearance of moderate to severe amounts of pleural fluid; and a concurrent decrease in hematocrit and total plasma protein. Both horses were treated successfully by intranasal administration of oxygen, intravenous administration of balanced polyionic solutions, and treatment with antibiotics, nonsteroidal anti-inflammatory drugs, and analgesics. In neither case was pleural blood removed. The hemothorax resolved in both horses without lasting abnormalities. Hemothorax does not require drainage for successful resolution.     

Mid-metacarpal Deep Digital Flexor Tenotomy in the Management of Refractory Laminitis in Horses

Deep digital flexor tendon transection at the mid-metacarpus was performed in 20 horses with severe acute or chronic laminitis that was not responsive to conventional treatment. Sixteen horses improved within 72 hours, one horse worsened, and two horses were unaffected by the surgery. Eleven horses survived less than 1 month after surgery and six horses survived longer than 6 months. Three horses surviving longer than 6 months have remained lame and no horse has returned to athletic performance. Transection of the deep digital flexor tendon at the mid-metacarpus may decrease the pain associated with the acute refractory stage of laminitis and may be useful as an immediate salvage procedure; however, despite the early clinical improvement observed after tenotomy, the survival rate of affected horses may not be altered.     

Pancytopenia Secondary to Lymphoid Leukemia in Three Horses

Pancytopenia was observed in two 3-year-old geldings and one 11-year-old mare. All horses had a brief history (2 days to 4 weeks) of fever, anorexia, and depression. One of the three horses had blast cells present on a peripheral blood smear. Examination of the bone marrow showed substantial infiltration with neoplastic lymphoid cells. At necropsy, neoplastic cells were restricted to the bone marrow in one horse, present in bone marrow, liver, and spleen in the second horse, and reported in multiple tissues in the third horse, including bone marrow, kidneys, lung, myocardium and lymph nodes. The value of a bone marrow aspirate and core biopsy in the investigation of pancytopenia is highlighted. (Journal of Veterinary Internal Medicine 1993; 7:360–363. Copyright © 1993 by the American College of Veterinary Internal Medicine.)     

Endoscopic Examination and Treatment of Paranasal Sinus Disease in 16 Horses

Sixteen horses with suspected paranasal sinus disease had endoscopic examination of the paranasal sinuses with a 4.0 mm arthroscope either while standing and sedated (14 horses) or under general anesthesia (two horses). Endoscopic diagnosis included sinusitis (four horses), sinus cyst (three horses), hemorrhage (three horses), neoplasia (three horses), and tooth root abnormalities (two horses). No abnormalities were detected in one horse. Endoscopic findings concurred with the radiographic findings in 13 horses (81%). Samples of sinus contents for bacteriologic (eight horses) and histologic examinations (five horses) were obtained using sinus endoscopy. Diagnostic sinus endoscopy was combined with debridement, lavage, and suction as a therapeutic technique in 10 horses. In three horses, sinus exploration was performed after diagnostic endoscopy confirmed sinus disease, whereas in three horses, further therapy was not recommended after sinus endoscopy. Clinical signs of sinus disease resolved in 11 horses (69%) overall and in eight of 10 horses (80%) with sinusitis, cyst formation, or hemorrhage using endoscopic techniques alone. Mild, local subcutaneous emphysema occurred at the portal sites in all horses, but healing occurred without additional complications, latrogenic damage to sinus structures occurred in one horse. Sinus endoscopy was useful in the diagnosis and management of paranasal sinus disease and avoided the need for exploratory sinusotomy in some horses.     

Cervical spondylosis deformans in two Quarter Horses

This case report describes 2 Quarter Horses diagnosed with severe bridging spondylosis deformans of the cervical spine. Clinical signs in both horses included severe neck stiffness, reduced mobility and issues with grazing normally. Both were diagnosed with cervical radiographs. Ataxia was noted in one horse. One horse has shown progressively worsening signs over 4 years. Where severe neck stiffness and reduced mobility are noted in a horse, cervical spondylosis deformans should be considered as a differential diagnosis.     

Fracture of the Supraglenoid Tubercle Treatment and Results in Five Horses

Five horses with fractures of the supraglenoid tubercle (tuber scapulae) were presented from 6 weeks to 1 year after injury. Clinical signs included lameness characterized by a shortened cranial phase of the stride and shoulder muscle atrophy. Radiographically, the fractures differed in the degree of cranioventral displacement of the fragment as well as the extent of joint involvement. Three horses were treated by resection of the fractured tubercle, including one using a new grid approach to the area of the fracture. Two of these horses have returned to athletic activity and one was euthanized due to postoperative infection. One horse with minimal displacement and joint involvement was treated with rest and raced successfully. One horse seen with a fracture of 1 year duration also was treated with rest and was a pasture sound broodmare.     

The Incidence of Australian Stringhalt in Horses in New Zealand

Seventeen horses diagnosed as having navicular syndrome on the basis of history, clinical findings, regional local anaesthesia and radiography were subjected to bilateral navicular suspensory desmotomy. Before surgery, the duration of navicular lameness ranged from 6 weeks to 4 years. Previous unsuccessful treatments prior to surgery included nonsteroidal anti-inflammatories, corrective shoeing, rest and isoxsuprine. For the seventeen horses subject to surgery, twelve horses were sound, one horse was improved and four horses were lame at a minimum of 6 months after surgery.     

Genetic Structure of Severe Combined Immunodeficiency Carrier Horses in Morocco Inferred by Microsatellite Data

A total of 17 microsatellite deoxyribonucleic acid loci used routinely for horse parentage control were used to evaluate genetic diversity among normal Arabian horses and severe combined immunodeficiency (SCID) carrier Arabian horses (ArS) and normal Arab-Barb horses and SCID carrier Arab-Barb horses (ArbeS). On the basis of the genotype of 186 horses, mean allelic diversity was estimated as 6.82, 5.53, and 6.7059 in normal Arabian horses, ArS, and for both groups of Arab-Barb horses, respectively. Five specific alleles were observed in ArS and ArbeS, with one common with ArS at HMS6, whereas five alleles common between ArS and ArbeS had a high frequency. Expected and observed heterozygosity showed great heterogeneity in the population studied and were similar or higher when compared with other studies on Arabian horses. Coefficient of gene differentiation G_st of Nei associated with Nei’s genetic distance and multivariate correspondence analysis indicated a possible differentiation between the studied populations when analyzed separately according to breed. Probability of assignment of a horse to a specific group was assessed using a full and partial Bayesian approach. In all, 80.6% of Arab horses and 78.2% of Arab-Barb horses were assigned properly with a partial Bayesian test, which provided better results than the full one. These findings will be useful for identification of SCID carrier horses by using the microsatellite deoxyribonucleic acid loci used routinely for horse parentage control in our laboratory.     

Repair of Facial Defects with Periosteal Flaps in Two Horses

Facial defects that extended into the sinuses of two horses were repaired by using adjacent periosteum to cover the defects, using either a single flap or double flap technique. Acceptable cosmetic appearance was restored in both horses. Resistance to penetration of a needle and ultrasonic scanning demonstrated bony bridging in one horse.     

Mandibular Condylectomy Technique and Results in Normal Horses

A technique of mandibular condylectomy and menisectomy is described. Unilateral condylectomy and menisectomy were performed in two horses, and two horses were treated by bilateral condylectomy and unilateral meniscectomy. Minor temporary alterations in mastication occurred following unilateral condylectomy; more severe and longer lasting abnormalities of prehension and mastication occurred following bilateral condylectomy. Malocclusion occurred in all horses following surgery but was only clinically significant in one horse that developed occlusion of the lower incisor teeth 3 mm caudal to the upper incisor teeth following bilateral condylectomy. Maximal mouth opening was normal following unilateral condylectomy and increased following bilateral condylectomy, both immediately following surgery and after 16 weeks. Maximal lateral deviation of the mandible was increased immediately following unilateral and bilateral condylectomy; 16 weeks following surgery one joint had increased, and two had normal and three had decreased maximal lateral deviations. On radiographic, gross, and histological evaluation, the condylectomy sites underwent remodelling and bony proliferation to produce "pseudo" condyles. At necropsy, 16 weeks following surgery, five of the six operated temporomandibular joints contained fibrous tissue with single or multiple cavities lined by synoviocytes. The nonoperated temporomandibular joints were normal. Functional use of the mandible was good in three horses; the fourth horse developed significant malocclusion and had satisfactory function following bilateral condylectomy.     

Regional Limb Perfusion with Antibiotics in Three Horses

Antibiotics were delivered to chronically infected tissues by regional limb perfusion in three horses with osteomyelitis associated with orthopedic implants. Two infections were resolved with implants in place; in one, a sequestrum was resorbed. In one horse, regional antibiotic perfusion was applied to treat progressively worsening bone infection after initial implants loosened and were removed.     

Levator Nasolabials Muscle Transposition to Prevent an Orosinus Fistula after Tooth Extraction in Horses

The ventral part of the levator nasolabialis muscle was transposed to the alveolar defect after sinusotomy and tooth extraction in five normal horses and six horses with a tooth root abscess and sinusitis. In the normal horses at weeks 6, 10, 14 and 18, the transposed muscles remained viable and were incorporated into the recipient sites, and orosinus fistulae did not form. Histologically, there was a progressive transition from muscle to fibrous tissue. There was no facial deformity or loss of nasal function at the donor site. A localized abscess was associated with incomplete removal of tooth root fragments in one horse. After 1 year or more, five horses treated for dental disease had complete resolution of clinical signs. One horse continued to have intermittent mild nasal discharge.     

Surgical Repair of Tibial Tuberosity Avulsion Fractures in Four Horses

Four horses, 2 to 17 years old, were treated for unilateral avulsion fractures of the tibial tuberosity. Two horses were treated successfully with tension band wiring or plating in combination with lag screw fixation. One horse was euthanatized because of implant failure during recovery and one was euthanatized on day 11 because a longitudinal fracture of the tibial tuberosity occurred through the plane of the screws used for stabilization.     

Incomplete Longitudinal Fracture of the Proximal Palmar Cortex of the Third Metacarpal Bone in Horses

Seven horses, 2 to 4 years of age, were examined because of moderate-to-severe forelimb lameness, mild effusion of the middle carpal joint (3 horses), and pain on palpation of the origin of the suspensory ligament (4 horses). The lameness was abolished by anesthetic infiltration of the middle carpal joint in six horses. In four of them, a high palmar nerve block also abolished the lameness. A linear radiolucency in the proximal end of the third metacarpal bone (McIII) was interpreted as an incomplete longitudinal fracture. In one horse, distinct intramedullary sclerosis limited to the palmar cortex was indicative of an incomplete fracture confined to the palmar cortex. No osteoproliferative lesions were identified on the dorsal cortex of any of the horses. Surgical treatment with cortical screws in lag fashion accompanied by a rest period was successful in one horse. In four horses, rest for at least 3 months resulted in clinical soundness. In two horses, a shorter rest period resulted in recurrence of the lameness even though the horses were sound when put back into training. Careful clinical and radiographic examinations helped differentiate incomplete longitudinal fractures from lesions involving the carpus and proximal aspect of the suspensory ligament.     

Comminuted First Phalanx Fractures in 30 Horses: Surgical vs. Nonsurgical Treatments

Comminuted first phalanx fractures were diagnosed in 30 horses. One leg was involved in each horse. Five horses were presented with open fractures. Nine horses had a portion of intact cortex (strut) extending from the proximal to distal joint. Ten horses were euthanized, including one with an open fracture, without treatment. The remaining 20 horses were treated by open reduction with a neutralization plate (8 horses, including one with an open fracture), open reduction with lag screw fixation (3 horses), lag screw fixation through stab incisions (2 horses), external coaptation with a cast (3 horses), and external skeletal fixation using a weight supporting shoe (4 horses, including 3 with open fractures).
Thirteen horses were euthanized following treatment because of persistent infection (9), chronic lameness (2), and third metacarpal bone fractures (2). Seven horses survived longer than 1 year after treatment. Six were lame and used as breeding animals, and one horse went on to race successfully. All four horses with open fractures that were treated were subsequently euthanized.
Significantly more horses with an intact strut of bone survived after treatment (4 of 7 [57%]) when compared to horses without an intact strut of bone that were treated (3 of 13 [23%]) (p < 0.05).
Invasive surgical approaches used for the repair of comminuted first phalanx fractures in this study were associated with an unacceptable infection rate (55%). Techniques involving less trauma to the compromised soft tissue around the fracture should afford a better chance for a successful outcome.