A Retrospective Analysis of Renal Carcinoma in the Horse

Background: Renal carcinoma is a rare tumor of horses.
Hypothesis: Presenting complaints and clinical signs of this disease are vague and early diagnosis increases survival time.
Animals: Data were collected from the medical records of 4 horses presented to Washington State University as well as the 23 previously published case reports of horses with renal carcinoma.
Methods: Retrospective study.
Results: Renal carcinoma affects horses of all ages with most cases observed in geldings and Thoroughbreds. The most common presenting complaints are nonspecific and usually do not occur until late in the course of the disease. Routine laboratory results generally are unremarkable with no evidence of renal dysfunction. Urine and peritoneal fluid analyses are consistently abnormal, but the changes usually are nonspecific. Rectal palpation often allows detection of an abnormal kidney or a mass in the area of the kidney. Renal ultrasound examination is the most rewarding imaging procedure, and when combined with renal biopsy, antemortem diagnosis can be achieved. Renal carcinoma is both locally invasive and metastatic, necessitating careful staging for metastasis using thoracic radiography and abdominal ultrasound examination. If the tumor is localized to 1 kidney, nephrectomy is the treatment of choice. No chemotherapy or radiation treatment for renal carcinoma has been reported in the horse. Median survival for this series of cases was 11 days (0 days–1 year).
Conclusions and Clinical Importance: Prognosis is poor to grave.     

Evaluation of Horse Fitness for Exercise: The Use of a Logit-Log Function to Model Horse Postexercise Heart Rate Recovery

The aim of this study was to test the adjustment of the logistic-log model with postexercise heart rate (HR) recovery data in horses and introduce the logit-log model as a parsimonious model, with the half recovery time as a measure of horse fitness. Postexercise HR (bpm) measurements at different timings were obtained from 32 polo ponies in two different exercise regimes: n = 16 “full chukker” and n = 16 in “half chukker.” Measurements were taken at rest, immediately after exercise and then 2, 4, 6, 10, and 20 minutes after exercise. The HR variable was transformed into a logit (HR) variable, and time was transformed into log (time). Means of logit (HR) at the different log (times) were obtained, creating two time series of transformed variables that were then adjusted by simple linear regression. The degree of adjustment of the model is high with values of r² = 0.989 for the full chukker and r² = 0.998 for the half chukker. Full chukker ponies have a half recovery time of 5.7 minutes and half chukker ponies of 11.2 minutes, with the former showing to be fitter than the latter, which is why they are chosen to play for longer periods. The logit-log model is parsimonious, and the half recovery time can be easily determined. The half recovery time has potential to be used as a measure of fitness degree, allowing comparison between horses.     

Gastric Torsion from an Intestinal Hernia Through a Rent in the Gastrosplenic Ligament in a Horse

The present report describes an 8-year-old gelding presenting with signs of severe abdominal pain. After performing a thorough physical examination, including rectal palpation and additional diagnostic tests, an exploratory laparotomy was recommended. The jejunum was found herniated through the gastrosplenic ligament, and the stomach was severely distended with gas. Given a poor prognosis, the horse was euthanized on the table. At necropsy, the stomach appeared dilated, with an 180° horizontal gastric torsion, from left (lateral) to right (medial), dividing the organ into dorsal and ventral compartments. We believe that the chronic traction exerted by an incarcerated and distended loop of jejunum, in the dorsal aspect of the gastrosplenic ligament, associated with trauma during episodes of intense rolling, enlarged the rent until it ruptured. Because of this rupture, the lateral dorsal aspect of the stomach became unattached, predisposing it to the torsion.     

Validation of the Lactate Plus Lactate Meter in the Horse and Its Use in a Conditioning Program

The equine industry has a need for a convenient, rapid, and reliable method of measuring blood lactate concentrations ([LA]). We hypothesized that the handheld Lactate Plus lactate meter (LPlus), developed and tested for use in humans, would provide dependable results when used in horses undergoing an exercise conditioning program and that horse's fitness would improve following individualized conditioning based on each horse's velocity at which [LA] = 4 mmol/L (V_LA4) was reached. Five adult horses underwent a 4-week training program that consisted of 3 exercise bouts/wk. Horses were subjected to an incremental step standardized exercise test (SET) before starting (SET-1) and after the completion of the program (SET-2). Blood samples were collected before each increase in speed until [LA] reached ≥4 mmol/L, and then the SET was terminated. The [LA] sample range in our study was 0–8 mmol/L. Blood was analyzed at the time of collection using a calibrated LPlus, and plasma was collected for [LA] determination using the lactate dehydrogenase–based enzymatic colorimetric method. Although the LPlus tended to significantly underestimate [LA] by 0.39 mmol/L (P < .001), the LPlus proved to be a dependable device for use in horses based on good correlation with the biochemical analysis (r = 0.978) and Bland–Altman limits of agreement and 95% confidence intervals. All horses showed an increase in V_LA4 from SET-1 to SET-2, consistent with improved fitness following our 3 exercise bout/wk training protocol. The LPlus can reliably be used in horses to determine [LA] ranging from 0–8 mmol/L. When determining serial [LA], analytical techniques should not be used interchangeably.     

Development of two surgical approaches to the pituitary gland in the Horse

Background: Current treatment of equine pituitary pars intermedia dysfunction (PPID) requires daily oral medication. Minimally invasive surgical palliation of this condition is appealing as a single treatment to alleviate the clinical signs of disease, dramatically improving the welfare of the horse.

Objective: To develop a surgical approach to the equine pituitary gland, for subsequent treatment of PPID.

Study design: A cadaver study to develop methodology and a terminal procedure under anaesthesia in the most promising techniques.

Animals and methods: Four surgical approaches to the pituitary gland were investigated in cadaver animals. A ventral trans-basispheniodal osteotomy and a minimally invasive intravenous approach via the ventral cavernous sinus progressed to live horse trials.

Results: Technical complications prevented the myeloscopic and trans-sphenopalatine sinus techniques from being successful. The ventral basisphenoidal osteotomy was repeatable and has potential if an intra-operative imaging guidance system could be employed. The minimally invasive approach was repeatable, atraumatic and relatively inexpensive.

Conclusions: A minimally invasive surgical approach to the equine pituitary gland is possible and allows for needle placement within the target tissue. More work is necessary to determine what that treatment might be, but repeatable access to the gland has been obtained, which is a promising step.     

Computed Tomography and Magnetic Resonance Imaging of an Epidermoid Cyst in a Foot of a Horse

An 18-year-old Quarter Horse mare was evaluated because of moderate left forelimb lameness of 4 weeks’ duration. The clinical evaluation and diagnostic perineural analgesia localized the lameness to the distal portion of the left forelimb. There was swelling on the dorsal and lateral aspect of the coronary band. Radiography, ultrasound, magnetic resonance imaging, and computed tomography of the foot revealed circumscribed well-capsulated soft tissue mass causing a focal deformation of the dorsolateral border of the middle phalanx. The treatment aimed to remove the mass surgically and stabilized the interphalangeal joint, but the owner elected human euthanasia before treatment attempt. Histopathology diagnosis was an epidermoid cyst, which was characterized by multilayers of keratin surrounded by stratified squamous epithelium. Although rare, an epidermoid cyst should be considered as a differential diagnosis for space-occupying mass in horses’ foot that develops chronic lameness after trauma. This report describes the multimodality appearance of the epidermoid cyst.     

Radiography and Standing Computed Tomography of an Osteochondritis Dissecans Lesion Found at the Dorsodistolateral Aspect of the Calcaneus in a 3-Year-Old Horse

An incidental osteochondritis dissecans (OCD) lesion was found in a left tarsus of a 3-year-old Freiberger stallion presented for a prepurchase examination. The lesion was best visualized on the dorsomedial-plantarolateral oblique and dorsoplantar projections. A standing computed tomographic examination confirmed a fragmentation of the dorsodistolateral aspect of the calcaneus. In suspected OCD lesions at the distal aspect of the talus or calcaneus, a dorsoplantar projection of the tarsus improves lesion localization and could be added to the standard radiographic protocol during OCD screenings. Computed tomography allowed more detailed evaluation of a not previously described calcaneal origin of this uncommon presumed OCD lesion in the equine tarsus.     

Exophthalmos Caused by Chronic Sinusitis in a Horse: A Case of Exophthalmos Caused by Sinusitis

A 12-year-old Thoroughbred gelding exhibited a unilateral exophthalmos on the left side. There had been no other clinical symptoms, such as rhinorrhea, before the first consultation. Clinical, hematologic, plasma biochemical, cytologic, and computed tomography (CT) examinations and complete necropsy were performed. These examinations did not reveal neoplastic lesions. CT images suggested that maxillary and frontal sinuses may have been filled with fluid. Cytologic and pathologic examinations revealed that the maxillary and orbital bones were pushed up with a large amount of the inflammatory fluid effused by chronic sinusitis. The CT and cytologic examinations were of great use for differential diagnosis in this case. This was an unusual case of exophthalmos induced by deformation of the orbital bones resulting from chronic sinusitis.     

Cholangiocarcinoma and Squamous Cell Carcinoma of the Stratified Epithelial Portion of the Stomach in a Horse: A Case Report

Both cholangiocarcinoma and squamous cell carcinoma of the stomach stratified squamous epithelial portion are rarely found in equine medicine despite being more common in human beings, dogs, and cats. The objective of the present article was to report the simultaneous occurrences of these two types of neoplasias in an 11-year-old mare. Numerous firm, whitish nodules were distributed throughout the liver parenchyma and those protruding over its surface were umbilicated in their appearance. It was verified that the nodules adhered to the peritoneum and omentum, diaphragm, spleen, and stomach serosa compressed the adjacent structures. The stomach stratified squamous epithelial portion, particularly originating in the margo plicatus toward the cardia, was covered by numerous smooth, whitish spherules. Microscopic examination allowed the liver, tumor, and the abdominal implants to be identified as a cholangiocarcinoma, and the stomach neoplasia as a carcinoma of its stratified squamous epithelial portion. Considering this as an uncommon finding, although when considered individually, the presence of a cholangiocarcinoma and a squamous cell carcinoma of the stratified squamous epithelial portion of the equine stomach in the same specimen is worthy of reporting.