Resection of a cervical tracheal bronchus in a foal

A 3-day-old Thoroughbred foal developed a large, air-distended, midcervical swelling that was diagnosed as a congenital tracheal bronchus with associated ectopic lung tissue. Clinical signs consisted of a compressible air-filled sac that enveloped the trachea. The nature and extent of the defect were evaluated endoscopically and radiographically. Surgical resection of the bronchus and associated air-filled sac resulted in a functionally and cosmetically acceptable outcome.     

PARAESOPHAGEAL CYST IN A HORSE

A 2 year old Morgan gelding was evaluated for a non-painful mass located caudodorsal to the larynx. Radiographically, the mass was ovoid shaped and had a peripheral rim of mineralization. Slight ventral displacement of the dorsal margin of the trachea could also be identified. Uniform moderate level echoes were seen throughout the interior of the mass on ultrasound examination. An esophagram was performed and demonstrated displacement without involvement of the esophagus by the mass. The esophagus appeared as a separate structure from the mass on both the ultrasound examination and esophagram. During surgical removal, the mass also appeared as a distinct structure from the esophagus. Histologically, the mass was consistent with an epithelial inclusion cyst which originated from the esophagus.     

Congenital branchial apparatus malformation in a Haflinger colt

Objective— To report the diagnosis and treatment of a branchial apparatus anomaly (BAA) associated with a mandibular malformation in a foal.
Design— Clinical report.
Animal— Haflinger foal.
Methods— A 6-day-old foal had a fluctuating cystic mass in the pharyngeal (throatlatch) region, which changed in appearance after ingestion of milk. Upper airway endoscopy and diagnostic imaging (ultrasonography, radiography, computed tomography) permitted identification of the anatomic location of a communicating tract between the lumen of the cystic mass and the pharynx. The mass was surgically removed and communication with the pharynx ligated. Histologic appearance of this mass was consistent with a branchial cyst or sinus. The mandibular malformation was managed conservatively.
Results— Surgical resection of a third branchial sinus resulted in an excellent functional and cosmetic outcome. There was no evidence of any mandibular deformity 2 years later.
Conclusion— BAA may induce secondary mandibular deformation in utero and may cause respiratory compromise postpartum. Careful surgical dissection and removal of BAA resulted in an excellent outcome.
Clinical Relevance— BAAs should be included in the differential diagnosis of a throatlatch region mass in equine neonates. Complete surgical excision is recommended and full recovery of any associated mandibular deformity may be anticipated without additional treatment in very young patients.     

IMAGING DIAGNOSIS—NASAL SEPTAL AND LARYNGEAL CYST‐LIKE MALFORMATIONS IN A THOROUGHBRED WEANLING COLT DIAGNOSED USING ULTRASONOGRAPHY AND MAGNETIC RESONANCE IMAGING

A foal was examined for abnormal upper airway noise. Endoscopically, there were narrowed nasal passages and an extralumenal mass of the cranial trachea. Using ultrasonography and magnetic resonance (MR) imaging of the larynx and cranial cervical trachea, irregular margins of the laryngeal cartilages and first tracheal ring containing areas consistent with fluid were identified. In MR images, a widened nasal septum was seen that contained material consistent with fluid. Postmortem examination confirmed the diagnosis of nasal septal, laryngeal, and cranial cervical tracheal cyst‐like lesions. This is a unique congenital condition, in which premortem imaging was instrumental in defining the abnormalities.     

Congenital cystic polypoid rectal hamartoma in a newborn foal

A neonatal foal with signs of rectal bleeding was diagnosed with an intraluminal rectal mass and intussusception on surgical exploration of the abdomen. Histologically, the mass consisted of cystic spaces lined by simple columnar epithelium with numerous goblet cells and was surrounded by thin bands of smooth muscle in a myxomatous stroma. Although the mass shared similarities with retrorectal cystic hamartoma (tailgut cyst) and juvenile polyps, described in human medicine, location and histologic findings were not entirely consistent with either condition.     

A clinical case of a subepiglottic cyst in a Japanese Black calf

A 36-day-old Japanese Black calf exhibited wheezing associated with dyspnea from birth. Arterial blood gas analysis revealed a low oxygen partial pressure of 51 mmHg, low oxygen saturation of 83%, and high carbon dioxide partial pressure of 58.8 mmHg. Computed tomography, endoscopy, and ultrasonography showed cyst formation under the epiglottis. When the cyst was aspirated under ultrasonic guidance to secure the airway, 30 ml of viscous white turbid content was aspirated. The cyst shrank immediately after aspiration, but the wheezing and respiratory symptoms resumed 7 days after aspiration. Therefore, the cyst was surgically removed from the ventral side of the neck. No cyst remodeling was observed 30 days after surgical removal.     

Surgical management of a thyroglossal duct cyst in a cat

CASE DESCRIPTION: A 14-year-old castrated male domestic shorthair cat was evaluated because of a large fluid-filled mass on the ventral aspect of the neck that failed to resolve after repeated draining. CLINICAL FINDINGS: Radiography and computed tomography revealed a fluid-filled mass 13 cm in diameter extending from the level of the first cervical vertebra to the manubrium. No evidence of metastasis was seen. Cytologic examination of the fluid revealed it to be a transudate with a T4 concentration considered to be normal. Incisional biopsy of the cyst wall was performed and led to a diagnosis of thyroglossal duct cyst. TREATMENT AND OUTCOME: The cyst was excised, and no recurrence was observed 15 months after surgery. Aside from temporary seroma formation, no complications developed after the surgery. A distinct tract through the hyoid apparatus to the base of the tongue, as has been described in humans, was not identified. CLINICAL RELEVANCE: Thyroglossal duct cyst should be considered as a differential diagnosis in cats with masses on the ventral aspect of the neck. Complete excision appeared to be curative in the cat of this report.     

Horner's syndrome associated with a functional thyroid carcinoma in a dog

A seven-year-old entire male Irish setter was presented because of a neck mass, prolapse of the third eyelid and apparent drooping of the upper eyelid. Historical findings included increased appetite as well as polyuria and polydipsia for about two weeks. The most remarkable findings on physical examination were right-sided Horner's syndrome, pre-scapular lymphadenopathy and a large, ventral cervical mass. Lateral cervical radiographs showed a large, soft tissue opacity surrounding the trachea and retropharyngeal area which was causing displacement and narrowing of the cervical trachea and oesophagus. Results of thyroid testing suggested hyperthyroidism. At necropsy, a large, invasive tumour was identified in the ventral cervical region and multiple metastases of various sizes were detected in the lungs. Histopathological examination of the tumour revealed follicular thyroid carcinoma and confirmed widespread pulmonary metastasis.     

Diagnosis and surgical treatment of a nasopharyngeal cyst in a dog

A 21-month-old boxer dog was presented with clinical signs caused by nasopharyngeal obstruction. A mineralised mass in the nasopharynx was identified by radiography. Computed tomography allowed accurate anatomical localisation of the cystic lesion and identification of an ossified wall. Surgical removal of the mass by a ventral approach resulted in complete resolution of clinical signs. Histopathological examination strongly suggested that the cyst was derived from remnants of Rathke's pouch.     

Marsupialization and iodine sclerotherapy of a branchial cyst in a horse

A 6-month-old Morgan colt was evaluated because of a 10-cm right-sided retropharyngeal swelling. The swelling was soft and moveable on examination, and palpation did not elicit signs of pain. Radiography revealed a large space-occupying mass ventral to the second cervical vertebra; ultrasonography revealed an anechoic fluid-filled structure with a well-defined hyperechoic capsule. Fine-needle aspiration yielded a viscous amber fluid. Cytologic evaluation indicated that the fluid was an exudate; anaerobic and aerobic bacterial culture did not yield any growth. Histologic examination of a portion of the cyst capsule revealed a connective tissue wall lined by pseudostratified columnar to cuboidal epithelium, consistent with a branchial cyst. The cyst wall was marsupialized to the skin, and iodine sclerotherapy was performed twice daily for 14 days, at which time forceps were introduced into the cyst and the cyst lining was removed. The site was allowed to heal by second intention, but 10 days later, the swelling recurred. An incision was made over the previous marsupialization site, and residual remnants of the cauterized cyst lining were removed with a forceps. The foal did not have any other complications during the subsequent 2 years. Branchial arch cysts are uncommon embryonic anomalies of horses, mice, cats, dogs, and cattle. Results suggest that marsupialization and iodine sclerotherapy may be a viable alternative to surgical excision in horses with branchial cysts; however, the entire cyst lining must be removed at the completion of sclerotherapy to prevent recurrence and abscess formation.     

Removal of a retropharyngeal foreign body in a horse, with the aid of ultrasonography during surgery

Diagnostic ultrasonography was used during surgery to assist in the removal of a piece of wire from the retropharyngeal region. A 3-year-old Quarter Horse mare was referred with dysphagia of 2 days' duration. Radiography revealed a 9-cm piece of wire located caudodorsal to the larynx. A ventral surgical approach was performed, dissecting along the right side of the larynx and trachea. The surgical field was filled with 0.85% sterile physiologic saline solution. A 5 MHz-mm sector scanner probe immersed in the fluid was able to locate the wire and facilitate the direction and depth of dissection to where the wire was identified and removed.     

Management of apposing,full‐thickness tracheal perforations in two horses

Two horses, one 15‐year‐old Arabian gelding and one 10‐year‐old Quarter Horse gelding, presented with a history of marked subcutaneous emphysema. The first case exhibited no external wound, although there was a depression noted on the ventral neck. The second case had a laceration on the ventral aspect of the neck over the trachea. Endoscopic examination revealed both horses to have concurrent dorsal and ventral perforations of the trachea. The horses were managed by placing a short, cuffed, J‐shaped tracheostomy tube in the ventral perforation, while the dorsal perforation healed. The dorsal perforation in the first horse was allowed to heal by second intention, whereas sutures were placed in the dorsal perforation in the second case to reduce the healing time. Both horses were maintained on oral antimicrobial and nonsteroidal anti‐inflammatory medications throughout treatment. The dorsal perforation healed after 13 days in the first horse, and 22 days in the second horse. The ventral perforation healed in both horses by second intention following tracheostomy removal, giving a cosmetically acceptable result. In addition to facilitating tracheal healing, the tracheostomy tubes prevented the progression of subcutaneous emphysema, and promoted its resolution.     

Long-term retrospective study of 52 horses with sinunasal cysts

REASONS FOR PERFORMING STUDY: The spectrum of clinical presentation, methods of diagnosis, management and prognosis in cases of sinunasal cysts (SNCs) requires more extensive study. Despite the extensive nature of SNCs, the prognosis for afflicted horses appears to have improved since earlier studies were conducted. OBJECTIVES: To evaluate prognosis and cosmetic outcome of surgical ablation in 52 cases of SNCs. METHODS: Fifty-two case records (1982-2005) of horses affected with SNCs were retrieved from the archives. Subject details, clinical signs, diagnostic techniques, surgical management and post surgical complications were extracted. Owners and referring veterinarians were contacted to assess the results of treatment. RESULTS: There was no biphasic age distribution. The major presenting signs in descending order of frequency were facial swelling, mucopurulent nasal discharge, nasal airflow obstruction and abnormal respiratory noise. Common endoscopic findings included narrowed nasal meati, a cyst in the nasal cavity and a cyst visible caudal to the nasal septum viewed from the contralateral unaffected nasal meatus. Typical radiological signs included a discrete mass in the sinunasal region, a diffuse increase in opacity over the sinunasal region, free fluid lines, nasal septal deviation, expansion of the ventral conchal sinus and distortion of dental apices. Cyst extirpation using an osteoplastic flap provided a successful outcome. Forty-five of 48 horses showed complete resolution of clinical signs after subtotal or total extirpation of the cyst wall. Follow-up information was not available for the other 3 horses. Thirty-nine of 45 horses had a good to fair cosmetic appearance, judged to be good in 26 horses, fair in 13 and poor in 6. Results confirmed that the prognosis for full recovery has improved since a previous report of 15 cases. CONCLUSIONS AND POTENTIAL RELEVANCE: Equine sinunasal cysts may arise in horses of any age; presenting signs should alert clinicians to their likely presence. A discrete well-circumscribed mass found during radiographic examination provides supporting evidence of a cyst. The vivid yellow, translucent, seromucoid fluid aspirated from cysts is characteristic of the condition.     

Ventral intraspinal cysts associated with the intervertebral disc: magnetic resonance imaging observations in seven dogs

Objective— To report clinical and diagnostic imaging features, and outcome after surgical treatment of ventral intraspinal cysts in dogs.
Study Design— Retrospective study.
Animals— Dogs (n=7) with ventral intraspinal cysts.
Methods— Clinical signs, magnetic resonance imaging (MRI) findings and surgical findings of 7 dogs and histologic findings (1 dog) with intraspinal cysts associated with the intervertebral disc were reviewed.
Results— Ventral intraspinal cyst is characterized by: (1) clinical signs indistinguishable from those of typical disc herniation; (2) an extradural, round to oval, mass lesion with low T1 and high T2 signal intensity on MRI, compatible with a liquid-containing cyst; (3) cyst is in close proximity to the intervertebral disc; and (4) MRI signs of disc degeneration. Although the exact cause is unknown, underlying minor disc injury may predispose to cyst formation.
Conclusion— Intraspinal cysts have clinical signs identical to those of disc herniation. Given the close proximity of the cyst to the corresponding disc and the similarity of MRI findings to discal cysts in humans, we propose the term "canine discal cyst" to describe this observation.
Clinical Relevance— Discal cysts should be considered in the differential choices for cystic extradural compressing lesions.     

Acquired peri-articular ganglion cyst in the lateral femorotibial joint in an 18-year-old Percheron cross mare

This report describes a case of sudden lameness in an 18-year-old Percheron cross mare after presumably being kicked by another horse, and the subsequent formation of a ganglion cyst originating from the lateral femorotibial joint. Physical examination, radiographic and ultrasonographic investigation identified a soft round 5 cm diameter mass attached to the left lateral femorotibial joint. After surgical removal, histopathological examination confirmed a ganglion cyst. The horse responded well to the surgical removal of the cyst, and 4 weeks after the surgery, the mare has returned back to her same athletic performance. According to the authors’ knowledge, this is the first reported case that describes a peri-articular ganglion cyst originating from the stifle joint.     

Tubular duplication of the cervical portion of the esophagus in a foal.

Tubular duplication of the cervical portion of the esophagus was diagnosed in a 10-day-old female Quarter Horse. The foal was examined because of the development of a 12- to 15-cm diameter mass at the caudal aspect of the mandible after suckling. The foal was dyspneic when in lateral recumbency. Radiography and ultrasonography revealed a fluid- and gas-filled mass. Endoscopy revealed a normal-appearing upper airway and esophagus. Complete surgical resection of the mass was successful. The mass had a 3-mm diameter communication with the esophageal lumen at the pharyngoesophageal oriface. Histologic examination revealed stratified squamous epithelium lining the cyst-like cavity. The wall of the mass had circumferential and longitudinal layers of smooth muscle with few submucosal glands. The clinical, gross pathologic, and histopathologic findings were consistent with tubular duplication of the cervical portion of the esophagus.     

Congenital Aneurysmal Bone Cyst in a Foal

A 2-week-old female Thoroughbred foal was born with a firm, expansile, progressively enlarging mass involving the left hemimandible. Grossly, the mass was composed of variably sized cavernous spaces containing clotted blood and serofibrinous exudate, separated by fibrous and fibroosseous septa. Histologically, the spaces were lined by flattened to plump spindle cells and contained hemorrhage, fibrin, and multinucleated osteoclast-like cells. The septa separating adjacent cavernous spaces contained interlacing bundles and streams of spindle cells, multinucleated giant cells, hemosiderophages, mineral deposits, and spicules and trabeculae of reactive and poorly mineralized bone. A diagnosis of congenital aneurysmal bone cyst was made based on histologic features. The pathogenesis for the development of aneurysmal bone cysts is still undetermined, although spindle cells lining cavernous spaces in the foal exhibited negative immunolabeling for factor-VIII (F8) and positive immunolabeling for smooth muscle actin, suggesting vascular smooth muscle origin and possible blood flow disturbance.     

Tracheal reconstruction in a foal

A 6-month-old Standardbred foal was admitted for repair of an acquired tracheal deformity. At 2 months of age, 4 midcervical tracheal rings had been transected and, as a result, that portion of the trachea would collapse when the foal became excited or was exercising. At surgery, partial chondrotomies allowed remodeling of the deformed rings, which were then anchored to 2 partially encircling, polypropylene prostheses. After surgical repair, the horse raced successfully.     

Bilateral hypoplasia of the soft palate in a foal

Bilateral hypoplasia of the soft palate and aspiration pneumonia occurred in a Standardbred foal. The filly was presented with a history of illthrift, dyspnoea, coughing and bilateral nasal discharge. Abnormal sounds (crackels and wheezes) were auscultated over all lung fields and the cervical trachea. Endoscopy revealed a shortened soft palate with a uvula-like mass protruding from the free border into the nasopharynx. Mucopurulent material was present in the trachea. Samples obtained by tracheal wash were submitted for cytology, culture and sensitivity testing. Results indicated a septic inflammatory process. On lateral radiographs of the thorax there were patchy areas of consolidation and air bronchograms. The foal was euthanased. Necropsy confirmed the presence of a palatal defect and aspiration pneumonia of moderate severity. No other congenital abnormalities were present.