Thrombocytopenia in Horses: 35 Cases (1989–1994)

The records of 3,952 equine patients presenting to the Veterinary Teaching Hospital at North Carolina State University College of Veterinary Medicine were evaluated to determine risk factors associated with thrombocytopenia. Of 2,346 horses from which a CBC was obtained, 35 (1.49%) were thrombocytopenic (platelet count < 75,000/μL). A reference population of 189 horses with normal platelet counts (75,000 to 300,000/μL) was also studied. Standardbred horses were at increased risk for thrombocytopenia. but age and gender were not identified as significant risk factors. Horses with infectious or inflammatory diseases were at increased risk for thrombocytopenia. The potential association of clinical and clinicopathologic factors with thrombocytopenia were assessed by reviewing a series of multiple logistic regression models. Clinical and clinicopathologic variables significantly associated with thrombocytopenia in the final model included increased PCV, increased band neutrophil count, increased total WBC, and decreased plasma protein concentration. Increased mature neutrophil count was associated with normal platelet counts. Thrombocytopenic horses were significantly more likely to die or be euthanized than were horses with normal platelet counts. J Vet Intern Med 1996;10:127–132. Copyright © 1996 by the American College of Veterinary Internal Medicine .     

Prognostic Indicators for Horses with Duodenitis-Proximal Jejunitis 75 Horses (1985–1989)

The medical records of 75 horses with duodenitis-proximal jejunitis (DPJ) were reviewed. Ages, physical parameters, laboratory values, and treatment data were compared between horses surviving DPJ and horses not surviving DPJ (Table 1). Fifty of 75 horses (66.6%) survived. Sixty-six horses (88.0%) were managed with medical treatment alone and nine horses (12.0%) were managed with medical treatment plus surgical intervention. Using a logistic regression model, the association of each of the 19 physical and laboratory parameters with death was evaluated retrospectively in the 75 horses. Three parameters (anion gap, abdominal fluid total protein concentration, and volume of gastric fluid for the first 24 hours of hospitalization) were significantly associated with death by univariate analysis. Using a stepwise multiple logistic regression, two parameters remained significantly associated with death (P < 0.05), anion gap and abdominal fluid total protein concentration.     

Disseminated Intravascular Coagulation Associated with Colic in 23 Horses (1984–1989)

Disseminated intravascular coagulation (DIC) secondary to colic was diagnosed in 23 horses. Each horse was categorized retrospectively as to the cause of the colic based on surgical and/or necropsy findings: group 1 consisted of 14 horses with compromised intestine that required resection and anastomosis; group 2 consisted of 3 horses with nonstrangulating intestinal displacement and/or impactions; and group 3 consisted of 6 horses with colic associated with enteritis and/or colitis. Horses were considered to be affected with DIC if at least three of five hemostatic parameters were significantly abnormal: decreased antithrombin III (AT III) values, increased level of fibrin degradation products (FDP), thrombocytopenia, prolonged activated partial thromboplastin time, and prolonged prothrombin time. The most consistent hemostatic abnormalities were decreased AT III activity, increased FDP titers, and thrombocytopenia. Clotting times were more variable and did not always correlate with the presence of excessive hemorrhage. Excessive hemorrhage was present during surgery in seven horses and occurred within 1 to 12 hours after surgery in nine other horses. In addition to treatment of the primary disease, 19 horses received treatment for DIC consisting of heparin and/or plasma or fresh whole blood transfusions. Heparin alone was used in 12 horses. Heparin, in addition to fresh whole blood transfusions or fresh plasma, was administered to four horses. Three horses were treated with plasma alone. Four other horses were not treated specifically for the DIC. Eight horses (34%) survived the acute coagulopathy. Although a greater proportion of the surviving horses received heparin therapy (87.5%; 7/8) than did those that died (60%; 9/15), the difference was not statistically significant (P = 0.345).(ABSTRACT TRUNCATED AT 250 WORDS)     

Palmar Digital Neurectomy in Horses 57 Cases (1984–1990)

The medical records of 57 horses that had palmar digital neurectomy performed between 1984 and 1990 were reviewed. Neurectomies were performed either by transection and elec-trocoagulation (47 horses) or by the guillotine technique (10 horses). Middle-aged geldings, Quarter Horses, and Thoroughbreds were significantly over-represented when compared with the hospital population. Horses used as hunter/jumpers also appeared to be over-represented. Complications occurred in 17 (34%) of the 50 horses for which follow-up information was obtained. Recurrence of heel pain was the most common complication (14 horses). Palpable painful neuromas were detected in three horses. One year after neurectomy, 74% of the horses were sound; this decreased to 63% after 2 years.     

Surgical Treatment of Bile Peritonitis in 24 Dogs and 2 Cats: A Retrospective Study (1987–1994)

Objective — The purpose of this study was to determine the signalment, history, clinical signs, diagnosis, treatment, outcome, and factors affecting outcome of dogs and cats surgically treated for bile peritonitis. Study Design — Retrospective study. Animals or Sample Population — Twenty-four dogs and two cats surgically treated for bile peritonitis. Methods — The medical records of dogs and cats surgically treated for biliary effusions at the Ohio State University and Michigan State University between 1987 and 1994 were reviewed. Statistical analysis was performed to compare factors affecting outcome. Results — The cause of the biliary effusion was determined in 24 animals, and resulted from disruption of the biliary tract secondary to trauma (n = 13) or necrotizing cholecystitis (n = 11). Determination of the bilirubin concentration of the abdominal effusion was the only diagnostic test that was 100% effective in diagnosing bile leakage before surgical intervention. The bilirubin concentration of the effusion was consistently at least two times higher than the serum bilirubin concentration. Bacteriologic culture and sensitivity revealed that a septic, biliary effusion was usually associated with multiple types of gram-negative bacteria. The overall survival rate was 50% (13 of 26). The peripheral white blood cell count was significantly lower in survivors (mean 20,608/uL) compared with nonsurvivors (mean 35,712/uL). The immature neutrophil count was also significantly lower in survivors (mean 686/uL) than in nonsurvivors (4,852/uL). Only 27% (3 of 11) of the animals with a septic biliary effusion survived. In contrast, 100% (6 of 6) of the animals in which no bacteria were isolated from the abdominal effusion survived. Open abdominal drainage was not a successful treatment for 7 of 9 animals with septic biliary effusions. Survival was not significantly affected by the distribution of the peritonitis, cause of biliary effusion, or duration of clinical signs before surgical intervention. Conclusions — Patients with sterile biliary effusions have a much lower mortality rate than those with septic biliary effusions. The successful treatment of sterile biliary effusions does not require open abdominal drainage, and is not affected by the duration of the effusion. Clinical Relevance — This retrospective study provides information that may aid the surgeon in the diagnosis and treatment of bile peritonitis.     

Femoral diaphysis fractures in cattle: 26 cases (1994–2005)

Objective   This retrospective study was conducted to evaluate the outcome for cattle with diaphyseal fractures of the femur, but not including capital physeal injuries.
Methods   Sources of information were medical records of cattle having a definitive diagnosis of diaphyseal femoral fractures and telephone survey of owners.
Results   Medical records for 26 cattle with femoral fracture were found; of the 20 aged less than 2 months, 15 were treated surgically, 4 conservatively (stall rest) and 1 was euthanased without treatment. The surgical treatment varied according to the configuration of the fracture and the surgeon's experience. Surgery for mid-diaphyseal fractures had a significantly better surgical outcome then distal diaphyseal fractures (P < 0.05), as there were significantly fewer postoperative complications. Of the 15 calves treated surgically, 10 were discharged from hospital and 5 were retained in the herd without noticeable lameness. Of the 4 calves treated conservatively, 3 were alive at follow-up, but 2 were still lame. Of the 6 older cattle, 3 were euthanased without treatment and 3 were treated conservatively, 2 of which were alive at follow-up but 1 was still lame.
Conclusion   Conservative treatment of femur fracture in cattle is possible but associated with complications during the convalescence. Continued research is needed to optimise distal diaphyseal fracture stabilisation in young cattle.     

Bronchointerstitial Pneumonia and Respiratory Distress in Young Horses: Clinical, Clinicopathologic, Radiographic, and Pathological Findings in 23 Cases (1984–1989)

Twenty-three foals, between 1 and 7 months old, with signs of acute respiratory distress, were examined at the Veterinary Medical Teaching Hospital (VMTH), University of California, Davis, between 1984 and 1989. Characteristic features included sudden onset of severe respiratory distress and tachypnea, cyanosis unresponsive to nasal oxygen, pyrexia, hypoxemia, hypercapneic respiratory acidosis, poor response to treatment, and histopathologic lesions of bronchiolitis and bronchointerstitial pneumonia. Seven of the 23 foals were normal before the onset of respiratory distress, 3 foals were found dead, aqd 13 foals were being treated for respiratory tract infections at the time of presentation. Laboratory data obtained for 13 horses showed increased plasma fibrinogen concentration (630.7 ±193 mg/dL), leukocy-tosis (18,607 ± 7,784/μL), and neutrophilia (13,737 ± 8,211/μL). Thoracic radiographs showed a diffuse increase in interstitial and bronchointerstitial pulmonary opacity and, in 5 foals, an alveolar pulmonary pattern of increased density was also seen. In 3 foals heavy interstitial infiltration proceeded to a coalescing nodular radiographic appearance. Microbiological culture of tracheobronchial aspirates (TBA) from 9 foals yielded bacterial growth, but no one bacterial species was consistently isolated. Microbiological culture of postmortem specimens of the lung from 6 foals yielded growth of bacteria that included Escherichia coli, Enterobacter spp., Proteus mirabilis, Klebsiella pneumonias, Rhodococcus equi, or β-hemolytic Streptococcus spp. Tracheobronchial aspirates from 4 foals and lung samples collected from a further 4 foals at necropsy yielded no bacterial growth. Cultures were not taken from two foals premortem or postmortem. Virologic examination of TBA, lung tissue, or pooled organ tissue from 12 foals was negative. Viral culture of TBA from 1 foal showed cytopathic effects and positive immunoflu-orescence for equine herpes virus type II (EHV-II). In addition to the 3 foals that were found dead, 11 foals died or were euthanatized. Pathologic lesions were limited to the lungs in 50% of the foals; the remainder also had bowel lesions suggestive of hypoxic injury. The predominant histopathologic pulmonary lesions included bronchiolitis, bronchiolar and alveolar epithelial hyperplasia, and necrosis. Many bronchioles were filled with mucoid and fibrinocellular exudate. The peribronchiolar interstitium and adjacent alveolar spaces were also infiltrated with inflammatory cells and contained proteinaceous edema fluid. Type II cell hyperplasia and hyaline membrane formation were observed in the majority of foals and in 2 foals alveolar multinucleate giant cells were also present. Nine of 13 foals (69%) on which treatment was attempted at the VMTH survived after aggressive medical care that included external thermoregulatory control, oxygen by nasal insufflation, antimicrobial drugs, bronchodilating agents, nonsteroidal anti-inflammatory drugs, and corticosteroids. Persistent radiographic evidence of increased interstitial density was noted up to 24 months after initial presentation, and one horse remained exercise intolerant for at least 15 months after discharge. The exact etiopathogenesis of this disorder and long-term sequalae in the survivors have yet to be fully determined. However, it is likely that a number of different insults rather than a single agent may initiate the pulmonary damage that leads to severe interstitial pneumonia and subsequent acute respiratory distress or apparent sudden death in foals. (Journal of Veterinary Internal Medicine 1993; 7:277–288. Copyright © 1993 by the American College of Veterinary Internal Medicine.)     

Medical Management of Right Dorsal Colitis in 5 Horses: A Retrospective Study (1987–1993)

Right dorsal colitis in horses has been associated with administration of phenylbutazone. Although reports of right dorsal colitis in this species have described surgical treatment associated with a poor prognosis, we have had success treating this condition medically. This report describes 5 horses with right dorsal colitis confirmed during celiotomy that were initially managed medically. All horses had a history of intermittent abdominal pain; weight loss was noted in only 1 horse. The doses (2.0 to 4.6 mg/kg PO bid) and duration (5 to 30 days) of administration of phenylbutazone were not unusually high relative to those recommended (4.4 mg/kg PO bid). Hypoproteinemia and hypoalbuminemia were observed in all horses at the time of admission; packed cell volume was low in 4 horses, and hypocalcemia was also observed in 4 horses. Three of 5 horses (60%) appeared to respond to dietary management and discontinuation of administration of nonsteroidal anti-inflammatory drugs. Dietary management consisted of feeding pelleted feed, and restricting or eliminating roughage for a period of at least 3 months. Two horses developed strictures of the right dorsal colon. One horse that developed a colonic stricture, possibly because its owners did not comply with recommendations for management, was subsequently treated surgically. The remaining horse that developed a stricture of the right dorsal colon was euthanized. These data indicate that some horses with right dorsal colitis can be successfully managed with medical treatment.     

Outcome of Adult Horses with Botulism Treated at a Veterinary Hospital: 92 Cases (1989–2013)

Background

There are no studies evaluating a large population of adult horses treated for botulism. Reported survival rates in outbreak situations are low; however, many horses in outbreaks do not receive treatment.

Hypothesis/Objectives

That adult horses treated at a veterinary hospital would have improved survival compared to outbreak situations. Additional aims included identification of predictors of nonsurvival.

Animals

All horses greater than 6 months of age with a final diagnosis of botulism admitted to a veterinary teaching hospital between 1989 and 2013 were included.

Methods

Retrospective study. Historical, admission, and hospitalization data were retrieved from medical records and associations between variables and nonsurvival were identified using logistic regression. Two multivariable models were developed pertaining to (1) information available at admission and (2) clinical findings during hospitalization.

Results

Ninety‐two records met inclusion criteria. Retained variables for the two models indicated that higher rectal temperature (OR, 1.94; CI, 1.19–3.17) and dysphagia (OR, 4.04; CI, 1.01–16.17) observed at admission increased the odds of survival, as did treatment with antitoxin (OR, 121.30; CI, 9.94–1,480.65). Horses with abnormal respiratory effort or inability to stand had decreased odds of survival. Overall survival was 48% but was significantly higher (67%, P = .011) for horses that arrived standing, and even higher (95%, P < .001) for horses that remained able to stand throughout hospitalization. Complications occurred in 62% of horses but were not associated with nonsurvival.

Conclusions and Clinical Importance

Horses that lose the ability to stand have a poor chance of survival. Complications are common in treated horses but do not reduce survival.     

Efficacy of metoclopramide for treatment of ileus in horses following small intestinal surgery: 70 cases (1989–1992)

Summary: In this retrospective study, postoperative ileus was studied in horses having resection of the small intestine followed by a jejunojejunal (n=35) or a jejunocaecal (n=35) anastomosis. Twenty-six horses received no metoclopramide, 27 received metoclopramide as an intermittent intravenous infusion and 17 horses received metoclopramide as a continuous intravenous infusion (0.04 mg/kg/hour). Horses receiving a continuous infusion of metoclopramide had a reduced total volume (P< 0.001), shorter duration (P< 0.001), and a slower rate (P< 0.001) of postoperative gastric reflux, and a shorter postoperative hospital stay (P< 0.01) when compared to horses receiving no metoclopramide and horses receiving metoclopramide as an intermittent infusion. Horses having jejunocaecostomy performed had a larger volume (P< 0.05), longer duration (P< 0.05), and a greater rate (P< 0.05) of postoperative gastric reflux, and a longer postoperative hospital stay (P< 0.001) than horses undergoing jejunojejunostomy. Horses that had an abdominal drain placed during surgery had a longer length of intestine resected (P< 0.05) and a longer postoperative hospital stay (P< 0.05) than horses without an abdominal drain. Horses that died or were euthanased during the postoperative period had a greater total volume (P< 0.05), longer duration (P< 0.05), and greater rate of postoperative gastric reflux (P< 0.01), a longer length of small intestine resected (P< 0.01), and a shorter postoperative hospital stay (P< 0.05) than horses that survived until discharge from the hospital. In a multivariate regression analysis the continuous infusion of metoclopramide was the only variable that contributed significantly to predicting the total volume (P< 0.001; r²= 0.24), duration (P< 0.001; r²= 0.24) and rate (P< 0.001; r²= 0.25) of postoperative gastric reflux. We concluded that metoclopramide given as a continuous intravenous infusion decreased the incidence and severity of ileus following small intestinal resection and anastomosis in horses.     

Prognosis Factors for Survival in Cats After Removal of a Primary Lung Tumor: 21 Cases (1979–1994)

Objective —To identify possible prognostic factors for survival time in cats with a primary lung tumor after surgical excision.
Study Design —Retrospective clinical study.
Animal Population —21 cats with histologically confirmed primary lung tumors removed surgically.
Methods —Medical records for cats treated between 1979 and 1994 at 14 participating veterinary referral hospitals were reviewed.
Results —After surgical resection and recovery, 18 cats died from metastatic disease with a median survival time of 115 days (range, 13 to 1,526 days). Three cats were lost to follow-up at 119 days, 251 days, and 410 days after the surgical procedure. Contingency table analysis to determine if an association existed between clinical findings (breed, age, gender, body weight, clinical signs, duration of clinical signs, and radiographic findings) or histological features and survival time was performed. Only histological morphology of the primary lung tumor showed a significant association with survival time. Twelve cats with moderately differentiated tumors had a significantly longer survival time (median, 698 days; range, 19 to 1,526 days) than the nine cats with poorly differentiated tumors (median, 75 days; range, 13 to 634 days).
Conclusions —Surgical resection of a solitary primary lung tumor in cats is indicated.
Clinical Relevance —A poor prognosis for long-term survival is warranted for those cats having a poorly differentiated primary lung tumor.     

Feline acne and results of treatment with mupirocin in an open clinical trial: 25 cases (1994–96)

Clinical and diagnostic parameters, and response to topical mupirocin in 25 cats with feline acne are described. The chin was the most common area affected, but the lower lip, upper lip and the commissure of the lips also frequently had lesions. The most common clinical sign was the presence of crusts, followed by comedones, erythema, alopecia, pruritus and nodules/fistulas. Deep skin scrapings for ectoparasites, cytological examination of superficial skin scrapings, and fungal cultures from the chin were performed on all cats. Dermatophytes were cultured from two cats and Malassezia pachydermatis was cultured ( n  = 2), seen on cytology smears ( n  = 1), or noted on histopathology ( n  = 1). Skin biopsies were obtained from three of the cats and most commonly showed dilatation of sebaceous gland ducts, neutrophilic or pyogranulomatous infiltration of the sebaceous glands, and pyogranulomatous inflammation of the dermis.
All cats were treated with topical 2% mupirocin ointment twice daily for 3 weeks as the sole treatment. Treatment response was excellent in 15 cats and good in nine cats. One cat had a contact reaction to the mupirocin, necessitating stopping treatment. The response to treatment of the six cats with dermatophyte or years involvement was good ( n  = 3) or excellent ( n  = 3).     

Survival and factors affecting survival in small ruminants and camelids attacked by dogs: 62 cases (1994–2004)

Objective: To determine the survival rates and factors affecting survival in small ruminants and camelids attacked by dogs. Design: Retrospective study. Setting: Two university teaching hospitals. Animals: Thirty goats, 28 sheep, 3 alpacas, and 1 llama. Measurements and main results: Medical records were reviewed to obtain signalment, time between injury and admission, hospitalization length, lesion site, treatment, complications, survival rate, and cost. Follow‐up information was obtained by telephone conversation with the owner. Sixty‐two patients met the inclusion criteria. Six animals were euthanized at admission and thus excluded. Of the 56 animals that were treated, 43 (77%) were discharged, 5 (9%) died, and 8 (14%) were euthanized. Animals that had thoracic or abdominal injuries, required surgery, or received more potent analgesic therapy were less likely to survive to discharge from hospital compared with animals that did not. Complications developed in 50 (82%) animals. Animals with respiratory complications were also less likely to survive to discharge from hospital than animals that did not. Long‐term follow up was available on 38/43 (88%) animals that were discharged. Thirty‐five of 38 (92%) animals were discharged and recovered from their injuries and 5 animals had long‐term complications. Conclusions: Small ruminants and camelids that are attacked by dogs have a good prognosis for short‐term survival. Short‐term survival is affected by lesion location and complications.     

Vegetative Endocarditis in Equids (1994–2006)

Background: Endocarditis is a rare heart condition with variable clinical expressions in equids. Risk factors for this disease are incompletely understood. Objective: Describe risk factors for endocarditis in equids. Animals: One hundred and fifty‐three equids admitted to Liège University, 9 diagnosed with endocarditis and 144 free from endocarditis but admitted to the hospital with a differential diagnosis including this disease. Methods: Retrospective case‐control study. Results: Equids with endocarditis were significantly younger (mean age = 4.84 ± 5.74 years) than control equids (mean age = 10.8 ± 7.73 years) (P= .01). No sex or breed predisposition was observed. Animals with hyperthermia (odds ratio [OR] = 24.4; confidence interval [CI] = 1.40–428), synovial distension (OR = 13.4; CI = 3.00–59.8), lameness (OR = 6.52; CI = 1.63–26.1), hyperglobulinemia (OR = 26.4; CI = 3.03–229), hypoalbuminemia (OR = 11.4; CI = 1.34–96.8), hyperfibrinogenemia (OR = 9.81; CI = 1.16–82.7), or leukocytosis (OR = 7.12; CI = 1.40–36.4) presented a significantly higher risk of having endocarditis than control horses. The presence of two of the clinical signs mentioned above significantly increased the probability of a diagnosis of endocarditis (P≤ .05). Conclusions and Clinical Importance: Age is associated with equine endocarditis. The diagnostic value of certain clinical signs and abnormalities in blood parameters in this disease are described.