Immune-mediated keratitis in horses: 19 cases (1998-2004)

OBJECTIVE: The purpose of this study is to describe clinical and histologic findings, treatment, and outcome of horses with suspected immune-mediated keratitis (IMMK). DESIGN: Retrospective study. ANIMALS: Nineteen horses that presented to NCSU-VTH from 1998 to 2004 with IMMK. Procedures Information retrieved from the medical records included signalment, duration of clinical signs, therapy prior to initial examination, ophthalmic abnormalities, diagnostics performed, therapy instituted, and long-term vision. RESULTS: Nineteen horses (22 eyes) were diagnosed with IMMK. Three distinct clinical groups were identified based on the depth of the lesion in the cornea: superficial stromal (n = 11 eyes), midstromal (n = 6 eyes), or endothelial (n = 5 eyes). Horses ranged from 5 to 19 years of age, with a mean age +/- SD of 11.9 +/- 3.6 years. Eleven horses had 12 months or greater duration of clinical signs of corneal disease prior to referral. Overall there was a mean duration of 11.8 +/- SD 8.3 months. Superficial stromal keratitis appeared as a superficial stromal cellular infiltrate with diffuse vascularization. Midstromal keratitis appeared as midstromal cellular infiltrate with mild, surrounding corneal edema and vascularization. Endothelial disease appeared as endothelial cellular infiltrate with diffuse corneal edema. In all types of IMMK, signs of uveitis or severe discomfort were not observed. CONCLUSIONS AND CLINICAL RELEVANCE: Horses with superficial IMMK responded to topical medical therapy, but responded best to surgical removal of the lesion. Horses with midstromal keratitis responded to topical cyclosporine therapy. Endothelial disease was the least amenable to therapy.     

Outcome of medical treatment for horses with foot pain: 56 cases

Reasons for performing study: Currently, there are limited data regarding the long‐term outcome of horses with foot pain treated with corrective shoeing, rest and rehabilitation, and intrasynovial anti‐inflammatory medication to target lesions detected with MRI. Objective: To report the long‐term (≥12 months) outcome of horses with foot lesions following medical therapy. Hypotheses: 1) There is no association between clinical parameters considered and a poor response to therapy. 2) Horses with a deep digital flexor tendinopathy are less likely to respond to medical therapy than horses without a deep digital flexor tendinopathy. Methods: The medical records of horses with foot pain subjected to MRI examination and medical therapy (2005–2007) were evaluated retrospectively. Data collected included history, signalment, occupation, duration and severity of lameness at the time of MRI, radiological and MRI abnormalities. Number of treatments, complications and long‐term response to treatment were obtained by detailed telephone questionnaires. Association between clinical and MRI findings and long‐term lameness were investigated. Results: Frequent abnormal structures included the navicular bone, the deep digital flexor tendon, the navicular bursa and the distal interphalangeal joint. Thirty‐four of 56 horses (60.7%) failed to return to previous level of exercise due to persistent or recurrent lameness or owners' decision to decrease the horse's athletic level; however, 11 horses (32.3%) were being used for light riding. Prognosis for horses with concurrent deep digital flexor tendon, navicular bone and navicular bursa lesions was worse than horses with individual lesions. Deep digital flexor tendinopathy was strongly associated with persistent or recurrent lameness. Conclusions: Horses with multiple foot lesions managed with conservative therapy have a guarded prognosis for long‐term soundness. Deep digital flexor tendinopathies negatively influence prognosis.     

Comparison of bone marrow aspiration at the sternum and the tuber coxae in middle-aged horses

The objective of this study was to compare bone marrow (BM) aspirates from the sternum and the tuber coxae of middle-aged horses. Bone marrow was obtained from the sternum and both tubera coxae of 12 healthy, 13-year-old geldings. Two different puncture techniques were used for the tuber coxae. The 2 syringes used for sternal sampling were evaluated separately. The mononuclear cell (MNC) fraction of the BM was isolated and the mesenchymal stem cells (MSCs) were culture-expanded. At the sternum, BM aspiration was always possible. Bone marrow aspiration at the tuber coxae required straight and deep needle penetration combined with high negative pressure. With this technique a median sample amount of 11.0 mL with large individual variation was obtained. A median of 3.06 × 10(6) MNC/mL BM (1st syringe) and 2.46 × 10(6) MNC/mL BM (2nd syringe) was isolated from sternal samples. In contrast, the tuber coxae yielded a median of 0.27 × 10(6) MNC/mL BM. The first passage yielded a median of 2.19 × 10(6) MSC (1st syringe) and 1.13 × 10(6) MSC (2nd syringe) from sternal samples, compared to a significantly lower median number of MSC from tuber coxae BM (0.06 × 10(6) MSC). The number of MNC and MSC obtainable from the BM aspirates taken from the tuber coxae is significantly lower than that obtained from the sternal BM aspirates. Autologous BM for the equine athlete is particularly clinically relevant at an advanced age. Based on our findings, the tuber coxae cannot be recommended for BM aspiration in middle-aged horses.     

Outcome of superficial keratectomy without conjunctival graft as a surgical technique for immune-mediated keratitis in horses: Four cases

This case report describes four horses with unilateral superficial or mid-stromal immune-mediated keratitis (IMMK) treated with a superficial keratectomy (SK) without a conjunctival graft. In two horses, the surgery was performed under general anaesthesia, and in two horses standing with sedation and local blocks. Results of this report show that SK is a viable treatment option in horses with chronic superficial and/or mid-stromal IMMK that can even be performed in the standing, sedated horse. When sufficient corneal tissue is removed, no recurrence is to be expected in the long-term follow-up (up to 31 months). In two horses, healing occurred without complications. Two horses developed a secondary bacterial infection post-operatively (Enterococcus faecalis and Staphylococcus aureus). In one case, this resulted in a pre-perforating melting corneal ulcer necessitating conjunctival pedicle graft surgery 13 days post keratectomy. In three horses, there was no recurrence of the IMMK with a long-term follow-up of 6–31 months. One case showed recurrence of IMMK in the cornea region surrounding the keratectomy 9 months after surgery.     

Tiludronate infusion in the treatment of bone spavin: A double blind placebo‐controlled trial

Reasons for performing study: Tiludronate regulates bone remodelling through a decrease of the resorptive process and should therefore ameliorate the remodelling processes active in osteoarthritis of the distal tarsal joints (‘bone spavin’) and alleviate pain associated with abnormal bone lysis. Objective: To confirm the efficacy of tiludronate, administered as a single infusion at a dose of 1 mg/kg bwt, in the treatment of bone spavin in the horse. Methods: A double blind placebo controlled trial on 108 clinical cases of bone spavin was undertaken. The lameness score of the lamest limb was assessed following distal tarsal analgesia of the contralateral limb and followed‐up using the same procedure throughout the study. Bone spavin in the lamest limb was confirmed by distal tarsal analgesia and radiography. Horses were treated at Day 0 and reassessed 60 days later after controlled exercise. A second nonblinded treatment was given to unresponsive horses and all horses were re‐examined at Day 120. Exercise levels were recorded at each examination. Results: Eighty‐seven horses completed the trial as per the protocol. The tiludronate horses were significantly less lame than the placebo horses (P = 0.0318). Horses treated at Day 60 with tiludronate showed further improvement in lameness at Day 120 (P = 0.0096 and P = 0.0034 for horses treated with tiludronate and placebo at Day 0, respectively). The only significant difference in radiographic findings between tiludronate and placebo was for presence of periarticular osteophytes (P = 0.006). Conclusions: Tiludronate treatment is proven to be effective in bone spavin in horses in association with a controlled exercise programme. Clinical relevance: Tiludronate in combination with controlled exercise offers an alternate medical treatment for bone spavin.     

Superficial, nonhealing corneal ulcers in horses: 23 cases (1989-2003)

Objective To characterize superficial, nonhealing corneal ulcers in the horse and to assess the affect of age, breed, sex, inciting cause of the ulcer, and treatment on healing time of these ulcers. Design Retrospective study. Animals Twenty‐three horses with superficial, nonhealing corneal ulcerations. Procedure Medical records from 1989 to 2003 of horses diagnosed with superficial, nonhealing corneal ulcers were reviewed. Signalment, duration of clinical signs, ophthalmic abnormalities, treatment and response to treatment were recorded. Horses were treated, in addition to medical therapy, using debridement, debridement and grid keratotomy, superficial keratectomy, and superficial keratectomy with conjunctival graft placement. Results Mean age ± SD of horses was 13.7 ± 5.8 years. The mean time of presence of the corneal ulceration was 38.9 ± 21.3 days. Mean time to complete re‐epithelialization of the corneal ulcers after treatment was 20 ± 14.7 days. Horses treated with debridement alone, grid keratotomy and superficial keratectomy healed in a mean time of 15.3 ± 14.6 days, 16 ± 12.6 days, and 22.8 ± 6.7 days, respectively. Conclusions and clinical relevance Horses treated with a single debridement at initial evaluation healed in a significantly shorter time period than horses treated with grid keratotomy or superficial keratectomy. The latter two procedures may be beneficial in the treatment of nonhealing ulceration in horses, but the results of this study suggest that these procedures should only be performed following failure of the ulcer to heal after epithelial debridement.     

Prevalence of ophthalmic disease in blue‐eyed horses

A perception exists amongst referring veterinarians and the lay public that blue‐eyed horses have increased frequency of ocular disease. The aim of this retrospective study was to assess the prevalence of ocular disease in horses with blue or heterochromic eyes relative to those with brown eyes. The medical records of horses presenting to either the Comparative Ophthalmology services or Equine Medicine/Surgery services at 2 institutions were reviewed. Signalment, ocular and nonocular diagnoses were recorded. Ocular disease was divided into 4 categories: adnexa, cornea, intraocular/orbit and squamous cell carcinoma (SCC). Owners were contacted by telephone to confirm iris colour. Chi‐square analysis was used to compare group proportions. A total of 164 eyes of horses with ocular disease and 212 eyes of horses without ocular disease were included. Blue eyes were equally common in the ocular disease and nonocular disease groups (P = 0.265). There was no significant difference in the proportion of blue‐ and brown‐eyed horses when comparing the adnexal and corneal (P = 0.548), corneal and intraocular/orbit (P = 0.379) and adnexal and intraocular/orbit (P = 0.843) categories. A significant difference was detected in the proportion of blue‐eyed horses between the adnexal (P = 0.000), corneal (P = 0.033), intraocular/orbital (P = 0.000) and SCC categories, with a higher proportion of blue‐eyed horses in the SCC than in the other 3 groups. Horses with blue or heterochromic irides are more likely to develop ocular SCC than horses with brown irides, but are not more likely to have adnexal, corneal or intraocular/orbital disease or to be presented for evaluation of ophthalmic disease. Veterinarians should consider the results of this study when answering questions from the lay public regarding the predisposition of blue‐eyed horses to ocular disease.     

Autologous point‐of‐care cellular therapies variably induce equine mesenchymal stem cell migration,proliferation and cytokine expression

Reasons for performing study: Autologous cellular therapy products including adipose‐derived stromal vascular fraction (SVF), bone marrow mononuclear cells (BMMNs), cord blood mononuclear cells (CBMNs) and platelet rich plasma are options for treatment of acute orthopaedic lesions while mesenchymal stem cells (MSCs) are culture expanded. These products may contribute to healing by secreting matrix proteins or growth factors, but they may also act on endogenous MSCs to facilitate healing. Objectives: To determine the effects of cell therapy products on MSCs function in vitro. The hypothesis was that cell therapy products promote MSCs functions including proliferation, migration and mediator release. Methods: Fat, bone marrow (BM), cord blood and platelets were obtained from 6 Quarter Horses. The BM‐MSCs and their autologous cell therapy products were co‐incubated in transwells. Mesenchymal stem cells proliferation, migration, gene expression and cytokine concentrations were determined. Results: All cell therapy products increased MSCs proliferation, but SVF induced significantly more proliferation than any other product. Also SVF elicited more MSCs chemotaxis and, along with BMMNs, significantly more MSCs chemoinvasion. Cord blood mononuclear cells stimulated MSCs to produce high concentrations of interleukin‐6 (IL‐6), transforming growth factor‐β1 (TGF‐β1), and prostaglandin E₂ (PGE₂). Stromal vascular fraction and platelet lysate did not stimulate MSCs but SVF and platelet lysate themselves contained high concentrations of PGE₂ and IL‐6 (SVF) and TGF‐β1 (platelet lysate). Conclusions: Autologous cell products variably stimulate MSCs functions with 2 primary patterns apparent. Products either contained preformed mediators that may have intrinsic healing function, or products stimulated MSCs to secrete mediators. Potential relevance: The specific clinical indications for these products may differ to include administration as a sole treatment modality prior to MSCs injection for intrinsic cell and cytokine activity (i.e. SVF) or administration concurrently with MSCs to activate MSCs for treatment of chronic lesions (i.e. CBMNs).     

Treatment of Bilateral Medial Femoral Condyle Articular Cartilage Fissures in a Horse Using Bone Marrow-Derived Multipotent Mesenchymal Stromal Cells

The objective of this study was to describe the use, and outcome, of multipotent mesenchymal stromal cells (MSCs) in the treatment of equine articular cartilage defects of the medial femoral condyle. A 4-year-old Thoroughbred gelding (n = 1) with bilateral stifle athroscopy was found to have bilateral articular cartilage fissure defects of the medial femoral condyles with concurrent cranial cruciate ligament injury. Bone marrow derived MSCs were isolated, expanded, and suspended in a partially autologous fibrin glue. The initial cell/fibrin glue mixture was delivered arthroscopically into the articular cartilage defects 90 days after the initial arthroscopic examination. Follow-up treatments included two additional injections of MSCs suspended in lactated Ringers solution, 5 and 13 months after the initial examination, directly into the joint. Post-treatment outcome was assessed by arthroscopic examination and by comparison of preinjury and post-treatment performance records. Arthroscopic evaluation 4 months after the initial MSC treatment revealed marked smoothing, reduction in the depth of cartilage defects and observation of moderate improvement in the cranial cruciate ligament. Approximately 15 months after the initial MSC treatment the horse returned to racing. Analysis of race records demonstrated that the post-treatment (including all three MSC treatments) average race earnings (earnings per start) were comparable with those predating the initial injury. The favorable clinical response in the face of an unknown, but likely, guarded prognosis suggest that MSC therapy is not deleterious and may augment healing of articular cartilage fissures of the medial femoral condyle. MSCs represent a viable and promising alternative therapy in the treatment of articular cartilage injuries in performance horses.     

The association of 2‐year‐old training milestones with career length and racing success in a sample of Thoroughbred horses in New Zealand

Reasons for performing study: There is increasing evidence that exercise early in life has a positive effect on musculoskeletal health. At present, there is little whole population research investigating the effect of racing as 2‐year‐olds on future racing career. Objectives: To investigate the association between attaining training milestones as 2‐year‐olds with length of career and racing success in Thoroughbred horses in New Zealand. Methods: Retrospective data were obtained of the 2001/02‐born Thoroughbred foal crop. The 3 training milestones were: registered with a trainer, trialled and raced. The association of the training milestones with career length was measured using the outcomes: number of race starts and number of years raced, in a Cox regression model. Logistic regression models analysed the association of the training milestones with the outcomes: won or placed in a race. Linear regression was performed to assess the association of training milestones with total career earnings. Results: Of 4683 horses in the population; 3152 horses were registered with a trainer, 2661 horses trialled and 2109 horses raced. Horses that raced as 2‐year‐olds had significantly (P<0.001) more race starts than those first raced as 3‐year‐olds or older, this was also true when the 2‐year‐old year data were omitted. Horses that raced as 2‐year‐olds had significantly (P<0.001) more years racing. Horses registered with a trainer, trialled or raced as 2‐year‐olds were more likely to have won or been placed in a race than those that achieved the milestones as 3‐year‐olds or older. Horses that first trialled and raced as 2‐year‐olds had greater total earnings than those that first trialled or raced at a later age. Conclusions and potential relevance: Two‐year‐old training milestones had a strong association with positive racing career outcomes. Horses in training or racing as 2‐year‐olds may have better musculoskeletal health throughout life than horses that are first in training or racing at a later age.     

Epidemiological features and association with crib‐biting in horses with neurological disease associated with temporohyoid osteoarthropathy (1991–2008)

A retrospective study of 43 cases of temporohyoid osteoarthropathy was performed to evaluate the epidemiological features and a possible association with crib‐biting. Data collected from records included case details, what diagnostics were utilised, whether medical or surgical treatment was administered, and outcome. Owners were contacted via telephone and asked whether the horse had displayed crib‐biting behaviour. Forty‐three horses were diagnosed with neurological disease associated with temporohyoid osteoarthropathy, 62.8% of which were Quarter Horse‐types. Median age at presentation was 10 years and median duration of neurological signs prior to presentation was 3 days. Skull radiographs and guttural pouch endoscopy were used to definitively diagnose temporohyoid osteoarthropathy in 72% of the cases. Of 43 horses, 21 received medical treatment and 15 surgical treatment, with an overall survival rate of 55.8%. Crib‐biting was observed in 31.3% of cases and there was a significant association between being afflicted with THO and likelihood of possessing the behaviour. Horses with neurological disease associated with THO were 8 times more likely to be crib‐biters compared to the general population.     

Carpometacarpal Osteoarthritis in Thirty‐Three Horses

Objective— To describe signalment, clinical, and radiographic changes associated with carpometacarpal osteoarthritis (CMC‐OA) and to report long‐term outcome. Study Design— Case series. Animals— Horses (n=33) with CMC‐OA. Methods— Medical records (1992–2007) of horses diagnosed with CMC‐OA were reviewed and signalment, clinical, and radiographic findings retrieved. Owners were contacted for information on the impact of lameness on intended use, response to treatment, progression of lameness, outcome, and owner satisfaction with response to treatment. Results— CMC‐OA identified in 39 limbs, occurred predominantly in middle‐aged and older Quarter Horses and Arabians, and caused severe lameness that prevented normal use. Characteristic swelling was centered over the 2nd metacarpal bone/2nd carpal bone articulation. Radiographic changes consisted of proliferative new bone, narrowed joint space, and subchondral lysis. Of 20 horses with follow‐up, 7 of 14 treated horses were euthanatized within 4 years and 4 of 5 nontreated horses within 3 years. Response to treatment was short lived and considered very poor by most owners. Conclusion— CMC‐OA seemingly occurs primarily in Quarter Horses and Arabians in our region. Response to conservative treatment is very poor and short‐lived with most horses being euthanatized. Clinical Relevance— Conventional treatment methods are unsuccessful for treating CMC‐OA.     

Nonulcerative bullous keratitis associated with Pseudomonas alcaligenes infection in a Thoroughbred mare

A 5‐year‐old Thoroughbred mare presented with an intermittently mildly painful right eye with a nonulcerative corneal opacity of several weeks' duration that had improved with topical steroids but recurred when steroids were withdrawn. Ophthalmic examination demonstrated a focal region of moderate corneal oedema and midstromal corneal infiltrate centrally but no other significant ocular abnormalities, and suggested a diagnosis of immune‐mediated keratitis. Empirical courses of both topical and systemic anti‐inflammatory drugs, both nonsteroidal and steroidal, led to initial improvement but bullous keratopathy developed when corneal oedema became profound. Due to the rapidly progressive nature of the bullous keratopathy combined with poor response to medical therapy, a keratectomy and conjunctival graft were performed under general anaesthesia. Intraoperative corneal culture of the keratectomy site grew Pseudomonas alcaligenes, a common soil and water contaminant. Histopathology of the keratectomy specimen revealed neutrophilic inflammation. Keratectomy and conjunctival graft led to resolution of ocular pain and inflammation, with an acceptable cosmetic and visual outcome. This report describes an unusual case of a nonulcerative Pseudomonas keratitis that responded well to surgical therapy, and underscores the complicated nature of nonulcerative keratitis in horses.     

Influence of various concentrate‐to‐roughage ratios on dietary intake and nutrient digestibilities of weanling horses

The objective of this study was to compare the feed intake and the apparent digestibilities of three different diets varying in concentrate‐to‐roughage ratios in weanling horses (n = 24) at 5 and 8 months of age. Horses were stratified by breed, gender, birth date and body weight and assigned to one of three dietary treatments containing the following concentrate‐to‐roughage ratios on an as‐fed basis: 70:30 (High Con), 50:50 (Equal) and 30:70 (Low Con). All horses were fed their respective diets for a 10‐day adaptation period and a 4‐day collection period at 5 and 8 months. There were no differences in BW or daily feed intake among treatments during both trials. The horses consuming Low Con had a greater amount of faecal output than High Con at both 5 and 8 months (p < 0.01). At 5 months, High Con had the highest crude protein (CP) digestibility (p < 0.05). At 8 months, High Con had a higher CP digestibility than Low Con (p < 0.01) and tended to be higher than Equal (p = 0.07). Acid detergent fibre (ADF) digestibility did not differ among treatments; however, horses fed the Low Con tended to digest a higher percentage of neutral detergent fibre (NDF) than both the Equal and High Con treatments (p = 0.09). Horses in the High Con treatment tended to digest a higher percentage of energy than those in the Low Con treatment (p = 0.06). Weanlings seem to digest protein more thoroughly when fed high‐concentrate diets and may digest fibre more efficiently when fed diets higher in fibre.     

Effects of diet and weight gain on circulating tumour necrosis factor‐α concentrations in Thoroughbred geldings

Low‐grade inflammation precedes the development of obesity‐related metabolic disorders in humans, but whether the same is true in the horse is not known. The objective of this study was to examine the effects of weight gain and diet on the inflammatory state of horses as determined by serum concentrations of tumour necrosis factor‐α (TNF), an inflammatory cytokine. Fifteen mature Thoroughbred geldings with an initial body weight (BW) of 519 ± 12 kg and body condition score (BCS) of 4.3 ± 0.1 were fed a diet of hay plus a concentrate that was either high in non‐structural carbohydrates (NSC) (i.e. starch and sugar), similar to those commercially available (CON) or one that had the energy source replaced with fat and fibre (FAT) for 32 weeks. Weight gain was achieved by feeding an additional 20 Mcal/day in excess of digestible energy maintenance requirements and resulted in a final BW of 608 ± 12 kg and BCS of 6.9 ± 0.1. Horses were exercised twice daily at a walk during the weight gain period. Horses were assessed bi‐weekly for BW and BCS. Serum TNF was analysed from blood samples collected at 4‐week intervals. Although treatment groups began the study with similar mean serum TNF concentrations, 12 weeks of FAT feeding promoted a decrease in circulating TNF that was maintained throughout the study with the exception of weeks 20 and 32. For either diet, there were no linear correlations between serum TNF concentration and BCS when horses increased in BCS from four to seven. The higher level of TNF observed in horses fed the CON diet indicates an increase in some level of systemic inflammation that was independent of their weight gain from a moderately thin to fleshy condition. The influence of diet on serum TNF concentrations should be investigated in horses fed to maintain body condition.     

Antimicrobial‐associated diarrhoea in three equine referral practices

Reasons for performing study: Although antimicrobial‐associated diarrhoea (AAD) is the most frequently observed adverse effect of antimicrobial therapy in horses, few multicentred studies on the prevalence of AAD have been performed. Objectives: To determine the prevalence of AAD in horses that developed diarrhoea after antimicrobial treatment for nondiarrhoeic conditions and identify the antimicrobials used. Methods: The 2009 database of 3 referral hospitals was searched to identify nonhospitalised horses (weanling age or older) treated with antimicrobials for nongastrointestinal conditions. Horses with these criteria that presented with diarrhoea during 2009 were included in the study. Additional information, including antimicrobial administered and results of faecal pathogen testing, was gathered on each hospitalised case. Results: Of the 5251 horses treated with antimicrobials for nongastrointestinal signs, 32 were diagnosed with probable AAD, a prevalence of 0.6% (95% confidence interval: 0.43–0.86%). The AAD‐diagnosed horses had an 18.8% (6/32) mortality rate. Horses with AAD had been treated for an average of 4.2 days. The most frequently used antimicrobials in horses with AAD were gentamicin in combination with penicillin (n = 7), enrofloxacin (n = 7) and doxycycline (n = 4). Clostridium difficile was identified in faecal samples from 4 horses, 2 of which died and Salmonella from 3 horses. Conclusions: Results indicated that the prevalence of AAD is low. Any antimicrobial class commonly used in equine practice is a potential cause of equine AAD. Other risk factors, such as opportunistic enteropathogens, may play a part in the development of diarrhoea secondary to antimicrobial usage. Potential relevance: Although the risk of equine AAD is low, this sequela of antimicrobial treatment is possible especially when opportunistic enteropathogens or other risk factors are present. Because drugs from any antimicrobial class can be potentially involved in AAD, clinicians have additional incentive to ensure the judicious use of antimicrobial agents.     

Precursor‐targeted immune‐mediated anemia in a dog with a stage IV mast cell tumor and bone marrow infiltration

A 12‐year‐old spayed female Shiba Inu dog was referred to our hospital for a suspected mast cell tumor (MCT) of the bone marrow (BM). Laboratory abnormalities included severe nonregenerative anemia (packed cell volume or PCV: 12.5%; reference interval (RI): 37.3‐61.7%; reticulocytes: 35.1 × 10³/µL; RI: 10‐110 × 10³/µL), and a few mast cells were visualized in the blood smear examination. The BM was hypercellular with hematopoietic cells, a decreased myeloid:erythroid (M:E) ratio (0.77; RI, 0.9‐1.8), and no dysplastic hematopoietic cells. Mast cells accounted for 11.5% of the total nucleated BM cells. Neoplastic mast cells and histiocytes phagocytizing erythroid progenitor cells were occasionally noted. The dog was diagnosed with precursor‐targeted immune‐mediated anemia (PIMA) concurrent and a stage IV MCT infiltrating the BM. Multimodal treatment included toceranib, imatinib, vinblastine, lomustine (CCNU), prednisolone, cyclosporine, mycophenolate mofetil, and a blood transfusion. The dog died due to MCT progression lasting 139 days after the initial BM examination. To the best of our knowledge, this is the first report of a dog presenting with PIMA and a stage IV MCT infiltrating the BM.     

Efficacy and safety of sound wave treatment of recurrent airway obstruction in horses

Background: One proposed nonmedical therapy for recurrent airway obstruction (RAO) in horses is a handheld acoustic device that propels sound waves from the nose down the tracheobronchial tree where it is intended to dislodge mucous and relax bronchospasm, permitting clearance of mucoid secretions. Objective: To evaluate the effectiveness and safety of this device when used as per the manufacturer's recommendations as a treatment for RAO. Animals: Nine adult horses previously diagnosed with RAO. Methods: Prospective, cross‐over clinical trial. Horses were exposed to a dusty environment until airway obstruction developed as defined by standard lung mechanics (SLM). Horses were randomly assigned to receive either acoustic therapy or a sham treatment for 4 weeks while being maintained in this environment. Horses were evaluated by clinical scores, SLM, and forced expiration regularly for 4 weeks. The opposite treatment was administered after a washout period. Results: Seven horses received the treatment; 9 received the sham. There were no changes (P > .05) in clinical score, maximal change in transpulmonary pressure (ΔP_Lmax), lung resistance (R_L), or the forced expiratory flow rate averaged over the last 75–95% of expiration (FEF_75?95%) over the study period. The device was determined to be safe, although several minor adverse effects were noted, including head tossing, coughing, and chewing during treatment. Conclusions and Clinical Importance: Treatment with this device did not improve clinical signs or lung function in horses with RAO kept in a dusty environment. Currently accepted treatments, including environmental management and medical therapy, should be recommended.     

Equine corneal stromal abscesses: An evolution in the understanding of pathogenesis and treatment during the past 30 years

The last 30 years have seen many changes in the understanding of the pathogenesis and treatment of equine corneal stromal abscesses (SAs). Stromal abscesses were previously considered an eye problem related to corneal bacterial infection, equine recurrent uveitis, corneal microtrauma and corneal foreign bodies in horses. They were more commonly diagnosed in horses living in subtropical climatic areas of the world. Therapeutic recommendations to treat equine SAs were historically nearly always a medical approach directed at bacteria and the often associated severe iridocyclitis. Today the pathogenesis of most equine SAs appears to be more often related to fungal inoculation of the anterior corneal stroma followed by posterior migration of the fungi deeper into the corneal stroma. There is also now an increased incidence of diagnosis of corneal SAs in horses living in more temperate climates. Medical and surgical treatments are now directed towards elimination of fungal and bacterial infections, reduction and replacement of diseased corneal stroma, and suppression of iridocyclitis. If the abscess and anterior uveitis do not respond satisfactorily to medical therapy, full thickness or split thickness lamellar keratectomy to remove the fungal hyphae and diseased stroma, followed by transplantation of healthy corneal allografts has a high rate of success in speeding healing and preserving sight. This paradigm shift in the ability to diagnose and institute therapy for corneal SAs in horses has evolved over the last 30 years, and is the focus of this paper.