Arthroscopic treatment for cervical articular process joint osteochondrosis in a Thoroughbred horse

A yearling Thoroughbred colt was presented for investigation of neck stiffness and episodes of intermittent neck pain without neurological signs. Osteochondrosis (OCD) of the cervical articular process joints (APJs) was diagnosed with the aid of radiography and computed tomography. An articular osteochondral fragment of the left fourth caudal cervical articular process was removed arthroscopically following a cut down approach to the joint capsule of the affected APJ. Surgical removal resulted in resolution of clinical signs at 4 weeks. However, subsequently the horse was markedly ataxic 6 weeks post surgery after being found cast in its stable. Cervical stenotic myelopathy was considered the most likely cause based on clinical and radiographic signs and the horse was subjected to euthanasia due to a poor prognosis for racing. Post‐mortem examination identified atypical cartilage within several cervical APJs with histological changes consistent with OCD. This case report supports OCD of the APJs as a cause of neck pain and confirms the clinical practicality and short‐term effectiveness of arthroscopic fragment removal. Surgical treatment for cervical OCD should be considered in horses without neurological signs, although case selection is important and the underlying pathology remains a risk factor for the development of subsequent neurological signs.     

Iohexol myelography in the horse

Iohexol, a water soluble non-ionic contrast agent, was evaluated for myelography in the horse. Both 300 and 350 mg iodine/ml iohexol gave diagnostic cervical myelograms. Pathological changes were limited to extradural oedema and an increase in the number of white blood cells and specific gravity in the cerebrospinal fluid two days after myelography. This increase in white blood cells in the cerebrospinal fluid was, however, much less than that recorded by other authors using metrizamide and iopamidol contrast media. These findings indicate that iohexol is a less irritant myelographic contrast agent than those previously evaluated in the horse.     

Iopamidol myelography in the horse

The use of the non-ionic, water-soluble contrast agent iopamidol for myelography in seven horses is described. Contrast columns of diagnostic quality were produced in all seven cases and the procedure did not invoke any adverse reactions in the five cases which were recovered from general anaesthesia. It is concluded that iopamidol is a safe and effective contrast agent for myelography in the horse.     

Use of iohexol for myelography in the horse

The use of iohexol as a contrast agent for myelography is reported in two groups of horses. Group 1 (n = 6) were used only for myelography and to assess the clinical and pathological effects of intrathecal administration of iohexol. A volume of 20 ml at a concentration of 300 or 350 mg iodine/ml gave satisfactory myelographic detail with no serious clinical or neurological side effects. Only a minimal inflammatory response could be demonstrated in cerebrospinal fluid at four and 14 days after injection. At post mortem examination 14 days after myelography there was no evidence of meningitis nor was any other pathological change detected. Group 2 (n = 19) comprised a series of clinical cases of suspected cervical vertebral malformation. The only untoward sequelae recorded involved two horses in which iohexol was diluted with sterile water prior in intrathecal injection. A progressive necrotising meningitis developed in both cases which necessitated euthanasia. It was concluded that the major advantages of iohexol for use in the horse were its diagnostic quality, safety and low cost.     

Refractive state of the Spanish Thoroughbred horse: a comparison with the crossbred horse

Objective To assess the refractive state of the equine eye utilizing retinoscopy. To compare the refractive state of Spanish Thoroughbred horses with the refractive state of Crossbred horses. Procedures The refractive state of 135 horses (264 eyes) was assessed utilizing streak retinoscopy. Two perpendicular meridians were examined in order to assess astigmatism at a working distance of approximately 67 cm. A group of 81 Spanish Thoroughbred horses was compared with a group of 54 Crossbred horses. Cyclopentolate ophthalmic solution was instilled in the eyes of a group of 18 horses to determine if accommodation has any influence on the assessment of the refractive state. Results Mean ± SE refractive state of all horses examined was ?0.17 ± 0.04 D. The mean refractive state of the Spanish Thoroughbred was ?0.28 ± 0.06 D while that of the Crossbred was ?0.01 ± 0.05 D. The refractive state of the Spanish Thoroughbred was found to be statistically different to that of the Crossbred. The most prevalent refractive state was emmetropia in all cases, followed by hyperopia for the Crossbred, and myopia for the Spanish Thoroughbred. Astigmatism ≥0.50 D present in both eyes from the same individual was found in 21.7% of all horses examined. Anisometropia ≥1.00 D was diagnosed in 4 out of 129 horses with both visual eyes. Cycloplegia did not statistically affect the refractive state of the evaluated eyes. Conclusions The equine eye has a refractive state close to emmetropia. Myopia is higher among Spanish Thoroughbred horses than among Crossbred horses.     

Sequelae of myelography in the horse

The records of 131 horses undergoing general anaesthesia and positive contrast cervical myelography with metrizamide were examined to determine the effect of the procedure on the 'patient'. Three per cent of minimally ataxic and moderately ataxic horses had serious complications after myelography. Thirty-two per cent of severely ataxic horses died or were destroyed after general anaesthesia and myelography. Although general anaesthesia and myelography are essential components of a complete neurological evaluation of a horse, they impose a significant risk.     

Tracheal morphometrics in the Thoroughbred horse

Equine tracheal lesions have been associated with the orotracheal intubation procedure. These lesions may occur because of differences in the dimensions of the endotracheal tube and the trachea. The importance of the dimensions of the trachea for studies on respiratory mechanics and the lesions produced by the endotracheal tubes encouraged us to determine the size of trachea of the Thoroughbred horse. This study determined and compared the length and internal diameters of the tracheas from 59 Thoroughbred horses, 35 males and 34 females, weighing between 400 kg and 500 kg, and free of signs of respiratory or cardiopulmonary diseases. The tracheas were removed from the horses between 2 and 12 hours after death. The internal diameters were measured in tracheal rings one, twenty, forty and the last before the carina. The length of each trachea was measured in both the normal and extended state. The number of tracheal rings was also determined. In the unstretched trachea, the width of the last tracheal ring and the number of tracheal rings were significantly greater in males than females. The results of this study provide information for better design and manufacturing of endotracheal tubes and as basic information for further studies on equine respiratory mechanics.     

Pressure-volume index-based volume calculation of contrast medium for atlanto-occipital myelography in dogs

Subarachnoid pressure recordings were made during atlanto-occipital myelography in 45 dogs with clinical signs of spinal disease. Iohexol was injected at a dosage of 0.3 ml/kg body weight and simultaneous pressure values were recorded in the cerebellomedullary cistern. The mean subarachnoid pressure was 9 ± 3 mmHg before and 70 ± 32 mmHg at the end of administration. From the pressure change induced by the volume load, the pressure-volume index (PVI) of the subarachnoid space was calculated and found to be in close correlation with body weight and the crown-rump length (r = 0.94 and 0.87). Using the estimated PVI values, the appropriate volume of contrast medium can be calculated for an animal according to body weight. Dogs of a large body size require relatively less contrast medium than small-sized dogs (range 0.17-0.35 ml/kg). This calculated volume is unlikely to increase the subarachnoid pressure above 40 mmHg as a specific pressure limit. Using these data, simplified recommendations for the choice of contrast medium volumes have been generated.     

Ultrasonographic investigation of the atlanto-occipital articulation in the horse

The purpose of this study was to evaluate ultrasonographic imaging as a means of easy and noninvasive diagnosis of articular and periarticular structures of the atlanto-occipital articulation in the horse; and to find a safe approach to the atlanto-occipital joint. Ultrasonographic investigations were performed on 6 healthy horses and 16 specimens from horses humanely destroyed age 2-17 years (mean 9.56 years). Preliminary examinations included anatomical studies and preparation of cross-sections. On 4 horse specimens, puncture of the atlanto-occipital joint under ultrasonographic guidance was performed and a new lateral approach undertaken. For ultrasonographic investigations, the neck was divided into 4 zones according to anatomical and clinical modalities: 1) insertion of the funiculus nuchae; 2) tuberculum dorsale of the atlas; 3) atlanto-occipital joint and 4) region above the foramen alare. Each zone was examined in transverse and longitudinal planes proceeding from cranial to caudal. Ultrasonography was found to be useful for soft tissue imaging of this region and was performed down to the atlanto-occipital joint of which the joint surfaces, joint capsule and collateral ligament could be delineated in both planes. We conclude that ultrasonography of the neck is a useful technique, representing an easy to use and safe method. However, further studies are indicated which should be performed on live subjects.     

Osteochondrosis of the occipital condyles and atlanto-occipital dysplasia in a Belgian horse

A lesion in the cervical region of a 14-month-old Belgian gelding with severe ataxia was suspected. Necropsy revealed symmetric focal cartilage defects compatible with osteochondrosis of the occipital condyles and atlanto-occipital dysplasia. To our knowledge this is the first equine report of symmetrical osteochondrosis of the occipital condyles causing neurologic signs.     

Pleuropneumonia as a sequela of myelography and general anaesthesia in a Thoroughbred colt

A 3-year-old Thoroughbred colt was presented to the University Veterinary Centre Camden for evaluation of ataxia. The horse was anaesthetised to facilitate cervical radiography and myelographic examination of the spinal cord. Recovery from anaesthesia was uneventful. Five days after general anaesthesia the horse re-presented with pleuropneumonia. It was euthanased 24 hours after presentation on humane grounds. Necropsy revealed severe tracheal erosion over the middle third of the ventral surface of the trachea, pleuropneumonia and narrowing of the cervical cord between C4 and C6. It is postulated that extension and flexion of the neck during myelography resulted in movement of the endotracheal tube cuff, causing the tracheal lesion and predisposing the colt to pleuropneumonia. Severe tracheal lesions and pleuropneumonia have not been reported as sequela of equine myelography, and should be considered as possible complications following repeated cervical manipulation during myelography in the horse.     

Skeletal aspects of the atlanto-occipital fusion in a Japanese brown calf.

Atlanto-occipital fusion in a Japanese Brown calf was examined morphologically, paying special attention to skeletal changes. At the craniovertebral junction, the basal occipital bone fused to the cranial extremity of the ventral arch of the atlas with the rudiment of the atlantal centrum. The dens was not formed at the axis. These changes suggest that a hypocentrum and a centrum of the atlas derived from the first cervical sclerotome had failed to separate the occipital base from the proatlantal sclerotome including the apical element of the dens. Although a developmental disturbance at the cervical and thoracic vertebrae was also associated, critical neurological signs such as ataxia and paralysis were absent.     

Mediastinal lymphoma with complete atrioventricular block in a horse

A 15-year-old, neutered-male pony presented with a history of weight loss during 4 months. Clinical evaluation revealed severe bradycardia and complete atrioventricular block. At necropsy, a lobulated mass in the anterior mediastinum and moderate enlargement of the superficial cervical lymph nodes were observed. The vagus nerve and the brachiocephalic trunk were embedded in this anterior mediastinal tumor. Histologically, the mass was composed of sheets of neoplastic lymphoid cells expressing CD3, with a low mitotic rate. To the best of our knowledge, this is the first reported case of mediastinal lymphoma associated with complete atrioventricular block in horses.     

Inclined running increases pulmonary haemorrhage in the Thoroughbred horse

REASONS FOR PERFORMING STUDY: Capillary stress failure-induced (exercise-induced) pulmonary haemorrhage (EIPH) during intense running in horses is thought to involve both intravascular (i.e. mean pulmonary arterial pressure [Ppa] > 100 mmHg) and extravascular (e.g. negative inspiratory pressure swings) mechanisms. HYPOTHESIS: That inclined running would reduce breathing frequency (coupled to stride frequency) and increase tidal volume thus increasing lung volume changes and intrapleural pressure swings resulting in more pronounced EIPH. METHODS: Six Thoroughbred horses were run to volitional fatigue (incremental step test) on a level (L) and inclined (I; 10%) treadmill in random order. Pulmonary minute ventilation, arterial blood gases and mean Ppa were obtained during each run while EIPH severity was quantified via bronchoalveolar lavage (BAL) 30 mins post run. RESULTS: Time to fatigue did not differ between trials (P > 0.05). At end-exercise, breathing frequency was reduced (L, 127.8 +/- 3.0; I, 122.6 +/- 2.1 breaths/min; P < 0.05) and tidal volume increased (L, 11.5 +/- 0.6; I, 13.1 +/- 0.5 L; P < 0.05) during inclined running. No differences existed in end-exercise plasma [lactate] between trials (L, 24.5 +/- 2.9; I, 26.2 +/- 3.4 mmol/l, P > 0.05); however, the mean peak Ppa was reduced during the inclined run (L, 105+5; I, 96 +/- 4 mmHg, P < 0.05). In the face of reduced Ppa, EIPH severity was increased significantly (P < 0.05) during the inclined vs. level run (L, 37.0 +/- 11.7; I, 49.6 +/- 17.0 x 10(6) red blood cells/ml BAL fluid). CONCLUSIONS: Although inclined running lowered peak Ppa, EIPH severity was increased. It is likely that this effect resulted, in part, from an altered ventilatory pattern (i.e. increased tidal volumes and associated intrapleural pressure changes). POTENTIAL RELEVANCE: This conclusion supports an important role for extravascular factors in the aetiology of EIPH.     

Initial evaluation of a technique for complete cecal bypass in the horse

OBJECTIVE: To describe a novel stapling technique for creation of a complete cecal bypass, without ileal transection in horses. STUDY DESIGN: Experimental study. ANIMALS: Four adult horses. METHODS: Through a ventral median celiotomy, jejunocolostomy was made with an intraluminal anastomosis device (ILA-100) and oversewn with a Cushing pattern to reinforce the staple line. Immediately distal to the anastomosis, 4 rows of staples were applied using a thoracoabdominal stapling device (TA-90) to occlude the lumen of the distal jejunum and proximal ileum. Necropsy exams were performed at least 60 days after surgery. RESULTS: No intraoperative complications occurred. Cecal bypass was functional in all horses at necropsy. The most oral staple line across the ileum partially failed in 1 horse; however cecal bypass was functional. CONCLUSIONS: Complete cecal bypass without ileal transection is a viable alternative to traditional methods of complete cecal bypass. Two sets of staple lines across the ileum are recommended. Longer term follow-up is warranted before clinical use of this technique. CLINICAL RELEVANCE: Cecal bypass without ileal transection is technically simple and effectively bypasses the cecum. It also should intuitively require less time and have a reduced risk of contamination compared with complete cecal bypass with ileal transection.     

T-plate repair of fracture of the nasal bones in a horse.

A 5-hole T-plate was used to repair an unstable compound depression fracture of the nasal bones in a horse. Substantial bone loss was evident as a result of severe trauma. Satisfactory bone healing, facial contour, and airway function were achieved. The use of a T-plate can be an alternative means of repair of a nasal bone fracture in a situation in which instability and/or bone loss exists.