Initial Experience Using Contrast Magnetic Resonance Imaging in Laminitic Horses: 18 Studies

Plain radiographic imaging inadequately identifies soft-tissue pathology and only distinguishes chronic laminitis after the development of notable displacement of the distal phalanx. The window of opportunity for maximum response to treatment occurs before biomechanical failure of the lamellar attachment. Radiographic and magnetic resonance venograms allow vascular assessment of patients affected with acute laminitis. When vascular findings are interpreted with additional magnetic resonance information, the degree of damage to the foot in patients affected with laminitis is understood more thoroughly. This article describes the technique, findings, and outcome in a group of laminitic horses that underwent contrast magnetic resonance imaging.     

Magnetic Resonance Assessment of the Equine Distal Phalanx Facies Flexoria

Abnormalities of the facies flexoria of the distal phalanx (FF) of the horse associated with podotrochlear syndrome have been scarcely described in the literature. The objective of this retrospective study was to determine correlation between modification of the FF and lesions of the podotrochlear apparatus. This study includes 100 horses referred for forelimb lameness that underwent a standardized magnetic resonance (MR) imaging protocol of the affected foot. Of the 100 MR studies, 74 had podotrochlear lesions and 26 free of podotrochlear lesions served as controls. A comparison of the FF compact bone thickness between affected and control feet was performed. Presence and location of a deep digital flexor tendon (DDFT) lesion was noted. Grading systems were used to score: FF osseous resorption, FF bone marrow lesion, FF sclerosis and abnormalities of the navicular bursa and the distal interphalangeal joint. Compact bone thickness of the FF was not increased in case of tendinopathy of the DDFT or other podotrochlear lesions (P = .86). Significant correlation was observed between osseous resorption of the FF at the level of the distal recess of the navicular bursa and synovial proliferation of the navicular bursa (P = .05). Compact bone thickening at the DDFT enthesis is not predictive of podotrochlear syndrome and should rather be considered as an interindividual anatomical variation. Navicular bursitis may play a role in osseous resorption of the FF.     

Quantitative Evaluation of Equine Deep Digital Flexor Tendon Morphology using Magnetic Resonance Imaging

Injury of the distal aspect of the deep digital flexor tendon (DDFT) is a recognized cause of lameness, but diagnosis is difficult. This study aimed to improve understanding of DDFT morphology and pathology using retrospective evaluation of magnetic resonance (MR) images. We hypothesized that: (1) The distal aspect of the DDFT in normal horses would have a repeatable proximal/distal pattern and symmetry between limbs and between lobes; (2) DDFT dimensions would be related to bodyweight, navicular bone dimensions and hoof size; (3) this symmetry and pattern would be lost in DDFT injury; and (4) DDFT size would increase with injury. MR images of 64 live horse limbs, 26 with no identified DDFT lesion and 38 with identified DDFT abnormalities, and 19 normal cadaver limbs were analyzed. Using standardized transverse images, measurements of DDFT cross-sectional area, medial-lateral (ML) width and dorsal-palmar depth were obtained at six preselected sites. A uniform distal to proximal shape pattern was identified in all horses. The flattened crescent shape at the insertion changed to a deeper bilobed shape more proximally, with the mid-navicular area having the greatest cross-sectional area. Strong ML (P < 0.0006) and left/right symmetry (P < 0.02) were observed. In addition, there was a strong association between DDFT cross-sectional area and horse weight (P = 0.005) and between DDFT and navicular bone ML width (P = 0.004). Symmetry between sides or between lobes was lost at sites with a unilateral lesion and correlation between horse weight and DDFT cross-sectional area was lost in the presence of lesions. DDFTs with core lesions had a consistent increase in cross-sectional area overall, but other lesion types had no significant increase in size. The shape and symmetry seen in normal tendons could be related to the mechanical demands placed upon individual lobes. The limited increase in cross-sectional area with injury may be explained by the restrictive structures of the hoof, possibly explaining the ongoing pain seen in such lesions.     

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

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

Evaluation of Right Ventricular Myocardial Function in Healthy Horses With Recurrent Airway Obstruction Using Tissue Doppler Imaging

It has been described in humans that chronic obstructive bronchitis leads to pathologic changes, especially in the right ventricular myocardium due to hypoxia, which can be assessed by tissue Doppler imaging (TDI). In our study, different TDI techniques, that is, pulsed-wave TDI and color TDI, were evaluated for applicability in different scan planes (apical long-axis view and short-axis view) for the analysis of right ventricular myocardial function in six healthy horses (control) and six horses affected with recurrent airway obstruction (RAO) (RAO group). Tissue Doppler imaging was applicable to all scan planes described. Myocardial movement directions in general and the absolute values of TDI parameters were assessable. Significantly reduced early diastolic filling velocities (E), elevated late diastolic filling velocities (A), thereby decreased E/A quotient, prolonged electromechanical coupling periods between electrocardiograph Q-wave and maximal velocities, and compensatory elevated systolic strain as well as diminished displacement could be observed in horses with RAO compared with the control group. To conclude, equine right ventricular myocardial function is assessable by TDI. Significant changes of right ventricular myocardial function could be demonstrated by TDI in horses with RAO compared with matched healthy controls. The hypothesis that RAO potentially leads to right ventricular dysfunction detectable by TDI before conventional echocardiography changes are evident is supported by this explorative study.     

Metabolomic Profile of Allantoic and Amniotic Fluid in Late-term Gestational Mares Characterized by 1H-nuclear Magnetic Resonance Spectroscopy

The amniotic and allantoic fluid compartments in the mare serve essential roles throughout pregnancy and parturition. Although the global metabolomic profile of amniotic fluid in women has been extensively characterized, current data for equine fetal fluids are limited. Therefore, the goal of this study was to characterize the global metabolomic profile of equine allantoic and amniotic fluid through nuclear magnetic resonance spectroscopy. Fetal fluids were collected between 270 and 295 days of gestation from 12 pregnancies through ultrasound-guided transabdominal puncture. A total of 24 samples (n = 10 allantoic fluid; n = 9 amniotic fluid; n = 5 admixed fluid) were analyzed by one-dimensional proton (¹H) and two-dimensional (¹H-¹³ C) nuclear magnetic resonance spectroscopy. Metabolites were integrated and compared between fluid types using a Kruskal–Wallis test at P < .05 significance. A total of 28 distinct metabolites were found in allantoic and admixed fluid, whereas 23 metabolites were identified in amniotic fluid. Allantoic fluid contained significant elevations (P < .05) in the metabolites betaine, creatine, creatinine, citrate, histidine, nitrophenol, tryptophan, π-methylhistidine, and unknown metabolite #1 compared with amniotic fluid, whereas amniotic fluid contained statistically increased concentrations of the metabolite lactate compared with allantoic fluid (P = .003).     

Ultrasonography of the Collateral Ligaments of the Distal Interphalangeal Joint in Horses: Technique and Reference Images

This study describes ultrasound (US) technique and reference images of the equine distal interphalangeal joint collateral ligaments (CLs), and evaluates the portion of the CLs assessable by US in a series of normal forelimbs. Transverse and longitudinal US images were obtained on five healthy horses and on 25 equine cadaver forelimbs. On six limbs, a needle was placed under US-guidance at the distal limit of visualization of each CL, and the portion of CL visible at US was evaluated on computed tomographic (CT) images. The normal CLs appear as oval structures located abaxial to the fossae of the middle phalanx in the transverse sections, obtained at the level of the coronary band. A centrodorsal hypoechoic image appears with increasing proximodistal probe inclination, demonstrating different fiber orientations within the ligament. Two main fascicles, a deep and a superficial, distally divergent, are visible on longitudinal images obtained in the central part of the ligament. The proportion of CL visible at US examination was more than 50% of the total ligament length in nine of the 12 CLs assessed by CT. Awareness of the estimated portion of distal interphalangeal joint CLs visible at US and detailed knowledge of the US technique and CLs morphology are essential to efficiently use US examination on clinical cases.     

Movement Caused by Electrical Stimulation of the Lumbosacral Region in Standing Horses

Electrical stimulation is commonly used as a modality for physical therapy in human and veterinary medicine. However, studies measuring the movement generated by electrical stimulation in horses are rare. The present study therefore evaluates the range of movement provoked by a commercially available physical therapy unit (FES310) and contrasts it with the movement generated by manually induced pelvic inclination (back rounding). Ten horses were tested on three measurement days over one week. Electrical stimulation was applied via a back treatment pad (belonging to the FES310 system) containing six electrodes (three on either side of the spine) placed over the lumbosacral region. This system produced a pulsed, biphasic electrical stimulation in a rectangular waveform which was gradually increased to a maximum of 10 volts. Before and after electrical stimulation testing, manual pelvic inclination was achieved by pressure on two points lateral to the root of the tail. Muscle tone and lameness were evaluated before and after treatments. Skinfold thickness, body condition score, and body mass were measured to detect possible confounding factors. Using kinematics, the angle ranges during movement of ten three-dimensional angles of the trunk, the pelvis, and the hind limbs were further analyzed. Movement was produced with manual stimulation in every tested individual on all measurement days and with electrical stimulation on at least one measurement day. The electrical stimulation led to significantly (P < .05) smaller angle ranges which were 15 %–57 % of the median of the manually stimulated movement. Strong positive correlations between angle ranges of the electrically generated movement were found for the hind limbs implicating their involvement in the movement created. Correlations between skinfold thickness, body condition score, and body mass with the angle ranges were weak and not significant. Before and after electrical and manual stimulation, muscle tone and lameness were similar. In the present study, both electrical and manual stimulation were proven to produce significant trunk and hind limb movement. Within this study’s electrical stimulation treatment protocol, the movement generated by electrical stimulation was significantly less than the movement caused by manual pelvic inclination. However, electrical stimulation could easily be applied over a longer period and in a higher frequency than it would be possible for manual pelvic inclination. This treatment shows potential for stabilization and or mobilization of the lumbosacral region, although its efficiency as a therapeutic tool and its effect on specific orthopedic problems and is to be evaluated in further research.     

The Histological Appearance of the Proximal Aspect of the Dorsal Condylar Sagittal Ridge of the Third Metacarpal and Metatarsal Bone in Young Warmblood Horses: Normal Appearance and Correlation with Detected Radiographic Variations

The objective of this study is to describe the normal histological appearance of the dorsoproximal aspect of the sagittal ridge of the third metacarpal/metatarsal bone in young Warmblood horses, and to compare it to the different radiographic variations (irregular, indentation, lucency, notch) described at this level. A total of 25 metacarpo/metatarsophalangeal joints of 12 Warmblood horses were used. Five samples of each radiographically described group were selected for histological processing. Each category was compared with the normal control group. Each group showed a bone cortex, covered by hyaline cartilage and longitudinally aligned collagen fibres covered by loosely organized connective tissue proximally. The normal and irregular group showed a smooth bone cortex. In the indentation and lucency group, a depression in the cortex was detected. The notch group presented an expansion of the cortex. The collagen fibres and connective tissue were located in the depression in the indentation group whereas the location varied in the lucency and notch group. The radiologic detected differences are translated into detectable histological differences. Further research is warranted to determine whether these variations are developmental or congenital and to evaluate their potential influence on the joint function during hyperextension.