Cholelithiasis in horses: ten cases (1982-1986)

Ten horses with clinical signs consistent with cholelithiasis were evaluated. Fever, icterus, mild intermittent colic, and weight loss were reported. Clinical laboratory abnormalities included leukocytosis, hyper-proteinemia, and hyperfibrinogenemia. Gamma glutamyltransferase and liver isoenzyme of lactate dehydrogenase activities also were high. Choleliths were observed via ultrasonography of the liver in 5 of the 8 horses evaluated, and increased echogenicity of the hepatic parenchyma and dilated bile ducts were observed in all horses. Seven horses were treated medically, 5 of which died or were euthanatized. Three horses were treated surgically, of which only 1 survived. Cholelith composition varied, but cholesterol, calcium bilirubinate, and mixed bile pigments were most commonly observed.     

Pyelonephritis in cows: 15 cases (1982-1986)

Medical records of 15 adult cows with a final diagnosis of pyelonephritis were evaluated retrospectively. Only 3 cows had obvious clinical signs that indicated urinary tract disease. Physical examination, including rectal and vaginal examinations, and urine chemical reagent strip screening detected abnormalities in all 15 cows and allowed subsequent confirmation by culture results of urine samples obtained using a catheter. Bacteriologic cultures of urine revealed Corynebacterium renale infection in 6 cows and Escherichia coli infection in 9 cows. Long-term treatment with antimicrobial drugs resulted in recovery in 9 of 11 treated cows. Of these, 4 of 4 cows with C renale infection and 5 of 7 cows with E coli infection recovered; the remaining 2 cows with E coli infection died.     

Keratomas in horses: seven cases (1975-1986)

The diagnosis of keratoma in 7 horses and their treatment and outcome were evaluated. Horses were 2 to 20 years old, of various breeds, and were intact or castrated males. All were lame, and 6 horses had had previous injuries of the affected hoof that had not responded to prior treatments. Only 1 hoof was affected in each horse. Keratomas were beneath the hoof wall (6 horses) or sole (1 horse). Radiographically, a circular or semicircular defect with a discrete margin was present in the distal portion of the third phalanx in 3 horses. Grossly, keratomas were firm solitary masses (1.5 to 5 cm diameter); gray, tan, or yellow; and oval or conical. Keratomas were excised from beneath the hoof wall by removing a section of hoof wall (5 horses) or by undermining the wall beginning at its junction with the sole (1 horse). A keratoma beneath the sole in 1 horse was excised by excavating the sole to the level of the palmar surface of the third phalanx. Keratoma was verified microscopically by the presence of characteristic rings of squamous epithelial cells with abundant keratin. Purulent exudate and inflammatory infiltrate often were present concurrently, reflecting an associated localized infection. Aftercare included daily application of an antiseptic iodine solution and foot bandages, and shoeing with a treatment plate several weeks after surgery. Hoof and sole defects healed completely between 6 months and 1 year. By 1 year after surgery, 6 horses were sound, and keratoma had not recurred.     

Protozoal encephalomyelitis in horses: 82 cases (1972-1986)

Medical records of 82 horses with clinical signs of neurologic disease and histologic lesions suggestive of protozoal encephalomyelitis were reviewed. The presence of a protozoan parasite in the CNS was not influenced by prior treatment of the horse with corticosteroids. Prior treatment of horses with trimethoprim-sulfonamide alone or in combination with pyrimethamine resulted in a decreased number of horses in which a protozoan parasite was detected in the CNS at necropsy. The mean age of affected horses was 3.62 +/- 2.78 years, with male and Standardbred horses being overrepresented, compared with that of the hospital population of horses that were studied at the same time.     

Heterotopic polyodontia in horses: nine cases (1969-1986)

Nine horses with heterotopic polyodontia, examined at Purdue University since 1969, were treated surgically and had a favorable outcome. Six of the horses had received prior medical or surgical treatment, but without success. An understanding of the congenital nature of the problem contributed to an accurate diagnosis in each case. General anesthesia, aseptic technique, removal of all aberrant tissue, and wound suture for primary healing appeared to be essential for preserving ear function and obtaining an effective treatment.     

Pancreatic abscess in dogs: six cases (1978-1986)

Pancreatic abscess was diagnosed by exploratory celiotomy in 6 dogs. The most common clinical signs included acute onset of lethargy (n = 5), anorexia (n = 6), vomiting (n = 5), and diarrhea (n = 2). Physical examination revealed pain response to abdominal palpation (n = 5), depression (n = 5), icterus (n = 3), fever (n = 3), and cranial abdominal mass (n = 2). Consistent preoperative clinicopathologic abnormalities included leukocytosis with left shift, observance of toxic neutrophils on the blood smear, hyperlipasemia, hyperamylasemia, hyperbilirubinemia, and increased serum alkaline phosphatase activity. In 5 of 6 dogs, abdominal radiography revealed increased soft tissue density in the cranial portion of the abdomen. Ultrasonography performed on 4 dogs confirmed pancreatic mass. In all dogs, exploratory celiotomy revealed a cavitary pancreatic mass that contained sterile, mucopurulent material. Histopathologic diagnoses included acute necrotizing or chronic-active pancreatitis and steatitis. Two dogs were euthanatized at the time of diagnosis, and the remaining 4 were treated by use of pancreatic debridement(s), open abdominal drainage, and intensive administration of fluids and antibiotics. One dog was euthanatized 4 days after surgery, because of progressive pancreatic abscessation. Three dogs recovered and were discharged.     

Open joint injuries in horses: 58 cases (1980-1986)

A retrospective study was made of 58 horses with open joint injuries admitted to the veterinary teaching hospital. Twenty-five (43%) were admitted within 24 hours of injury, 15 (26%) were examined 2 to 7 days after injury, and 18 (31%) were evaluated a week or more after the initial injury. The joints of the lower portions of the limbs most commonly were affected, with injuries that varied from puncture wounds to severe lacerations with soft tissue deficits. Diagnosis was made on the basis of clinical signs and results of synovial fluid analysis and radiography. Radiography was found to be an important diagnostic tool, indicating joint involvement in 80% of horses on which it was done. Sixteen horses were euthanatized on the day of admission; of the horses treated, 53% that were examined within the first 24 hours developed septic arthritis, and the overall survival was 65%. Ninety-two percent of horses examined within 2 to 7 days of injury developed septic arthritis, with 38.5% surviving; all horses evaluated a week or more after joint injury had septic arthritis, and 50% survived. The prognosis for return to function was best in horses that were examined within the first 24 hours. Horses examined more than 24 hours after injury had a significantly (P less than 0.05) higher chance of developing septic arthritis, and thus, were significantly (P less than 0.0014) less likely to survive the injury.     

Complications of umbilical hernias in horses: 13 cases (1972-1986)

Of 147 horses treated for umbilical hernias over a 13.5-year period, 13 horses (8.8%) developed complications in association with umbilical defects. Six horses had intestinal incarceration; the incarceration was reduced manually in 3 horses before admission, resolved without treatment in 2 others, and was surgically reduced in one. Herniorrhaphy was performed on 4 of the 5 horses in which the incarceration did not require surgical reduction, and the fifth was managed conservatively. A horse with a parietal hernia and a horse with intestinal stragulation were treated surgically; in the latter, the involved intestine was resected. These 8 horses recovered. Three horses developed an umbilical abscess and 2 developed an enterocutaneous fistula through their umbilical hernias. Four of these horses responded well to surgery, but one horse with an enterocutaneous fistula died from electrolyte imbalances and peritonitis after an unsuccessful attempt at simple closure. The results of this study confirmed that complications of umbilical hernias are rare in horses; however, when they do develop, they may be one of various forms, some of which are insidious in onset.     

Clinical features of salmonellosis in cats: six cases (1981-1986)

Of 6 cats with salmonellosis, only cats 1, 4, and 5 manifested clinical signs of gastroenteritis. In cats 2 to 5, salmonellosis was characterized by fever, a left-shifted leukogram, and vague nonspecific signs of illness. Salmonellae were isolated from blood and feces of cats 1 to 4, and from extraintestinal sites as part of a mixed gram-negative bacterial flora in cats 5 and 6. Of 4 cats with Salmonella bacteremia, cats 2, 3, and 4 were successfully treated with trimethoprim-sulfadiazine, amoxicillin, and/or chloramphenicol; treatment with cephapirin was ineffective in 3 cats. In some cats, salmonellosis was observed as a chronic febrile illness without specific gastrointestinal signs or as a localized tissue infection.     

Nutritionally variant streptococci associated with corneal ulcers in horses: 35 cases (1982-1988)

Nutritionally variant streptococci (NVS) are nutritionally deficient viridans streptococci that require pyridoxal for growth. Although NVS are pathogenic in human beings, they have not been considered to be pathogenic in domestic animals. In 1982 and 1983, 24 isolates of NVS were recovered from horses with ulcerative keratitis. A retrospective study was done to determine the incidence of NVS in horses with corneal disease. The medical records of 249 horses (259 eyes) examined for clinical signs of corneal disease were reviewed. Nutritionally variant streptococci were isolated from approximately 13.5% of horses with ulcerative keratitis.     

Diaphragmatic hernia in horses: 44 cases (1986–2006)

Objectives – To present a case series of horses diagnosed with diaphragmatic hernia, and to determine the significance of (1) historical information, examination findings, and laboratory data; and (2) exploratory laparotomy or necropsy findings on short- and long-term outcome.
Setting – University Referral Hospital.
Design – Retrospective study.
Animals – Forty-four horses/foals admitted between 1986 and 2006 with a diagnosis of diaphragmatic hernia made either at exploratory laparotomy or necropsy.
Interventions – None.
Measurements and Main Results – Information from the medical records included history, clinical examination findings at presentation, and findings of exploratory laparotomy or necropsy. Logistic regression or the Fisher exact test was used to determine factors associated with survival. Outcome was defined as survival to discharge (short-term survival), and long-term survival was defined as horses alive at least 1-year post surgery. Of the 44 horses, 18 died or were euthanized before surgery. Twenty-six were taken to surgery, 17 were euthanized. Nine horses recovered from anesthesia, 7 of which survived to hospital discharge. Of these, 5 were alive at long-term follow-up. Survival was significantly associated with the age of the horse (≤2 y old) at presentation, presence of normal peritoneal fluid at presentation, amount of compromised viscera at surgery (<50% small intestine), and the size (<10 cm) and location (ventral) of the diaphragmatic tear.
Conclusion – This study confirms that size and location of the lesion do play a significant role in prognosis. And, although the prognosis for horses with diaphragmatic hernia is poor, if horses have operable lesions there is a fair prognosis for long-term survival.     

Gray-scale ultrasonography in the diagnosis of adrenal neoplasia in dogs: six cases (1981-1986)

In addition to survey abdominal radiography, 2-dimensional gray-scale ultrasonography was utilized as a non-invasive imaging mode in 6 dogs with adrenal neoplasia. Ultrasonography was a safe method of obtaining information about the organ of involvement, extra-adrenal extent of disease, vascular invasion or compression, and internal architecture of abdominal masses in the area of the adrenal gland. The data obtained ultrasonographically was determined to be useful in diagnosing adrenal neoplasia.     

Neodymium:yttrium-aluminum-garnet laser-assisted excision of progressive ethmoid hematomas in horses: 20 cases (1986-1996)

OBJECTIVE: To describe a technique of contact neodymium:yttrium-aluminum-garnet (Nd:YAG) laser-assisted excision of progressive ethmoid hematoma (PEH) in horses, to determine the recurrence rate of clinical signs of PEH in horses with follow-up time of a minimum of 12 months, and to compare this result with reported results achieved by using conventional techniques. DESIGN: Retrospective study. ANIMALS: 21 horses with 26 PEH. PROCEDURE: Medical records of all horses with PEH treated by Nd:YAG laser excision from December 1986 through August 1996 were analyzed. Twenty-one horses underwent unilateral (18 surgeries) or bilateral (14) frontonasal bone flap with excision of the mass, using an Nd:YAG laser. One horse with bilateral PEH underwent a unilateral bone flap twice, 1 year apart. RESULTS: 1 horse died. Four of 20 horses with followup times of 12 months or longer had recurrence of PEH. The PEH recurrence rate was 20% (5/25 PEH). Three of 6 horses with bilateral lesions had recurrence of PEH. Recurrence rate for horses that had bilateral PEH (3/6 horses) was greater than for horses with unilateral PEH (1/14 horses). CLINICAL IMPLICATIONS: Treatment of PEH by Nd:YAG laser excision through a frontonasal bone flap results in a recurrence rate comparable with that reported for conventional techniques. Horses with bilateral lesions are more likely to have a recurrence of PEH.     

Cardiac arrhythmias identified in horses with duodenitis/proximal jejunitis: six cases (1985-1988)

During a 3 1/2-year period, cardiac arrhythmias were identified in 6 of 67 horses diagnosed with duodenitis/proximal jejunitis (DPJ). Arrhythmias were detected by auscultation of irregular cardiac rhythm and subsequently were characterized by electrocardiographic evaluation. Arrhythmias included frequent second-degree atrioventricular block, ventricular ectopic depolarizations, and atrioventricular conduction disturbance. In 4 horses, arrhythmias resolved with recovery from the primary problem. One horse died suddenly 66 hours after admission, and another was euthanatized at 72 hours after admission. Clinical and laboratory data from horses with DPJ and cardiac arrhythmias (group 1) were compared with findings for horses with DPJ and without arrhythmias (group 2). Group-1 horses had significantly (P less than 0.05) higher serum bicarbonate concentration and serum creatine kinase activity. Normal sinus rhythm returned in all 4 group-1 horses that recovered from DPJ, suggesting a causal relationship between DPJ and the arrhythmias. Two group-1 horses were necropsied, and both had myocarditis. The cause of these lesions was not determined.     

Acute febrile diarrhoea in horses: 86 cases (1986–1991)

SUMMARY: Eighty-six horses presented for examination at the Rural Veterinary Centre between January 1986 to December 1991 with acute diarrhoea. The average age of affected horses was 3.2 ± 0.2 years (mean ± SE), with 69% three years or younger. Sixty-one horses were male (36 stallions, 25 geldings) and 83 horses were Thoroughbreds (47) or Standardbreds (36). Sixty-six horses were undergoing routine training at the time of onset of diarrhoea. Eight horses were afflicted with a non-specific illness within one to five days before the onset of diarrhoea, whereas eight horses developed diarrhoea during or within 48 h of discontinuation of antimicrobial therapy. Three horses developed the diarrhoea within 24 h of road transportation. Clinically, the disorder was characterised by a fever, sudden onset of profuse diarrhoea, clinical evidence of dehydration (estimated to be 5 to 12% of body weight at the time of admission) and shock. Degenerative leucopaenia, hyponatraemia, hypochloraemia, hyperkalaemia, hyperglycaemia and azotaemia were characteristic laboratory findings. Laminitis was a sequel in about 30% of cases. The cause of diarrhoea remained undetermined in most cases. Salmonellas were isolated from faecal or tissue samples in only two cases. Similarly, there was no evidence of seroconversion to Erhlichia risticii in 17 cases. Sixty-two of the horses survived the acute phase of the disease in response to supportive care. In horses that did not survive, necropsies were performed and revealed sanguineous or turbid peritoneal fluid. The colonic and caecal walls were oedematous and thickened with serosal congestion and discolouration of these organs evident grossly. Histopathological examination of the caecum and colon revealed diffuse congestion, oedema, inflammatory reactions and submucosal vascular thrombosis with varying degrees of mucosal devitalisation. Most cases presented in this series represent a distinct syndrome of diarrhoea characterised by acute diarrhoea predominantly affecting young horses in training with concomitant signs of fever and toxaemia.     

Mycotic omasitis and rumenitis as sequelae to sepsis in dairy cattle: six cases (1979-1986)

Medical records of 6 cows with mycotic rumenitis or omasitis, but no history of grain engorgement, were reviewed. A diagnosis was made at necropsy in all cows, although the condition was suspected before euthanasia in 3 cows. Common clinical findings included inappetence, rumen stasis, fluid rumen contents, and scant, pasty, or loose feces. Postmortem findings included severe ulcerative rumenitis or omasitis, with thrombosis of blood vessels in the submucosa, and branching, septate fungal hyphae abundant in inflamed tissues. In these cows, mycotic omasitis and rumenitis were thought to be sequelae of sepsis, with reflux of abomasal fluid into the forestomach and broad spectrum antimicrobial therapy as possible predisposing factors for mycotic infections.     

Positive end-expiratory pressure during colic surgery in horses: 74 cases (1986-1988).

Positive end-expiratory pressure (PEEP) was applied in 74 anesthetized, ventilated horses during colic surgery, to attempt to increase arterial oxygen tensions. In 28 horses with an initial PaO2 less than 70 mm of Hg, PEEP increased PaO2 values to a mean of 173 +/- 24 mm of Hg. Arterial oxygen content increased from 14.1 +/- 0.05 ml/dl to 17.2 +/- 0.05 ml/dl. In the remaining 46 horses, PEEP increased PaO2 from a mean value of 101 +/- 6 mm of Hg to 194 +/- 15 mm of Hg, and arterial oxygen content increased from 14.9 +/- 0.09 ml/dl to 16.9 +/- 0.07 ml/dl. Cardiovascular depression and decrease in arterial blood pressure was observed after the application of PEEP in 54 horses. These 54 horses required use of pressors (n = 8), inotropes (n = 32), or both (n = 14) to keep the mean arterial blood pressure greater than 60 mm of Hg. Combined with pharmacologic support of blood pressure, PEEP could be a useful clinical treatment of arterial hypoxemia in horses.     

Blastomycosis in cats: five cases (1979-1986)

Medical records of 5 cats with blastomycosis examined at the University of Tennessee Veterinary Teaching Hospital from 1979 to 1986 were reviewed. Clinical signs of blastomycosis varies depending on the organ(s) affected, but respiratory tract disease was most common, followed by CNS signs and ocular problems. A definitive diagnosis was made by identification of characteristic fungal organisms in biopsy or necropsy specimens. Two cats treated with amphotericin B did not respond to treatment and died or were euthanatized. The lungs, brain, eyes, and lymph nodes commonly were affected, but one cat had only cutaneous and regional lymph node involvement. The respiratory tract appeared to be a common primary site of infection, with dissemination to other organ systems. The typical host response was a pyogranulomatous cellular infiltrate with numerous fungal organisms evident.     

Hemoperitoneum in horses: 67 cases (1989-2004)

OBJECTIVE: To evaluate clinical findings, underlying causes, and short-term outcome associated with hemoperitoneum in horses. DESIGN: Retrospective case series. ANIMALS: 67 horses with hemoperitoneum. PROCEDURES: Medical records of horses with hemo-peritoneum (excluding postoperative abdominal hemorrhage) from 1989 through 2004 were analyzed. Information obtained included history, signalment, physical examination findings, diagnostic test results, and short-term outcome. RESULTS: Breed distribution was 28 Thoroughbreds, 13 Arabians, 10 Quarter Horses, 5 Warmbloods, 3 Appaloosas, and 1 each of 8 other breeds. There were 40 mares, 23 geldings, and 4 stallions. Median age was 12 years (range, 1 month to 40 years). Signs of abdominal discomfort were the primary complaint in 79% of horses. Clinical findings included shock (60%) and pale mucous membranes (60%). Median heart rate was 76 beats/min (range, 30 to 216 beats/min), median respiratory rate was 30 breaths/min (range, 8 to 92 breaths/min), median Hct was 31% (range, 10.5% to 73.0%), and total protein concentration was 5.8 g/dL (range, 3.3 to 8.7 g/dL). Cause of hemoperitoneum was attributed to trauma (25.4%), neoplasia (17.9%), uterine artery rupture (13.4%), mesenteric injury (11.9%), disseminated intravascular coagulopathy (6.0%), other causes (3.0%), and idiopathic causes (22.4%). Fifty-one percent of horses survived to hospital discharge, 37% were euthanized, and 12% died. Poor short-term outcome was significantly associated with high respiratory rate and certain underlying causes. CONCLUSIONS AND CLINICAL RELEVANCE: Hemoperitoneum is an infrequent but important cause of abdominal discomfort in horses. Predominant underlying causes were trauma, neoplasia, and idiopathic causes. Identification of underlying cause is important because of its association with outcome.