Use of acupuncture for the treatment of chronic back pain in horses: stimulation of acupuncture points with saline solution injections

Fifteen horses that could not train or perform their sport at an acceptable level because of chronic back pain of 2 to 24 months' duration, and that did not obtain lasting improvement from other previous treatments, were treated with acupuncture. The treatments consisted of injection of 1 ml of sterile saline (0.9% NaCl) solution, with no preservatives, at 9 acupuncture points. The horses were treated once a week for a mean of 9 treatments. The mean number of treatments before obvious improvement was 4. After treatment, 13 of the 15 horses had apparent alleviation of their signs of pain and could train and compete. Six to 12 months after their last treatment, 2 horses had been removed from competition; one had sustained a fracture and the other had died. The remaining 11 of the original 13 that competed after treatment were still competing.     

Treatment of Chronic Back Pain in Horses Stimulation of Acupuncture Points with a Low Powered Infrared Laser

Fourteen horses that could not perform at their expected standards due to chronic back pain of 4 to 48 months duration, and had not obtained lasting improvement from other forms of therapy, were treated by stimulating nine acupuncture points using a low powered infrared laser (300 microW, 904 nm). The treatments were performed weekly, and consisted of stimulating each point for 2 minutes with a pulse frequency of 360 pulses per second. After completion of a mean of 11 treatments, clinical signs of back pain were alleviated in 10 of the 14 horses, there was no change in three, and one was lost to follow-up. Of the 10 horses who were training and competing, four won. One year after treatment was discontinued, 9 of these 10 horses continued to perform at a standard acceptable to the owner.     

Pressure algometry to quantify muscle pain in racehorses with suspected sacroiliac dysfunction

REASONS FOR PERFORMING STUDY: Despite the prevalence of orthopaedic injuries to horses, there is no objective means of quantifying the intensity of musculoskeletal pain. HYPOTHESES: Mechanical nociceptive thresholds (MNT) can be measured repeatably by pressure algometry in horses and MNTs are correlated with both severity of clinical signs and subjective scores of muscle pain on palpation in horses with suspected sacroiliac dysfunction (SID). METHODS: The technique of pressure algometry and its repeatability was tested at 4 anatomical sites on either side of the thoracolumbar and pelvic region in 12 Thoroughbreds in training. In a second series of 15 racing Thoroughbreds, using a different set of landmarks, pain on palpation was assessed by pressure algometry. Horses were grouped based on clinical scores of SID as normal (n = 5), mild (n = 5), moderate (n = 4) and severe (n = 1) suspected SID and scored for muscle pain response by manual palpation. RESULTS: Pressure algometry was shown to be a repeatable measure of MNTs. Horses with suspected SID had significantly lower mean MNT when sites and horses were pooled and showed greater differences in mean algometer measurements between left and right sides, compared to control horses. A significant correlation was found between mean pressure algometry measurements and both suspected SID grade and muscle pain response on palpation. CONCLUSION AND POTENTIAL RELEVANCE: Horses with suspected SID displayed lower MNTs compared to control horses, especially in the pelvic region. This supports a potential role for pressure algometry in providing an objective means of quantifying musculoskeletal pain reflected as a reduced MNT associated with SID and its response to physiotherapy or other treatments.     

Successful treatment of persistent dorsal displacement of the soft palate and evaluation of laryngohyoid position in 15 racehorses

Reasons for performing study: Caudal descent of the larynx has been proposed to be associated with intermittent dorsal displacement of the soft palate (DDSP) as it leads to a loss of the seal between the epiglottis and soft palate but further investigation of this theory is required. Objectives: To evaluate laryngohyoid position of horses with persistent DDSP in comparison to horses with intermittent DDSP and evaluate the outcome of treatment. Hypotheses: Horses with persistent DDSP have a different laryngohyoid position compared to those with intermittent DDSP. Horses with persistent DDSP can be returned successfully to racing with a laryngeal tie‐forward procedure. Methods: Medical records of 15 racehorses presented for persistent DDSP between 2002 and 2007 were reviewed. Age, sex and breed matched horses diagnosed with intermittent DDSP were used as a comparison group. Treatment of all horses was performed by laryngeal tie‐forward, 8/15 horses with persistent DDSP had a subsequent laser staphylectomy. Preoperative laryngohyoid position was compared between the 2 groups using a radiographic reference system. Surgical effect on position was assessed by comparing pre‐ and post operative radiographic measurements. Outcome was assessed by return to racing and comparison of pre‐ and post operative race earnings ($). Results: Thirteen of 15 horses with persistent DDSP returned to racing. Seven of 15 horses were treated with laryngeal tie‐forward alone while 8/15 horses were also treated with a laser staphylectomy. Horses with persistent DDSP had a more caudal larynx (ossification of the thyroid cartilage) (13 mm, P = 0.014), a more caudal (10 mm, P = 0.044) and dorsal (7 mm, P = 0.01) basihyoid bone, and a more dorsal thyrohyoid‐thyroid articulation (10 mm, P = 0.002) than horses with intermittent DDSP. Conclusions and potential relevance: Racehorses with persistent DDSP can be treated successfully by laryngeal tie‐forward or by laryngeal tie‐forward followed by laser staphylectomy. Horses with persistent DDSP have a more caudal larynx and more caudal and dorsal basihyoid bone than horses with intermittent DDSP.     

Evaluation of electroacupuncture treatment of horses with signs of chronic thoracolumbar pain

OBJECTIVE: To evaluate use of electroacupuncture for treatment of horses with signs of chronic thoracolumbar pain. DESIGN: Prospective study. ANIMALS: 15 horses with signs of chronic thoracolumbar pain. PROCEDURE: Horses were randomly allocated to 1 of 3 treatment groups. Horses in group 1 received electroacupuncture stimulation (once every 3 days for 5 treatments), those in group 2 received phenylbutazone (2.2 mg/kg [1 mg/lb], PO, q 12 h, for 5 days), and those in group 3 received saline (0.9% NaCl) solution (20 mL, PO, q 12 h, for 5 days). Thoracolumbar pain scores (TPSs) were evaluated before (baseline) and after each treatment. RESULTS: Mean +/- SE TPSs in horses receiving phenylbutazone or saline solution did not change significantly during the study. After the third treatment, mean +/- SE TPS (2.1 +/- 0.6) in horses receiving electroacupuncture stimulation was significantly lower than baseline (6.0 +/- 0.6) TPS. Mean +/- SE TPSs in horses receiving electroacupuncture stimulation were significantly lower than baseline TPSs and TPSs in horses receiving phenylbutazone or saline solution after the third treatment to 14 days after the last treatment. CONCLUSIONS AND CLINICAL RELEVANCE: TPSs are useful for evaluating the efficacy of various analgesic methods used for treatment of thoracolumbar pain in horses. Electroacupuncture was effective for treatment of chronic thoracolumbar pain in horses. Results provided evidence that 3 sessions of electroacupuncture treatment can successfully alleviate signs of thoracolumbar pain in horses. The analgesic effect induced by electroacupuncture can last at least 2 weeks. Phenylbutazone administered PO did not effectively alleviate signs of thoracolumbar pain in horses in this study.     

Effects of Low-Level Laser Therapy and Chiropractic Care on Back Pain in Quarter Horses

Low-level laser therapy has been used clinically to treat musculoskeletal pain; however, there is limited evidence available to support its use in treating back pain in horses. The objective of this study was to evaluate the clinical effectiveness of low-level laser therapy and chiropractic care in treating thoracolumbar pain in competitive western performance horses. The subjects included 61 Quarter Horses actively involved in national western performance competitions judged to have back pain. A randomized, clinical trial was conducted by assigning affected horses to either laser therapy, chiropractic, or combined laser and chiropractic treatment groups. Outcome parameters included a visual analog scale (VAS) of perceived back pain and dysfunction and detailed spinal examinations evaluating pain, muscle tone, and stiffness. Mechanical nociceptive thresholds were measured along the dorsal trunk and values were compared before and after treatment. Repeated measures with post-hoc analysis were used to assess treatment group differences. Low-level laser therapy, as applied in this study, produced significant reductions in back pain, epaxial muscle hypertonicity, and trunk stiffness. Combined laser therapy and chiropractic care produced similar reductions, with additional significant decreases in the severity of epaxial muscle hypertonicity and trunk stiffness. Chiropractic treatment by itself did not produce any significant changes in back pain, muscle hypertonicity, or trunk stiffness; however, there were improvements in trunk and pelvic flexion reflexes. The combination of laser therapy and chiropractic care seemed to provide additive effects in treating back pain and trunk stiffness that were not present with chiropractic treatment alone. The results of this study support the concept that a multimodal approach of laser therapy and chiropractic care is beneficial in treating back pain in horses involved in active competition.     

Field efficacy of ivermectin plus praziquantel oral paste against naturally acquired gastrointestinal nematodes and cestodes of horses in North America and Europe

The efficacy of an oral formulation of ivermectin plus praziquantel in the reduction of nematode and cestode egg counts in horses was assessed in 273 horses under field conditions at 15 sites in North America (n = 6) and Europe (n = 9). Horses were confirmed by fecal examination to have natural infections of strongyles (100%) and tapeworms (76%). Replicates of four horses were formed at each site, and in each replicate three animals received ivermectin (0.2 mg/kg body weight) plus praziquantel (1 mg/kg body weight) oral paste and one animal remained untreated or received vehicle paste. Fecal samples were collected for fecal nematode and cestode egg counting before and 7, 8, 9, 14, 15, and 16 days after treatment. Horses treated with ivermectin plus praziquantel oral paste had significantly (P <.01) lower posttreatment strongylid and cestode egg counts (reductions of 98% or more) than controls. Combined site analyses revealed that 95% or 96% of the horses positive for cestode eggs before treatment that were treated with ivermectin plus praziquantel were negative for cestode eggs at each posttreatment fecal examination. No adverse reactions attributable to ivermectin plus praziquantel oral paste treatments were observed. The results of the studies demonstrated that ivermectin plus praziquantel paste was highly effective in reducing egg shedding by gastrointestinal nematodes and cestodes, and no adverse reactions were observed in horses treated under field conditions.     

Caecal disease in equids

Objective To review the breed, age, gender, clinical and laboratory findings, treatment and outcome of horses with caecal disease presented to a referral centre. Design Retrospective study of 96 cases. Procedure The breed, age, and gender of the study population were compared with the corresponding hospital population for the same period. The means (± SD) for clinical and laboratory findings were recorded for each caecal disorder. Treatment was categorised as medical or surgical, and outcome was recorded. Results Caecal diseases included impaction (40% of total cases), rupture associated with concurrent unrelated disease (13%), rupture with parturition (9%), rupture with no associated disease (5%), infarction (11%), torsion (9%), abscess or adhesion (7%), tumour (3%), and miscellaneous conditions (3%). The breed or gender of affected horses did not differ from the hospital population, although horses > 15 years were more frequently represented (P < 0.05). This age group was specifically more predisposed to caecal impaction (P < 0.05), as were Arabian, Morgan, and Appaloosa breeds (P < 0.05). In horses with caecal impaction transrectal examination was the most useful diagnostic procedure; 90% of affected horses treated medically were discharged while horses treated by typhlotomy alone, or typhlotomy and blind end ileocolostomy, had survival rates to discharge of 71% and 86%, respectively. Horses with caecal rupture associated with concurrent un-related disease showed no signs of impending rupture; all were receiving phenylbutazone, all were euthanased, and 50% had caecal ulceration at necropsy. Of horses with caecal rupture with parturition 56% had prior dystocia; in two-thirds the site of rupture was the ileocaecal junction and all were euthanased. Horses with caecal rupture with no associated disease died or were euthanased; rupture was idiopathic. Horses with caecal infarction usually had signs of abdominal pain and abdominal fluid changes consistent with peritonitis; transrectal examination was nonspecific, and typhlectomy was successful in seven of eight horses. Horses with caecal torsion had signs of severe, acute abdominal pain and typhlectomy was successful in three of five horses. Diagnosis of caecal adhesion or abscess was assisted by transrectal palpation in two of seven horses and surgical treatment was successful in two of five horses. A caecal tumour was diagnosed in three horses aged 20 years or older that presented with chronic weight loss. Other caecal diseases were uncommon. Conclusion Caecal disease is uncommon in equids but some specific features of the history and physical findings can alert the veterinarian to the possibility of caecal involvement in horses with gastrointestinal dysfunction. Medical or surgical therapy can be effective in horses where caecal rupture has not occurred.     

Assessment of glycosaminoglycan concentration in equine synovial fluid as a marker of joint disease.

A modification of a colorimetric assay was used to determine synovial fluid total and individual sulphated-glycosaminoglycan concentration in various clinical presentations of joint disease in horses. Concentrations of synovial fluid and serum sulphated-glycosaminoglycan (GAG) were measured by the 1,9-dimethylmethylene blue (DMMB) dye assay in normal horses (n = 49), horses with acute (n = 26) or chronic (n = 27) joint disease (defined by clinical, radiographic, and clinicopathological parameters), and horses with cartilaginous lesions at diagnostic arthroscopy, but with normal radiographs and synovial fluid (n = 9). Horses with acute joint disease were subdivided into moderate acute (n = 21) and severe acute (n = 5) joint disease on the basis of synovial fluid analysis and clinical examination. Horses with chronic joint disease were subdivided into mild chronic (n = 9), moderate chronic (n = 10), and severe chronic (n = 8) joint disease on the basis of synovial fluid analysis, clinical examination, and radiographic findings. The concentrations of chondroitin sulphate (CS) and keratan sulphate (KS) were analyzed in each sample following sequential enzymatic digestion of the sample with chondroitinase or keratanase. In addition, the concentration of hyaluronate (HA) in each sample was determined by a colorimetric assay following digestion of the sample with microbial hyaluronidase.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effects of the cyclooxygenase inhibitor meloxicam on recovery of ischemia-injured equine jejunum

OBJECTIVE: To determine the effect of meloxicam and flunixin meglumine on recovery of ischemia-injured equine jejunum. ANIMALS: 18 horses. PROCEDURES: Horses received butorphanol tartrate; were treated IV with saline (0.9% NaCl) solution (SS; 12 mL; n = 6), flunixin meglumine (1.1 mg/kg; 6), or meloxicam (0.6 mg/kg; 6) 1 hour before ischemia was induced for 2 hours in a portion of jejunum; and were allowed to recover for 18 hours. Flunixin and SS treatments were repeated after 12 hours; all 3 treatments were administered immediately prior to euthanasia. Selected clinical variables, postoperative pain scores, and meloxicam pharmacokinetic data were evaluated. After euthanasia, assessment of epithelial barrier function, histologic evaluation, and western blot analysis of ischemia-injured and control jejunal mucosa samples from the 3 groups were performed. RESULTS: Meloxicam- or flunixin-treated horses had improved postoperative pain scores and clinical variables, compared with SS-treated horses. Recovery of transepithelial barrier function in ischemia-injured jejunum was inhibited by flunixin but permitted similarly by meloxicam and SS treatments. Eighteen hours after cessation of ischemia, numbers of neutrophils in ischemia-injured tissue were higher in horses treated with meloxicam or flunixin than SS. Plasma meloxicam concentrations were similar to those reported previously, but clearance was slower. Changes in expression of proteins associated with inflammatory responses to ischemic injury and with different drug treatments occurred, suggesting cyclooxygenase-independent effects. CONCLUSIONS AND CLINICAL RELEVANCE: Although further assessment is needed, these data have suggested that IV administration of meloxicam may be a useful alternative to flunixin meglumine for postoperative treatment of horses with colic.     

Investigation of Myofascial Trigger Points in Equine Pectoral Muscles and Girth-Aversion Behavior

Horses displaying aversion to fastening of the girth may be expressing pain from myofascial trigger points (MTrPs). The location of MTrPs in the pectoral region of horses has not been previously described. The objectives of this study were as follows: (1) to locate and map MTrPs in the transverse and ascending pectoral muscles; (2) to score the severity of the MTrPs by behavioral reaction to palpation; and (3) to look for associations between these findings and girth-aversion behavior. Thirty-eight horses were recruited in a cross-sectional clinical study. Taut bands were identified on palpation of horses undergoing physiotherapy assessment and then scored for behavioral reaction to palpation as normal (0), mild (1), moderate (2), or severe (3) and mapped. Owner-reported history of girth-aversion behavior was compared with the severity score using chi-squared analysis. Myofascial trigger points were identified in all horses (average severity: mild n = 6, moderate n = 24, and severe n = 8) with the most common regions of ascending pectoral muscles being the axillary and along the region usually covered by the girth. Horses with an owner-reported history of girth-aversion behavior (n = 13) had higher severity scores than horses without a history of girth-aversion behavior (n = 25; P = .014). Knowledge of the presence and location of MTrPs could assist in the development of prevention and management strategies to improve comfort, optimize performance, and reduce girth-aversion behavior.     

Fistulous withers in horses: 24 cases (1984-1990).

Between Jan 1, 1984 and Aug 1, 1990, 27 horses were admitted to the veterinary medical center for evaluation of fistulous withers. Nine (37.5%) of 24 horses tested for antibody to Brucella abortus were seropositive. Horses that tested seropositive were significantly (P = 0.046) more likely to have been pastured with cattle that were seropositive for B abortus, and were significantly (P = 0.010) more likely to have had radiographic evidence of vertebral osteomyelitis than were horses that tested seronegative. Five horses that were seropositive for B abortus were administered strain 19 brucella vaccine sc (n = 1) or iv (n = 4). The horse treated by sc injection of vaccine improved during hospitalization, but was lost to follow-up evaluation. Three (75%) of 4 horses treated by iv injection died, but 1 horse recovered within 4 weeks of treatment.     

Application of a Composite Pain Scale to Objectively Monitor Horses with Somatic and Visceral Pain under Hospital Conditions

Pain recognition and management in animals has advanced considerably in the last decade and currently animal welfare is receiving increasing public interest. However, the comprehensive assessment of pain has been inadequately addressed in horses and till recently composite pain scales (CPSs) have hardly been validated for use in patients. We investigated the reliability and clinical applicability of a CPS, originally developed under experimental conditions for assessing pain in horses with various acute soft-tissue and orthopedic conditions before and after general anesthesia and/or (non)elective surgery. These clinical cases (n = 94) were scored by means of the CPS twice daily. Horses without painful conditions and horses admitted for nonpainful diagnostic procedures under general anesthesia were compared with those that were admitted with either acute or chronic surgical and nonsurgical painful conditions of both visceral and somatic origin. Scores of observer 1 were compared with observer 2 to study inter-observer reliability. Composite pain scores showed low baseline values in healthy animals with nonpainful conditions and were not affected when general anesthesia was the only intervention. Inter-observer reliability was very high (n = 23 horses; weighted kappa correlation coefficient, κ = 0.81). Horses with painful conditions responding well to analgesic treatment could be discriminated from horses that had to be euthanized on humane grounds because of painful nonresponsive conditions. We found the CPS to be a promising tool that has the potential to provide a good basis for direct day-to-day assessment of pain status in equine patients with various painful conditions in the future.     

Necrosis of the collateral cartilage of the distal phalanx in horses: 16 cases (1970-1985)

The medical records of 16 horses with necrosis of the collateral cartilage of the distal phalanx were reviewed. Typical history included a laceration or puncture wound over the affected cartilage, resulting in persistent drainage proximal to the coronary band. All horses had signs of lameness. The duration of drainage prior to admission to the hospital ranged from 5 days to 5 months. The involved cartilages were left front lateral (n = 4), right front lateral (n = 5), left rear lateral (n = 1), right rear lateral (n = 4), left front medial (n = 1), and left rear medial (n = 1). The affected cartilage was curetted or resected in 13 horses, and conservative treatment was used in 3 horses. Follow-up information on 15 horses (2 to 72 months after discharge) revealed that 66% were sound and able to perform at their previous level. One horse was euthanatized 2 months after discharge from the hospital because it had septic arthritis of the distal interphalangeal joint. The outcome of treatment for each horse was evaluated with respect to the duration of drainage and the method of treatment. Horses with drainage of less than 1 month's duration had a better prognosis for eventual soundness, compared with horses with drainage of greater than or equal to 1 month's duration prior to initiation of treatment. Nine of the 13 horses managed surgically and 1 of the 3 horses managed conservatively were sound at follow-up evaluation.     

Comparison of detomidine hydrochloride, xylazine, and xylazine plus morphine in horses: a double blind study

Detomidine (30 mcg/kg), xylazine (1.1 mg/kg) and xylazine/morphine (1.1 mg/kg and 0.75 mg/kg with 300 mg maximum dose) were compared in horses admitted for broncho-alveolar lavage. Horses (n=99) were randomized and clinicians performing the procedure were unaware of the sedation used. Horses were assessed during the procedure and for the next 2 hours. A significant number of xylazine/morphine-sedated horses showed excitement (p<0.05). The frequency of sinus block or arrest and second-degree atrioventricular block was significantly greater with detomidine. Detomidine-sedated horses were significantly more depressed than either xylazine or xylazine/morphine treated animals. Heart rate was significantly greater in horses given xylazine/morphine by 60 min. There was no significant difference between drug treatments related to reactions to the procedure or respiratory rate depression. The study indicated that all three methods are suitable for standing restraint. The more frequent adverse side effects (circling, muscle fasciculations, head pressing) accompanying xylazine/morphine should be considered.     

Postmortem diagnosis of potassium poisoning

Serum potassium concentrations in horses euthanatized by intravenous injection of potassium chloride (KC1) were determined and compared to potassium concentrations in control horses euthanatized by injection of sodium pentobarbital. Horses euthanatized with 50 (n=7) or 100 (n=5) mg KCl/kg body weight had significantly higher (P<0.05) serum potassium concentrations compared to control horses, (11.3±0.8 meq/1 or 16.0±4.7 meq/1 versus 7.6±2.2 meq/1, respectively) at 2 hours after death. Both test groups sustained elevated serum potassium concentrations from 15 to 120 minutes postmortem. Whole blood potassium and serum chloride concentrations were of little diagnostic value.     

Development and validation of a periarticular injection technique of the sacroiliac joint in horses

REASONS FOR PERFORMING STUDY: Sacroiliac joint osteoarthritis has been recognised as a significant cause of poor performance in competition and racehorses. Reliable diagnostic tools are currently lacking. The diagnosis has been based typically on exclusion of other possible causes of poor performance, back pain and hindlimb lameness. OBJECTIVES: To develop a safe, reliable and minimally invasive periarticular or intra-articular injection technique of potential use for diagnosis and therapy of sacroiliac joint disease in horses. METHODS: Twenty-six horses were used to develop and assess a medial approach to the sacroiliac joint with a 15 gauge, 25 cm long spinal needle. In Part I, the cadaveric study, the spinal needle was introduced cranial to the contralateral tuber sacrale and advanced along the medial aspect of the ipsilateral iliac wing until the dorsal surface of the sacrum was encountered. One ml methylene blue (MB) was injected in both sacroiliac joint regions of the sacropelvic specimens. The location of MB-stained tissues relative to the sacroiliac joints was recorded after dissection and disarticulation of the sacroiliac joint. In Part II, the in vivo study, 18 horses were used to validate the in vivo application of the sacroiliac joint injection technique. Horses were restrained in stocks and sedated in preparation for needle placement. One ml MB was injected bilaterally prior to euthanasia. Stained tissues were identified and recorded at necropsy. Successful joint injections were characterised as having MB located intra-articularly or < or = 2 cm periarticularly from the sacroiliac joint margin and localised to the middle or caudal third of the sacroiliac joint. RESULTS: Intra-articular MB was not observed in any specimen. However, MB-stained tissue was identified periarticularly in all injection sites (n = 48). Based on the predetermined success criteria, 96% of the methylene blue depots were located at the middle or caudal third of the sacroiliac joint. Dye-stained tissue was located < or = 2 cm from the sacroiliac joint margins in 88% of the specimens. Median distance of the MB from the sacroiliac joint margins was 1.0 cm (range 0.2-3.8 cm). The overall success rate considering both location and distance of the MB-stained tissue relative to sacroiliac joint margins was 83% (40 of 48 joints). CONCLUSIONS: The injection technique provides a reliable, easy to perform and consistent access to the medial periarticular aspect of the sacroiliac joint. POTENTIAL RELEVANCE: The described injection technique has the potential for both diagnostic and therapeutic applications in the medical management of equine sacroiliac joint disease. Further investigation is necessary to evaluate clinical efficacy and potential adverse effects.     

A Technique for Laser‐Facilitated Equine Pastern Arthrodesis Using Parallel Screws Inserted in Lag Fashion

Objective— To report a technique for laser‐facilitated, minimally invasive proximal interphalangeal joint (PIJ) arthrodesis in horses. Study Design— Case series. Animals— Horses (n=6); 5 thoracic and 2 pelvic limb PIJ. Methods— PIJ osteoarthritis (OA) diagnosis was confirmed by radiography. A diode laser was used to apply 2000 J of energy to the joint followed by insertion of 3 parallel 5.5 mm screws in lag fashion through stab incisions to achieve PIJ arthrodesis. After anesthetic recovery, limbs were maintained in bandages (n=2) or bandage casts (5) for 3 weeks. Horses were allowed exercise or turnout by 3 months. Results— Three horses (4 limbs) were sound throughout follow‐up (6–18 months). One horse remained lame the 1st month, another had mild lameness at pasture at 6 weeks, and another had persistent low‐grade lameness and delayed joint fusion (1 year). Within 6 months, 5 horses were sound, 4 had radiographic evidence of successful joint fusion, and 5 had returned to intended use. Conclusion— Diode laser‐facilitated, 3 parallel screw arthrodesis for PIJ OA costs less and is associated with less pain compared with standard, open PIJ arthrodesis using 3 parallel screws inserted in lag fashion. Clinical Relevance— In horses with advanced PIJ OA, this technique appears to be a viable alternative for PIJ arthrodesis. Further study including characterization of the effects of the laser, ideal case selection indications, and optimal laser dose is indicated before this technique is recommended for routine PIJ arthrodesis.     

Esophageal disorders in 61 horses. Results of nonsurgical and surgical management

Obstructive esophageal disorders in 61 horses included feed or foreign body impaction (27 horses), strictures (18 horses), perforations (11 horses), and diverticula (5 horses). Horses with feed impaction were treated nonsurgically (25 horses) or by esophagotomy (2 horses). Survival to discharge was 78%, and 37% of these had persistent chronic obstruction at home. Long-term survival was 52%. Long-term survival of nine horses treated nonsurgically for esophageal strictures was 22%; for nine horses treated surgically it was 44%. Long-term survival of horses treated nonsurgically was significantly better in acute than chronic strictures. Surgical repair of esophageal mural strictures was more successful than repair of annular or mucosal strictures. One third of the horses with strictures were foals. Long-term survival for horses with strictures was 33%. Long-term survival was higher for the horses with perforations managed surgically (2 of 4) than nonsurgically (0 of 7). Long-term survival for this group was 18%. One esophageal diverticulum was managed nonsurgically, and four were treated surgically; all horses survived long term. Complications of obstructive esophageal disorders included aspiration pneumonia, chronic obstruction, esophageal mucosal ulceration, postoperative infection, pleuritis, laminitis, laryngeal paralysis, and Horner's syndrome.     

Esophageal Disorders in 61 Horses: Results of Nonsurgical and Surgical Management

Obstructive esophageal disorders in 61 horses included feed or foreign body impaction (27 horses), strictures (18 horses), perforations (11 horses), and diverticula (5 horses). Horses with feed impaction were treated nonsurgically (25 horses) or by esophagotomy (2 horses). Survival to discharge was 78%, and 37% of these had persistent chronic obstruction at home. Long-term survival was 52%. Long-term survival of nine horses treated nonsurgically for esophageal strictures was 22%; for nine horses treated surgically it was 44%. Long-term survival of horses treated nonsurgically was significantly better in acute than chronic strictures. Surgical repair of esophageal mural strictures was more successful than repair of annular or mucosal strictures. One third of the horses with strictures were foals. Long-term survival for horses with strictures was 33%. Long-term survival was higher for the horses with perforations managed surgically (2 of 4) than nonsurgically (0 of 7). Long-term survival for this group was 18%. One esophageal diverticulum was managed nonsurgically, and four were treated surgically; all horses survived long term. Complications of obstructive esophageal disorders included aspiration pneumonia, chronic obstruction, esophageal mucosal ulceration, postoperative infection, pleuritis, laminitis, laryngeal paralysis, and Horner's syndrome.