Rupture of collateral ligaments in metacarpophalangeal and metatarsophalangeal joints in horses: 17 cases (1999--2005)

OBJECTIVE: To characterize ruptures of collateral ligaments (CLs) in metacarpophalangeal and metatarsophalangeal joints in horses. DESIGN: Retrospective case series. ANIMALS: 17 horses with ruptured CLs. PROCEDURES: Data were obtained from medical records, including signalment, history, clinical signs, ultrasonographic and radiographic findings, treatment, and outcome. Additional follow-up information was obtained from owners or referring veterinarians. RESULTS: The lateral CL was ruptured in 11 horses; the medial CL was ruptured in 6 horses. Ultrasonography revealed ipsilateral rupture of the short and long components of the CL in 11 horses and rupture of only 1 component in 6 horses. No biaxial ruptures were detected, but 9 horses had desmitis of the CL on the nonruptured side of the affected joint. All horses were lame (lameness score range, 2/5 to 4/5). Joint instability was palpable in 9 horses; only 4 horses had episodes of joint luxation. Avulsion fractures were identified radiographically in 6 horses and ultrasonographically in another 2 horses. Stress radiography revealed joint instability in 10 horses. Horses were managed by stall confinement, limb immobilization, and gradual return to exercise. Eight horses returned to riding, 2 resumed breeding, 2 were retired, 2 were euthanized, and 3 were doing well 86 to 139 days after injury. CONCLUSIONS AND CLINICAL RELEVANCE: Ultrasonographic examination is indicated in horses with acute lameness and swelling at the metacarpophalangeal or metatarsophalangeal joint, particularly when stress radiography cannot be performed or findings are equivocal. Affected horses can be conservatively managed. Prognosis for athletic use may be better than originally believed.     

Detailed ultrasonographic mapping of the pelvis in clinically normal horses and ponies.

OBJECTIVE: To map the equine pelvis using ultrasonography, validated by use of computed tomography (CT), magnetic resonance imaging (MRI), and measurements of frozen cadaver slices. ANIMALS: 6 ponies and 6 horses. PROCEDURE: Ultrasonographic examination of the pelvis was performed on 6 clinically normal ponies. Measurements were obtained for imaged structures. Computed tomography, MRI, and measurements of frozen sections were performed after death and used to verify measurements. Linear regression determined the degree of correlation between measurements obtained ultrasonographically and the other modalities. Six clinically normal horses were then examined by use of ultrasonography. For each structure measured mean, SD, and range were calculated. RESULTS: Data obtained from ponies revealed high correlations between ultrasonographic findings and those of CT, MRI, and frozen section measurements (r2 = 0.97, r2 = 0.99, and r2 = 0.99, respectively). Differences between structures measured on each side of the pelvis were not significant. Variation in size of structures was not associated with weight of horses. A correlation was not found between weight of horses and ponies and size of structure. CONCLUSIONS AND CLINICAL RELEVANCE: Ultrasonography can be used to accurately measure and evaluate the musculoskeletal structures of the pelvis of horses. The use of CT, MRI, and measurements of frozen sections provided a means of validating the ultrasonographic measurements. Reference range values determined in our study can be used to evaluate horses with suspected pelvic disease.     

Ultrasonographic characteristics of splenic and hepatic lymphosarcoma in three horses.

Splenic and hepatic ultrasonography were beneficial for diagnosis of lymphosarcoma in 3 horses with anorexia, weight loss, and lethargy. Ultrasonographic abnormalities of the spleen included a large, complex, hypoechoic mass in 1 horse, multiple well-marginated, hypoechoic nodules in 1 horse, and diffuse hyperechogenicity in another horse. Ultrasonographic abnormalities of the liver included a spherical, hypoechoic nodule in 1 horse and diffuse hyperechogenicity in another. Histologic examination of ultrasound-guided biopsy specimens or aspirates revealed lymphosarcoma. Necropsy findings confirmed diagnosis of lymphosarcoma in all horses. Necropsy findings of the liver and spleen correlated well with antemortem ultrasonographic images.     

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.     

Ultrasonography as a diagnostic and prognostic approach in cattle and buffaloes with fatty infiltration of the liver

The aim of the present study was to determine whether ultrasonographic evaluation of the hepatic parenchyma could be used as a diagnostic and prognostic approach in cows and buffaloes with hepatic lipidosis. For this purpose, cows (n=16) and buffaloes (n=10) with fatty infiltration of the liver were examined by ultrasonography. Treated cows and buffaloes were monitored for hepatic changes ultrasonographically, biochemically and histologically. Clinical findings were non-specific and included anorexia, recumbency, muzzle necrosis, and icteric mucosal membranes. Laboratory data revealed neutrophilia, hyper gamma-globulinemia, elevated activities of aspartate aminotransferase, gamma-glutamyl transpeptidase, creatine kinase and lactate dehydrogenase, and high concentrations of insulin, total bilirubin, non-esterified fatty acids and beta-hydroxyl butyric acid. Laboratory results 7, and 21 days after treatment showed progressive improvement in the chemistry profile. On admission, ultrasonographic examination of the hepatic parenchyma in cows and buffaloes revealed either increased or decreased hepatic echogenicity; histologic examination revealed marked fatty infiltration of the hepatocytes. One week after treatment, the hepatic parenchyma was visualized easily, liver boundaries were clearly imaged, and histologic examination of hepatic specimen showed a moderate degree of fatty infiltration. Three weeks after treatment, the hepatic parenchyma was almost similar to normal, the hepatic and portal blood vessels could be easily imaged, and the histologic picture had greatly improved where the liver resembled the normal organ. Six cows and seven buffaloes made a full recovery while the remaining ten cows and three buffaloes were slaughtered and thoroughly examined postmortem. Ultrasonography showed a good correlation with histologic and laboratory findings.     

ULTRASONOGRAPHIC DIAGNOSIS OF COXOFEMORAL SUBLUXATION IN HORSES

The clinical and ultrasonographic features of seven horses with coxofemoral subluxation are presented. Affected horses included five adult geldings (11–20 years), one large pony (6 years) and a 3-month-old filly. All were lame at the walk except for the pony with grade 3/5 lameness. Lameness was acute in all horses, but three horses progressed after initial improvement. Crepitus, muscle atrophy, and pelvic asymmetry were inconsistent findings. Ultrasonographic diagnosis of subluxation required dynamic visualization of femoral head displacement from the acetabulum while placing weight on the affected limb and subsequent replacement into its normal position upon limb resting. Acetabular rim fractures and joint effusion were visible regardless of weight bearing status in six horses each. No fractures were identified in the pony; the only patient with a good outcome. Six horses had a poor outcome with severe chronic lameness, four of which were euthanized. Postmortem ventrodorsal radiographs obtained in two horses confirmed subluxation only on extended limb projections, but not on hip-flexed projections. Acetabular rim fractures were not visible radiographically in either horse but were confirmed at necropsy. Subluxation was due to an elongated but intact ligament of the head of the femur in both horses. Osteoarthrosis was evident ultrasonographically, radiographically, and at necropsy. Dynamic ultrasonography was readily performed in the standing horse and produced diagnostic images with a low frequency curvilinear transducer. The apparent poor prognosis for horses with subluxation and acetabular fracture illustrate the importance of this imaging technique to identify affected horses.     

Reliability of ultrasonography compared to radiography in revealing intestinal sand accumulations in horses

In order to investigate the reliability of ultrasonography in revealing intestinal sand accumulations, the cranioventral parts of the abdomen of 32 horses (age 3-20 years) with signs suggestive of gastrointestinal sand were examined radiographically and ultrasonographically. The amount of sand and its localisation, relative to the ventral abdominal wall, were evaluated radiographically and graded (scale 0-4). Motility of the intestine and whether it was lying against the ventral abdominal wall were evaluated ultrasonographically and the findings summed and graded (scale 0-3) to express the likelihood of the presence of sand. The ultrasonographic and radiographic grades were significantly associated. Out of 14 horses with a moderate or large ventral sand accumulation radiographically, 13 (92.9%) had a positive sand finding ultrasonographically. Out of 8 horses with no signs of sand radiographically, 7 were considered negative for sand ultrasonographically. The specificity of ultrasonography in detecting sand accumulations was 87.5% (7/8) and the sensitivity 87.5% (21/24). Small and more dorsally located accumulations were more difficult to detect ultrasonographically. Of the horses with a small or moderate amount of sand relatively ventrally or only a small part of sand close to the ventral abdominal wall, 70% (7/10) were considered suggestive or positive for sand ultrasonographically. The ventral aspect of sand accumulations was hyperechoic, causing varying acoustic shadowing and the intestine had decreased or absent motility. Ultrasonography revealed the length of the accumulations but gave very limited information of their height. Ultrasonography is a practical and reliable method for detecting sand accumulations but it cannot replace radiography.     

STARRY SKY HEPATIC ULTRASONOGRAPHIC PATTERN IN HORSES

The starry sky hepatic pattern is an unusual ultrasonographic appearance of equine liver characterized by numerous small, hyperechoic foci, some of which cast an acoustic shadow, distributed randomly throughout the hepatic parenchyma. Our objectives were to describe the signalment, clinical signs, clinicopathological findings, primary disease process, and ultrasonographic findings of horses with this ultrasonographic pattern, as well as determine the associated gross and histologic changes. The starry sky pattern was identified in 18 adult horses of mixed gender and breed. The horses had various clinical signs, with weight loss and anorexia reported most commonly. Liver size and parenchymal echogenicity were normal in most horses. The hyperechoic foci frequently caused acoustic shadowing. Biliary dilation was noted rarely. The ultrasonographic pattern was the result of numerous fibrosing hepatic granulomas in all horses evaluated histologically. γ‐Glutamyltransferase was the most commonly elevated hepatic enzyme, though it was increased in fewer than half the horses. Fifteen horses had an additional disease that was identified as the apparent cause of clinical signs. Three horses had primary hepatic disease while 12 had diseases of other body systems. Therefore, the starry sky ultrasonographic pattern is likely incidental in most horses and not clinically significant. Improved recognition of this pattern and further investigation of affected horses may help refine the etiology and clinical significance of the granulomas.     

Diagnosis, management, and outcome in 19 horses with deltoid tuberosity fractures

Objective: To describe the diagnosis and treatment of fractures of the deltoid tuberosity. Study Design: Case series. Methods: Medical records (1992–2009) of 19 horses with radiographic confirmation of deltoid tuberosity fractures were reviewed. Data retrieved included signalment, clinical and diagnostic imaging findings, and treatment. Outcome was determined by telephone questionnaire of owners and referring veterinarians. Results: Most horses were markedly lame on admission and 53% had reduced protraction of the affected limb. All fractures were identified on a cranio45° medial‐caudolateral oblique projection; however, only 32% (6 horses) were detected on a mediolateral projection whereas 86% were evident ultrasonographically. Treatment by local wound care and stall rest resulted in return to athletic function without lameness for 13 of 14 horses that had follow‐up. Conclusions: A cranio45° medial‐caudolateral oblique radiographic view was better than a mediolateral projection for identification of deltoid tuberosity fractures. Ultrasonographic detection of fractures was similar except when gas accumulation obscured the fracture site. Deltoid tuberosity fractures can cause severe lameness but can be treated successfully with conservative management.     

Correlation of clinical score, intrapleural pressure, cytologic findings of bronchoalveolar fluid, and histopathologic lesions of pulmonary tissue in horses with summer pasture-associated obstructive pulmonary disease

OBJECTIVE: To correlate clinical score, intrapleural pressure, cytologic findings of bronchoalveolar lavage fluid (BALF), and histologic lesions of pulmonary tissue in horses affected with summer pasture-associated obstructive pulmonary disease (SPAOPD). ANIMALS: 8 adult horses affected with SPAOPD and 6 adult horses without evidence of respiratory tract disease. PROCEDURE: Clinical score, change in intrapleural pressure (deltaPpl) during tidal breathing, results of cytologic examination and bacteriologic culture of BALF, and results of histologic examination of pulmonary parenchyma were evaluated. RESULTS: Clinical scores for SPAOPD-affected horses (median, 5.75; range, 4.0 to 7.5) were significantly greater, compared with clinically normal horses (median, 2.0; range, 2.0 to 3.0). Cytologic examination of BALF from SPAOPD-affected horses revealed predominantly nondegenerate neutrophils. Histologic lesions were identified throughout pulmonary tissue and included severe accumulation of mucus and neutrophils within the small airways, metaplasia of bronchiolar goblet cells, and mild peribronchial infiltrate. Histologic examination of specimens collected via percutaneous biopsy was predictive of disease and corresponded to findings at postmortem examination. Clinical score and deltaPpl were highly correlated with mucus accumulation in the airways of affected horses. Peribronchial inflammatory infiltrate correlated with percentage of neutrophils in BALF of affected horses. CONCLUSIONS AND CLINICAL RELEVANCE: Clinical scoring and deltaPpl provided valid estimates of disease severity. Findings from cytologic examination of BALF of SPAOPD-affected horses varied, although, in most instances, it was diagnostically useful. Severe mucus accumulation in the airways was the most remarkable histopathologic finding in SPAOPD-affected horses. Examination of biopsy specimens collected from pulmonary parenchyma was consistently useful in diagnosing SPAOPD.     

ULTRASONOGRAPHIC FINDINGS IN 13 HORSES WITH LYMPHOMA

Ultrasonography and radiography are commonly used for staging of lymphoma in horses, however there is little published information on imaging characteristics for horses with confirmed disease. The purpose of this retrospective, case series study was to describe ultrasonographic and radiographic findings for a group of horses with a confirmed diagnosis of lymphoma. A total of 13 horses were sampled. Lymphadenopathy (8/13), peritoneal effusion (6/13), splenic (6/13), and hepatic (5/13) lesions were the most frequently identified. The predominant splenic and hepatic ultrasonographic lesions were hypoechoic nodules, organomegaly, and changes in echogenicity. Digestive tract lesions were detected in three horses and these included focal thickening and decreased echogenicity of the small (2/13) and large intestinal (2/13) wall. Thoracic lesions were predominantly pleural effusion (4/13), lymphadenopathy (4/13), and lung parenchymal changes (3/13). Enlarged lymph nodes were detected radiographically (4/13) and/or ultrasonographically (2/13) in the thorax and ultrasonographically in the abdomen (7/13) and in the caudal cervical region (4/13). Findings supported the use of abdominal and thoracic ultrasonography for lymphoma staging in horses. Ultrasound landmarks for localizing cecal and caudal deep cervical lymph nodes were also provided.     

Clinical and scintigraphic findings in horses with a bone fragility disorder: 16 cases (1980-2006)

OBJECTIVE: To describe clinical and scintigraphic abnormalities in horses with a bone fragility disorder. DESIGN: Retrospective case series. ANIMALS: 16 horses with scintigraphic evidence of multiple sites of increased radiopharmaceutical uptake (IRU). Procedures-Medical records were reviewed for information on signalment; history; clinical, clinicopathologic, and diagnostic imaging findings; and treatment. Follow-up information was obtained through telephone interviews with owners. RESULTS: Horses ranged from 4 to 22 years old; there were 8 castrated males and 8 females. Foci of IRU most commonly involved the scapulae, ribs, sternebrae, sacral tubers, ilia, and cervical vertebrae. Most horses were examined because of chronic intermittent (n = 10) or acute (6) lameness involving a single (10) or multiple (6) limbs that could not be localized by means of regional anesthesia. Cervical stiffness (n = 3), scapular bowing (3), swayback (3), and ataxia (1) were also seen in more advanced cases. Signs of respiratory tract disease and exercise intolerance were evident in 4 horses. Ultrasonographic or radiographic evidence of bone remodeling or degeneration was seen in 19 of 33 affected bones. Histologic examination of bone biopsy specimens revealed reactive bone. Improvement was initially seen with conservative treatment in some horses, but the condition worsened in all horses, and 11 horses were euthanized within 7 years. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that horses may develop a bone fragility disorder characterized clinically by an unlocalizable lameness and scintigraphically by multiple sites of IRU involving the axial skeleton and proximal portion of the appendicular skeleton.     

Retrospective analysis of historical, clinical, ultrasonographic, serum biochemical and haematological data in prognostic evaluation of equine liver disease

REASONS FOR PERFORMING STUDY: Results of noninvasive tests of liver disease do not always correlate with the degree of hepatic disease nor outcome of the case. OBJECTIVE: To investigate the prognostic value of data collected using noninvasive tests during the investigation of cases of suspected liver disease in mature horses. HYPOTHESIS: Much of the data gathered during the investigation of suspected hepatopathy cases offers little prognostic guidance and interpretation of such data can be misleading. METHODS: The results from a range of common and noninvasive diagnostic techniques applied in 116 mature horses with suspected liver disease, were assessed for their ability to predict survival within a 6 month period. RESULTS: A significantly poorer prognosis was found in association with clinical signs suggestive of liver disease, presence of hepatic encephalopathy, ultrasonographic abnormalities, increased serum globulins, increased total bile acids (TBA), increased alkaline phosphatase (AP), increased gamma-glutamyl transferase (gammaGT), erythrocytosis, leucocytosis, low serum albumin and low serum urea. Additional significant novel findings of interest included an association between increased plasma fibrinogen and low serum creatinine concentrations with nonsurvival in cases of liver disease, an association between raised serum concentrations of AP and gammaGT with biliary hyperplasia and also an association between hepatic fibrosis, haemosiderosis and biliary hyperplasia with ultrasonographically detected hepatic abnormalities. CONCLUSIONS: The most useful noninvasive prognostic test in cases of suspected liver disease in mature horses is the severity of clinical signs. Other data may be of some limited prognostic value. POTENTIAL RELEVANCE: Application of the findings in this study may not be directly applicable to other case populations. However, the findings should at least be considered when prognosis is based on similar criteria.     

Ultrasonographic evaluation of the thickness of the small intestinal wall in dogs with inflammatory bowel disease

OBJECTIVES: To establish whether the intestinal wall thickness, as measured ultrasonographically, is significantly increased in dogs with inflammatory bowel disease (IBD). The results would provide the information necessary to decide whether measurement of ultrasonographic wall thickness can predict IBD in dogs. METHODS: The intestinal wall thickness of 75 dogs with idiopathic IBD, as measured by ultrasonography, was compared with recently published normal values. IBD was either confirmed histologically (n = 54) or suspected (n = 21). In all cases there was a positive response to immunosuppressive treatment. RESULTS: A positive association between intestinal wall thickness in dogs and either the histological diagnosis or the response to treatment was not found. Ultrasonographic intestinal wall measurements do not appear to be able to establish a diagnosis of intestinal inflammation and may result in a false negative diagnosis in cases of IBD. CLINICAL SIGNIFICANCE: The same 'grey zone' of between 4 and 6 mm used in humans can be used in the canine duodenum to distinguish the normal range, reserving the term 'abnormal' for an intestinal measurement greater than 6 mm in the duodenum and greater than 4.7 mm in the jejunum.     

Clinicopathological features of equine primary hepatic disease: a review of 50 cases.

The clinicopathological features of 50 cases of equine hepatic disease were reviewed. There was a wide range of clinical signs and at least 50 per cent of the animals exhibited either dull demeanour, anorexia, abdominal pain, cerebral dysfunction and/or weight loss. Life-threatening complications of hepatic failure recorded were: gastric impaction in 10 cases, bilateral laryngeal paralysis in seven cases and coagulopathy in five cases. All the cases had high activities of gamma-glutamyl transferase (GGT) and most had high activities of glutamate dehydrogenase (GLDH) and high concentrations of bile acids. Fewer of the horses had abnormal concentrations of bilirubin, albumin and globulin. The horses that were euthanased or died had significantly higher concentrations of GGT, GLDH and bile acids than the survivors. There were biochemical data for 18 cases with signs of hepatic encephalopathy, all of them had plasma ammonia levels greater than 90 micromol/litre but this was not significantly correlated with the clinical severity of the condition. Half of the cases with hepatic encephalopathy were hyperglycaemic, none was hypoglycaemic, and none had abnormally low levels of plasma urea.     

Ultrasonographic findings in cats with clinical,gross pathologic,and histologic evidence of acute pancreatic necrosis: 20 cases (1994-2001)

OBJECTIVE: To determine ultrasonographic findings in cats with clinical, gross pathologic, and histologic evidence of acute pancreatic necrosis. DESIGN: Retrospective study. ANIMALS: 20 cats. PROCEDURE: Ultrasound reports and permanent ultrasonographic images were reviewed, and ultrasonographic findings were recorded. Thoracic and abdominal radiographs were also reviewed, when available. Anatomic localization of pancreatic necrosis was determined from the gross pathology report; duration and severity of pancreatic necrosis were determined by reviewing histologic specimens. The presence of concurrent disease was recorded from the final pathology report. RESULTS: The pancreas was considered ultrasonographically normal in 10 cats and was not observed in 3. Ultrasonographic findings were considered compatible with pancreatitis in the remaining 7 cats. Gross pathologic findings indicated that pancreatitis was multifocal in all 7 of these cats; histologically, pancreatitis was acute or subacute in 5 and associated with severe or moderate necrosis in 6. In the remaining 13 cats, gross pathologic findings indicated that pancreatitis was multifocal (n = 8) or focal (2), or gross pathologic findings were normal (3). Histologically, pancreatitis was peracute or acute in 11 of these 13 cats and associated with severe or moderate necrosis in 8. Thoracic and abdominal radiographic findings were nonspecific. CONCLUSIONS AND CLINICAL RELEVANCE: Results of ultrasonography were consistent with a diagnosis of pancreatitis in only 7 of 20 cats with acute pancreatic necrosis in the present study. This suggests that new diagnostic criteria must be established if abdominal ultrasonography is to be an effective tool in the diagnosis of pancreatitis in cats.     

ULTRASONOGRAPHY OF THE SOLAR ASPECT OF THE DISTAL PHALANX IN THE HORSE

Ultrasonographic examinations were performed on the solar aspect of the distal phalanx of 10 feet of five normal live horses (Group 1), 22 feet of seven normal cadavers (Group 2), and nine feet of five horses with pathology of the dorsal solar aspect of the distal phalanx (Group 3). Lateromedial radiographs of the distal phalanx were made in all groups, and in Group 2, digits were sagitally sectioned after imaging. The ultrasonographic and radiographic appearance of the sagittal solar aspect of the distal phalanx was described. Measurements of the distance between the sole and the distal tip of the distal phalanx (A), the solar aspect of the apex of the frog and the distal phalanx (B), and the body of the frog's surface and flexor surface of the distal sesamoid bone (C) were made ultrasonographically, radiographically, and on the sectioned cadaver specimens. There was no statistical difference between the radiographic, ultrasonographic, and direct cadaver measurements in A and C. In B, there was a statistical difference between the radiographic, ultrasonographic, and cadaver measurements-most likely as a result of the difference in trimming of the frog apex. Ultrasonographic and radiographic examination of the nine feet of the five horses in Group 3 were performed and the abnormalities described. Color flow and power Doppler ultrasonography were performed on the normal sagittal solar distal phalanx, on the impar distal sesamoidean ligament, and at the insertion of the deep digital flexor tendon on the facies flexoria of the distal phalanx. Power Doppler in these horses showed blood flow at 0.16-0.48 kHz at the tip of the distal phalanx and at 0.16 kHz at the deep digital flexor tendon insertion and in the impar distal sesamoidean ligament. Using color flow Doppler in normal horses mean blood flows ranged from 1.8 to 5.4 cm/s at the tip of the distal phalanx and 1.8-2.0 cm/s at the deep digital flexor tendon insertion and in the impar distal sesamoidean ligament.     

Azoospermia in an 8-month-old boar due to bilateral obstruction at the testis/epididymis interface

An 8-month-old Yorkshire boar was presented for apparent azoospermia. Two semen collections also revealed azoospermia. Ultrasonographic examination of the gonads revealed bilateral caput epididymal dilatation and anechoic fluid within the tubules. Because a testicular biopsy revealed normal spermatogenesis, an outflow tract obstruction was suspected. Multiple sperm granulomas were found within the parenchyma of both testes at necropsy.     

Internal abdominal abscesses in the horse: a study of 25 cases

internal abdominal abscesses in 25 horses, including 8 horses that died or were euthanatized, were found to be caused by Streptococcus equi, Streptococcus zooepidemicus, or Corynebacterium pseudotuberculosis. Breed or sex predilection was not found. Although horses of all ages were affected, those under 5 years of age were more commonly affected. Nearly all of the horses had a history of respiratory catarrh or lymphadenitis. Horses with internal abdominal abscesses also had intermittent, prolonged colic or chronic weight loss. Most horses had increased rectal temperature, increased heart and respiratory rates, and varying degrees of anorexia. Chronic depression anemia, increased plasma fibrinogen concentration, increased total plasma protein with hypergammaglobulinemia, and hypoalbuminemia were prominent clinicopathologic findings. Results of rectal examination or surgical exploration often revealed an abdominal mass. Peritoneal fluid from 14 horses was examined, and the protein content was greater than 2.5 g/dl, with increased numbers of neutrophils. Culture results were negative in all 14 cases, although bacteria were seen intracellularly in 5 cases. Long-term (2- to 6-month) antimicrobial therapy with procaine penicillin G resulted in clinical resolution in most of these animals.