Pelvic fractures in horses: 19 cases (1974-1984)

The clinical features of 19 horses with pelvic fractures were reviewed. The most common problem was a grade III or IV unilateral hind limb lameness. The prevalence of fractures was greater in females and horses less than 4 years old. All horses were treated with a combination of analgesic administration and stall rest for 2 to 6 months. Seven of 11 horses (64%) available for long-term follow-up evaluation recovered and 4 of 11 (36%) had no lameness when being ridden. Five of seven (71%) horses with fractures that involved the acetabulum recovered, and 4 (57%) had complete resolution of lameness. No correlation was found between the long-term outcome of the horses and the bone fractured, age of horse, or duration of injury before admission.     

Nasopharyngeal cicatrices in horses: 47 cases (1972-1985)

Nasopharyngeal cicatrices were observed endoscopically in 47 horses examined because of abnormal respiratory noises and/or exercise intolerance. A review of these cases revealed a correlation between cicatrization and age, sex, and the presence of other upper airway abnormalities. The age of affected horses ranged from 6 to 21 years, with a mean age of 12.7 +/- 7.8 (+/- 2 SD) years. Females were affected 2.7 times more frequently than males. Abnormalities commonly observed with a nasopharyngeal cicatrix included chondritis of the arytenoid cartilage, epiglottic deformity, and deformity of the guttural pouch openings. The nasopharyngeal cicatrix was responsible for respiratory obstruction in only 3 horses. Treatment for the cicatrix was not performed on any horse in this series. Generalized nasopharyngeal and laryngeal inflammation were postulated as causes of the cicatrices and associated abnormalities.     

Cutaneous vasculitis in horses: 19 cases (1978-1985)

The medical records of 19 horses with cutaneous vasculitis were reviewed. Most (73.7%) affected horses were between 3 and 10 years old, and there were significantly more mares (14) than stallions or geldings (5) (P less than 0.01). Subcutaneous edema of the limbs, body, and/or head was the predominant clinical sign (18/19 horses; 94.7%). The single most prevalent laboratory abnormality was neutrophilia (greater than 7,000 neutrophils/microliter), which was detected in 10 horses (52.6%). Leukocytoclastic vasculitis was evident in skin biopsy specimens from 12 of 14 horses (85.7%). All horses were treated with corticosteroids and supportive care, and the overall survival rate was 63.1% (12/19). The mean duration of treatment with corticosteroids in surviving horses was 14 (+/- 5.3) days. Of the 7 horses that died, 5 failed to respond to treatment (4 were euthanatized, 1 died), and 2 others had persistent debilitating sequelae (euthanatized). The only significant clinical or laboratory abnormality predictive of poor prognosis was fever (odds ratio, 17.81; P less than 0.05). Seven horses had history of, or were exposed to horses with, abscessed peripheral lymph nodes and likely were suffering from equine purpura hemorrhagica. In spite of histopathologic evidence of hypersensitivity-vasculitis and/or the clinical suspicion that the cause for vasculitis was immune mediated, 7 of 19 horses (36.8%) had no history of bacterial or viral infection nor a history of current drug administration.     

Clostridial myonecrosis in horses (37 cases 1985-2000)

REASONS FOR PERFORMING STUDY: Previous reports of clostridial myonecrosis have either focused on individual case reports or have been small retrospective studies reporting very high mortality rates. OBJECTIVES: The objective of this study was to describe the outcome of cases of clostridial myonecrosis submitted to 2 referral equine hospitals in the United States over a 15 year period. METHODS: A retrospective study of case material selected on the basis of positive Clostridium spp. culture or the identification of Clostridium spp. by specific fluorescent antibody testing from soft tissue wounds was performed at Cornell and Wisconsin. RESULTS: 37 cases of clostridial myonecrosis were documented. Twenty-seven horses survived, 8 were subjected to euthanasia and 2 died during treatment for an overall survival rate of 73%. Twenty-five cases (68%) were associated with Clostridium perfringens alone, 6 cases (16%) with Cl. septicum alone, 4 cases with mixed clostridial infections (11%), 1 case with Cl. sporogenes and 1 with an unspeciated Clostridium spp. The highest survival rate of 81% was documented for those cases from which Cl. perfringens alone was isolated. The most common antecedent condition prior to referral was colic. The myonecrotic lesion occurred within 6-72 h of a soft tissue injection in 34 cases but was associated with a wound or laceration in the remaining 3 cases. Of the 34 cases associated with recent injections, 24 were associated with i.m. injections in the cervical region, 4 in the semimembranosus/semitendinosus region, 3 in the gluteal region, 2 with perivascular leakage of drugs administered into the jugular vein and 1 case developed simultaneously in the gluteal and neck region following injections at both sites. CONCLUSIONS: Clostridial myonecrosis can occur following the i.m. or inadvertent perivascular administration of a wide variety of commonly administered drugs. It is most common in the neck musculature. Aggressive treatment can be associated with survival rates of up to 81% for cases due to Cl. perfringens alone. Survival rates for other Clostridial spp. tend to be lower. POTENTIAL RELEVANCE: A combination of high dose i.v. antibiotic therapy and surgical fenestration/debridement is the best approach to cases of clostridial myonecrosis. With rapid diagnosis and therapeutic intervention, horses may have up to an 81% chance of survival.     

Congestive heart failure in horses: 14 cases (1984-2001)

OBJECTIVE: To identify clinical signs, underlying cardiac conditions, echocardiographic findings, and prognosis for horses with congestive heart failure. DESIGN: Retrospective study. ANIMALS: 14 horses. PROCEDURE: Signalment; history; clinical signs; clinicopathologic, echocardiographic, and radiographic findings; treatment; and outcome were determined by reviewing medical records. RESULTS: All 14 horses were examined because of a heart murmur; tachycardia was identified in all 14. Twelve horses had echocardiographic evidence of enlargement of 1 or more chambers of the heart. Other common clinical findings included jugular distention or pulsation, crackles, cough, tachypnea, and ventral edema. Nine horses had signs consistent with heart failure for > 6 days. Underlying causes for heart failure included congenital defects, traumatic vascular rupture, pericarditis, pulmonary hypertension secondary to heaves, and valvular dysplasia. Seven horses were euthanatized after diagnosis of heart failure; 5 were discharged but were euthanatized or died of complications of heart disease within 1 year after discharge. The remaining 2 horses were discharged but lost to follow-up. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that congestive heart failure is rare in horses. A loud heart murmur accompanied by either jugular distention or pulsation, tachycardia, respiratory abnormalities (crackles, cough, tachypnea), and ventral edema were the most common clinical signs. Echocardiography was useful in determining the underlying cause in affected horses. The long-term prognosis for horses with congestive heart failure was grave.     

Strangulated umbilical hernias in horses: 13 cases (1974-1985)

The medical records of 13 horses with strangulated umbilical hernias were reviewed. Typical history included increased swelling, warmth, and firmness of the hernial sac. Enterocutaneous fistulas had developed in 2 horses. Four horses had signs of abdominal pain. Surgery was performed on all horses, and the hernia was reduced by an open reduction technique. Incarcerated tissue included omentum (1 horse), jejunum (5), ileum (4), cecum (1), and ventral colon (2). All horses survived and were discharged from the hospital. Follow-up information on 9 horses (5 to 52 months after discharge) revealed no complications in 6 horses. Of the remaining 3 horses, one horse was euthanatized 5 months after discharge because of laminitis. One horse had persistent drainage from the skin incision requiring removal of nonabsorbable suture material 8 months after discharge. One foal required a second surgery because of signs of abdominal pain 17 days after the initial surgery. The foal was euthanatized during surgery because of severe peritonitis secondary to anastomotic leakage.     

Coccidioidomycosis in horses: 15 cases (1975-1984).

Fifteen confirmed cases of equine coccidioidomycosis that originated in California and Arizona were studied retrospectively. Age, breed, and sex varied among affected horses. The most common historical problems were chronic weight loss (53% of cases) and persistent cough (33% of cases). The most frequent physical examination abnormalities were related to the respiratory tract (60% of cases). In 27% of cases, horses had signs of musculoskeletal pain. Horses consistently had hyperproteinemia, hyperfibrinogenemia, leukocytosis, and neutrophilia. An antemortem etiologic diagnosis was made for 11 (73%) horses, all of which had positive serologic tests for coccidioidomycosis. Of the seropositive horses, 5 (46%) also had positive cultures for Coccidioides immitis. One horse died naturally. The other 14 were euthanatized. Prolonged treatment with specific antifungal agents was attempted in 4 horses without apparent benefit. Postmortem abnormalities included pulmonary parenchymal lesions (64% of cases), thoracic lymphadenopathy (57% of cases), hepatic parenchymal involvement (43% of cases), and osteomyelitis (29% of cases). The lesions were granulomatous or pyogranulomatous and C immitis was observed microscopically in 83% of cases.     

Clinical use of metronidazole in horses: 200 cases (1984-1989)

Case records of 200 horses treated with metronidazole were reviewed. Horses were treated for respiratory tract infections (90 cases), peritonitis or abdominal abscess (39 cases), celiotomy (49 cases), orthopedic infections (6 cases), and miscellaneous soft tissue infections (16 cases). Bacteria of the genus Bacteroides were most prevalent (55 of 167 anaerobic isolates). Metronidazole was always used in combination with other antimicrobial drugs. Only 4 of the 200 horses had signs of adverse effects associated with metronidazole treatment. Those 4 horses had poor appetite that resolved when metronidazole treatment was discontinued.     

Ultrasonographic findings in horses with cholelithiasis: eight cases (1985-1987)

Cholelithiasis and/or obstructive biliary tract disease was diagnosed ultrasonographically in 8 horses, 5 to 15 years old. Ultrasonographic findings revealed greater than normal amount of hepatic parenchyma in the right side of the abdomen in 8 horses and in the left side in 3 horses. The echogenicity of the liver was greater than normal, and thick distended bile ducts were seen in all horses. Choleliths were imaged ultrasonographically in 6 horses. Subsequently, postmortem findings in 6 horses revealed periportal and intralobular fibrosis, moderate bile duct dilatation, proliferation, and cholestasis. One or more choleliths were found in all horses. Ultrasonographic findings accurately depicted the histologic changes in the hepatic parenchyma in horses with cholelithiasis.     

Ventricular arrhythmias in horses: 21 cases (1984-1989).

Ventricular premature depolarizations (VPD) were identified in 21 horses in which unexplained tachycardia or an arrhythmia was detected on auscultation. Horses were categorized into 3 groups on the basis of ECG findings. Seven horses had uniform isolated VPD (group 1); 7 horses had repetitive uniform VPD at a rate < 100 VPD/min (group 2); and 7 horses had either multiform VPD, R-on-T, or > or = 100 VPD/min (group 3). Concurrent systemic disease was identified in 12 horses, 7 of which had gastrointestinal tract disorders. Serum cardiac isoenzyme activities were high in 6 (2 from each group) of 13 horses in which they were measured. Serum electrolyte concentrations were normal in all but 1 of 11 horses in which they were measured. Antiarrhythmic drugs were given to 9 horses (all of which were in group 2 or group 3), 6 of which converted to sinus rhythm. Two horses that had R-on-T in the ECG died shortly after initiation of antiarrhythmic treatment. An accelerated idioventricular rhythm persisted in 1 horse for at least 8 months and failed to respond to antiarrhythmic drugs. Ventricular premature depolarizations resolved or decreased considerably in frequency in 11 horses without the administration of antiarrhythmic agents. Treatment in these horses included therapy for any underlying systemic disease, corticosteroids, nonsteroidal antiinflammatory drugs, or stall rest. The remaining horse was euthanatized several hours after hospitalization. Five horses died or were euthanatized either during hospitalization or several months after being discharged. Myocardial lesions were identified at necropsy in 2 horses.     

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.     

Renosplenic entrapment of the large colon in horses: 33 cases (1984-1989)

Between 1984 and 1989, 33 horses were diagnosed with renosplenic entrapment of the large colon. Duration of colic, signalment, physical findings, and laboratory values were determined, and treatment methods were evaluated. Nonsurgical correction was attempted in 22 of the horses with suspected renosplenic entrapment of the large colon and was successful in 11 cases. Survival and complication rates also were determined. Nonsurgical correction is a viable alternative to immediate surgery for renosplenic entrapment of the large colon, if cases are selected properly.     

Comparison between diagnostic ultrasonography and radiography in the evaluation of horses and cattle with thoracic disease: 56 cases (1984-1985)

The results of radiography and ultrasonography were compared on 56 horses and cows with lower respiratory tract disease. Ultrasonography was more sensitive than radiography for the detection of small pleural effusions and consolidations in large animals. The side of the thorax affected and the character of the pleural fluid and lung in large animals with pleural effusion can be evaluated ultrasonographically. The periphery of the lung must be affected to characterize pulmonary lesions ultrasonographically. Radiography is the best technique to characterize lesions deep within the lung when the periphery of the lung is normal.     

Use of phacofragmentation for cataract removal in horses: 12 cases (1985-1989)

The medical records of 12 horses that had cataracts removed by use of phacofragmentation were reviewed. Cataracts were removed from 16 eyes in horses ranging in age from 2 months to 15 years. Complications after surgery included corneal ulcers in 13 eyes, diffuse corneal edema in 5 eyes, and uncontrollable uveitis in 3 eyes. Follow-up information was obtained in all horses from 1 month to 3.5 years after surgery. Visual results were judged good by owners or veterinarians in 10 of the horses.     

Management of arytenoid chondropathy and failed laryngoplasty in horses: 75 cases (1979-1985)

By use of endoscopy, 75 horses with respiratory noise and/or exercise intolerance were determined to have structural arytenoid cartilage abnormalities (60 primary, 11 after previous laryngeal surgery), or failed left laryngoplasty (4 horses) for laryngeal hemiplegia in which the arytenoid cartilage still appeared normal. Eighty-eight percent of the horses were either Thoroughbred (54 horses; 72%) or Standardbred (12 horses; 16%) racehorses; only 9 horses (12%) had occupations not related to racing. Seventy-six percent of the racehorses were 2 to 4 years old; all non-racehorses were greater than 4 years old. The male:female ratio was approximately 2:1. Of the horses with cartilage abnormalities, 28 had left-sided involvement, 22 had right-sided involvement, and 21 had bilateral involvement. Sixty-two arytenoidectomies were performed, 58 for cartilage abnormalities (22 left, 19 right, 17 bilateral), and 4 for failed left laryngoplasties. Overall, 45% of the Thoroughbred racehorses that returned to racing after arytenoidectomy raced successfully (50% left, 75% right, 22% bilateral); only 20% of the Standardbreds were able to race. Seventy-five percent of non-racehorses were able to return to their previous use. Many horses were retired intentionally after surgery.     

Sagittal fractures of the third carpal bone in horses: 12 cases (1977-1985)

Third carpal sagittal fractures were found to be related to racing injuries in 10 of 12 horses. These fractures occurred most commonly on the medial aspect of the bone. A dorsoproximal-dorsodistal view of the carpus was required to visualize the fracture in all cases. Healing of the fracture required periods of rest of up to one year. Conservative management of these fractures resulted in return to function in 7 of 12 horses.     

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.     

Fractures of the palmar aspect of the carpal bones in horses: 10 cases (1984-2000)

OBJECTIVE: To determine clinical and radiographic findings, treatment, and outcome of horses with fractures of the palmar aspect of the radial carpal bone, with or without concurrent fractures of the palmar surfaces of the other carpal bones. DESIGN: Retrospective study. ANIMALS: 10 horses. PROCEDURE: Medical records were reviewed to obtain information on history, signalment, clinical and radiographic findings, treatment, and outcome. Follow-up information was gathered from owners and referring veterinarians. RESULTS: 7 horses became lame after recovery from general anesthesia for treatment of an unrelated problem. The remaining 3 horses developed a fore-limb lameness after falling (1 horse) or being turned out in a pasture (2 horses). Fractures involved the palmar surface of the radial carpal bone in all 10 horses; in addition, the ulnar carpal bone was affected in 2 horses, the intermediate carpal bone in 2 horses, and the distal aspect of the radius in 4 horses. None of the 4 horses treated nonsurgically returned to work, and 3 were euthanatized because of recalcitrant lameness. In the other 6 horses, fragments were removed surgically. Two were euthanatized because of continued lameness, 1 was euthanatized for other reasons, 2 were sound enough for light work, and 1 returned to athletic work. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that fractures of the palmar aspect of the carpal bones are uncommon in horses. The prognosis appears to be poor for affected horses but may be better for horses that undergo arthroscopic removal of intra-articular fragments.