Treatment and outcome of chronic tenosynovitis in three horses

Three horses were presented for treatment of chronic infections of the digital flexor tendon sheath. Clinical signs included severe lameness, and heat, pain and swelling of the digital flexor tendon sheath. The horses were treated with surgical lavage of the tendon sheath, systemic and local antibiotics, and analgesics. In each case, resolution of the lameness occurred over weeks to months. Only one horse returned to athletic activity, while the other two became comfortable at pasture. Response to treatment in cases of chronic tenosynovitis may not be as rapid or complete as that reported for acute tendon sheath infections.     

Treatment and outcome of chronic septic tenosynovitis in three horses

Three horses were presented for treatment of chronic infections of the digital flexor tendon sheath. Clinical signs included severe lameness, and heat, pain and swelling of the digital flexor tendon sheath. The horses were treated with surgical lavage of the tendon sheath, systemic and local antibiotics, and analgesics. In each case, resolution of the lameness occurred over weeks to months. Only one horse returned to athletic activity, while the other two became comfortable at pasture. Response to treatment in cases of chronic tenosynovitis may not be as rapid or complete as that reported for acute tendon sheath infections.     

Management of fractures in endurance horses

This paper provides relevant information for veterinarians responsible for treatment of endurance horses, including a retrospective study of fractures in endurance horses presenting to one referral hospital and to treatment clinics at 3 different race venues. Treatment and case outcome were also noted. The information presented provides clinicians working with high level endurance horses increased awareness of common sites of fractures, of prefracture stress related bone injury within this population of athletes and guidelines in order to manage them more effectively. The most common fractures involve the metacarpo‐(tarso‐)phalangeal joint. Most distal limb fractures can be diagnosed radiographically, but magnetic resonance imaging or scintigraphy may be required in some cases.     

Indications for and short- and long-term outcome of permanent tracheostomy performed in standing horses: 82 cases (1995-2005)

OBJECTIVE: To identify indications for and short- and long-term outcome of permanent tracheostomy performed in standing horses. DESIGN: Retrospective case series. ANIMALS: 82 horses undergoing permanent tracheostomy. PROCEDURES: Data obtained from medical records included signalment, diagnosis, surgical technique, complications, use of the horse before and after surgery, and owner satisfaction. Follow-up information was obtained through a telephone questionnaire administered to owners. RESULTS: Indications for permanent tracheostomy included nasopharyngeal cicatrix (n = 59), arytenoid chondropathy (55), and laryngeal hemiplegia (20); 54 horses had multiple indications for tracheostomy. Complications identified prior to discharge included partial dehiscence (n = 8), transient fever (10), and excessive swelling (13). Complications identified after discharge included partial dehiscence (n = 3), inversion of skin (2), and stenosis of the tracheostomy requiring repair (1). Long-term follow-up information was available for 64 horses. Fifty-seven of the 64 (89%) horses returned to their previous use, and owners of 63 (98%) horses reported being very satisfied with the results. The owner of 1 (2%) horse was unsatisfied with the results. The 1-year survival rate was 97% (95% confidence interval, 95% to 100%). Mean estimated truncated survival time (ie, failure-free period) was 9.7 years (95% confidence interval, 9.3 to 10.1 years). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that permanent tracheostomy can be safely performed in standing horses and was a viable treatment for horses with obstructive disease of the upper respiratory tract that was unresponsive to medical treatment or other surgical treatments.     

Management of bladder rupture in mature horses

Rupture of the urinary bladder of adult horses is rare with both reports of surgical repair and conservative management in the literature. The case report by Gosling et al. in this issue describes the successful treatment of an iatrogenic bladder tear in an adult gelding. The aim of this commentary is to review the described treatment options.     

Diagnostic evaluation and short-term outcome as indicators of long-term prognosis in horses with findings suggestive of inflammatory bowel disease treated with corticosteroids and anthelmintics

Background

Recurrent colic and unexplained weight loss despite good appetite and adequate feeding and management practices are common conditions in the horse. However, little information has been published on the systematic diagnostic evaluation, response to treatment, prognostic factors or outcome of either presentation. The aims of this study were to 1) identify possible prognostic indicators and 2) report the short- and long-term response to treatment with corticosteroid therapy of a variety of horses with a presumptive diagnosis of inflammatory bowel disease (IBD).Thirty-six horses with a history of recurrent colic and/or unexplained weight loss were screened with a detailed clinical, clinicopathological and diagnostic imaging examination. Twenty horses were subsequently selected that had findings consistent with inflammatory bowel disease based on the fulfilment of one or more of the following additional inclusion criteria: hypoproteinaemia, hypoalbuminaemia, malabsorption, an increased intestinal wall thickness on ultrasonographic examination or histopathological changes in rectal biopsy. These 20 horses were treated with a standardized larvicidal anthelmintic regime and a minimum of three weeks of corticosteroid therapy.

Results

The initial response to treatment was good in 75% (15/20) of horses, with a 3-year survival rate of 65% (13/20). The overall 3-year survival in horses that responded to initial treatment (12/15) was significantly higher (P = 0.031) than in those that did not respond to initial treatment (1/5). The peak xylose concentration was significantly (P = 0.048) higher in survivors (1.36 ± 0.44 mmol/L) than non-survivors (0.94 ± 0.36 mmol/L).

Conclusions

The overall prognosis for long-term survival in horses with a presumptive diagnosis of IBD appears to be fair to moderate, and the initial response to anthelmintic and corticosteroid therapy could be a useful prognostic indicator. The findings of the present study suggest that a low peak xylose concentration in absorption testing is associated with a less favourable prognosis, supporting the use of this test.     

Complete and partial hoof wall resection for keratoma removal: post operative complications and final outcome in 26 horses (1994-2004)

REASONS FOR PERFORMING STUDY: There are no data on the frequency of post operative complications following keratoma removal, such as recurrence, hoof wall instability and excessive granulation tissue formation, or their relation to the method of surgical removal. OBJECTIVE: To identify important factors in the outcome for horses undergoing surgical removal of a keratoma and compare the post operative complications encountered following keratoma removal by complete hoof wall resection (CR) and partial hoof wall resection (PR). HYPOTHESIS: Horses undergoing PR would have fewer post operative complications and would return to work more quickly than those undergoing CR. METHODS: A retrospective review of medical records from one equine hospital identified 26 horses that underwent removal of a keratoma by CR or PR. Clinical, radiological and surgical findings and outcome were analysed. RESULTS: Common clinical signs included lameness and the presence of a subsolar abscess. Fourteen horses underwent CR and 12 PR. The complication rate following CR (71%) was significantly lower than that following PR (25%) (P<0.01). Complications encountered included excess granulation tissue formation, hoof crack formation and keratoma recurrence at the surgical site. The time taken to return to full work post operatively was significantly shorter in horses undergoing PR compared to CR (P<0.01). All horses, except one, returned to their previous exercise level. CONCLUSIONS: PR resulted in fewer post operative complications and a more rapid return to athletic activity than CR. Potential relevance: Although the overall complication rate for CR was higher than for PR, the overall prognosis for return to soundness and the previous performance level is very good.     

Intestinal fibrosis with partial obstruction in five horses and two ponies.

Fibrosis of the small intestine led to recurrent colic and weight loss in 2 ponies and 5 horses. There was a reduction in the length of the small intestine to one-half normal in horses 4 to 7. Histologic examination revealed substantial small intestinal submucosal fibrosis and arteriole sclerosis. The cause was not determined, but an environmental factor was suspected because 3 horses were from the same farm and the other animals were from within a 10-mile radius of the farm. The submucosal fibrosis appeared to be secondary to sclerosis of arterioles in the submucosa and mesentery, with low blood flow state or altered vessel permeability.     

Injuries and outcome of three horses hospitalised in the aftermath of Hurricane Isaac

This case series describes 3 horses rescued from flooded areas, hospitalised and treated at the Louisiana State University Veterinary Teaching Hospital in the wake of Hurricane Isaac. The purpose of the paper is to familiarise practitioners with the injuries that may be found in flood‐afflicted horses and livestock. Case 1 presented with a degloving injury of the right hindlimb. The gelding developed neurological signs and was subjected to euthanasia; necropsy was consistent with Salmonella sepsis and disseminated mycosis due to Candida krusei, the first case reported in a horse. Case 2 presented with dermatitis attributable to chemical exposure and pneumonia and was subjected to euthanasia due to severe bilateral laminitis. Case 3 sustained a degloving injury of the left hindlimb and was subjected to euthanasia due to intractable pain. This case series illustrates the need for preparation and evacuation to avoid life‐threatening injuries in equids and livestock caused by hurricanes and their aftermath.     

Larval viability and serological response in horses with long-term Trichinella spiralis infection

The horse is considered an aberrant host for the nematode parasite Trichinella spiralis, and many aspects of the biology and epidemiology of Trichinella infection in the horse are poorly understood. It has been reported that experimentally-infected horses produce a transient serological response to infection and that muscle larvae are cleared more rapidly than in parasite-adapted hosts such as the pig and humans. However, limited numbers of animals have been studied, and both the longevity of larvae in horse musculature and the immune response to Trichinella larvae remain unclear. In this study, we infected 35 horses with 1000, 5000, or 10,000 T. spiralis muscle larvae and followed the course of infection for 1 year, assessing larval burdens in selected muscles, the condition and infectivity of recovered larvae, and the serological response of infected horses. The results demonstrated that T. spiralis establishes infection in horses in a dose dependent manner. Anti-Trichinella IgG antibodies peaked between weeks 6-10 post-inoculation. Viable, infective larvae persisted in horse musculature for the duration of the study (12 months), and exhibited no apparent reduction in muscle burdens over this period. Encapsulated larvae showed no obvious signs of degeneration in histological sections. Larval capsules were surrounded by infiltrates consisting of mature plasma cells and eosinophils. Macrophages were notably absent. Given the lack of a detectable serological response by 26 weeks p.i. and the persistence of infective muscle larvae for at least 1 year, parasite recovery methods are currently the only suitable detection assays for both meat inspection and epidemiological studies of Trichinella infection in the horse.     

Severe hypertriglyceridaemia in clinically ill horses: diagnosis, treatment and outcome

REASONS FOR PERFORMING STUDY: Sporadic measurement of serum triglycerides in depressed and inappetant clinically ill horses revealed severe hypertriglyceridaemia without visible evidence of lipaemia on several occasions, leading to the inclusion of serum triglyceride concentrations in the routine serum biochemistry evaluation of our hospital. Since then, more cases have been identified and treated for hypertriglyceridaemia, raising questions about the prevalence, predisposing factors and significance of these findings. HYPOTHESES: 1) Severe hypertriglyceridaemia without visible opacity of the serum occurs more commonly in clinically ill and inappetant horses than previously described and 2) appropriate treatment using i.v. dextrose and/or partial parenteral nutrition would decrease serum triglycerides to normal limits and might result in improved appetite and attitude of the patient. METHODS: The laboratory computer database from 2000 and 2001 was searched for increased serum triglycerides (> 5.65 mmol/l) in any horse breed, ponies and miniature breeds excluded. Data analysed included subject details, diagnosis, clinical and laboratory parameters, treatment, response to treatment and outcome. RESULTS: Severe hypertriglyceridaemia was identified in 13 horses, with serum triglyceride concentrations 6.17-18.29 mmol/l, while none showed visible lipaemia. All horses had clinical and laboratory findings consistent with systemic inflammatory response syndrome and all but one had an increased serum creatinine concentration. Treatment with i.v. dextrose and/or partial parenteral nutrition resulted in decrease of the serum triglycerides to normal limits. CONCLUSIONS: Severe hypertriglyceridaemia occurs in inappetant and clinically ill horses without evidence of serum opacity more commonly than previously described. The presence of systemic inflammatory response syndrome might predispose horses to hypertriglyceridaemia, while the increased creatinine concentration might be a predisposing factor or result of the condition. Horses identified in our study readily responded to treatment and appetite and attitude improved coincident with decrease of the serum triglycerides to normal limits. POTENTIAL RELEVANCE: Hypertriglyceridaemia could perpetuate inappetance and depression in clinically ill horses and potentially predispose to fatty infiltration of the liver and other organ systems.     

Aetiology and long-term outcome of juvenile epilepsy in 136 dogs

The aetiology and outcome of dogs with juvenile-onset seizures were investigated. One hundred and thirty-six dogs whose first seizure occurred before the age of one year were investigated. One hundred and two dogs were diagnosed with idiopathic epilepsy (IE), 23 with symptomatic epilepsy (SE), nine with reactive seizures (RS) and two with probable symptomatic epilepsy (pSE). The outcome was known in 114 dogs; 37 per cent died or were euthanased as a consequence of seizures. The mean survival time of this population of dogs was 7.1 years. Factors that were significantly associated with survival outcome included the diagnosis of SE and the number of antiepileptic drugs (AEDs) used before investigation. The use of one AED before investigation and a diagnosis of SE were associated with a negative outcome, whereas receiving no AED medications before referral was associated with a longer survival. For dogs with IE, survival time was shortened if the dog was a border collie or with a history of status epilepticus;receiving no AEDs before referral in the IE group was associated with a positive outcome. Seizure-free status was achieved in 22 per cent of dogs diagnosed with IE. While the survival times were longer than previously reported in canine epilepsy, similar remission rates to those reported in childhood epilepsy, where a 70 per cent remission rate is documented, were not seen in the canine juvenile population.     

Lyme neuroborreliosis in 2 horses

Lyme neuroborreliosis--characterized as chronic, necrosuppurative to nonsuppurative, perivascular to diffuse meningoradiculoneuritis--was diagnosed in 2 horses with progressive neurologic disease. In 1 horse, Borrelia burgdorferi sensu stricto was identified by polymerase chain reaction amplification of B burgdorferi sensu stricto-specific gene targets (ospA, ospC, flaB, dbpA, arp). Highest spirochetal burdens were in tissues with inflammation, including spinal cord, muscle, and joint capsule. Sequence analysis of ospA, ospC, and flaB revealed 99.9% sequence identity to the respective genes in B burgdorferi strain 297, an isolate from a human case of neuroborreliosis. In both horses, spirochetes were visualized in affected tissues with Steiner silver impregnation and by immunohistochemistry, predominantly within the dense collagenous tissue of the dura mater and leptomeninges.