Deep digital flexor tenotomy for treatment of severe laminitis in a cow

A first-calf Guernsey cow was referred for evaluation of severe udder edema, mastitis, metritis, and ketosis. During the course of treatment, the cow became recumbent and was unable to rise. Intensive treatment resulted in the cow being able to stand for short periods with the aid of a sling. However, severe pressure necrosis of the udder and ongoing mastitis made performance of a complete mastectomy necessary. After surgery, the cow's condition improved, although assistance in standing was still required. Radiography of the distal phalanges revealed severe rotation in the right lateral and left medial digits of the hind limbs. The laminitis was nonresponsive to medical management; therefore, a deep digital flexor tenotomy was performed in the affected claws. The procedure provided almost immediate relief of signs of foot pain and resulted in ability to stand without assistance. Deep digital flexor tenotomy should be considered when treating cows with severe laminitis.     

Radiotherapy for the treatment of periocular tumours in the horse

Periocular tumours are a relatively common problem in the horse, and present some unique challenges. Radiotherapy has long been considered the ‘gold standard’ for the treatment of periocular tumours in the horse, and there are various techniques of delivering this treatment. Although teletherapy and plesiotherapy are occasionally used, the most commonly used technique is interstitial brachytherapy. Low-dose rate interstitial brachytherapy has reported success rates of between 74 and 100% for the treatment of periocular sarcoids, and other tumours can also be successfully treated using this technique. There are significant disadvantages to the low-dose rate brachytherapy approach, and recently, a technique using high-dose rate brachytherapy has been described with a reported success rate of 100% for periocular sarcoid treatment. Electronic brachytherapy is a technique which may provide an alternative to high-dose rate brachytherapy, but its use for the treatment of periocular tumours has not been reported, and the requirement for general anaesthesia is a significant disadvantage.     

Arthroscopic biceps brachii tenotomy as a treatment for canine bicipital tenosynovitis

Five dogs of varying breeds, ranging from 4 to 8 years in age, were presented with clinical signs consistent with bicipital tenosynovitis. After failure of conservative treatment, each dog underwent shoulder arthroscopy. Following examination of the scapular humeral joint, the bicipital tendon was severed with a bipolar radiofrequency electrosurgical system. The arthroscopic procedure resulted in a good to excellent outcome for all five dogs.     

Subconjunctival voriconazole for the treatment of mycotic keratitis in a horse

Fungal keratitis in the horse is a common but challenging disease. This report describes the successful treatment of Fusarium keratitis with both topical and subconjunctival voriconazole 1%. Voriconazole is a new triazole antifungal that has demonstrated efficacy against common fungal pathogens. Topical voriconazole is able to penetrate the intact corneal epithelium making it a good choice for superficial or deep mycotic keratitis. Reports of subconjunctival use of antifungal drugs are sparse in the veterinary literature. We found subconjunctival voriconazole was well tolerated and easy to safely administer.     

Gabapentin for the treatment of neuropathic pain in a pregnant horse

CASE DESCRIPTION: A 24-year-old 732-kg (1,610-lb) pregnant Belgian draft horse mare developed neuropathy and signs of intractable pain following colic surgery. CLINICAL FINDINGS: Following recovery from colic surgery to treat compression of the small and large intestines because of a large fetus, the mare was noticed to have signs of femoral neuropathy involving the left hind limb. Within 36 hours after recovery, the mare developed signs of severe pain that were unresponsive to conventional treatment. No gastrointestinal tract or muscular abnormalities were found, and the discomfort was attributed to neuropathic pain. TREATMENT AND OUTCOME: The mare was treated with gabapentin (2.5 mg/kg [1.1 mg/lb], PO, q 12 h). Shortly after this treatment was initiated, the mare appeared comfortable and no longer had signs of pain. Treatment was continued for 6 days, during which the dosage was progressively decreased, and the mare was discharged. The mare subsequently delivered a healthy foal. CLINICAL RELEVANCE: Gabapentin appeared to be a safe, effective, and economical treatment for neuropathic pain in this horse.     

The treatment of diarrhoea in the adult horse

The priority in treating the equine patient with acute diarrhoea is to stabilise the haemodynamic aberrations secondary to the fluid and electrolyte losses. Once this has been initiated and the patient is stabilised ancillary treatments may be beneficial. Besides the well established effects of NSAIDs and polymixin B on systemic inflammation, recent studies suggest that the use of DTOS to bind bacterial toxins and Saccharomyces boulardii to reduce the severity and duration of diarrhoea may be beneficial. The justification for using probiotic products is scant. There is no evidence to suggest that systemic use of antimicrobials benefits equine patients with colitis, with the exception of metronidazole in cases of clostridial diarrhoea. In light of their potentially detrimental effects, their use can, in the opinion of the authors, not be advocated. Better understanding of the pathways of systemic inflammation and more selective anti‐inflammatory drugs may be of great benefit in the future.     

Arthroscopic treatment of meniscal cysts in the horse

Reasons for performing study: To describe the clinical symptoms, treatment, and outcome of meniscal cysts in horses. These structures have not been previously described in the literature as a potential cause of lameness in the horse. Hypothesis: Meniscal cysts are an uncommon condition of the femorotibial joint but can be a significant cause of lameness. Symptoms can be resolved by arthroscopic excision. Methods: Records of horses diagnosed with meniscal cysts and treated by cyst excision and meniscal debridement at 2 surgical practices were reviewed. Clinical outcome was determined by repeat veterinary examination and contact with owner. Results: Seven cases of meniscal cyst were treated with arthroscopic cyst excision and meniscal debridement. Five of 7 horses had lameness attributable to femorotibial joint pathology, while the remaining 2 horses had meniscal cysts found incidentally during diagnostic arthroscopy for the treatment of osteochondritis dissecans of the lateral trochlear ridge of the femur. Five of 6 horses with long‐term follow‐up were sound and a 7th horse was improved 11 months after surgery. Conclusions and potential relevance: Meniscal cysts, while uncommon, can be associated with progressive lameness in the horse. Surgical excision of the cysts results in resolution or improvement of symptoms, without evidence of recurrence on follow‐up examination.     

Role of prokinetic drugs for treatment of postoperative ileus in the horse

All horses undergoing coeliotomy for an acute abdominal crisis are at risk of developing ileus and should receive therapy aimed at promoting gastrointestinal function by restoring fluid and electrolyte balance. Adequate analgesia and prevention against peritonitis, bacteraemia and endotoxaemia should be provided. Horses that at the time of surgery have a strangulating or non-strangulating small intestinal obstruction should be considered to be at greater risk of developing a persistent ileus that is refractory to treatment than those horses with lesions involving the large intestine. In horses considered to be at greater risk of developing a persistent ileus, the use of prokinetic agents should be considered. Agents that may be used to improve gastrointestinal motility include adrenergic receptor antagonists, cholinergic agonists, benzamides, dopamine antagonists, macrolide antimicrobials, opiate receptor agonists and antagonists, somatostatin analogues and local anaesthetics. There are limited studies into the use of these agents in the horse. Until further research provides more information on motility disorders following intestinal surgery and the efficacy of prokinetic agents in this species, only selective use of some of these drugs can be recommended.     

Systemic d-phenylalanine and d-leucine for effective treatment of pain in the horse

This study showed that subcutaneous injection of a solution of D-amino acids produced effective analgesia in horses. It is postulated that systemic D-phenylalanine and D-leucine may become one of the safe, effective and nonaddictive drugs for acute and chronic pain treatment. These D-amino acids cause analgesia by presumably preserving brain endorphins. They may bind reversibly to enkephalinases and prevent enzymatic degradation of enkephalins.     

Fibrotic Myopathy of the Semitendinosus Muscle in Four Dogs

Fibrosis of the semitendinosus muscle resulted in a characteristic gait abnormality in four male German shepherd dogs. Blood chemistry, electrophoresis, and electromyographic studies were performed. Surgery was undertaken in each case to relieve the restricting fibrous tissue. The lameness returned with reappearance of the fibrous band within six months. The etiology of fibrotic myopathy is unknown, but electromyographic studies and electrophoresis results suggest a myopathy due to chronic inflammation. Histopathologic exam reveals replacement of degenerating muscle fibers with connective tissue.     

Mandibular condylectomy in a standing horse for treatment for osteoarthritis of the temporomandibular joint

An Irish Sport Horse mare presented for evaluation and treatment of inability to masticate effectively with subsequent severe weight loss. A slowly expanding, firm, nonpainful mass was noted at the left temporomandibular joint. Radiographic examination revealed extensive osteoarthritic changes of this joint. Due to the age and debilitated condition of the horse, along with financial constraints on the owner's behalf, the decision was made to perform a mandibular condylectomy as a standing procedure using sedation and local and regional anaesthesia techniques. The mare tolerated the procedure very well and post operatively improved significantly.