Herniation of the small intestine through the femoral canal after castration in a 3‐year‐old Thoroughbred

Complications following castration are a potential problem in equine practice. Intestinal evisceration is a life‐threatening condition requiring immediate correction. The following case report describes a rare condition associated with post castration evisceration in a 3‐year‐old Thoroughbred. Shortly after the eviscerated small intestine was repositioned in the abdomen, the horse showed signs of colic and at the second surgery a 4.5 m jejunal loop was found incarcerated in the femoral canal. After resection and anastomosis, the femoral canal was obliterated using large moistened gauze sponges. The horse made a complete recovery and returned to race training. The occurrence of femoral hernia, a condition fairly common in man, has been described but no clinical cases have been reported in horses. This is a severe, although rare, complication after castration.     

Thoracotomy for repair of a large dorsal diaphragmatic hernia in an 18‐year‐old mare

An 18‐year‐old Arabian‐mix mare was presented with a history of severe colic. Emergency exploratory celiotomy revealed diaphragmatic hernia, with a large rent in the left dorsal aspect of the diaphragm and large colon volvulus. Attempts to close the defect in the diaphragm in dorsal recumbency were unsuccessful. Therefore, a thoracic approach through lateral thoracotomy was elected, and a mesh was attached to the diaphragm using skin staples. While in dorsal recumbency, the mare suffered from significant respiratory acidosis. Thus, the mare was tilted into reverse Trendelenburg (30° head upward) and ventilation improved markedly. The mare recovered uneventfully, and was doing well 5 years after surgery.     

Results and complications of a novel technique for primary castration with an inguinal approach in horses

Reasons for performing study: Complications associated with equine castration can have medical and financial consequences. This retrospective study investigated a novel method of castration via an inguinal approach in mature stallions and compared the incidence of complications with other methods. Hypothesis: Castration via an inguinal approach has a low complication rate at the site of surgery compared with other castration techniques. Methods: Mature stallions (n = 238) were castrated under general anaesthesia in dorsal recumbency using an inguinal approach. The vaginal process was incised, the spermatic cord ligated twice and the testis removed. After suturing, the vaginal process and one or 2 layers of fascia, the subcutis and cutis were closed in a simple continuous pattern. Results: Five of 238 (2.1%) horses had post operative haemorrhage and a haematoma in the scrotal region, which required additional treatment. All horses made a full recovery. Five of 238 (2.1%) of the horses had a post operative respiratory infection, which resolved with antibiotic therapy. Sixteen of 238 (8.8%) had transient signs of colic shortly after surgery. Conclusion: This technique of castration with an inguinal approach had a low incidence of complications at the site of surgery compared with other methods. An inguinal approach and leaving the vaginal tunic in situ may cause less soft tissue trauma than a scrotal approach.     

Mesh repair of a large traumatic lateral abdominal wall hernia in an 8‐day‐old foal

An 8‐day‐old French trotter colt was admitted with a traumatic lateral abdominal wall hernia with reducible intestinal content. A 15 cm long full thickness tear was identified in both the internal abdominal oblique and transverse abdominal muscles. This case report describes the surgical repair of the hernia using a polypropylene mesh.     

Clinical findings and outcomes of ulcerative keratomycosis in 30 horses in the mid‐Atlantic United States (2006–2007)

The purpose of this study was to determine the clinical course and outcome associated with keratomycosis in horses in the mid‐Atlantic USA. Records of horses diagnosed with keratomycosis at New Bolton Center from November 2006 to November 2007 with positive fungal culture were retrospectively studied. Neither horses with ulcerative keratitis and a negative fungal culture nor those with stromal abscesses were included. Subject details, history, clinical findings, therapy and outcome were recorded. Thirty horses fitted both inclusion criteria (diagnosis of keratomycosis and positive corneal fungal culture). Fourteen of 30 cases occurred during summer. Aspergillus was the most commonly cultured fungal genus (17/30, or 57%) followed by Alternaria (4/30). Seventeen horses had positive bacterial and fungal cultures. Fifteen of 30 horses were treated surgically by a keratectomy and amnion (8) or conjunctival (7) graft. Itraconazole was the most common topical anti‐fungal therapy and was utilised in 25/30 horses. Globe survival was 97% (29/30). All surviving globes had a positive menace response and were visual at the last examination. It was concluded that in the mid‐Atlantic USA, fungal keratitis is common, has the highest incidence in summer, and is usually associated with a positive outcome. Aspergillus may be a relatively more common corneal pathogen in this region than elsewhere in the USA. Surgical cases were more likely to have fungal hyphae identified on cytology and tended to be hospitalised longer than medical cases. There was no apparent association between surgical disease and all other patient, organism and treatment variables.     

Evaluation of basal plasma α‐melanocyte‐stimulating hormone and adrenocorticotrophic hormone concentrations for the diagnosis of pituitary pars intermedia dysfunction from a population of aged horses

Reasons for performing study: The sensitivity and specificity of basal plasma α‐melanocyte‐stimulating hormone (α‐MSH) and adrenocorticotrophic hormone (ACTH) for the diagnosis of pituitary pars intermedia dysfunction (PPID) has not been evaluated in a population‐based study. Objectives: To evaluate basal plasma α‐MSH and ACTH concentrations for the diagnosis of PPID in a population of horses aged ≥15 years. Methods: Owner‐reported data were obtained using a postal questionnaire distributed to an equestrian group. A subgroup of surveyed owners was visited and veterinary examination performed on horses aged ≥15 years. Blood samples were analysed for plasma α‐MSH and ACTH concentrations. Seasonally adjusted cut‐off values for α‐MSH and ACTH concentrations for the diagnosis of PPID were obtained using Youden index values against a clinical gold standard diagnosis (hirsutism plus 3 or more clinical signs of PPID). Results: α‐melanocyte‐stimulating hormone and ACTH were highly correlated with each other and with clinical and historical indicators of PPID. The increase in both α‐MSH and ACTH with increasing numbers of clinical signs in affected horses supports a spectrum of disease. Both variables were affected by season, with derived cut‐off values being higher in autumn compared with other seasons. Sensitivity and specificity were moderate and good in nonautumn seasons (59 and 93%, respectively) for α‐MSH using a cut‐off of 52.0 pmol/l. Sensitivity and specificity were good in nonautumn seasons (80 and 83%, respectively) for ACTH using a cut‐off of 29.7 pg/ml. For both α‐MSH and ACTH, sensitivity and specificity were close to 100% for samples obtained during the autumn period. Conclusions and potential relevance: Basal plasma α‐MSH and ACTH had moderate‐to‐good sensitivity and specificity for the diagnosis of PPID, which improved substantially during the autumn period, suggesting this may be the ideal time to test. Further studies to develop seasonally adjusted reference intervals for different geographical locations are warranted.     

Intralesional 5‐fluorouracil (5‐FU) for the treatment of eyelid squamous cell carcinoma in 5 horses

Eyelid squamous cell carcinoma in equine patients often presents a therapeutic challenge to practitioners due to the generally large area affected upon presentation. Surgical excision can be curative if wide enough margins are achieved, but this is not often attainable without enucleation. Other alternatives have been examined including cryotherapy, radiotherapy, brachytherapy, intralesional chemotherapy and photodynamic therapy. Intralesional chemotherapy using cisplatin, mitomycin‐C and bleomycin have been shown to be successful in treating eyelid squamous cell carcinomas but may be prohibitive to some owners due to the cost of therapy. To the authors' knowledge, this is the first case series to illustrate the effectiveness of intralesional 5‐fluoruracil in treating large equine eyelid squamous cell carcinomas. Macroscopic reduction in the size of the affected areas was noted in each case together with regression of clinical signs associated with the mass. This, coupled with the relative inexpensive nature of the procedure, makes this technique an attractive therapy for either primary treatment of eyelid squamous cell carcinoma or as a cytoreductive technique prior to surgical excision.     

Comparison of ultrasound‐guided vs. ‘blind’ techniques for intra‐synovial injections of the shoulder area in horses: Scapulohumeral joint,bicipital and infraspinatus bursae

Reasons for performing study: Diagnosis and treatment of pathologies involving synovial structures in the shoulder region are technically difficult. Ultrasound‐guided (UG) injection techniques have been shown to be highly accurate, safe and reliable for various structures in human and equine patients. Objectives: To develop easy‐to‐use and reliable UG injection techniques for the infraspinatus bursa (IB), bicipital bursa (BB) and scapulohumeral joint (SHJ) and to compare them with conventional ‘blind’ methods. Methods: Eight pairs of equine shoulders were positioned on a computed‐tomography (CT) table with left and right shoulders randomly assigned to Operator A (UG) and Operator B (‘blind’). Contrast medium mixed with methylene blue was injected into the target structures. Time and number of attempts for correct needle placement and ease of injection were recorded. A CT scan of each shoulder was performed after every injection to evaluate the location of contrast material. Once injections and CT scans were completed, anatomic dissections were conducted. Statistical analysis was used to compare UG and ‘blind’ techniques with significance set at P<0.05. Results: Intra‐synovial injections using UG techniques were successful in all 24 synovial structures compared with 14/24 with conventional methods. The median number and range of needle repositioning to obtain accurate needle placement was 1 (1–2) for UG and 2 (1–4) for the ‘blind’ techniques. The median time and range required for accurate needle placement was 75.5 s (32–210 s) for UG and 43.5 s (11–140) for ‘blind’ technique. In 31% of all attempts, ease of injection was not indicative of successful intra‐synovial administration. Conclusions: Ultrasound‐guided injections of IB, BB and SHJ proved to be highly reliable and more accurate than conventional ‘blind’ techniques. Potential relevance: Ultrasound‐guided injection techniques may be of great help for equine practitioners in the diagnosis and treatment of pathologies involving synovial structures in the shoulder region. Further work is needed to confirm these results in clinical cases.     

A possible solution to model nonlinearity in elimination and distributional clearances with α2‐adrenergic receptor agonists: Example of the intravenous detomidine and methadone combination in sedated horses

The alpha(α)₂‐agonist detomidine is used for equine sedation with opioids such as methadone. We retrieved the data from two randomized, crossover studies where detomidine and methadone were given intravenously alone or combined as boli (STUDY 1) (Gozalo‐Marcilla et al., 2017, Veterinary Anaesthesia and Analgesia, 2017, 44 , 1116) or as 2‐hr constant rate infusions (STUDY 2) (Gozalo‐Marcilla et al., 2019, Equine Veterinary Journal, 51 , 530). Plasma drug concentrations were measured with a validated tandem Mass Spectrometry assay. We used nonlinear mixed effect modelling and took pharmacokinetic (PK) data from both studies to fit simultaneously both drugs and explore their nonlinear kinetics. Two significant improvements over the classical mammillary two‐compartment model were identified. First, the inclusion of an effect of detomidine plasma concentration on the elimination clearances (Cls) of both drugs improved the fit of detomidine (Objective Function Value [OFV]: ?160) and methadone (OFV: ?132) submodels. Second, a detomidine concentration‐dependent reduction of distributional Cls of each drug further improved detomidine (OFV: ?60) and methadone (OFV: ?52) submodel fits. Using the PK data from both studies (a) helped exploring hypotheses on the nonlinearity of the elimination and distributional Cls and (b) allowed inclusion of dynamic effects of detomidine plasma concentration in the model which are compatible with the pharmacology of detomidine (vasoconstriction and reduction in cardiac output).     

Different prostaglandin F2α secretion in response to oxytocin injection between pregnant and non‐pregnant cows: effect of the day of oxytocin challenge test for determining the difference

The present study was conducted to determine the difference in plasma prostaglandin F₂α metabolite concentrations following oxytocin (OT) challenge between pregnant and non‐pregnant cows. Experiment 1: cows were subjected to the OT challenge test on days 12, 14 or 16 (day of estrus = day 0) with or without prior insemination and plasma 13,14‐dihydro‐15‐keto prostaglandin F₂α (PGFM) concentrations were measured from ?30 to 180 min after OT injection. On day 16, the increment of plasma PGFM concentrations in response to OT injection was significantly smaller in pregnant than that in cyclic cows. On days 12 and 14, there was little OT‐induced PGFM secretion and no difference in PGFM increase between the pregnant and cyclic cows. Experiment 2: cows were inseminated on day 0 and subjected to the OT challenge test on day 16. Cows were classified into non‐pregnant/early embryonic death (NP/EED), late embryonic death (LED) and pregnant (PREG) groups. The increment of PGFM concentrations in response to OT injection was less in both PREG and LED groups than that in the NP/EED group. In conclusion, plasma PGFM secretion induced by OT is suggested as the base of pregnancy diagnosis prior to returning estrus in cows.