Meniscal damage diagnosed by ultrasonography in horses: A retrospective study of 74 femorotibial joint ultrasonographic examinations (2000–2005)

This retrospective study reports diagnostic findings in 74 horses with ultrasonographic diagnosis of femorotibial joint damage; it describes the ultrasonographic features of meniscal tears and determines the prevalence of medial or lateral meniscal involvement and of associated synovial effusions. Horses were classified into four groups: with medial meniscal damage, with lateral meniscal damage, with lesions in both menisci, and with no ultrasonographic evidence of meniscal damage. After ultrasonographic appearance, meniscal lesions were described as central degeneration, horizontal tear, partial oblique tear of the distal angle, combined horizontal and oblique tears, or complex tear. Meniscal protrusion or other associated ultrasonographic or radiographic abnormalities were recorded. Of the 74 horses, 54 (73%) had medial meniscal damage, 5 (6.75%) had lateral meniscal damage, 5 (6.75%) had lesions in both menisci, and 10 (13.5%) had no meniscal lesion. Meniscal protrusion occurred in 20 cases (27%). Horizontal tears were the most frequent type of meniscal lesion (26 horses). Complex lesions were found in 6 lateral menisci and 14 medial menisci. Lesions of the cranial meniscal ligaments were seen in 10 horses. Synovial effusion of one or several joint compartments was found in 51 cases (68.9%).This study demonstrates the high prevalence of meniscal tears and synovitis in horses with ultrasonographic evidence of femorotibial derangement. Based on this series of clinical cases, horizontal tears of the medial meniscus appear to be the most frequent soft tissue injury of the equine stifle.     

Diaphragmatic herniation as a cause of lethargy and exercise intolerance in a mare.

A diaphragmatic hernia in which 90% of the large colon had herniated through a 16-cm linear tear in the diaphragm was found in a 12-year-old Quarter Horse mare. Clinical signs included lethargy and exercise intolerance. Diagnosis of diaphragmatic hernia was made based on careful thoracic auscultation, combined with ultrasonographic and radiographic examination of the thorax.     

Clinical features and treatment of renal tubular acidosis in two horses

Two horses were admitted separately for evaluation and treatment of profound hyperchloremic metabolic acidosis without azotemia. One, an 11-year-old Quarter Horse mare, had been depressed and ataxic for 2 days. The other, a 2-year-old Quarter Horse colt, had a 6-week history of depression, anorexia, and weight loss. Both horses responded to fluid and electrolyte therapy, but required daily oral administration of sodium bicarbonate for maintenance. In each case, the diagnosis was renal tubular acidosis.     

Hereditary equine regional dermal asthenia (HERDA) in Quarter Horses: A review of clinical signs,genetics and research

Hereditary equine regional dermal asthenia (HERDA) results from a genetic mutation which affects the skin and other tissues of Quarter Horses and horses with Quarter Horse lineage. The disease HERDA has an autosomal recessive mode of inheritance and has become a significant concern in the Quarter Horse industry due to the high frequency of heterozygote carriers. Affected homozygous horses appear normal at birth; however, within the first 2 years of life they usually acquire loose, hyperextensible skin and wounds which result in disfiguring scars either spontaneously or from minor trauma. Some severely affected horses also develop haematomas and seromas. Consequently, most affected horses are subjected to euthanasia at an early age. No treatment options other than palliative therapy currently exist. As part of a five panel test ( http://www.aqha.com/News/News-Articles/2013/April/04292013-Genetic-Testing.aspx ) the American Quarter Horse Association presently requires DNA testing for HERDA on all breeding stallions. There are currently no restrictions on registration of horses heterozygous or homozygous for the HERDA mutation. Due to the autosomal recessive nature of the disease, Quarter Horse mares and horses of all breeds from HERDA‐associated bloodlines should also be tested.     

Hand‐assisted laparoscopic nephrectomy in a standing horse for the management of renal cell carcinoma

An 18‐year‐old Quarter Horse gelding was examined for haematuria of 6 weeks' duration. Rectal examination identified an enlarged left kidney and ultrasonographic examination of the kidney identified grossly abnormal renal architecture. Hand‐assisted laparoscopic nephrectomy was performed following laparoscopic exploration of the abdomen for metastatic disease. A laparoscopic stapling device was successfully used to transect and ligate the renal vasculature and ureter. Histopathological examination of the kidney identified renal cell carcinoma. A 7 month survival was documented following surgery. Unilateral nephrectomy should be considered a therapeutic or palliative procedure for horses with renal cell carcinoma.     

Hyperkalaemic periodic paralysis in Australian Quarter Horses

SUMMARY Three Quarter Horse stallions and 5 of their 11 tested progeny were diagnosed as affected with the inherited autosomal dominant defect hyperkalaemic periodic paralysis in Victoria in 1992. The diagnoses were based on the appearance of clinical signs and associated increased plasma potassium concentrations in response to oral potassium loading. All affected horses were descendants of the American Quarter Horse Impressive. Indirect evidence indicates that at least 3 other affected Quarter Horse stallions have stood or are standing at stud in Australia. The clinical details of the affected horses are described and the size of the affected population in Australia is discussed.     

Incompetent cervix and pneumouterus in a maiden mare

This case report describes an uncommon case of a congenitally incompetent cervix and a resulting pneumouterus in a 5‐year‐old maiden Quarter Horse mare. The mare was presented for artificial insemination at the Clinic for Animal Reproduction, Freie Universität Berlin, Germany. Routine vaginal and rectal examinations revealed a shortened cervix of 3 cm length and a dilated uterus filled with a considerable amount of air. During ultrasonographic examination, ovaries of normal size with regular cyclic activity were detected. Chromosomal analysis could not confirm any genetic anomalies such as an expected XO karyotype. The mare was excluded from breeding due to its anatomical constitution.     

Arthroscopic evaluation of menisci in dogs with cranial cruciate ligament injuries: 100 cases (1999-2000)

OBJECTIVE: To determine prevalence of meniscal injuries by use of arthroscopic examination in dogs with cranial cruciate ligament (CCL) injuries. DESIGN: Retrospective study. ANIMALS: 94 dogs with 100 injured CCLs. PROCEDURE: Records for 94 large dogs (> 20 kg [44 lb]) with 100 naturally occurring CCL injuries that were examined arthroscopically were reviewed. Pathologic findings in the CCL (complete or partial tears), prevalence and type of meniscal injuries, and periarticular osteophytes were recorded. RESULTS: 77% of joints had tears of the lateral meniscus; most were a series of small radial tears of the cranial horn. Fifty-eight percent of joints had tears of the medial meniscus. Positive correlation between complete tears of the CCL and medial meniscal damage was found. No significant relationships were detected between periarticular osteophyte formation and meniscal injury, medial and lateral meniscal injury, or degree of CCL tear and lateral meniscal injury. CONCLUSIONS AND CLINICAL RELEVANCE: There is a strong association between CCL injury and lateral and medial meniscal injuries in dogs. Clinical importance of lateral meniscal lesions is not known; a much higher percentage of dogs had such injuries than has been reported previously, possibly because of use of arthroscopy.     

Complex stifle injury in a foal

A 130 kg, 60-day-old Quarter Horse male foal presented with bilateral stifle effusion and severe left hindlimb lameness. Clinical examination and imaging including radiography, ultrasound and computed tomography revealed bilateral stifle trauma. Specifically, disruption of the left medial meniscus and deep bone injury to the left medial femoral condyle (MFC) were detected, and bilateral injury to the origin of the cranial cruciate ligaments was suspected. Treatment consisted of stall rest and joint injection with corticosteroids, however there was little improvement in lameness. Due to the poor prognosis for soundness, the foal was subject to euthanasia 10 weeks after initial presentation. Post-mortem examination supported the left medial meniscus and MFC injuries and revealed avulsions of the origin of the cranial cruciate ligaments (complete on the left and partial on the right) from the lateral femoral condyle. Histopathology of the left stifle joint revealed varying depths of MFC osteochondral injury and severe left medial meniscus damage.     

Malignant seminoma in a horse

An antemortem diagnosis of malignant seminoma was made on a 14-year-old Quarter Horse stallion. Castration was performed and histopathology showed evidence of vascular and lyumphatic metastasis. Ten months later the horse was off feed with diffuse swelling in the rear leg. Necropsy confirmed the diagnosis of malignant seminoma.     

A case of idiopathic eosinophilic pneumonia in a Quarter Horse gelding

A 16-year-old Quarter Horse gelding was presented to the Kansas State Veterinary Health Center for acute onset of diffuse, nonpruritic, generalised and coalescing urticaria. A single dose of dexamethasone resulted in resolution of the urticaria within 24 h; however, 48 h after discharge, he presented with mild colic. The patient was febrile and thoracic ultrasound was abnormal, evidenced by bilateral pleural echogenic irregularities, mild pulmonary consolidation and slight unilateral pleural effusion. Thoracic radiographs also revealed caudoventral soft tissue opacity in the same region of the ultrasonographic abnormalities. Transtracheal wash was performed and broad spectrum antimicrobials initiated. Poor clinical response to therapy and marked peripheral eosinophilia resulted in the necessity for bronchoalveolar lavage, which revealed a predominance of pulmonary eosinophils. A diagnosis of acute idiopathic eosinophilic pneumonia was made. Treatment included a tapering dose of dexamethasone over 4 weeks. Due to incomplete disease resolution, the patient was moved to an alternate environment which resulted in disease resolution.     

Bicavitary effusion in a horse with multicentric lymphoma

A 14-year-old Quarter Horse gelding presented for a 2-week history of increased respiratory rate, fever and weight loss. The referring veterinarian performed an ultrasonographic examination on the farm and considered a differential diagnosis of pleuritis and pleuropneumonia. On presentation, transtracheal wash showed suppurative septic inflammation with bacteria within macrophages. Thoracic ultrasonography showed increased hypoechoic fluid in the pleural and peritoneal cavities. Cytologic analysis of pleural and peritoneal fluids revealed lymphorrhagic effusion with atypical lymphocytes, suggestive of a lymphatic flow obstruction or lymphoma. Treatment consisted of drainage of the pleural fluid, anti-inflammatory agents, fluid therapy and antimicrobial therapy. Continued fluid accumulation in the thoracic cavity, tachypnoea, lack of response to pain medication and progressive lethargy resulted in the horse being subjected to euthanasia. At necropsy, bicavitary effusion was confirmed and histopathological diagnosis of multicentric lymphoma was made. Horses presenting with pleural effusion should also be evaluated for peritoneal effusion, as bicavitary effusion may indicate noninflammatory conditions such as neoplasia.     

Intra-abdominal hypertension in two adult horses

Objective – To describe the clinical and pathological findings in 2 adult horses with documented increases in intra-abdominal pressure (IAP), and to describe the direct puncture technique used to measure this pressure.
Series Summary – Two adult horses developed increases in IAP secondary to large-volume abdominal effusion. A 9-year-old Quarter Horse cross gelding was presented for evaluation of urinary and neurologic signs. Abdominal ultrasonographic examination showed a hepatic abscess along with abdominal effusion. A 4-year-old Quarter Horse gelding was presented for evaluation of castration complications. A castration site infection extended into surrounding tissues, resulting in peritonitis, abdominal effusion, and severe cellulitis of the limbs. IAP measured in both horses was increased relative to reported equine reference values. Changes in hemodynamic parameters in both horses, notably increased central venous pressure, were consistent with those seen in other species in which intra-abdominal hypertension (IAH) and its sequellae have been documented.
New or Unique Information Provided – Extensive research and clinical literature guides management of humans with IAH and abdominal compartment syndrome. Knowledge of these conditions in companion animal and large domestic species is less well developed. Recent research has established reference values for standing, sedated and recumbent, anesthetized horses. Detailed reports of equine clinical cases of IAH have not been reported in the literature. This report provides information on the clinical, hemodynamic, and pathologic characteristics of 2 horses with measured increases in IAP, and describes the direct puncture technique used to perform these measurements.     

Allele frequency and likely impact of the glycogen branching enzyme deficiency gene in Quarter Horse and Paint Horse populations

Glycogen Branching Enzyme Deficiency (GBED), a fatal condition recently identified in fetuses and neonatal foals of the Quarter Horse and Paint Horse lineages, is caused by a nonsense mutation in codon 34 of the GBE1 gene, which prevents the synthesis of a functional GBE protein and severely disrupts glycogen metabolism. The aims of this project were to determine the mutant GBE1 allele frequency in random samples from the major relevant horse breeds, as well as the frequency with which GBED is associated with abortion and early neonatal death using the tissue archives from veterinary diagnostic laboratories. The mutant GBE1 allele frequency in registered Quarter Horse, Paint Horse, and Thoroughbred populations was 0.041, 0.036, and 0.000, respectively. Approximately 2.5% of fetal and early neonatal deaths in Quarter Horse-related breeds submitted to 2 different US diagnostic laboratories were homozygous for the mutant GBE1 allele, with the majority of these being abortions. Retrospective histopathology of the homozygotes detected periodic acid Schiff's (PAS)-positive inclusions in the cardiac or skeletal muscle, which is characteristic of GBED, in 8 out of the 9 cases. Pedigree and genotype analyses supported the hypothesis that GBED is inherited as a simple recessive trait from a single founder. The frequency with which GBED is associated with abortion and neonatal mortality in Quarter Horse-related breeds makes the DNA-based test valuable in determining specific diagnoses and designing matings that avoid conception of a GBED foal.     

Ileocecocolic intussusception as a sequel to jejunocecostomy in a mare

An excessively long ileal stump, the result of a previous jejunocecostomy, had intussuscepted into the cecum and subsequently obstructed the cecocolic orifice of a 12-year-old Quarter Horse mare. Clinical signs were dehydration, ileus, and endotoxemia. The diagnosis was made at necropsy.     

Computed Tomography and Magnetic Resonance Imaging of an Epidermoid Cyst in a Foot of a Horse

An 18-year-old Quarter Horse mare was evaluated because of moderate left forelimb lameness of 4 weeks’ duration. The clinical evaluation and diagnostic perineural analgesia localized the lameness to the distal portion of the left forelimb. There was swelling on the dorsal and lateral aspect of the coronary band. Radiography, ultrasound, magnetic resonance imaging, and computed tomography of the foot revealed circumscribed well-capsulated soft tissue mass causing a focal deformation of the dorsolateral border of the middle phalanx. The treatment aimed to remove the mass surgically and stabilized the interphalangeal joint, but the owner elected human euthanasia before treatment attempt. Histopathology diagnosis was an epidermoid cyst, which was characterized by multilayers of keratin surrounded by stratified squamous epithelium. Although rare, an epidermoid cyst should be considered as a differential diagnosis for space-occupying mass in horses’ foot that develops chronic lameness after trauma. This report describes the multimodality appearance of the epidermoid cyst.     

Pancytopenia caused by bone marrow aplasia in a horse

Pancytopenia was evaluated in a mature Quarter Horse gelding. A diagnosis of bone marrow aplasia was made on the basis of bone marrow hypocellularity. History of drugs administered included penicillin, oxytetracycline, trimethoprim-sulfadiazine, phenylbutazone, dipyrone, flunixin meglumine, and isoxsuprine. Clinical remission was observed after treatment with glucocorticoids, androgens, and broad-spectrum antimicrobials.     

Surgical repair of a congenital lateral abdominal wall hernia in a neonatal foal

A 16‐hour‐old Quarter Horse filly presented for evaluation of a soft mass in the right caudoventral lateral abdominal wall. Radiography and ultrasonography confirmed the presence of a nonreducible lateral abdominal wall hernia with small intestine located between the skin and body wall. The size of the defect itself could not be imaged and the filly was taken to surgery. A 4 cm vertical defect that appeared congenital was found in the transverse abdominal muscle and was repaired by primary apposition. This case report describes the repair and outcome of this unusual type of congenital hernia.     

Sand-induced diarrhea in a foal

A diagnosis of sand enteropathy was made in a 3 1/2-month-old Quarter Horse filly. Clinical signs included diarrhea and weight loss of 2 1/2 months' duration. Abdominal radiographs were useful in diagnosis of the condition and in evaluating response to therapy. The filly responded to treatment with psyllium hydrophilic mucilloid although full recovery took 2 months. Diagnosis and treatment of sand enteropathy is discussed.