IMAGING FEATURES OF DISCOSPONDYLITIS IN TWO HORSES

Two horses with discospondylitis are described with emphasis on the imaging modalities used and their contribution to the final diagnosis and outcome. Radiographic findings were vertebral endplate lysis with sclerosis in both horses, with additional vertebral subluxation and ventral spondylosis in one horse. Ultrasonographic findings included vertebral malalignment and obliteration of the intervertebral disc by spondylotic bone in one horse and irregular endplates, a widened disc space, a hypoechoic paravertebral abscess and hypoechoic, atrophic adjacent musculature with loss of linear fiber pattern in the other horse. Bone scintigraphy excluded additional affected sites. A systematic approach is recommended when performing an ultrasound examination of the spine.     

Multimodal therapy including electroacupuncture for the treatment of facial nerve paralysis in a horse

This Case Report describes a 5‐year‐old Standardbred gelding that was referred to the Equine Hospital of ONIRIS Veterinary School of Nantes, France for a surgical procedure under general anaesthesia. Anaesthesia was induced and maintained intravenously and the horse was placed in left lateral recumbency with a padded halter. On post operative Day 1, a post anaesthetic distal facial nerve branch paresis was diagnosed based on clinical signs. The horse was discharged on post operative Day 2 with medical treatment based on anti‐inflammatory drug administration locally and systemically. The horse was re‐examined 2 weeks after the surgery; the left partial facial paralysis was still present and associated with amyotrophy of the muscles supplied by the buccal branches of the facial nerve. In accordance with the owner, the horse was hospitalised to start an electrostimulation treatment. The horse was treated every day for the first 4 days, then every 2 or 3 days during the following 3 weeks, for a total of 11 sessions. At the end of the second week of treatment, the horse was able to normally prehend the food and atrophy seemed reduced. The horse was discharged from hospitalisation at the end of the third week of treatment with specific recommendations. One month after discharge from the hospital just a slight asymmetry could be noticed at rest. Six months later, the training season began and the horse was able to perform. Facial paralysis due to nerve compression is a well‐known complication of anaesthesia. Gradual recovery of function over the weeks of treatment suggests that electroacupuncture may promote recovery and may hasten time of recovery.     

Right Dorsal Colon Resection and Bypass for Treatment of Right Dorsal Colitis in a Horse

Objective: To describe a novel surgical technique for management of right dorsal colitis in the horse. Study Design: Clinical report. Animals: 14‐year‐old Warmblood gelding. Methods: The horse was referred for treatment of a stromal abscess and signs of right dorsal colitis. Plasma chemistry revealed marked hypoproteinemia. Abdominal ultrasonographic examination showed a thickened right dorsal colon (RDC). Medical treatment was unsuccessful. With the horse in left lateral recumbency under general anesthesia, an approach to the right side of the abdomen through a 16th rib resection was made. The thoracic cavity was entered during the approach. Surgical resection of the RDC and side‐to‐side anastomosis of the diaphragmatic flexure to the small colon (bypass) was performed. The thoracic cavity was closed by attaching the diaphragm to the body wall and air was removed at the completion of surgery. Results: Resection of the RDC and bypass of the resected area was successfully performed. The colic signs and hypoproteinemia resolved. Complications of surgery included a deep surgical site infection with development of a large intrathoracic abscess. The abscess was managed with drainage and long‐term antimicrobial treatment. Conclusion: Right dorsal colitis can be treated successfully with resection and bypass of the RDC. In cases where the thoracic cavity is penetrated during the abdominal approach, the diaphragm should be sutured to the body wall at the beginning of surgery to avoid development of an infection within the thoracic cavity. Clinical Relevance: RDC resection and bypass may be an alternative approach for management of horses with right dorsal colitis.     

Perirectal abscess, colic, and dyschezia in a horse

A quarter horse gelding with intermittent colic was diagnosed with a perirectal abscess and dyschezia. Rectal ultrasonography identified a multiloculated, fluid-filled mass. A perirectal abscess was diagnosed when the mass ruptured and drained into the rectum. The abscess was treated successfully with warm soapy water enemas and trimethoprim and sulfamethoxazole.     

Intervertebral disc disease of the cervical and cranial thoracic vertebrae in equidae: eight cases

Intervertebral disc disease in the cervical and cranial thoracic vertebrae is unusual in horses and the majority of documented cases have been associated with infection and resulted in ataxia. The current retrospective study documents the clinical and imaging features, and outcome in eight Equidae with neck stiffness ± forelimb lameness (n = 3) or ataxia (n = 2) assessed during a 10-year period at two clinics. The Equidae (one donkey and seven horses) ranged in age from 1.5 to 12 years (median 5.5 years). The duration of clinical signs ranged from 1 to 6 months (median 1.5 months). The donkey had a depressed demeanour. All Equidae had reduced range of neck movement. The donkey and one horse showed mild and severe ataxia respectively. Two horses showed a propensity to stumble on each forelimb, one of which exhibited forelimb lameness on the lunge or ridden. Two additional horses showed lameness in hand. One horse experienced ‘neck locking’ during grazing. Radiological abnormalities were identified involving the intervertebral symphysis between the sixth cervical vertebra (C6) and C7 in four Equidae; in two horses the articulation between C7 and the first thoracic vertebra (T1) was involved. One horse had abnormalities of the intervertebral symphyses of both C7 and T1, and T1 and T2. In one horse the articulation between C2 and 3 was affected. The donkey was treated with a prolonged course of doxycycline and improved. An advanced dressage horse returned to full-function after surgical fusion of the affected intervertebral symphysis. Intervertebral disc disease is a rare cause of neck stiffness ± lameness or ataxia.     

Equine glaucoma: a retrospective study of 13 cases presented at the Western College of Veterinary Medicine from 1992 to 1999

The prevalence of equine glaucoma seen by the ophthalmology service at the Western College of Veterinary Medicine (WCVM) was 6.5%. The majority of cases (11/13) were associated with clinical manifestations of uveitis. Congenital glaucoma was documented in 1 case, and primary glaucoma was diagnosed in a 12-year-old quarter horse. There were no breed or sex predilections evident. Affected horses were middle-aged to old (average age = 9.5 years, ranging from 2 weeks to 23 years). The clinical manifestations of equine glaucoma included blindness, diffuse corneal edema, corneal vascularization, buphthalmia, corneal striae, recurrent secondary ulcerative keratitis, and less commonly, iris bombé, tapetal hyper-reflectivity, complete pupillary occlusion from posterior synechiae, and optic disc cupping. Elevated intraocular pressure confirmed the diagnosis (n = 10), while 3 cases were normotensive with signs of glaucoma including corneal striae and buphthalmia. Affected eyes were treated medically and/or surgically. Regardless of the therapy instituted, the visual outcome was poor. Most affected eyes were blind at presentation or became blind within a few weeks.     

Percutaneous drainage of an abscess in the lateral neck region of a horse

A large abscess in the lateral neck region of a horse was treated with percutaneous drainage. The abscess was localized with ultrasonography and aspirated by use of a 7.7-cm spinal needle. A stainless-steel guide wire was passed through the needle, and tissue dilators were used to enlarge the percutaneous hole. A multiperforated polyvinylchloride catheter that was placed within the abscess cavity permitted aspiration and lavage of the abscess. The abscess resolved over the next 10 days with no complications. Percutaneous abscess drainage is commonly performed in people and may have application in veterinary medicine.     

Subscapular lymph node abscessation as a result of metastatic Streptococcus equi subspecies equi infection: An atypical presentation of bastard strangles in a mare

The case reported here represents an atypical presentation of bastard strangles in an 18‐year‐old Arab mare. The horse initially presented for progressive neck pain characterised by reluctance to lateral and ventroflexion of the neck. Subsequent diagnostics revealed a subscapular abscess and aspirates of the mass cultured positive for Streptococcus equi ssp. equi. Surgical drainage and debridement of the abscess was performed under general anaesthesia. Six months post surgery, the mare had made a complete recovery.     

Diagnosis of lumbosacral intervertebral disc disease and protrusion in a horse using ultrasonographic evaluation and computed tomography

This case report describes the clinical presentation, diagnostic imaging modalities, treatment and post mortem evaluation of lumbosacral intervertebral disc protrusion in a mature Quarter Horse gelding 10 days after initial signs were noted. Grade 3 hindlimb ataxia, conscious proprioceptive deficits, urinary and faecal incontinence were present, which did not improve with anti‐inflammatories, antimicrobial therapy, corticosteroids, antioxidant therapy, cold‐laser therapy or electroacupuncture. Imaging modalities utilised ante mortem were computed radiography, transcutaneous and transrectal ultrasonography. Transrectal ultrasonography yielded findings highly suggestive of lumbosacral intervertebral disc protrusion and due to the lack of improvement and a poor prognosis, the horse was humanely subjected to euthanasia. Post mortem computed tomography, necropsy and histopathological evaluation confirmed lumbosacral intervertebral disc disease and protrusion into the spinal canal with subsequent impingement of the spinal nerve roots. Lumbosacral intervertebral disc protrusion as a clinical disease in the horse has not been previously described and should be included as a differential diagnosis in cases with acute hindlimb ataxia, proprioceptive deficits, and urinary and faecal incontinence.     

Pulmonary artery compression in a Thoroughbred colt due to a mediastinal abscess

In the case presented, a young horse was referred for further evaluation based on a presumptive diagnosis of pulmonic valve endocarditis, bronchopneumonia and a cranial mediastinal abscess based on thoracic ultrasound, echocardiography and clinical signs. However, further echocardiographic evaluation revealed that the abscess was compressing the right ventricular outflow track causing outflow obstruction, a murmur associated with right ventricular outflow tract obstruction (acquired pulmonic stenosis) and right ventricular hypertrophy. Vegetative endocarditis was not present. Medical management was unsuccessful, but surgical drainage and long‐term antimicrobial therapy were effective and the horse returned to a successful racing career.     

A retrobulbar meningioma as a cause of unilateral exophthalmos and blindness in a horse

This report describes the unusual diagnosis of a retrobulbar syncytial meningioma in a 16‐year‐old Thoroughbred gelding. The horse initially presented with unilateral left sided exophthalmos and apparent blindness characterised by unilaterally absent menace and pupillary light responses. Magnetic resonance imaging (MRI) identified a well‐defined soft tissue mass intimately associated with the optic nerve. Based on the characteristic MRI appearance, a meningioma was suspected. The eye was enucleated under general anaesthesia and partial excision of the mass was achieved. Histopathology confirmed the diagnosis and the horse underwent a course of adjuvant radiotherapy. Twelve months following surgery the horse is back in work, no neurological abnormalities have been detected and follow‐up computed tomographic imaging of the skull has revealed mild bone sclerosis with no remnants of the mass identified.     

Survival of an adult Quarter Horse gelding following bacterial meningitis caused by Escherichia coli

Bacterial meningitis in the mature horse is a rare and typically fatal condition. This report describes a 7‐year‐old Quarter Horse gelding that initially presented following suspected trauma to the left eye but subsequently developed bacterial meningitis, and a nasal and palpebral abscess, all of which cultured the same isolate of Escherichia coli. The entry site of infection in bacterial meningitis is often related to a breach in the calvarium and extension of bacteria residing in the paranasal sinuses. This case is unique as there were multiple pathways through which bacteria may have entered the central nervous system including haematogenous spread from a nasal abscess, local extension of periocular infection or an undetected skull fracture. Aside from persistent blindness in the left eye, the horse made a full recovery.     

A case of a periarticular abscess and suppurative arthritis of the atlanto-occipital joint

This Case Report describes a periarticular abscess and a suppurative arthritis of the atlanto-occipital joint in an adult horse. The horse showed a painful swelling localised on the atlanto-occipital region and ataxia in all 4 limbs. During hospitalisation, the horse developed recumbency, dysphagia, facial paralysis and seizures. Ultrasonography of the atlanto-occipital region enabled a tentative diagnosis to be made, which was later confirmed at autopsy. Culture of the abscess revealed a Staphylococcus aureus. However, the horse had a history of recurrent fever, hypertrophy and abscessation of the submandibular lymph nodes, neck pain and dyspnoea for 2 months, which was suggestive of strangles.     

Retropharyngeal infections in five horses

Five horses with retropharyngeal (RP) infections had clinical signs of dysphagia and/or dyspnea. Diagnosis was confirmed, using pharyngeal endoscopy and lateral radiography of the pharynx. One horse responded to surgical drainage of a RP abscess and was sound at light work. One horse responded to medical management after the site of infection was surgically explored. Two horses recovered after medical management; the RP abscess of 1 of these 2 horses ruptured spontaneously into the pharynx and the other horse became racing sound. The fifth horse remained dysphagic and had left laryngeal hemiplegia after medical treatment.     

Normal structure and age-related changes of the equine retina

Investigations of the pathophysiology of ocular diseases require a detailed knowledge of the microanatomy of the eye. The available information is still inadequate for the equine retina despite the importance of eye diseases in equine medicine. Here we provide a comprehensive analysis of the histologic features of the horse eye as a reference for future studies. Thirty normal eyes of 15 healthy horses were examined immediately after slaughter. The retina of the horse differs considerably in the degree and quantity of neurons and glial elements as well as in vascular patterns compared to the retina of other domestic animals. Morphometric analysis revealed that the thickness of the retina varies between 80 microm at the ora serrata and 250 microm medial to the optic disc. Approximately 90% of the equine retina is comparatively thin (< 130 microm). This is a physiologic response to the distance that oxygen can diffuse in avascular retina. Ganglion cells form a single layer in all parts of the retina. The majority of ganglion cells are very large Nissl-positive cells. Small Nissl-negative ganglion cells are less abundant. A high ganglion cell density is found only in the central area. Vascularization is virtually absent from the retina with the exception of a narrow strip around the disc of the optic nerve, as revealed by lectin histochemistry. Light microscopy of the eyes of older horses repeatedly revealed cystoid degenerations in the retina adjacent to the pars plana of the ciliary body, as well as a destruction of the regular layering of the peripheral region of the retina.     

Levator Nasolabials Muscle Transposition to Prevent an Orosinus Fistula after Tooth Extraction in Horses

The ventral part of the levator nasolabialis muscle was transposed to the alveolar defect after sinusotomy and tooth extraction in five normal horses and six horses with a tooth root abscess and sinusitis. In the normal horses at weeks 6, 10, 14 and 18, the transposed muscles remained viable and were incorporated into the recipient sites, and orosinus fistulae did not form. Histologically, there was a progressive transition from muscle to fibrous tissue. There was no facial deformity or loss of nasal function at the donor site. A localized abscess was associated with incomplete removal of tooth root fragments in one horse. After 1 year or more, five horses treated for dental disease had complete resolution of clinical signs. One horse continued to have intermittent mild nasal discharge.     

Anaesthesia and ventilation strategy in a horse undergoing pulmonectomy

A 7‐year‐old, 430 kg Standardbred gelding was presented to the hospital with severe bilateral purulent pleuropneumonia requiring partial pulmonectomy. Prior to surgery the trachea was intubated through a tracheotomy site using a customised tube (10 mm internal diameter)‐in‐tube (26 mm internal diameter) endotracheal tube, similar to a bronchial blocker tube in design. The left lung was selectively mechanically ventilated. Thoracotomy was performed and a major lung abscess and surrounding lung tissue were resected. Arterial PO₂ and PCO₂ remained 79–305 and 43–72 mmHg, respectively, and haemodynamic variables within a range acceptable for general anaesthesia in the horse. A 5 month follow‐up revealed complete resolution of the pleuropneumonia without signs of recurrence.     

Bilateral traumatic optic nerve avulsion in a Thoroughbred gelding

This report describes an unusual case of acute blindness following traumatic head injury in a mature horse. The horse fell over backwards and subsequently presented with bilateral blindness and epistaxis. Vision did not return following medical supportive therapy and euthanasia was elected. Post mortem findings revealed a basisphenoid fracture and bilateral optic nerve avulsion rostral to the optic chiasm, an uncommon presentation of traumatic blindness not previously reported in the horse.     

A randomised, double-blinded, placebo-controlled study on the efficacy of a unique extract of green-lipped mussel (Perna canaliculus) in horses with chronic fetlock lameness attributed to osteoarthritis

Reasons for performing study: Lyophilised products from green‐lipped mussel (Perna canaliculus[LPPC]) are used to orally treat horses with osteoarthritis (OA). However, no randomised, controlled or double‐blinded studies on the efficacy of this treatment in horses have been reported to date. Objective: To investigate the effects of a unique LPPC (Biolane) ¹ in improving clinical signs of OA in the fetlock. Methods: Data were analysed from 26 horses with primary fetlock lameness in a controlled, randomised and double‐blinded, multi‐centre clinical trial. The study design was a partial crossover with a washout period and consisted of 19 horses treated with LPPC and 20 with a placebo. Horses were dosed orally with 25 mg/kg bwt/day LPPC or placebo for 56 days. Efficacy was evaluated by clinical assessment of lameness, passive flexion, pain, swelling and heat in the affected joint. Relationships between variables were analysed using an ordinal logistic model with random effects for horse and horse x treatment according to a modified intention‐to‐treat analysis. Results: Clinical evaluation of horses with a fetlock lameness treated with LPPC showed a significant reduction in severity of lameness (P<0.001), improved response to the joint flexion test (P<0.001) and reduced joint pain (P = 0.014) when compared with horses treated with placebo. Conclusions: The LPPC significantly alleviated the severity of lameness and joint pain and improved response to joint flexion in horses with lameness attributable to OA in the fetlock.     

Subchondral cyst‐like lesions in the talus of four horses

Subchondral cyst‐like lesions (SCLs) of horses have been found in various locations, but SCLs of the talus have been reported rarely. In this report, we describe 4 horses affected with a SCL of the talus. Each SCL was identified using digital radiography, and each horse was treated by intralesional injection of triamcinolone acetonide. Case details, history, findings during clinical and radiographic examination, treatment, and outcome of each horse are discussed.