Surgical Repair of an Esophageal Stricture in a Horse

An esophageal stricture was diagnosed in a 9-month-old quarterhorse by esophagoscopy and positive pressure contrast esophagography. Medical management and two attempts at surgical intervention were unsuccessful. The initial surgical technique used was a linear esophagotomy, mucosal resection and anastomosis, and closure of the muscular tunic, which resulted in a more severe stricture. The second surgical procedure was interruption of the stricture cicatrix by a single linear esophagotomy and primary closure of only the esophageal muscular tunic. This technique resulted in an increased lumen diameter, but failed to adequately resolve the stricture. Successful resolution of the stricture with return to a normal diet was achieved by a two stage repair using formation of an esophagostomy to stabilize the esophagus, followed by fenestration of the mucosal-submucosal cicatrix. Six months postoperatively, the horse was asymptomatic on a normal diet.     

Dorsal Frontal Fractures of the First Phalanx in the Horse

Dorsal frontal fractures of the first phalanx in nine horses are described. All fractures were in hindlimbs, and two horses were affected bilaterally. Of the eleven fractures, seven were incomplete and nondisplaced, one was complete and nondisplaced, and three were complete and displaced. Two horses with complete displaced fractures had their fractures repaired with lag screw fixation combined with open reduction, and the other seven horses were treated nonsurgically.
All horses were sound on the injured limb within 3 to 6 months of the injury. Lag screw fixation was recommended for horses with complete, displaced dorsal frontal fractures in order to reduce the articular defect and help prevent secondary joint changes. Nonsurgical therapy in the form of stall rest with a heavy support wrap resulted in bony healing of the fracture in 4 to 6 months.
Follow-up was obtained on all nine horses: two were retired for breeding; five performed equal to or better than their previous level of racing performance; one was performing successfully as a combined training horse; and one returned to a lower level of performance due to an unrelated forelimb lameness.     

Repair of an Ulnar Fracture With Radial Luxation in a Horse

An ulnar fracture with radial luxation (Monteggia fracture) was repaired in a horse. Reduction of the radial luxation was difficult, requiring 2 incisions, limb traction, neuromuscular blockade, and direct radial manipulation. The ulnar fracture was repaired by use of a dynamic compression plate. Three months postoperatively, the horse was free of any apparent lameness.     

Surgical Repair of an Intrathoracic Esophageal Pulsion Diverticulum in a Horse

An intrathoracic esophageal pulsion diverticulum causing repeated episodes of esophageal obstruction in a Morgan weanling colt was diagnosed by endoscopy, positive contrast radiography, and pleuroscopy. Surgical excision of the diverticulum alleviated clinical signs, and the horse was able to resume a normal diet by day 6. After 9 months the colt remains asymptomatic.     

Proximal Radius Fracture in a Horse: Angle Blade Plate Repair

The repair of a comminuted fracture of the proximal radius in a 300-kg horse was achieved using an angle blade plate and a dynamic compression plate. Placement of an angle blade plate required adequate preoperative preparation to ensure successful use and to avoid joint damage. The horse has been returned to atheletic performance and has remained sound.     

A Large Frontonasal Bone Flap for Sinus Surgery in the Horse

A large frontonasal bone flap was created to treat diseases of the paranasal sinuses in 14 horses. The bone flap was made as wide as possible within the confines of the nasolacrimal duct so the floor of the frontal sinus and the dorsal and ventral conchae could be opened. These openings exposed the nasal passages, maxillary sinuses, and ventral conchal sinus thereby facilitating removal of diffuse and localized lesions from these sites. Diseases treated were ethmoid hematomas (4 horses), sinus cysts (5 horses), cryptococcal granuloma, osteoma, hemangiosarcoma, pus in the ventral conchal sinus, and periapical infection of a second molar. Four horses were euthanatized during or after surgery, one because of postsurgical pleuritis and pneumonia (horse with osteoma) and three because of their primary problems (cryptococcal granuloma, hemangiosarcoma, pus in the ventral conchal sinus). Skin suture abscesses that responded to treatment developed in four horses. Ten horses returned to their intended uses, the sinus flaps healed without blemish, and the original problems did not recur. The frontonasal flap technique provided greater access to all paranasal sinuses than methods described previously.     

Open Nasal Cavity and Frontal Sinus Treatment of Chronic Canine Aspergillosis

Five dogs with nasal aspergillosis were treated by surgical exposure and delayed closure of the nasal cavity and involved frontal sinus. Diseased tissue was excised, and 10% povidone-iodine solution was applied three times daily with cotton-tipped applicators. Skin wounds were closed at weeks 6 through 8. In one dog, the frontal sinus was partially obliterated with a temporalis muscle flap before skin closure. At months 6 through 34, all dogs were clinically free of aspergillosis. Open treatment has potential clinical application as a primary approach to nasal aspergillosis or for cases that are unresponsive to previous medical management.     

Conjunctival Pedicle Grafts Used to Repair Corneal Perforations in the Horse

Four horses with corneal perforations of various etiologies were presented for surgical correction. Pedicle grafts taken from the bulbar or palpebral conjunctiva were used to repair the defects. Two horses regained functional vision in the affected eyes while a third had significant impairment. The fourth eye, which had an intense uveitis pre and postoperative, became phthisic and blind.     

Carotenodermia in a Horse

This case report describes an 11-year-old Appaloosa gelding that was examined because of yellow–orange tinting of the skin of the muzzle, eyelids, sheath, anus, and perianal region without discoloration of the sclera or mucus membranes. The horse was reported to preferentially eat dandelions which were plentiful in the pasture. Physical examination was normal, except for the discolored skin. A serum chemistry panel was normal. Carotenodermia was suspected. Serum carotenoid concentrations were higher in the affected horse as compared with concentrations in two horses with depigmented skin of normal color that were on grass pasture in the same geographic area. The horse remained systemically healthy and the abnormal skin color had almost disappeared when he was examined 7 weeks later. Carotenodermia can occur in horses and can be differentiated from jaundice because the sclera remains unaffected. Veterinarians should be aware that the condition is benign and spontaneously resolves after stopping carotenoid intake.     

Distal Humeral Salter Harris (Type II) Fracture Repair by an Ulnar Osteotomy Approach in a Horse

Objectives: To report repair of a comminuted distal humeral type II Salter–Harris fracture using an ulnar osteotomy approach and locking compression plates (LCP). Study Design: Case report. Animal: A 3‐month‐old Standardbred filly with a type II Salter–Harris fracture of the distal humerus. Methods: Radiographic and computed tomography examinations were performed to assist surgical planning. The distal humeral fracture was approached by an ulnar osteotomy and repaired using a 7‐hole broad LCP and screws inserted in lag fashion. The osteotomy was subsequently repaired using a 7‐hole narrow LCP. Results: The distal humeral fracture was successfully approached and stabilized by an ulnar osteotomy approach. At 6‐month follow‐up, the filly was ambulating comfortably with a normal cosmetic appearance. Conclusions: An ulnar osteotomy approach was readily performed and allowed for repair of a type II Salter–Harris fracture of the distal humerus. Clinical Relevance: The equine distal humerus can be accessed readily using an ulnar osteotomy approach. LCPs allow for repair of complicated fractures that have previously been associated with a grave prognosis.     

Laparoscopic Adhesiolysis in a Horse

Objective —The purpose of this report was to describe the use of laparoscopy as a method of treatment for abdominal adhesions in the horse.
Clinical Report —Unilateral ovariectomy for removal of a granulosa cell tumor was performed through a diagonal paramedian approach in a 14-year-old Arabian mare. Progressive incisional swelling and hemorrhage culminated in acute incisional dehiscence with herniation of ileum on the sixth postoperative day. Septic peritonitis that responded to parenteral antibiotic therapy was identified 7 days after hernia repair. Seven days later, the mare had signs of abdominal pain, and adhesions of small intestine to the paramedian incision were identified on rectal palpation. Transrectally assisted laparoscopic adhesiolysis was performed. No further complications occurred.
Clinical Relevance —Laparoscopic adhesiolysis may provide better observation of adhesions and reduced postoperative morbidity compared with laparotomy.     

Pemphigus Foliaceus in a Horse

Abstract— A 3-year-old gelding was presented with a generalized chronic dermatitis characterized by erosions, ulcerations, crusting, scaling and widespread alopecia. The diagnosis of pemphigus foliaceus was based on history, clinical signs, histological lesions and immunohistological test results. Typical dermatohistopathological findings comprised intraepidermal acantholysis and cleft formation in both epidermis and hair follicle epithelium. Additionally, blisters and erosive lesions were found in the epithelia of various mucocutaneous junctions, the distal oesophagus and the oesophageal zone of the stomach. In formalin-fixed and paraffin-embedded tissues an immunoperoxidase technique was established to demonstrate deposits of the immunoglobulins G and M and the complement component C3 providing the opportunity to compare histological and immunohistological findings. Résumé— Un cheval hongre de 3 ans a été présenté avec une dermite chronique caractérisée par des érosions, des ulcères, des croutes, des squames et une alopécie très étendue. Le diagnostic de pemphigus foliacé reposait sur l'anamnèse, l'examen clinique et les résultats des examens histopathologiques et immunopathologiques. Les lésions histologiques typiques comprenaient des acantholyses intraépldermiques et la formation de fissures tant au niveau de lépiderme que des follicules pileux. En outre, des bulks et des érosions ont été retrouvées au niveau de différentes junctions cutanéomuqueuses et de la partie distalé de l'oesophage. Une technique d'immunopéroxydase sur tissus fixés au formol et en paraffine a été utilisée pour mettre en évidence des dépôts d'immunoglobulines G et M et de C3, permettant de comparer les observations histologiques et immunopathologiques. Zusammenfassung— Ein dreijähriger Wallach wurde mit einer generalisierten chronischen Dermatitis vorgestellt, die durch Erosionen, Ulzerationen, Krusten, Schuppen und ausgedehnte Alopezie gekennzeichnet war. Die Diagnose Pemphigus foliaceus stützte sich auf den Vorbericht, die klinischen Symptome, die histologischen Veränderungen und die Ergebnisse des immunohistologischen Tests. Die typischen histopathologischen Befunde umfaßten intraepidermale Akantholyse und Spaltbildung sowohl in der Epidermis wie im Epithel des Haarfollikels. Zusätzlich wurden Blasen und erosive Veränderungen in den Epithelien verschiedener mukokutaner übergänge, im distalen ösophagus und in der ösophagealen Zone des Magens gefunden. An formalinfixiertem und in Paraffin eingebettetem Gewebe wurde eine Immunoperoxidasetechnik durchgeführt, um die Ablagerungen von Immunglobulinen G und M und der Komplementkomponente C3 zu zeigen, wodurch die Gelegenheit bestand, histologische und immunohistologische Befunde zu vergleichen. Resumen Un caballo de tres anos fue presentado con una dermatitis crónica de tipo generalizado presentando erosiones, ulceraciones, costras y escamas epidérmicas, además de una alopecia generalizada. Una diagnosis de pémfigo foliáceo se basó en la historia y cuadro clínico, lesiones histológicas y resultados de tests inmunohistológicos. Los hallazgos dermato-histopatológicos típicos comprendieron acantolisis intraepidermica y la formación de indentaciones epidérmicas en ambos, epidermis y epitelio del folículo piloso. También se observó la presencia de vesículas y lesiones erosivas en el epitelio de las uniones mucocutaneas, asi como en áreas distales del esófago, y en zonas esofágicas del estómago. Después de la fijación en formol y sumersión en parafina de los tejidos, se utilizo la técnica de inmunoperoxidasa para la demonstratión de depósitos de inmunoglobulinas G y M, y el complemento C3, que proporcionó la oportunidad de comparar los hallazgos inmuno e histológicos.     

Alopecia Universalis in a Horse

Abstract— Alopecia universalis was diagnosed in a 3-year-old brown Percheron mare. Clinical and histo-pathologic findings in this previously unreported condition in the horse are described.