Diaphragmatic hernia in horses: 44 cases (1986–2006)

Objectives – To present a case series of horses diagnosed with diaphragmatic hernia, and to determine the significance of (1) historical information, examination findings, and laboratory data; and (2) exploratory laparotomy or necropsy findings on short- and long-term outcome.
Setting – University Referral Hospital.
Design – Retrospective study.
Animals – Forty-four horses/foals admitted between 1986 and 2006 with a diagnosis of diaphragmatic hernia made either at exploratory laparotomy or necropsy.
Interventions – None.
Measurements and Main Results – Information from the medical records included history, clinical examination findings at presentation, and findings of exploratory laparotomy or necropsy. Logistic regression or the Fisher exact test was used to determine factors associated with survival. Outcome was defined as survival to discharge (short-term survival), and long-term survival was defined as horses alive at least 1-year post surgery. Of the 44 horses, 18 died or were euthanized before surgery. Twenty-six were taken to surgery, 17 were euthanized. Nine horses recovered from anesthesia, 7 of which survived to hospital discharge. Of these, 5 were alive at long-term follow-up. Survival was significantly associated with the age of the horse (≤2 y old) at presentation, presence of normal peritoneal fluid at presentation, amount of compromised viscera at surgery (<50% small intestine), and the size (<10 cm) and location (ventral) of the diaphragmatic tear.
Conclusion – This study confirms that size and location of the lesion do play a significant role in prognosis. And, although the prognosis for horses with diaphragmatic hernia is poor, if horses have operable lesions there is a fair prognosis for long-term survival.     

Retinal detachment in horses: 40 cases (1998-2005)

OBJECTIVE: To determine clinical features, ophthalmic examination findings, etiology, treatment, and outcome of horses diagnosed with retinal detachment (RD). ANIMALS STUDIED: Forty horses, presented to the North Carolina State University and The Ohio State University Veterinary Teaching Hospitals from 1998 to 2005 that were diagnosed with RD. PROCEDURE(S): Horses with documented RD, confirmed either on ophthalmic examination or by ultrasonography, and with a complete medical record were included. Information retrieved from the medical records included signalment, presenting complaint, duration of clinical signs, ophthalmologic examination findings, diagnostics performed, identified cause of the retinal detachment, treatment given, and outcome. RESULTS: Forty horses (46 eyes) were diagnosed with RD. Mean +/- SD duration of clinical signs of ocular disease was 10.5 +/- 14.7 months. Thirty-four horses presented with unilateral involvement, 6 with bilateral, 14 with partial and 32 with complete RD. Ultrasonography was used to make the diagnosis in 26 eyes, while RD was diagnosed on routine ocular examination in 20 eyes. Bullous RD was the only type of RD observed, although small vitreal traction bands were considered secondary to the underlying inflammation or trauma. RD caused by equine recurrent uveitis (ERU) was diagnosed in 27 of 40 (67.5%) horses. Trauma-induced RD involved 10 of the 40 horses (25%). Presenting problems included known ERU (n = 16), acute or progressive vision loss (n = 9), known ocular trauma (n = 6), cataract (n = 6), and a cloudy cornea (n = 3). No horses regained vision after RD despite therapy. Many eyes were enucleated or eviscerated, or the horses were euthanized. Seven eyes with complete RD were noted to be unchanged and comfortable with medical therapy. CONCLUSIONS: The visual prognosis of RD in horses is grave; however, horses with nontraumatic RD (most commonly ERU) may be able to maintain a comfortable but blind globe with anti-inflammatory medical therapy.     

Mares admitted to a referral hospital for postpartum emergencies: 163 cases (1992–2002)

Objective: To identify and describe the physical, historical, and clinicopathologic characteristics of diseases requiring emergency treatment in postpartum mares, and to evaluate the utility of these characteristics in making an accurate diagnosis in these mares. Design: Retrospective study. Setting: University large animal hospital. Animals: One hundred and sixty‐three mares admitted for emergency treatment within 30 days following parturition between the years 1992 and 2002. Interventions: None. Measurements and main results: Information obtained from the medical records included age, breed, date of admission, sex of the foal from this parturition, time from parturition to admission, duration of clinical signs prior to admission, and any report of dystocia or normal attended delivery, physical examination and clinicopathologic findings and diagnosis. Urogenital hemorrhage and large colon volvulus were the most common diagnoses, comprising 16.6% and 15.9% of total cases, respectively. Older mares were more likely to have a diagnosis of urogenital hemorrhage than younger mares. Mares with urogenital hemorrhage had a median age of 13 years and were admitted to the hospital significantly closer to parturition than mares with other diagnoses. Anemia, hypoproteinemia, and hypofibrinogenemia were significantly associated with a diagnosis of urogenital hemorrhage and occurred in 32%, 36%, and 26% of the mares with urogenital hemorrhage, respectively. Dystocia was more commonly reported (70%) in mares with metritis. Leukopenia was more common (88%) in mares with uterine tears. Conclusions: Careful evaluation of clinicopathologic data can aid the emergency clinician in making a correct diagnosis in postpartum mares with emergent problems.     

Wounds of the pastern and foot region managed with phalangeal casts: 50 cases in 49 horses (1995–2006)

Objective   Describe the use of a phalangeal cast as treatment for wounds in the pastern and foot region of horses. Secondly, to evaluate the healing and soundness of horses treated with phalangeal casts.
Design   Retrospective study of 49 horses.
Procedures   Medical records of 49 horses that were treated with a phalangeal cast for 50 cases of wounds in the pastern and foot region at equine referral hospitals from 1995 to 2006 were reviewed and follow-up information was obtained.
Results   Treatment consisted of wound debridement, lavage, wound closure (28 wounds), cast application and antibiotics (84%). At follow-up, the majority of horses were sound (42 of 47 wounds, 89.4%), three horses were still lame and one horse was euthanased because of persistent lameness. Three horses were lost to follow-up. There was no statistical difference between the outcomes of horses treated acutely (<24 h) or after a 24-h delay. Similarly, the involvement of synovial structures in the wound did not significantly influence outcome.
Conclusions   In this study, wounds involving the pastern and foot that were treated with a phalangeal cast carried a good prognosis for soundness (89.4%) and cosmetic healing (89.5%). The phalangeal casts were well-tolerated and effective.     

Evaluation of cardiorespiratory and biochemical effects of ketamine‐propofol and guaifenesin‐ketamine‐xylazine anesthesia in donkeys (Equus asinus)

ObjectivesTo evaluate the cardiorespiratory and biochemical effects of ketamine-propofol (KP) or guaifenesin-ketamine-xylazine (GKX) anesthesia in donkeys.Study designProspective crossover trial.AnimalsEight healthy, standard donkeys, aged 10 ± 5 years and weighing 153 ± 23 kg.MethodsDonkeys were premedicated with 1.0 mg kg^?1 of xylazine (IV) in both treatments. Eight donkeys were administered ketamine (1.5 mg kg^?1) and propofol (0.5 mg kg^?1) for induction, and anesthesia was maintained by constant rate infusion (CRI) of ketamine (0.05 mg kg^?1 minute^?1) and propofol (0.15 mg kg^?1 minute^?1) in the KP treatment. After 10 days, diazepam (0.05 mg kg^?1) and ketamine (2.2 mg kg^?1) were administered for induction, and anesthesia was maintained by a CRI (2.0 mL kg^?1 hour^?1) of ketamine (2.0 mg mL^?1), xylazine (0.5 mg mL^?1) and guaifenesin (50 mg mL^?1) solution. Quality of anesthesia was assessed along with cardiorespiratory and biochemical measurements.ResultsAnesthetic induction took longer in GKX than in KP. The induction was considered good in 7/8 with KP and in 6/8 in GKX. Anesthetic recovery was classified as good in 7/8 animals in both treatments. Xylazine administration decreased heart rate (HR) in both treatments, but in KP the HR increased and was higher than GKX throughout the anesthetic period. Respiratory rate was higher in GKX than in KP. PaO₂ decreased significantly in both groups during the anesthetic period. Glucose concentrations [GLU] increased and rectal temperature and PCV decreased in both treatments. Arterial lactate [LAC] increased at recovery compared with all time points in KP. [GLU] and calcium were higher in GKX than in KP at recovery.Conclusion and clinical relevanceThese protocols induced significant hypoxemia but no other cardiorespiratory or metabolic changes. These protocols could be used to maintain anesthesia in donkeys, however, they were not tested in animals undergoing surgery.     

Femoral diaphysis fractures in cattle: 26 cases (1994–2005)

Objective   This retrospective study was conducted to evaluate the outcome for cattle with diaphyseal fractures of the femur, but not including capital physeal injuries.
Methods   Sources of information were medical records of cattle having a definitive diagnosis of diaphyseal femoral fractures and telephone survey of owners.
Results   Medical records for 26 cattle with femoral fracture were found; of the 20 aged less than 2 months, 15 were treated surgically, 4 conservatively (stall rest) and 1 was euthanased without treatment. The surgical treatment varied according to the configuration of the fracture and the surgeon's experience. Surgery for mid-diaphyseal fractures had a significantly better surgical outcome then distal diaphyseal fractures (P < 0.05), as there were significantly fewer postoperative complications. Of the 15 calves treated surgically, 10 were discharged from hospital and 5 were retained in the herd without noticeable lameness. Of the 4 calves treated conservatively, 3 were alive at follow-up, but 2 were still lame. Of the 6 older cattle, 3 were euthanased without treatment and 3 were treated conservatively, 2 of which were alive at follow-up but 1 was still lame.
Conclusion   Conservative treatment of femur fracture in cattle is possible but associated with complications during the convalescence. Continued research is needed to optimise distal diaphyseal fracture stabilisation in young cattle.     

Left atrial rupture in dogs: 14 cases (1990–2005)

Objective: To describe the clinical parameters, treatment, and prognosis of dogs with left atrial rupture secondary to chronic mitral valve insufficiency. Design: Retrospective study. Setting: University referral hospital. Animals: 14 dogs with left atrial rupture. Interventions: None. Measurements and main results: Mixed breed dogs (n=6, 43%) and Shetland Sheepdogs (n=3, 21%) were most commonly affected. The median age was 12 years (range 5.8–18 y). The median weight was 11 kg (range 4–30 kg). Eight dogs had been previously diagnosed with chronic valvular disease. The most common presenting complaints included collapse (13/14), cough (9/14), and dyspnea (8/14). Four dogs were presented in either respiratory or cardiac arrest. Pericardial effusion was present in 13 dogs. The median left atrium:aortic outflow ratio was 2.66 (range 1.66:1–5.52:1). Pericardiocentesis was performed to alleviate tamponade in 3 dogs. Five dogs were discharged from the hospital, 3 of which were euthanized within 35 days of initial diagnosis for recurrence of clinical signs (n=2) and for hematochezia and lethargy (n=1). Five dogs were euthanized while in the hospital for a variety of reasons including DIC, progressive azotemia, collapse and recurrence of pericardial effusion, or possible seizure episode. Conclusions: Although rare, left atrial rupture resulting in pericardial effusion should be considered in older small‐ to medium‐sized dogs presenting with collapse, cough, and dyspnea. The overall prognosis appears poor.     

Splenectomy as an adjunctive treatment for dogs with immune-mediated hemolytic anemia: ten cases (2003–2006)

Objective – To describe the patient population, disease severity, and outcome in dogs with immune-mediated hemolytic anemia (IMHA) that underwent splenectomy. To compare presurgical and postsurgical data.
Design – Retrospective case series.
Setting – Emergency clinic/referral hospital.
Animals – Ten dogs diagnosed with IMHA.
Interventions – Splenectomy in addition to standard medical management for IMHA.
Measurements – Medical records of 10 dogs with IMHA, in which a splenectomy was performed were reviewed. The population was analyzed with regards to physical and clinicopathologic data, severity, treatment, and outcome. Outcome was defined as survival at 30 days, percentage of dogs on medications at 30 days, and number of relapses documented by 30 days. The presurgical and postsurgical PCV and transfusion requirements were documented and compared for each dog.
Results – Nine of 10 dogs survived to 30 days. Four of the 9 that survived were not on any immunosuppressive medications. There were no relapses during the 30 days. The 3-day postsplenectomy PCVs were significantly higher than presplenectomy. The number of transfusions administered postsplenectomy was significantly less than those administered presplenectomy.
Conclusion – The use of splenectomy may be associated with an improved outcome in dogs with IMHA.     

Management and complications of anesthesia for transvenous electrical cardioversion of atrial fibrillation in horses: 62 cases (2002-2006)

OBJECTIVE: To describe management of anesthesia for transvenous electrical cardioversion (TVEC) in horses and report perianesthetic complications. DESIGN: Retrospective case series. ANIMALS: 62 horses with atrial fibrillation and without underlying cardiac disease and 60 horses without atrial fibrillation. PROCEDURES: Medical records of horses with atrial fibrillation anesthetized for TVEC were reviewed, as were records of horses without atrial fibrillation anesthetized for magnetic resonance imaging (MRI). The TVEC group horses were compared with MRI group horses for incidence of intraoperative bradycardia and use of inotropic drugs. Data obtained included patient signalment, weight, duration of anesthesia, heart rate and arterial blood pressure during anesthesia, anesthetic drugs administered, mode of ventilation, perioperative complications, and quality of recovery. RESULTS: The TVEC group horses were > 1 year of age and were predominantly Standardbreds. The TVEC group horses underwent a total of 76 anesthetic episodes. For 40 (52.6%) anesthetic episodes, horses received xylazine only for premedication, and for 26 (34.2%) anesthetic episodes, horses received xylazine and butorphanol. Induction of anesthesia consisted of ketamine administration in various combinations with diazepam and guaifenesin for 74 (97.4%) anesthetic episodes and ketamine alone for 2 (2.6%). Bradycardia in horses was encountered during 15 of 76 (19.7%) anesthetic episodes. Minor signs of possible postanesthetic myopathy occurred following 6 (7.9%) anesthetic episodes. No significant difference was found between TVEC and MRI group horses regarding incidence of bradycardia and inotropic drug administration. CONCLUSIONS AND CLINICAL RELEVANCE: Short-duration anesthesia for TVEC of atrial fibrillation in horses without underlying cardiac disease was a safe procedure.     

Efficacy of metoclopramide for treatment of ileus in horses following small intestinal surgery: 70 cases (1989–1992)

Summary: In this retrospective study, postoperative ileus was studied in horses having resection of the small intestine followed by a jejunojejunal (n=35) or a jejunocaecal (n=35) anastomosis. Twenty-six horses received no metoclopramide, 27 received metoclopramide as an intermittent intravenous infusion and 17 horses received metoclopramide as a continuous intravenous infusion (0.04 mg/kg/hour). Horses receiving a continuous infusion of metoclopramide had a reduced total volume (P< 0.001), shorter duration (P< 0.001), and a slower rate (P< 0.001) of postoperative gastric reflux, and a shorter postoperative hospital stay (P< 0.01) when compared to horses receiving no metoclopramide and horses receiving metoclopramide as an intermittent infusion. Horses having jejunocaecostomy performed had a larger volume (P< 0.05), longer duration (P< 0.05), and a greater rate (P< 0.05) of postoperative gastric reflux, and a longer postoperative hospital stay (P< 0.001) than horses undergoing jejunojejunostomy. Horses that had an abdominal drain placed during surgery had a longer length of intestine resected (P< 0.05) and a longer postoperative hospital stay (P< 0.05) than horses without an abdominal drain. Horses that died or were euthanased during the postoperative period had a greater total volume (P< 0.05), longer duration (P< 0.05), and greater rate of postoperative gastric reflux (P< 0.01), a longer length of small intestine resected (P< 0.01), and a shorter postoperative hospital stay (P< 0.05) than horses that survived until discharge from the hospital. In a multivariate regression analysis the continuous infusion of metoclopramide was the only variable that contributed significantly to predicting the total volume (P< 0.001; r²= 0.24), duration (P< 0.001; r²= 0.24) and rate (P< 0.001; r²= 0.25) of postoperative gastric reflux. We concluded that metoclopramide given as a continuous intravenous infusion decreased the incidence and severity of ileus following small intestinal resection and anastomosis in horses.     

Clinical and clinicopathologic variables in adult horses receiving blood transfusions: 31 cases (1999-2005)

OBJECTIVE: To determine clinical and clinicopathologic abnormalities in horses administered a blood transfusion and evaluate effects of blood transfusion on these variables. DESIGN: Retrospective case series. ANIMALS: 31 adult horses that received > or = 1 blood transfusion. Procedures-Medical records of horses receiving a blood transfusion were reviewed to obtain clinical findings, laboratory test results before and after transfusion, adjunctive treatments, transfusion type and volume, response to transfusion, results of donor-recipient compatibility testing, adverse reactions, and outcome. RESULTS: 31 horses received 44 transfusions for hemorrhagic anemia (HG; n = 18 horses), hemolytic anemia (HL; 8), or anemia attributable to erythropoietic failure (EF; 5). Tachycardia and tachypnea were detected in 31 of 31 (100%) and 22 of 31 (71%) horses, respectively, before transfusion. The PCV and hemoglobin concentration were less than the reference range in 11 of 18 horses with HG, 8 of 8 horses with HL, and 5 of 5 horses with EF. Hyperlactatemia was detected in 16 of 17 recorded values before transfusion. Heart rate, respiratory rate, and PCV improved after transfusion, with differences among the types of anemia. Seventeen (54%) horses were discharged, 9 (29%) were euthanized, and 5 (16%) died of natural causes. Adverse reactions were evident during 7 of 44 (16%) transfusions, varying from urticarial reactions to anaphylactic shock. CONCLUSIONS AND CLINICAL RELEVANCE: Abnormalities in clinical and clinicopathologic variables differed depending on the type of anemia. Colic, cold extremities, signs of depression, lethargy, tachycardia, tachypnea, low PCV, low hemoglobin concentration, and hyperlactatemia were commonly detected before transfusion and resolved after transfusion.     

Adverse events associated with pericardiocentesis in dogs: 85 cases (1999–2006)

Objective – To quantify the frequency of adverse events occurring during or post pericardiocentesis and to determine if adverse events are related to the cause of the pericardial effusion or frequency of pericardiocentesis.
Design – Retrospective study.
Setting – Referral hospital.
Animals, Intervention and Measurements – Medical records of 85 dogs that underwent 112 episodes of pericardiocentesis were reviewed. Any adverse events during pericardiocentesis and in the 48 hours post pericardiocentesis were noted. The frequency of adverse events was compared between dogs with a suspected neoplastic cause and a suspected nonneoplastic cause of their pericardial effusion and also between the first and subsequent pericardiocenteses.
Main Results – The incidence of adverse events was 10.7% within 1 hour of pericardiocentesis and 15.2% within 48 hours. There was no significant difference in the frequency of adverse events between the groups. Most adverse events identified were dysrhythmias. Forty-one percent of those dogs with adverse events were euthanized or died within 48 hours.
Conclusion – The incidence of adverse events seen within 48 hours of pericardiocentesis was 15.2%.     

Clinical and scintigraphic findings in horses with a bone fragility disorder: 16 cases (1980-2006)

OBJECTIVE: To describe clinical and scintigraphic abnormalities in horses with a bone fragility disorder. DESIGN: Retrospective case series. ANIMALS: 16 horses with scintigraphic evidence of multiple sites of increased radiopharmaceutical uptake (IRU). Procedures-Medical records were reviewed for information on signalment; history; clinical, clinicopathologic, and diagnostic imaging findings; and treatment. Follow-up information was obtained through telephone interviews with owners. RESULTS: Horses ranged from 4 to 22 years old; there were 8 castrated males and 8 females. Foci of IRU most commonly involved the scapulae, ribs, sternebrae, sacral tubers, ilia, and cervical vertebrae. Most horses were examined because of chronic intermittent (n = 10) or acute (6) lameness involving a single (10) or multiple (6) limbs that could not be localized by means of regional anesthesia. Cervical stiffness (n = 3), scapular bowing (3), swayback (3), and ataxia (1) were also seen in more advanced cases. Signs of respiratory tract disease and exercise intolerance were evident in 4 horses. Ultrasonographic or radiographic evidence of bone remodeling or degeneration was seen in 19 of 33 affected bones. Histologic examination of bone biopsy specimens revealed reactive bone. Improvement was initially seen with conservative treatment in some horses, but the condition worsened in all horses, and 11 horses were euthanized within 7 years. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that horses may develop a bone fragility disorder characterized clinically by an unlocalizable lameness and scintigraphically by multiple sites of IRU involving the axial skeleton and proximal portion of the appendicular skeleton.     

Transendoscopic, laser-assisted ventriculocordectomy for treatment of left laryngeal hemiplegia in horses: 22 cases (1999-2005)

OBJECTIVE: To determine long-term effects of transendoscopic, laser-assisted ventriculocordectomy (LAVC) on airway noise and performance in horses with naturally occurring left laryngeal hemiplegia. DESIGN: Retrospective case series. ANIMALS: 22 horses with left laryngeal hemiplegia treated by means of LAVC. PROCEDURES: Medical records were reviewed and initial complaint, intended use of the horse, duration of abnormal airway noise, preoperative performance level, endoscopic findings, surgical procedure, postoperative treatment, and complications were recorded. Follow-up telephone interviews with owners and trainers were conducted to determine time for return to intended use, level of postoperative performance, and percentage reduction in airway noise. RESULTS: All horses were examined because of excessive airway noise; 10 (45%) had concurrent exercise intolerance. Left ventriculocordectomy was performed in all 22 horses; bilateral ventriculocordectomy (right ventriculocordectomy was done 1 year later) was performed in 1 horse (5%). Complications occurred in 3 (14%) horses. Twenty (91%) horses returned to their intended use. Excessive airway noise was eliminated after surgery in 18 (82%) horses; exercise intolerance improved postoperatively in 8 of 10 horses. Three racing Thoroughbreds returned to racing; 1 additional racehorse returned to racing but required a laryngoplasty 1 year later to continue racing. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that LAVC was an effective procedure for elimination of excessive airway noise and improvement of performance in horses with left laryngeal hemiplegia.     

Large colon resection and anastomosis in horses: 52 cases (1996-2006)

Reasons for performing study: Large colon resection and anastomosis (LCRA) is the most aggressive method of surgical management of a colon with questionable viability. Currently, published studies are comprised mostly of broodmares and discuss short‐term survival. Objectives: To determine the prognosis for survival after LCRA in a diverse population of horses, report the incidence of post operative complications, and determine if associations between analysed variables and survival rate exist. Methods: The medical records of 52 horses that underwent LCRA were evaluated. Data were used to identify univariable associations with survival as well as complications related to LCRA. Chi‐square, odds ratio with 95% confidence interval, Mann‐Whitney or Kruskal‐Wallis tests were used, with significance set at P<0.05. Results: Forty‐four horses (84.6%) survived anaesthesia and recovery, 30 (57.7%) survived to be discharged from the hospital. Of the variables analysed, heart rate 24 h after recovery was significantly associated with mortality, as were endotoxaemia, ileus and peritonitis experienced post operatively. Conclusions: Heart rate 24 h after recovery may be a more reliable prognostic indicator than other analysed variables. Survival rate and complications after LCRA were similar to those previously reported. Potential relevance: By reporting on LCRA in a diverse group of horses, referral clinics with similar populations may have a better understanding of prognosis and complications associated with the procedure. When a colon with questionable viability is removed, waiting until 24 h after recovery may be advised to allow for a more informed decision regarding prognosis.     

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.     

Clinical features and outcomes of phacoemulsification in 39 horses: a retrospective study (1993-2003)

OBJECTIVE: To identify visual outcome and postoperative complications following phacoemulsification of equine cataracts. ANIMALS: Records of 39 horses (55 eyes) with cataracts were reviewed. METHODS: Eyes with cataracts removed by phacoemulsification were included in the study. Data collected included age, breed, sex, stage and etiology of cataract, unilateral vs. bilateral involvement, and ultrasound findings. Horses were grouped by etiology of the cataract. Visual outcome and complications were evaluated for each group and the overall population. RESULTS: Immediately postoperatively 46 out of 47 eyes (98%) were sighted. Four weeks postoperatively 23 of 29 operated eyes (79%) were sighted [13/18 (72%) eyes with congenital/juvenile onset, 6/6 (100%) eyes with traumatic and 4/5 (90%) eyes with uveitis-induced cataracts], with 18 eyes lost to follow-up. The most common postoperative complications included corneal edema (19 eyes/40%), fibrin in the anterior chamber (11 eyes/23%), postoperative ocular hypertension (9 eyes/19%), synechia/dyscoria (9 eyes/19%), and hyphema (7 eyes/15%). CONCLUSIONS: Prognosis for vision is favorable for horses following phacoemulsification and planned posterior continuous tear circular capsulorrhexis. Success rates depend on age of patient, cause of cataract and pre-existing intraocular disease. The highest success rate occurred in eyes with traumatic cataracts.     

The use of amniotic membrane transplantation for ocular surface reconstruction: a review and series of 58 equine clinical cases (2002–2008)

Amniotic membrane transplantation (AMT) is an effective clinical therapy for reconstruction of the ocular surface in human and veterinary patients. Amnion is avascular and strong, contains antiangiogenic and antiinflammatory properties and growth factors, and has properties that prevent or decrease fibrosis in healing tissue. Indications for its use are steadily growing and include grafting to replace diseased, missing or excised tissue, patching to support diseased tissue during the healing process and as a substrate for the expansion of epithelial cells for transplantation to the cornea. AMT through a combination of mechanical and biologic factors can preserve the integrity of the globe, optimize the visual outcome, and minimize scarring in severely diseased corneas.