Contrast radiography in the equine orthopaedic case

Routine contrast radiography has a valuable role in equine orthopaedics, providing additional information to standard radiography. However, ultrasonography provides additional information with respect to soft tissue pathology not appreciable when using contrast radiography alone, particularly in the investigation of synovial sepsis, ligament and tendon pathology, and osteochondral defects. The benefits of contrast media in more advanced imaging modalities such as computed tomography are just being recognised clinically.     

Postprandial arterial vasodilation in the equine distal thoracic limb

The effects of feeding on blood flow to the equine foot are poorly understood. In a temperature-controlled room, duplex Doppler ultrasonographic observations were made pre- and postprandially of the lateral proper palmar digital artery of 5 horses, randomly assigned to twice and 4 times daily feeding in an unbalanced 2 period crossover design. Arterial diameter and blood velocity were measured over 4 h and additional observations made of heart rate, blood pressure, total plasma protein, packed cell volume, plasma glucose and insulin. There was no effect of the feeding regimen on any variable. Postprandially, there were significant increases in arterial diameter, blood velocity, total plasma protein, plasma glucose and insulin; the other variables were unchanged. It appeared that the normal postprandial response was an increase in blood flow to the foot. The value of ultrasonography for noninvasive investigation of the peripheral vasculature of the conscious horse was established; and in the future it may have a role in the diagnosis of vascular diseases of the foot.     

Sonographic observations of the peripheral vasculature of the equine thoracic limb

Investigations of the equine peripheral vascular system have been constrained by the lack of a non-invasive method of examining the arteries and veins of the limbs of the conscious horse. Precise correlations were established between the gross anatomical features of the peripheral vessels and their B-mode sonographic appearance in each thoracic limb of 35 horses. A sonographic imaging protocol was established. Additional Doppler sonographic recordings defined the arterial waveforms and demonstrated that blood flow to the foot could be evaluated in the lateral proper digital artery, distal to the level of the coronary band. Valves (with 2-4 cusps) were identified in the lumina of the medial and lateral palmar common digital veins and those of the medial and lateral palmar proper digital veins. Spontaneous echo contrast, a smoke-like haze of echoic blood, was seen in the lateral and medial palmar common digital veins, the distal deep palmar venous arch and communicating branches, and the palmar proper digital veins, and occasionally seen in the distal deep palmar arterial arch and distal proper palmar digital arteries. The value of duplex sonography (B-mode and Doppler) for anatomical and physiological studies of the peripheral vasculature of the horse was clearly established. Such data could be applied to the investigation of diseases affecting the peripheral circulation.     

The integration of radiography and alternative imaging methods in the diagnosis of equine orthopedic disease

There is increasing demand on equine practitioners to provide confirmation of their diagnoses. For obscure lameness and for many of the more difficult locomotory problems presented in referral hospitals, the question to be answered is not only how to make the most accurate diagnosis but also how to document the findings so that there is less doubt in the mind of the client. This article describes a quasi algorithmic approach to choosing the best combinations of the increasingly sophisticated imaging methods available for evaluation of orthopedic disease.     

Comparison of radiography and ultrasonography for the diagnosis of osteochondritis dissecans in the equine femoropatellar joint

Reasons for performing study: Osteochondritis dissecans (OCD) lesions of the femoropatellar (FP) joint are diagnosed routinely by radiography, but lesions located in the trochlear groove or without accompanying subchondral bone changes can be difficult to visualise. Ultrasonography allows evaluation of articular cartilage and subchondral bone in the FP joint. Objectives: To document the radiographic and ultrasonographic appearance of OCD lesions in the equine FP joint, grade ultrasonographic lesions and compare their accuracy in the diagnosis of these lesions. Methods: The medical records of all horses diagnosed with FP OCD between 1995 and 2006 were assessed. Inclusion criteria included availability of both radiographic and ultrasonographic images. Lesion characteristics were evaluated in each trochlear ridge and trochlear groove. For assessment of the accuracy (sensitivity and specificity) of both imaging techniques in the diagnosis of OCD, only cases with an arthroscopic or necropsy examination were studied. Results: Twenty‐one horses were included. OCD lesions were diagnosed by radiography (30/32 joints) and ultrasound (32/32 joints). The lateral trochlear ridge (LTR, 91%) and the medial trochlear ridge (MTR, 17%) were involved on radiography. The localisation on ultrasound examination was similar (97% LTR, 25% MTR). All but one lesion seen on radiography were also detected with ultrasound; 2 LTR and 3 MTR lesions, not seen on radiography were diagnosed by ultrasound and confirmed at arthroscopy or necropsy. The specificity was 100% regardless of the site and imaging procedure except for the distal third of the MTR (94% for ultrasound). The sensitivity varied, depending on lesion site. Conclusion: Ultrasonography is a valuable diagnostic tool to diagnose OCD lesions in the FP joint and more sensitive than radiography for lesions affecting the MTR of the distal femur. Clinical relevance: Ultrasound should be considered as a useful adjunct to radiography for diagnosing equine FP OCD, especially in cases of high clinical suspicion but equivocal radiographic findings. Images can be generated immediately when digital radiography is not available, permitting an immediate on‐site diagnosis.     

Spontaneous hoof capsule loss following lacerations of the equine distal limb

In this article, 3 cases of an infrequent complication of lower limb trauma that presented as a cellulitis and deteriorating comfort a few days after lower limb laceration are described. All 3 horses sloughed the hoof capsule 10 days after initial trauma to that particular limb. Development of subsequent cellulitis/lymphangitis contributed to deterioration of distal limb perfusion. The exact pathophysiological mechanisms remain unknown but clinicians should be aware of this unusual but major complication following limb trauma.     

Effect of an isoxsuprine-resin preparation on blood flow in the equine thoracic limb.

The effects of an oral isoxsuprine-resin preparation on the blood flow in the thoracic limb of seven horses was determined by thermography. Treatment with the oral resin preparation resulted in increased skin temperatures compared with the non-medicated controls. The maximal temperature differences, 2.2 degrees C for the horses treated with 0.9 mg/kg and 1.8 degrees C for the horses treated with 1.2 mg/kg, occurred four hours after dosing. Plasma total isoxsuprine, determined in three horses, was detectable two hours after oral dosing and maximal eight hours after dosing, but free isoxsuprine could not be detected. Receptor binding studies demonstrated strong alpha-receptor binding, and this binding was so strong that even at isoxsuprine concentrations below the detection level receptors could have been stimulated.     

Comparison between radiography and computed tomography for diagnosis of equine skull fractures

The equine head is a complex structure prone to traumatic injuries. To determine the value and limitations of radiography and (CT) for the diagnosis of skull fracture, the differences between the two modalities were described. Two observers retrospectively reviewed the radiographic and CT images of 18 horses with a skull fracture. To allow direct comparison between the two modalities, a simplified fracture classification system was used. In 3/18 cases the evaluation of the radiographic examination concluded no injuries visible. In 2/15 cases soft tissue involvement was not detected and in 7/15 cases the extension of the fracture was underestimated with radiography. Radiography classified 4/10 multiple fractures incorrectly as single fracture and 5/15 comminuted fractures on CT were diagnosed as simple fracture with radiography. The number of fragments was underestimated with radiography in 14/15 cases. In conclusion, radiography is able to diagnose a skull fracture in most cases. Skull fractures however are not similarly classified after radiographic and CT evaluation, which causes a difference in interpretation and perception of the fractures. Therefore, CT should be the modality of choice for surgical planning and prognosis.     

Effects of detomidine on equine oesophageal function as studied by contrast radiography

The effects of sedation with detomidine on oesophageal function were assessed by contrast radiography in 10 healthy adult thoroughbred horses. Barium swallows were monitored by means of image intensification, first without sedation and then after the intravenous administration of detomidine at doses of 10 and 20 micrograms/kg bodyweight. The transit time of contrast agent to the oesophageal hiatus was recorded and each swallow was scored for markers of oesophageal dysfunction. Analysis of the data indicated that there were highly significant dose dependent increases in the transit time, the retention of barium within the longitudinal mucosal folds, and retrograde peristalsis and pooling of contrast agent within the oesophagus at both the thoracic inlet and caudal to the base of the heart. The degree of gastrooesophageal reflux was not affected at either dosage. These changes in oesophageal function were similar to those recorded from cases of grass sickness and indicate that care should be taken in the interpretation of studies of swallowing in animals that have been given detomidine before a radiographic examination.     

Importance of uniform cuff application for equine blood pressure measurement

Seventeen horses were used to determine the variances associated with blood pressure cuff application (Sp2) and with other inherent errors (So2). Systolic pressure values had Sp2 = 3.9 mmHg and So2 = 5.6 mmHg, while diastolic pressure values had Sp2 = 1.1 mmHg and So2 = 4.4 mmHg. Thus, to be considered different, two blood pressure means (in mmHg), each derived from three readings, had to differ by at least 3.9 for systolic pressure and 3.4 for diastolic pressure when all readings were made without cuff displacement; 6.8 for systolic pressure and 4.6 for diastolic pressure when the cuff was reapplied between, but not during, measurement of each mean; and 5.0 for systolic pressure and 3.8 for diastolic pressure when the cuff was reapplied between all readings. It was concluded that uniform cuff application is readily achieved.     

Bilateral oblique facial clefts,rudimentary eyes and hydrocephalus in an aborted equine foetus

Knowledge of congenital malformations and their causes in horses is generally sparse. Such conditions require more scientific attention to improve their diagnostics and inform prevention strategies. Here, a unique syndrome of bilateral oblique facial clefts (meloschisis), rudimentary eyes and hydrocephalus is reported in an equine foetus spontaneously aborted at gestation day 224. The cause of abortion was considered to be intrauterine death caused by umbilical cord torsions and subsequent compromised blood flow, but the aetiology of the malformation could not be determined. A detailed history, which includes exposure to a range of pharmaceutical compounds during the early stages of pregnancy, is provided and emphasizes the need for accurate recording of treatments in pregnant animals.     

Short-term habituation of equine limb kinematics to tactile stimulation of the coronet.

A lightweight bracelet that provides tactile stimulation to the horse's pastern and coronet induces a higher flight arc of the hoof. This study addresses the pattern of habituation to these devices. OBJECTIVE: To evaluate short-term habituation to tactile stimulation of the pastern and coronet in trotting horses. METHODS: Tactile stimulation was provided by a lightweight (55 g) device consisting of a strap with seven chains that was attached loosely around the pastern. Reflective markers were fixed to the dorsal hoof wall, the forehead and over the tenth thoracic vertebra of eight sound horses. The horses trotted in hand 10 times at a consistent velocity along a 30 m runway under three conditions applied in random order at two-hour intervals: no stimulators, stimulators on both front hooves or stimulators on both hind hooves. One stride per trial was analyzed to determine peak hoof heights in the swing phase. Sequential trials with stimulators were compared with unstimulated trials using a nested ANCOVA and Bonferronni's post hoc test (P < 0.005). RESULTS: Peak hind hoof height increased significantly for all 10 trials when wearing hind stimulators, whereas peak fore hoof height increased during the first six trials only when wearing fore stimulators. The first trial with stimulators showed the greatest elevation, followed by a rapid decrease over the next three trials and then a more gradual decrease. CONCLUSIONS: If the goal is to facilitate a generalized muscular response, a short burst of tactile stimulation is likely to be most effective, whereas longer periods of stimulation will be more effective for strength training.     

The use of radiography for diagnosis of apical infection of equine cheek teeth

Despite recent developments in advanced imaging, radiography remains the most commonly employed imaging modality for investigating apical infection of cheek teeth in horses. Radiographic technique, knowledge of the normal anatomy and horse compliance are paramount for acquiring good quality dental radiographs. Interpretation of subtle pathology can be difficult for even the most experienced radiologist; however, in more chronic cases, identification of dental abnormalities is easier.     

Importance of the horse and financial impact of equine trypanosomiasis on cattle raising in Venezuela

In Venezuela, horses are indispensable for extensive cattle raising, and extensive cattle raising prevails in all regions. This determines the numerical relationship between horses and cattle (r?=?0.93) to be relatively constant nationwide. At regional level, the average extension of cattle ranches varies greatly. However, in relation to the area covered by pastures, the numbers of horses (r?=?0.95) and cattle (r?=?0.93) are relatively uniform nationwide. Water buffalo occupy small fractions of the territory; therefore, their numbers are related to the area of pastures less strongly (r?=?0.56). There is no information on the numerical relationship between the numbers of horses and water buffalo. In the Llanos region of the country, equine trypanosomiasis is responsible for a high mortality in horses, causing considerable financial losses to cattle ranches. So far, such losses have not been assessed. For this region, in 2008, it can be calculated that: (1) with no treatment, losses owing to horse mortality caused by this hemoparasitosis would have amounted to US$7,486,000; (2) the diagnosis and treatment of affected horses would have required an investment of US$805,000; and (3) in terms of horses saved, this investment would have resulted in benefit of US$6,232,000. Therefore, for every monetary unit invested, there would be a benefit 7.75 times greater, this ratio being applicable to any year and all regions of the country. It follows that the profitability of investing in the diagnosis and treatment of equine trypanosomiasis is guaranteed.