Haemolytic anaemia as a complication following colic surgery in a 10‐year‐old Arabian stallion

Immune‐mediated haemolytic anaemia is rare in the horse. This case report discusses the clinical presentation and treatment of this condition in an Arabian stallion following abdominal surgery for large colon volvulus. On Day 10 of hospitalisation the stallion's PCV dropped by 10% whilst his total solids remained stable, consistent with haemolytic anaemia. The stallion was treated with whole blood transfusions and dexamethasone and recovered to be discharged on Day 42. This is an interesting example of immune mediated haemolytic anaemia associated with a complicated gastrointestinal condition. It demonstrates the wide variety of potential aetiologies underlying a haemolytic episode and the necessity for expedient treatment.     

Haemolytic anaemia in a pony associated with a perivascular abscess caused by Clostridium perfringens

A 5‐year‐old Welsh Pony mare presented with a history of dullness and inappetence and a large swelling on the left side of the neck extending to the pectoral region. Flunixin meglumine had been administered intravenously 10 days previously for treatment of laminitis. The pony was anaemic at presentation. Clostridium perfringens was isolated from an abscess overlying the left external jugular vein. Treatment consisted of supportive treatment, drainage of the abscess and administration of sodium benzyl penicillin G intravenously. A marked improvement in the mare's demeanour and a gradual increase in packed cell volume over a period of one month were observed. The historical, clinical and clinicopathological findings were consistent with immune‐mediated haemolysis associated with C. perfringens infection.     

Haemolytic anaemia in cattle in NSW associated with Theileria infections

Several outbreaks of anaemia, jaundice, abortion and mortality in cattle in New South Wales were attributed to the intracellular parasite, Theileria buffeli . Disease occurred predominantly in periparturient animals that had been moved from inland to coastal areas. Diagnosis was made via exclusion of other causes of haemolytic anaemia and observation of the parasite in blood smears. Treatments included both registered and non-registered products. There is a possibility of a new strain of Theileria sp. in Australia and the possible vectors encountered in NSW are discussed.     

Soft tissue sarcomas in the pharyngeal region of a 5‐year‐old Quarter Horse mare

This case report describes the identification of multiple soft tissue sarcomas in the pharyngeal region of a 5‐year‐old Quarter Horse mare. Diagnostic work‐up included physical examination, radiography, ultrasonography, endoscopic examination of upper airways and guttural pouch, and post mortem examination with histopathology. Humane euthanasia was indicated due to the chronicity of the condition, prognosis and financial constraints.     

Caecal lipomatosis as a cause of colic in a 9‐year‐old gelding

Lipomatosis is an uncommon cause of colic. This case report details the pre‐ and intraoperative findings of a 9‐year‐old gelding, presented with acute abdominal pain. Exploratory laparotomy revealed a massive fatty infiltrate involving an extensive portion of the base and mid‐body of the caecum. To the authors' knowledge, this is the first report of an infiltrative lipomatous lesion of the equine caecum.     

Direct preputial hernia associated with a ventral abdominal wall defect in a two‐year‐old gelding

The case of a 2‐year‐old gelding with acute onset of preputial swelling and prolapse is presented. After initiating conservative management using a penile repulsion device, the horse repeatedly displayed signs of mild abdominal discomfort with sudden deterioration to an episode of violent colic after 5 days of hospitalisation. Ultrasonographic examination of the preputial swelling at that time demonstrated the presence of small intestine between the internal and external laminae of the prepuce and led to the diagnosis of a direct preputial hernia. The contents of the hernia were readily reduced through a defect in the ventral abdominal wall after the anaesthetised horse was placed in dorsal recumbency. The historical information, clinical progression and surgical findings were supportive of an acquired ventral abdominal wall defect. To the authors' knowledge, this is the first reported case of a direct preputial hernia associated with an acquired ventral abdominal wall defect.     

Cutaneous habronemiasis in a 9‐year‐old Arab gelding in the United Kingdom

Cutaneous habronemiasis causes ulcerative granulating lesions in the skin of equids. Dramatic exuberant tissue may be seen, which becomes traumatised by the horse. To the authors' knowledge, cutaneous habronemiasis has not previously been documented on the distal limb of horses in the UK. Cutaneous habronemiasis should be considered as a potential differential diagnosis for ulcerative granulating skin lesions on the distal limb of the horse.     

Multiple extra-pulmonary disorders associated with Rhodococcus equi infection in a 2-month-old foal

A 2-month-old Thoroughbred filly was referred to Hagyard Equine Medical Institute for further evaluation of acute pyrexia and a suspected intra-abdominal abscess based on abdominal ultrasonography performed in the field. Initial examination revealed bilateral uveitis, polysynovitis, a large internal abdominal abscess and pneumonia. A transtracheal wash confirmed the presence of a multi-sensitive strain of Rhodococcus equi. Anaemia and thrombocytopenia were noted during hospitalisation. Results of a Coombs test were consistent with an immune-mediated haemolytic process. Recurrent pyrexia, abdominal discomfort and severe respiratory distress unresponsive to intensive medical support motivated euthanasia followed by necropsy after 30 days of treatment. Overall, six extra-pulmonary disorders were simultaneously diagnosed despite the lack of pulmonary pyogranulomas.     

Carcinoma of an accessory genital gland in a 23‐year‐old Camargue gelding

This report describes the case management, histopathological and post mortem findings in a 23‐year‐old gelding with a peri‐rectal mass. The mass was debulked surgically and submitted samples revealed it to be a poorly differentiated carcinoma. In the post operative period the horse developed signs of abdominal pain and dysuria and was subjected to euthanasia. Post mortem examination revealed a large infiltrative mass located between the rectum and urethra, consistent with a carcinoma of an accessory genital gland, most likely the seminal vesicle.     

Cerebellar abiotrophy in a 6‐year‐old Arabian mare

Cerebellar abiotrophy (CA) is an uncommon neurological disease that most commonly affects Arabian horses. Affected horses are typically identified within the first 6 months of life. Intention tremor, wide based stance and ataxia are common clinical signs observed in affected individuals. No treatment is available for resolution of clinical signs. Definitive diagnosis is based on histopathological examination of cerebellar tissue, which is characterised by loss of Purkinje cell layer. This report describes a case of cerebellar abiotrophy that had a delayed diagnosis until 6 years of age.     

Duodenal volvulus as a cause of gastric rupture in a 15‐year‐old Warmblood gelding

Duodenal volvulus is an unreported cause of colic in the horse. This case report describes a 15‐year‐old Warmblood gelding evaluated for acute abdominal discomfort. Exploratory celiotomy revealed duodenal volvulus and gastric rupture resulting in severe, acute, septic peritonitis. To the authors' knowledge, this is the first report of a volvulus of the equine duodenum.     

Atypical histopathological findings in a 15‐year‐old Warmblood gelding diagnosed with anhidrosis in a temperate climate

This case report describes the atypical histopathological findings in a horse with anhidrosis that presented for evaluation of suspected respiratory disease during autumn/winter in a temperate climate. Anhidrosis in this horse was associated with mononuclear infiltration of T lymphocytes around sweat glands, a finding not previously reported in cases of equine anhidrosis. This report highlights the importance of considering anhidrosis as a differential diagnosis in the investigation of respiratory disease and illustrates that the condition can occur in horses residing in temperate climates.     

Ataxia and weakness as uncommon primary manifestations of hepatic encephalopathy in a 15‐year‐old trotter gelding

A 15‐year‐old trotter gelding was evaluated because of an acute onset of ataxia in all 4 limbs. There was no known history of trauma. The gelding showed grade 2/5 ataxia in all 4 limbs, which was localised after clinical neurological examination to the cervical vertebral spinal cord. Initial therapy consisted of oral anti‐inflammatory doses of prednisolone and antimicrobial treatment with potentiated sulphonamides. The ataxia progressed to grade 3/5 at Day 10 of hospitalisation. Additionally, the horse was slightly depressed and showed spontaneous yawning during examination. Facial sensation was blunted. Blood chemistry revealed a marked elevation of liver specific enzymes and blood ammonia levels. Transcutaneous abdominal ultrasonography revealed hepatomegaly. Due to a guarded prognosis, the horse was subjected to euthanasia. At necropsy the left lateral liver lobe was markedly enlarged and showed a firm texture, whereas the cranial part and the right and quadratic liver lobe displayed a severe and diffuse atrophy. Histopathologically, the left lateral liver lobe revealed a moderate to severe cirrhosis with a severe, diffuse hepatocellular iron‐accumulation. Increased numbers of Alzheimer type II astrocytes in the cerebral cortex and cerebral white matter vacuolisation were indicative for encephalopathy. These findings were interpreted as haemosiderosis and cirrhosis of the liver with consecutive hepatic encephalopathy. Aetiologically, haemosiderosis should be considered as a cause of liver cirrhosis with consecutive hepatic encephalopathy. Although hepatic encephalopathy in horses usually presents with predominating cerebral signs, it has to be taken into account as a differential diagnosis in cases of acute onset generalised ataxia.     

Staphyloccocus aureus-associated infarctive purpura haemorrhagica,immune-mediated haemolytic anaemia and myocarditis in a Quarter Horse mare

A 7-year-old Quarter Horse mare was presented for severe left hindlimb oedema and nonweightbearing lameness that was progressive over approximately 48 h. The mare subsequently developed marked and worsening oedema, immune-mediated haemolytic anaemia (IMHA), myositis and myocarditis. The marked oedema, degree of pain and severity of myositis were consistent with infarctive purpura haemorrhagica. Fine needle aspiration of affected tissue resulted in positive bacterial culture of Staphylococcus aureus. Purpura haemorrhagica and associated complications are typically associated with Streptococcal sp. infection or exposure, and have not been previously reported in association with Staphylococcus aureus in the horse. The mare responded favourably to long-term, high-dose corticosteroid therapy, antimicrobials and supportive care.     

Mandibular squamous cell carcinoma in a 5‐year‐old Tennessee Walking Horse

Squamous cell carcinoma (SCC) is the second most common neoplasm reported in the horse, but occurs rarely in the oral cavity. Clinical signs may be insidious in onset and mimic other non‐neoplastic processes, thus delaying appropriate treatment. Timely evaluation and advanced diagnostic imaging may offer the opportunity to initiate definitive treatment. This report describes a young gelding with mandibular SCC that was evaluated for mandibular swelling failing to respond to symptomatic therapy.     

Transitional cell carcinoma of the urinary bladder in a 12‐year‐old Belgian Warmblood gelding

A 12‐year‐old Belgian Warmblood gelding was examined for haematuria and dysuria of 24 h duration. Cystoscopy revealed an intraluminal multinodular soft tissue mass originating from the dorsal bladder neck. Histopathological examination of biopsies identified transitional cell carcinoma. The bladder mass was surgically debulked via a temporary perineal urethrotomy. The horse commenced treatment with oral piroxicam. Follow‐up examination 18 months post operatively revealed no evidence of tumour recurrence. Neoplasia of the equine bladder is uncommon and this case describes the successful short‐term outcome of treatment of a transitional cell carcinoma by surgical debulking and oral piroxicam.     

Septic funiculitis caused by Streptococcus equi subspecies equi infection with associated immune‐mediated haemolytic anaemia

A 2‐year‐old Quarter Horse gelding presented for anaemia, icterus, depression and intermittent colic 2 weeks after routine castration. Bilateral septic funiculitis with Streptoccocus equi ssp. equi with secondary immune‐mediated haemolytic anaemia were diagnosed. A blood transfusion was required to facilitate general anaesthesia for surgical excision of the septic funiculitis. Antibiotic therapy was provided initially with chloramphenicol and later enrofloxacin. Immunosuppressive therapy was provided with dexamethasone and later azathioprine. The horse responded well to treatment and was discharged 8 weeks after presentation. Streptococcus equi ssp. equi should be considered in cases with septic funiculitis and the potential for a secondary immune‐mediated haemolytic anaemia exists with this bacterial species.     

Successful management of multiple extrapulmonary complications associated with Rhodococcus equi pneumonia in a foal

This report describes the diagnosis and successful treatment of multiple extrapulmonary sequelae of Rhodococcus equi (R. equi) pneumonia in a 3‐month‐old filly. Bilateral uveitis and hyphaema, haemolytic anaemia and polysynovitis developed in this foal and were likely due to immune‐mediated mechanisms. The challenges associated with diagnosis and treatments of these extrapulmonary disorders are discussed. The filly was treated initially with clarithromycin and rifampin; however, a blood transfusion and immunosuppressive therapy with dexamethasone were required due to progressive haemolysis and for treatment of uveitis and polysynovitis. Bilateral hyphaema was successfully treated with intracameral injections of a recombinant tissue plasminogen activator. The development of antimicrobial resistance in R. equi was an additional challenge encountered in the management of this case and emphasises the importance of culture and in vitro antimicrobial susceptibility testing of isolates from foals with R. equi pneumonia. Extrapulmonary disorders associated with R. equi pneumonia are likely underdiagnosed and associated with a poor prognosis. This case highlights the importance of thorough and ongoing diagnostic assessment of foals with R. equi pneumonia and demonstrates that a successful outcome can be achieved with appropriate and directed treatment.     

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.     

Caecal duplication in a 13‐year‐old Thoroughbred

A 13‐year‐old Thoroughbred gelding was presented for evaluation of recurrent colic of 4 weeks duration. These colic episodes were mild and responsive to medical therapy. Episodes of colic became more frequent and more painful. Exploratory laparotomy revealed a large intestine duplication with a cystic structure located at the caecocolic junction that was unable to be exteriorized and therefore not amenable to surgical correction. Thirty‐six hours following surgery, the horse became acutely painful, sweaty, and febrile suggesting gastrointestinal rupture. Post mortem examination showed a 0.6 × 1 m duplication and a 0.5 × 0.6 m cystic dilation that was probably associated with the caecum. There was a 10 × 30 cm area of rupture located within the duplication. Histological evaluation confirmed the presence of a true duplication.