Traumatic coccygeal luxation and distal amputation of the tail of an Appaloosa mare

A 17‐year‐old Appaloosa mare presented to the emergency service for acute, traumatic, partial amputation of the tail at the level of the ninth coccygeal vertebra. The patient did not have tail or anal tone and did not respond to sharp stimulation of skin in the perineal region. Two grade 1 rectal tears were found during rectal palpation. Radiographs revealed dislocation of the second (Cd2) and third (Cd3) caudal vertebrae. The patient was treated with antibiotics, an anti‐inflammatory drug and stall confinement. The ninth caudal vertebra was surgically removed to facilitate closure of skin over the wound. When the mare was discharged after 7 days of hospitalisation, she had regained partial sensation of the perineum and partial function of the internal and external anal sphincters. At re‐evaluation one year following injury, the mare was able to move her tail laterally and had regained sensation of her perineum and tail; however, she still was unable to lift her tail.     

Treatment of a poorly differentiated sarcoma in the oropharynx of a horse

A 10-year-old Thoroughbred mare was referred to Tennessee Equine Hospital for evaluation and treatment of a subepiglottic mass. Physical and laboratory examinations revealed no other abnormalities. The tumour was excised through a laryngotomy site using transendoscopic laser and sharp excision. Histological evaluation revealed a poorly differentiated sarcoma with features of a leiomyosarcoma, a rarely identified neoplasm in the oropharynx of the horse. The mare developed intermittent dorsal displacement of the soft palate (iDDSP) after surgery but was able to resume full training. There was no evidence of regrowth 8 months post-operatively.     

Chronic intermittent colic in a mare attributed to uterine marbles

A 13‐year‐old Quarter Horse mare presented for evaluation of chronic intermittent colic. Following extensive diagnostics, abdominal radiographs revealed two round, radiopaque objects in the caudal abdomen. Palpation per rectum and transrectal ultrasonography of the reproductive tract confirmed that the round objects were uterine marbles. Dinoprost tromethamine (Lutalyse, 5 mg i.m. q. 24 h for 2 days) was administered to bring the mare into oestrus, and both uterine marbles were manually removed from the uterus following digital dilation of the relaxed cervix. Follow‐up with the owner 12 months after discharge revealed that the mare had shown no further signs of abdominal discomfort since having the uterine marbles removed. To the authors' knowledge, this is the first published report of chronic intermittent colic attributed to uterine marbles in a mare.     

Direct approach to the nasal cavity through a bone flap for the treatment of a large nasal cyst

A 21‐year‐old Warmblood mare was referred to the Equine Department, Vetsuisse Faculty, University of Zurich, because of recurrent unilateral nasal discharge 3 months after partial removal of a large cyst from the left maxillary and frontal sinuses. Endoscopic, radiographic and computed tomographic examinations showed that the remnant of the cyst, which originally had extended from the left maxillary and frontal sinuses into the left nasal cavity, had expanded and was obliterating the left middle nasal meatus. A direct surgical approach to the cyst through the left nasal and maxillary bones rostral to the facial crest was chosen, which allowed evaluation and removal of the entire cyst. Endoscopic examination 3 days post operatively showed no remnants of the cyst, and the mare was discharged in good health. Re‐examination one year later showed no recurrence of the cyst.     

Anastomosis of the medial digital artery in a mare following traumatic laceration

A 7‐year‐old Warmblood mare presented with blood loss from a laceration of the medial digital artery sustained in the field. The mare was initially managed conservatively by pressure bandaging but the bleeding did not stop. After a blood transfusion the mare underwent arterial repair under general anaesthesia and was initially managed in a cast post operatively. Doppler ultrasonography 4 days post operatively confirmed effective blood flow distal to the arterial anastomosis and the mare was discharged from the hospital. At 6 months follow‐up the owner reported that the mare was sound at the trot with an excellent cosmetic outcome of the surgical site.     

Surgical treatment of a mammary gland comedocarcinoma in an Arabian mare: Post-operative management,and histopathological and immunohistochemical features

A lactating 20-year-old, brown, Arabian mare, weighing about 300 kg, presented for bleeding from one teat and severe swelling of the entire mammary gland. The mare had untreated mastitis 10 months before. Consequently, a gangrenous teat developed after chronic bloody and purulent discharges. The teat was removed surgically by the field veterinarian. At that time, the mammary gland increased in size. Bloody and purulent discharges restarted 10 days previously. Under general anaesthesia, the entire mammary gland was removed. Comedocarcinoma was diagnosed by histopathological assessment. Immunohistochemical staining was performed for pan-cytokeratin and vimentin. Microscopic examination of immunohistochemical stained slides revealed expression of pan-cytokeratin. In conclusion, this report describes clinical, macroscopic, histopathological and immunohistochemical characteristics of comedocarcinoma that did not metastasise to regional lymph nodes. Reports in the field of equine oncology contribute to improved general knowledge in equine medicine, contributing to better diagnosis and treatment.     

Surgical correction of entrapment of the large colon and caecum through a mesoduodenal rent with standing laparoscopic repair in a mare

A 12-year-old Tennessee Walking Horse mare displaying signs of severe colic for 48 h was found during an exploratory celiotomy to have entrapment of a cranially displaced large colon and the caecum through a rent in the mesoduodenum. The entrapment was relieved, and 24 h later, the mesoduodenal rent was closed laparoscopically, with the mare standing. The owner reported 6 months later that the mare had displayed no signs of colic since being discharged from the hospital 11 days after surgery.     

Partial gastrectomy and total splenectomy for the treatment of a gastric mass in a horse

A 9-year-old cob mare with a history of recurrent colic presented during an acute colic episode. Ultrasonography revealed a mass emanating from the greater curvature of the stomach and was tightly adhered to the cranial edge of the spleen. Partial gastrectomy and total splenectomy were performed via a midline celiotomy incision. The mass was subsequently confirmed to be granulomatous inflammation, postulated to be secondary to a penetrating injury to the stomach. Post-operatively, the mare had episodes of recurrent colic that were successfully managed with optimisation of the horse's diet and feeding regime. At 10 months’ post-operatively the mare was managed on full turn out, with no evidence of colic and had returned to the previous level of ridden work. The horse then presented 14 months post-operatively with severe colic due to a large colon impaction and displacement and was euthanased. This is the first report to describe successful partial gastrectomy as a treatment option for a gastric mass in the horse.     

Standing repair of a proximal,incomplete, articular fracture of the third metatarsal bone

A 5-year-old National Hunt Thoroughbred mare presented with sudden onset left hindlimb lameness after race training on the gallops. Clinical examination revealed a marked painful reaction over the proximal metatarsal region but no other obvious abnormalities were detected. Survey radiographs at the yard did not reveal any abnormalities. Nuclear scintigraphic examination 3 days after injury revealed focal marked increased radiopharmaceutical uptake in the proximal metatarsal region. Subsequent radiography revealed an incomplete, articular fracture of the proximal left third metatarsal bone. Repair of the fracture using 3 × 4.5 mm cortical screws placed in lag fashion was performed under standing sedation following perineural analgesia. Follow-up radiographs demonstrated progressive healing of the fracture. The mare returned to race training 8 months after the fracture was repaired and raced successfully 12 months post injury.     

Occurrence of Unilateral Posterior Polyneuritis in an 8-year-old Crossbred Mare

An 8-year-old Thoroughbred Turkoman crossbred mare was examined for right pelvic limb paresis and ataxia. The signs had been progressing through time. Neurological examinations revealed a gait deficit, right pelvic limb gluteal muscles atrophy, skin hypalgesia around the tail, perineum, and right pelvis. Hyperesthesia was found in the margins of anesthetic areas. Hypotonic anal sphincter and flaccid tail were also evident. Fecal and urinary retention were revealed by rectal palpation. At necropsy, the affected nerve roots in right lumbar, sacral vertebrae, as well as cauda equina were found to be significantly thickened and fibrotic with adhesions to the related vertebral bodies. Histopathological examinations confirmed the diagnosis of polyneuritis in this mare.     

Hormonal Stimulation in a Gonadal Dysgenesis Mare

The present case report aimed to determine the responsiveness of the endometrium and the ovaries of an X0 mare after hormonal treatment. On transrectal palpation, the uterus was flaccid and smaller than normal, and the ovaries were small and smooth. The endometrium had normal histological architecture, with an atrophic glandular epithelium. A karyotype evaluation was performed, and 70 cells presented 63 chromosomes, lacking one sex chromosome. Circulating hormonal levels of total estrogens were 43.93 pg/mL; progesterone 0.01 ng/mL; testosterone 48 pg/mL; FSH 30.3 ng/mL; and LH 1.71 ng/mL. Immunohistochemistry tests showed the presence of estrogens and progesterone receptors in the endometrial samples of the X0 mare. 17β estradiol was administrated on three consecutive days and long-action progesterone on the fourth day. After hormonal stimulation, the mare showed changes in endometrial ultrasonography and histology. After treatment with estradiol, uterine edema was noted, and after progesterone, a reduction in edema was observed. At the request of the owner, no further treatment or follow-up occurred. This report showed that the endometrium is functional, but the ovaries did not change macroscopically under hormonal therapy.     

Influence of various concentrate‐to‐roughage ratios on dietary intake and nutrient digestibilities of weanling horses

The objective of this study was to compare the feed intake and the apparent digestibilities of three different diets varying in concentrate‐to‐roughage ratios in weanling horses (n = 24) at 5 and 8 months of age. Horses were stratified by breed, gender, birth date and body weight and assigned to one of three dietary treatments containing the following concentrate‐to‐roughage ratios on an as‐fed basis: 70:30 (High Con), 50:50 (Equal) and 30:70 (Low Con). All horses were fed their respective diets for a 10‐day adaptation period and a 4‐day collection period at 5 and 8 months. There were no differences in BW or daily feed intake among treatments during both trials. The horses consuming Low Con had a greater amount of faecal output than High Con at both 5 and 8 months (p < 0.01). At 5 months, High Con had the highest crude protein (CP) digestibility (p < 0.05). At 8 months, High Con had a higher CP digestibility than Low Con (p < 0.01) and tended to be higher than Equal (p = 0.07). Acid detergent fibre (ADF) digestibility did not differ among treatments; however, horses fed the Low Con tended to digest a higher percentage of neutral detergent fibre (NDF) than both the Equal and High Con treatments (p = 0.09). Horses in the High Con treatment tended to digest a higher percentage of energy than those in the Low Con treatment (p = 0.06). Weanlings seem to digest protein more thoroughly when fed high‐concentrate diets and may digest fibre more efficiently when fed diets higher in fibre.     

Adverse effects of intrapleural instillation of tissue plasminogen activator in a horse: Suspected re‐expansion pulmonary oedema

This case report describes a 5‐year‐old pregnant Warmblood mare that was being treated for fibrinous bacterial pleuropneumonia. Since initial attempts to drain and lavage both pleural cavities were ineffective due to the presence of extensive intrapleural fibrin loculations, recombinant human tissue plasminogen activator (tPA) was instilled into both pleural cavities, to promote fibrinolysis and improve drainage. Within 1–2 h of instilling tPA, the horse became distressed, with increasing dyspnoea, tachycardia, pleurodynia and hypoxaemia. At 4 h post tPA instillation, diffuse bilateral pulmonary oedema was evidenced by the onset of widespread audible inspiratory crackles and ultrasonographic ring‐down artefacts. Ultrasonography demonstrated that tPA had induced pleural fibrinolysis, thereby removing the restrictive effects of pleural adhesions on lung motion and facilitating lung re‐expansion. Re‐expansion pulmonary oedema was suspected, although an adverse drug reaction could not be excluded. The complication resolved with nasal oxygen supplementation, and administration of frusemide, meloxicam, morphine and hydroxyethyl starch. Subsequent repetition of intrapleural tPA instillation and thoracic drainage had no apparent adverse effect. The mare was discharged from the hospital and subsequently foaled successfully. The pathogenesis, diagnosis and management of re‐expansion pulmonary oedema are reviewed.     

Treatment of a pulmonary granular cell tumour by repeated transendoscopic diode laser photoablation

A 27‐year‐old Shetland mare was examined for persistent coughing, increased respiratory rate and mild exercise intolerance. Over the previous 5 months, the mare had experienced a persistent cough nonresponsive to medical and environmental management. Upon endoscopic examination of the lower airways, a mass was seen within the left mainstem bronchus; biopsy identified a granular cell tumour. The tumour was successfully reduced by repeated transendoscopic diode laser photoablation over a period of 4 months with no evidence of recurrence at 10 months post treatment.     

Single‐port laparoscopic incisional hernia repair in a horse

A 16‐year‐old Italian Saddle Horse gelding was referred for treatment of an incisional hernia that developed 7 months after a ventral midline laparotomy for treatment of acute abdominal pain. Physical examination revealed a hernia approximately 20 cm long and 15 cm wide on the ventral aspect of the abdomen. Ultrasonography revealed the dimensions of the hernia ring to be approximately 15 cm in length and 10 cm in width. A single‐port laparoscopic incisional hernia repair using an operating 0° laparoscope was performed with an appropriately sized (24 × 18 cm) piece of mesh fixed in place with simple interrupted transabdominal sutures. At 4 weeks post operatively, follow‐up physical examination and ultrasonography confirmed healing of the surgical site with no evidence of hernia recurrence. The same evaluation was done 6 months post operatively, and the horse returned to its previous level of activity 8 months post operatively. In horses, laparoscopic application of mesh should be considered among the treatment options for incisional hernia. In the present case, this technique was performed with a single port using an operative laparoscope, in contrast to the multiportal techniques reported previously. The case presented here demonstrates that single‐port laparoscopic herniorrhaphy is feasible, and allows proper placement of an expanded polytetrafluoroethylene intraperitoneal mesh in horses     

Surgical repair of a chronic,oronasal fistula in a horse using an alveolar bone flap

An 8‐year‐old Andalusian stallion was presented to the Equine Hospital with a 1.5 year history of an oronasal fistula measuring approximately 2 cm long (caudal to rostral) by 1.5 cm wide following an oral extraction of the right second maxillary premolar (106). An alveolar bone flap was created adjacent to the oronasal fistula and rotated axially and ventrally to close the oral aspect of the fistula. At 3 days after surgery, clinical signs of the fistula, such as green‐tinged purulent nasal discharge and malodorous breath, were no longer evident. At 10 days after surgery, the oral opening of the fistula filled with granulation tissue and mucosa and decreased in size to less than 2 ml. The horse was fed a pelleted mash and grass diet and the small fistula was flushed orally twice daily until it completely healed. At 6 months following surgery, the fistula had completely healed. Few options are available for repairing an oroantral or an oronasal fistula in horses. This case report suggests that a large, chronic oronasal fistula involving the alveolus of a maxillary second premolar can be repaired successfully with an alveolar bone flap.     

Ceftiofur Side Effect in a Mare–Case Report

Adverse drug reactions in horses are rare. The antimicrobials are in the list of the most common drugs associated with reaction in horses. The aim of this report is to describe the clinical presentation of an adverse drug reaction after the intramuscular administration of ceftiofur hydrochloride. A 5-year-old crioulo broodmare at one day postpartum presented signs of difficulty to walk, positive pulse in the four limbs, and heart rate of 80 beats per minute (bpm), with a history of fighting with another mare. The clinical suspicions were rhabdomyolysis and laminitis. Initially a dose of flunixin meglumine was administrated intravenous to prevent an endotoxemia. On the same day, the blood collection showed an elevated number of white blood cells, predominantly neutrophils and monocytes. An antimicrobial treatment with ceftiofur hydrochloride at a dose of 2.2 mg/kg intramuscular was applied. At the first day, the mare does not show signs of drug side effect. However, 24 hours later, in the second application, the patient presents incoordination, dizziness, and loss of equilibrium. At the same time, dexamethasone was administrated. The signs were reverted, and the mare was normal after the reaction. The treatment with ceftiofur was changed to enrofloxacin, and the animal had a complete recovery. These drug reactions are not common in the routine of equine clinical practitioners, but they cause a great preoccupation for the owner and the veterinarian.     

Vestibulovaginal leiomyosarcoma in a mare

A 14-year-old Quarter Horse mare presented for a mass within the vestibule and vagina resulting in external compression and incomplete occlusion at the external urethral opening with subsequent difficulty urinating. Examination revealed an approximately 15 × 10 cm lobulated mass within the vestibule and caudal vagina attached via a broad base dorsally. Histopathology of the mass identified a low-grade leiomyosarcoma. Complete resection was not possible, and surgical debulking of the mass was performed during standing sedation using a vessel-sealing and dividing device. The mare was discharged 3 days post-operatively without any complications. Recheck examinations performed at 1 month and 8 months’ post-surgery revealed excellent healing of the surgical site and no apparent tumour regrowth.     

Effects of Topical Application of Misoprostol on Cervical Relaxation in Mares

Mares who have not delivered a foal early in life may experience limitations in cervical relaxation, primarily during oestrus. A closed cervix prevents intrauterine deposition of semen during natural breeding, may delay uterine clearance after insemination leading to intrauterine fluid accumulation in, and subsequent infertility. Therefore, a reliable pharmacological method of dilating the equine cervix would have practical application in veterinary medicine. The goal of this study was to investigate the effectiveness of topically applied, synthetic prostaglandin E₁ analogue (PGE₁) for stimulating dilation of the equine cervix. Ten mares in dioestrus were randomly assigned to one of two treatments in a single‐blind crossover study: (treatment) PGE₁ gel (1000 mcg compounded misoprostol cream) applied topically to the external cervical os (n = 5), and (control) a vehicle cream applied topically to the external cervical os (n = 5). Transrectal palpation and ultrasonographic measurements of the cervix were performed prior to, six and 24 h post‐treatment. Digital measurements were taken, per vagina, at six and 24 h post‐treatment. Mares were monitored through the subsequent oestrous cycle for ovulation. Mares were assigned to the opposite treatment group such that each mare served as her own control (crossover). Data were analysed using parametric (split‐plot anova ), as well as nonparametric (Kruskal–Wallis anova , Wilcoxon's rank‐sum test) methods. At six and 24 h there were no significant differences for tone, length, height, degree of relaxation or echotexture between control and PGE₁ treated groups at the measured time points (p > 0.05). Topical cervical application of PGE₁ did not induce a measurable degree of cervical relaxation under the conditions of this experiment.     

Successful closed reduction of an atlantoaxial luxation in a mature Warmblood horse

A 5‐year‐old Warmblood mare was presented to the clinic 8 h after being found by the owners with luxation of the second cervical vertebra. Clinically, the horse showed an extended posture and reduced movement of the head and neck. A defined lateral swelling of the neck at the level of the first cervical vertebrae was evident. Successful reduction was achieved with the horse under general anaesthesia in lateral recumbency using an electrically powered hand pallet truck. The mare showed no neurological disorders before or after reduction. Seven months after the incident the mare could be ridden and exhibited no functional abnormalities relating to the neck.