Evaluation of ethyl alcohol for use in a minimally invasive technique for equine proximal interphalangeal joint arthrodesis

Objective: To determine whether intra‐articular 70% ethyl alcohol alone (IAEA) or in combination with 2 percutaneously placed transarticular lag screws (EA‐TLS) would result in arthrodesis of the equine proximal interphalangeal (PIP) joint. Study Design: Experimental. Animals: Healthy horses (n=6), aged 1.5–3 years, free of lameness, diagonally paired front and hind PIP joints. Methods: Six milliliters 70% ethyl alcohol was injected into randomly selected diagonally paired front and hind PIP joints. Thirty days later, 2 parallel 5.5 mm cortical screws were inserted in lag fashion across the hind PIP joints and the limbs were cast. Horses were confined for 60 days after surgery before free exercise was permitted. Serial lameness examinations were performed at 1, 6, and 10 months. Radiographs of the PIP joints were obtained before injection with alcohol (front, hind PIP joints), at 6 and 10 months (front PIP joints) and 1, 3, 6, and 10 months (hind PIP joints). At 10 months, horses were euthanatized and gross and histopathologic examination of the treated joints was performed. Results: Horses had variable cartilage thinning (more severe in hind PIP joints) and dorsal bone proliferation. One front and 1 hind PIP joint were fused 10 months after alcohol injection. Conclusions: Ethyl alcohol injected alone or in combination with percutaneously placed transarticular lag screws failed to reliably produce fusion of the PIP joint.     

Growth characteristics of fibroblasts isolated from the trunk and distal aspect of the limb of horses and ponies

OBJECTIVE: To determine if there is a difference in in vitro growth of fibroblasts isolated from the trunk and distal aspect of the limb of horses and ponies. To determine the effects of a corticosteroid and monokine on in vitro growth of fibroblasts isolated from the trunk and distal aspect of the limb of horses and ponies. STUDY DESIGN: Growth of fibroblasts from tissues harvested from the trunk and limb were compared from horse and pony samples grown in control media and control media with triamcinolone or monokine added. ANIMALS OR SAMPLE POPULATION: Dermal and subcutaneous tissue from 22 horses and 17 ponies of various ages and breeds. METHODS: Fibroblast growth was assessed by tritiated thymidine uptake using standard cell culture techniques. The effect of a monokine or triamcinolone plus control media were compared with control media for fibroblast growth. RESULTS: Fibroblast growth from tissues isolated from the horse limb was significantly less than growth from the horse trunk and the limb and trunk of ponies. Monokine was more effective than triamcinolone in suppressing fibroblast growth from tissues isolated from the trunk and limb in both horses and ponies. CONCLUSIONS: There are growth differences in fibroblasts isolated from the limb of horses compared with those isolated from the trunk and from the limb and trunk of ponies. CLINICAL RELEVANCE: The difference in fibroblast growth from tissues isolated from the trunk and limb of horses and ponies may provide evidence for the difference reported in the healing characteristics of limb wounds in horses and ponies. Influencing fibroblast growth may provide a key to controlling the development of exuberant granulation tissue in horses and ponies.     

An in vitro biomechanical comparison of the breaking strength and stiffness of polydioxanone (sizes 2, 7) and polyglactin 910 (sizes 3, 6) in the equine linea alba

OBJECTIVE: To determine failure strength, stiffness, and failure mode of 4 suture materials in equine linea alba. STUDY DESIGN: Randomized complete block design. SAMPLE POPULATION: Linea albas collected from 12 adult horses (mean weight, 475 kg; mean age, 10 years). METHODS: The ventral abdominal fascia, including the linea alba, was collected and bisected along the linea alba into right and left halves. Each half was divided into four, 5-cm sections extending from the umbilicus cranially, and randomly assigned to 1 of 4 suture materials: 2 polydioxanone (2 PD), 3 polyglactin 910 (3 PG), 6 polyglactin 910 (6 PG), and 7 polydioxanone (7 PD). A single cycle to failure test was performed on each specimen at a distraction rate of 100 mm/min. Differences in failure strength and stiffness for the materials were evaluated using a mixed linear model with significance set at P<.05. RESULTS: In 94 of 96 test sections, constructs failed by suture failure. There were significant differences in failure strength (P<.0001) and stiffness (P<.001) among the suture/tissue constructs. 7 PD had the highest breaking strength (316.8 N) followed by 6 PG (281.3 N), 3 PG (229.9 N), and 2 PD (193.0 N). Six PG had the largest stiffness (14 N/mm) followed by 3 PG (12.7 N/mm), 7 PD (10.1 N/mm), and 2 PD (7.2 N/mm). Suture breaking strength and stiffness were not affected by linea or fascia thickness, individual horse, half of the linea alba, or abdominal wall position. Eighty-five (90.4%) suture loops failed adjacent the knot. CONCLUSIONS: When tested in single cycle to failure, suture material was more likely to fail than the linea alba. Larger suture materials had higher breaking strengths than smaller suture materials and stiffness was also affected by suture material and size. CLINICAL RELEVANCE: Given its high initial breaking strength and its relatively longer in vivo strength retention, 7 PD seems an appropriate choice of suture material for closure of the equine linea alba when maximal short-term failure strength is desired.     

Equine amnionitis and fetal loss: The case definition for an unrecognised cause of abortion in mares

A series of abortions occurred in mares in New South Wales during 2004 that involved similar and unusual findings on post mortem examination of aborted fetuses and fetal membranes. The term Equine Amnionitis and Fetal Loss (EAFL) was developed to describe the condition. This form of abortion had not been previously recognised in Australia. The pathology alone is not specific for EAFL and diagnosis requires demonstration of a combination of certain pathological and bacteriological features. The purpose of this paper is to describe patterns considered consistent with EAFL cases as a working case definition for use by veterinarians and veterinary pathologists in identifying future cases of EAFL. More detailed papers are in preparation to fully describe the epidemiological, histopathological, and microbiological aspects of EAFL.     

Anesthesia for patients with severe systemic debilitation.

Any patient presenting for anesthesia and surgery who has a severe debilitating problem is at great risk for a prolonged recovery, renal failure, or hypotension. A stable hemodynamic state should be maintained. Fluid homeostasis should be ensured. Anesthetic induction techniques using narcotics and benzodiazepines are my preferred approach, with maintenance of anesthesia incorporating isoflurane, narcotics, or both or the use of regional anesthesia.     

Diet-induced alterations in progesterone clearance appear to be mediated by insulin signaling in hepatocytes

Factors that affect progesterone clearance from plasma and by hepatocytes in culture were examined in a series of experiments. In Exp. 1, the objective was to determine whether an increase in hepatic portal blood acetate or propionate could alter progesterone metabolism by the liver. For ewe lambs gavaged orally with sodium propionate compared with those gavaged orally with sodium acetate, serum progesterone concentrations began to diverge as early as 0.5 h after administration and were greater (P < 0.05) at 3 and 4 h after administration. The objective of Exp. 2 was to determine the effect of a single oral gavage of either sodium acetate or sodium propionate on peripheral insulin and glucagon concentrations. Ewes gavaged orally with sodium propionate had greater (P < 0.05) insulin concentrations at 0.5 and 1 h after gavage than ewes gavaged with sodium acetate. Furthermore, glucagon concentrations were greater (P < 0.05) at 0.5, 1, and 2 h for ewe lambs gavaged orally with sodium propionate compared with those receiving sodium acetate. The third experiment investigated the rate of in vitro progesterone clearance by cultured hepatocytes in response to treatment with different concentrations of insulin and glucagon. Progesterone clearance was reduced (P < 0.05) with the addition of 0.1 nM insulin compared with the control. Furthermore, there was a greater reduction (P < 0.05) in progesterone clearance in response to 1.0 and 10 nM insulin compared with the control and 0.1 nM insulin. No change was observed in progesterone clearance in hepatocytes treated with either physiological (0.01 and 0.1 nM) or supraphysiological (1.0 nM) glucagon. Supraphysiological concentrations of glucagon (1.0 nM) negated the effects of either 0.1 or 1.0 nM insulin on progesterone clearance by hepatocytes. However, with physiological concentrations of glucagon (0.1 nM) and 1.0 nM insulin, glucagon was not able to negate the reduction in progesterone clearance caused by insulin. These data are consistent with a paradigm in which elevated hepatic portal vein propionate increases plasma insulin in ruminants, which decreases progesterone clearance, thereby increasing serum progesterone concentrations.     

Assessment of mild hindlimb lameness during over ground locomotion using linear discriminant analysis of inertial sensor data

REASONS FOR PERFORMING STUDY: Hindlimb lameness is common and can be difficult to diagnose or quantify in evaluating response to nerve blocks. An objective measure of lameness can also be used to evaluate the effectiveness of the treatment's contribution to evidence-based medicine. The inertial sensor system can be used to capture 6 degree of freedom movement during over ground locomotion and here was used to quantify tuber coxae movement in nonlame and lame horses. HYPOTHESIS: Tuber coxae movement is useful for discriminating between nonlame and lame horses. OBJECTIVES: To measure left and right tuber coxae movement in lame and nonlame horses during over ground locomotion and to implement a linear discriminant analysis to discriminate between lame and nonlame horses. METHODS: Two inertial sensors were attached to the skin over left and right tuber coxae of 21 horses (9 mildly and 12 not lame). Horses were trotted on a hard surface. A total of 1021 strides were collected. For each stride 34 features were extracted from the dorsoventral and craniocaudal movement and used in 2 different classification scenarios (lame vs. nonlame or left lame, right lame and nonlame) using linear discriminant analysis. RESULTS: Six degree of freedom inertial sensors were successfully used to collect kinematic data continuously from left and right tuber coxae in horses during over ground locomotion. These data were used for an automated classification of lameness. In the first scenario, a sensitivity of 89% was achieved with a specificity of 75%. In the second scenario, all horses could be correctly assigned to the correct class in a simple 3 class reclassification test. POTENTIAL RELEVANCE: A mobile system that reliably detects and quantifies hindlimb lameness in horses during unconstrained locomotion could be a valuable tool to perform an evidence-based assessment of lameness in horses in a clinical setting, e.g. before and after nerve blocks or before and after surgery.