Use of Intraoperative Ultrasonography to Identify a Cervical Foreign Body A Case Report

Real-time ultrasound was used to identify a foreign-body abscess causing an extraluminal esophageal obstruction in the neck of a horse. Surgical exploration to remove the foreign body and drain the abscess was performed after 2 months of medical management that had failed to resolve the problem. The abscess could not be visualized because there was no draining tract or other localizing sign of inflammation. Ultrasound was used aseptically to guide surgical dissection to the walled off abscess with minimal damage to adjacent vital structures in the surgical field. The signs of esophageal obstruction abated and have not recurred in 15 months.     

lleocolostomy A Technique for Surgical Management of Equine Cecal Impaction

Several surgical alternatives have been described for the management of cecal impaction in the horse, but none has met with consistently successful results. This study was done to evaluate a surgical bypass of the cecum by anastomosis of the ileum to the right ventral colon (ileocolostomy). A ventral midline celiotomy was performed on nine adult ponies (155-350 kg) and a mechanically stapled 10 cm side-to-side ileocolostomy was created. In five ponies a complete cecal bypass (CCB) was created by transecting the ileum distal to the anastomosis. In the other four, an incomplete cecal bypass (ICB) was created with no interruption of the ileum. Six horses with clinical cecal impaction also underwent cecal bypass procedures. Five had a CCB and one had an ICB. All the ponies maintained body weight, had no change in consistency of the feces and had no abdominal pain during the 6 month observation period. At necropsy, the lengths of the lateral cecal band, lateral free band of the colon, and the diameter of the anastomotic stoma were compared to measurements made at surgery. The lateral cecal band length decreased significantly more in the CCB ponies than in the ICB ponies (p = 0.008). The anastomotic stoma diameter was significantly larger in the ICB group than in the CCB group (p = 0.032). Five of the six clinical cases recovered and returned to their previous activity. CCB by an ileocolostomy resulted in removal of the cecum from the functional flow of ingesta without complication in the ponies, and was successful in five clinical cases of cecal impaction.     

Wide Local Excision of Acanthomatous Epulides in the Dog

Twenty-five dogs bearing acanthomatous epulides of the oral cavity underwent tumor resection by wide local excision. The surgical procedures included rostral mandibulectomy, removal of the mandibular body, premaxillectomy, and partial maxillectomy. Postoperative complications were rare, and local recurrence was not encountered in any dogs over periods of 1 to 6 1/2 years (median, 22 months). The authors conclude from the high incidence of local recurrence after simple excision through the tumor margins and the potential for malignant transformation after irradiation that wide surgical resection is the technique of choice for the management of acanthomatous epulis.     

A Muscle Separating Approach to the Equine Shoulder Joint for the Treatment of Osteochondritis Dissecans

A muscle separating approach with tenotomy of the teres minor was used to expose osteochondritis dissecans lesions in the shoulder joints of five horses. Horses selected for surgery were severely lame or had a long history of lameness. Adequate surgical access allowed removal of cartilage flaps, curettage of the subchondral bone, and in one horse, the removal of an osteocartilaginous free body. Surgical wounds healed by primary intention; one horse developed a seroma that was drained. Three of the five horses were clinically sound 3 months following surgery. Two other horses were pasture sound but lame after extensive athletic activity.     

SONOGRAPHIC APPLICATION IN THE DIAGNOSIS OF INTRAABDOMINAL ABSCESS IN THE DOG

The sonographic appearance of intraabdominal abscess, excluding prostatic abscess, is presented. The most common sonographic pattern identified for intraabdominal abscess is an irregularly defined, hypoechoic mass with minimal to no through transmission. Definitive diagnosis of intraabdominal abscess using only sonography is not possible, as variations of this common sonographic pattern are imaged. Sonography is best utilized to scan an animal when there is a high suspicion of intraabdominal abscess with no overt physical or radiographic evidence, and to better characterize intraabdominal masses. Sonography can be used to assist in percutaneous aspiration, catheterization, and intraoperative localization of abscessation.     

The Intercarpal Ligaments of the Equine Midcarpal Joint, Part 3: Clinical Observations in 32 Racing Horses With Midcarpal Joint Disease

Objective— To characterize the clinical features of intercarpal ligament pathology and to determine the relationship among palmar intercarpal ligament tearing, dorsomedial intercarpal ligament (DMICL) hypertrophy, and other intraarticular lesions.
Study Design— Prospective clinical observations.
Animals or Sample Population— Twenty-eight thoroughbred and four standardbred race horses.
Methods— Clinical, radiographic, and arthroscopic examination of 53 midcarpal joints of 32 horses.
Results— Palmar intercarpal ligament tearing was observed in 30 joints of 22 horses. Some tearing of the medial palmar intercarpal ligament (MPICL) was present in 27 joints of 20 horses, and tearing of the lateral palmar intercarpal ligament in 9 joints of 7 horses. There was no correlation between the severity of clinical signs recorded and the degree of MPICL tearing. Joints with grade 2–4 MPICL tearing had significantly less cartilage and bone damage than joints with grade 1 or no ligament damage ( P <.05). There was a significant inverse relationship between the number and size of intra-articular fractures, as assessed radiographically, and ligament damage ( R = -.31). The DMICL was identified in all joints, and in 18 joints the ligament was enlarged. There was a significant correlation between MPICL damage and hypertrophy of the DMICL ( R =.35). There was no correlation between DMICL hypertrophy and articular cartilage damage or subchondral bone damage.
Conclusions— Severe subchondral bone and MPICL damage rarely occur in the same joint and DMICL hypertrophy may be associated with, rather than a cause of, joint disease.
Clinical Relevance— There are no clinical or radiographic findings that will differentiate intercarpal ligament injury from other carpal injuries. Diagnosis is only possible by arthroscopic examination of the midcarpal joint.     

Chemonucleolysis with Collagenase A Radiographic and Pathologic Study in Dogs

Collagenase, a proteolytic enzyme, was injected intradiscally in nine clinically normal, middle-aged beagles. Calcium chloride diluent solution (control), 100 ABC units of collagenase, and 250 ABC units of collagenase, were injected in randomly selected intervertebral discs (T13-L1 to L5-L6). On day 11, the discs injected with collagenase were narrowed radiographically, but there was no significant change in myelograms. Grossly and histologically, there was dissolution of the intervertebral discs, mainly nucleus pulposus, and protrusion of nucleus material in the vertebral body through bony end-plates in discs injected with collagenase. Collagenase chemonucleolysis may be an alternative to spinal surgery for intervertebral disc protrusion in dogs.