The Reliability of Endoscopic Examination in Assessment of Arytenoid Cartilage Movement in Horses Part I: Subjective and Objective Laryngeal Evaluation

Videorecordings of the laryngeal activity of 108 unsedated horses were obtained at rest by passing a flexible videoendoscope into the nasopharynx through the right ventral meatus. All videotaped images were reviewed once, and 72 were reviewed twice, by three veterinarians. Laryngeal cartilage movement was assessed subjectively with a five-tier grading system. The mean intraobserver agreement was 83.3% (range, 75.0%-90.2%) with a kappa statistic of .65 to .98. The mean interobserver agreement was 79.0% (range, 70.4%-80.6%) with a kappa statistic of .51 to .90. A computer program was developed to measure the left:right ratio of the rima glottidis. The mean left:right ratio for horses assigned a median laryngeal grade of I was 0.84 (range, 0.55-1.03); for grade II, 0.82 (0.50-1.12); for grade III, 0.59 (0.39-0.91); and for grade IV, 0.24 (0.07-0.35).     

Craniolateral Approach to the Humerus with Transection of the Brachialis Muscle

Six fractures of the midshaft or distal third of the humerus were repaired through a modified craniolateral approach in which the brachialis muscle was transected rather than retracted to improve exposure of the bone. The approach simplified fracture reduction and fixation. Normal fracture healing and excellent limb function resulted in each case.     

COMPUTED TOMOGRAPHY OF THE PHARYNX IN A CLOSED VS. OPEN MOUTH POSITION

The pharynx is anatomically complex and evaluation can be difficult even with cross‐sectional imaging. Eight animals had computed tomography (CT) studies of the head performed with the mouth open and closed. The studies were anonymized and evaluated by four radiologists for visibility of six anatomic regions (dorsal wall of nasopharynx, lumen of nasopharynx, dorsal margin of the soft palate, ventral margin of the soft palate, oropharynx, and laryngopharynx) and for certainty of a normal or abnormal diagnosis of four different anatomic regions (nasopharynx, soft palate, oropharynx, and laryngopharynx). Mean visual scores differed significantly between mouth positions and were improved when the mouth was open. The ability of radiologists to classify anatomic regions as normal or abnormal vs. unsure also varied between mouth positions, and there was greater uncertainty when the mouth was closed. In addition, estimated volume of the air‐filled nasopharynx differed significantly as a function of mouth position and was greater when the mouth was open (mean=1.187 cm³, SE=0.177) vs. closed (mean=0.584 cm³, SE=0.116). Computed tomographic evaluation of the pharynx can be improved with the mouth open.     

Arterial Grafting in the Horse An Experimental Study

The feasibility of repairing an arterial defect with a graft was evaluated in the horse. Arterial autografts, venous autografts, and expanded polytetrafluoroethylene (PTFE) vascular prostheses were used. Four 3 cm grafts of each type were used to replace a 3 cm section of medial palmar artery that had been removed from 12 forelimbs of 11 horses. Patency was assessed by arteriography performed 30 days after the grafting procedure. All four arterial autografts, one of four venous autografts, and two of four PTFE grafts were patent at 30 days. Thrombosis caused the failure of one venous autograft and two PTFE grafts. Fibrous replacement caused the failure of two venous autografts. Results indicate that arterial grafting is feasible in the horse.     

Effect of Four Antimicrobial Lavage Solutions on the Tarsocrural Joint of Horses

Three concentrations of povidone-iodine (0.1% w/v, 0.2% w/v, 0.5% w/v) and one concentration of chlorhexidine (0.5% w/v) were selected as antimicrobial joint lavage solutions. Through-and-through joint lavage was performed with one of these antimicrobial solutions on a tarsocrural joint of 12 horses. The contralateral tarsocrural joints (control limbs) were lavaged with a balanced electrolyte solution (BES). The effect of the lavage solution on the joints was evaluated with respect to lameness, foot flight pattern, soreness to joint palpation, articular and periarticular enlargement, and synovial fluid composition on Day 1,4, and 8 postlavage. On Day 8 postlavage, all horses were euthanized and the tarsocrural joints were examined.
All solutions induced a synovitis. Based on clinical assessment, synovial fluid protein levels, color, clarity, mucin clot forming ability, gross appearance of the joint at necropsy, and synovial membrane histologic evaluation, a similar, mild, transient, synovitis was induced by the BES and 0.1% povidone-iodine (PI) solution. The 0.2% PI solution induced a more prolonged neutrophilic response and poorer mucin clot forming ability in the synovial fluid as compared to the BES.
The 0.5% PI and 0.5% chlorhexidine solutions produced severe lameness, soreness to joint palpation, and limb enlargement. The elevated synovial fluid total protein content persisted significantly longer (p < 0.05) than the corresponding control (BES) solution. Histologic evaluation of the synovial membrane confirmed the presence of a moderate to severe neutrophilic synovitis in these treatment groups.     

High-Frequency Ventilation A Review

High-frequency ventilation (HFV) is a form of artificial ventilation that uses higher rates and smaller tidal volumes than those used with conventional mechanical ventilation (intermittent positive pressure ventilation [1PPV]). HFV is divided into three categories based on the rate and type of equipment used: 1) high-frequency positive pressure ventilation administered through a system with low internal compliance having an expiratory valve to maintain positive airway pressure during expiration and rates of 60 to 120/minute; 2) high-frequency jet ventilation delivered through an open system or a system with an expiratory valve at rates of 120 to 400/minute; and 3) high-frequency oscillation using open systems and rates of 400 to 2400/minute. All forms of HFV provide adequate ventilation in normal animals at lower peak and mean airway pressures, resulting in less cardiovascular depression than that associated with 1PPV. HFV provides adequate ventilation with less cardiovascular depression and risk of barotrauma than 1PPV in the presence of pulmonary disease. The exact mechanism of gas exchange during HFV is not clearly understood, but enhanced diffusion as a result of turbulent gas flow appears to be a major factor.     

Full-thickness Thoracic and Abdominal Wall Reconstruction in Dogs Using Carbon/Polycaprolactone Composite

Square 9 × 9 cm full-thickness defects were created in the thoracic wall of five dogs and the abdominal wall of five dogs. The skin was retained. Ten centimeter squares of carbon fabric with a thin polycaprolactone (PCL) lining were sutured into the defects with the PCL lining facing the viscera. The dogs were observed for 5 months. The surgical technique was simple and fast. All implants were well tolerated. Cosmetic results were excellent in nine dogs. One dog (abdominal implant) developed an infection and draining tract, and a second dog (thoracic implant) had a subclinical infection. Thoracic implants caused brief serosanguinous pleural transudate. Mild paradoxical respiratory motion disappeared by 8 weeks. Lungs were radiographically normal. At necropsy, fibrous tissue was present but lacked orientation. Loose adhesions covered 20 to 80% of implant linings. There was no significant difference in ultimate tensile strength of implant/fibrous tissue compared to control abdominal wall. No carbon fragments were observed in lymph nodes. Increased numbers of secondary follicles, plasma cells, eosinophils, and sinus histiocytes in lymph nodes suggested immunologic stimulation of undetermined significance.     

Electroencephalography of Detomidine-Ketamine-Halothane and Detomidine-Ketamine-lsoflurane Anesthetized Horses During Orthopedic Surgery A Comparison

This study was done to compare the electroencephalographic (EEG) response evoked by orthopedic surgery in halothane- and isoflurane-anesthetized horses. Eight horses scheduled for bilateral arthroscopic surgery of the stifle were premedicated with detomidine (20 μg/kg) intravenously and five minutes later induced to anesthesia with ketamine (2.2 mg/kg) intravenously. Anesthesia was maintained with either halothane or isoflurane. Assignment of inhalation anesthetic was done randomly. The multiple of minimal alveolar concentration (MAC) of halothane required for anesthesia was significantly higher than the multiple of MAC of isoflurane (p < .05) required. Total amplitude of the EEG with halothane was smaller than with isoflurane (p < .05), but 13.0 to 32.0 Hz high frequency/0.0 to 3.9 Hz low frequency (|3/A) ratio was greater for halothane (p < .05). Arterial partial pressure of oxygen (PaO₂) was significantly (p < .05) higher with isoflurane than with halothane. The differences in EEG frequency shift observed suggest that isoflurane provided better analgesia than halothane for this group of horses.     

Thiamylal-Sparing Effect of Midazolam for Canine Endotracheal Intubation A Clinical Study of 118 Dogs

One hundred eighteen dogs were studied at three veterinary teaching hospitals after the administration of midazolam (0.1 mg/kg, intravenously [IV]) or a placebo. Midazolam and placebo treatments were randomized and blinded to the investigators. The dose of thiamylal required for tracheal intubation 3 to 5 minutes after midazolam or placebo was calculated. The dose of thiamylal at the three hospitals was 10.6,9.8, and 10.1 mg/kg IV after midazolam, and 12.1,11.2, and 11.6 mg/kg IV after placebo. Pooled data from the three hospitals yielded a significant (p < .001) decrease in mean IV thiamylal dose after midazolam (10.2 mg/kg) compared with placebo (11.6 mg/kg). Overall, there was a 12% decrease in the dose of thiamylal required for tracheal intubation after midazolam compared to that after the placebo. The thiamylal dose was significantly (p < .001) decreased after midazolam compared with placebo for dogs weighing more than 15 kg but not for dogs weighing less than 15 kg.     

In Vitro Comparison of the Three Loop Pulley and Locking Loop Suture Patterns for Repair of Canine Weightbearing Tendons and Collateral Ligaments

Both triceps tendons and the medial collateral ligaments of both stifles of 10 freshly euthanized dogs were sharply transected. One tendon and one ligament of each dog were sutured with a three loop pulley pattern, and the opposite tendons and ligaments were sutured with a locking loop pattern. The tendons and ligaments were harvested with their muscular and bony attachments. The anastomoses were slowly tested in tension until failure occurred. The amount of tensile load required to produce failure of the anastomosis, the amount of distraction of the sutured ends prior to failure, and the modes of failure were recorded. In both tendons and ligaments, the three loop pulley pattern provided significantly greater tensile strength (p < 0.01) and allowed significantly less distraction between the sutured ends (p < 0.01) than the locking loop pattern. In tendons, disruption of the suture material was the most common mode of failure with both patterns. In ligaments, both patterns failed most commonly by pulling free from the tissue.