Use of quantitative analysis of sonographic brightness for detection of early healing of tendon injury in horses

OBJECTIVES: To determine whether quantitative analysis of sonographic brightness could be used to detect healing of an induced injury of the superficial digital flexor tendon in horses and whether rate of healing was influenced by equine recombinant growth hormone. ANIMALS: 8 clinically normal Standardbreds. PROCEDURES: A localized injury was created in the left and right superficial digital flexor tendons of each horse by injection of 2,000 units of collagenase. After injury, 4 horses received equine recombinant growth hormone, a possible promoter of tendon healing. Sonographic images (7.5 MHz) of the flexor tendons and ligaments of the metacarpal region were recorded on videotape prior to injury and weekly for 7 weeks after injury. Images were digitized, and sonographic brightness of tendons and ligaments was calculated. RESULTS: Collagenase-induced injury was sonographically similar to naturally occurring injury. After injury, sonographic brightness of the tendon decreased; after 3 weeks, brightness progressively increased, although by 7 weeks brightness had not returned to preinjury value. Equine recombinant growth hormone had no significant effect on the rate of tendon healing, as evaluated sonographically or at necropsy. CONCLUSIONS AND CLINICAL RELEVANCE: As healing developed, alterations in sonographic brightness of injured tendons coincided with real changes in tendon structure. Quantitative sonographic brightness could be used to accurately monitor healing of equine tendon and ligament injuries and investigate the efficacy of various treatment regimens.     

Evaluation of high-speed treadmill videoendoscopy for diagnosis of upper respiratory tract dysfunction in horses

OBJECTIVE: To evaluate high-speed treadmill videoendoscopy as a diagnostic technique and document the abnormalities found in Australian horses referred for poor performance associated with abnormal upper respiratory tract noise but where a definitive diagnosis could not be made at rest. DESIGN: A retrospective clinical study using client-owned horses. PROCEDURE: The clinical records and videorecordings of all horses referred to the University of Sydney for poor performance associated with abnormal upper respiratory tract noise during a 13-month period were examined. Only horses with a normal physical examination including absence of lameness, and where a definitive diagnosis of the cause of the abnormal upper respiratory tract noise could not be made from the resting videoendoscopic examination were included in the study. The age, gender, breed of horse and the purpose for which the horse was used were ascertained from the record and videorecordings were reviewed by the authors and any abnormalities noted. RESULTS: There were 37 horses included in the study. An upper airway abnormality was identified during high-speed treadmill videoendoscopy in 73% of horses. One abnormality was identified in 22 horses, 2 abnormalities in 4 horses and 3 abnormalities in 1 horse. Abnormalities identified included laryngeal hemiparesis (n = 15), axial deviation of the aryepiglottic folds (n = 10), pharyngeal collapse (n = 3), dorsal displacement of the soft palate (n = 2), epiglottic collapse (n = 1), axial deviation of the vocal cord (n = 1) and laryngeal collapse (n = 1). CONCLUSIONS: The results of this study are similar to reports from overseas and suggest high-speed treadmill videoendoscopy appears to be a useful technique to diagnose the cause of upper airway dysfunction in Australian horses referred specifically for poor performance associated with abnormal upper respiratory noise. However, a diagnosis will not be made in all horses undergoing this procedure. There were five horses with two or three abnormalities none of which were apparent at rest. This would suggest that in all horses making abnormal upper respiratory noise associated with poor performance, even where an abnormality is identified at rest, high-speed treadmill videoendoscopy should be performed for a complete diagnosis.     

A case-control study of respiratory disease in Thoroughbred racehorses in Sydney, Australia

In order to investigate the role of infectious agents in the aetiology of lower respiratory tract disease in Thoroughbred racehorses, a matched case-control study was conducted. Cases were identified by the presence of coughing, and were compared to a control population matched on time of sample collection and location within the same training establishment. Tracheal wash samples were collected from 100 cases and 148 controls. Case horses were more likely than controls to have endoscopic and cytological evidence of airway inflammation. There was no significant association between serological evidence of infection by commonly implicated respiratory viruses and coughing. Similarly, mycoplasma were rarely isolated and were not associated with disease. In contrast, there was a strong association between isolation of greater than a total of 10(3) colony-forming units/ml of tracheal wash and coughing. Individual bacterial species associated with disease included Streptococcus zooepidemicus, Streptococcus pneumoniae, Streptococcus suis, Streptococcus sanguis, Pasteurella spp and Bordetella bronchiseptica. This study provides evidence of the role of bacterial infection in the aetiology of lower respiratory tract inflammation in racehorses. However, in 58% of cases, few or no bacteria were isolated. Hence, at the time of identification of disease, there was no evidence of viral, bacterial or mycoplasmal infection in the majority of coughing horses. The aetiology of the signs observed in these horses requires further investigation.     

Peritonitis associated with Actinobacillus equuli in horses: 51 cases

OBJECTIVE: To review the clinical findings, diagnosis and treatment of 51 horses with peritonitis attributed to Actinobacillus equuli. DESIGN: Retrospective study of clinical cases. METHODS: Breed, age and gender of horse, history, physical examination findings, treatment and outcome were determined from the hospital records of 51 horses in which a diagnosis of peritonitis attributed to A. equuli was made between January 1993 and June 1999. Results of abdominal fluid cytology and bacteriology, antimicrobial sensitivity patterns, haematology and faecal egg counts, when performed, were also retrieved. RESULTS: There was a variety of breeds of horses affected. There were 35 male and 17 female horses, aged from 9 months to 22 years, presented. Lethargy, signs of depression with mild to moderate signs of abdominal pain and inappetence were the most common reasons for presentation. Most horses had elevated heart and respiratory rates, an elevated rectal temperature and reduced intestinal borborygmi heard on auscultation of the abdomen. Abnormal colour with an elevated protein were features of an abdominal fluid sample in 98% of horses and a marked elevation in nucleated cell count was present in all samples. Pleomorphic gram-negative rods were seen on cytology in 53% of samples and a positive culture of A. equuli was returned in 72% of samples. Other laboratory findings in some horses included mild haemoconcentration, hypoproteinaemia, an elevated circulating nucleated cell count with a left shift, an elevation in fibrinogen concentration and an elevated faecal egg count. All horses demonstrated a rapid response to treatment with procaine penicillin alone, or a combination of procaine penicillin and gentamicin sulphate. Where antimicrobial sensitivity tests were performed, all but two isolates were sensitive to procaine penicillin. All horses responded to antimicrobial and supportive therapy and were discharged from hospital. CONCLUSION: Horses with A. equuli peritonitis present with similar clinical signs as horses with other causes of abdominal pain. However, these signs, when evaluated in conjunction with the results of abdominal fluid analysis and response to treatment, are characteristic of A. equuli peritonitis. Pleomorphic gram-negative bacteria may be seen on a cytological preparation of the abdominal fluid sample, and a positive bacterial culture may be obtained in some, but not all, cases. Most isolates are sensitive to procaine penicillin, so treatment with procaine penicillin and gentamicin sulphate is recommended until antimicrobial sensitivity is known.     

Surgical correction of carpal valgus deformity in three alpacas

Two alpaca crias and one 14-month-old alpaca were referred for treatment of bilateral carpal valgus. In one cria, hemi-circumferential periosteal transection and elevation combined with an ulna osteotomy was performed initially without success, however transphyseal bridging with screws and wires was used successfully in both crias to straighten the limbs. As the distal radial and ulna growth plates had closed in the 14-month-old alpaca, bilateral wedge ostectomies of the distal radius and transfixation casts were used to straighten and stabilise the limbs. The ostectomy sites healed and the alpaca is ambulatory, although carpal flexion is significantly reduced. Until the relationship between the growth rate of crias and the success of hemicircumferential periosteal transection and elevation and ulna osteotomy is established, transphyseal bridging may provide a more reliable result in crias with carpal valgus deformity and open physes. Wedge ostectomy and application of a transfixation cast can be used to correct severe carpal valgus deformities in alpacas with closed physes.     

Prevalence and demographic characteristics of exertional rhabdomyolysis in horses in Australia

The proportion of the horses, of both sexes and of different ages, breeds and levels of activity, owned by a stratified random sample of Australian owners, which had suffered one or more episodes of exertional rhabdomyolysis during the previous 12 months was determined. The proportion in the general population was 1.9 per cent, and horses which exercised were significantly more likely to have experienced the condition than horses which did not. There were significant differences between the sexes and between certain breeds and activity groups in the proportions of horses affected.     

Pathophysiological and immune cell responses in calves prior to and following lung challenge with formalin-killed Pasteurella multocida biotype A:3 and protection studies involving subsequent homologous live challenge

Pneumonic pasteurellosis is a common respiratory infection in cattle that has major economic and welfare implications world-wide and the incidence in the UK due to Pasteurella multocida, currently the same as that associated with Mannheimia haemolytica, is increasing. Whereas much is known regarding the pathogenesis of M. haemolytica infections little information is available on the pathogenic process of pasteurellosis initiated by P. multocida. In the present work calf systemic and innate immune responses to intratracheal challenge with formalin-killed P. multocida biotype A:3 and to subsequent experimental lung infection with live P. multocida were investigated. Eight-week-old calves were challenged intratracheally on day 0 with either 10⁹ colony forming units (cfu) of formalin-killed P. multocida biotype A:3 in 300 ml saline (n=10) or 300 ml saline alone (n=10), followed, at day 21, by challenge with 10⁹ cfu live P. multocida. Pathophysiological and lung phagocyte responses were assessed by clinical monitoring, sequential lung lavage and blood sampling. Results for samples obtained before, during and after challenge showed clinical and acute phase protein responses to both bacterial culture and saline control treatments, although higher responses were associated with bacterial challenge. Phagocytosis of P. multocida during 1 h incubation periods with lavaged cells in vitro was unaffected by exposure in vivo to killed P. multocida and there was evidence that P. multocida was able to survive intracellularly during this assay. There was no indication that lung exposure to formalin-killed P. multocida conferred protection against subsequent homologous live challenge.     

Transnasal laryngoscopy for the diagnosis of laryngeal paralysis in dogs

Four dogs with clinical signs of laryngeal paralysis and three normal dogs were evaluated with transnasal laryngoscopy. Six of these dogs subsequently underwent standard laryngoscopy. For transnasal laryngoscopy, a video endoscope was passed through the left nasal passage after intramuscular sedation and topical anesthesia. The laryngeal opening was observed during spontaneous ventilation. Laryngeal paralysis was diagnosed in four dogs and was confirmed with traditional laryngoscopy in three dogs. Normal motion of the arytenoid cartilages was present in the other three dogs; however, two required mechanical stimulation of the laryngeal mucosa for full evaluation. Transnasal laryngoscopy provided a means for diagnosing laryngeal paralysis in dogs without general anesthesia.     

Surgical treatment of tarsometatarsal joint luxation in a miniature horse foal

A 2-week-old Miniature Horse foal was referred for evaluation and treatment of a luxated right tarsometatarsal joint. Treatment consisted of closed reduction and internal fixation using two partially threaded Steinmann pins placed in normograde fashion through the tuber calcis into the proximal third metatarsus. Traumatic luxation has been reported to occur in the tarsocrural, proximal intertarsal and tarsometatarsal joints within the equine tarsus. Treatment for luxation of the distal intertarsal joint has not been documented. The treatment method most commonly suggested for tarsal luxation is closed reduction and cast immobilisation. Internal fixation using lag screws and plating has also been described. A combination of internal fixation and external coaptation is thought to achieve maximal stability and allow faster convalescence in cases of tarsal luxation. This case report describes for the first time a technique using two Steinmann pins to achieve successful internal fixation of a traumatic tarsometatarsal joint luxation in a 2-week-old Miniature Horse foal.     

Superficial digital flexor tendonitis in the horse

The superficial digital flexor tendon (SDFT) is an elastic structure that during maximal exercise appears to operate close to its functional limits. The biomechanical and biochemical responses to exercise, injury, and healing are still poorly understood but ongoing research is providing valuable new information which is addressed in this review. It appears that the SDFT matures early, after which time it has limited ability to adapt to stress and undergoes progressive degeneration. Focal hypocellularity, collagen fibril degeneration, selective fibril loading and alterations in the noncollagenous matrix occur primarily within the central core region of the midmetacarpal segment. Current treatment strategies have had equivocal results in returning animals to optimal athletic activity. To date it would seem that progressive rehabilitation programmes coupled with regular ultrasonographic evaluations are a cost-effective and comparable strategy when compared to surgical treatment methods. Recent interest in pharmacological modulation of intrinsic healing of collagenous structures has led to the investigation of various growth factors as potential therapeutic aids in the healing of tendon injuries. However, one of the major goals in tendon research, and one which holds the most optimism for success in the immediate future, is the prevention of tendon injuries.