Navicular bone fracture and severe deep digital flexor tendinopathy after palmar digital neurectomy in two horses.

Background: Navicular syndrome is a common cause of forelimb lameness in horses. Beyond changes to the navicular bone itself, horses with a clinical diagnosis of navicular syndrome often have pathology associated with other components of the navicular apparatus, including the navicular bursa, deep digital flexor (DDF) tendon, collateral sesamoidean ligaments, and impar ligament. Palmar digital neurectomy (PDN) is often used as a salvage procedure for horses diagnosed with navicular syndrome that become unresponsive to medical management. There are many potential complications associated with PDN, some of which are debilitating. Case Description: This report describes two cases of navicular bone fracture with severe DDF tendinopathy and distal interphalangeal joint subluxation/hyperextension that occurred 12 and 19 weeks after bilateral forelimb PDN. Conclusion: These two cases highlight the importance of proper patient selection before PDN due to the high incidence of undiagnosed soft tissue pathology in conjunction with radiographic evidence of navicular syndrome. Advanced imaging of the digit is recommended to identify and characterize any soft tissue pathology associated with the navicular apparatus before pursuing PDN to avoid disease progression and catastrophic injury.

Case report: Use of penicillin G potassium in poloxamer 407 gel to aid in healing of an equine sublingual abscess.

The use of poloxamer 407 gels have been reported in several studies to prolong the release of drugs at the injection site. Oral lesions unrelated to dental disease are rare but may result in ulceration and sequestration of bone. To date, there have been no reports on the use of penicillin G potassium poloxamer 407 gel and its effect on wound healing. The present case report describes the use of a penicillin G potassium poloxamer 407 gel for the treatment of a sublingual abscess involving the mandible in a 20 year old Arabian mare who initially presented with acute onset of dysphagia, hypersalivation, and a mass under the tongue. A presumptive diagnosis of lingual cellulitis was made, and a sublingual abscess ruptured on day 7 of hospitalization. In this case, poloxamer 407 gel was used to decrease wound contamination, protect the exposed mandible, and potentially prolong the release of penicillin G potassium into the wound.