Ultrasonographic abnormalities detected in the sacroiliac area in twenty cases of upper hindlimb lameness.

REASONS FOR PERFORMING STUDY: The pelvis is covered with extensive musculature and often presents a challenge in diagnostic imaging. Ultrasonography provides diagnostic information about soft tissue, articular cartilage and bone surfaces, although little information exists about the normal ultrasonographic appearance of the equine sacroiliac region. OBJECTIVES: To determine the clinical applicability of ultrasonographic examination in horses with sacroiliac pain. METHODS: Horses presented to the University of Minnesota Veterinary Teaching Hospital for hindlimb lameness were evaluated and lower limb lameness was ruled out with examination and local anaesthesia. Twenty cases were diagnosed with sacroiliac pain, characterised by response to palpation over the tuber sacrale. Seven of the 20 had visible asymmetry of the tuber sacrale. Ultrasonography was performed percutaneously and per rectum. Structures imaged were measured and compared to normal reference measurements. Other methods used to confirm diagnoses included thermography, scintigraphy and radiology. RESULTS: All 20 cases with sacroiliac pain showed ultrasonographic abnormalities of the sacroiliac area. Abnormalities were detected in the dorsal sacroiliac ligaments. Ligament size was significantly different from the normal ranges (P < 0.01). Malalignment of the sacroiliac area and sacral fractures were also imaged. CONCLUSIONS: Ultrasonography of the sacroiliac region aided diagnosis of ligament damage and displacement of bone surfaces; and may aid in monitoring the progression of healing. POTENTIAL RELEVANCE: Diagnostic ultrasound is readily available to most practitioners. Therefore the findings of this study show that diagnosis of sacroiliac injuries is possible in the field.

Detailed ultrasonographic mapping of the pelvis in clinically normal horses and ponies.

OBJECTIVE: To map the equine pelvis using ultrasonography, validated by use of computed tomography (CT), magnetic resonance imaging (MRI), and measurements of frozen cadaver slices. ANIMALS: 6 ponies and 6 horses. PROCEDURE: Ultrasonographic examination of the pelvis was performed on 6 clinically normal ponies. Measurements were obtained for imaged structures. Computed tomography, MRI, and measurements of frozen sections were performed after death and used to verify measurements. Linear regression determined the degree of correlation between measurements obtained ultrasonographically and the other modalities. Six clinically normal horses were then examined by use of ultrasonography. For each structure measured mean, SD, and range were calculated. RESULTS: Data obtained from ponies revealed high correlations between ultrasonographic findings and those of CT, MRI, and frozen section measurements (r2 = 0.97, r2 = 0.99, and r2 = 0.99, respectively). Differences between structures measured on each side of the pelvis were not significant. Variation in size of structures was not associated with weight of horses. A correlation was not found between weight of horses and ponies and size of structure. CONCLUSIONS AND CLINICAL RELEVANCE: Ultrasonography can be used to accurately measure and evaluate the musculoskeletal structures of the pelvis of horses. The use of CT, MRI, and measurements of frozen sections provided a means of validating the ultrasonographic measurements. Reference range values determined in our study can be used to evaluate horses with suspected pelvic disease.

Percutaneous ultrasound-guided pyelography aided diagnosis of ectopic ureter and hydronephrosis in a 3-week-old filly.

Ultrasound-guided percutaneous pyelography has previously been used in dogs to diagnose ectopic ureter. To the authors' knowledge its use has never been reported in the horse. This paper reports the technique used in a three-week-old filly with a suspected ectopic ureter. Pyelography can be performed under sedation and is a relatively simple, safe procedure. The technique enables assessment of individual renal function through collection and analysis of urine from each renal pelvis.

Thoracoscopic-assisted diaphragmatic hernia repair using a thoracic rib resection.

OBJECTIVE: To describe the surgical treatment of a dorsal diaphragmatic hernia in an adult horse using thoracic rib resection aided by thoracoscopy and a flank incision. STUDY DESIGN: Case report. ANIMAL POPULATION: One client-owned horse. RESULTS: A six-year-old Dutch warmblood gelding was admitted for colic-associated colonic incarceration in a diaphragmatic hernia. Seven weeks after the initial colic surgery, the gelding underwent surgery to repair the defect. Thoracoscopy and a flank incision were used to identify the location of the hernia and the subsequent site of rib resection. The stomach was adhered to the edges of the defect, leaving only a small residual hole. Resection of the 14th rib provided excellent exposure of the defect and closure of the remaining hernia. CONCLUSION AND CLINICAL RELEVANCE: Thoracic rib resection can provide access to diaphragmatic hernias in adult horses. Thoracoscopy or a flank incision, or both, may aid in determining which rib is best resected.

Hepatoblastoma with erythrocytosis in a young female horse.

A 2.5-year-old female Thoroughbred was examined because of lethargy, anorexia, and weight loss. Analysis of a CBC revealed erythrocytosis and an increase in PCV. Serum biochemical analysis revealed increases in activities of several hepatic enzymes. Ultrasonography revealed hepatomegaly and a heterogeneous appearance of the hepatic parenchyma. The horse did not improve despite supportive care, and it was euthanatized. Necropsy revealed numerous raised white to gray foci in the liver. Histologically, these foci consisted of neoplastic cells that resembled fetal hepatocytes, embryonal-type cells, and cells with features intermediate between those 2 cell types. Immunohistochemical staining revealed that hepatocytes stained strongly with anti-alpha-fetoprotein. On the basis of these results, hepatoblastoma was diagnosed. Diagnosis of hepatoblastoma is difficult, because it can appear histologically similar to other hepatic tumors, such as hepatocellular carcinomas. Definitive diagnosis requires histologic evaluation of tumor architecture and cell morphology. Immunohistochemical staining for alpha-fetoprotein in tumor cells may serve as a tumor marker but is not pathognomonic of hepatoblastoma. Paraneoplastic syndromes, such as erythrocytosis, can accompany hepatoblastoma. The prognosis for horses with hepatoblastoma is grave.

Evaluation of diagnostic ultrasound as a mass screening technique for the detection of hydatid cysts in the liver and lung of sheep and goats.

Ultrasound examination of the liver and lung followed by post-mortem examination was performed in 16 sheep and 284 goats. Thirty-one (10.3%) were positive for hydatid cysts on ultrasound examination and 46 (15.3%) were positive on post-mortem examination. Twenty-one positive on post-mortem examination were falsely identified as negative on ultrasound examination. Of the 254 animals negative on post-mortem examination, six (2.4%) were falsely identified as positive on ultrasound examination. The sensitivity and specificity of ultrasound examination for detecting hydatid cysts in sheep and goats was 54.36% and 97.64%, respectively (positive predictive value: 80.64%; negative predictive value: 92.19%).