Effects of low-level laser therapy on bone healing and signs of pain in dogs following tibial plateau leveling osteotomy.

OBJECTIVE To assess the effect of low-level laser therapy (LLLT) on markers of synovial inflammation and signs of pain, function, bone healing, and osteoarthritis following tibial plateau leveling osteotomy (TPLO) in dogs with spontaneous cranial cruciate ligament rupture (CCLR). ANIMALS 12 client-owned dogs with unilateral CCLR. PROCEDURES All dogs were instrumented with an accelerometer for 2 weeks before and 8 weeks after TPLO. Dogs were randomly assigned to receive LLLT (radiant exposure, 1.5 to 2.25 J/cm2; n = 6) or a control (red light; 6) treatment immediately before and at predetermined times for 8 weeks after TPLO. Owners completed a Canine Brief Pain Inventory weekly for 8 weeks after surgery. Each dog underwent a recheck appointment, which included physical and orthopedic examinations, force plate analysis, radiography and synoviocentesis of the affected joint, and evaluation of lameness and signs of pain, at 2, 4, and 8 weeks after surgery. Select markers of inflammation were quantified in synovial fluid samples. Variables were compared between the 2 groups. RESULTS For the control group, mean ground reaction forces were greater at 2 and 4 weeks after TPLO and owner-assigned pain scores were lower during weeks 1 through 5 after TPLO, compared with corresponding values for the LLLT group. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that the LLLT protocol used had no beneficial effects on signs of pain or pelvic limb function following TPLO. Further research is necessary to evaluate the effects of LLLT and to determine the optimum LLLT protocol for dogs with CCLR.

Treatment of Osteochondrosis Dissecans of the Canine Stifle Using Synthetic Osteochondral Resurfacing.

OBJECTIVE: This article aimed to describe the use and evolution of a synthetic osteochondral resurfacing (SOR) implant in the treatment of osteochondrosis dissecans (OCD) of the femoral condyle and to report the clinical, radiographic, computed tomography and magnetic resonance imaging outcomes of this technique. METHODS: Medical records of dogs that were treated with first-generation (G1) and second-generation (G2) SOR at a single institute were reviewed. Surgical reports and clinical examinations as well as the preoperative, postoperative, and follow-up radiographs, computed tomographic images and magnetic resonance imaging images were reviewed. RESULTS: Fourteen stifles (nine dogs) were included in the study. G1-SOR implants were employed in six stifles of four dogs and G2-SOR implants in eight stifles of five dogs. Osteochondrosis dissecans of the medial femoral condyle was confirmed as the sole pathology in all dogs treated with G1-SOR. Only one of eight OCD lesions was located on the medial condyle in the G2-SOR group with the remaining seven lesions affecting the lateral femoral condyle. At 12 weeks, 13 of 14 stifles displayed implant stability, with no subchondral bone changes or evidence of lucency around any implant. Eight of nine dogs achieved a good-excellent clinical outcome. Complications included one minor surgical site infection and one infective arthritis which required implant removal. CLINICAL SIGNIFICANCE: In this cohort of dogs, both G1-SOR and G2-SOR were successful and repeatable surgical procedures for dogs with OCD of the femoral condyle.

EFFECTS OF IMAGE PLANE, PATIENT POSITIONING, AND FORAMINAL ZONE ON MAGNETIC RESONANCE IMAGING MEASUREMENTS OF CANINE LUMBOSACRAL INTERVERTEBRAL FORAMINA.

Degenerative lumbosacral stenosis has been suspected to have a dynamic component, especially regarding encroachment of the L7 nerve roots exiting the lumbosacral foramina. Angled cross-sectional imaging of the neuroforamina has been found improve the accuracy of the diagnosis of stenosis in humans. In this anatomic study, foraminal apertures were evaluated by MRI at the entry, middle, and exit zones of the nerve roots in 30 dogs that were clinically affected by lumbosacral disease. Standard vs. oblique planar orientation and neutral vs. hyperextended positioning of the lumbosacral area were compared by measuring the median values for entry, middle, and exit zones. The neuroforaminal area acquired using oblique plane acquisition was significantly smaller than standard parasagittal measurements. Furthermore, standard parasagittal neuroforaminal dimensions in the hyperextended position were significantly smaller than standard parasagittal measurements in the neutral position. This statistical difference was even more pronounced for neuroforaminal dimension evaluated in the oblique plane and hyperextended position. Positioning of the dog during imaging has a significant effect on neuroforaminal dimension, corroborating the notion that spinal position may influence neural claudication in clinically affected patients. Reductions in neuroforaminal dimension are more evident on oblique planar image acquisition, suggesting that this approach may be more useful than parasagittal imaging as a tool for identifying subtle changes in L7 neuroforaminal dimensions in cases of canine lumbosacral stenosis.

MEDULLOBLASTOMA IN A GRIZZLY BEAR (URSUS ARCTOS HORRIBLIS).

A 3-yr-old female spayed grizzly bear (Ursus arctos horribilis) was evaluated for seizure activity along with lethargy, inappetence, dull mentation, and aggressive behavior. Magnetic resonance (MR) examination of the brain revealed a contrast-enhanced right cerebellar mass with multifocal smaller nodules located in the left cerebellum, thalamus, hippocampus, and cerebrum with resultant obstructive hydrocephalus. Cerebrospinal fluid analysis revealed mild mononuclear pleocytosis, with differentials including inflammatory versus neoplastic processes. Blood and cerebrospinal fluid were also submitted for polymerase chain reaction and agar gel immunodiffusion to rule out infectious causes of meningitis/encephalitis. While awaiting these results, the bear was placed on steroid and antibiotic therapy. Over the next week, the bear deteriorated; she died 1 wk after MR. A complete postmortem examination, including immunohistochemisty, revealed the cerebellar mass to be a medulloblastoma. This is the only case report, to the authors' knowledge, describing a medulloblastoma in a grizzly bear.

USE OF CONTRAST-ENHANCED COMPUTED TOMOGRAPHY TO STUDY THE CRANIAL MIGRATION OF A LUMBOSACRAL INJECTATE IN CADAVER DOGS.

Volumes used in lumbosacral epidural injections for anesthesia have remained unchanged since the 1960s. The goals of this cross-sectional observational study were to characterize the three-dimensional spread of a lumbosacral epidural injection, as well as confirm that the commonly used volume of 0.2 ml/kg injected into the lumbosacral epidural space reaches the thoracolumbar (TL) junction in the majority (≥80%) of dogs. Ten clinically normal, adult, nonpregnant, mixed-breed dogs were obtained within five minutes of euthanasia and 0.2 ml/kg of radiopaque contrast medium was injected into the lumbosacral epidural space. A computed tomography scan of the TL spine was performed immediately following the injection. Migration of contrast reached the TL junction in 8 of 10 (80%) dogs. Contrast was well visualized in all epidural planes with contrast travelling predominantly in the dorsal epidural space in 7 of 10 (70%) dogs. There was no significant difference in the weight of dogs where the epidural injectate reached the TL junction and those where it did not (P = 0.16), or in the weight of dogs where the cranial-most point of the contrast column was in the dorsal versus the ventral epidural space (P = 0.32). This preliminary study supports the use of computed tomography to characterize injectate distribution in the canine thoracolumbar epidural space and provides evidence that a 0.2-ml/kg volume is likely to reache the TL junction in most dogs. Further studies are needed in live dogs to determine if variables affecting human epidural injectate doses have similar effects in the dog.

Multiple oral carcinomas associated with a novel papillomavirus in a dog.

Papillomaviruses (PVs) are well recognized to cause human oral squamous cell carcinomas (SCCs). However, there is currently little evidence that PVs similarly cause oral cancer in dogs. In the present case, a dog developed an invasive SCC and multiple in situ carcinomas within the mouth. Cell changes consistent with PV infection were prominent within the neoplasms and the surrounding gingiva. Immunohistochemical staining revealed PV antigens and intense p16(CDKN2A) protein (p16) immunostaining within the invasive SCC. Papillomaviral DNA sequences were amplified from the invasive and in situ carcinomas. Sequencing revealed that the DNA was from a novel PV that appears most closely related to canine PV-2 and -7. To the authors' knowledge, multiple carcinomas have not been previously reported in the mouth of a dog. Additionally, the current study describes PV cytopathology in a canine oral SCC. Whether the PV infection influenced neoplasm development cannot be definitively determined in this case. However, the presence of p16 immunostaining and the development of multiple oral carcinomas support a role of the PV in tumorigenesis in this dog.

Bilateral mandibular pyogranulomatous lymphadenitis and pulmonary nodules in a dog with Bartonella henselae bacteremia.

This report describes a 2-year-old collie dog with pulmonary nodules, visualized by computed tomographic (CT) scan, with evidence of Bartonella henselae bacteremia and pyogranulomatous lymphadenitis. Clinical signs resolved with antimicrobial therapy.

Lymphadénite pyogranulomateuse mandibulaire latérale et nodules pulmonaires chez un chien atteint de bactériémie àBartonella henselae. Ce rapport décrit un chien Collie âgé de 2 ans atteint de nodules pulmonaires, visualisés par tomodensitométrie, avec des signes de bactériémie à Bartonella henselae et de lymphadénite pyogranulomateuse. Les signes cliniques se sont résorbés avec un traitement antimicrobien.(Traduit par Isabelle Vallières).

Clinical features and magnetic resonance imaging characteristics of diskospondylitis in dogs: 23 cases (1997-2010).

OBJECTIVE: To describe the signalment, clinical features, and most common MRI characteristics in dogs with diskospondylitis and investigate whether a correlation exists between the degree of spinal cord compression and neurologic status of the patient. DESIGN: Retrospective case series. ANIMALS: 23 dogs. PROCEDURES: The medical records and imaging database of the Veterinary Teaching Hospital at Washington State University were retrospectively cross-referenced for cases of diskospondylitis in dogs from 1997 through 2010. Signalment, clinical signs, MRI characteristics, and results of bacteriologic cultures of urine, blood, CSF, or intervertebral disk material were reviewed. RESULTS: On T2-weighted sequences, vertebral endplates were most often of mixed signal intensity, whereas the vertebral body was hypointense. The intervertebral disk space was most often hyperintense on T2-weighted and short tau inversion recovery sequences and of mixed signal intensity on T1-weighted sequences. Paravertebral soft tissue hyperintensities were noted commonly on T2-weighted and short tau inversion recovery sequences. Heterogenous contrast enhancement of endplates and intervertebral disk spaces also occurred commonly, whereas contrast enhancement of vertebral bodies and paravertebral soft tissues was uncommon. Intramedullary spinal cord intensity was noted at 10 of 27 sites on T2-weighted sequences. Static spinal cord compression occurred in 17 of 23 dogs, and a significant direct correlation was found between the percentage of spinal cord compression and the patient neurologic score. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that diskospondylitis in dogs has a characteristic MRI appearance, and in some patients, MRI may aid in the identification of severe spinal cord compression, which could warrant surgical intervention.

Evaluation of the biliary and brain distribution of technetium Tc 99m sestamibi in healthy dogs with the ABCB1 wildtype genotype before and after treatment with spinosad.

OBJECTIVE: To determine whether the reported drug-drug interaction between the flea medication spinosad and ivermectin is attributable to inhibition of P-glycoprotein by spinosad. ANIMALS: 6 healthy adult dogs with the ABCB1 wildtype genotype. PROCEDURES: The study was conducted as a prospective, masked, randomized crossover design. Six dogs were allocated to 2 groups; each dog served as its own control animal. Dogs in one of the groups received spinosad at the manufacturer's recommended dose; the other group received no treatment. Forty-eight hours later, scintigraphic imaging of the head and abdomen were performed with the radiolabeled P-glycoprotein substrate methoxy-isobutyl-isonitrile (sestamibi) in both groups of dogs. After a washout period of 60 days, the dogs in each group received the alternate treatment, and scintigraphic imaging again was performed 48 hours later. Gallbladder-to-liver and brain-to-neck musculature ratios of technetium Tc 99m sestamibi were calculated for each dog and compared between treatments. RESULTS: No significant differences in gallbladder-to-liver or brain-to-neck musculature ratios were found between treatments. CONCLUSIONS AND CLINICAL RELEVANCE: Results provided evidence that spinosad did not inhibit P-glycoprotein function 48 hours after spinosad was administered at the manufacturer's recommended dose. Further investigations will be necessary to elucidate the mechanism of the reported toxic interaction between spinosad and ivermectin.

Description and validation of a magnetic resonance imaging-guided stereotactic brain biopsy device in the dog.

A stereotactic brain biopsy system that is magnetic resonance (MR) imaging-guided has not been validated in dogs. Our purpose was to determine the mean needle placement error in the caudate nucleus, thalamus, and midbrain of a canine cadaver brain using the modified Brainsight stereotactic system. Relocatable reference markers (fiducial markers) were attached to the cadaver head using a dental bite block. A T1-weighted gradient echo three-dimensional (3D) sequence was acquired using set parameters. Fiducial markers were used to register the head to the acquired MR images in reference to a 3D position sensor. This allowed the planning of trajectory path to brain targets in real time. Coordinates (X, Y, Z) were established for each target and 0.5 microl of diluted gadolinium was injected at each target using a 26-gauge needle to create a lesion. The center of the gadolinium deposition was identified on the postoperative MR images and coordinates (X', Y', Z') were established. The precision of this system in bringing the needle to target (needle placement error) was calculated. Seventeen sites were targeted in the brain. The mean needle placement error for all target sites was 1.79 +/- 0.87 mm. The upper bound of error for this stereotactic system was 3.31 mm. There was no statistically significant relationship between needle placement error and target depth (P = 0.23). The ease of use and precision of this stereotactic system support its development for clinical use in dogs with brain lesions > 3.31 mm.

Combined intramedullary and external skeletal fixation of metatarsal and metacarpal fractures in 12 dogs and 19 cats.

OBJECTIVE: To report surgical technique, clinical experiences, and long-term outcomes of combined intramedullary/external skeletal fixation of metatarsal (MT) and metacarpal (MC) fractures in dogs and cats. STUDY DESIGN: Case series. ANIMALS: Dogs (n = 12); 19 cats. METHODS: Clinical and radiographic records of animals managed by combined intramedullary/external fixation of MT/MC fractures were reviewed. Signalment, fracture configuration, complications, and subjective clinical findings were recorded. Surgical technique involved retrograde intramedullary pin placement into fractured MT/MC bones, and transverse pin placement in the base of the MT/MCs or tarsal/carpal bones. Contoured pin ends were enshrouded dorsally in epoxy resin and implants maintained until fracture union. Postoperative clinical and radiographic reassessment was performed where possible. RESULTS: Small breed dogs (n = 12) and 19 cats were operated. Fixator removal occurred in < 10 weeks in all cases. Complications included synostosis (n = 2), pin tract discharge (7), excessive postoperative swelling (8), skin abrasions from the frame (2), and paw distortion associated with frame impingement (2). Long-term radiography documented degenerative changes associated with MT-phalangeal or MC-phalangeal joints in 2 dogs; 7 cats, but changes were typically graded mild or moderate and affected only 1 or 2 joints. CONCLUSIONS: Combined intramedullary/external fixation of MT/MC fractures is viable, particularly juxta-articular fractures. Pin penetration of MT-phalangeal or MC-phalangeal joints may cause morbidity and requires further study.

Imaging diagnosis-metastatic adrenal pheochromocytoma in a dog.

A 10-year-old Akita mix became acutely paraplegic. Upon magnetic resonance imaging, multiple, slightly T2-hyperintense, T1-isointense extradural masses, relative to spinal cord were found in the vertebral canal. The retroperitoneal masses had mixed T2-signal intensity. The contrast enhancement pattern for the spinal masses was both homogenous and heterogenous. The diagnosis was metastatic pheochromocytoma. Signal intensity of the tumors in this dog was similar to reports of pheochromocytoma in human beings.

Imaging diagnosis--Vertebral canal porcupine quill with presumptive secondary arachnoid diverticulum.

A 3-year-old Gordon Setter developed cervical hyperesthesia and a stiff gait. Upon magnetic resonance (MR) imaging, an arachnoid diverticulum was detected at the C1 level. Upon surgical resection, a porcupine quill was identified within the vertebral canal in the area of the cyst. At a retrospective review of the MR images, the quill appeared as a circular well-demarcated T2-hypointense lesion. Porcupine quill migrations are common in the dog but migration into the central nervous system is rare.

Magnetic resonance imaging findings in horses with recent onset navicular syndrome but without radiographic abnormalities.

Seventy-two horses with recent onset of navicular syndrome and normal radiographs were assessed. Horses underwent magnetic resonance (MR) imaging of both front feet. All abnormalities were characterized and the most severe abnormality identified, if possible. Abnormal signal intensity in the navicular bone was the most severe abnormality in 24 (33%) horses. Pathologic change in the deep digital flexor tendon was the most severe abnormality in 13 (18%) horses. Pathologic change in the collateral sesamoidean ligament was the most severe abnormality in 11 (15%) horses. Pathologic change in the distal sesamoidean impar ligament was the most severe abnormality in seven (10%) horses. Multiple abnormalities were observed in 13 (18%) horses in which an abnormality that was more severe than the others could not be determined. Abnormalities were not observed in the navicular bone or its supporting soft tissues in four (5%) horses. Fifty-six horses had abnormalities that were most severe in one limb; in 52 (93%) horses, the most severe abnormalities were in the foot of the most lame limb. In 7% (4/56) of horses, the most severe findings were in the opposite limb, and in 16 horses, the findings on both limbs were similar. MR imaging is a useful technique for evaluating horses with navicular syndrome and can differentiate between multiple abnormalities. This provides a more specific diagnosis which affects further treatment of the horse. Pathologic changes in different locations in the foot can cause similar clinical signs that, before MR imaging, were categorized as one syndrome.

Lead bullet fragments in venison from rifle-killed deer: potential for human dietary exposure.

Human consumers of wildlife killed with lead ammunition may be exposed to health risks associated with lead ingestion. This hypothesis is based on published studies showing elevated blood lead concentrations in subsistence hunter populations, retention of ammunition residues in the tissues of hunter-killed animals, and systemic, cognitive, and behavioral disorders associated with human lead body burdens once considered safe. Our objective was to determine the incidence and bioavailability of lead bullet fragments in hunter-killed venison, a widely-eaten food among hunters and their families. We radiographed 30 eviscerated carcasses of White-tailed Deer (Odocoileus virginianus) shot by hunters with standard lead-core, copper-jacketed bullets under normal hunting conditions. All carcasses showed metal fragments (geometric mean = 136 fragments, range = 15-409) and widespread fragment dispersion. We took each carcass to a separate meat processor and fluoroscopically scanned the resulting meat packages; fluoroscopy revealed metal fragments in the ground meat packages of 24 (80%) of the 30 deer; 32% of 234 ground meat packages contained at least one fragment. Fragments were identified as lead by ICP in 93% of 27 samples. Isotope ratios of lead in meat matched the ratios of bullets, and differed from background lead in bone. We fed fragment-containing venison to four pigs to test bioavailability; four controls received venison without fragments from the same deer. Mean blood lead concentrations in pigs peaked at 2.29 microg/dL (maximum 3.8 microg/dL) 2 days following ingestion of fragment-containing venison, significantly higher than the 0.63 microg/dL averaged by controls. We conclude that people risk exposure to bioavailable lead from bullet fragments when they eat venison from deer killed with standard lead-based rifle bullets and processed under normal procedures. At risk in the U.S. are some ten million hunters, their families, and low-income beneficiaries of venison donations.

Desmitis of the distal digital annular ligament in seven horses: MRI diagnosis and surgical treatment.

OBJECTIVE: (1) To describe the clinical signs and abnormalities observed on magnetic resonance imaging (MRI) in 7 horses with desmitis of the distal digital annular ligament (DDAL); (2) to describe the normal magnetic resonance (MR) appearance and thickness of the DDAL in health; and (3) to describe a tenoscopic surgical technique for treating horses with desmitis of the DDAL. STUDY DESIGN: Retrospective study. ANIMALS: Horses (n=7) with desmitis of the DDAL. METHODS: MR examinations of 20 sound horses were reviewed to determine the normal appearance of the DDAL. Dimensions obtained from these images were compared with MR findings from 7 horses with DDAL desmitis. Desmitis of the DDAL was treated by tenoscopic surgery and outcome assessed. RESULTS: Horses with DDAL desmitis had lameness (grade 2-3 out of 5) that improved after a palmar digital nerve block. The affected DDAL was enlarged and had an abnormal signal on MR images of the feet. After tenoscopy and DDAL transection, 5 horses returned to athletic performance, including 2 horses that failed to respond to medical treatment and rest before surgery. CONCLUSION: Primary desmitis of the DDAL is a cause of lameness in horses. Transection of the DDAL allowed 5 horses with this injury to return to athletic performance. CLINICAL RELEVANCE: DDAL desmitis should be included in the differential diagnoses of horses with lameness that improves after a palmar digital nerve block but have no abnormalities observed on radiographs of the feet. Tenoscopic surgical transection of the DDAL is an effective treatment for some horses.

Surgical approach for removal of nonarticular base sesamoid fragments of the proximal sesamoid bones in horses.

OBJECTIVES: To describe a surgical approach for the removal of nonarticular base sesamoid fragments in performance horses and to report the outcome. STUDY DESIGN: Retrospective study. ANIMALS: Horses (n=11), 7 months to 10 years of age, with lameness because of nonarticular base sesamoid fragments. METHODS: Lameness was localized to the metacarpophalangeal/metatarsophalangeal region by clinical examination or response to diagnostic local anesthesia. Radiographs confirmed the diagnosis of a nonarticular base sesamoid fragment. Surgical removal was performed with an incision over the base of the affected sesamoid through the digital flexor tendon sheath. After identifying the fragment with the aid of needles, a small vertical incision was made in the straight distal sesamoidean ligament (SDSL) and the fragment was freed from its attachments and removed. Six months convalescence and rehabilitation was prescribed for all horses. RESULTS: Eleven horses had 16 nonarticular fragments of the base of the proximal sesamoid bones. Eleven (69%) fragments occurred in the forelimbs with the right front (82%) and medial sesamoid (73%) more commonly affected. Horses were treated by surgical fragment removal. In horses with follow-up, 9 of 10 returned to their intended use. CONCLUSIONS: Surgical removal of nonarticular base sesamoid fragments can be accomplished through a palmar/plantar approach through the digital flexor tendon sheath and SDSL. This "keyhole" approach minimizes damage to the distal sesamoidean ligament attachments to the sesamoid base and allows some horses to return to their intended use. CLINICAL RELEVANCE: Surgical removal of nonarticular base sesamoid fragments should be considered in horses with performance-limiting lameness as a result of the fragment.

Magnetic resonance imaging features of proximal metacarpal and metatarsal injuries in the horse.

Magnetic resonance (MR) imaging abnormalities in horses with lameness localized to the proximal metacarpal or metatarsal region have not been described. To accomplish that, the medical records of 45 horses evaluated with MR imaging that had lameness localized to either the proximal metacarpal or metatarsal region were reviewed. Abnormalities observed in the proximal suspensory ligament or the accessory ligament of the deep digital flexor tendon included abnormal high signal, enlargement, or alteration in shape. Twenty-three horses had proximal suspensory ligament desmitis (13 hindlimb, 10 forelimb). Sixteen horses had desmitis of the accessory ligament of the deep digital flexor tendon. One horse had desmitis of the proximal suspensory ligament and the accessory ligament of the deep digital flexor tendon on the same limb and one horse had desmitis of the proximal suspensory ligament on one forelimb and desmitis of the accessory ligament of the deep digital flexor tendon on the other forelimb. Four horses did not have abnormalities in the proximal suspensory ligament or accessory ligament of the deep digital flexor tendon. Eighty percent of horses with forelimb proximal suspensory ligament desmitis and 69% of horses with hindlimb proximal suspensory ligament desmitis returned to their intended use. Sixty-three percent of horses with desmitis of the accessory ligament of the deep digital flexor tendon were able to return to their intended use. MR imaging is a valuable diagnostic modality that allows diagnosis of injury in horses with lameness localized to the proximal metacarpal and metatarsal regions. The ability to accurately diagnose the source of lameness is important in selecting treatment that will maximize the chance to return to performance.

Endoscopic removal of a molariform supernumerary intranasal tooth (heterotopic polyodontia) in a horse.

CASE DESCRIPTION: A 3-year-old Thoroughbred mare was evaluated because of abnormal upper respiratory tract sounds (that had become apparent during race training) of 3 to 4 months' duration. CLINICAL FINDINGS: On initial physical evaluation, there were no abnormal findings. During trotting, an abnormal upper airway expiratory sound was audible. Endoscopic examination revealed a small mass protruding into the right ventral nasal meatus. Radiographic images of the skull revealed no abnormal findings. Computed tomography of the head revealed an abnormal structure in the same location as the mass that was observed during endoscopy. The x-ray attenuation of the mass was identical to that of dental tissue. TREATMENT AND OUTCOME: The mass was surgically removed with endoscopic guidance. On gross examination, the excised mass appeared to be a nearly normal molariform tooth. Histologic examination revealed that it was a well-formed tooth, with no other associated cellular populations. The mass was determined to be a molariform supernumerary intranasal tooth. Six months following discharge from the hospital, the trainer reported that the abnormal respiratory tract sound was no longer audible. During a follow-up endoscopic examination performed at the training facility, no abnormalities were detected. CLINICAL RELEVANCE: In horses, an intranasal tooth should be considered as a differential diagnosis for expiratory stridor. Clear definitions of heterotopic polyodontia, dentigerous cyst, and temporal teratoma can be used to clinically diagnose these separate anomalies. In the horse of this report, computed tomographic findings contributed to determination of a diagnosis and formulation of a treatment plan.

Magnetic resonance imaging features of oblique and straight distal sesamoidean desmitis in 27 horses.

Injury to the oblique and straight distal sesamoidean ligaments is becoming recognized as a more common cause of lameness in horses than was previously thought. The purpose of this study was to review the magnetic resonance (MR) imaging findings of 27 horses affected with desmitis of the oblique and/or straight distal sesamoidean ligament and determine long-term prognosis for horses with this diagnosis. Imaging was performed with horses in right lateral recumbency in a high-field 1 T magnet. All horses had lameness localized to the digit or metacarpophalangeal/metatarsophalangeal joint region with diagnostic local anesthetic blocks. Ten horses had forelimb lameness and 17 horses had hind limb lameness. MR imaging revealed abnormalities in the oblique distal sesamoidean ligaments in 18 horses, in the straight distal sesamoidean ligament in three horses, and in both the oblique and straight distal sesamoidean ligament in six horses. Treatment consisted of a 6-month rest and rehabilitation program in all horses. The digital flexor tendon sheath was injected with methylprednisolone acetate and hyaluronic acid in 22 horses to decrease inflammation in the injured ligaments before starting the rest and rehabilitation program. Two horses had ligament splitting performed, one in the oblique distal sesamoidean ligament and one in the straight distal sesamoidean ligament. MR imaging is an effective method for diagnosing injury to the oblique and straight distal sesamoidean ligaments in horses. Treatment, primarily a 6-month rest and rehabilitation program, allowed 76% of the horses to successfully resume performance.