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Delivery of mesenchymal stem cells (MSC) via intravascular techniques to treat diffuse and/or inaccessible soft tissue injuries has grown in popularity. The purpose of the current prospective, analytical pilot study was to utilize CT to validate this novel technique and provide additional evidence to support its use for injectate delivery to specific soft tissue structures. Of particular interest was the proximal suspensory ligament, which presents a challenging injection target. Six adult horses without lameness underwent CT of the distal hindlimbs. Scans were obtained prior to ultrasound-guided catheterization of the cranial tibial artery, in addition to early and delayed scans acquired following intra-arterial contrast administration. Region of interest analysis of the superficial and deep digital flexor tendons and suspensory ligament was used to assess contrast enhancement within these structures. Linear mixed models were used to determine statistical significance. Significant (P < 0.05) mean contrast enhancement was seen in all postinjection time points in all soft tissue structures of interest. This indicates that ultrasound-guided injection of the cranial tibial artery results in perfusion of injectate throughout the distal hind limb, including the major soft tissue structures of the metatarsus. This provides further support for this technique as a method of MSC delivery to multifocal or inaccessible injury of these structures, including the proximal suspensory ligament.
Asunto(s)
Enfermedades de los Caballos , Metatarso , Caballos , Animales , Metatarso/diagnóstico por imagen , Arterias Tibiales/diagnóstico por imagen , Proyectos Piloto , Cojera Animal , Ultrasonografía Intervencional/veterinaria , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: To describe the ureteropyeloscopic removal of a nephrolith in a horse. ANIMALS: A 19 year old Hanoverian gelding with history of urolithiasis requiring surgical intervention. STUDY DESIGN: Case report METHODS: The horse presented with signs of abdominal straining and stranguria. A proximal urethral calculus was palpable externally within the perineal urethra. Perineal urethrostomy (PU) at the location of the urethral calculi was performed to remove the urethral obstruction. Left nephrolithiasis was then treated by endoscopic retrieval, inserting the endoscope through the PU. The procedures were performed over 2 consecutive days, with the horse standing and sedated. Medical therapy included antimicrobial and anti-inflammatory treatment. RESULTS: The ureteropyeloscopic removal of a nephrolith from the left renal pelvis was completed. No complications were appreciated following the procedure, and the horse was able to return to athletic activity within 2 weeks. The horse had no further clinical signs referable to urinary dysfunction 7 months later. CONCLUSION: Ureteropyeloscopic removal of a nephrolith from the renal pelvis is technically feasible in the equine patient and preserves function of the affected kidney. The availability of a treatment that maintains renal function is a distinct benefit over unilateral nephrectomy, particularly when treating a condition that frequently involves both kidneys.
Asunto(s)
Enfermedades de los Caballos , Cálculos Renales , Obstrucción Uretral , Urolitiasis , Animales , Enfermedades de los Caballos/cirugía , Caballos , Cálculos Renales/veterinaria , Masculino , Uretra , Obstrucción Uretral/cirugía , Obstrucción Uretral/veterinaria , Urolitiasis/veterinaria , Procedimientos Quirúrgicos Urológicos/veterinariaRESUMEN
OBJECTIVE: To determine the efficacy and dermal tolerance of a novel alcohol-based skin antiseptic (ABSA) in horses. STUDY DESIGN: Experimental study. ANIMAL POPULATION: Systemically healthy horses (n = 25) with no history or clinical signs of skin disease. METHODS: Four clipped sites on the abdomen were randomly assigned to a skin preparation protocol: saline (negative control; NC), chlorhexidine gluconate followed by isopropyl alcohol (positive control; PC), saline followed by the ABSA (ABSA A), or a commercially available horse shampoo followed by the ABSA (ABSA B). Microbiological swabs were obtained from each site and cultured on MacConkey and mannitol salt agar plates. Colony-forming units were counted 18-24 hours later. All sites were scored for signs of skin reaction before, immediately after, 1 hour after, and 24 hours after skin preparation. RESULTS: The PC, ABSA A, and ABSA B methods reduced skin microbial burden compared with the NC method (P < .001), but no difference was detected between antiseptic products. Preparation time did not differ between ABSA A and ABSA B methods (P = 0.108); both were faster than the PC method (P < 0.001 for both). Skin reactions were most abundant 24 hours after skin preparation (30.5%), but there was no significant association with antiseptic used, and no horses required veterinary treatment. CONCLUSION: The ABSA preparations tested in this study were as effective and well tolerated as a chlorhexidine gluconate-based method, but required less time in healthy horses. CLINICAL SIGNIFICANCE: The ABSA tested here provides an efficacious, fast-acting, and well-tolerated alternative to achieve skin antisepsis in healthy horses. These results justify further investigation in clinical cases.
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2-Propanol/farmacología , Antiinfecciosos Locales/farmacología , Clorhexidina/análogos & derivados , Recuento de Colonia Microbiana , Piel/microbiología , Administración Cutánea , Animales , Antiinfecciosos Locales/administración & dosificación , Antiinfecciosos Locales/efectos adversos , Clorhexidina/administración & dosificación , Clorhexidina/efectos adversos , Clorhexidina/farmacología , Fármacos Dermatológicos/administración & dosificación , Fármacos Dermatológicos/efectos adversos , Fármacos Dermatológicos/farmacología , Desinfección/métodos , CaballosRESUMEN
BACKGROUND: Pheochromocytomas have been previously reported in horses, but successful antemortem diagnosis and surgical removal without recurrence of clinical signs have not been described. OBJECTIVE: To report the clinical presentation, diagnostic evaluation, surgical technique, anaesthetic management and post-operative care of a mare diagnosed with pheochromocytoma. STUDY DESIGN: Clinical case report. METHODS: An 18-year-old Quarter Horse mare presented for recurrent episodes of colic, profuse sweating, muscle fasciculations and agitation over a 2-month period. Clinical, clinicopathologic and ultrasonographic (transcutaneous, transrectal) abnormalities were consistent with a unilateral left-sided adrenal mass. Surgical removal of the mass was performed via a trans-costal approach with removal of the 18th rib and retraction of the left kidney to improve exposure. Associated vasculature was ligated, and the adrenal mass was removed and submitted for histopathology and immunohistochemistry. RESULTS: A trans-costal surgical approach provided excellent visualisation of the adrenal mass and allowed for identification and ligation of associated vessels. Total surgical and anaesthesia time were 86 and 114 min, respectively. Several intraoperative (hypertension, tachycardia) and post-operative (colic with tachycardia, tachypnea, large colon pelvic flexure impaction and nasogastric reflux) complications were encountered and managed successfully. Immunohistochemistry demonstrated positive labelling for synaptophysin and chromogranin A, confirming diagnosis of pheochromocytoma. The mare had recovered well at 6-week recheck post-operatively and returned to training at 6 months post-operatively. No further clinical signs consistent with pheochromocytoma have been observed following removal. CONCLUSIONS: The trans-costal approach allowed for surgical removal of a pheochromocytoma in a mare. Surgical removal of adrenal masses in horses may be associated with complications yet was successfully performed without subsequent recurrence of clinical signs associated with tumour presence and return to athletic use in this mare.
RESUMEN
During the stance phase of equine locomotion, ground reaction forces are exerted on the hoof, leading first to rapid deceleration ("braking") and later to acceleration ("propulsion") as the hoof leaves the ground. Excessive hoof deceleration has been identified as a risk factor for musculoskeletal injury and may be influenced by arena surface properties. Therefore, our objective was to evaluate the effect of arena surface type (dirt, synthetic) on hoof translation of the leading and trailing forelimbs during jump takeoff and landing. Solar hoof angle, displacement, velocity, and deceleration were captured using kinematic markers and high-speed video for four horses jumping over a 1.1 m oxer at 12 different arenas (5 dirt, 7 synthetic). Surface vertical impact and horizontal shear properties were measured simultaneously. The effects of surface type (dirt, synthetic), jump phase (takeoff, landing), and limb (leading, trailing) on hoof movement were assessed using ANOVA (p < 0.05), while the relationships of hoof movement with surface mechanical properties were examined with correlation. Slide time (p = 0.032), horizontal velocity of the hoof (p < 0.001), and deceleration (p < 0.001) were greater in the leading limb, suggesting a higher risk of injury to the leading limb when braking. However, surface type and jump phase did not significantly affect deceleration during braking.
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BACKGROUND: Correct diagnosis and characterisation of deep digital flexor tendon (DDFT) lesions in equine athletes allows targeted treatment and improved prognostication. OBJECTIVES: To assess the prevalence and character of pathological change within the DDFT in the pastern with concurrent tendon injury distally. It is hypothesised that tendon lesions in the pastern will be associated with tendinopathy within the hoof capsule. STUDY DESIGN: Retrospective descriptive case series. METHODS: Cases with DDFT lesions in the pastern and magnetic resonance imaging (MRI) or ultrasonography of the foot were evaluated retrospectively. Lesion location and type were recorded. Odds ratios were calculated to determine the associations between more distal tendinopathy and the presence of different DDFT lesion types in the pastern. RESULTS: Thirty-four MRI scans of 33 horses and 64 ultrasonographic exams of 58 horses were analysed. Lesion location and type were recorded. Distal DDFT lesions were found in 75% (95% CI: 66.0-84.0) of total cases of pastern DDF tendinopathy and in 97% (95% CI: 91.6-100.0) of cases with core lesions of the DDFT in the pastern. A core lesion in the pastern was significantly more likely (OR = 20.7, 95% CI: 2.2-191.0; P = .008) to be associated with injury in the foot than other types of pastern lesion. MAIN LIMITATIONS: MRIs of the foot were not obtained on all included limbs which did not allow for fully inclusive evaluation of DDFT lesions distal to the navicular bone. CONCLUSIONS: DDFT pathological change in the pastern, particularly core lesions, is associated with additional tendinopathy within the hoof capsule. When a DDFT lesion is found in the pastern, further imaging of the tendon within the foot is indicated to direct appropriate treatment and improve prognostication.
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Enfermedades del Pie , Enfermedades de los Caballos , Tendinopatía , Animales , Enfermedades del Pie/diagnóstico por imagen , Enfermedades del Pie/veterinaria , Enfermedades de los Caballos/patología , Caballos , Humanos , Cojera Animal/diagnóstico , Imagen por Resonancia Magnética/métodos , Imagen por Resonancia Magnética/veterinaria , Estudios Retrospectivos , Tendinopatía/complicaciones , Tendinopatía/diagnóstico por imagen , Tendinopatía/veterinaria , Tendones/patologíaRESUMEN
The clinical relationship between equine limb lameness and secondary back dysfunction is largely unknown. Proper function of the spine is critical to maintain the integrity of the kinetic chain and attenuate forces from the appendicular skeleton. The musculus multifidus (m. multifidus) is the primary muscle providing spinal intersegmental stabilization and a functional relationship between m. multifidus hypertrophy and equine postural stability has been established. The relationship between equine thoracolumbar m. multifidus cross-sectional area (CSA) and limb lameness is unknown. The objective was to evaluate ultrasonographic changes in thoracolumbar m. multifidus CSA in horses with chronic single limb lameness, compared with sound horses. We hypothesized that the CSA of m. multifidus, ipsilateral to the lame limb would be smaller than the contralateral side, and within the sound group there would be no difference between sides. Thirty-six horses were enrolled, with twelve horses per group: sound, forelimb lame, and hindlimb lame. M. multifidus CSA was measured ultrasonographically at multiple spinal levels and compared between groups, spinal levels, and sides. M. multifidus CSA at the spinal level T18 was significantly larger than at all other measured levels, regardless of group (P ≤ .05). CSA at all levels was significantly larger in sound horses than the forelimb lame group, regardless of side (P = .002). This is the first study to evaluate the impact of chronic lameness on the axial skeleton and showed a decrease in m. multifidus CSA with forelimb lameness. These results support that axial skeletal adaptation occurs in response to naturally occurring chronic lameness.