Arthroscopic removal of a solitary osteochondroma interfering with the podotrochlear apparatus in a foal.

OBJECTIVE: To report the diagnostics, surgical treatment, and outcome of a juvenile foal with solitary osteochondroma (SO) interfering with the podotrochlear apparatus. STUDY DESIGN: Case report ANIMAL: One 36-day-old Arabian colt. METHODS: Clinical, radiographic, ultrasonographic, computed tomographic, and histopathologic examinations were required to characterize and treat an SO located at the palmar aspect of the diaphysis of the second phalanx of the left forelimb. This SO caused severe distal interphalangeal joint (DIPJ) inflammation, marked interference with the podotrochlear apparatus, and associated lameness. RESULTS: Despite the small size of the foal's foot, complete resection of the SO was possible via palmar DIPJ arthroscopy by using motorized equipment. Full resolution of the lameness was achieved within 3 months of surgery. CONCLUSION: Atypical SO located on the palmar aspect of the second phalanx can cause marked nonseptic inflammation of the DIPJ and interference with the podotrochlear apparatus and should be considered among the differential diagnoses for severe lameness in juvenile foals. Arthroscopic resection of the SO led to an excellent outcome.

Arthroscopic approach and intra-articular anatomy of the equine atlanto-occipital joint.

OBJECTIVE: To develop arthroscopic approaches to the atlanto-occipital (A-O) and describe associated arthroscopic anatomy. STUDY DESIGN: Experimental ex vivo study and clinical case report. ANIMALS: Ten equine cadaver joints and 1 clinical case. METHODS: CT arthrograms of 8 A-O joints were performed to determine the placement of an arthroscopic portal. Arthroscopy was performed via dorsal and/or ventral approaches (dorsal or ventral to the longissimus capitis tendon) in 10 cadaveric A-O joints and the A-O joint of a 2-week-old foal with septic arthritis. Accessible cartilage was debrided in 3 cadaver joints. Accessibility and risks were assessed by review of arthroscopic images, postoperative necropsy, and computed tomography (CT). RESULTS: Dorsal and ventral outpouchings of the A-O joint were identified with CT. Arthroscopy of the dorsal pouch provided access to 50% of the dorsocranial occipital condyle and 15% of the dorsocranial atlas articular surfaces. Joint distension caused displacement of the dura. Dura perforation occurred with a blind dorsal approach in 2 of 5 joints. Dura perforation did not occur after ultrasonography-guided approaches. Arthroscopic debridement of septic arthritis and osteomyelitis was successful in 1 clinical case. CONCLUSION: Approaches to the A-O joint were determined from CT examinations. The cranial aspect of the dorsal pouch of the A-O joint was accessed via arthroscopic triangulation in all horses of this study. Ultrasound-guided joint access prevented perforation of vital structures, including the spinal canal. CLINICAL SIGNIFICANCE: Advanced imaging improves the diagnosis of A-O joint pathology. Descriptions of arthroscopic anatomy and accessibility provide important information for surgical intervention.

PROSPECTIVE COMPARISON OF TUMOR STAGING USING COMPUTED TOMOGRAPHY VERSUS MAGNETIC RESONANCE IMAGING FINDINGS IN DOGS WITH NASAL NEOPLASIA: A PILOT STUDY.

Identification of nasal neoplasia extension and tumor staging in dogs is most commonly performed using computed tomography (CT), however magnetic resonance imaging (MRI) is routinely used in human medicine. A prospective pilot study enrolling six dogs with nasal neoplasia was performed with CT and MRI studies acquired under the same anesthetic episode. Interobserver comparison and comparison between the two imaging modalities with regard to bidimensional measurements of the nasal tumors, tumor staging using historical schemes, and assignment of an ordinal scale of tumor margin clarity at the tumor-soft tissue interface were performed. The hypotheses included that MRI would have greater tumor measurements, result in higher tumor staging, and more clearly define the tumor soft tissue interface when compared to CT. Evaluation of bone involvement of the nasal cavity and head showed a high level of agreement between CT and MRI. Estimation of tumor volume using bidimensional measurements was higher on MRI imaging in 5/6 dogs, and resulted in a median tumor volume which was 18.4% higher than CT imaging. Disagreement between CT and MRI was noted with meningeal enhancement, in which two dogs were positive for meningeal enhancement on MRI and negative on CT. One of six dogs had a higher tumor stage on MRI compared to CT, while the remaining five agreed. Magnetic resonance imaging resulted in larger bidimensional measurements and tumor volume estimates, along with a higher likelihood of identifying meningeal enhancement when compared to CT imaging. Magnetic resonance imaging may provide integral information for tumor staging, prognosis, and treatment planning.

Gross, histologic, and micro-computed tomographic anatomy of the lacrimal system of snakes.

OBJECTIVE: To describe the lacrimal system of snakes using contrast micro-computed tomography (micro-CT) with 3-dimensional reconstruction, fluorescein passage ('Jones') testing, histology, and gross dissection. ANIMALS STUDIED: One royal python and 19 snake cadavers representing 10 species. PROCEDURES: Direct observation following injection of fluorescein into the subspectacular space, micro-CT following injection of three contrast agents into the subspectacular space, gross dissection following injection of latex into the subspectacular space, and histopathology. RESULTS: Injection of fluorescein confirmed patency, but not course of the lacrimal duct. Barium enabled clear visualization of the lacrimal duct, whereas two iodinated contrast agents proved inadequate. Collectively, micro-CT, anatomic dissections, and histology suggest tears are produced by a single, large, serous, retrobulbar gland, released into the subspectacular space via several ductules, and drained through a single punctum originating in the ventronasal subspectacular space, and the lacrimal duct, which takes one of three routes of variable tortuosity before opening into the oral cavity in close association with the opening of the duct of the vomeronasal organ. CONCLUSIONS: The ophidian lacrimal duct has a generally tortuous course, and the details of its anatomy are species-variable. The tortuous course of the duct likely predisposes snakes to duct occlusion and must be considered when planning medical and surgical interventions in snakes with pseudobuphthalmos and subspectacular abscessation.

Computed tomographic arthrography of the intercarpal ligaments of the equine carpus.

Injuries of the intercarpal ligaments are an important cause of lameness in performance horses. The purpose of this prospective cadaver study was to determine whether computed tomography (CT) arthrography would be a feasible method for visualizing and characterizing intercarpal ligaments in the horse. One cadaver limb from each of eight nonlame horses was collected immediately after euthanasia. For each limb, overlapping 2.0 mm CT images were acquired before and after injection of iodinated contrast medium into the antebrachiocarpal joint, middle carpal joint, and carpal sheath. Spin echo magnetic resonance imaging (MRI) sequences were acquired in three planes using a 1.5 Tesla MRI scanner in three limbs. Following MRI, colored resin was injected into the synovial structures of these three limbs, limbs were frozen, and anatomic sections were obtained in three planes. Findings from CT arthrograms were compared to findings from precontrast CT, MRI, anatomic slices, and arthroscopy. Medial and lateral palmar intercarpal ligaments, radiocarpal and transverse intercarpal ligaments, and palmar carpal ligament were visible in CT arthrograms of all limbs. The proximal and distal entheses of all ligaments were readily identifiable. Findings indicated that CT arthrography is feasible for visualizing intercarpal ligaments and may be a useful adjunct imaging technique for diagnosing lameness due to suspected carpal ligament injury in horses.

Extraoral surgical correction of lingual entrapment in a Chinese goose (Anser cygnoides).

An adult female Chinese goose (Anser cygnoides) presented with a ventral displacement of the hyoid apparatus, associated with distension of the intermandibular sublingual space and of the gular skin, causing difficulties with prehension and deglutition of food and water. Physical examination revealed that the tongue was able to move normally and could be replaced into a normal anatomical position by external compression of the distended ventral intermandibular region. A mild hypoalbuminemia was the only remarkable finding of the biochemistry panel. Radiographs and computed tomography scan of the head and neck regions confirmed a normal hyoid apparatus. An extraoral surgical reconstruction of the distended intermandibular skin was performed: the excess skin was incised and resected and the margins of the incision were sutured with appropriate tissue tension to obtain a good apposition and prevent ventral displacement of the hyoid apparatus. Postoperative complication included airway obstruction by a large amount of respiratory secretions, which were successfully aspirated from the trachea. A supportive elastic bandage was placed at the level of the beak commissure during the following 24 hours in order to reduce downward pressure on the suture line and minimize the risk of dehiscence of the suture. The goose resumed eating within 4 hours following the surgery and oxygen supplementation was discontinued after 24 hours. Respiration was assessed as normal and the tongue remained permanently in normal position. The lingual entrapment did not recur during the following 18 months.

An Estimation of Lameness in Sable Island Horses Using Radiographic Evaluation of the Distal Phalanx and Hoof Capsule.

Laminitis is a painful condition that causes lameness in horses. However, monitoring this condition in feral horses is logistically difficult. Laminitis can be detected postmortem, as inflammation of the sensitive laminae of the hoof changes the relative location of the bony structures within the hoof capsule. Thus, evaluation of cadavers may be used to estimate laminitis prevalence in feral populations of horses. The objective of this study was to estimate the prevalence of laminitis in feral horses inhabiting the Sable Island National Park Reserve, Canada, using radiographic imagery on the hooves of naturally deceased horses. Radiographic indicators evaluated included coronary band extensor process distance (CE), capsular rotation (CR), palmar angle (PA), ratio of the dorsal hoof wall thickness to the length of the distal phalanx (DHWT:P3) and sole depth (SLD). Each value measured indicated the following prevalence of laminitis: CE 0% (97.5% Confidence Interval (CI) 0-4.51%), 8.75% CR (95%CI 3.59-17.2%), PA 25% (95% CI 15.99-35.94%), DHWT:P3 6.25% (95%CI 2.06-14.0%) and 65% SLD (95% CI 53.52-75.33%). The majority of indices measured for laminitis were low. These findings suggest that laminitis is fairly infrequent in the Sable Island horses evaluated in this study.

Advances in equine computed tomography and use of contrast media.

Advances in equine computed tomography have been made as a result of improvements in software and hardware and an increasing body of knowledge. Contrast media can be administered intravascularly or intrathecally. Contrast media is useful to differentiate between tissues of similar density. Equine computed tomography can be used for many different clinical conditions, including lameness diagnosis, fracture identification and characterization, preoperative planning, and characterization of skull diseases.

Ultrasound-guided injection technique of the equine cervical nerve roots.

Radiculopathy in horses is often a diagnosis of exclusion because of the non-specific clinical signs related to neck pain and possible forelimb lameness. There are no reported treatment options in the equine veterinary literature. The purpose of the study was to describe an ultrasound-guided injection of the cervical nerve root C3 to C8, to evaluate accuracy, time and safety and to anticipate possible complications on clinical cases. Under general anesthesia and with ultrasound guidance, five horses were injected from C3 to C8 with 1.5mL mix of contrast and latex. Immediately after euthanasia, the necks were taken for CT examination and then dissection was performed 3 days later. Data regarding the accuracy of injection, the presence of injectate in the nerve root, vertebral vessel or vertebral canal were recorded from both CT and dissection. The time of injection and ability to visualize the nerve root prior to injection were also recorded. Out of 60 intended injections, 55 (CT images) and 57 (dissection) led to injectate deposited within the target zone with direct contact between contrast/latex and cervical nerve roots noted in 76.4% and 73.7%, respectively. Presence of contrast/latex injectate within nerves (≤11%), vertebral vessels (<4%) and canal (<4%) were rarely encountered. No variation on success rate or safety noted based on the site of injection. The technique described has excellent accuracy, with injectate deposition in direct contact (≈75%) or close vicinity (≈25%) of C3-C8 cervical nerve roots. Injectate diffusion is likely to further improve success rate. Rare presence of injectate within nerve/sheath, vertebral vessels/canal along with diffusion warrants caution when performing this procedure in clinical cases.

Computed tomographic anatomy of the equine stifle joint.

OBJECTIVE: To provide a detailed computed tomography (CT) reference of the anatomically normal equine stifle joint. Sample-16 hind limbs from 8 equine cadavers; no horses had evidence of orthopedic disease of the stifle joints. PROCEDURES: CT of the stifle joint was performed on 8 hind limbs. In all limbs, CT was also performed after intra-articular injection of 60 mL of contrast material (150 mg of iodine/mL) in the lateral and medial compartments of the femorotibial joint and 80 mL of contrast material in the femoropatellar joint (CT arthrography). Reformatted CT images in the transverse, parasagittal, and dorsal plane were matched with corresponding anatomic slices of the 8 remaining limbs. RESULTS: The femur, tibia, and patella were clearly visible. The patellar ligaments, common origin of the tendinous portions of the long digital extensor muscle and peroneus tertius muscle, collateral ligaments, tendinous portion of the popliteus muscle, and cranial and caudal cruciate ligaments could also be consistently evaluated. The cruciate ligaments and the meniscotibial ligaments could be completely assessed in the arthrogram sequences. Margins of the meniscofemoral ligament and the lateral and medial femoropatellar ligaments were difficult to visualize on the precontrast and postcontrast images. CONCLUSIONS AND CLINICAL RELEVANCE: CT and CT arthrography were used to accurately identify and characterize osseous and soft tissue structures of the equine stifle joint. This technique may be of value when results from other diagnostic imaging techniques are inconclusive. The images provided will serve as a CT reference for the equine stifle joint.

Radiological prevalence of osteoarthritis of the cervical region in 104 performing Warmblood jumpers.

BACKGROUND: Cervical osteoarthritis (OA) has been documented as a potential source of pain and poor performance in sport horses. OBJECTIVES: To assess the prevalence of cervical OA in a population of Warmblood jumpers and its correlation with age, level of performance, neck pain and mobility. STUDY DESIGN: Descriptive observational study. METHODS: Warmblood jumpers free of lameness or neurological disorders were selected. Cervical pain and range of motion of the neck were subjectively assessed. Left to right lateral views were taken at C3-C4, C4-C5, C5-C6 and C6-C7. The presence of OA at the cervical articular process joints (APJs) was evaluated and graded as absent, mild or moderate to severe by three board-certified radiologists. The agreement between radiologists and the potential associations between OA grades with age and other variables were statistically assessed (P < .05). RESULTS: One hundred and four horses were included [median age = 10 years (range 6-18 years)]. Agreement between radiologists varied from fair to substantial (Kappa-weighted 0.37-0.61). The C6-C7 APJ was most commonly affected by OA with only 32.7% of APJ considered free of radiographic abnormalities at this location versus 60.5% at C5-C6, 81.7% at C4-C5 and 84.6% at C3-C4. Horses competing in higher level classes (peak of performance) had significantly higher OA grades at C6-C7 (P = .013). There was no association between age, age when started jumping, neck pain and neck range of motion with the presence of OA on radiographs. MAIN LIMITATIONS: Open enrolment and lack of orthogonal views. CONCLUSIONS: This study showed that, although there is a range of interpretation of radiographic findings of the APJ, OA of the caudal cervical region is not rare in performing sound Warmblood jumpers. This suggests that OA in the caudal cervical region may be of low clinical significance.

Hemodynamic and serum biochemical alterations associated with intravenous administration of three types of contrast media in anesthetized dogs.

OBJECTIVE: To determine the incidence and type of alterations in heart rate (HR), peak systolic blood pressure (PSBP), and serum biochemical variables (total bilirubin, BUN, and creatinine concentrations) associated with IV administration of ionic-iodinated contrast (IIC), nonionic-iodinated contrast (NIC), and gadolinium dimeglumine (GD) contrast media in anesthetized dogs. ANIMALS: 280 anesthetized dogs undergoing cross-sectional imaging. PROCEDURES: HR and PSBP were recorded at 5-minute intervals for 20 minutes for untreated control dogs and dogs that received IIC, NIC, or GD contrast medium. The development of an HR of < 60 beats/min or > 130 beats/min that included a > or = 20% change from baseline was considered a response. The development of PSBP of < 90 mm Hg or > 160 mm Hg that included a > or = 20% change from baseline was considered a response. Pre- and postcontrast serum biochemical values were recorded. Results-Of dogs receiving IIC medium, 3% (3/91) had a response in HR and 4% (4/91) had a response in PSBP at > or = 1 time points. None of the dogs receiving NIC medium had a response in HR; 1 of 16 had a response in PSBP. Of dogs receiving GD contrast medium, 1% (1/92) had a response in HR and 4% (4/92) had a response in PSBP. Of control dogs, 2% (2/81) had a response in HR and 4% (3/81) had a response in PSBP. No serum biochemical alterations were observed. CONCLUSIONS AND CLINICAL RELEVANCE: IV administration of contrast media in anesthetized dogs caused moderate bradycardia, tachycardia, hypotension, or hypertension.

Hemodynamic and serum biochemical alterations associated with intravenous administration of three types of contrast media in anesthetized cats.

OBJECTIVE: To determine the incidence and type of alterations in heart rate (HR), peak systolic blood pressure (PSBP), and serum biochemical variables (serum total bilirubin, BUN, and creatinine concentrations) associated with IV administration of ionic-iodinated contrast (IIC), nonionic-iodinated contrast (NIC), and gadolinium (GD) contrast media in anesthetized cats. ANIMALS: 220 anesthetized cats undergoing cross-sectional imaging. PROCEDURES: HR and PSBP were recorded at 5-minute intervals for 20 minutes for untreated control cats and cats that received IIC, NIC, or GD contrast medium. The development of HR < 100 beats/min or > 200 beats/min that included a > or = 20% change from baseline was considered a response. The development of PSBP of < 90 mm Hg or > 170 mm Hg that included a > or = 20% change from baseline was considered a response. Pre- and postcontrast serum biochemical values were recorded. Results-Of cats receiving IIC medium, 2% (1/60) had a response in HR at > or = 1 time point. Of cats receiving IIC medium, 7% (4/60) had a response in PSBP. None of the cats receiving NIC medium had a response in HR; 2 of 12 had a response in PSBP. Of cats receiving GD contrast medium, 6% (5/83) had a response in HR and 8% (7/83) had a response in PSBP. None of the control cats had a response in HR or PSBP. No serum biochemical alterations were observed. CONCLUSIONS AND CLINICAL RELEVANCE: IV administration of iodine and GD contrast media in anesthetized cats was associated with changes in HR and PSBP.

Measurement of equine laminar blood flow and vascular permeability by use of dynamic contrast-enhanced computed tomography.

OBJECTIVE: To define the reference range for laminar blood flow (BF) and vascular permeability (VPM) in horses without laminitis by use of dynamic contrast-enhanced computed tomography (CT). ANIMALS: 9 adult horses that were not lame and had no abnormalities of the laminae or phalanges detectable via radiographic examination. PROCEDURES: Each horse was anesthetized by use of a routine protocol. Horses were placed in right or left lateral recumbency with the dependent forelimb in the CT gantry; only 1 limb of each horse was scanned. Serial 10-mm collimated transverse CT images were acquired at the same location every other second for 90 seconds during infusion of ionic, iodinated contrast medium. Custom software was used to estimate BF, VPM, and fractional vascular volume (FVV) in the dorsal, dorsomedial, and dorsolateral laminar regions. RESULTS: Among the 9 horses' forelimbs, mean +/- SD dorsal laminar BF was 0.43 +/- 0.21 mL*min(1)*mL(1). Mean dorsomedial and dorsolateral laminar BFs were 0.26 +/- 0.16 mL*min(1)*mL(1) and 0.24 +/- 0.16 mL*min(1)*mL(1), respectively. Mean dorsal laminar VPM was 0.09 +/- 0.03 mL*min(1)*mL(1). Mean dorsomedial and dorsolateral laminar VPMs were 0.16 +/- 0.06 mL*min(1)*mL(1) and 0.12 +/- 0.06 mL*min(1)*mL(1), respectively. Mean dorsal laminar FVV was 0.63 +/- 0.20 and dorsomedial and dorsolateral laminar FVV were 0.37 +/- 0.14 and 0.34 +/- 0.17, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: In horses, laminar BF, VPM, and FVV can be non-invasively measured by use of dynamic contrast-enhanced CT.

Clinical and scintigraphic findings in horses with a bone fragility disorder: 16 cases (1980-2006).

OBJECTIVE: To describe clinical and scintigraphic abnormalities in horses with a bone fragility disorder. DESIGN: Retrospective case series. ANIMALS: 16 horses with scintigraphic evidence of multiple sites of increased radiopharmaceutical uptake (IRU). Procedures-Medical records were reviewed for information on signalment; history; clinical, clinicopathologic, and diagnostic imaging findings; and treatment. Follow-up information was obtained through telephone interviews with owners. RESULTS: Horses ranged from 4 to 22 years old; there were 8 castrated males and 8 females. Foci of IRU most commonly involved the scapulae, ribs, sternebrae, sacral tubers, ilia, and cervical vertebrae. Most horses were examined because of chronic intermittent (n = 10) or acute (6) lameness involving a single (10) or multiple (6) limbs that could not be localized by means of regional anesthesia. Cervical stiffness (n = 3), scapular bowing (3), swayback (3), and ataxia (1) were also seen in more advanced cases. Signs of respiratory tract disease and exercise intolerance were evident in 4 horses. Ultrasonographic or radiographic evidence of bone remodeling or degeneration was seen in 19 of 33 affected bones. Histologic examination of bone biopsy specimens revealed reactive bone. Improvement was initially seen with conservative treatment in some horses, but the condition worsened in all horses, and 11 horses were euthanized within 7 years. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that horses may develop a bone fragility disorder characterized clinically by an unlocalizable lameness and scintigraphically by multiple sites of IRU involving the axial skeleton and proximal portion of the appendicular skeleton.

Evaluation of continuous infusion of lidocaine on gastrointestinal tract function in normal horses.

OBJECTIVE: To determine the effect of continuous infusion of lidocaine on fecal transit time in normal horses. STUDY DESIGN: Experimental randomized cross-over study. ANIMALS: Healthy horses (n=6). METHODS: Barium-filled microspheres were administered to horses by nasogastric intubation and feces were collected every 2 hours for 4 days. A bolus of 2% lidocaine (1.3 mg/kg) was administered randomly, followed by a continuous infusion of lidocaine (0.05 mg/kg/min) for 3 days or an equivalent volume of saline. The washout period was 10 days. Variables assessed included defecation frequency, weight of feces produced, intestinal transit time (number of microspheres observed on radiographs), fecal moisture content, borborygmus score, heart and respiratory rate, and signs of lidocaine toxicity (e.g., ataxia, CNS depression). RESULTS: During the first 24 hours of lidocaine administration, mean (+/-SD) fecal output (10.8+/-6.9 kg) was decreased compared with controls (15+/-4.9 kg). Mean (+/-SEM) time for passing 50% of the barium-filled microspheres was shorter in controls (42+/-1.13 hours) compared with the lidocaine group (50+/-1.32 hours). CONCLUSIONS: Continuous infusion of lidocaine increases the transit time of feces in normal horses. CLINICAL RELEVANCE: Clinicians need to be aware of the effects of using a continuous infusion of lidocaine on the transit time of feces in normal horses, with a potential for exacerbating those effects when combined with drugs that decrease motility and in horses with medical colic (e.g., impaction) or where a diagnosis has not been made.

Ultrasound-assisted collection of cerebrospinal fluid from the lumbosacral space in equids.

OBJECTIVE: To describe ultrasonographic landmarks for use in collection of CSF from the lumbosacral region in equids. DESIGN: Prospective study. ANIMALS: 37 equids (27 with neurologic disease and 10 with nonneurologic disease). PROCEDURES: Standing equids (n = 17) were sedated with detomidine hydrochloride (0.006 to 0.01 mg/kg [0.003 to 0.005 mg/lb], IV) followed by butorphanol tartrate (0.01 mg/kg, IV) and restrained with a nose twitch for collection of CSF. The CSF was collected from 20 laterally recumbent equids (10 sedated and 10 immediately after euthanasia). Anatomic landmarks were identified ultrasonographically. Height at the dorsal point of the shoulders, body weight, depth of the spinal needle, number of attempts to collect CSF, and cytologic evaluation of CSF were recorded. RESULTS: Lumbosacral puncture cranial to the cranial border of the most superficial location of both tuber sacrale along the midline was consistently successful for CSF collection (35/37 equids). Two horses had anatomic abnormalities that precluded CSF collection. Mean number of attempts to collect CSF per animal was 1.1. Height and body weight were strongly correlated with needle depth for CSF collection. Pelvic and sacral displacement was observed in several laterally recumbent animals, which resulted in discrepancies of the midline between the cranial and caudal aspects of the vertebral column. In most equids, the spinal needle was aligned on the midline of the caudal aspect of the vertebral column. CONCLUSIONS AND CLINICAL RELEVANCE: Ultrasonography was a useful aid for collection of CSF from the lumbosacral space and decreased the risk of repeated trauma and contamination in equids.

Multiple intravenous injections of allogeneic equine mesenchymal stem cells do not induce a systemic inflammatory response but do alter lymphocyte subsets in healthy horses.

INTRODUCTION: Intravenous (IV) injection of mesenchymal stem cells (MSCs) is used to treat systemic human diseases and disorders but is not routinely used in equine therapy. In horses, MSCs are isolated primarily from adipose tissue (AT) or bone marrow (BM) and used for treatment of orthopedic injuries through one or more local injections. The objective of this study was to determine the safety and lymphocyte response to multiple allogeneic IV injections of either AT-derived MSCs (AT-MSCs) or BM-derived MSCs (BM-MSCs) to healthy horses. METHODS: We injected three doses of 25 × 10(6) allogeneic MSCs from either AT or BM (a total of 75 × 10(6) MSCs per horse) into five and five, respectively, healthy horses. Horses were followed up for 35 days after the first MSC infusion. We evaluated host inflammatory and immune response, including total leukocyte numbers, serum cytokine concentration, and splenic lymphocyte subsets. RESULTS: Repeated injection of allogeneic AT-MSCs or BM-MSCs did not elicit any clinical adverse effects. Repeated BM-MSC injection resulted in increased blood CD8(+) T-cell numbers. Multiple BM-MSC injections also increased splenic regulatory T cell numbers compared with AT-MSC-injected horses but not controls. CONCLUSIONS: These data demonstrate that multiple IV injections of allogeneic MSCs are well tolerated by healthy horses. No clinical signs or clinico-pathologic measurements of organ toxicity or systemic inflammatory response were recorded. Increased numbers of circulating CD8(+) T cells after multiple IV injections of allogeneic BM-MSCs may indicate a mild allo-antigen-directed cytotoxic response. Safety and efficacy of allogeneic MSC IV infusions in sick horses remain to be determined.

Use of digital abdominal radiography for the diagnosis of enterolithiasis in equids: 238 cases (2008-2011).

OBJECTIVE: To evaluate the sensitivity and specificity of direct digital abdominal radiography for the diagnosis of enterolithiasis in equids and to assess the effect of the number and anatomic location of enteroliths and gas distention of the gastrointestinal tract on diagnostic sensitivity of the technique. DESIGN: Retrospective case series. SAMPLE POPULATION: 238 horses and ponies ≥ 1 year old that underwent digital abdominal radiography with subsequent exploratory celiotomy or postmortem examination. PROCEDURES: For each case, 3 reviewers independently evaluated radiographic views. Radiographic images were evaluated for presence or absence and location of enteroliths and the degree of gas distention. Signalment, definitive diagnosis based on exploratory celiotomy or postmortem examination findings, and number and anatomic location of enteroliths were obtained from the medical records. RESULTS: 70 of the 238 (29.4%) equids had confirmed enterolithiasis. With regard to diagnosis of enterolithiasis via digital radiography, overall sensitivity and specificity for the 3 reviewers were 84% and 96%, respectively. Sensitivity was lower for small colon enteroliths (61.5%) than for large colon enteroliths (88.9%) and was negatively affected by gas distention of the gastrointestinal tract. Sensitivity was not affected by the number of enteroliths. CONCLUSIONS AND CLINICAL RELEVANCE: Sensitivity and specificity of digital radiography for the diagnosis of large colon enterolithiasis in equids was high. Sensitivity of digital radiography for detection of small colon enteroliths was lower than that for large colon enteroliths, but was higher than that typically associated with computed radiography. In geographic regions in which enterolithiasis in equids is endemic, digital abdominal radiography could be used as a diagnostic test for equids with colic.