Changes in Head and Pelvic Movement Symmetry after Diagnostic Anaesthesia: Interactions between Subjective Judgement Categories and Commonly Applied Blocks.

Limited evidence is available relating gait changes to diagnostic anaesthesia. We investigated associations between specific movement patterns and diagnostic anaesthesia of different anatomical structures in a retrospective analysis. Referral-level lameness cases were included with the following criteria: presence of diagnostic anaesthesia of a forelimb and/or hind limb; subjective efficacy classified as "negative", "partially positive", or "positive"; quantitative gait data available from inertial measurement units. Gait changes were calculated for three forelimb (palmar digital, abaxial sesamoid, low 4-point nerve block) and five hind limb diagnostic blocks (tarso-metatarsal, metatarsophalangeal joint block, deep branch of lateral plantar, low 6-point, abaxial sesamoid nerve block). Mixed models (random factor "case", fixed factors "diagnostic anaesthesia type" and "efficacy", two-way interaction) assessed the head and pelvic movement (p < 0.05, Bonferroni correction). Four parameters were significantly affected by forelimb anaesthesia (N = 265) (all p ≤ 0.031) and six by hind limb anaesthesia (N = 342) efficacy (all p ≤ 0.001). All head movement parameters and pelvic push-off asymmetry were significantly affected by the two-way interaction after forelimb anaesthesia (all p ≤ 0.023) and two pelvic movement symmetry parameters by the two-way interaction after hind limb anaesthesia (all p ≤ 0.020). There are interactions between block efficacy and type resulting in changes in weight-bearing and push-off-associated head and pelvic movement symmetry after diagnostic anaesthesia.

Computed tomography findings in horses presented with signs of head-shaking.

BACKGROUND: Trigeminal nerve-mediated head-shaking (TNMH) in horses is a diagnosis made by exclusion. Computed tomography (CT) is frequently used to identify any disease process that could cause the clinical signs of head-shaking. Although abnormalities are frequently identified, it is unknown whether treatment of these conditions improves clinical signs. OBJECTIVES: To ascertain the clinical significance of CT findings in horses presented with a complaint of head-shaking. STUDY DESIGN: Retrospective case series. METHODS: CT and patient records were reviewed and all abnormal findings and any treatments subsequently carried out was recorded. A questionnaire was sent to referring veterinarians and owners were contacted by telephone to establish whether treatment of the identified condition improved clinical signs. RESULTS: This study included 103 horses presented for head CT with the complaint of head-shaking with follow-up information obtained for 84 horses (81.6%). The diagnosis of TNMH was based on a combination of positive maxillary nerve block and/or response to treatment for TNMH. Although TNMH was the most common diagnosis with 62 horses (60.2%) affected, in 22 horses (21.4%), a primary disease process was identified and treatment of the condition eliminated signs of head-shaking. Clinically relevant primary diseases included dental fracture, primary sinusitis, temporo-mandibular joint arthritis, nuchal bursitis, musculoskeletal pathologies, basisphenoid fracture, otitis externa and a mass affecting the infra-orbital nerve. MAIN LIMITATIONS: Some clinical information was missing and follow-up information was not obtained in all cases. CONCLUSIONS: CT was perceived as a useful diagnostic tool by most veterinarians, ruling out significant abnormalities. In over 20% of the cases, a treatable primary condition was identified leading to complete resolution of clinical signs.

HISTORIAL: Las sacudidas de cabeza mediadas por el nervio Trigémino (TNMH) en caballos es un diagnostico por exclusión. La tomografía computarizada (CT) es frecuentemente utilizada para identificar cualquier proceso patológico que pudiese ser la causa de los síntomas de sacudida de cabeza. Aunque se identifican frecuentemente anomalías, no se sabe si es que el tratamiento de estas condiciones mejora los signos clínicos. OBJETIVOS: Demostrar la significancia clínica de los hallazgos por CT en caballos presentados con queja de sacudida de cabeza. DISEÑO DEL ESTUDIO: Series de casos retrospectivos. MÉTODOS: Los archivos de tomografía computarizada y de pacientes fueron revisados y todos los hallazgos anormales y los tratamientos llevados a cabo subsecuentemente fueron anotados. Un cuestionario fue mandado a los veterinarios que difirieron los casos y los dueños fueron contactados por teléfono para saber si el tratamiento de la condición identificada mejoro los síntomas. RESULTADOS: Este estudio incluyo a 103 caballos presentados para CT de cabeza con queja de sacudida de cabeza con información subsecuente obtenida en 84 caballos (81.6%). TNMH fue el diagnostico basados en un combinación de bloque positivo del nervio maxilar y/o respuesta positiva a tratamiento de TNMH. Aunque TNMH fue el diagnostico mas común con 62 caballos (60.2%) afectados, en 22 caballos (21.4%), un proceso patológico primario fue identificado y el tratamiento de la condición elimino los síntomas de sacudida de cabeza. Las enfermedades clínicas primarias relevantes incluyeron fracturas dentales, sinusitis primaria, artritis de la articulación temporo-mandibular, bursitis nucal, patologías musculo esqueléticas, fracturas basifenoideas, otitis externa y masas tumorales afectando al nervio infra-orbital. LIMITACIONES PRINCIPALES: No se pudo obtener toda la información clínica e no se obtuvo información de seguimiento en todos los casos. CONCLUSIONES: La tomografía computarizada era considerada como un herramienta diagnostica por la mayoría de los veterinarios, descartando anomalías significativas. En mas de un 20% de los casos, una condición primaria con tratamiento fue identificada y esta llevo a la resolución de los síntomas clínicos.

Changes in Head, Withers, and Pelvis Movement Asymmetry in Lame Horses as a Function of Diagnostic Anesthesia Outcome, Surface and Direction.

Evaluation of diagnostic anesthesia during equine lameness examination requires comparison of complex movement patterns and can be influenced by expectation bias. There is limited research about how changes in movement asymmetries after successful analgesia are affected by different exercise conditions. Movement asymmetry of head, withers and pelvis was quantified in N = 31 horses undergoing forelimb or hindlimb diagnostic anesthesia. Evaluation on a straight line and a circle was performed with subjective diagnostic anesthesia outcome and quantitative changes recorded. Mixed linear models (P < .05) analyzed the differences in movement asymmetry before/after diagnostic anesthesia - random factor: horse, fixed factors: surface (soft, hard), direction (straight, inside, outside, inside-outside average), diagnostic anesthesia outcome (negative, partially positive, positive) and two-way interactions. Forelimb diagnostic anesthesia influenced primary movement asymmetry (all head and withers parameters) and compensatory movement asymmetry (two pelvic parameters) either individually (P≤.009) or in interaction with surface (P≤.03). Hindlimb diagnostic anesthesia influenced primary movement asymmetry (all pelvic parameters) and compensatory movement asymmetry (two head and two withers parameters) either individually (P≤.04) or in interaction with surface (P≤.01;) or direction (P≤.006). Direction was also significant individually for two pelvic parameters (P≤.04). Changes in primary movement asymmetries after partially positive or positive outcomes indicated improvement in the blocked limb. Compensatory changes were mostly in agreement with the 'law of sides'. The changes were more pronounced on the hard surface for hindlimb lameness and on the soft surface for forelimb lameness. Withers asymmetry showed distinct patterns for forelimb and hindlimb lameness potentially aiding clinical decision-making.

Linear Discriminant Analysis for Investigating Differences in Upper Body Movement Symmetry in Horses before/after Diagnostic Analgesia in Relation to Expert Judgement.

Diagnostic analgesia and lunging are parts of the equine lameness examination, aiding veterinarians in localizing the anatomical region(s) causing pain-related movement deficits. Expectation bias of visual assessment and complex movement asymmetry changes in lame horses on the lunge highlight the need to investigate data-driven approaches for optimally integrating quantitative gait data into veterinary decision-making to remove bias. A retrospective analysis was conducted with inertial sensor movement symmetry data before/after diagnostic analgesia relative to subjective judgement of efficacy of diagnostic analgesia in 53 horses. Horses were trotted on the straight and on the lunge. Linear discriminant analysis (LDA) applied to ten movement asymmetry features quantified the accuracy of classifying negative, partial and complete responses to diagnostic analgesia and investigated the influence of movement direction and surface type on the quality of the data-driven separation between diagnostic analgesia categories. The contribution of movement asymmetry features to decision-making was also studied. Leave-one-out classification accuracy varied considerably (38.3-57.4% for forelimb and 36.1-56.1% for hindlimb diagnostic analgesia). The highest inter-category distances (best separation) were found with the blocked limb on the inside of the circle, on hard ground for forelimb diagnostic analgesia and on soft ground for hindlimb diagnostic analgesia. These exercises deserve special attention when consulting quantitative gait data in lame horses. Head and pelvic upward movement and withers minimum differences were the features with the highest weighting within the first canonical LDA function across exercises and forelimb and hindlimb diagnostic analgesia. This highlights that movement changes after diagnostic analgesia affect the whole upper body. Classification accuracies based on quantitative movement asymmetry changes indicate considerable overlap between subjective diagnostic analgesia categories.

Laparoscopic cryptorchidectomy in a mature llama.

A 5-year-old llama was presented for unilateral cryptorchidism. Clinical findings included an abdominally retained right testicle. Surgical treatment consisted of laparoscopic removal of the abdominally retained testicle and routine closed castration of the descended testicle, which is presented as a therapeutic option for cryptorchidectomy. Key clinical message: Laparoscopic exploration and castration should be considered as a suitable surgical treatment for a llama with abdominally retained testicles.

Cryptorchidectomie laparoscopique chez un lama mature. Un lama âgé de 5 ans fut présenté avec une cryptorchidie unilatérale. Les trouvailles cliniques incluaient une rétention abdominale du testicule droit. Le traitement chirurgical consistait en un retrait par laparoscopie du testicule retenu dans la cavité abdominale et une castration fermée de routine du testicule descendu, ce qui est présenté comme une option thérapeutique lors de cryptorchidectomie.Message clinique clé :L'exploration laparoscopique et la castration devraient être considérées comme un traitement chirurgical approprié pour un lama avec des testicules retenus dans l'abdomen.(Traduit par Dr Serge Messier).

Squamous cell carcinoma invading the right temporomandibular joint in a Belgian mare.

This report describes a rare case of squamous cell carcinoma invading the right temporomandibular joint, right guttural pouch, and calvarium. Radiography, computed tomography, and histopathology were performed in the diagnostic workup. Computed tomography depicted more accurately than radiography the invasive nature, exact location, and extent of the lesion.

Urogenital leiomyosarcoma in an alpaca.

A mass in the pelvic canal of a 4-year-old pregnant alpaca hembra diagnosed as leiomyosarcoma of the urogenital tract was confirmed by biopsy. Following a tube cystotomy, the alpaca was presented 33 d later, 2 d after the tube cystotomy had been dislodged. A dead cria was delivered by caesarean section.

Primary mandibular hemangiosarcoma in a bull.

Disseminated pulmonary and subcutaneous-muscular hemangiosarcoma at the left hemimandible was diagnosed postmortem in a 2-year-old Jersey bull that presented with a 7-day history of facial swelling from suspected traumatic injury. Hemangiosarcoma is uncommon in cattle and has never been reported to affect the bones of the skull.

Acceleration of second and fourth metatarsal fracture healing with recombinant human bone morphogenetic protein-2/calcium phosphate cement in horses.

OBJECTIVE: To compare the efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2)/calcium phosphate (CP) to autogenous cancellous bone graft (CBG) and to no treatment on bone healing, in surgically induced osteotomies and ostectomies of the accessory metatarsal bones in an equine model. STUDY DESIGN: Experimental. ANIMALS: Adult horses (n=9). METHODS: Segmental ostectomies of the second metatarsal bone (MT2) and osteotomies of the fourth metatarsal bone (MT4) were performed bilaterally in 9 horses. There were a total of 35 defects (1 MT4 was previously fractured) created and supplemented randomly either with no treatment (untreated control), rhBMP-2/CP cement, or matrix (CPC or CPM), or CBG. Radiography was performed every 2 weeks until study endpoint at 12 weeks. After euthanasia, bone healing was evaluated using radiography, mechanical testing, and histology. Data were analyzed with ANOVA followed by the Duncan's Multiple Range Test or nonparametric analyses. RESULTS: At 12 weeks, radiographic scores for union were significantly greater for the rhBMP-2 (P<.0001) and CBG (P=.004) groups compared with the untreated control group, for both MT2 ostectomies and MT4 osteotomies. The rhBMP-2 treated MT2 had greater maximum torque to failure in torsion than CBG and control limbs at 12 weeks (P=.011). Histologic analysis demonstrated increased bone formation and more mature bone at the ostectomy site for MT2 in the rhBMP-2 and CBG groups compared with the untreated control group. CONCLUSION: Injection of rhBMP-2/CP into surgically induced ostectomies and osteotomies of the accessory metatarsal bones might accelerate early bone healing in the horse. CLINICAL RELEVANCE: RhBMP-2/CP may be as effective if not superior to CBG as an adjuvant treatment to accelerate healing of bone defects.