A Case Series of 11 Horses Diagnosed with Bone Spavin Treated with High Intensity Laser Therapy (HILT).

The aim of this work was to characterize and describe the effect of High Intensity Laser Therapy (HILT) used in the treatment of chronic osteoarthritis in horses. Over a 2 year period, 11 horses with diagnosed bone spavin were treated with HILT as a monotherapy. The horses chosen for this report presented hind limb lameness, were positive in a spavin flexion test and showed improvement after intra-articular anesthesia of the tarsometatarsal joint. Additionally, all the horses presented radiological signs of tarsus osteoarthritis and had not been treated for bone spavin for a minimum of 6 months. Each horse received 10 HILT therapies over 14 days' treatment time with the same laser protocol. At post-treatment orthopedic examination, 4 horses (36%) had improved 2 lameness grades (in the 5 grade American Association of Equine practitioners lameness scale), 4 horses (36%) had improved 1 lameness grade and 3 horses (28%) did not improve. Additionally, 3 horses were totally sound after HILT. Post-treatment spavin test result improvement was observed in 5 horses (45%), and 6 horses (55%) showed the same spavin test grade as before treatment. There were no horses that were sound in the spavin test performed after HILT. Therefore, it seems probable that the application of HILT in horses suffering from bone spavin may decrease joint pain, which influences visual lameness reduction.

Pressuring of Acupoints as a Complement to the Diagnosis of Stifle Diseases in Horses.

Diseases of the stifle joint remain a challenge for veterinarians. The objective of this study was to achieve a valuable acupuncture suggestive diagnosis to be considered for stifle joint diseases in horses. Thirty-nine nonlame horses involved in different activities were assessed. Acupuncture was independently performed by two evaluators. Reactions of the animal when pressurizing the point suggestive of stifle disease (PSSD), Bladder-20 and/or Bladder-21, were considered as the inclusion criteria for inclusion in the stifle group (SG, n = 31), and the animals with no reactions were assigned to the control group (n = 8). Radiographic and ultrasonographic examinations were performed and evaluated by two independent professionals blinded to the group allocation. Thermographic examination of the PSSD and stifles was also performed, after acclimatization. The ultrasound scores and radiographic findings were higher in the SG than in the control group. Thermography evidenced increased temperature in the PSSD and stifles in the SG. The minimum acupuncture diagnostic criteria for stifle joint disease had a sensitivity of 87.5% and a specificity of 57.0%, and the addition of the acupoints Gallbladder-dorsal tuber coxae, Gallbladder-27, and Spleen-13 to the minimum diagnostic criteria improved sensitivity and specificity. In conclusion, assessing the reaction at the demonstrated acupoints can facilitate a diagnosis of a potential stifle lesion.

Synostosis of the first and second ribs in six horses.

CASE DESCRIPTION Over a 2-year period, 6 horses (4 Selle Français, 1 Hanoverian, and 1 Thoroughbred) were referred for evaluation of forelimb lameness. All horses had radiographic evidence of synostosis of the first and second ribs (SFSR). CLINICAL FINDINGS For 1 horse, the SFSR was considered the probable cause of the lameness (grade 3/5), with a shortening of the cranial phase of the stride in the affected limb. For 3 horses, it was considered a possible cause of the lameness (grade 1/5) for the same reason. For 2 horses, SFSR was considered an incidental finding unassociated with any clinical signs. The 4 horses with lameness suspected as attributable to SFSR had a moderate to severe amount of irregularly marginated new bone formation at the site of the SFSR, with a cranial displacement of the first rib, compared with findings for the 2 horses in which the SFSR was considered incidental. A likely congenital abnormality of the first rib was first suspected on nuclear scintigraphy in the 1 horse for which it was performed or on radiography of the caudal cervical portion of the vertebral column (3 horses) or shoulder joint (2 horses). TREATMENT AND OUTCOME The horse in which SFSR was considered the probable cause of the lameness was retired to the field and remained chronically lame. Two of the 3 horses in which SFSR was considered a possible cause of lameness received an IV infusion of tiludronate disodium and mesotherapy over the caudal cervical and cranial thoracic regions; both returned to competition but with poor results. One of the 2 horses with subclinical SFSR never developed lameness on the affected side. No follow-up information was available for the other 2 horses. CLINICAL RELEVANCE SFSR can be an incidental finding in horses, with or without clinical manifestations. This abnormality should be considered as a differential diagnosis for horses with forelimb lameness and associated shortening of the cranial phase of the stride that fails to improve with diagnostic analgesic techniques.

Catastrophic gastric rupture in a horse secondary to psyllium pharmacobezoars.

A mare was euthanized because of gastric rupture secondary to complete duodenal obstruction by 2 bezoars located in the pylorus and proximal duodenum. Infrared spectroscopy showed that the bezoars were composed of psyllium. The mare had been receiving treatment with a pelleted psyllium product at 4 times the recommended dosage. Veterinarians should be aware that treatment of colic in horses with pelleted psyllium products could be associated with gastric impaction.

Rupture gastrique catastrophique secondaire à des pharmacobézoards de psyllium en boulettes chez un cheval. Une jument a été euthanasiée en raison d'une rupture gastrique secondaire à une obstruction duodénale complète par deux bézoards situés dans le pylore et le duodénum proximal. La spectroscopie infrarouge a montré que les bézoards se composaient de psyllium. La jument avait reçu un traitement composé d'un produit de psyllium en boulettes à quatre fois la dose recommandée. Les vétérinaires devraient être au courant que le traitement des coliques chez les chevaux avec des produits de psyllium en boulettes pourrait être associé à une impaction gastrique.(Traduit par Isabelle Vallières).

Efficacy of intravenous administration of hyaluronan, sodium chondroitin sulfate, and N-acetyl-d-glucosamine for prevention or treatment of osteoarthritis in horses.

OBJECTIVE To evaluate the efficacy of IV administration of a product containing hyaluronan, sodium chondroitin sulfate, and N-acetyl-d-glucosamine for prevention or treatment of osteoarthritis in horses. ANIMALS 32 healthy 2- to 5-year-old horses. PROCEDURES The study involved 2 portions. To evaluate prophylactic efficacy of the test product, horses received 5 mL of the product (n = 8) or saline (0.9% NaCl) solution (8; placebo) IV every fifth day, starting on day 0 (when osteoarthritis was induced in the middle carpal joint of 1 forelimb) and ending on day 70. To evaluate treatment efficacy, horses received either the product or placebo (n = 8/treatment) on days 16, 23, 30, 37, and 44 after osteoarthritis induction. Clinical, diagnostic imaging, synovial fluid, gross anatomic, and histologic evaluations and other tests were performed. Results of each study portion were compared between treatment groups. RESULTS Limb flexion and radiographic findings were significantly worse for horses that received the test product in the prophylactic efficacy portion than for placebo-treated horses or product-treated horses in the treatment efficacy portion. In the prophylactic efficacy portion, significantly less articular cartilage erosion was identified in product-treated versus placebo-treated horses. In the treatment efficacy portion, joints of product-treated horses had a greater degree of bone edema identified via MRI than did joints of placebo-treated horses but fewer microscopic articular cartilage abnormalities. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that caution should be used when administering the evaluated product IV to horses, particularly when administering it prophylactically, as it may have no benefit or may even cause harm.

Chronic nodular panniculitis in a three-year-old mare.

The clinical signs of chronic nodular panniculitis in a three-year-old mare were consistent with a diagnosis of sterile nodular panniculitis, but the mare had histopathological signs of both generalised steatitis and sterile nodular panniculitis. The mare was deficient in vitamin E and selenium.

Abdominal radiography in monitoring the resolution of sand accumulations from the large colon of horses treated medically.

This retrospective study consisted of 14 horses (age 6 weeks-12 years) with radiographically evident sand accumulations cranioventrally in the abdomen and clinical signs suggestive of sand enteropathy. The horses were treated medically and resolution of sand was monitored radiographically. Routine treatment consisted of psyllium mucilloid, combined with magnesium sulphate and/or mineral oilif needed. Initially, the number, size and shape of the sand accumulations showed large variation and the response to therapy was not predictable based on the initial appearance of the accumulation. In 2 foals, some of the sand was passed and the rest was mixed with other intestinal contents within 2-4 days. Even large accumulations disappeared in 2-4 days with psyllium alone or combined with mineral oil in 4 horses. In another 4 horses, the size of the accumulations decreased but varying amounts remained approximately at the same site, despite treatment for 1-4 weeks, and all these horses also had either gastric or large colon impaction. Three horses had a limited response to psyllium treatment, but the accumulation resolved with repeated doses of magnesium sulphate, with or without mineral oil. One horse did not respond to prolonged laxative treatment but the accumulation resolved on pasture. Clinical improvement was not necessarily related to the resolution of sand. Radiography of the cranioventral abdomen was found to be a useful means for monitoring the resolution of sand and confirming the effect of medical treatment in removing sand from the large colon in the horse.

Hyaluronate and large molecular weight proteoglycans in synovial fluid from horses with various arthritides.

OBJECTIVE: To investigate the presence of large molecular weight (MW) proteoglycans (PG) and hyaluronate (HA) in synovial fluid (SF) from horses with various arthritides and from control joints. DESIGN: Horses with acute (< 2 weeks) or chronic (> 4 weeks) lameness were examined by clinical examination, intrasynovial anesthesia, radiography, arthroscopy, and SF analysis. Joints were grouped on the basis of diagnosis: acute traumatic arthritis, chronic traumatic arthritis (with a subgroup of degenerative joint disease), intra-articular fracture, and infectious arthritis. ANIMALS: 31 horses with arthritis and 9 control horses; altogether 43 SF samples were analyzed. PROCEDURE: High-performance liquid chromatography was used to assess HA and large MW PG in SF samples. RESULTS: A PG peak was identified in 8 of 23 SF samples of joints with chronic traumatic arthritis, 4 of which had no or minimal abnormal radiographic findings but mild articular cartilage fibrillation detected by arthroscopy, and in 3 joints with intra-articular fracture and 1 with resolving infectious arthritis, but not in joints with acute traumatic arthritis or in control joints. There was significant difference (P < 0.01) in mean (+/- SEM) HA concentration between control joints and joints with chronic traumatic arthritis (0.32 +/- 0.04 g/L; n = 9 vs 0.18 +/- 0.01 g/L; n = 23). CONCLUSION: Large MW PG fragments are released into equine SF in the course of articular disease and can be detected simultaneously with HA by high-performance liquid chromatography. CLINICAL RELEVANCE: The SF HA concentration can be used as diagnostic marker for chronic traumatic arthritis. However, SF PG or other marker cannot be used for diagnosing or monitoring degenerative joint disease.

[Management of acute tendinitis]. / Management der akuten Tendinitis.

Ultrasonography must be used in combination with physical examination for the appropriate diagnosis of acute tendon injuries. Therapy should be designed to return the tendon to its normal function and appearance. Local and systemic anti-inflammatory agents, cold hydrotherapy and massage minimize excessive scar formation and progressively increasing tensile forces directs scar tissue to replace the tendon function.

Gamma scintigraphic analysis of the distribution of perfusion of blood in the equine foot during black walnut (Juglans nigra)-induced laminitis.

Twelve horses, with acute laminitis (primarily in the forefeet) at 12 hours after intragastric dosing with an aqueous extract of black walnut (Juglans nigra) heart-wood, were studied. The distribution of perfusion of blood to the foot and to outlined regions within the foot was quantified, using gamma scintigraphy of regionally infused 99mTc-labeled macroaggregated albumin, before and 12 hours after extract administration. Horses 1 to 3 were not studied further. Perfusion was quantified again for horses 4 to 12 at 84 hours after extract administration. At the onset of acute laminitis, horses 7 to 12 were administered a single dose of prazosin (0.025 mg/kg of body weight, IV) immediately after scintigraphy of the right forelimb and before scintigraphy of the left forelimb. When compared with baseline images, perfusion to the forefoot of horses after the development of acute laminitis was quantitatively decreased vs perfusion to the entire distal portion of the forelimb. Also with the onset of laminitis, perfusion also decreased to the dorsal laminar and coronary corium regions vs the distal portion of the forelimb. The acute laminitis-associated deficit in perfusion to the dorsal laminitis-associated deficit in perfusion deficit in perfusion to either the coronary corium or the entire forefoot. Equivalent deficits in the distribution of perfusion were not detected in forelimbs from horses with acute laminitis and which had been treated with prazosin. When compared with baseline images, perfusion to the dorsal lamina was increased in relation to perfusion to the distal portion of the limb at postdosing hour 84. Prazosin treatment did not influence that increase in perfusion to the dorsal lamina.

Methods of stimulating acupuncture points for treatment of chronic back pain in horses.

Horses with chronic back pain of 2 to 108 months' duration were treated using acupuncture (n = 15), laser acupuncture (n = 15), or injection acupuncture (n = 15). Horses were treated once a week for 8 treatments (mean) with needle acupuncture, 11 treatments with laser acupuncture, or 9 treatments with injection acupuncture. After treatment, 37 horses had alleviation of clinical signs of pain and could train and compete: 13 horses treated with needle acupuncture; 11 horses treated with laser acupuncture; and 13 horses treated with injection acupuncture. Seemingly, the 3 types of acupuncture were equally useful for treating horses with chronic back pain.

Diarrhea associated with sand in the gastrointestinal tract of horses.

Four horses with diarrhea had radiographic evidence of large quantities of sand in the gastrointestinal tract. Initially, none of the horses had sufficient fecal sand quantity to suggest sand enteropathy. Diarrhea resolved in all horses within 2 days of oral administration of psyllium hydrophilic mucilloid. Historically, all 4 horses had lost weight or had difficulty maintaining weight. After treatment was administered, the horses either gained weight or were easier to maintain in good condition.

Some observations on lameness associated with pain in the proximal metacarpal region.

The carpus and metacarpus of 40 horses which were free from lameness and 40 horses with lameness associated with the metacarpophalangeal joint or more distal limb were examined radiographically (Group A). The opacity of the proximal third of the third metacarpal bone was regular, with a uniform trabecular pattern. Osseous cyst-like lesions (OCLLs) were identified in the radial carpal bone (1), the ulnar carpal bone (2), the second carpal bone (15) and the fourth carpal bone (1). Thirty-one of 638 horses (4.8 percent) with forelimb lameness had pain localised to the proximal metacarpal region using local anaesthesia (Group B). All these horses were examined radiographically and an ultrasonographic examination was performed in seven. No definitive diagnosis was reached in 16 horses, seven of which had an OCLL in one of the carpal bones or the second metacarpal bone. One horse had, in addition to a poorly defined lucent area in the second carpal bone, radiographic evidence of degenerative joint disease of the carpometacarpal joint and an hypoechoic lesion in the accessory ligament of the deep digital flexor tendon. One horse had an hypoechoic lesion in the proximal part of the suspensory ligament. Abnormalities of the trabecular structure of the third metacarpal bone were identified in 13 horses. In 11 of these there was a vertically orientated lucent line, usually surrounded by sclerotic bone. These lucent lines may represent fatigue fractures seen end on. In one horse an horizontal lucent line was seen. One of these 13 horses also had a lesion in the proximal part of the suspensory ligament. Ten of the 13 (77 per cent) horses with presumed fractures of the third metacarpal bone recovered completely, whereas only eight of the 16 (50 per cent) horses in which no definitive diagnosis was reached returned to their former function.

Repair of a delayed-union stress fracture of the dorsal cortex of a metacarpal bone in a horse.

A delayed union metacarpal stress fracture was repaired in a horse, using lag-screw fixation in conjunction with dc electrical stimulation. Twelve weeks after surgery, radiographic and scintigraphic evaluations revealed that the fracture line was not discernible and that there was a decrease in radiopharmaceutic uptake, as compared with that in previous bone imaging studies. In this horse, DC stimulation of a delayed union stress fracture in a bone resulted in a healing pattern similar to that in human beings with delayed union fractures when treated with electrical stimulation.

Review of pulsing electromagnetic field therapy and its possible application to horses.

The relevant literature on electrostimulation in general, and pulsing electromagnetic fields in particular, is reviewed. DC current influences cell behaviour by affecting transmembrane ion transport, which is often under enzymatic control. Pulsing electromagnetic fields influence cell functions through adsorption of ions or dipole formation at the cell membrane. Invasive and non-invasive DC current stimulation is compared to pulsing electromagnetic fields. The mode of application of pulsing electromagnetic fields to the equine limb and suggested treatment times are briefly discussed. Two case reports are used to illustrate the effect of pulsing electromagnetic fields in equine fracture treatment.

Symposium on back problems in the horse. (2) The diagnosis of diseases of the horse's back.

A description of some of the clinical features of low back pain in the horse has been given and a number of methods for assisting diagnosis considered. As well as a complete clinical examination both at rest and during exercise, a useful diagnostic aid in some chronic cases was the injection of local anaesthetic into the interspinous spaces. A laboratory examination, including haematological and biochemical profiles, was undertaken in all cases. The serum enzymes GOT and CPK were particularly valuable as an aid to diagnosis in atypical tying-up. A technique for radiography of the vertebral column of the mid back in the standing position and of the pelvic and sacroiliac regions of the anaesthetised horse was described using a Siemens Triplex Optimatic 1023 machine. Some of the radiological features of the vertebral column were considered and a breakdown of the diagnosis of 110 referred back cases. The most important conditions included muscle strain, crowding and overriding of the dorsal spinous processes in the mid back, spondylosis, undue curvature of the spine and vertebral fractures.

Osteoporosis in a six year old pony.

A case of what can be presumed to be secondary nutritional hyperparathyroidism, due to high phosphorus diet, in a six year old pony is discussed. The findings are compared to those found when the disease occurs in young growing horses.