Ultrasound-guided periarticular injections of the sacroiliac region in horses: a cadaveric study.

REASON FOR PERFORMING STUDY: The traditional techniques for injection of the sacroiliac (SI) region are based on external landmarks. Because of the depth of the SI joint and pathological modifications, SI injections are sometimes challenging in horses. HYPOTHESIS: An ultrasound-guided techniques would allow placement of the needle without depending on external landmarks. METHODS: Fourteen pelvic specimens were isolated from mature horses. A 20 cm bent spinal needle was positioned with ultrasonographic guidance under both iliac wings aiming for SI joints using 5 approaches: cranial, craniomedial, medial and 2 caudal approaches. The length of needle inserted was recorded and 2 ml of latex injected. The distance from latex to the closest sacral articular margin, the contact between latex and the SI interosseous ligament or the contact with the neurovascular structures emerging from the greater sciatic foramen were recorded at the time of dissection. RESULTS: Latex was identified under the iliac wing in all injections but one. The distance from the latex to the closest sacral articular margin was significantly shorter (P = 0.02) for the 2 caudal approaches compared to the cranial, craniomedial and medial approaches. Contact between latex and the SI interosseous ligament was significantly more frequent (P = 0.01) with the cranial, craniomedial and medial approaches (38/73) compared to the caudal approaches (1/24). Contact between latex and the neurovascular structures was significantly less frequent (P = 0.005) for the cranial and craniomedial approaches (0/47) compared to the medial and caudal approaches (8/60). Four erratic injections were encountered. CONCLUSIONS: Ultrasonographic guidance allowed the needle to engage under the iliac wing without being dependent on external landmarks. The caudal approaches allowed deposition of liquid extremely close to the SI joint although retroperitoneal injections occurred. CLINICAL RELEVANCE: Each approach has advantages/drawbacks that could be favoured for selected purposes, but additional work is required to evaluate them on clinical cases.

Ligation of the ipsilateral common carotid artery and topical treatment for the prevention of epistaxis from guttural pouch mycosis in horses.

The objective of the study was to evaluate the effect of ligation of the ipsilateral common carotid artery (CCA) combined with various antimycotic treatments for the prevention of epistaxis in horses with guttural pouch mycosis. For each case, ipsilateral ligation of the CCA was performed, followed by application of various topical medications under endoscopic guidance. Frequency and number of treatments, outcome and recurrence of haemorrhage were retrospectively recorded. Twenty-four horses were included. Topical medication was administered by detachment of the diphtheric membrane and spraying (n=16) or by intralesional injection directly in the plaques using a transendoscopic needle (n=8). Epistaxis recurred in five horses (20.8 per cent), causing death of four horses (16.6 per cent). The mean number of treatments was 6.3±4.0 (range 2-14) for all topical treatments. Ligation of the ipsilateral CCA and topical medication carries a fair prognosis for avoidance of recurrent episodes of epistaxis, but fatal haemorrhage can occur. Removal of the fungal plaque and topical treatment of the underlying lesion appeared to speed up resolution of the mycotic mucosal lesions. The described technique is a salvage procedure when financial or technical constraints prevent the use of transarterial catheter occlusion techniques.

Effects of adding butorphanol to a balanced anaesthesia protocol during arthroscopic surgery in horses.

Three groups of horses scheduled for arthroscopic surgery were premedicated with 0.025 mg/kg acepromazine, 88 microg/kg romifidine and 25 mg/kg guaifenesin, and anaesthesia was induced with 2.2 mg/kg ketamine. In group 1 (14 horses), anaesthesia was maintained by halothane vaporised in oxygen, with supplementary doses of 20 microg/kg romifidine and 0.5 mg/kg ketamine every 20 minutes. The 17 horses in group 2 were maintained as for group 1; however, an additional dose of 0.05 mg/kg butorphanol was administered before the first incision. The 14 horses in group 3 were maintained as for group 2, except that the dose of romifidine was halved to 10 microg/kg. The mean (sd) dose of vaporised halothane (6.5 [1.1], 4.8 [1.3] and 4.8 [1.3] microl/kg/minute, for groups 1, 2 and 3, respectively), vaporiser dial setting (2.3 [0.2],1.6 [0.4] and 1.3 [0.1] per cent) and dose of dobutamine administered to correct episodes of hypotension (0.16 [0.08], 0.07 [0.09] and 0.0 [0.0] microg/kg/minute) were all significantly lower in groups 2 and 3 than in group 1. Mean arterial blood pressure was significantly higher in groups 2 and 3 than in group 1 (71 [3], 74 [5] and 80 [5] mmHg, for groups 1, 2 and 3, respectively).

Location of radiological lesions of the thoracolumbar column in French trotters with and without signs of back pain.

The radiographs of 102 French trotters presented with signs of back pain were reviewed retrospectively, and a control group of 16 French trotters without back pain was analysed. The age, sex, type of race, number of starts, earnings and index of performance were recorded. Radiological evaluation was performed from the 14th thoracic (T14) to the third lumbar (L3) vertebra. Impingement of the spinous processes (ISP), periarticular proliferation of synovial intervertebral articulations (PP-SIA) and sclerosis of SIA (S-SIA) were located and graded. Radiological lesions were identified in 10 (62 per cent) of horses in the control group and 98 (96 per cent) of horses in the clinical group. The number of affected horses, the number of radiological lesions per horse and the mean number of affected intervertebral spaces were significantly higher in the clinical group. For ISP, the number of affected horses was not significantly different between the groups, but the number of affected interspinous spaces and the grade of lesions were significantly higher in the clinical group. For PP-SIA, the number of affected horses, the number of affected SIA and the grade of lesions were significantly higher in the clinical group. For S-SIA, the number of affected horses and the number of affected SIA were not significantly different between the groups but the grade of lesions was significantly higher in the clinical group. In both groups, ISP was most commonly encountered between T15-T18 and PP-SIA and S-SIA were most commonly encountered between T17-L2. Radiographic lesions of the back were less severe and more localised in horses without back pain than in those with back pain.