Radiation safety practices among Canadian equine veterinary workers during diagnostic procedures with portable X-ray equipment.

The objective of this study was to report observed radiation safety practices among equine workers using portable X-ray units at 3 veterinary practices in Canada. Practice 1 was comprised of equine field service workers from an academic institution, whereas Practices 2 and 3 were comprised of workers from private equine referral practices. Out of 2969 exposure-worker observations, protective aprons were worn for > 99% (2968/2969), thyroid shields for 87% (2584/2969), and eyeglasses for 10% (310/2969). The cassette was held by hand for 97% (1078/1114) of observations, and the X-ray unit was held by hand for 100% (1293/1293) of observations. Gloves were used for 54% (606/1114) and < 1% (5/1293) of observations involving cassette holders and X-ray tube operators, respectively. Use of gloves was more frequent among technologists than DVMs (P = 0.004), and among workers in Practices 1 and 3 than in Practice 2 (P < 0.001). In conclusion, given that workers commonly hold cassettes and X-ray tubes by hand, improvement in shielding use is needed. Consideration should be given to specific behavior recommendations in radiation regulations.

Pratiques de radioprotection chez les travailleurs vétérinaires équins canadiens pendant les procédures de diagnostic avec un équipement de radiographie portable. L'objectif de la présente étude était de rapporter les pratiques de radioprotection observées chez les travailleurs équins utilisant des appareils de radiographie portatifs dans trois pratiques vétérinaires au Canada. La pratique 1 était composée de travailleurs équins sur le terrain d'une institution universitaire, tandis que les pratiques 2 et 3 étaient composées de travailleurs sur le terrain issus de pratiques de référence équines privées. Sur 2969 observations de travailleurs exposés, des tabliers de protection ont été portés pour > 99 % (2968/2969), des écrans thyroïdiens pour 87 % (2584/2969) et des lunettes pour 10 % (310/2969). La cassette a été tenue à la main pour 97 % (1078/1114) des observations et l'unité de radiographie a été tenue à la main pour 100 % (1293/1293) des observations. Des gants ont été utilisés pour 54 % (606/1114) et < 1 % (5/1293) des observations impliquant des porteurs de cassette et des opérateurs de tubes à rayons X, respectivement. L'utilisation de gants était plus fréquente chez les technologues que chez les vétérinaires (P = 0,004) et chez les travailleurs des Pratiques 1 et 3 que ceux de la Pratique 2 (P < 0,001). En conclusion, étant donné que les travailleurs tiennent généralement des cassettes et des tubes à rayons X à la main, une amélioration de l'utilisation du blindage est nécessaire. Il faudrait tenir compte des recommandations de comportement spécifiques dans les réglementations relatives aux rayonnements.(Traduit par Dr Serge Messier).

Transendoscopic Ventriculocordectomy Using Monopolar Electrosurgical Instrumentation for Conjunctive Treatment of Laryngeal Hemiplegia in Horses: 24 Cases (2017-2019).

Objective: The objective of this study is to evaluate the safety, efficacy, and owner satisfaction following electrosurgical ventriculocordectomy (EVC), in conjunction with prosthetic laryngoplasty, in equine clinical cases affected with left- or right-sided recurrent laryngeal neuropathy. Methods: Retrospective data analysis of clinical signalment, surgery, athletic outcome, intra- and postoperative complications, and postoperative examinations from clinical cases wherein EVC was performed in conjunction with traditional prosthetic laryngoplasty from one practice. Owners were contacted by phone or email for a follow-up questionnaire. Results: Twenty-four horses underwent unilateral EVC, performed transendoscopically under sedated restraint, using monopolar electrosurgical instrumentation successfully. One horse experienced excessive intraoperative hemorrhage. No horses demonstrated postoperative complications. Twenty cases had a history of increased airway noise prior to surgery. In 15 of these cases (15/20, 75%), the airway noise was reported as fully improved post-surgery. Eighteen cases had a history of exercise intolerance prior to surgery. In 15 of these cases (15/18; 83%), the exercise intolerance was reported as resolved. Conclusion: EVC, in conjunction with prosthetic laryngoplasty, can contribute to improvement of RLN symptoms and aid in the effective return to athletic work. Performing transendoscopic ventriculocordectomy with monopolar electrosurgical instrumentation provides comparable clinical outcomes to traditional techniques using a diode laser or direct excision via laryngotomy.

Fibro-Osseous Lesions Of The Craniofacial Complex In Horses: 30 Cases (2001-2019).

OBJECTIVE: To describe the presentation, diagnosis, treatment, and outcome for horses with fibro-osseous lesions of the craniofacial complex. STUDY DESIGN: Retrospective multicenter case series. ANIMALS: Thirty horses evaluated for fibro-osseous lesions of the skull from January 1, 2001 through December 31, 2019 in four centers. METHODS: Medical records were reviewed for signalment, clinical presentation, histological and diagnostic imaging findings, treatment instituted, and outcome. Long-term outcome information was obtained by owner questionnaire or the medical record. RESULTS: Diagnoses included ossifying fibroma in 20 of 30 horses, osteoma in eight of 30 horses, and fibrous dysplasia in two of 30 horses. Twelve of 30 lesions were diagnosed in horses <1 year old, and 20 of 30 lesions originated from the rostral mandible. The most common treatment was rostral mandibulectomy. Recurrence was not reported after complete excision. Incomplete excision was confirmed in eight horses (four ossifying fibromas, three osteomas, and one fibrous dysplasia), and follow-up information was available for seven horses. Recurrence occurred in one horse, while six horses had long-term resolution of clinical signs. Prognosis for survival and return to use was excellent in 23 horses with long-term follow-up. CONCLUSION: Fibro-osseous lesions were uncommon in this multicenter study; they were most commonly diagnosed in young animals and most frequently affected the rostral mandible. Long-term survival was excellent. CLINICAL SIGNIFICANCE: The definitive diagnosis of fibro-osseous lesions of the craniofacial complex in horses is made from results of histopathology and cannot be determined on the basis of clinical presentation alone. Surgical excision is indicated, and prognosis can be favorable even when complete surgical margins are not obtained.

Adaptation and evaluation of a monopolar electrosurgical triangle-tip knife for transendoscopic ventriculocordectomy in healthy horses.

OBJECTIVE: To evaluate the efficacy and safety of a transendoscopic monopolar electrosurgical triangle-tip knife as instrumentation to perform unilateral ventriculocordectomy (VC) in healthy adult horses. STUDY DESIGN: In vivo experimental study. STUDY POPULATION: Nine horses donated for medical conditions unrelated to respiratory system. METHODS: The triangle-tip knife was applied in contact fashion. Left VC was performed under standing sedation. Endoscopic images of the upper airway were graded for inflammation by 2 masked surgeons preoperatively and immediately, 24 hours and, in 2 cases, 7 and 14 days postoperatively. Four larynxes were examined for histological evidence of inflammation and collagen deposition at 24 hours (n = 2) and at 14 days (n = 2) after surgery. RESULTS: Ventriculocordectomy was successfully performed in all horses. Endoscopic evidence of inflammation was scored as normal (preoperatively), mild (immediately postoperatively), mild (24 hours postoperatively), mild (7 days postoperatively), and normal (14 days postoperatively). According to histopathology, inflammation of the surgical site and ventricularis muscle was generally increased (variable is common and is present in most high-power fields) 24 hours and 14 days postoperatively. Fibrosis and collagen deposition also seemed increased at the surgical site 14 days postoperatively. CONCLUSION: Ventriculocordectomy was successfully performed with an electrosurgical triangle-tip knife and resulted in acceptable short-term outcomes. CLINICAL SIGNIFICANCE: The use of an electrosurgical triangle-tip knife alternative instrumentation may be offer an alternative option to perform VC in practices when diode laser is not available or is cost prohibitive. Longer term evaluation of the VC site is required to determine the effect on rima glottic cross-sectional area.

Alcohol-facilitated ankylosis of the distal intertarsal and tarsometatarsal joints in horses with osteoarthritis.

OBJECTIVE: To assess the safety and efficacy of alcohol-facilitated ankylosis of the distal intertarsal (DIT) and tarsometatarsal (TMT) joints in horses with osteoarthritis (bone spavin). DESIGN: Prospective clinical trial. ANIMALS: 21 horses with DIT or TMT joint-associated hind limb lameness and 5 nonlame horses. PROCEDURES: 11 horses (group 1) underwent lameness, force-plate, and radiographic examinations; following intra-articular analgesia, lameness and force-plate examinations were repeated. Nonlame horses were used for force-plate data acquisition only. Following localization of lameness to the DIT and TMT joints, contrast arthrographic evaluation was performed; when communication with the tibiotarsal joint was not evident or suspected, 70% ethyl alcohol (3 mL) was injected. Group 1 horses underwent lameness, force-plate, and radiographic examinations every 3 months for 1 year. Ten other horses (group 2) underwent lameness and radiographic examinations followed by joint injection with alcohol; follow-up information was obtained from owners or via clinical examination. RESULTS: Significant postinjection reduction in lameness (after 3 days to 3 months) was evident for all treated horses. Twelve months after injection, 10 of 11 group 1 horses were not lame; lameness grade was 0.5 in 1 horse. Follow-up information was available for 9 of 10 group 2 horses; 7 were not lame, and 2 remained mildly lame (1 had a concurrent problem in the injected limb, and the other had DIT joint collapse that precluded needle entry). CONCLUSIONS AND CLINICAL RELEVANCE: Intra-articular alcohol injection in horses with bone spavin resulted in a rapid (usually within 3 months) reduction in lameness and joint space collapse.

Comparison of the response to experimentally induced short-term inflammation in the temporomandibular and metacarpophalangeal joints of horses.

OBJECTIVE: To investigate the relationship between inflammatory responses of the temporomandibular joint (TMJ) and the metacarpophalangeal (MCP) joint in clinically normal horses. ANIMALS: 7 mature horses. PROCEDURES: In each horse, 1 TMJ and 1 MCP joint were injected with lipopolysaccharide (LPS; 0.0025 µg). The contralateral TMJ and MCP joint were injected with saline (0.9% NaCl) solution. Synovial fluid samples were collected from all 4 joints over 24 hours after injection. Concentrations of interleukin-6, tumor necrosis factor-α, transforming growth factor-ß, and total protein were measured via immunoassay. Horses were assessed for clinical signs of joint inflammation at each time point. RESULTS: Concentrations of interleukin-6 were not significantly different between LPS-injected MCP joints and TMJs at any time point. Transforming growth factor-ß concentrations were significantly increased in MCP joints, compared with concentrations in TMJs, at 12 and 24 hours after injection. Tumor necrosis factor-α concentrations were significantly higher in LPS-injected TMJs than in LPS-injected MCP joints at 1 and 6 hours after injection. Total protein concentration did not differ significantly between LPS-injected MCP joints and TMJs. Injection of LPS induced clinical inflammation at all time points; additionally, 2 MCP joints (but no TMJs) had an inflammatory response to injection of saline solution. CONCLUSIONS AND CLINICAL RELEVANCE: The inflammatory response to LPS appeared to be attenuated more quickly in TMJs than in MCP joints of horses. The difference in response suggested that a lack of clinical osteoarthritis in the TMJ of horses could be attributable to a difference in cytokine response.

Outcomes of podotrochlear (navicular) bursa injections for signs of foot pain in horses evaluated via magnetic resonance imaging: 23 cases (2005-2007).

OBJECTIVE: To determine clinical outcome following intrathecal injection of the podotrochlear (navicular) bursa for signs of foot pain in horses evaluated via magnetic resonance imaging (MRI) and evaluate efficacy of corticosteroids administered with or without hyaluronate. DESIGN: Retrospective case series. ANIMALS: 23 horses. PROCEDURES: Data collected included signalment, history, intended use, duration and severity of lameness, results of diagnostic anesthesia, radiographic abnormalities, MRI abnormalities, and outcomes for return to use. RESULTS: MRI was conducted on 23 horses with lameness localized to the foot. Thirteen horses had bilateral forelimb lameness, and 10 had unilateral forelimb lameness. Mean duration of lameness was 10.5 months. Seventeen of 23 (74%) horses had excellent outcomes and returned to intended use within 2 to 4 weeks after navicular bursa injection. Hyaluronate treatment was not associated with outcome; however, horses receiving < 10 mg of trimacinolone had significantly worse outcomes than those treated with hyaluronate. Among horses with excellent outcomes, mean duration of soundness was 7.3 months. Seven of 8 horses with erosive lesions of the flexor surface of the distal sesamoid (navicular) bone diagnosed via MRI had a poor outcome. Horses with navicular bursitis responded optimally to injection, compared with horses with other problems. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that intrathecal injection of corticosteroid in horses with erosions of the flexor surface of the navicular bone associated with deep digital flexor tendon adhesions yielded a poor response. Treatment of horses with navicular bursitis via injection of the navicular bursa should be highly effective in alleviating lameness.