[Ultrasonographic findings of the stomach in warmblood horses at different filling states]. / Die sonografische Darstellung des Magens beim Warmblutpferd bei unterschiedlichen Füllungszuständen.

SUBJECT AND AIM: The aim of the study was to clarify to what extent the sonographic representation of the stomach changes depending on its filling state. MATERIAL AND METHODS: In a prospective controlled study, warmblood horses presented for gastroscopy were assessed sonographically. The examinations took place when the horses were fed normally (measurement 1), after 12 hours of food deprivation (measurement 2), after insufflation of air during gastroscopy (measurement 3) and after removal of air from the stomach at the end of the gastroscopy (measurement 4). The following objective parameters were recorded: Number of intercostal spaces (craniocaudal extension) and determination in which intercostal spaces the stomach could be visualized sonographically, maximum dorsal extension of the stomach, distance between skin and stomach wall. RESULTS: The median number of intercostal spaces in which the stomach could be visualized sonographically was 7.5 (IQR 3.75), 1.0 (IQR 1.0), 7.0 (IQR 2.0) and 2.0 (IQR 1.0) for measurements 1, 2, 3 (n=32) and 4 (n=15), respectively. The differences were significant between measurements 1 and 2 and between measurements 2 and 3. There was no significant difference between measurements 1 and 3. After 12 hours of food deprivation, the stomach size measured by the number of intercostal spaces visualizing the stomach was reduced by 75%. The maximum dorsal expansion of the stomach for measurements 1, 2, 3 (n=32) and 4 (n=15) was a median of 38 cm (IQR 15.25), 13 cm (IQR 6.75), 43 cm (IQR 7.00) and 21 cm (IQR 8.00), respectively. The differences were significant between measurements 1 and 2 and between 2 and 3. Concerning the distance between skin and stomach wall, the following medians were determined for measurements 1, 2, 3 (n=32) and 4 (n=15): 5.8 cm (IQR 2.27), 4.05 cm (IQR 3.05), 4.8 cm (IQR 1.48) and 5.9 cm (IQR 2.90). The only statistically significant difference was observed between measurements 1 and 3. CONCLUSIONS AND CLINICAL RELEVANCE: The sonographic appearance of the stomach changes according to the state of filling. Parameters that are readily determined sonographically are the craniocaudal and maximum dorsal extension as well as the distance between the skin and the stomach wall.

Variation in the MRI signal intensity of naturally occurring equine superficial digital flexor tendinopathies over a 12-month period.

BACKGROUND: Signal intensity (SI) of equine tendinopathies in MRI differs between the superficial digital flexor tendon (SDFT) and the deep digital flexor tendon (DDFT). In DDFT lesions, short tau inversion recovery (STIR) SI decreases earlier than T2-weighted (T2w) SI, while the latter decreases earlier in SDFT lesions, but long-term results using STIR sequences are lacking. METHODS: Standing MRI of eight horses with naturally occurring SDFT lesions was performed at the day of treatment as well as 2, 6 and 12 months after treatment. RESULTS: After 12 months, six horses were sound and showed complete resolution of increased SI in T2w fast spin echo (FSE) images, but increased SI was found in STIR images in three horses and persisted in T1w and T2*w gradient recall echo images of all horses. In contrast, hyperintense areas were still visible in the SDFT in T2w FSE images in two horses presenting with re-injury. In the six horses without re-injury, percentage of cross-sectional areas affected and SI decreased over time in all sequences. CONCLUSIONS: This study suggests that SI in naturally occurring SDFT lesions decreases earlier in T2w FSE than in STIR images, in contrast to the DDFT.

[Comparison between gastric ultrasonography findings and the obtained reflux amounts in warmblood horses - First results]. / Vergleich zwischen sonografischen Untersuchungsbefunden am Magen und gewonnener Refluxmenge beim Warmblutpferd.

OBJECTIVE: The aim of the present study was to investigate the degree of correlation between ultrasonographic findings of the stomach and the obtained reflux volume in horses with secondary gastric distension. MATERIAL AND METHODS: In this prospective, controlled clinical study, warmblood horses presented with secondary gastric distension at the Clinic for Horses between 2017 and 2018 were included. Gastric fluid content was assessed sonographically by evaluating the number of intercostal spaces with detectable fluid level as well as the maximum height of gastric fluid. These findings were compared to the amount of reflux obtained. RESULTS: Eleven horses with a total of 52 examinations were included into the study. Gastric fluid levels were detectable over a median of 6 intercostal spaces (interquartil range [IQR] 3). The maximum extension recorded was over 9 intercostal spaces. Median obtained reflux amounted to 7 liters (IQR 6.5), with a maximum of 14 liters. The number of intercostal spaces with detectable fluid levels and obtained reflux volume exhibited a strong correlation with a correlation coefficient of 0.77 (p ≤ 0.001). Moderate correlation (correlation coefficient 0.59 with p ≤ 0.001) was observed between the maximum height of fluid levels and the obtained volume of reflux. Based on number of intercostal spaces with measurable gastric fluid levels estimation values for the obtainable reflux volume were established. When fluid levels are detectable over 5 or 6 intercostal spaces approximately 5.7-7.4 liters of reflux are to be expected. The maximum height of gastric fluid levels may be considered insufficient for an accurate prediction of reflux volume due to the moderate correlation of these 2 parameters. CONCLUSION AND CLINICAL RELEVANCE: Due to the high correlation between number of intercostal spaces with sonographically detectable fluid levels and the obtained reflux volume, this parameter seems to be adequate to predict reflux amount. Based on this estimation, management of horses with paralytic ileus may be optimized.

Comparison of incisional complications between skin closures using a simple continuous or intradermal pattern: a pilot study in horses undergoing ventral median celiotomy.

BACKGROUND: Development of incisional complications following ventral median celiotomy might depend on suture pattern for skin closure. METHODS: In this prospective study, 21 healthy male horses underwent celiotomy. Skin closure was either performed via a continuous percutaneous pattern (CO group; 5 warmbloods/5 ponies) or an intradermal pattern (ID group; 5 warmbloods/6 ponies). Follow-up examination of the incisional site included daily monitoring for edema, dehiscence, and drainage. Transcutaneous ultrasound was performed at Days 3, 6, and 10 as well as on Week 8 and 12 to evaluate size of edema and presence or absence of sinus formation, and hernia formation. Prevalence of incisional infection on base of positive microbiological analysis at any time up to Day 10 was evaluated and compared between ID and CO group. Furthermore, edema size was analysed by a linear mixed-effect model for group and time dependency. RESULTS: Observed incisional complications included edema (9/10 in CO, 10/11 in ID), suture sinus formation (2/10 in CO, 1/11 in ID), surgical site infection (2/10 in CO, 0/11 in ID), and incisional hernia (1/10 in CO, 0/11 in ID). The overall prevalence of incisional infection was 9.5% without significant differences between both groups (20% in CO, 0% in ID; p = 0.214). Edema size was not dependent on time or group (p = 0.545 and p = 0.627, respectively). DISCUSSION: CO and ID suture pattern are appropriate for skin closure following ventral median celiotomy in horses. None of the animals in the continuous ID group developed surgical site infections, even without the use of antibiotics.

Incisional complications following ventral median coeliotomy in horses. Does suturing of the peritoneum reduce the risk? / Wundheilungsstörungen nach ventraler medianer Laparotomie beim Pferd. Reduziert die Bauchfellnaht Wundheilungsstörungen?

OBJECTIVE: Despite advances in surgical technique in abdominal surgery, incisional complications are frequently reported following ventral midline laparotomy in horses. The aim of this study was to determine the incidence of incisional complications at our clinic and to identify possible risk factors. Furthermore, we investigated whether suturing the peritoneum leads to a reduction of incisional complications. MATERIAL AND METHODS: In this retrospective study, records of patients of the Large Animal Clinic for Surgery of the University of Leipzig from January 2010 to December 2015 were analysed. Horses with ventral midline laparotomy following colic were included in the study. Evaluated parameters comprised breed, sex, age of the horse, localisation of the colic disease, invasiveness of the surgical intervention, duration of general anaesthesia, suture pattern of the laparotomy wound and postoperative fever or leukopenia. Incisional complications included suture dehiscence, exudation from the wound and incisional hernia formation. Wound oedema formation was evaluated separately. RESULTS: Incisional complications in the form of exudation and suture dehiscence occurred in 8.9% (18/202) of the horses. Postoperative hernia formation was observed in 5.2% (9/173) of patients. Breed, sex, localisation of the colic disease, invasiveness of the surgical intervention, duration of general anaesthesia and postoperative leukopenia did not influence the frequency of incisional complications. An increased risk of incisional complications was found in horses aged 20 years and older (odds ratio [OR] 17.90), in animals with postoperative fever (OR 7.48) and in horses with unsutured peritoneum (OR 7.68). Furthermore, patients with moderate and severe wound oedema displayed a significantly increased risk for the development of incisional complications. CONCLUSION AND CLINICAL RELEVANCE: Suture pattern is the only risk factor that can be directly influenced by the surgeon. Because a peritoneal suture is associated with a decreased risk of incisional complications, it should be standard practice when closing a laparotomy wound in the horse.

Retrospective Evaluation of Hemithyroidectomy in 14 Horses.

OBJECTIVE: To describe the presentation, presurgical diagnostic findings, treatment, and outcome of horses with histologically confirmed, unilateral thyroid neoplasia. The complications, particularly laryngeal hemiplegia, were investigated. STUDY DESIGN: Retrospective case series. ANIMALS: Client-owned horses (n=14). METHODS: Medical records of horses presenting with a unilateral thyroid mass due to neoplasia from 2003-2015 were reviewed. Horses must have undergone preoperative clinical evaluations that included ultrasound examination of the mass and upper airway endoscopy. Short-term follow-up at 2 weeks after surgery and owner questionnaire for long-term follow-up at >6 months were completed. RESULTS: Fourteen horses aged 6-21 years were included. The majority of tumors were adenocarcinomas (11/14), mainly diagnosed in mares (9/14). Intraoperative complications included hemorrhage (1/14) and postoperative complications included seroma formation (4/14). No horse developed postoperative laryngeal hemiplegia. No horses developed clinical signs of metastases or a thyroid disorder long term (mean follow-up 4.9 years). All owners reported a successful long-term outcome. CONCLUSION: The clinical findings of thyroid neoplasia in horses are not associated with the diagnosis of malignancy. Complete surgical resection of the abnormal lobe prevents local recurrence of neoplastic thyroid tissue. The modified hemithyroidectomy technique preserves the function of the recurrent laryngeal nerve.

Longitudinal Cell Tracking and Simultaneous Monitoring of Tissue Regeneration after Cell Treatment of Natural Tendon Disease by Low-Field Magnetic Resonance Imaging.

Treatment of tendon disease with multipotent mesenchymal stromal cells (MSC) is a promising option to improve tissue regeneration. To elucidate the mechanisms by which MSC support regeneration, longitudinal tracking of MSC labelled with superparamagnetic iron oxide (SPIO) by magnetic resonance imaging (MRI) could provide important insight. Nine equine patients suffering from tendon disease were treated with SPIO-labelled or nonlabelled allogeneic umbilical cord-derived MSC by local injection. Labelling of MSC was confirmed by microscopy and MRI. All animals were subjected to clinical, ultrasonographical, and low-field MRI examinations before and directly after MSC application as well as 2, 4, and 8 weeks after MSC application. Hypointense artefacts with characteristically low signal intensity were identified at the site of injection of SPIO-MSC in T1- and T2 (∗) -weighted gradient echo MRI sequences. They were visible in all 7 cases treated with SPIO-MSC directly after injection, but not in the control cases treated with nonlabelled MSC. Furthermore, hypointense artefacts remained traceable within the damaged tendon tissue during the whole follow-up period in 5 out of 7 cases. Tendon healing could be monitored at the same time. Clinical and ultrasonographical findings as well as T2-weighted MRI series indicated a gradual improvement of tendon function and structure.

Bovine thoracoscopy: surgical technique and normal anatomy.

OBJECTIVE: To describe a surgical technique for thoracoscopy and report visible anatomy within the thoracic cavity of standing cattle. STUDY DESIGN: Prospective study. ANIMALS: Adult clinically healthy Holstein-Friesian cows (n = 15). METHODS: Each cow had four thoracoscopic examinations. Initially, the left hemithorax was examined after passive lung collapse, then again 24 hours later after CO2 insufflation. The right hemithorax was examined 24 hours later after passive lung collapse and again 24 hours later after CO2 insufflation. RESULTS: CO2 insufflation did not significantly improve visibility within the pleural space. Collapsed lung, aorta, esophagus, diaphragm, and azygos vein were readily viewed; however, the pericardial region was not consistently visible. Minor laceration of the lung occurred in 1 cow with adhesions, otherwise there were no intra- or postoperative complications. All cows recovered without signs of discomfort. No local swelling or emphysema occurred at the portals. CONCLUSIONS: Thoracoscopy can be safely performed on healthy standing cattle.

Stent reconstruction of an injured parotid duct in a thoroughbred colt.

OBJECTIVE: To report successful use of stent repair for a chronically injured parotid duct in a thoroughbred colt. STUDY DESIGN: Clinical report. ANIMAL: A 2-year-old thoroughbred colt. METHODS: Chronic injury to the parotid duct was identified 4-cm caudal to the facial vessel notch on the ventral border of the right mandible. After careful surgical dissection of the surrounding firm fibrous tissue, the defect was temporarily stented using an 8-Fr human ureteral catheter (223600 ERU(®) SOFT URETERAL(®) , Laboratoires pharmaceutique, Betschdorf, France) to bridge the tissue loss. The rostral end of the catheter exited the oral cavity through a buccotomy stab incision at the level of the second premolar tooth of the maxilla. RESULTS: Primary wound healing occurred and the stent was maintained for 5 weeks with saliva drainage visible when the colt was fed. After stent removal, function was restored with good cosmesis. CONCLUSIONS: A tissue defect in the parotid duct can be repaired successfully by temporary use of a stent until wound healing occurs.

Immunotherapy of equine sarcoid: dose-escalation trial for the use of chimeric papillomavirus-like particles.

Equine sarcoids are fibrosarcoma-like skin tumours with a prevalence of approximately 1-2 %. Strong evidence exists for a causative role of bovine papillomavirus (BPV) type 1 or type 2 in the development of sarcoids. No effective treatment of equine sarcoid is available and after surgical excision relapse of the tumours is very frequent. We developed chimeric virus-like particles (CVLPs) of BPV 1 L1-E7 for the immunotherapy of equine sarcoid. In a phase I clinical trial 12 horses suffering from equine sarcoid with an average number of more than 22 tumours per animal were vaccinated in a dose-escalation setting. The animals were followed-up for 63 days, eight of the twelve horses were followed-up for more than a year and side-effects, humoral immune responses and tumour appearance were recorded. BPV DNA was detected in tumours of 11 cases. CVLPs were well tolerated in all dose groups, a robust anti-L1 antibody response was induced in all but one of the horses. Anti-E7 antibodies were detected in five of the 12 animals at low titres. Two animals showed a clear improvement of the clinical status after treatment, i.e. the number of the tumours per horse was reduced. In another horse regression of five sarcoids was observed; three of them relapsed during the study. Two animals showed tumour regression as well as growth of new sarcoids. In two horses the clinical status remained unchanged, in another two horses growth of existing tumours or growth of additional tumours was observed. The remaining three animals showed simultaneously regression and growth of existing tumours. Neither the humoral immune responses nor the observed effects on the tumours was correlated with the dose group.