Standing hand-assisted laparoscopic ovariohysterectomy to treat chronic pyometra in a mare.

OBJECTIVE: To describe a standing hand-assisted laparoscopic ovariohysterectomy in a mare. ANIMAL: A 15-year-old maiden Oldenburg mare. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES: The mare was presented for evaluation of bucking under saddle and uncharacteristic aggressive behavior. Evaluation of a 24-hour video of the mare in a stall showed behavior consistent with caudal visceral abdominal discomfort. Reproductive evaluation revealed a pyometra secondary to complete transluminal cervical adhesions. The mare was initially managed medically with disruption of the adhesions and uterine lavage, but the adhesions reformed within 6 weeks and could not be manually disrupted. TREATMENT AND OUTCOME: To eliminate the recurrence of pyometra, the mare underwent standing hand-assisted laparoscopic ovariohysterectomy through bilateral flank incisions. The only complication was a seroma at 1 flank incision that resolved after drainage. CLINICAL RELEVANCE: Complete ovariohysterectomy in the mare is a challenging procedure and has previously been performed under general anesthesia. This is the first report of the procedure being performed completely in the standing mare without inversion of the uterus through the cervix.

Sonographic appearance of the late gestation equine fetal intestine.

Variable gestation length in the mare poses a challenge for determination of fetal readiness for birth. The objectives of this study were to describe sonographic characteristics of the fetal GI tract in the late gestation mare and identify changes that occur with progressing fetal maturity. Based on these characteristics, a grading scale modeled after the existing human and canine scoring system was developed. Weekly sonographic examination of the fetus by one observer beginning 2-3 weeks prior to a calculated due date of 330 days was performed. Fetal assessment included; presence of stomach rugae, bowel segment definition (uniform echogenic, some defined, clearly defined), bowel segment dilation (none, segmental dilation), intestinal contents (none, mixed echogenicity) and peristalsis (none, occasional, every 3 s, continuous). Based on these characteristics a phase was assigned to the GI tract (1-5). Phase 1 was defined as a uniform echogenic grey area caudal to the diaphragm. The differentiation of Phase 2-5 was based primarily on the frequency of peristalsis, with Phase 2 exhibiting no peristalsis, Phase 3 exhibiting occasional peristalsis, Phase 4 exhibiting peristalsis every 3 s and Phase 5 exhibiting continuous peristalsis. Only data from mares with a normal parturition and healthy foals were included in the statistics (N = 10). Associations amongst sonographic fetal GI characteristics and days prepartum were validated using a simulation-based bootstrap approach with 1000 replicates using Stata 14. Stomach rugae, peristalsis, intestinal contents, tail head relaxation and udder development were all highly correlated with days prepartum. Using a multiple linear regression model, tail head relaxation and peristalsis predicted days prepartum with a 95% CI ±â€¯6 days. The same model predicted days prepartum with a 95% CI ±â€¯4 days when day of gestation, tail head relaxation and peristalsis were included as variables. Based on these findings, characterization of the fetal GI tract could provide valuable information concerning the maturity of the equine fetus. Further studies are needed comparing high risk mares to normal mares before this information could be used with confidence in the clinical setting.

Notes from the Field: Outbreak of Cryptosporidiosis Among Veterinary Medicine Students--Philadelphia, Pennsylvania, February 2015.

On February 20, 2015, a northeastern university's student health center was notified of five veterinary medicine students with gastrointestinal symptoms. An investigation was conducted to establish the existence of an outbreak, determine the etiology, evaluate risk factors, and recommend control measures.

Effects of intratesticular zinc gluconate treatment on testicular dimensions, echodensity, histology, sperm production, and testosterone secretion in American black bears (Ursus americanus).

Eight adult American black bears were used to evaluate the effects of chemical castration by intratesticular zinc gluconate treatment on testicular dimensions, echodensity, histology, sperm production, and testosterone secretion. Treatment did not affect testicular dimensions and did not result in decreased resting or GnRH-stimulated testosterone secretion. Multifocal hyperchoic areas in the testicular parenchyma were observed on ultrasound examination, and white foci were observed on gross pathology examination after zinc gluconate treatment. Histologically, there were normal seminiferous tubules containing either round or elongated spermatids, along with abnormal tubules in all bears after treatment. Vacuolation of the seminiferous epithelium, sloughing of germ cells into the tubules' lumen, presence of multinuclear giant cells, and reduced height of the seminiferous epithelium with missing generations of germ cells were commonly observed. The most severe testicular changes were multifocal and included fibrosis, complete degeneration of the seminiferous epithelium with shrinkage of the tubule, and sperm stasis. Epididymal sperm reserve was 982.74 ± 654.16 × 10(6) sperm (mean ± SEM) and motile sperm were observed in the epididymis of all but one of the bears. In conclusion, although intratesticular zinc gluconate treatment in black bears resulted in testicular degenerative changes detected by ultrasound and histology examinations, sperm production was not completely ablated. We inferred that normal fertility might have been compromised, but treatment unlikely resulted in sterility.

Ultrasonographic assessment of fetal well-being during late gestation: development of an equine biophysical profile.

Mares with complicated pregnancies (illness, problems at parturition or delivery of an abnormal foal, n = 30) were scanned transabdominally from 298 days gestation to term in order to measure fetal size, evaluate fetal well-being and characterise the intrauterine environment. The results of the last scan obtained prior to parturition were compared to normal data obtained from fetuses of comparable gestational age to develop a biophysical profile specific for the equine fetus. Twelve mares produced a normal foal (positive outcome) and 18 mares delivered 19 abnormal foals (negative outcome). Both fetuses that were inactive throughout the entire scan and 4 of 5 fetuses with heart rate abnormalities were abnormal at birth. Three of 4 fetuses surrounded by decreased allantoic fluid quantities had a negative outcome. All mares with large anechoic spaces between the uterus and placenta (n = 3) and/or thickened uteroplacental units (n = 5) delivered abnormal foals. There was a significant correlation between fetal aortic diameter and neonatal foal weight in these complicated pregnancies (P<0.0001, r = 0.85). Fetal aortic diameters were predicted from maternal weight and 6 fetuses had smaller than predicted aortic diameters, all with negative outcomes. A biophysical profile of the equine fetus from 298 days gestational age to term was developed that included 6 factors related to pregnancy outcome: fetal heart rate, fetal aortic diameter, maximal fetal fluid depths, uteroplacental contact, uteroplacental thickness and fetal activity. The profile proved informative about fetal well-being, perinatal morbidity and perinatal mortality. A low score was a definite indication of an impending negative outcome; however, a high score was not assurance of a positive outcome. The utility of such a biophysical profile and future directions for research are discussed.