A novel case of tracheal injury secondary to gunshot trauma in a white rhinoceros (Ceratotherium simum).

OBJECTIVE: To describe a case of tracheal injury secondary to gunshot trauma in a rhinoceros. ANIMALS: 5-year-old female white rhinoceros (Ceratotherium simum). CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES: The rhinoceros was found alive with an apparent bullet entry wound cranial to the left shoulder. The rhinoceros was agitated and had bilateral epistaxis and increased respiratory noise. Immobilization of the animal facilitated closer examination and initiation of medical therapy. Radiographs obtained of the neck region at this first examination were nondiagnostic. Subsequent immobilization events allowed for further diagnostics and treatment. TREATMENT AND OUTCOME: Initial treatment included a broad-spectrum antibiotic and a corticosteroid. Five days following the injury, the rhinoceros was considered stable, and the animal was immobilized to investigate the cause of the epistaxis and respiratory signs. Tracheoscopy revealed a full-thickness penetrating wound in the mid to caudal region of the trachea, and the surface of a metallic projectile was viewed within the wound. Medical treatment was continued and the rhinoceros was managed conservatively. At 14 days, radiographs of the neck made with a more powerful unit revealed tissue emphysema dorsal to the trachea. A subsequent tracheoscopy 54 days after injury revealed a granulated wound. Follow-up at 4 years after injury determined that the rhinoceros was reported to be behaving normally and had successfully calved. CLINICAL RELEVANCE: Gunshot wounds associated with poaching are a prevalent problem in rhinoceros in Africa. Although more aggressive therapy including surgery may likely be considered in zoo or domestic animals, limited conservative treatment was successful in this wild-managed rhinoceros.

Evaluation of lidocaine for brachial plexus blockade in eastern box turtles (Terrapene carolina carolina).

OBJECTIVE: To evaluate latency and duration of a brachial plexus block technique in eastern box turtles performed with 2% lidocaine at three dose rates. STUDY DESIGN: Prospective, randomized, blinded crossover study. ANIMALS: Adult eastern box turtles, two for drug dose evaluation and a group of six (three male, three female) weighing 432 ± 40 g (mean ± standard deviation) for the main study. METHODS: Animals were randomly assigned to four brachial plexus blocks with lidocaine at 5, 10 and 20 mg kg-1 or 0.9% saline (treatments LID5, LID10, LID20 and CON, respectively), separated by 1 week. Treatment side was randomized and blocks were performed unilaterally. Baseline observations of mentation, heart rate (HR), respiratory rate (fR), skin temperature and limb response to manipulation or toe pinch were evaluated. Assessments were made every 10 minutes until 1 hour of normal sensory and motor function to the treated thoracic limb, or for a total of 2 hours if no block was evident. RESULTS: Motor and sensory blockade was achieved in treatments LID10 and LID20 in one turtle, with a latency of 10 minutes and duration of 50 minutes for both doses. Raising of the ipsilateral lower palpebra occurred with both blocks. Turtles administered lidocaine experienced higher HR compared with CON, and HR decreased over time for all individuals. Mentation and fR were not changed with any lidocaine dose. CONCLUSIONS: The technique was unreliable in producing brachial plexus motor and sensory blockade at the lidocaine doses evaluated in this study. HR was higher in lidocaine-administered turtles but remained within normal limits for the species. No change in mentation or fR was observed among treatments. CLINICAL RELEVANCE: General anesthesia with systemic analgesia is recommended for surgical procedures involving the chelonian thoracic limb. Further studies are needed to optimize a brachial plexus block in this species.

Anatomy and Physiology of the Equine Foot.

This article provides an overview of foot anatomy and physiology, with a focus on fundamental knowledge. The foot is defined as the epidermal hoof capsule and all structures enveloped by the capsule. The anatomy is described using terminology published in Nomina Anatomica Veterinaria.

Feasibility of a blind perineural injection technique for brachial plexus blockade in eastern box turtles (Terrapene carolina carolina): a cadaver study.

OBJECTIVE: To describe the anatomy of the brachial plexus in eastern box turtles (Terrapene carolina carolina), develop a blind perineural injection technique for brachial plexus blockade and evaluate the distribution of three volumes of new methylene blue dye for injection in cadavers. STUDY DESIGN: Prospective, randomized, blinded cadaveric study. ANIMALS: A total of 24 frozen-thawed box turtle cadavers; two turtles identified with shoulder injuries were subsequently excluded from the study. The remaining 22 turtles weighed 397 (190-581) g, median (range). METHODS: The brachial plexus and regional anatomy were identified by dissection of seven cadavers to determine anatomic landmarks for a perineural injection technique. This technique was tested by randomizing 15 cadavers into one of three groups to be injected bilaterally with one of three volumes (0.1, 0.2 or 0.3 mL) of methylene blue dye 1% aqueous solution. Investigators blinded to the assigned group dissected cadavers 15 minutes after injection and used staining of the four cervical spinal nerves (C5-C8; 25% for each nerve) to record a staining score of the brachial plexus (0-100%). RESULTS: Based on descriptions of the anatomy of the brachial plexus, an injection technique was designed. Injections of 0.1 mL methylene blue dye resulted in nine/10 injections with 100% nerve stained, and one/10 injection with 50% (two) nerves stained. All injections of 0.2 or 0.3 mL of methylene blue dye resulted in 100% nerves stained. CONCLUSIONS AND CLINICAL RELEVANCE: Perineural injection of the brachial plexus with 0.1, 0.2 or 0.3 mL methylene blue dye was successful in 29/30 injections in box turtle cadavers weighing 190-581 g. Further studies are needed to determine the minimum volume of injectate that can be successfully used for this technique, and to evaluate its application and efficacy in live turtles.

IDENTIFICATION OF A NASOCONCHAL PARANASAL SINUS IN THE WHITE RHINOCEROS ( CERATOTHERIUM SIMUM).

African rhinoceros are poached for their horns using indiscriminate and aggressive methods. Rhinoceros that survive these attacks often have severe facial trauma, and treatment is limited by a lack of understanding and published information of the normal anatomy. This study was performed to investigate and describe the anatomy of the most commonly injured area of the head of the white rhinoceros ( Ceratotherium simum). Two white rhinoceros cadaver heads were imaged by computed tomography and grossly dissected. A combined dorsal conchal sinus and nasal sinus (named the nasoconchal sinus) was identified and confirmed to be readily exposed by horn removal. The nasoconchal sinus communicates via a relatively large opening with the middle nasal meatus of the nasal cavity. Awareness of the combined sinus space and its single communicating pathway will assist with accurate assessment and treatment of trauma to the dorsal facial region of the white rhinoceros.

Sleep hygiene among veterinary medical students.

OBJECTIVE: The objective of this study was to better understand veterinary medical students' sleep hygiene and identify the extent to which sleep hygiene behaviors may result in consequences (either positive or negative) for students. SAMPLE: A total of 187 doctor of veterinary medicine (DVM) program students at a large College of Veterinary Medicine in the United States. METHODS: The Epworth Sleep Scale and Daytime Sleepiness Scale were administered to 393 students enrolled in the DVM program. RESULTS: About 55.1% of students reported <7 h of sleep per night, 28.9% reported having trouble sleeping, and 50.3% reported feeling sleepy all day. With respect to sleep quality, 5.3% described it as excellent, 52.4% as good, 34.2% as fair, and 8.0% as poor. CONCLUSIONS: A significant percentage of veterinary medical students exhibit poor sleep hygiene habits that may be detrimental to both their health and academic endeavors.

Defining local nerve blocks for feline distal pelvic limb surgery: a cadaveric study.

Objectives Anatomical and methodological detail is lacking regarding local anesthetic peripheral nerve block techniques for distal pelvic limb surgery in cats. The aim of this study was to develop, describe and test nerve block methods based on cadaveric dissections and dye injections. Methods Ten pairs of feline pelvic limbs (n = 20) were dissected and the tibial nerve (T n.), common fibular (peroneal) nerve (CF n., and its two branches, the superficial fibular [peroneal] nerve [SpF n.] and the deep fibular [peroneal] nerve [DpF n.]) and the saphenous nerve (Sa n.) were identified. Based on these dissections, a 'distal crus block' (selective blockade of the CF n., T n. and Sa n.) and a 'distal pes block' (selective blockade of the SpF n., DpF n., T n. and Sa n.) were developed for surgical procedures in two different regions of the distal pelvic limb. Techniques were tested using new methylene blue (NMB) dye injections in feline pelvic limbs (n = 12). Using a 25 G × 5/8 inch needle and 1 ml syringe, 0.1 ml/kg of NMB dye solution was injected at the site of the CF n., and 0.05 ml/kg was injected at the sites of the SpF n., DpF n., Sa n. and T n. The length and circumference (fully or partially stained) of each stained nerve were measured. Results Positive staining of nerves was observed in 12/12 limbs. The lengths stained for the CF n., DpF n., SpF n., Sa n. and T n. were 27.19 ± 7.13, 20.39 ± 5.57, 22.82 ± 7.13, 30.89 ± 6.99 and 25.16 ± 8.09 mm, respectively. The nerves were fully stained in 12, 12, 10, 11 and 11 out of 12 limbs, respectively. Conclusions and relevance These two, three-point injection methods may be an effective perioperative analgesia technique for feline distal pelvic limb procedures.

Defining the local nerve blocks for feline distal thoracic limb surgery: a cadaveric study.

OBJECTIVES: Though controversial, onychectomy remains a commonly performed distal thoracic limb surgical procedure in cats. Peripheral nerve block techniques have been proposed in cats undergoing onychectomy but evidence of efficacy is lacking. Preliminary tests of the described technique using cadavers resulted in incomplete staining of nerves. The aim of this study was to develop nerve block methods based on cadaveric dissections and test these methods with cadaveric dye injections. METHODS: Ten pairs of feline thoracic limbs (n = 20) were dissected and superficial branches of the radial nerve (RSbr nn.), median nerve (M n.), dorsal branch of ulnar nerve (UDbr n.), superficial branch of palmar branch of ulnar nerve (UPbrS n.) and deep branch of palmar branch of ulnar nerve (UPbrDp n.) were identified. Based on these dissections, a four-point block was developed and tested using dye injections in another six pairs of feline thoracic limbs (n = 12). Using a 25 G × 5/8 inch needle and 1 ml syringe, 0.07 ml/kg methylene blue was injected at the site of the RSbr nn., 0.04 ml/kg at the injection site of the UDbr n., 0.08 ml/kg at the injection site of the M n. and UPbrS n., and 0.01 ml/kg at the injection site of the UPbrDp n. The length and circumference of each nerve that was stained was measured. RESULTS: Positive staining of all nerves was observed in 12/12 limbs. The lengths stained for RSbr nn., M n., UDbr n., UPbrS n. and UPbrDp n. were 34.9 ± 5.3, 26.4 ± 4.8, 29.2 ± 4.0, 39.1 ± 4.3 and 17.5 ± 3.3 mm, respectively. The nerve circumferences stained were 93.8 ± 15.5, 95.8 ± 9.7, 100 ± 0.0, 100 ± 0.0 and 93.8 ± 15.5%, respectively. CONCLUSIONS AND RELEVANCE: This described four-point injection method may be an effective perioperative analgesia technique for feline distal thoracic limb procedures.

Radiation therapy communication: nasal passage and paranasal sinus lymphoma in a pony.

An aged pony with extensive paranasal sinus and nasal passage B-cell lymphoma was treated with palliative radiation therapy. Sixteen gray were administered in two fractions, 7 days apart. A lateral field was used for the first fraction and a dorsal field for the second. Because of tumor being present in the left frontal sinus, gross tumor was knowingly excluded from the treated volume in the lateral field. The tumor regressed within 2 months and the pony remained free of clinical disease for 2.5 years. Acute, temporary blindness developed shortly after the second radiation fraction, but a direct causal relationship with the radiation therapy was not confirmed. The only radiation side effect was leukotrichia. Palliative treatment was successful in improving and prolonging the quality of life. These results suggest that localized equine B-cell lymphoma is radiosensitive, and that palliative radiation therapy is a reasonable consideration for large tumors, even when tumor volume prevents all gross tumor from being irradiated.

Analysis of sodium carboxymethylcellulose administration and related factors associated with postoperative colic and survival in horses with small intestinal disease.

OBJECTIVE: To analyze the effect of the intraoperative use of sodium carboxymethylcellulose (CBMC) and related perioperative factors on postoperative colic and survival in horses that had abdominal surgery for colic. STUDY DESIGN: Retrospective study. ANIMALS: Horses (n=203) that had surgery for small intestinal disease; 33 horses had intraoperative administration of CBMC. METHODS: Information was obtained from medical records for 170 horses that had surgery for colic before use of CBMC and 33 horses that had intraoperative CBMC. Kaplan-Meier survival curves were used to estimate median survival time and a Cox proportional hazards model was used to estimate the hazard ratio for the effect of CBMC and other perioperative variables on survival. RESULTS: Seventy-five percent of horses administered CBMC survived to 180 days, whereas 75% of untreated horses survived 8 days (median survival time=18 days). Horses not administered CBMC were twice as likely to die compared with horses administered CBMC. Horses that had postoperative ileus (POI) were 1.4 times more likely to die than horses without ileus. Similarly, horses with signs of colic after surgery were 1.3 times more likely to die than horses without postoperative signs of colic. CONCLUSIONS: CBMC administration is seemingly protective against death and prolongs survival when used intraoperatively in horses with small intestine disease, particularly horses with postoperative colic or POI. Both POI and colic increased risk of death after surgery. CLINICAL RELEVANCE: Intraoperative administration of CBMC in horses that have surgery for small intestinal disease may improve survival, possibly by reducing early adhesion formation.

Bilateral occurrence of granulosa-theca cell tumors in an Arabian mare.

An Arabian mare was referred for right granulosa-theca cell tumor (GTCT) evaluation. The mare was presented 4.5 years later for a left GTCT, after successfully conceiving and delivering a normal foal in the interim. The concurrent or nonconcurrent occurrence of bilateral GTCT in mares appears to be rare.

Infections of the head and ocular structures in the horse.

Infectious conditions of the equine head are commonly encountered in clinical practice. Pathogenic bacterial, viral, and fungal organisms may localize in the extensive nasal passages, paranasal sinuses, and guttural pouches, creating a range of clinical signs and conditions that can be severe enough to lead to unexpected fatality. Renewed interest in equine dentistry has led to a greater recognition of dental disease that is associated with infection. This article focuses on bacterial and fungal infections of the main anatomic regions of the equine head, where advances in diagnosis and management have been made or consolidated in recent years. It also addresses recent advances made in the area of infectious equine corneal disease, including bacterial, viral, and fungal etiologies. Recent developments in equine recurrent uveitis as it relates to infectious diseases and ocular manifestations of systemic disease are also discussed.

Bilateral renal agenesis in an alpaca cria.

A 3-day-old male alpaca cria was presented for lack of vigor and failure to urinate since birth. Based on the history, laboratory data, ultrasonographs, surgical findings, and postmortem examination, the cria was diagnosed with bilateral renal agenesis and hypoplastic bladder, a congenital condition rarely seen in veterinary medicine.

Effects of recombinant equine growth hormone on in vitro biomechanical properties of the superficial digital flexor tendon of Standardbred yearlings in training.

OBJECTIVE: To determine whether recombinant equine growth hormone (rEGH) would alter the in vitro biomechanical properties of the forelimb superficial digital flexor tendon (SDFT) in exercising young Standardbred horses. STUDY DESIGN: Randomized complete block design. ANIMALS: Twelve Standardbred yearlings. METHODS: Horses were trained for 12 weeks on a high-speed treadmill (10% positive incline). rEGH was administered intramuscularly (IM) daily (10 microg/kg during week 4; 20 microg/kg for weeks 5-9) to 6 horses (treated group), whereas 6 horses (control group) were administered an equivalent daily volume of sterile water IM. At 12 weeks, horses were euthanatized and left forelimb SDFTs were collected and stored (-70 degrees C). A section from the mid-region of the SDFT was held in cryoclamps with a 4 cm interspace distance and distracted at 10 mm/s until failure. The variables evaluated were maximal load at yield and failure, ultimate and yield tensile stress and strain, tendon stiffness, and mode of failure. Data were analyzed using unpaired, two-tailed, Student's t-test. Statistical significance was set at P < or =.05. RESULTS: Yield and ultimate tensile stress were significantly lower in the rEGH-treated horses compared with controls. There was a trend toward increased maximal displacement, increased ultimate tensile strain, and decreased tendon stiffness in rEGH-treated horses compared with controls. Tensile stress and cross-sectional area, and tensile stress and stiffness were significantly correlated at yield and failure points. CONCLUSIONS: rEGH, administered at the manufacturer's recommended dose rates to maturing Standardbred horses in training, does not significantly augment the in vitro biomechanical properties of the forelimb SDFT. CLINICAL RELEVANCE: Administration of rEGH to young horses in training is unlikely to enhance the physiologic adaptation of the SDFT to exercise stress.