Ultrasonographic assessment of the atlanto-occipital space in healthy Thoroughbred foals and Thoroughbred foals with neonatal maladjustment syndrome.

Ultrasonography of the atlanto-occipital (AO) space may be useful as a non-invasive diagnostic tool in neonatal foals. The aims of the study were establish a range of values for ultrasonographic measurements of the AO space in healthy Thoroughbred foals and to compare these variables in healthy foals with foals diagnosed with neonatal maladjustment syndrome (NMS). Ultrasonography of the AO space was performed on 38 healthy Thoroughbred foals and 28 Thoroughbred foals with NMS≤4days of age. Transverse image spinal cord height (P=0.001), width (P<0.001) and spinal cord cross sectional area (P<0.001), and longitudinal image dorsoventral diameter of the ventral spinal artery, were significantly smaller in foals with NMS than in healthy foals. Ratios of spinal canal to cord width and cross sectional area were significantly smaller in healthy foals than in foals with NMS (P<0.001). Spinal canal variables were not significantly different between groups. Several ultrasonographic measurements of the AO space were significantly different between healthy foals and foals with NMS. Further investigation is warranted to investigate the clinical application of this technique.

Abnormal plasma neuroactive progestagen derivatives in ill, neonatal foals presented to the neonatal intensive care unit.

REASONS FOR PERFORMING THE STUDY: Increased levels of pregnanes have been reported in foals with neonatal maladjustment syndrome (NMS). These steroids may cross the blood-brain barrier and have depressive effects in the central nervous system leading to behavioural abnormalities and altered states of consciousness in affected foals. OBJECTIVES: The aim of this study was to determine the pregnane profile of foals with NMS and compare it with that of healthy controls and sick, non-NMS foals. STUDY DESIGN: Prospective-clinical study. METHODS: Thirty-two foals with a clinical diagnosis of NMS, 12 foals with other neonatal disorders and 10 healthy control foals were selected for the study. Heparinised blood samples were collected from each group of foals and pregnane and androgen concentrations determined using liquid chromatography mass spectrometry at 0, 24 and 48 h of age. RESULTS: Healthy foals showed a significant decrease in pregnane concentrations over the first 48 h of life (P<0.01). Foals with NMS and sick, non-NMS foals had significantly increased progesterone, pregnenolone, androstenedione, dehydroepiandrosterone and epitestosterone concentrations compared with healthy foals (P<0.05). Progesterone and pregnenolone concentrations of sick, non-NMS foals decreased significantly over 48 h (P<0.05), whereas concentrations in NMS foals remained increased. CONCLUSIONS AND POTENTIAL RELEVANCE: Pregnane concentrations of ill, neonatal foals remain increased following birth, reflecting a delayed, or interrupted, transition from intra- to extra-uterine life. Serial progesterone and pregnenolone measurement may be useful in aiding diagnosis of NMS.

Treatment with histamine-type 2 receptor antagonists and omeprazole increase the risk of diarrhoea in neonatal foals treated in intensive care units.

REASONS FOR PERFORMING STUDY: The use of anti-ulcer medication in the neonatal intensive care unit (ICU) is common due to the concern for development of catastrophic gastric ulcerdisease. In man, however, the use of acid-suppressive medication has been shown in some studies to be a substantial riskfactorfor the development of Clostridium difficile-associated diarrhoea (CDAD), bacteraemia and neonatal sepsis. OBJECTIVE: The purpose of the study reported herein is to evaluate the influence of anti-ulcer medications on the development of diarrhoea in the neonatalfoal. HYPOTHESIS: The use of anti-ulcer medication does not alter the incidence of diarrhoea in foals treated in an ICU. METHODS: The records of 1710 foals from 6 different equine hospitals were examined and the use of anti-ulcer drugs was recorded. The presence of in-hospital acquired diarrhoea, CDAD, Clostridium perfringens-associated diarrhoea, neonatal sepsis and salmonellosis were documented. In addition, the presence of gastric ulceration, duration of hospital stay and short-term outcome were examined. RESULTS: The use of anti-ulcer medications increased the odds of in-hospital diarrhoea by 2.0 (95% CI 1.4-2.9; P < 0.0001), relative to the use of no anti-ulcer medication. There was no significant association of anti-ulcer medication with CDAD (P = 0.3189) (OR 2.0; 95% CI 0.4-9.5). Further, results indicated that decreased prevalence of gastric ulceration was not associated with use of anti-ulcer drugs among foals in the study for which these data were known (P = 0.5522). CONCLUSIONS: Use of anti-ulcer drugs increases the odds of developing diarrhoea, and may not reduce the incidence of gastric ulceration in hospitalised equine neonates. POTENTIAL RELEVANCE: The use of anti-ulcer drugs in neonatal foals being treated in a hospital setting should be carefully evaluated on an individual basis to determine if such use is warranted.

Necrosis of the femoral condyles in a four-week-old foal: clinical, imaging and histopathological features.

A 4-week-old Thoroughbred filly foal with a history of sepsis was evaluated for right hindlimb lameness. Bilateral femoropatellar and femorotibial joint effusions were detected. Ultrasonography and radiography of the right stifle revealed signs of joint collapse and periarticular swelling. Computed tomography revealed abnormalities in the bone density of the medial femoral condyle of the right hindlimb and lateral femoral condyle of the left hindlimb. Euthanasia was recommended based on the severity of the lesions. Gross and microscopic examinations revealed extensive separation of the articular-epiphyseal cartilage complex from the subchondral bone of the femoral condyles. The histological features suggest an ischaemic aetiology; comparisons are made with lesions of osteochondrosis and avascular necrosis of bone.

Surgical removal of a canine orbital lipoma.

A 10-year-old, female, neutered Cairn terrier was presented with a progressively enlarging, cream-white fluctuant subconjunctival swelling in the right eye. A fine-needle aspirate performed under topical anaesthesia showed that the mass contained lipomatous tissue. Orbital ultrasonography showed the mass to have a distinct border and to extend into the posterior orbit. The mass was removed via a conjunctival incision. It had a distinct capsule anteriorly, while the border of the mass was less readily identified in the posterior orbit. Histopathological examination showed the mass to be a lipoma. The dog recovered uneventfully from surgery, and no recurrence has been noted after 12 months.