Angular limb deformities in foals.
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Biomedical subjects
Publications and source records attributed to A L Bertone.
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Initial management of injuries includes safely gaining control of the animal and assessing and treating systemic shock. If hemorrhage is life threatening, it must be controlled. If the limb is nonfunctional it should be stabilized. Any open orthopedic injury should be treated by cleaning the tissues, protecting the exposed tissues, and administering systemic antibiotics. A commercial splint is available (Equine Regular Leg Saver Splint, Kimzey Welding Works, Woodland, CA) that can immobilize and relieve weightbearing for cases of phalangeal fracture, flexor tendon rupture, fetlock breakdown, and lower joint luxations/subluxations. Hock and carpal luxation and radius fracture in foals can be stabilized by wooden or metal splint incorporation in a bandage. Tibial fractures can be stabilized with a modified Thomas splint. Injuries that expose a joint or infectious arthritis require emergency diagnosis of joint involvement, and subsequent joint lavage, intra-articular antibiotics, and systemic antibiotics. For further treatment of septic arthritis, the cases can be referred to a hospital for joint drainage. The appropriate emergency treatment of these injuries is often the determining factor in whether the injury remains in a condition that can be successfully repaired.
The use of extremely small dosages of intra-articular E. coli lipopolysaccharide (LPS) endotoxin can create a model of synovitis that mimics acute synovitis in horses. Dosages of 5000 ng, 25 ng, 0.5 ng, 0.25 ng, 0.17 ng and 0.125 ng per joint were injected into various joints of a total of 6 horses. The dose response of LPS on clinical signs and synovial fluid parameters was evaluated at baseline and 12, 24, 36 and 48 h after LPS injection. Peripheral venous blood analysis was performed at baseline and at 0, 4, and 12 h after LPS injection. Dosages greater than 0.5 ng/joint resulted in clinical signs of endotoxaemia including fever, depression, inappetence and non-weightbearing lameness. Although the total peripheral venous leucocyte count was not decreased at any dosage, the 5000 ng/joint dosage of LPS altered venous leucocyte differential resulting in an increase in the number of segmented and band neutrophils with a concomitant decrease in lymphocytes. Synovial fluid total nucleated cell count (TNC) and total protein (TP) was linearly responsive to increases in intra-articular LPS dosages up to the 0.5 ng/joint dose. At dosages of LPS > 0.5 ng, synovial fluid mean +/- s.e.m. TNC and TP were 122.0 +/- 27 x 10(9) cells/l and 59.3 +/- 1.7 milligrams respectively, at 12 h after injection. This may represent the maximal response of the joint to increased concentrations of LPS endotoxin over 0.5 ng/joint.(ABSTRACT TRUNCATED AT 250 WORDS)
Changes in contact area and pressure distribution with loading were evaluated on the proximal articulating surface of the equine third carpal bone using safranin-O dye staining and pressure sensitive film techniques. A significant increase in percentage contact area resulted as the applied load was increased from 3115 to 9000 N (54.93% +/- 7.99 vs 61.43% +/- 7.37 respectively, P = 0.016). The area in contact shifted towards the dorsal aspect of both the radial and intermediate facets of the third carpal bone. Changes were also detected in the mean pressure under the same loading conditions. There was a significant increase (P < 0.05) in the mean pressure on the dorsomedial to dorsolateral aspect of the radial facet and the dorsomedial to middle-lateral aspect of the intermediate facet with increased loading. A trend towards an increase (P < 0.10) in mean pressure was detected on the middle-medial aspect of the radial facet and the middle-medial to palmar-lateral aspect of the intermediate facet. There was no significant increase (P > 0.05) in mean pressure with an increase in load from 3115 to 9000 N at the palmar aspect of either facet. The increase in contact area and mean pressure with loading in the most dorsal and dorsomedial aspect of the radial facet may explain the large amount of third carpal bone trauma seen in this location in racing horses.
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Effects of low-flow ischemia and reperfusion of the large colon on mucosal architecture were determined in horses. Twenty-four adult horses were randomly allocated to 3 groups: sham-operated (n = 6), 6 hours of ischemia (n = 9), and 3 hours of ischemia and 3 hours of reperfusion (n = 9). Low-flow ischemia was induced in horses of groups 2 and 3 by reducing colonic arterial blood flow to 20% of baseline values. Systemic hemodynamic and metabolic variables were maintained constant and in a normal physiologic range. Full-thickness biopsy specimens were obtained from the left ventral colon for histomorphologic and morphometric examination at baseline and at 30-minute intervals for 6 hours; additional biopsy specimens were collected at 185, 190, and 195 minutes (corresponding to 5-, 10-, and 15-minute periods of reperfusion in group-3 horses). There were no differences among groups at baseline or across time in group-1 horses for any of the histopathologic variables. There were significant (P < 0.05) increases in percentage of surface mucosal disruption, estimated and measured percentage depth of mucosal loss, mucosal hemorrhage, mucosal edema, and cellular debris index during 0 hour to 3 hours, compared with baseline, and from 3 hours to 6 hours, compared with 3 hours in horses of groups 2 and 3. Estimated percentage depth of mucosal loss and cellular debris index were significantly (P < 0.05) greater in group-3 horses, compared with group-2 horses during the interval from 3 to 6 hours. There were trends toward greater percentage of surface mucosal disruption and mucosal edema during the early phase of reperfusion (3 to 4 hours) and greater mucosal hemorrhage, measured percentage depth of mucosal loss, and mucosal interstitial-to-crypt ratio during the late phase (4 to 6 hours) of reperfusion in group-3 horses vs group-2 horses. Reestablishment of colonic arterial blood flow after low-flow ischemia caused greater mucosal injury than did a comparable period of continued ischemia. Thus, reperfusion injury was detected in the large colon of horses after low-flow arterial ischemia. The serial mucosal alterations that developed in the colon were comparable in horses of groups 2 and 3; however, reperfusion exacerbated colonic mucosal injury.
Effects of low-flow ischemia and reperfusion of the large colon on systemic and colonic hemodynamic and metabolic variables were determined in horses. Twenty-four adult horses were randomly allocated to 3 groups: sham-operated (n = 6), 6 hours of ischemia (n = 9), and 3 hours of ischemia and 3 hours of reperfusion (n = 9). Low-flow ischemia was induced in groups 2 and 3 by reducing colonic arterial blood flow to 20% of baseline. Heart rate, arterial blood pressures, cardiac index, pulmonary artery pressure, right atrial pressure, and colonic blood flow were monitored. Arterial, mixed-venous, and colonic venous blood gas and oximetry analyses; PCV; and blood lactate and pyruvate and plasma total protein concentrations were measured. Data were recorded, and blood samples were collected at baseline and at 30-minute intervals for 6 hours; additionally, data were collected at 185, 190, and 195 minutes (corresponding to 5, 10, and 15 minutes of reperfusion in group-3 horses). There were no differences among groups at baseline or across time for any systemic hemodynamic or metabolic variable. Colonic blood flow did not change across time in group-1 horses. Colonic blood flow significantly (P < 0.05) decreased to 20% of baseline at induction of ischemia in horses of groups 2 and 3 and remained significantly decreased throughout the ischemic period in horses of groups 2 (6 hours) and 3 (3 hours). Colonic blood flow significantly (P < 0.05) increased above baseline by 5 minutes of reperfusion in group-3 horses. Colonic oxygen delivery and oxygen consumption, and colonic venous pH, PO2, percentage saturation of hemoglobin, and oxygen content were significantly (P < 0.05) decreased within 30 minutes after induction of ischemia in horses of groups 2 and 3; colonic venous PCO2, colonic oxygen extraction ratio, and lactate and pyruvate concentrations were significantly (P < 0.05) increased by 30 minutes of ischemia. These alterations continued throughout ischemia, but within 5 minutes of reperfusion in group-3 horses, these variables either returned to baseline (pH, PCO2, lactate, pyruvate), significantly (P < 0.05) increased above baseline (PO2, oxygen content, % saturation of hemoglobin), or significantly (P < 0.05) decreased below baseline (colonic oxygen extraction ratio). Colonic oxygen consumption remained decreased during reperfusion in group-3 horses. Colonic mucosal ischemia-reperfusion injury observed in this model of ischemia was associated with local colonic hemodynamic and metabolic alterations in the presence of systemic hemodynamic and metabolic stability.(ABSTRACT TRUNCATED AT 400 WORDS)
Histomorphologic/morphometric evaluation, leukocyte scintigraphy, and myeloperoxidase activity were used to determine whether neutrophils accumulate in the large colon of horses during low-flow ischemia and reperfusion. Twenty-four adult horses were assigned to 1 of 3 groups: group 1, sham-operated (n = 6); group 2, 6 hours of ischemia (n = 9); and group 3, 3 hours of ischemia and 3 hours of reperfusion (n = 9). Low-flow ischemia of the large colon was induced in horses of groups 2 and 3 by reducing colonic arterial blood flow to 20% of baseline. Radiolabeled (99mTc) autogenous neutrophils were injected at 175 minutes, which corresponded to 5 minutes prior to reperfusion in group-3 horses. Full-thickness biopsy specimens of the left ventral colon were collected at baseline and at 30-minute intervals for 6 hours; a portion of the biopsy specimen was placed in formalin for histologic examination, and the remainder was used to measure mucosal radioactivity and myeloperoxidase activity. There were no differences in baseline mucosal neutrophil index, mucosal neutrophil numbers, submucosal venular neutrophil numbers, mucosal radioactivity, or mucosal myeloperoxidase activity among groups, or over time in group-1 horses. Neutrophils accumulated in the colonic mucosa during ischemia and further increased at reperfusion, as indicated by neutrophil index (morphology) and mucosal neutrophil numbers (morphometry); mucosal neutrophil index was significantly (P < 0.05) greater in group-3 horses during reperfusion than at the corresponding periods of ischemia in group-2 horses. Neutrophil numbers were significantly (P < 0.05) increased in submucosal venules at 10 minutes of reperfusion in group-3 horses and were significantly (P < 0.05) greater in group-3 than in group-2 horses during the interval from 3 to 6 hours. Mucosal radioactivity significantly (P < 0.05) increased at reperfusion in group-3 horses; there was a trend (P = 0.076) toward greater mucosal radioactivity in group-3, compared with group-2 horses, throughout the 3- to 6-hour interval. There were no differences in mucosal myeloperoxidase activity among or within any of the 3 groups over time. Neutrophils accumulated in the large colon of horses during low-flow ischemia and reperfusion. Neutrophil infiltration was detected by histologic examination and leukocyte scintigraphy, but not by measurement of myeloperoxidase activity. The accumulation of neutrophils during ischemia and the further neutrophil infiltration during reperfusion indicate that neutrophils may contribute to reperfusion injury of the large colon.
Equine tumors are rather uncommon; however, of the body regions, the head is a relatively common location for neoplasia, including sarcoids and squamous cell carcinomas of the skin, tumors of the sinus/nasal cavity, and bony tumors of the head. Tumors discussed in the article include odontogenic and bony tumors; sarcoids; tumors of the guttural pouch and pharyngeal and oral mucosa; tumors of the larynx; and tumors of the paranasal sinuses and nasal passages. In general, tumors involving deeper structures of the head carry a poor prognosis; however, some tumors such as sarcoids, ossifying fibromas, and osteomas of the paranasal sinus often can be treated effectively by cytoreductive surgery, with or without adjunctive treatment modalities. The clinical signs, prognoses, and therapeutic options for specific tumor types and locations are reviewed. Ophthalmic tumors are not discussed.
Fractures of the humerus were diagnosed in horses at The Ohio State University Veterinary Teaching Hospital. Twenty-four horses (44.4%) were destroyed after radiographic assessment (mean age of 5.0 years). Surgical treatment was elected in 13 horses (24.1%, mean age of 0.42 years). Conservative management, consisting of prolonged stall rest, was chosen for 17 horses (31.5%, mean age of 2.2 years). In the surgically treated group, 3 foals (23.1%) all less than 2 months of age at the time of fracture and treated with intramedullary stack pinning, survived and became athletically sound. After conservative treatment, 9 (52.9%) horses were considered successful, 4 becoming athletically sound and 5 becoming pasture sound. The mean age at the time of presentation in the 9 horses considered successful was 1.81 years. With current fixation techniques, conservative management of equine humeral fractures appears to be as good an option as surgical treatment.
The effects of intra-articular administration of methylprednisolone acetate (MPA) on the healing of full-thickness osteochondral defects and on normal cartilage were evaluated in 8 horses. In group-1 horses (n = 4), a 1-cm-diameter, full-thickness defect was created bilaterally in the articular cartilage on the dorsal distal surface of the radial carpal bone. Cartilage defects were not created in group-2 horses (n = 4). One middle carpal joint was randomly selected in each horse (groups 1 and 2), and treated with an intra-articular injection of 100 mg of MPA, once a week for 4 treatments. Injections began 1 week after surgery in group-1 horses. The contralateral middle carpal joint received intra-articular injections of an equivalent volume of 0.9% sodium chloride solution (SCS), and served as a control. Horses were evaluated for 16 weeks, then were euthanatized, and the middle carpal joints were examined and photographed. Synovial and articular cartilage specimens were obtained for histologic and histochemical evaluation. Gross morphometric evaluation of the healing defects in group-1 horses revealed that 48.6% of the defect in control joints and 0% of the defect in MPA-treated joints was resurfaced with a smooth, white tissue, histologically confirmed as fibrocartilage. This replacement tissue was a firmly attached fibrocartilage in control joints and a thin fibrous tissue in MPA-treated joints. The articular cartilage in joints treated with MPA had morphologic changes, including chondrocyte cluster formation, loss of palisading architecture, and cellular necrosis in both groups of horses.(ABSTRACT TRUNCATED AT 250 WORDS)
To evaluate the clinical, laboratory, and histologic effects of 2 methods of treatment for infectious arthritis in horses, Staphylococcus aureus (3.4 to 3.9 x 10(3) colony-forming units) was inoculated into the tarsocrural joints of 8 horses on day 0. Each horse was treated with phenylbutazone (2 g, PO, q 24 h) and gentamicin sulfate (2.2 mg/kg of body weight, IV, q 8 h) for 14 days. On day 2, general anesthesia was induced, and each horse had 1 tarsocrural joint treated by arthrotomy, with removal of accessible fibrin and lavage with 3 L of sterile balanced electrolyte solution. An indwelling plastic drain was placed in the standing horse to provide a means for lavage with 3 L of balanced electrolyte solution twice daily for 72 hours. The contralateral tarsocrural joint was treated via arthroscopic debridement, synovectomy, and lavage with 3 L of balanced electrolyte solution. Arthrotomy and arthroscopic portals were allowed to heal by second intention. Lameness and thermographic examinations, analysis and bacteriologic culture of synovia, CBC, and WBC differential count were performed prior to inoculation and on days 1, 3, 6, 8, and 13. On day 14, each horse was euthanatized, and the joints were measured, opened, and photographed. Synovium and articular cartilage were obtained for semiquantitative histologic (H&E stain) and histochemical (safranin O fast green stain) evaluation. Lameness and joint circumference were significantly (P less than 0.05) greater in limbs treated by arthroscopy, synovectomy, and lavage. Arthrotomy with lavage eliminated the S aureus infection significantly (P less than 0.05) earlier than arthroscopy, synovectomy, and lavage, however, both treatments eliminated the infection in all but a single joint.(ABSTRACT TRUNCATED AT 250 WORDS)
A 16-year-old stallion was presented to the Louisiana State University Veterinary Teaching Hospital for evaluation of acute abdominal pain. Physical examination and diagnostic procedures indicated a strangulating obstruction of the small intestine. At exploratory celiotomy, a strangulating incarceration of the jejunum through the epiploic foramen was found. The incarcerated small intestine was reduced, then resection of the nonviable bowel and anastomosis performed. After surgery, the horse exhibited clinical signs and laboratory findings associated with hypoglycemia and died in spite of emergency treatment. On post-mortem examination, a large thrombus was present in the portal vein at the level of the epiploic foramen and the liver had multiple large infarcted areas. The post-operative signs of hypoglycemia and necropsy findings of widespread hepatic ischemic necrosis are complications of epiploic foramen incarceration of the small intestine not previously reported and may in part explain the high mortality rate described for this lesion.
The decision to perform a procedure in the standing patient rather than in a completely anesthetized patient depends on many factors, such as patient health, cost, time, facilities, and anesthetic expertise. Although the procedure often is technically easier to perform if the patient is anesthetized, cost and patient risk considerations may result in a decision to do the surgery standing. Surgical experience in performing procedures standing is important for a successful outcome.
Neoplasms of the bovine gastrointestinal tract are rare, possibly because of the low age of the sample population (slaughtered cattle). Forestomach neoplasia (papilloma/squamous cell carcinoma) has a high incidence in cattle from northern England and Scotland because of the mutagenic effects of bracken fern consumption and its interaction with BPV-4. Lymphosarcoma in the abomasum occurs in 41 per cent of cattle with lymphosarcoma, the most common bovine neoplasm in the United States. Small intestinal adenocarcinoma is associated with the papilloma/squamous cell carcinoma complex in the forestomach in England and Scotland, but occurs sporadically in other geographic locations. These lesions may be amenable to surgery, but death from metastatic disease occurs within 1 year. Neoplasms of the large intestine are rarely reported, but usually are adenocarcinoma. Adenoma and fibroma of the rectum may produce clinical signs of tenesmus and rectal prolapse. In general, neoplasia in cattle carries a poor prognosis because of early metastasis of adenocarcinoma and the high fatality of lymphosarcoma. Forestomach fibroma may be treated surgically with success, and palliative surgery for focal small intestinal tumors may be rewarding in individual cases.
Lactase, maltase, sucrase, and alkaline phosphatase activities were determined in the intestinal mucosa from 3 locations in the small intestine and 4 locations in the large intestine 1 year after extensive large-colon resection (group 1; n = 5) and 1 year after sham operation (group 2; n = 3) in horses. Lactase, maltase, and sucrase activities were similar (P greater than 0.05) between group-1 and group-2 horses in all locations measured in the intestinal tract. Alkaline phosphatase activity in the remaining large colon of group-1 horses was significantly (P less than 0.05) greater than the activity in the large colon of group-2 horses. Decreased apparent digestion of phosphorus and a negative phosphorus balance are persistent features of large-colon resection in horses. Increases in alkaline phosphatase activity in the remaining colon of horses with extensive large-colon resection may be a specific functional adaptive mechanism that attempts to counteract the derangements in phosphorus metabolism.
Cardiovascular responses to sublethal endotoxin infusion (Escherichia coli, 50 micrograms/ml in lactated Ringer solution at 100 ml/h until pulmonary arterial pressure increased by 10 mm of Hg) were measured 2 times in 5 standing horses. In a 2-period crossover experimental design, horses were either administered hypertonic (2,400 mosm/kg of body weight, IV) or isotonic (300 mosm/kg, IV) NaCl solution after endotoxin challenges. Each solution was administered at a dose of 5 ml/kg (infusion rate, 80 ml/min). Complete data sets (mean arterial, central venous, and pulmonary arterial pressures, pulmonary arterial blood temperature, cardiac output, total peripheral vascular resistance, heart rate, plasma osmolality, plasma concentration of Na, K, Cl, and total protein, blood lactate concentration, and PCV) were collected at 0 (baseline, before endotoxin infusion), 0.25, 1, 1.5, 2, 2.5, 3, 3.5, 4, and 4.5 hours after initiation of the endotoxin infusion. Blood constituents alone were measured at 0.5 hour and cardiovascular variables alone were evaluated at 0.75 hour. By 0.25 hour, endotoxin infusion was completed, a data set was collected, and saline infusion was initiated. By 0.75 hour, saline solutions had been completely administered. Mean (+/- SEM) cardiac output decreased (99.76 +/- 3.66 to 72.7 +/- 2.35 ml/min/kg) and total peripheral resistance (1.0 +/- 0.047 to 1.37 +/- 0.049 mm of Hg/ml/min/kg) and pulmonary arterial pressure (33.4 +/- 0.86 to 58.3 +/- 1.18 mm of Hg) increased for both trials by 0.25 hour after initiation of the endotoxin infusion and prior to fluid administration. For the remainder of the protocol, cardiac output was increased and total peripheral resistance was decreased during the hypertonic, compared with the isotonic, saline trial.(ABSTRACT TRUNCATED AT 250 WORDS)
Light microscopy, morphometry, and scanning electron microscopy were used to examine the mucosal morphologic features of 7 intestinal specimens (3 from the small intestine; 4 from the large intestine) from each of 8 horses 1 year after sham operation (group 1; n = 3) or extensive large-colon resection (group 2; n = 5). Qualitative light microscopic examination did not reveal differences between groups, but morphometry revealed significantly (P less than 0.05) greater intercrypt area and distance in horses with colon resection and this was most pronounced in the cecum and remaining right ventral and dorsal colon. Crypt area and depth were similar for horses with colon resection and sham operation (P greater than 0.05). Qualitative evaluation of the scanning electron micrographs revealed more prominent crypt orifices in the large intestine of horses with colon resection. The larger intercrypt distance in the colon of horses with resection was not an obvious feature of the qualitative evaluation of the surface with scanning electron microscopy. Small intestinal morphologic features were variable and significant differences were not detected between horses with sham operation and colon resection. Horses adapted to extensive large-colon resection within 1 year by increasing the absorptive (intercrypt) surface area of the remaining large intestine.