Rupture of the biceps tendon in a Thoroughbred steeplechase horse.
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Biomedical subjects
Publications and source records attributed to B B Martin.
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REASONS FOR PERFORMING STUDY: Fractures of the tibial tuberosity (FTT) are caused by direct trauma, and are the second most commonly reported injury in event horses with stifle trauma. Conservative management of horses with FTT has been advocated, but results and prognosis for this method of therapy are unknown. OBJECTIVES: To report and review the findings of a retrospective study of 17 horses admitted to a veterinary teaching hospital from 1986-2001 with nonarticular FTT that received conservative management. METHODS: Subject details, aetiology of the accident, limb affected, degree of lameness at time of admission, size and degree of displacement of the fracture fragment, complications such as comminution of the fracture fragment or damage to soft tissue structures within the affected stifle, and treatment recommendations were obtained from medical records. Owners and trainers were contacted regarding the horse's return to athletic use. The follow-up period consisted of 11-154 months. RESULTS: Two horses were reportedly sound, but unable to return to competition for unrelated reasons. Of the horses that completed the rehabilitation period, 12/15 (80%) returned to athletic use at the same level as before the injury. Three horses were diagnosed with damage to soft tissue supporting structures of the affected stifle and could not return to their former level of competition. CONCLUSIONS: Concurrent soft tissue damage, diagnosed at the time of the initial injury, was statistically significant in precluding horses from returning to athletic careers. All other variables were found to have no effect upon outcome. POTENTIAL CLINICAL RELEVANCE: This retrospective study suggests that the conservative management of nonarticular FTT is a viable treatment modality in managing athletic equine patients presenting with these fractures.
The incidence and severity of exercise-induced pulmonary haemorrhage (EIPH) in the 2 most commonly raced horse breeds, Thoroughbreds (TB) and Standardbreds (STD), were studied, with particular interest in the possible influence of frusemide (F) and/or the breed (or running gait) on EIPH. The appearance of blood within the trachea was semi-quantified using a published 5-point system, with zero assigned when no blood was observed, and numbers 1-4 assigned with increasing amounts of blood. Considering each endoscopic examination as a separate event, approximately 75% of the postrace endoscopic examinations had blood-scores of 1, 2, 3, or 4, regardless of breed or F administration. For horses examined twice, the chances of finding blood-scores of 1 or greater in either of the examinations increased to approximately 95%. All horses examined 3 or more times had endoscopic blood-scores of 1 or greater following one or more races, again, irrespective of the breed or F administration. Mean +/- s.e. 'blood scores' were 1.5 +/- 0.1 and 1.8 +/- 0.2 for TB, and 1.4 +/- 0.2 and 1.2 +/- 0.1 for STD racing with and without prerace F, respectively. Therefore, there was no apparent effect of breed (or possibly racing gait) on EIPH, and no differences in the incidence or severity of EIPH were observed between horses with or without prerace frusemide administration.
The primary goal was to investigate the relationship between dynamic upper airway abnormalities and arterial blood gas tensions during exercise. Horses that completed a high-speed treadmill examination consisting of upper-airway videoendoscopy, blood gas evaluation and electrocardiogams and, postexercise, echocardiograms and tracheal washes, were included. An age-matched group of fit, healthy Thoroughbreds, trained to run on a high-speed treadmill, served as controls for blood gas values at specific exercise speeds. One hundred and nineteen horses completed the treadmill examination. Sixty (50%) were Thoroughbreds (TB), 51 (43%) Standardbreds (STD) and 8 (7%) other breeds. Mean +/- s.d. age TB 3.8 +/- 2.2 years and STD 4.0 +/- 1.7 years, with no gender predilection. Fifty-four horses (45%) had abnormal upper respiratory tract (URT) abnormalities alone or in combination with abnormalities in another body system. Thirty-eight (70%) were TB, 14 (26%) were STD and 2 (4%) were other breeds. Of these, 24 (45%) had exercising PaO2 values significantly lower than those observed in healthy TB. Nineteen (35%) horses also had significantly elevated exercising PaCO2. Only 14 (12%) horses had abnormal clinical findings in the URT alone, and of these, only 3 (21%) had an abnormally low PaO2 and/or elevated PaCO2. Multiple URT abnormalities were more commonly associated with abnormal exercising blood gases than were single disorders, but pharyngeal collapse (PC) was much more commonly associated with abnormal values if only one disorder was detected. Fifty-five percent (n = 65) of all cases admitted had no evidence of URT disease. Twenty-two (35%) were TB and 37 (57%) were STD. Twenty (31%) of these had abnormally low PaO2 and 14 (22%) had elevated PaCO2 values. Seventy percent (14) of the horses with abnormal PaO2 were STD, while almost 80% (11) of the horses with elevated PaCO2 were STD. These data suggest that dynamic URT dysfunction can adversely affect gas exchange during exercise. While multiple abnormalities were more commonly associated with gas exchange problems than were single disorders, pharyngeal collapse, either alone or in combination with other URT problems, was the disorder most frequently associated with blood gas abnormalities. Additionally, URT disease was more commonly seen in TB, and the proportion of URT diagnoses in horses with abnormal blood gases reflected this percentage, while STD without URT disease had a much higher incidence of abnormal blood gases than did TB without URT abnormalities.
Physical dependence on the synthetic cannabinoid-receptor agonist R(+)-[2,3-dihydro-5-methyl-3-[(morpholinyl)methyl]pyrrolo[1,2,3-de]-1,4-benzoxazinyl]-(1-naphthalenyl) methanone mesylate (WIN 55212-2) was demonstrated in rats by the use of a chronic continuous infusion. Spontaneous withdrawal, of moderate intensity, was shown for the first time with this class of drugs of abuse. Behavioral withdrawal signs were also elicited after challenge with (N-(piperidin-1-yl)-5-(4-chlorophenyl)-1-(2,4-dichlorophenyl)-4-methyl-1H-pyrazole-3-carboxamide.HCl (SR141716A), a specific CB(1) cannabinoid-receptor antagonist. In both instances, the high-dose regimen (4, 8, 16 and 16 mg/kg/day, i.p. on days 1-4, respectively) was sufficient to evoke a typical withdrawal syndrome quantified by the signs wet-dog shakes and facial rubs. These results are discussed relative to those obtained with Delta(9)-tetrahydrocannabinol and anandamide. With Delta(9)-tetrahydrocannabinol, precipitated but not spontaneous or abrupt withdrawal was observed, and this was ascribed to pharmacokinetic properties. Anandamide, which showed little, if any, physical dependence potential, behaved atypically. Possible implications regarding pharmacotherapeutic and human abuse issues are discussed.
OBJECTIVE: To determine results for horses undergoing a high-speed treadmill examination, including videoendoscopy of the pharynx and larynx before and during exercise, echocardiography before and after exercise, and electrocardiography before, during, and after exercise, because of poor performance. DESIGN: Retrospective study. ANIMALS: 348 horses. RESULTS: A definitive diagnosis was obtained for 256 (73.5%) horses. One hundred forty-eight horses had dynamic obstruction of the airway during exercise, 33 had clinically important cardiac arrhythmias alone, 22 had a combination of dynamic airway obstruction and clinically important cardiac arrhythmias, 19 had poor cardiac fractional shortening immediately after exercise, 10 had exertional rhabdomyolyis, 15 had clinically apparent lameness, and 9 had other disorders. Thirty-nine of the horses with dynamic obstruction of the airway during exercise had multiple airway abnormalities. Fifty-three horses also had subclinical myopathy CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that a complete evaluation, including a high-speed treadmill examination, should be conducted in horses with poor performance, regardless or whether horses do or do not have a history of abnormal respiratory noises and particularly if the horses have grade-II or -III left laryngeal hemiplegia.
OBJECTIVE: To evaluate results of cytologic examination of specimens obtained by means of tracheal washes (TW) in 42 horses with a history of poor performance. DESIGN: Cross-sectional case series. ANIMALS: 42 horses with a history of poor performance. PROCEDURE: A TW was performed via endoscopy before and after horses exercised on a high-speed treadmill, and specimens were evaluated microscopically and graded. RESULTS: Ten (24%) horses were considered to be clinically normal before and after exercise. Pulmonary hemorrhage was diagnosed in 8 (19%) horses. One horse had evidence of exercise-induced pulmonary hemorrhage (EIPH) before exercise and pulmonary hemorrhage and allergic or inflammatory airway disease (IAD) after exercise. Five (12%) horses had IAD, and 1 had IAD and pulmonary hemorrhage after exercise. Seven (17%) horses had evidence of EIPH and IAD in both specimens. Four (10%) horses with EIPH had an increase in the proportion of hemosiderophages in the specimen obtained after exercise. Specimens obtained before exercise in 6 (14%) horses were not representative of the respiratory tract and could not be compared with specimens obtained after exercise. CLINICAL IMPLICATIONS: Interpretation of TW specimens obtained before and after exercise differed for only 5 of 36 (14%) horses. Specimens obtained after exercise were more likely to reveal airway disease. All specimens obtained after exercise adequately represented the respiratory tract, whereas 6 specimens obtained before exercise did not. Specimens obtained after exercise contained more airway secretions and had less cytologic evidence of pharyngeal contamination. Therefore, we recommend that TW samples be obtained after exercise in horses.
OBJECTIVE: To determine the prognosis in horses with cecocolic or cecocecal intussusception. DESIGN: Retrospective study. ANIMALS: 30 horses with cecocolic intussusception or cecocecal intussusception. PROCEDURE: Information on history, physical examination findings, and laboratory values was summarized from the medical records. Laboratory data included results of hematologic examination, serum biochemical analysis, and peritoneal fluid color, total nucleated cell count, and total protein concentration. A one-year follow-up via the telephone was used to determine long-term survival. RESULTS: Horses ranged from 7 months to 30 years old, but 63% were < or = 3 years. Standardbred horses were significantly overrepresented. Twenty-six horses had acute-to-subacute disease, and 4 had a chronic wasting disease. Cecal intussusceptions were suspected on the basis of finding a mass on abdominal palpation per rectum (14 of 24 horses) and positive ultrasonographic findings (2 of 3 horses). Thirteen horses with colic for > 1 day had scant, soft feces. Six horses died or were euthanatized without undergoing surgery, and 24 were treated surgically. Six of the latter horses were euthanatized during surgery because of peritonitis, rupture of the cecum, and irreducible intussusception. All 4 horses with a chronic disease were euthanatized because of irreversible changes in the cecum. Of the 18 horses allowed to recover from surgery, 15 survived long-term. Surgical treatments were reduction, with or without partial typhlectomy (6 horses), partial typhlectomy through a colotomy and reduction (6), reduction through a colotomy and partial typhlectomy (3), partial typhlectomy for a cecocecal intussusception (1) and an ileocolostomy (2). CLINICAL IMPLICATIONS: Cecal intussusception has a good prognosis with surgical correction without delay. Reduction through colotomy has a high success rate. Bypass by ileocolostomy should be used as a last resort.
The diagnosis of back pain is often a diagnosis of exclusion of other problems in the face of poor performance. It requires careful observation, thought, an open mind, and experience. The signs of back pain can be extremely variable and range from subtle to obvious. Obvious forelimb or hind limb lameness is not usually a sign of back pain. The most common differential diagnosis may be back pain secondary to degenerative joint disease of the hocks, fetlocks, or stifle. These diseases can mimic signs of back pain including lack of impulsion, shortening of the stride length, and change in the stride character similar to those seen with back pair.
OBJECTIVE: To evaluate laryngeal function by means of videoendoscopy during high-speed treadmill exercise in racehorses with grade-III left laryngeal hemiparesis at rest and to determine outcome of treatment. DESIGN: Retrospective study. ANIMALS: 26 racehorses. PROCEDURE: Videoendoscopy of the larynx was performed while horses were at rest and exercising on a treadmill. Horses were classified as having grade-IIIA, -IIIB, or -IIIC laryngeal hemiparesis on the basis of the degree of arytenoid cartilage abduction maintained during exercise. Postoperative racing performance was determined by evaluating race records and conducting telephone surveys. RESULTS: 20 (77%) horses had grade-IIIC laryngeal hemiparesis (i.e., severe dynamic laryngeal collapse during exercise). Eighteen underwent surgery, and racing performance was improved in 9. Five (19%) horses had grade-IIIB laryngeal hemiparesis (i.e., left arytenoid cartilage and vocal fold were maintained in an incompletely abducted position during exercise). Four underwent surgery, and racing performance was improved in 1. One (4%) horse had grade-IIIA laryngeal hemiparesis (i.e., full abduction of arytenoid cartilage during exercise); surgery was not performed. CLINICAL IMPLICATIONS: Videoendoscopy is useful in determining dynamic laryngeal function in racehorses with grade-III laryngeal hemiparesis at rest.
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Tympany of the auditory tube diverticulum was treated in 2 Standardbred foals by fenestrating the median septum, using an endoscopically placed Nd:YAG laser. Recurrence in 1 foal was treated by enlarging the fenestration, using a modified Whitehouse approach, and the pharyngeal opening of the auditory tube. Use of the Nd:YAG laser eliminates the risk of inadvertent cranial nerve damage associated with incisions into the auditory tube diverticulum. The procedure can be performed with the horse sedated or anesthetized. Clinical signs can recur in the fenestration heals closed or if the condition is bilateral rather than unilateral.
Seven Standardbred horses, all pacers, with a mean age of 2.9 years (range, 2 to 4 years), had dorsomedial articular fracture of the proximal aspect of the third metacarpal bone. Fracture caused acute, unilateral, severe lameness after training or racing. Lameness was abolished by midcarpal joint anesthesia in 4 horses. Six horses had a palpable bony swelling, which caused signs of pain. Radiography revealed a nondisplaced, articular, oblique fracture extending distad toward the dorsomedial cortex for a mean distance of 28 mm (range, 15 to 40 mm). In all horses, chronic periosteal proliferative changes, seen near the distal aspect of the fracture, corresponded to palpable bony exostoses and were associated with the medial attachment of the extensor carpi radialis tendon. In 1 horse, internal fixation followed by a 6-month rest resulted in a successful outcome. All other horses were given 3 months' rest without surgery and were not lame. Five horses raced successfully and lowered the lifetime race records, 1 horse was sound and trained successfully, but died of colic, and 1 horse was not lame in early training.
Two mature breeding stallions were evaluated because of specific ejaculatory dysfunction, and each was found to have aortic-iliac thrombosis occluding 60 to 70% of the aortic lumen. In each case, the stallion had strong libido, normal mounting, and vigorous initial thrusting. With continued exertion, thrusting became weak and dismount was awkward. Treatment aimed at maximizing sexual arousal before mounting and reducing hind limb pain and exertion during breeding allowed these stallions to continue breeding. A program of gradually increasing daily exercise also was associated with improved breeding performance during subsequent breeding seasons. In cases of specific ejaculatory dysfunction, aortic-iliac disease should be included among the differential diagnoses.
The case records of 26 horses with ileocecal intussusception over a 7-year period were reviewed to determine clinical features of the disease and response to treatment. The median age of horses with ileocecal intussusception was 1 year and ranged from 2 weeks to 19 years. There was no apparent gender or breed predisposition to this disease. An acute form of ileocecal intussusception was diagnosed in 19 horses with signs of moderate to severe abdominal pain of less than or equal to 24 hours' duration, and a chronic form was diagnosed in 7 horses with signs of intermittent, mild to moderate abdominal pain of more than 3 days' duration. Horses with chronic ileocecal intussusception had a history of weight loss or failure to gain weight, slow growth, poor appetite, low-grade pyrexia, and postprandial signs of abdominal pain. At surgery, the involved segments of intestine (intussusceptum and intussuscipiens) in chronic cases were 2 to 10 cm long, and the ileum and much of the distal portion of the jejunum were flaccid, dilated, and thick walled. In the acute cases, the length of involved intestine ranged from 6 to 457 cm. Whereas only 1 of 7 chronic intussusceptions (14%) could be reduced, 9 of 19 (47%) acute intussusceptions were reducible. Surgical treatment included resection and jejunocecostomy (6 horses), partial resection through a cecotomy and a side-to-side jejunocecostomy (2 horses), and a side-to-side ileocecostomy or jejunocecostomy without resection (12 horses, 7 of which had chronic intussusception). Six horses with acute intussusception were euthanatized before or during surgery.(ABSTRACT TRUNCATED AT 250 WORDS)
Horses with chronic back pain of 2 to 108 months' duration were treated using acupuncture (n = 15), laser acupuncture (n = 15), or injection acupuncture (n = 15). Horses were treated once a week for 8 treatments (mean) with needle acupuncture, 11 treatments with laser acupuncture, or 9 treatments with injection acupuncture. After treatment, 37 horses had alleviation of clinical signs of pain and could train and compete: 13 horses treated with needle acupuncture; 11 horses treated with laser acupuncture; and 13 horses treated with injection acupuncture. Seemingly, the 3 types of acupuncture were equally useful for treating horses with chronic back pain.
Recent advances in ophthalmic microsurgical instrumentation and techniques make ab-externo trabeculotomy a more attractive alternative to goniotomy in the treatment of congenital glaucoma than was the case in the past. A series of seven consecutive cases (14 eyes) treated by trabeculotomy is presented, with the results of follow-up over a period of two to seven years. This, and other series, suggests that control of developmental glaucoma may be achieved utilizing fewer procedures when trabeculotomy is employed rather than goniotomy.
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