[Vision through cooperation between horse clinics].
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Biomedical subjects
Publications and source records attributed to B P Cornelissen.
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Bone mineral density (BMD) and cross-sectional area (CSA), measured using peripheral quantitative computed tomography, were determined in the left third metacarpal bone (MCIII) and left medial proximal sesamoid bone (psb) in 3 differently exercised groups of foals. Group(box) (n = 14) was confined to a box stall from birth to age 5 months, Group(training) (n = 14) was kept in similar box stalls but additionally given a daily exercise programme consisting of an increasing number of gallop sprints and Group(pasture) (n = 15) remained at pasture. At 5 months of age, 8 foals from each group were randomly selected and subjected to euthanasia, the remaining 19 foals were given an identical light exercise regimen for an additional 6 months and were killed at age 11 months. In MCIII CSA increased with age and was also significantly (P<0.05) larger in Group(pasture) compared to Group(box) at age 5 months. At 11 months this difference had disappeared. In the dorsal cortex, BMD was significantly (P<0.05) higher in Group(box) than in both other groups. At age 11 months all significant differences had disappeared. In the psb, CSA increased with age, but there were no differences between the exercise groups. At the apical level, trabecular BMD was higher in Group(training) than in Group(box) and Group(pasture) (P<0.001 and P<0.01, respectively). At 11 months, trabecular BMD in the foals that had belonged to Group(training) was less than in the foals that had belonged to Group(box) (P<0.05). It is concluded that box-rest during the first months of life results in a retardation of normal development which is compensated for when the restriction on exercise is lifted. Exercise during the first months of life induces an increase in CSA in the third metacarpal bone. In the psb exercise increases BMD, principally in trabecular bone. There is an indication that the specific training regimen used in this study led to an overstimulation of the bone resulting in less active mineral deposition in the longer term.
Sesamoiditis is characterized clinically by repeated lameness and radiologically by changes in the proximal sesamoid bones. This thesis, which was defended in June 1997, investigated two characteristics of sesamoiditis, namely the arterial blood supply and the innervation of the proximal sesamoid bones, in order to gain more insight into the etiopathogenesis of sesamoiditis. Experiments with patient material showed that the proximal sesamoid bones have an enormous arterial reserve, due in part to the formation of an arterial shift. Moreover, the sesamoid bones have their own sensory innervation, provided by a branch of the medial and lateral palmar nerve. This branch is called the sesamoid nerve in this article. A special technique was developed to anaesthetize this nerve and can be used for further differentiation of pastern lameness. That the sesamoid bones are sensitive to pain was demonstrated by detection of the so-called nociceptive neuropeptides, substance P and calcitonin gene-related peptide, which are specifically involved in pain sensation. However, the adjacent ligament appear to be even more sensitive. The etiopathogenesis of sesamoiditis is discussed, as are a number of clinical implications of pain in the sesamoid bones. A number of potential future developments are mentioned.
OBJECTIVE: To develop and define a model of acute synovitis/capsulitis in the equine metacarpophalangeal joint (fetlock) to study clinical effects of diagnostic or therapeutic procedures. ANIMALS: 5 adult Standardbreds. PROCEDURE: Polyvinyl alcohol foam particles were injected into the left front fetlock of horses; the right front fetlock was used as a control. Horses were examined clinically and for lameness on a regular basis. Blood samples were taken to measure routine variables. Synovial fluid samples were collected from both fetlocks, and macroscopic, microscopic, and biochemical variables were measured. The effects of local diagnostic nerve blocks and intra-articular anesthesia of the fetlock on ensuing lameness were determined on days 2 and 3. After macroscopic evaluation at necropsy, histologic examination was performed on the fetlock cartilage and capsule. RESULTS: Changes in synovial fluid variables included increased TNF-alpha and matrix metalloproteinases values and in other indicators of acute inflammation. With respect to application of local nerve blocks, lameness decreased most after a combination of metacarpal and palmar nerve blocks, whereas lameness could only partially be blocked by intra-articular anesthesia. At necropsy, mild chronic inflammation of the synovium and deeper layers of the joint capsule was found; polyvinyl alcohol particles had been incorporated into the joint capsule. There was no evidence of articular cartilage damage. CONCLUSIONS: Injection of polyvinyl alcohol foam particles induces transient synovitis/capsulitis in the fetlock, mimicking clinical joint disorders. The model does not seriously affect the horse's long-term wellbeing. Such model serves well for studying the effect of diagnostic or therapeutic procedures.
OBJECTIVE: To localize and determine relative frequency of occurrence of calcitonin gene-related peptide (CGRP) and substance P (SP) fibers in the proximal sesamoid bones (PSB) and adjacent structures in sound horses. SAMPLE POPULATION: 4 foals and 3 adult horses. PROCEDURE: Medial PSB and adjacent ligaments of both forelimbs were collected, flushed, and fixed in buffered 4% formalin. The left PSB were cut into 5 longitudinal, sagittally oriented slabs, and the right PSB were cut into 5 transverse slabs. After decalcification in EDTA, slices were transferred to a 30% sucrose solution, deep frozen, sectioned (80 microm), and stored in Tris-buffered saline solution for free-floating immunocytochemical processing, staining of which was performed by use of the peroxidase-antiperoxidase method with polyclonal rabbit antibodies against CGRP and SP. Sections were examined by light microscopy. RESULTS: Calcitonin gene-related peptide and SP fibers were present throughout the PSB; in ligaments, they were concentrated at the attachment sites. Presentation of the fibers, the innervation pattern, and intensity in the bones of horses differed from that in foals, in which the fibers were more delicate and frequency of occurrence was lower. In horses, innervation with CGRP and SP fibers was more dense in the periphery of the bone, whereas in foals, local difference in innervation of the bone was not evident. With the exception of the intersesamoidean ligament, ligaments were more richly innervated than was bone. CONCLUSION: Presence of the nociceptive peptides CGRP and SP indicated that the PSB and, more practically, the adjacent ligaments are sensitive structures.
Sesamoidosis in horses is characterised by lameness and radiographic changes in the proximal sesamoid bones and the aetiology is attributed to either mechanical factors or circulatory disturbances. In this study arteriograms of proximal sesamoid bones were investigated in 17 lame patients suffering from sesamoidosis, 6 sound horses and 4 yearlings. The arterial patterns of the proximal sesamoid bones from the patients, showed a shift from an abaxial to a basal arterial blood supply. This shift was only found in radiographically changed bones. Histological evaluation showed a significantly higher percentage of arteries with a large diameter in sections from the base of proximal sesamoid bones that showed an arterial shift. The presence of the shift appeared to be related to a change in shape of the bone, in particular to new bone formation along the abaxial border. The results of this study suggest that in horses suffering from sesamoidosis changes in the arterial pattern arise which might be a compensatory mechanism in respons to a vascular iischaemic challenge. Further investigations are needed to characterise the initial stimulus that induces this compensation and to determine if the compensation is sufficient to maintain a continuous and adequate blood supply.
The sesamoidean nerve branches from the palmar nerve and runs towards the proximal sesamoid bone. To study the structures innervated by this nerve, a technique for blocking it was developed. The effect of this nerve block was determined in ponies with an induced lameness located in the lateral proximal sesamoid bone (5 ponies) or in the distal part of the lateral branch of the suspensory ligament (5 ponies), and in 10 horses with clinical sesamoidosis. A lameness provoked by the implantation of an expansion plug in the proximal sesamoid bone could, to a large extent, be anaesthetized by a sesamoidean nerve block. However, lameness due to a local tendonitis in the lateral branch of the suspensory ligament, was only partially eliminated by a sesamoidean nerve block. In horses with sesamoidosis the lameness improved, on average, by about 30%. It is concluded that the sesamoidean nerve contains sensory fibres that innervate the proximal sesamoid bone. The sesamoidean nerve block is highly specific for pain originating from the proximal sesamoid bone including the adjacent distal part of the extensor branch of the suspensory ligament. In horses suffering from sesamoidosis the main source of pain appears not to be located in the proximal sesamoid bone. The specificity of the sesamoidean nerve block makes it a useful technique for differentiating the site of a lameness located in the fetlock area.
In chronical proximal sesamoid bone lameness it is difficult to localise the exact site of pain. A specific diagnostic analgesia is not available because of a deficiency of detailed information about the nerve supply to the proximal sesamoid bones and surrounding area. A macroscopic study of the nerve distribution to the proximal sesamoid bones of 10 foals and 5 adult horses revealed that these bones are innervated by two branches, in this study called the medial and lateral sesamoidean nerve, respectively, originating from the medial and lateral palmar nerve. Histology of the left forelimbs of two fetuses and one foal confirmed the macroscopic findings. Additionally, histology of ten proximal sesamoid bones of adult horses showed that myelinated nerve fibres are present in the nutrient foramina and in the trabecular bone, accompanying the larger arteries. This study provides possibilities for future diagnostics of proximal sesamoid bone lameness by specific local perineural analgesia.
Pseudotuberculosis or caseous lymphadenitis in goats is marked by superficial abscesses and was recently observed in the Netherlands. The literature on this disease is reviewed, concerning the incidence, aetiology, pathogenesis, symptoms, diagnosis, therapy and preventive measures. The damage which the disease could cause to goat husbandry in the Netherlands, is discussed. Although the losses from death and diminished production will probably be small, treatment is time-consuming and requires much labour. The greatest damage will possibly consist in the fact that breeders will not be able to sell their animals when caseous lymphadenitis occurs in their herd. Particularly, the export of breeding stock could be menaced by this disease.