Biomedical subjects
Publications and source records attributed to T N Phillips.
A 3-month-old Thoroughbred colt was presented with signs of colic. Findings from physical examination, abdominal paracentesis, abdominal radiographs and clinical pathology revealed uroperitoneum secondary to a calculus obstructing the urethra and causing subsequent urinary bladder rupture. Analysis of the calculus demonstrated a tissue center with outer concretions composed primarily of struvite.
Osteochondral fragmentation of the plantar aspect of the proximal phalanx was diagnosed as a cause of hind limb lameness in 19 horses. The lameness was evident at the upper levels of the horses' performance capabilities, and was isolated to the metatarsophalangeal joints by use of intra-articular or regional anesthesia. Fragments were surgically removed from 10 horses that later returned to full use. Seven horses were treated intra-articularly with polysulfated glycosaminoglycans or corticosteroids; only one horse was able to return to full use. One horse was retired from work at the time of diagnosis. Surgery appeared to be the most effective treatment for osteochondral fragmentation of the plantar aspect of the proximal phalanx, although medical treatment combined with a decrease in the horses' expected performance also was believed to be useful.
Chronic nongranulomatous intestinal inflammation was found during laparotomy in 7 horses. The clinical signs consisted of recurrent abdominal pain in all horses. Anti-inflammatory agents (corticosteroidal and nonsteroidal agents) appeared to be effective for controlling the signs. Surgical removal of the involved intestine also was effective. Nonocclusive or temporary mesenteric ischemia was proposed as a cause of the intestinal lesions.
Although coagulase-negative staphylococci (CoNS) are frequent etiologic agents in prosthetic valve endocarditis, they rarely infect native heart valves. We report three cases of CoNS endocarditis in patients with mitral valve prolapse (MVP). Review of other reports of MVP-associated endocarditis and of the limited experience with CoNS infection of native heart valves suggests that our experience is not unique. Coagulase-negative staphylococcal endocarditis superimposed on MVP may be difficult to recognize and to treat. The cardiac dysfunction can be quite subtle, the clinical course indolent, the blood culture results difficult to interpret, and the response to antimicrobial agents suboptimal.
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Axial sesamoid injuries were found in 4 of 18 horses with lateral condylar fractures of the metacarpus or metatarsus. The injuries appeared as axial sesamoid fractures or progressive demineralization of the axial border of one of the sesamoids. None of the horses with axial sesamoid injuries returned to performance soundness. Axial sesamoid injury appeared to be an indication of severe fetlock trauma due to condylar fracture. Such injuries appeared to indicate a poor prognosis for return to performance soundness.
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Intussusception associated with Anoplocephala perfoliata infection was found in 5 horses. The unusual types of intussusception and the presence of tapeworms at the leading edge of the intussuscipiens suggested tapeworms as the cause of the problem. Lesions attributable to tapeworm attachment on the mucosa were found to fit a mechanical model of intussusception. Treatment of two of the horses and some of their pasturemates with pyrantel pamoate caused elimination of intact tapeworms.
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The medical management of three horses with simple and strangulating small intestinal obstructions was unsuccessful and was therefore supported by surgical bypasses. Jejunocecostomies were used to treat horses with postoperative paralytic ileus that was unresponsive to medical management. These horses had abdominal pain, gastric distention, heart rate elevations greater than 60/minute, and small intestinal distention on rectal palpation. Two horses experienced weight loss which responded to bypass removal. The bypass effectively decreased the need for intravenous fluid administration and repeated nasogastric intubation.