PubMed Health⌕ Search

Biomedical subjects

V B Reef

Publications and source records attributed to V B Reef.

At least 37 records · Page 2Linked to original sources

Disseminated Halicephalobus deletrix infection in a horse.

A 13-year-old Quarter Horse gelding was referred for evaluation of a draining tract and fracture of the right hemimandible of 4 weeks' duration. Two days prior to admission, the horse had developed pigmenturia. Radiography of the mandible revealed a fracture of the vertical ramus of the right hemimandible, loss of the right lower second premolar, and osteomyelitis involving an extensive portion of the hemimandible. Ultrasonography of the left kidney revealed loss of normal renal architecture. Histologic examination of tissue obtained from the right hemimandible revealed granulomatous osteomyelitis and multiple metazoan parasites identified as Halicephalobus deletrix. The horse was treated with antimicrobial and deworming agents, and the mandible was surgically debrided. The horse became atactic 8 days after surgery and was euthanatized. Necropsy identified parasitic migration in the right hemimandible, kidneys, and CNS.

Animals↗

Pharmacokinetics of digoxin administered to horses with congestive heart failure.

Nine horses with (naturally acquired) congestive heart failure were treated with 2.2 micrograms of digoxin/kg of body weight by the IV route, followed by 11 micrograms/kg administered orally every 12 hours thereafter. Furosemide was administered IV concurrently with IV administered digoxin every 12 hours. Serum concentration of digoxin was measured after the first (IV) and seventh (orally administered) dose. After IV administration, digoxin disposition was described by a 2-compartment model, with a rapid distribution phase (t1/2 alpha = 0.17 hour), followed by a slower elimination phase (beta = 0.096 +/- 0.055 h-1, t1/2 beta = 7.2 hours, where beta is the exponential term from the elimination phase of the concentration vs time curve). Bioavailability after oral administration was 21.2 +/- 10.8%. After the seventh orally administered dose, serum concentration of digoxin peaked 1 to 2 hours later, and was 1.9 +/- 0.7 ng/ml (mean +/- SD). In 4 horses, a second increase in serum digoxin concentration was observed 4 to 8 hours after the initial peak, which possibly was evidence of enterohepatic recycling of the drug. Response to treatment included reduction in heart rate, peripheral edema, and pulmonary edema, but these could not be attributed to the digoxin alone because the horses were treated concurrently with furosemide.

Animals↗

Idiopathic, aseptic, effusive, fibrinous, nonconstrictive pericarditis with tamponade in a standardbred filly.

A Standardbred filly was admitted for evaluation of pleuritis and pneumonia. Heart rate was 80 to 120 beats/min, and the pulse was barely palpable. Thoracic and abdominal ultrasonography and echocardiography revealed substantial pericardial effusion with cardiac tamponade, fibrinous pericarditis, pleural effusion, and ascites. Initial electrocardiography revealed normal sinus rhythm with decreased amplitude of the QRS complexes consistent with pericardial effusion. Following thoracentesis, echocardiogram-guided pericardiocentesis was performed. Bacterial culture yielded no growth from any of the fluids, and bacteria were not seen on cytologic examination. Initial treatment included broad-spectrum antibiotic treatments, IV fluid therapy, and anti-inflammatory agent administration. On the basis of negative culture results, an immune-mediated cause was considered, and dexamethasone was instituted in a decreasing dosage regimen. Pericardial effusion, ventral edema, and ascites began to resolve within 3 days after beginning dexamethasone treatment. Thirty days following discharge, the filly was reexamined, and at that time, the prognosis for athletic performance was considered good so the horse was returned to race training. The final diagnosis in this case was idiopathic, effusive, nonconstrictive pericarditis with tamponade. Early identification, clinical understanding, and application of knowledge of the pathophysiologic mechanisms of pericarditis in horses, combined with use of diagnostic aids such as ultrasonography and aggressive therapy consisting of effusion drainage, pericardial lavage, antibiotics that penetrate the pericardium, and corticosteroids when indicated are critical for a successful outcome in horses with pericarditis.

Animals↗

Ventricular arrhythmias in horses: 21 cases (1984-1989).

Ventricular premature depolarizations (VPD) were identified in 21 horses in which unexplained tachycardia or an arrhythmia was detected on auscultation. Horses were categorized into 3 groups on the basis of ECG findings. Seven horses had uniform isolated VPD (group 1); 7 horses had repetitive uniform VPD at a rate < 100 VPD/min (group 2); and 7 horses had either multiform VPD, R-on-T, or > or = 100 VPD/min (group 3). Concurrent systemic disease was identified in 12 horses, 7 of which had gastrointestinal tract disorders. Serum cardiac isoenzyme activities were high in 6 (2 from each group) of 13 horses in which they were measured. Serum electrolyte concentrations were normal in all but 1 of 11 horses in which they were measured. Antiarrhythmic drugs were given to 9 horses (all of which were in group 2 or group 3), 6 of which converted to sinus rhythm. Two horses that had R-on-T in the ECG died shortly after initiation of antiarrhythmic treatment. An accelerated idioventricular rhythm persisted in 1 horse for at least 8 months and failed to respond to antiarrhythmic drugs. Ventricular premature depolarizations resolved or decreased considerably in frequency in 11 horses without the administration of antiarrhythmic agents. Treatment in these horses included therapy for any underlying systemic disease, corticosteroids, nonsteroidal antiinflammatory drugs, or stall rest. The remaining horse was euthanatized several hours after hospitalization. Five horses died or were euthanatized either during hospitalization or several months after being discharged. Myocardial lesions were identified at necropsy in 2 horses.

Animals↗

Postsurgical ventricular tachycardia in a horse.

A 2-year-old Thoroughbred racehorse developed ventricular tachycardia after elective laryngoplasty and ventriculectomy were performed while anesthesia was maintained with halothane. During surgery, the horse became febrile and developed transient mild hypercarbia. The horse was treated with an IV infusion of quinidine gluconate. Continuous electrocardiographic monitoring was used to evaluate cardiac rhythm during treatment, and conversion was achieved after 12 hours of IV infusion. The inciting cause for the arrhythmia was not determined.

Anesthesia, Inhalation↗

Ejaculatory failure associated with aortic-iliac thrombosis in two stallions.

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.

Animals↗

Echocardiographic diagnosis of an anomaly of the tricuspid valve in a male pygmy goat.

A 3-year-old male pygmy goat was evaluated because of a grade III/V plateau pansystolic murmur that was auscultated over the tricuspid valve area and a grade II/V plateau pansystolic murmur that was auscultated over the left heart base. Echocardiography revealed a large right atrium and ventricle, an atrial septal defect, and a dysplastic tricuspid valve displaced apically into the right ventricle. Contrast echocardiography and color-flow Doppler echocardiography revealed flow from right to left through the atrial septal defect and severe tricuspid regurgitation. A diagnosis of tricuspid valve dysplasia and severe tricuspid regurgitation was made. This anomaly (Ebstein's anomaly) of the tricuspid valve should be considered in goats that have systolic, with or without diastolic, murmurs over the tricuspic valve. Two-dimensional echocardiography can confirm the diagnosis of the anomaly. The associated tricuspid regurgitation and interatrial right-to-left shunt flow can be detected and semiquantitated by use of contrast, continuous wave, and color-flow Doppler echocardiography.

Animals↗

Ultrasonographic evaluation of horses with thrombophlebitis of the jugular vein: 46 cases (1985-1988).

Medical records of 46 horses with jugular vein thrombophlebitis that were evaluated ultrasonographically were reviewed. The ultrasonographic appearance of the thrombus within the jugular vein was classified as noncavitating if it had uniform low to medium amplitude echoes, or as cavitating if it was heterogenous with anechoic to hypoechoic areas representing fluid or necrotic areas within the thrombus, and/or hyperechoic areas representing gas. Signs of pain on palpation of the affected vein (P less than 0.001), heat over the vein (P = 0.001), and swelling of the vein (P less than 0.05) were significantly associated with the ultrasonographic detection of a cavitating lesion. Ultrasonography also was useful for selecting a site for aspiration of a specimen for bacteriologic culturing and susceptibility testing.

Animals↗

Comparison between diagnostic ultrasonography and radiography in the evaluation of horses and cattle with thoracic disease: 56 cases (1984-1985).

The results of radiography and ultrasonography were compared on 56 horses and cows with lower respiratory tract disease. Ultrasonography was more sensitive than radiography for the detection of small pleural effusions and consolidations in large animals. The side of the thorax affected and the character of the pleural fluid and lung in large animals with pleural effusion can be evaluated ultrasonographically. The periphery of the lung must be affected to characterize pulmonary lesions ultrasonographically. Radiography is the best technique to characterize lesions deep within the lung when the periphery of the lung is normal.

Animals↗

Echocardiographic detection of pulmonic valve rupture in a horse with right-sided heart failure.

Pulmonic valve rupture was determined to be the cause of severe right-sided heart failure in a 20-year-old Thoroughbred gelding. A flail in the intermediate pulmonic valve cusp was detected by 2-dimensional echocardiography. Significant pulmonic and tricuspid valvular regurgitation were confirmed by Doppler echocardiography. Despite treatment, the horse's condition deteriorated, and euthanasia was performed. At necropsy, a tear in the pulmonary artery extending into the right valve cusp and a tear at the base of the intermediate valve cusp were identified at the junction of the right and intermediate pulmonic valve cusps. Careful echocardiographic evaluation of the pulmonic valve is warranted for horses with right-sided heart failure, for which more common causes cannot be found.

Animals↗

Advances in echocardiography.

Before the development of echocardiography, cardiac disease in the horse was diagnosed if a loud heart murmur (grade III-IV/VI or louder) and clinical signs of congestive heart failure (coughing, edema, venous distention, jugular pulsations) were detected on physical examination. Arrhythmias that persisted during and after exercise also indicated cardiac disease, which could be characterized electrocardiographically. Electrocardiography, thoracic radiography, angiography, cardiac catheterization, and oximetry could add only small pieces of information about the heart. M-mode echocardiography provided the first "window" with which to evaluate the heart and its intracardiac structures, albeit an ice-pick one-dimensional view. With M-mode echocardiography, the diameter of the aorta at the valves, the left ventricle, right ventricle, and left atrial appendage, as well as the thickness of the interventricular septum and left ventricular free wall, could be measured. Motion and thickness of the tricuspid, mitral, and aortic valves could be assessed, but only in a one-dimensional plane. Two-dimensional echocardiography provided an added dimension, resulting in visualization of all the intracardiac structures, aorta, and pulmonary artery. Two-dimensional echocardiography became the diagnostic technique of choice for the evaluation and characterization of congenital cardiac disease in critically ill neonates, as well as in adult horses. Two-dimensional echocardiography also improved the ability to diagnose valvular regurgitations, characterize valvular lesions (bacterial endocarditis, ruptured chorda tendineae), myocardial function (segmental wall motion abnormalities), atrial size, mass lesions (endocarditis, neoplasia, and thrombi), and pericardial effusion. Information about blood flow was obtained using contrast echocardiography but was limited to certain cardiac abnormalities (congenital cardiac defects and tricuspid regurgitation). This information about blood flow was limited to the detection of positive or negative contrast jets. Comprehensive information about blood flow was lacking until the application of Doppler echocardiography to equine cardiology. Pulsed-wave and color flow Doppler echocardiography resulted in precise localization of the abnormal blood flow and semiquantitation of the shunt flow or regurgitant jet. Color flow Doppler echocardiography sped up the localization and semiquantitation of the jet in many instances and provided some information about blood flow velocity in the enhanced and variance modes. The peak velocity of jets can be determined using continuous-wave Doppler echocardiography. This value then can be used to estimate pressure difference between cardiac chambers or to calculate cardiac output noninvasively if angles parallel to flow can be obtained. Thus, information about cardiac size, function, and blood flow can be combined to diagnose cardiac disease in horses and to formulate a prognosis for life and performance.

Animals↗

Advances in diagnostic ultrasonography.

A wide variety of ultrasonographic equipment currently is available for use in equine practice, but no one machine is optimal for every type of imaging. Image quality is the most important factor in equipment selection once the needs of the practitioner are ascertained. The transducer frequencies available, transducer footprints, depth of field displayed, frame rate, gray scale, simultaneous electrocardiography, Doppler, and functions to modify the image are all important considerations. The ability to make measurements off of videocassette recorder playback and future upgradability should be evaluated. Linear array and sector technology are the backbone of equine ultrasonography today. Linear array technology is most useful for a high-volume broodmare practice, whereas sector technology is ideal for a more general equine practice. The curved or convex linear scanner has more applications than the standard linear array and is equipped with the linear array rectal probe, which provides the equine practitioner with a more versatile unit for equine ultrasonographic evaluations. The annular array and phased array systems have improved image quality, but each has its own limitations. The new sector scanners still provide the most versatile affordable equipment for equine general practice.

Animals↗

Surgical treatment of a mural teat abscess in a cow.

A 6-year-old multiparous Holstein cow was admitted for evaluation of progressive milk flow obstruction of one quarter of the udder. Physical examination findings suggested the presence of a mural teat abscess. Ultrasonography substantiated the physical examination findings and delineated the extent of the lesion. Surgical excision of the abscess en bloc yielded satisfactory functional and cosmetic results.

Abscess↗

Septicemia, atrial fibrillation, cardiomegaly, left atrial mass, and Rhodococcus equi septic osteoarthritis in a foal.

A foal with vegetative bacterial endocarditis affecting the wall of the left atrium was treated successfully with cefotaxime, erythromycin, and rifampin. Bacterial isolates included Escherichia coli from blood and Rhodococcus equi from a P-type osteomyelitic lesion of the left third metatarsal bone and from synovial fluid from the left metatarsophalangeal joint. Cardiac complications included cardiomegaly and atrial fibrillation, which responded to treatment with digoxin and quinidine sulfate. Cardiac function was considered normal 18 months after treatment. Bacteriologic cure of osteoarthritis was achieved by use of surgical debridement, lavage, and local and systemic antimicrobial treatment; however, lameness developed 18 months after treatment when training for flat racing was begun. Radiography revealed chronic degenerative joint disease.

Actinomycetales Infections↗

Echocardiographic detection of an intact aneurysm in a horse.

Two-dimensional real-time echocardiographic examination of a 3-year-old Thoroughbred gelding with pleuropneumonia revealed an intact aneurysm of the right sinus of Valsalva, which was confirmed at postmortem examination. The horse had no clinical signs associated with the aneurysm.

Animals↗