Laparoscopic evaluation after celiotomy for epiploic foramen entrapment revealed spontaneous closure of the epiploic foramen in 3/7 horses. This finding could explain the reported low recurrence rate after surgical treatment for epiploic foramen entrapment.
A 25-year-old Welsh Cob stallion was presented with a sudden onset of abnormal hind limb gait. Being led at walk on a straight line, the hindquarters were shifted to the right and the horse was walking on three tracks. Treatment with corticosteroids and non-steroidal anti-inflammatory drugs was attempted but ineffective and eventually the horse was euthanased. Postmortem examination of the coxofemoral joints revealed a bilateral degeneration of the articular cartilage of both the acetabulum and the femoral head, as well as a partial rupture of the left ligamentum capitis ossis femoris. Histological examination of this ligament showed collagen fibre fragmentation, increased proteoglycan and cellular infiltrates. The irreversible clinical signs were compatible with so-called ‘sidewinder syndrome’ and ‘crabwalking’ to the right and were associated with partial rupture of the left ligamentum capitis ossis femoris and bilateral degenerative joint disease of the coxofemoral joint, but the exact aetiology remains unknown.
Summary Diagnosis of caecal intussusception can be challenging. Transabdominal ultrasound is often used as a diagnostic tool in equine colic. Differentiation between caecocaecal and caecocolic intussusception might be useful in the decision process before surgery. The aims of this study were: 1) to assess the usefulness of ultrasound for diagnosis of intussusception and differentiation between caecocaecal and caecocolic intussusception; and 2) to determine survival to hospital discharge after surgery. Therefore, a retrospective case series (2009–2013) was performed of all colic cases with caecal intussusception (n = 60) confirmed at surgery or necropsy. In all horses, the intussusception could be visualised using ultrasound at admission. Caecocolic intussusception (n = 46) was much more common than caecocaecal (n = 14) intussusception and correct ultrasonographic differentiation between both types could be made in 92% of the cases. Ten horses (out of 14) diagnosed with caecocaecal intussusception underwent surgery, of which 8/10 (80%) were discharged, one horse (10%) was subjected to euthanasia during and one (10%) after surgery. Of the 28 (out of 46) operated horses with caecocolic intussusception, 17 (61%) survived to discharge, while 7 (25%) and 4 (14%) were subjected to euthanasia during and after surgery, respectively. Of all horses that underwent surgery, in 13/38 (34%) surgical reduction was possible, while 13/38 (34%) needed partial typhlectomy and 4/38 (11%) needed colostomy because of an irreducible intussusception. Survival to discharge after successful surgery was 12/13 (92%) when only reduction was performed, 11/13 (85%) if partial typhlectomy was needed and 2/4 (50%) after colostomy and partial typhlectomy. In conclusion, abdominal ultrasound is a useful tool in the diagnosis and differentiation of caecal intussusception. Survival to hospital discharge after successful surgery is good.
The purpose of this study was to describe the radiographic and ultrasonographic appearance of the esophagus of ten healthy horses. Contrast radiography showed variations in the long-axis shape of the esophagus at the thoracic inlet. Administration of a large volume contrast medium by intubation showed stasis of contrast material for several minutes in two of the ten horses. The wall thickness of the non-distended esophagus on ultrasound was 2.6 ± 0.3 mm with significant differences depending on the location. Distention of the esophagus by intubation or by a bolus of water or concentrate resulted in a decrease in wall thickness and it facilitated measuring with less variation. Stasis at the thoracic inlet was seen in five of the ten horses, when a water bolus was administered. Ultrasonographic evaluation of 100g spontaneously swallowed commercial concentrate was better than fluid (water bolus or 2.5mL/kg contrast medium) administration via intubation to assess esophageal motility at the thoracic inlet. Stasis seen at the thoracic inlet after bolus administration by intubation should not be regarded as an abnormal finding, and swallowing, with the subsequent peristaltic wave, has a positive influence on the bolus passage time.
Summary Background In human medicine, local and regional arterial wall stiffness (AWS) parameters are routinely used to assess the vascular health. In horses, information regarding reproducibility of ultrasonographically derived AWS parameters is lacking. Objectives To evaluate the inter‐day and inter‐observer and intra‐observer measurement variability of both local and regional AWS parameters in horses. Study design Experimental study. Methods In 10 healthy, adult Warmblood horses, B‐, M‐mode and pulsed‐wave Doppler ultrasound images were collected on two different days from aorta, cranial and caudal common carotid arteries and external iliac artery. Heart rate and noninvasive blood pressure were recorded simultaneously. From blinded data, diastolic and systolic vessel lumen areas and diameters were measured from B/M‐mode images and the velocity of the pressure wave was determined by pulsed‐wave Doppler spectra. From each horse, one examination was measured again by the same observer and by a second, independent observer. Local and regional AWS parameters were calculated and inter‐day and inter‐observer and intra‐observer measurement coefficient of variation (CV) were assessed. Results Low CV was found for both arterial diameter and lumen area measurements. Moderate to high CV was found for local AWS parameters, while regional AWS parameters had low CV. Main limitations The number of horses investigated was too low to obtain reference values. The inter‐operator variability was not evaluated. Conclusions Our results show good reproducibility of aortic, carotid and external iliac artery diameter and area measurements using both B‐ and M‐mode ultrasonography. Nevertheless, the variability of the derived local AWS parameters was relatively high. Therefore, local AWS parameters might be less suitable for follow‐up studies, although they might be useful for population studies. On the other hand, regional AWS parameters showed low CV, making them valuable for both follow‐up and population studies.
Background: Venous stenosis, a possible cause of jugular dilatation and congestion, is well known in human medicine but has poorly been described in horses.Objective: To report unilateral jugular vein stenosis as a cause of jugular vein dilatation in horses and describe treatment by percutaneous transluminal angioplasty (PTA). Study design: Case report.Methods: Details of horses diagnosed with unilateral jugular stenosis were retrieved from medical records.Results: Five horses were presented with a non-painful, unilateral dilatation of the jugular vein of which two horses showed headshaking during exercise. In one horse an indwelling catheter had been used and jugular dilatation developed 4 weeks later.In the other horses, no intravenous injections had been administered in the months before jugular dilatation developed. Ultrasonographic examination revealed venous stenosis in all horses approximately 5-10 cm cranial to the thoracic inlet. The internal diameter at the level of this stenosis was only 1-3.1 mm. The length of the stenosis was about 15-19 mm with a markedly thickened intima and media on ultrasonography. After enoxaparin treatment, PTA was performed in three horses. During the procedure the stenotic vein was dilated three times with progressively increasing pressures up to 12 atm. The stenotic diameter increased to a maximum of 4.9 mm with improved jugular blood flow. Aftercare included anti-inflammatory and antithrombotic therapy. Conclusion: Jugular vein stenosis occurs in horses and should be included in the differential diagnoses of unilateral jugular vein dilatation. It may present in the absence of previous intravenous treatment. PTA of the jugular vein is feasible to improve jugular blood flow.
This case report describes the 2-dimensional transthoracic (2D-TTE), 3-dimensional transthoracic (3D-TTE) and intracardiac echocardiographic (ICE) characterization of the fossa ovalis region in 2 horses. The first case was presented for poor performance and showed an anechoic zone in the interatrial septum on 2D-TTE. Based on 3D-TTE a deepened fossa ovalis could be identified and using ICE the presence of an interatrial shunt could be excluded. The second case was referred for a cardiac murmur and the presence of turbulent flow in and around the interatrial septum on 2D-TTE color flow Doppler. The complementary use of 2D-TTE, 3D-TTE, and ICE allowed detailed characterization of a patent foramen ovale, with evidence of a left-to-right shunt in a dorsocranial to ventrocaudal direction with limited hemodynamic implications. These 2 cases underline the feasibility of 3D-TTE and ICE in horses and especially show the added value of ICE in a clinical setting.
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