Summary An 8‐year‐old Warmblood gelding was referred for evaluation of headshaking to the Clinic for Horses, University of Veterinary Medicine Hannover. Based on clinical signs and computed tomography – as well as magnetic resonance imaging – findings, otitis media was diagnosed. Medical treatment including trimethoprim potentiated sulfadimethoxine and meloxicam for 3 weeks did not result in cessation of clinical signs. Therefore, the tympanic cavity was opened transendoscopically using an Nd:YAG‐laser via the guttural pouch according to surgical procedures in human and small animal medicine, leading to a considerable improvement of clinical signs.
ZusammenfassungObwohl die Ätiologie des idiopathischen Headshaking beim Pferd noch nicht vollständig geklärt ist, wird die Trigeminusneuralgie aufgrund der im Vergleich zum Menschen ähnlichen Symptomatik und der partiell positiven Behandlungserfolge mit Cyproheptadin und Carbamazepin als ursächlich angesehen. In der Humanmedizin wird zur Therapie der Trigeminusneuralgie unter anderen die retroganglionäre Glycerolinjektion eingesetzt. Schlüsselwörter: Headshaking / Ganglion trigeminale / Glycerol / Injektion / Therapie Treatment of idiopathic headshaking with an injection of glycerol into the trigeminal ganglion in a 5 year old Warmblood mareAccording to the similarities with human trigeminal neuralgia and the responsiveness to treatment with Cyproheptadine and Carbamazepine, equine idiopathic headshaking is suspected to be caused by trigeminal neuralgia, although the definitive reason is still unclear. In human medicine one treatment option of trigeminal neuralgia is retroganglional injection of glycerol. A five year old Warmblood mare was presented with a history of excessive headshaking induced by hot climate or sunshine. Clinical symptoms were recognized on pasture and during riding. After riding, headshaking was sustained for some hours in the stable. Based on history, clinical signs, laboratory, endoscopic and diagnostic imaging findings (x-rays of the head and computed tomography) diagnosis of idiopathic seasonal headshaking was made. The mare was treated with a computed tomography guided injection of glycerol (Glycerinum anhydriacum) in both trigeminal ganglions under general anaesthesia. Intervention was without severe complications. Follow up is lasting until today (2 years) and reveals a 95 % improvement of headshaking. In this case a long lasting significant improvement of idiopathic headshaking was achieved by the injection of glycerol in both trigeminal ganglions.
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Da Zwillingsgraviditäten bei der Stute in der Regel zu Aborten, Totgeburten oder der Geburt lebensschwacher Fohlen führen, werden in der gynäkologischen Praxis verschiedene Reduktionsmethoden angewendet. Der folgende Übersichtsartikel beschreibt die Einflussfaktoren auf die Entstehung von Zwillingsgraviditäten und erläutert die Durchführung und Erfolgsaussichten der verschiedenen Reduktionsmethoden. Ovulationsmuster Unilaterale Doppelovulationen führen zu einer geringeren Embryogewinnungs-und Zwillingsträchtigkeitsrate als getrennte Abb. 1 Trächtigkeitsverlust durch Zwillingsträchtigkeit am 110. Trächtigkeitstag. © J. Klewitz. 154 Klewitz J et al. Management von Zwillingsträchtigkeiten bei der Stute Enke Verlag | Pferdespiegel 2010; 4: 154-160 Abb. 2 Ultrasonografische Darstellung einer unikornualen Zwillingsträchtig-keit am 29. Trächtigkeitstag (B-Mode). © J. Klewitz. Abb. 3 Dopplersonografische Darstellung der Herzaktivität einer vitalen Fruchtanlage (weißer Pfeil) und einer Fruchtanlage ohne Herzaktivität (blauer Pfeil) nach natürlicher Reduktion am 31. Trächtigkeitstag. © J. Klewitz. ps.fachspiegel Enke Verlag | Pferdespiegel 2010; 4: 154-160 Klewitz J et al. Management von Zwillingsträchtigkeiten bei der Stute Abb. 9 Schematische Darstellung alternativer Reduktionsmethoden in Abhängigkeit vom Trächtigkeits-tag. D 14-16: Manuelle Kompression einer Fruchtanlage; D 30-35: Transvaginal-ultraschallgeleitete Punktion (TUA); D 35: Trächtigkeitsabbruch durch Prostaglandin-Applikation; D 70 (-90): Transrektale kraniozervikale Dislokation (TCD); D 100-130: Transabdominale fetale Punktion. ps.fachspiegel Enke Verlag | Pferdespiegel 2010; 4: 154-160 Klewitz J et al. Management von Zwillingsträchtigkeiten bei der Stute
SummaryLidocaine as a prokinetic drug is acting dose-dependently on the ischemia-reperfusion (IR) injured equine jejunal smooth muscle. The aim of the study was to examine the effects of different dosages of lidocaine on jejunal smooth muscle contractility in vitro as a basic research approach to examine the potential mechanism of lidocaine. Sustainability of this in vivo effect of applied lidocaine was tested under in vitro conditions. Hypothesis: Application of a higher initial dose of lidocaine during IR in vivo could change, improve or even impair the contractility effects on jejunal smooth muscle in vitro. 12 horses received either a 1.3 mg/kg (IRL1; N = 7) or 2.6 mg/kg (IRL2; N = 5) lidocaine bolus infusion over 10 minutes followed by 0.05 mg/kg/min intravenously for 5 minutes while artificial IR injury on the jejunum was induced. To examine the effects of lidocaine on jejunal smooth muscle function, isometric force performance (amplitude, frequency and contractility) was measured in vitro at two different times (t1,t2). The influence of either in vitro lidocaine supplementation (KHB+L) or no supplementation (KHB) was studied to assess the sustainability of lidocaine effects. IRL2 KHB+L showed a significant higher frequency of contraction at t2 compared to IRL1KHB+L. Amplitude of contractions and contractility were significantly decreased in the IRL1 KHB tissues compared to IRL1 KHB+L at t2. The IRL2 KHB tissues at t2 showed a significant decrease of frequency and amplitude of contractions compared to the IRL2 KHB+L. There was a significant decrease in frequency and an increase in amplitude of contractions and in contractility in IRL 1 KHB+L from t1 to t2. In IRL1 KHB a significant decrease in frequency was observed but increase in amplitude of contractions and contractility was lacking from t1 to t2. IRL2 KHB expressed a significant decrease in frequency and a significant increase in amplitude from t1 to t2, while amplitude, frequency and contractility in IRL2 KHB+L were not influenced by time. High dosage lidocaine bolus infusion with further supplementation increased frequency of contractions and maintained amplitude of contractions over the experimental time. This in vitro study suggested that immediate application of a high bolus dosage may improve protective effects of lidocaine furthermore in vitro. At the moment, no pharmacokinetic data for a 2.6 mg/kg over 10 min. lidocaine bolus in vivo is available. Recommending a higher initial lidocaine bolus in vivo, especially because of negative side effects, requires further investigation.Keywords: lidocaine / equine jejunum / contractility / smooth muscle / prokinetic effects / anesthesiology / horse In vitro untersuchte Effekte von zwei unterschiedlichen in vivo verabreichten Lidokaindosierungen auf die glatte Muskulatur des equinen Jejunums in einem Ischämie-Reperfusions-Modell Lidokain wirkt dosisabhängig prokinetisch auf die Ischämie-Reperfusion (IR) geschädigte glatte Muskulatur des equinen Jejunums. Ziel dieser Studie war, die Effekte unterschiedlic...
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