Computed tomography (CT) with CT myelography is a novel imaging modality for detailed anatomical imaging and precise diagnosis of equine cervical spine pathology. Computed tomography of the complete cervical vertebral column in live horses has not been reported previously. The objectives of this study were to describe the diagnostic utility of CT and CT myelography in horses, the technique, the type and distribution of lesions and procedure-related complications. Medical records of horses subjected to cervical CT and CT myelography between 2013 and 2018 were reviewed for this retrospective descriptive study. The examinations were performed with horses in lateral recumbency using a large-bore CT scanner. In total, 180 horses were included. The study population consisted of 79.4% Warmblood breed horses, 68.3% were male, the mean age was 7.1 years (range 21 days-21 years), and the bodyweight ranged from 61 to 717 kg (mean 530 kg). Pathology of the cervical vertebral column was identified in 176/180 horses (97.8%) and included osteoarthritis of the articular process joints in 83%. Impingement and compression of the spinal cord were detected using CT myelography in 125/147 horses (85%). Pathology was localised caudal to C5 in 90%. The mean AE s.d. anaesthesia time was 34 AE 19 min and 52 AE 13 min for CT examinations, excluding and including myelography, respectively. Adverse events occurred in 7.2% of the examined horses. The caudal location of the majority of lesions emphasises the importance of good-quality imaging of the most caudal cervical vertebrae in horses with suspected cervical spinal pathology and/or spinal cord compression. Computed tomography imaging enables identification of bony and soft tissue lesions of the entire cervical vertebral column in live, large-breed adult horses. Materials and methods Study subjects All horses subjected to CT examination of the cervical vertebral column, with or without CT myelography, at Evidensia Equine Specialist Hospital Helsingborg, Sweden, between June 2013 and February 2018, were included. Data retrieved from the medical records included horse signalment, history and presenting signs, anaesthesia time, adverse events during the CT procedure, anaesthetic recovery or immediate postanaesthetic period.
Recent research on chronic painful Achilles tendons in humans using ultrasonography and immunohistochemistry, has demonstrated an association between neurovascular ingrowth and tendon pain. In horses, chronic debilitating tendon conditions are well-known to be very difficult to treat, and the background to impaired function and pain is not scientifically clarified. In a collaborative research project between the Sports Medicine Unit in Umeå and Strömsholm Equine Hospital, grey-scale ultrasonography (US) and colour Doppler (CD) examination were performed in ten horses with chronic tendon injuries (>3 months) and a control group of six healthy and asymptomatic horses. In all symptomatic tendons, but not in any of the tendons in the control group, neovessels were seen in the area with structural tendon changes. The neovessels found in the horse tendons looked similar to what has recently been presented in human Achilles tendons. These findings motivate evaluation of the same treatment, a sclerosing injection that was demonstrated recently to give promising results in the treatment of chronic Achilles tendon injuries (tendinosis) in humans.
PAL injury is characterised by a convex contour of the palmar/plantar aspect of the fetlock, associated with thickening of the ligament with or without subcutaneous fibrosis. Bilateral PAL thickening is common in older horses, ponies and cobs; however, bilateral PAL enlargement is often present with only unilateral lameness. Treatment methods used in this study did not appear to influence outcome significantly.
Summary
Synovial sepsis represents a major cause of morbidity and mortality in foals; however, there are no studies focusing on foals particularly at risk during the first 2 months of life. Our objective was to analyse outcome in foals aged <2 months with haematogenous septic arthritis and to identify prognostic factors and compare the effects of two different lavage procedures on outcome. Sixty foals with synovial sepsis were used for our retrospective study in which medical records, online data and telephone interviews were utilised to analyse prognostic factors, and determine short‐ and long‐term survival and athletic performance of foals treated at Evidensia Equine Specialist Hospital, Helsingborg, between 2008 and 2014. Overall survival to discharge was 80% (48/60). Time to long‐term follow‐up ranged from 6 months to 6.5 years. Forty/60 (67%) horses survived long‐term. Four/8 (50%) of the nonsurvivors at long‐term follow‐up had been subjected to euthanasia due to sequelae of joint sepsis. Of the long‐term survivors, 37/40 (92.5%) achieved athletic soundness. Overall long‐term outcome for athletic soundness was 37/60 (62%). Prognostic factors based on historical, clinical or laboratory data, or the use of through‐and‐through needle lavage compared to endoscopic lavage as the first procedure, could not be identified. The present study demonstrates a more favourable prognosis than previously reported, with 80% of foals with synovial sepsis surviving to discharge, and approximately 60% achieving athletic soundness. However, the study was limited by a small population size, which may account for the failure to verify statistically significant prognostic factors.
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