Objective To evaluate two different barbed sutures for closure of pelvic flexure enterotomies and compare results achieved with two previously described closure techniques. Study design Ex vivo. Sample population Twenty‐four fresh cadaver adult equine large colons. Methods Cadavers were randomly assigned to four closure groups (n = 6 each group): single‐layer absorbable suture, double‐layer absorbable suture, single‐layer unidirectional barbed suture, or single‐layer bidirectional barbed suture. Construction time, luminal reduction (percentage), bursting pressure, and method of failure were measured. Cost, leakage, exposed suture, and general appearance were recorded. Comparisons were performed with one‐way analysis of variance and post hoc Bonferroni test (P < .05). Results Double‐layer absorbable closure had the highest bursting pressure (mean = 178.5 mm Hg, SD = 9.79, P < .001) but took more time (P = .001) compared with all other groups. The construction time of both barbed suture closures did not differ from the single‐layer closure (P > .06). Bursting strengths of both unidirectional (mean = 91.6 mm Hg, SD = 5.57) and bidirectional (mean = 87.5 mm Hg, SD = 8.69) barbed sutures were lower (P > .006 for both) than those of both single‐ (mean = 117.6 mm Hg, SD = 11.69) and double‐layer (mean = 178.5 mm Hg, SD = 9.79) closures. Unidirectional barbed suture closure had a reduction in lumen diameter (P = .004) compared with bidirectional and single‐layer closures. Conclusion Enterotomy closures with the two different barbed suture patterns were comparable in bursting strength and construction time. However, the barbed suture patterns had lower bursting strength compared with traditional single‐ and double‐layer closures. Unidirectional barbed suture closure also reduced lumen diameter. Clinical significance Closure of a large colon enterotomy with barbed suture patterns may be less secure than single‐ and double‐layer suture closure.
BackgroundSerum amyloid A (SAA) concentrations in blood and synovial fluid of horses with synovial sepsis have diagnostic value. Studies suggest serial blood SAA measurements could act as a prognostic indicator. This study evaluated the use of serial blood SAA concentrations for monitoring of horses with synovial sepsis.MethodsA prospective clinical trial was performed of horses referred to a single hospital with synovial sepsis that survived (n=17), synovial sepsis that were euthanised (n=5), non-septic intrasynovial pathologies (n=14) or extensive extrasynovial lacerations (n=5). SAA concentrations were determined on admission and every 24 hours thereafter. The area under the concentration–time curve from 0 to 144 hours of each group was compared by Kruskal-Wallis and post hoc Dunn’s tests (P<0.05).ResultsSignificant difference in mean blood concentration of SAA was found between synovial sepsis that survived and non-septic pathologies in the first 48 hours, as well as between non-septic intrasynovial pathologies and non-responsive sepsis requiring euthanasia. No difference was found between extensive extrasynovial lacerations and any septic group.ConclusionsWhile serial blood SAA is useful for monitoring clinical response of intrasynovial septic pathologies, interpretation should consider other clinical findings since blood SAA is not a specific marker for synovial sepsis.
Objective: To evaluate the accuracy of ultrasonographic guidance for injection near the ventral rami of the cervical spinal nerves (VRCSN).Study design: Ex vivo study. Sample population: Ten cadavers (n = 40 injections).Methods: Left and right VRCSN at C4/5 and C5/6 were infiltrated at the intervertebral foramen (IVF) under ultrasonographic guidance. A vertically orientated 3.5-MHz curvilinear probe was used to identify the craniocaudal midpoint of the articular process joint (APJ). The probe was moved ventrally until the IVF was identified. An 18-gauge 15-cm-long spinal needle was aimed immediately below the ventral margin of the cranial articular process, where 1 mL of latex was injected. Cadavers were dissected, and the location of the latex was recorded relative to the ventral ramus, the spinal cord, and the vertebral artery.Results: Direct infiltration of the ventral ramus occurred in 73% (29/40) of injections; 15% (6/40) of injections were < 0.5 cm from the ventral ramus, and 13% (5/40) of injections were > 0.5 cm (maximum 1.5 cm). Latex was located at a mean of 2.4 cm (range, 0.8-4) from the spinal cord and 0.9 cm (range, 0-1.5) from the vertebral artery. Conclusion:Ultrasonographic guidance of perineural injections of the caudal VRCSN was repeatable and accurate, with 88% of injections located within 0.5 cm of the ventral ramus. Iatrogenic damage was limited to one penetration into the vertebral artery.Clinical significance: Ultrasonographic guidance of perineural injections of the caudal VRCSN may be considered by operators experienced in cervical APJ scanning in horses with suspected cervical spinal nerve compression.
Corynebacterium ulcerans (C. ulcerans) may cause diphtheria in humans and can be carried by a wide range of animal species including dairy cows and, more recently, dogs and cats that have been increasingly involved in zoonotic trasmission. We isolated and characterized, by WGS, a toxigenic C. ulcerans strain from a diseased horse in the United Kingdom showing clinical signs of respiratory diphtheria comparable to those seen in people. Our results indicate a role for horses as reservoirs for zoonotic C. ulcerans.
Summary A 5‐year‐old Hanoverian gelding with acute moderate right forelimb lameness underwent nuclear scintigraphy, which identified marked increase in radiopharmaceutical uptake of the proximomedial aspect of the right metacarpus. Ultrasonography and radiography identified sclerosis and exostosis of the proximomedial aspect of the metacarpal bone III in‐between the suspensory ligament and the second metacarpal bone, and presence of a suspected fracture. The owner requested euthanasia of the gelding, and post‐mortem computed tomography and magnetic resonance imaging identified marked bone sclerosis and thickening of the palmar cortex of the metacarpal III (McIII), presence of an incomplete fracture in the palmar cortex of McIII and expansive exostosis from McIII extending in a palmar direction between the suspensory ligament and the second metacarpal bone. Histopathological examination confirmed the imaging findings of sclerosis and led to final diagnosis of a fracture of the palmar cortex of the McIII associated with an exostosis encroaching the medial aspect of the suspensory ligament. No abnormalities were present in the suspensory ligament or metacarpal bone II (McII).
An 18-month-old Welsh Cob was referred to a university teaching hospital for investigation of abnormal respiratory noise at rest. Video-endoscopy revealed persistent displacement of the soft palate with bilateral 2-3 cm diameter raised areas on either side of the midline. Neither trans-nasal nor oral approaches allowed sufficient visualisation of the caudal soft palate for diagnosis or treatment. Latero-lateral radiographs showed a blunted, thickened caudal edge of the soft palate consistent with a palatal cyst. Two palatal cysts were thermally ablated with a transendoscopic diode laser via temporary tracheotomy. The horse recovered uneventfully and resolution of the displacement was evident on follow-up endoscopy 11 months later. This report documents a novel surgical approach to the caudal aspect of the soft palate.
This report describes the likely development and growth of bilateral granulosa cell tumours (GCTs) in a Warmblood pony mare, during the first trimester of pregnancy after artificial insemination. The GCTs were initially suspected to be ovarian haematomas and were managed conservatively. However, they ultimately led to life-threatening haemoperitoneum (HP) and were later diagnosed as GCTs with histopathology. The case was successfully managed with emergency standing laparoscopic-assisted bilateral ovariectomy after haemodynamic supportive therapy. The mare made a full recovery and delivered a live filly foal at term. GCTs can be a rare cause of life-threatening HP and can be successfully managed with haemodynamic support and standing laparoscopic-assisted removal. Bilateral ovariectomy in a pregnant mare after 70 days of gestation can result in successful delivery of a live foal.
Background:The digital flexor tendon sheath (DFTS) is a common site of pathology in the UK equine population, often necessitating tenoscopic exploration. Common intrathecal pathologies may lead to fetlock canal constriction. The palmar/plantar annular ligament (PAL) is often surgically transected to relieve constriction or to facilitate surgical access and instrumentation. Objectives:The objectives of this study were (1) to establish whether diagnostic quality needle tenoscopy can be achieved in the proximal DFTS in cadaver limbs; (2) to determine if needle tenoscopy can be used to safely guide PAL transection; and (3) to evaluate iatrogenic damage when undertaking needle tenoscopy and PAL transection. Study design: Ex vivo experimental.Methods: Six cadaveric limbs were used and needle tenoscopy of the DFTS was performed via biaxial approach at the base of the sesamoids. Access to and diagnostic assessment of the proximal DFTS, as well as the completeness of needle tenoscopically guided transection of the PAL was recorded. Limbs were dissected and examined for iatrogenic damage and completion of PAL transection. Results:Positioning of the cannula/obturator unit was achieved on the first attempt 11/12 times. Laterally 16/24 and medially 18/24 proximal DFTS channels were accessed.Images were of diagnostic quality in 12/24 and 11/24 channels following lateral and medial approach, respectively. The PAL was completely transected in 4/6 limbs with partial transection in 1/6 limbs. The superficial digital flexor tendon (SDFT) was longitudinally lacerated instead of the PAL in one limb, with other iatrogenic damage limited to mild fibrillation to the intersesamoidean ligament.Main limitations: Ex vivo and sample size. Conclusions:The findings in this pilot study suggest that needle tenoscopically guided PAL transection in the live horse is not recommended currently. While diagnostic needle tenoscopy offered partial assessment of most of the proximal DFTS, further refinement is necessary before needle tenoscopy could be considered a viable alternative to traditional tenoscopy.
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