Objective: To report the performance of thoroughbred racehorses after surgical repair of a medial condylar fracture of the third metacarpal/metatarsal bone.Study design: Retrospective cohort study. Sample population: Forty-three horses surgically treated for medial condylar fractures, 30 with previous racing experience, 13 without previous racing experience (nonexperienced).Methods: Medical records (2009-2017) were reviewed for signalment, radiographic fracture characteristics, repair technique, and postoperative morbidity and mortality. Each experienced horse was matched with two horses randomly selected from its most recent race to serve as healthy controls. Racing performance parameters (race rating, competitive level, speed rating, performance index) and career racing statistics were compared with multiple regression models between injured experienced horses and controls. The career racing statistics for nonexperienced horses were evaluated. Reasons for nonreturn to racing were obtained. Results: The median duration of follow-up was 6 years (minimum 2, maximum 10). Twenty-one of 43 (49%) horses raced again as well as 18 of 30 (60%) experienced horses and three of 13 (23%) nonexperienced horses. Experienced horses were five times more likely than nonexperienced horses to return to racing (95% confidence interval = 0.07-0.58, P = .003). Higher preoperative racing performance parameters were associated with return to racing. Racing performance parameters were lower after the date of fracture in injured horses compared with controls.
Objective The aim of this study was to describe the signalment, clinical presentation, diagnostic findings, medical and surgical treatment and outcome of 22 farm animals diagnosed with a vertebral fracture or luxation. Study design Medical records of 22 farm animals (7 goats, 6 alpacas, 5 cattle, 3 sheep and 1 deer) were reviewed for signalment, history, presenting clinical signs and neurological examination findings, clinicopathological results, diagnostic imaging, final diagnosis, medical and surgical management, clinical progression and outcome. Results Animals' age ranged from 1 day to 15 years. Neurological examination findings included decreased motor function (20/22), recumbency (14/22), altered mentation (13/22), cranial nerve deficits (4/22) and lack of nociception (3/22). Lesions were localized to the atlanto-occipital region (2/22), C1 to C5 (7/22), C6 to T2 (4/22), T3 to L3 (3/22), and L4 to S1 (6/22). Diagnoses included vertebral fracture only (4/22), luxation only (5/22) or both vertebral fracture and luxation (13/22). In five cases, no therapy was attempted, while 12 cases were treated medically and five cases were treated surgically. Surgical interventions included manual reduction (n = 1); arthrodesis (n = 2); laminectomy (n = 1); and laminectomy with pin fixation, cerclage wire and polymethylmethacrylate bridging (n = 1). Five of the 22 cases survived to hospital discharge; two of these were treated surgically. Conclusion The cervical region was most commonly affected. Prognosis for these injuries in farm animals is guarded.
Objective To determine risk factors, especially age, associated with postoperative reflux (POR; >2 L of reflux present upon intubation), high‐volume POR (≥20 L in 24 hours), and short‐term outcome after small intestinal (SI) surgery. Study design Retrospective case‐control study. Sample population Horses aged ≥16 years (geriatric; range, 16–30; n = 44) and <16 years (mature; range, 2–15; n = 39) with an SI surgical lesion that survived general anesthesia and did not have a second exploratory celiotomy during the same visit. Methods Medical records (2009–2015) were reviewed; perioperative variables were evaluated for associations with outcomes by using multivariable logistic regression. Results Postoperative reflux was associated with an increasing packed cell volume at admission (odds ratio [OR], 1.08; 95% CI, 1.00–1.16; P = .042) and presence of nasogastric reflux at admission (OR, 4.61; 95% CI, 1.3–15.69; P = .014). High‐volume POR was associated with an increasing glycemia at admission (OR, 1.19; 95% CI, 1.01–1.40; P = .041), presence of nasogastric reflux at admission (OR, 10.05; 95% CI, 2.21–45.74; P = .003), and SI resection (OR, 10.52; 95% CI, 1.81–61.25; P = .009). Increasing surgical time (OR, 2.50; 95% CI, 1.16–5.29; P = .019) and high‐volume POR (OR, 6.37; 95% CI, 2.12–19.12; P = .001) were associated with nonsurvival. Conclusion Age, considered as both a continuous variable and a categorical variable, was not associated with the development of POR, high‐volume POR, or nonsurvival. Clinical significance Age does not influence the occurrence of POR and should not negatively impact an owner's decision to pursue surgery in aged horses.
Background: Facial nerve paralysis (FNP) in equids is not well described in the veterinary literature.Objective: To investigate the causes of FNP and associations among clinical variables, diagnosis, and outcome.Animals: Sixty-four equids presenting with FNP between July 2000 and April 2019.Cases of postanesthetic FNP were excluded.Methods: Medical records were retrospectively reviewed. Variables were evaluated for associations with outcomes (diagnosis and case outcome) using logistic regression.Results: The most common cause of FNP was trauma (n = 20). Additional diagnoses included central nervous system (CNS) disease (n = 16), idiopathic (n = 12, 4 of which had adequate diagnostic investigation and were considered "true" idiopathic, and 8 of which were considered "not investigated" idiopathic), temporohyoid osteoarthropathy (n = 10), otitis media-interna (n = 3), lymphoma (n = 1), iatrogenic as a consequence of infiltration of local anesthetic (n = 1), and clostridial myositis (n = 1).Follow-up was available for 55 (86%) cases. Twenty-nine (53%) equids had full resolution of FNP, 14 (25%) were euthanized, 6 (11%) partially improved, and 6 (11%) were unchanged or worse. Conclusions and ClinicalImportance: If FNP is the consequence of CNS disease, successful treatment of the primary disease likely leads to resolution of FNP. Most cases of FNP in equids are traumatic in origin. True idiopathic cases are uncommon. K E Y W O R D S cranial nerve, equine, neurological deficits, ophthalmology, peripheral neuropathy
Treatment failure in joint infections is associated with fibrinous, antibiotic-resistant, floating and tissue-associated Staphylococcus aureus aggregates formed in synovial fluid (SynF). We explore whether antibiotic activity could be increased against Staphylococcus aureus aggregates using ultrasound-triggered microbubble destruction (UTMD), in vitro and in a porcine model of septic arthritis. In vitro, when bacterially laden SynF is diluted, akin to the dilution achieved clinically with lavage and local injection of antibiotics, amikacin and ultrasound application result in increased bacterial metabolism, aggregate permeabilization, and a 4-5 log decrease in colony forming units, independent of microbubble destruction. Without SynF dilution, amikacin + UTMD does not increase antibiotic activity. Importantly, in the porcine model of septic arthritis, no bacteria are recovered from the SynF after treatment with amikacin and UTMD—ultrasound without UTMD is insufficient. Our data suggest that UTMD + antibiotics may serve as an important adjunct for the treatment of septic arthritis.
A 1-day-old American Paint Horse was presented for a large air-filled mass along the ventral aspect of the neck. Bronchoscopy and oesophagoscopy revealed no sign of communication with the trachea or oesophagus. Radiographs and a computed tomography scan of the neck identified a communicating tract between the lumen of the cystic mass and mid-trachea. The foal was systemically healthy at this initial presentation, and delayed removal of the cyst was recommended to allow further maturation of the foal prior to undergoing general anaesthesia. Upon discharge, the cyst continued to grow in size and became more fluid than airfilled requiring repeat centesis and draining. The foal was then re-presented at 3 weeks of age for surgical removal. In surgery, direct communication with the trachea was identified and ligated. Histopathology demonstrated that the cyst lining was composed of squamous epithelium with goblet cells and occasional ciliated cells. The location, morphological features and congenital presentation of the mass were consistent with a paratracheal air cyst (PAC). Surgical resection resulted in excellent functional and cosmetic outcome. Although not previously reported in horses, PAC should be included in the differential diagnosis of an air-filled ventral neck mass in equine neonates. Complete surgical excision may result in a successful outcome.
Summary A 22‐year‐old American Quarter Horse gelding was referred to the JT Vaughan Large Animal Teaching Hospital at Auburn University, College of Veterinary Medicine for moderate signs of abdominal pain responsive to sedation. A presumptive preoperative diagnosis of ileal impaction was made based on physical examination, ultrasonography of the abdomen and clinical pathological data. Despite appropriate medical therapy and improvement in the diagnostic and clinical parameters, the gelding continued to be uncomfortable. A standing right flank laparotomy facilitated access to the ileum which contained approximately 80 cm of consolidated ingesta from the ileocaecal orifice extending orally. The distal jejunum was exteriorised and an enterotomy performed, permitting lavage of the ingesta and resolution of the impaction. The gelding was discharged 6 days after surgery. Two weeks after surgery, the gelding re‐presented for surgical treatment of an incisional abscess. At 4‐month follow‐up, the gelding was reportedly doing well. The described surgical technique may be a viable option for resolution of ileal impactions in horses non‐responsive to medical management when exploratory celiotomy under general anaesthesia is not possible due to financial constraints, the health of the horse or other reason.
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