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Kim CS, Reisbig NA, Carmalt JL. Contrast arthrography of the equine temporomandibular joint. Front Vet Sci 2024; 11:1368131. [PMID: 38562918 PMCID: PMC10983794 DOI: 10.3389/fvets.2024.1368131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Background Disorders of the equine temporomandibular joint (TMJ) cause clinical problems and detailed investigations of this joint are becoming more common. Specialist radiographic projections have the potential to highlight osseous abnormalities; however, the ability to assess the intra-articular soft tissue structures is currently limited to computed tomography (with, or without contrast enhancement) or magnetic resonance imaging. Both modalities are expensive and not readily accessible. Objective To develop a technique of contrast arthrography of both compartments of the equine TMJ in cadavers and then perform the refined technique in three living horses as a proof-of-principle. Study design A descriptive, experimental, study. Methods Contrast arthrography of the discomandibular and discotemporal joint compartments of both TMJs was performed in 12 cadaveric equine heads using needles placed in the caudal pouches of the respective joint compartments. Radiographs were taken using previously published techniques, repeated with the mouth open and after air had been injected into the joints, to perform a double-contrast study. The TMJs of three healthy horses were subsequently examined to determine the validity of the procedure in live animals. Results Single and double-contrast arthrography allowed delineation of the dorsal and ventral surfaces of the intra-articular disc in addition to filling the rostral and caudal joint pouches of the independent joint compartments. Contrast extravasation was common, and in two instances iatrogenic disc penetration resulted in the false diagnosis of pathologic disc perforation. The techniques were well tolerated in all three live horses. Main limitations Low number of horses. Conclusion Contrast arthrography allows interpretation of intra-articular soft tissue structures, but caution is advised in diagnosing intra-articular disc perforation. Even with experience, accessing the discomandibular joint can be challenging.
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Affiliation(s)
| | | | - James L. Carmalt
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, Saskatoon, SK, Canada
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Carmalt JL, Pimentel KL. The Equine Temporomandibular Joint: Comparisons Between Standard and Needle Arthroscopic Examination of Cadaver Specimens and Standing Horses. Front Vet Sci 2022; 9:876041. [PMID: 35558885 PMCID: PMC9087581 DOI: 10.3389/fvets.2022.876041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/18/2022] [Indexed: 11/17/2022] Open
Abstract
Background Definitive diagnosis of equine temporomandibular joint osteoarthritis (TMJ-OA) may require advanced diagnostic imaging. Arthroscopy is a modern, minimally invasive, diagnostic, and treatment modality. Standing arthroscopic treatment of joint disease is a relatively recent advance in equine surgery, despite which there are few published comparisons between the available arthroscopic systems. Objective To compare and contrast two arthroscopic systems for assessing the equine temporomandibular joint compartments in cadavers and standing horses. Study design Experimental study. Methods Phase I involved the assessment of the discotemporal joint (DTJ) and discomandibular (DMJ) joint compartments of both temporomandibular joints (TMJ) of 14 cadaveric equine heads using a caudally placed arthroscopy portal. Joints were initially examined using the needle arthroscope and the results compared to the findings of examination using a 2.5 mm 30° arthroscope system (standard). Three healthy horses were subsequently examined to determine the validity of the procedure in live animals in Phase II. Results Needle and standard arthroscopy, in combination with mandibular manipulation, allowed evaluation of the caudal aspects of both joint compartments of the TMJ in Phase I. However, the extreme margins of the joint were more commonly visualized using standard arthroscopy. Live horses in phase II were restrained in stocks and both the rostral and caudal aspects of the DTJ and DMJ compartments of both TMJs were examined successfully understanding sedation and local analgesia. The use of a modified Guenther speculum allowed the mandible to be manipulated and offset, which facilitated a complete examination of the joint compartments. Despite adverse behavior encountered during the procedure in one horse, no surgical complications ensued. Main Limitations Not blinded-bias; learning curve. Conclusions The needle arthroscope system is a relatively inexpensive diagnostic tool, which can be used to evaluate the TMJ in the absence of advanced diagnostic imaging such as computed tomography or magnetic resonance imaging. However, if arthroscopic treatment is required after advanced imaging and pre-operative diagnosis, superior image quality and ease of manipulation may favor the use of the standard equipment.
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Affiliation(s)
- James L. Carmalt
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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3
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Pimentel KL, Allen AL, Carmalt JL. Developmental orthopaedic disease and early osteoarthritis of the temporomandibular joint in a 15‐month‐old Quarter Horse filly. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- K. L. Pimentel
- Department of Large Animal Clinical Sciences Western College of Veterinary Medicine University of Saskatchewan Saskatoon Saskatchewan Canada
| | - A. L. Allen
- Department of Veterinary Pathology Western College of Veterinary Medicine University of Saskatchewan Saskatoon Saskatchewan Canada
| | - J. L. Carmalt
- Department of Large Animal Clinical Sciences Western College of Veterinary Medicine University of Saskatchewan Saskatoon Saskatchewan Canada
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4
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Heun F, Schwieder A, Hansmann F, Bienert‐Zeit A, Hellige M. Dentigerous cysts with exostosis of the temporal bone in horses – A new variant diagnosed by computed tomography. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- F. Heun
- Clinic for Horses University of Veterinary Medicine Hannover, Foundation Hannover Germany
| | - A. Schwieder
- Clinic for Horses University of Veterinary Medicine Hannover, Foundation Hannover Germany
| | - F. Hansmann
- Department of Pathology University of Veterinary Medicine Hannover, Foundation Hannover Germany
- Institute of Veterinary Pathology Leipzig University Leipzig Germany
| | - A. Bienert‐Zeit
- Clinic for Horses University of Veterinary Medicine Hannover, Foundation Hannover Germany
| | - M. Hellige
- Clinic for Horses University of Veterinary Medicine Hannover, Foundation Hannover Germany
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5
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Wigley CA, Seitz MA, Won WW, Fontenot RL. What Is Your Diagnosis? J Am Vet Med Assoc 2021; 259:983-986. [PMID: 34647468 DOI: 10.2460/javma.259.9.983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Lean NE, Young A, Ahern BJ. Fusobacterium necrophorum
septic arthritis of the temporomandibular joint in an Australian Stockhorse mare. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- N. E. Lean
- School of Veterinary Science University of Queensland Gatton Queensland Australia
| | - A. Young
- School of Veterinary Science University of Queensland Gatton Queensland Australia
| | - B. J. Ahern
- School of Veterinary Science University of Queensland Gatton Queensland Australia
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7
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Rodríguez MJ. Unusual pathogen in an unusual joint: Implications on antimicrobial resistance. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Elzer EJ, Wulster KB, Richardson DW, Ortved KF. Standing Arthroscopic Treatment of Temporomandibular Joint Sepsis in a Horse. J Vet Dent 2020; 37:94-99. [PMID: 32815477 DOI: 10.1177/0898756420948269] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 15-year-old Thoroughbred gelding was presented for investigation of fever, right temporomandibular region swelling, and progressive pain when opening the mouth. Right temporomandibular joint (TMJ) sepsis was diagnosed based on synovial fluid analysis, sonographic imaging, and standing robotic cone-beam computed tomography. Concurrent otitis media and temporohyoid osteoarthropathy (THO) were also noted. The horse was treated with arthroscopic debridement and lavage during standing sedation followed by local and systemic antimicrobial therapy. There were no complications associated with the surgical procedure and the gelding's clinical signs resolved. Arthroscopy of the TMJ can be accomplished in the standing horse and should be considered when arthroscopic exploration or debridement of this joint is indicated. This is also the first case report of concurrent otitis media, TMJ sepsis, and THO; due to their close anatomic relationship, it is possible that septic otitis media could lead to pathology in the TMJ and temporohyoid joint, as described in humans.
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Affiliation(s)
| | - Kathryn B Wulster
- Department of Clinical Studies, New Bolton Center, 6572University of Pennsylvania, Kennett Square, PA, USA
| | - Dean W Richardson
- Department of Clinical Studies, New Bolton Center, 6572University of Pennsylvania, Kennett Square, PA, USA
| | - Kyla F Ortved
- Department of Clinical Studies, New Bolton Center, 6572University of Pennsylvania, Kennett Square, PA, USA
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Norvall A, Cota JG, Pusterla N, Cissell D. Ultrasound-guided arthrocentesis of the temporomandibular joint in healthy adult horses is equivalent to blind arthrocentesis. Vet Radiol Ultrasound 2020; 61:346-352. [PMID: 31896164 DOI: 10.1111/vru.12836] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 08/27/2019] [Accepted: 10/08/2019] [Indexed: 11/30/2022] Open
Abstract
Equine temporomandibular joint (TMJ) diseases are increasingly recognized as a problem for the well-being and performance of horses. Diagnosis is confounded by overlap of clinical signs associated with pathology of the oral cavity, poll, and cervical vertebrae. Arthrocentesis for intra-articular analgesia, sampling of synovial fluid, and medication is needed for diagnostic and therapeutic purposes. Ultrasound features of the normal TMJ and a blind arthrocentesis technique have been described, but a systematic approach to ultrasound-guided (USG) arthrocentesis has not been reported. Ultrasound guidance allows visualization of the TMJ that may prove beneficial in cases when pathology, abnormal anatomy, or clinician inexperience make blind arthrocentesis difficult. We hypothesized that USG arthrocentesis would result in fewer needle repositions than blind arthrocentesis. We also aimed to assess synovial fluid parameters for normal equine TMJs. A prospective randomized method comparison with crossover experimental design compared the number of needle positionings required for accurate injection of the TMJ using each technique. Arthrocentesis technique and operator experience were tested using cadavers and two operators. Injection success was confirmed using CT. The radiologist then applied both techniques in normal live horses. No statistically significant difference was noted between arthrocentesis techniques or operators (P > .05). No complications were observed in live horses following either technique. Synovial fluid parameters were largely within the normal range expected for other synovial joints. Either blind or USG arthrocentesis of the equine TMJ can be performed with minimal prior operator experience. Ultrasound-guided arthrocentesis is an alternative method and can be considered in cases with altered anatomy.
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Affiliation(s)
- Amy Norvall
- School of Veterinary Medicine, University of California, Davis, Davis, California
| | - Jose Guerrero Cota
- School of Veterinary Medicine, University of California, Davis, Davis, California
| | - Nicola Pusterla
- School of Veterinary Medicine, University of California, Davis, Davis, California
| | - Derek Cissell
- School of Veterinary Medicine, University of California, Davis, Davis, California
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Adams K, Schulz-Kornas E, Arzi B, Failing K, Vogelsberg J, Staszyk C. Functional anatomy of the equine temporomandibular joint: Collagen fiber texture of the articular surfaces. Vet J 2016; 217:58-64. [PMID: 27810212 DOI: 10.1016/j.tvjl.2016.09.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 09/09/2016] [Accepted: 09/23/2016] [Indexed: 11/29/2022]
Abstract
In the last decade, the equine masticatory apparatus has received much attention. Numerous studies have emphasized the importance of the temporomandibular joint (TMJ) in the functional process of mastication. However, ultrastructural and histological data providing a basis for biomechanical and histopathological considerations are not available. The aim of the present study was to analyze the architecture of the collagen fiber apparatus in the articular surfaces of the equine TMJ to reveal typical morphological features indicating biomechanical adaptions. Therefore, the collagen fiber alignment was visualized using the split-line technique in 16 adult warmblood horses without any history of TMJ disorders. Within the central two-thirds of the articular surfaces of the articular tubercle, the articular disc and the mandibular head, split-lines ran in a correspondent rostrocaudal direction. In the lateral and medial aspects of these articular surfaces, the split-line pattern varied, displaying curved arrangements in the articular disc and punctual split-lines in the bony components. Mediolateral orientated split-lines were found in the rostral and caudal border of the articular disc and in the mandibular fossa. The complex movements during the equine chewing cycle are likely assigned to different areas of the TMJ. The split-line pattern of the equine TMJ is indicative of a relative movement of the joint components in a preferential rostrocaudal direction which is consigned to the central aspects of the TMJ. The lateral and medial aspects of the articular surfaces provide split-line patterns that indicate movements particularly around a dorsoventral axis.
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Affiliation(s)
- K Adams
- Institute of Veterinary-Anatomy, -Histology and -Embryology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Frankfurter Str. 98, 35390 Giessen, Germany
| | - E Schulz-Kornas
- Max Planck Weizmann Center for Integrative Archaeology and Anthropology, Max Planck Institute for Evolutionary Anthropology, Deutscher Platz 6, 04103 Leipzig, Germany
| | - B Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
| | - K Failing
- Unit for Biomathematics and Data Processing, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Frankfurter Str. 95, 35390 Giessen, Germany
| | - J Vogelsberg
- Institute of Veterinary-Anatomy, -Histology and -Embryology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Frankfurter Str. 98, 35390 Giessen, Germany
| | - C Staszyk
- Institute of Veterinary-Anatomy, -Histology and -Embryology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Frankfurter Str. 98, 35390 Giessen, Germany.
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Carmalt JL, Kneissl S, Rawlinson JE, Zwick T, Zekas L, Ohlerth S, Bienert-Zeit A. COMPUTED TOMOGRAPHIC APPEARANCE OF THE TEMPOROMANDIBULAR JOINT IN 1018 ASYMPTOMATIC HORSES: A MULTI-INSTITUTION STUDY. Vet Radiol Ultrasound 2016; 57:237-45. [PMID: 26773281 DOI: 10.1111/vru.12334] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 10/14/2015] [Accepted: 11/02/2015] [Indexed: 11/30/2022] Open
Abstract
Published descriptions of nonseptic arthritis of the equine temporomandibular joint (TMJ) are rare and large studies investigating variations in the TMJ for asymptomatic horses are lacking. The objectives of this cross-sectional, retrospective, multi-institutional study were to describe anatomical variations in the TMJ detected using computed tomography (CT) in an equid population asymptomatic for TMJ disease and determine whether these variations were associated with patient signalment, reason for CT examination, or CT slice width. Medical records at eight hospitals were searched for horses that had head/neck CT scans and no clinical signs of TMJ disease. Age, breed, sex, clinical presentation, and CT slice width data were recorded. Alterations in CT contour and density of the mandibular condyles, mandibular fossae, and TMJ intra-articular discs were described for each horse. Generalized logistic regression was used to test associations between anatomical variations and horse age. A total of 1018 horses were sampled. Anatomical variations were found in TMJ CT images for 40% of horses and 29% of joints. These were dichotomous with regard to age. Horses <1 year old commonly had alterations in the shape and density of the mandibular condyle. Older horses commonly had spherical hypodensities within the mandibular condyles consistent with bone cysts; and hyperdense regions of the intra-articular disc consistent with dystrophic mineralization. Findings indicated that TMJ anatomic variations were common in CT images of younger and older horses asymptomatic for TMJ disease. Future studies are needed to more definitively characterize these CT variations using gross pathology and histopathology.
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Affiliation(s)
- James L Carmalt
- Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, S7N5B4, Canada
| | - Sibylle Kneissl
- Unit of Diagnostic Imaging, Department of Small Animals and Horses, University of Veterinary Medicine, Vienna, 1210, Vienna, Austria
| | - Jennifer E Rawlinson
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado.,Department of Clinical Sciences, College of Veterinary Medicine Cornell University, Ithaca, New York
| | - Timo Zwick
- Tierärztliche Klinik, Grasweg 2, 86459, Gessertshausen, Germany
| | - Lisa Zekas
- Department of Veterinary Clinical Sciences, Ohio State University, Columbus, Ohio
| | - Stefanie Ohlerth
- Clinic for Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse, 285c, 8057, Zurich, Switzerland
| | - Astrid Bienert-Zeit
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559, Hannover, Germany
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Smyth T, Allen AL, Carmalt JL. Clinically significant, nontraumatic, degenerative joint disease of the temporomandibular joints in a horse. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12382] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- T. Smyth
- Department of Large Animal Clinical Sciences; Western College of Veterinary Medicine; University of Saskatchewan; Saskatoon Saskatchewan Canada
| | - A. L. Allen
- Department of Veterinary Pathology; Western College of Veterinary Medicine; University of Saskatchewan; Saskatoon Saskatchewan Canada
| | - J. L. Carmalt
- Department of Large Animal Clinical Sciences; Western College of Veterinary Medicine; University of Saskatchewan; Saskatoon Saskatchewan Canada
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13
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Affiliation(s)
- T. H. Witte
- Clinical Science and Services; Royal Veterinary College; London UK
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14
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Jørgensen E, Christophersen MT, Kristoffersen M, Puchalski S, Verwilghen D. Does temporomandibular joint pathology affect performance in an equine athlete? EQUINE VET EDUC 2014. [DOI: 10.1111/eve.12268] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- E. Jørgensen
- Department of Large Animal Sciences; University of Copenhagen; Tåstrup Denmark
| | | | - M. Kristoffersen
- Helsingborg Regional Animal Hospital - Evidensia; Helsingborg Sweden
| | - S. Puchalski
- Helsingborg Regional Animal Hospital - Evidensia; Helsingborg Sweden
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine; University of California; Davis USA
| | - D. Verwilghen
- Department of Large Animal Sciences; University of Copenhagen; Tåstrup Denmark
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15
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Hawkins JF. Osteoarthritis of the temporomandibular joint and what is possible with standing surgery of the horse? EQUINE VET EDUC 2014. [DOI: 10.1111/eve.12254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J. F. Hawkins
- Department of Veterinary Clinical Sciences; Purdue University; West Lafayette Indiana USA
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Sanders RE, Schumacher J, Brama PAJ, Zarelli M, Kearney CM. Mandibular condylectomy in a standing horse for treatment for osteoarthritis of the temporomandibular joint. EQUINE VET EDUC 2014. [DOI: 10.1111/eve.12235] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R. E. Sanders
- Veterinary Clinical Sciences; School of Veterinary Medicine; University College Dublin; Ireland
| | - J. Schumacher
- Department of Large Animal Clinical Sciences; College of Veterinary Medicine; University of Tennessee; Knoxville USA
| | - P. A. J. Brama
- Veterinary Clinical Sciences; School of Veterinary Medicine; University College Dublin; Ireland
| | - M. Zarelli
- Veterinary Clinical Sciences; School of Veterinary Medicine; University College Dublin; Ireland
| | - C. M. Kearney
- Veterinary Clinical Sciences; School of Veterinary Medicine; University College Dublin; Ireland
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17
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Barrett MF, Easley JT. Acquisition and interpretation of radiographs of the equine skull. EQUINE VET EDUC 2013. [DOI: 10.1111/eve.12086] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- M. F. Barrett
- Department of Environmental and Radiological Health Sciences; Colorado State University; USA
| | - J. T. Easley
- Surgical Research Laboratory; Department of Clinical Sciences; Colorado State University; USA
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Feichtenhofer P, Simhofer H, Hof K, Kneissl S. A Complementary Radiographic Projection of the Equine Maxillary Sinus. J Equine Vet Sci 2013. [DOI: 10.1016/j.jevs.2012.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Barnett TP, Powell SE, Head MJ, Marr CM, Steven WN, Payne RJ. Partial mandibular condylectomy and temporal bone resection for chronic, destructive, septic arthritis of the temporomandibular joint in a horse. EQUINE VET EDUC 2013. [DOI: 10.1111/eve.12053] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- T. P. Barnett
- Rossdales Equine Hospital and Diagnostic Centre Newmarket UK
| | - S. E. Powell
- Rossdales Equine Hospital and Diagnostic Centre Newmarket UK
| | - M. J. Head
- Rossdales Equine Hospital and Diagnostic Centre Newmarket UK
| | - C. M. Marr
- Rossdales Equine Hospital and Diagnostic Centre Newmarket UK
| | - W. N. Steven
- Rossdales Equine Hospital and Diagnostic Centre Newmarket UK
| | - R. J. Payne
- Rossdales Equine Hospital and Diagnostic Centre Newmarket UK
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