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Pige C, Spriet M, Perez-Nogues M, Katzman S, Le Jeune S, Galuppo L. Comparison of 18F-sodium fluoride positron emission tomography and computed tomography for imaging of the fetlock in 25 nonracehorses. Equine Vet J 2024; 56:1008-1018. [PMID: 37872742 DOI: 10.1111/evj.14015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 09/14/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND 18F-sodium fluoride (18F-NaF) positron emission tomography (PET) has been validated as a useful imaging technique in the racehorse fetlock. The use of 18F-NaF PET in the nonracehorse fetlock has not been reported. OBJECTIVES To describe 18F-NaF PET findings in nonracehorse fetlocks, to compare with computed tomography (CT) findings and to compare PET findings between horses with and without fetlock pain. STUDY DESIGN Retrospective observational study. METHODS All horses undergoing 18F-NaF PET and CT imaging of the fetlock between October 2016 and March 2021 were included in the study. Medical records were reviewed for associated lameness information. RESULTS Thirty-six fetlocks (33 front and 3 hind) from 25 horses were included. The interobserver agreement for PET [0.62 (95% confidence interval [CI] 0.59-0.65)] was higher than for CT [0.47 (95% CI 0.43-0.51)]. Increased 18F-NaF uptake was most common in the medial subchondral bone of the proximal phalanx (23/36), the dorsomedial (20/36) and dorsosagittal (16/36) metacarpal/metatarsal distal subchondral bone, whereas sclerosis was identified on CT in these areas in 22 of 36 (p > 0.9), 33 of 36 (p = 0.001) and 23 of 36 (p = 0.15), respectively. Significant correlations were found between PET grades and both subchondral sclerosis and resorption CT grades (p < 0.001, Spearman r = 0.19 and 0.21, respectively). Abnormal 18F-NaF uptake in the proximal sesamoid bones (PSBs) was identified in 12 of 36 of the fetlocks, which was more common than CT abnormalities (3/36, p = 0.02). Periarticular increased uptake was seen in 7 of 36 fetlocks, whereas osteophytosis was recognised on CT in 20 of 36 (p = 0.1). Maximal standardised uptake values (SUVmax) were significantly higher in painful than in nonpainful fetlocks (22.0 and 11.9, respectively, p = 0.038). MAIN LIMITATIONS Retrospective study and limited sample size. CONCLUSIONS Overall PET and CT findings follow a similar distribution in their location. PET identified more abnormalities in the PSBs than CT. SUVmax is a pertinent factor to take into consideration for the assessment of the clinical significance of findings.
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Affiliation(s)
- Charlene Pige
- Veterinary Medical Teaching Hospital, University of California, Davis, California, USA
| | - Mathieu Spriet
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Marcos Perez-Nogues
- Veterinary Medical Teaching Hospital, University of California, Davis, California, USA
| | - Scott Katzman
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Sarah Le Jeune
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Larry Galuppo
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA
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2
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Gruyaert M, Oosterlinck M, Haspeslagh M, Nagy A. Computed tomographic evaluation of the proximity of needles placed for perineural anesthesia of the palmar digital nerves to synovial structures in the foot: an ex vivo study. Front Vet Sci 2024; 11:1404331. [PMID: 38895719 PMCID: PMC11183268 DOI: 10.3389/fvets.2024.1404331] [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: 03/20/2024] [Accepted: 05/15/2024] [Indexed: 06/21/2024] Open
Abstract
Background Potential synovial penetration following palmar digital nerve blocks has not been investigated. Objectives To evaluate the proximity of needles placed for palmar digital nerve blocks to nearby synovial structures using computed tomography (CT). Study design Descriptive observational study. Methods In 18 cadaver forelimbs, sequential injection of the navicular bursa (NB), distal interphalangeal joint (DIPJ) and digital flexor tendon sheath (DFTS) was performed using 3, 5 and 10 mL diluted radiodense contrast medium, respectively. After each synovial injection, 25 gage needles were placed over the palmar digital nerves at the proximal aspect of the ungular cartilages (distal injections) and 1 cm further proximally (proximal injections), and CT examination was performed. Subsequently, needles were removed, and the synovial structures further distended with the same volume as for the first injection. Perineural needle placement and image acquisition were repeated. The distance between the needle tip and adjacent synovial structures was measured (mm) in reconstructed images. Results were analyzed in separate general linear mixed models, to determine the effect of needle position and synovial distension on the distance from the tip of the needle to the NB, DFTS and DIPJ. Results Synovial penetration was confirmed following 12/420 (3%) needle placements (NB n = 5, 1 after proximal and 4 after distal injections; DIPJ n = 2, DFTS n = 2, NB or DIPJ n = 3, all after distal injections). The mean distance from the needle tip to the NB and DIPJ was significantly smaller after the second distension (NB: p = 0.025; DIPJ: p < 0.001) and with the distal needle placements (NB: p < 0.001; DIPJ: p < 0.001). For the DFTS, the distance from the needle tip was significantly smaller with the proximal needle placements (p = 0.001). Main limitations Ex-vivo study. Conclusion There is a small risk of synovial penetration when performing palmar digital nerve blocks, especially when distension of adjacent synovial structures is present.
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Affiliation(s)
- Mounia Gruyaert
- Faculty of Veterinary Medicine, Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Ghent University, Merelbeke, Belgium
| | - Maarten Oosterlinck
- Faculty of Veterinary Medicine, Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Ghent University, Merelbeke, Belgium
| | - Maarten Haspeslagh
- Faculty of Veterinary Medicine, Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Ghent University, Merelbeke, Belgium
| | - Annamaria Nagy
- Equine Department and Clinic, University of Veterinary Medicine, Budapest, Hungary
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Colla S, Seabaugh KA, Zanotto GM, Selberg K. Blind Versus Ultrasound-Guided Low-Volume Perineural Injection of Tibial and Fibular Nerves in Equine Cadaver Limbs. J Equine Vet Sci 2023; 126:104299. [PMID: 36990251 DOI: 10.1016/j.jevs.2023.104299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/21/2023] [Accepted: 03/23/2023] [Indexed: 03/30/2023]
Abstract
Techniques for local anesthesia of the tibial (TN) and superficial and deep fibular nerves (FNs) in horses are well established. Ultrasound-guided perineural blocks can identify the nerve location, reduce the anesthetic volume needed and avoid needle misplacement. The aim of this research was to compare the success of blind perineural injection technique (BLIND) to ultrasound-guided technique (USG). Fifteen equine cadaver hindlimbs were divided into two groups. Perineural injection of the TN and FNs was performed using a mixed solution of radiopaque contrast, saline and food dye. BLIND (n = 8) used 15 mL for the TN and 10 mL for each fibular nerve. USG (n = 7) used 3 mL for the TN and 1.5 mL for each fibular nerve. The limbs were radiographed immediately after injections and sectioned transversally to evaluate the diffusion and presence of the injectate adjacent to the TN and FNs. The presence of dye immediately adjacent to the nerves was considered a successful perineural injection. No statistically significant difference was observed between groups for success. Distal diffusion of injectate following perineural injection of the TN was significantly less for USG compared to BLIND. Proximal, distal and medial diffusion of injectate following perineural injection of FNs was significantly less for USG compared to BLIND. Low-volume USG results in less diffusion but similar success compared to BLIND leaving it up to veterinarian preference when selecting a technique.
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Affiliation(s)
- Sandro Colla
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO.
| | - Kathryn A Seabaugh
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO
| | - Gustavo Miranda Zanotto
- Large Animal Clinical Science, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - Kurt Selberg
- Department of Environmental and Radiological Health Science, Colorado State University, Fort Collins, CO
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Maia BT, Vendruscolo CDP, de Souza AF, Zoppa ALDVD. Anatomical position of the palmar/plantar nerves at the metacarpal/metatarsal distal level in horses: An in vivo study by means of ultrasonography. Anat Histol Embryol 2022; 51:236-243. [PMID: 35000219 DOI: 10.1111/ahe.12782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/05/2021] [Accepted: 12/27/2021] [Indexed: 11/30/2022]
Abstract
The neurovascular bundle of the equine distal cannon can dynamically vary with limb position, and this can affect the performance of low 4- or 6-point block. This study aims to identify and describe the anatomical position and variations of the lateral and medial palmar/plantar nerve at the metacarpal/metatarsal distal level in horses by ultrasonography. Eight mares underwent ultrasound examination on the lateral and medial palmar/plantar sides of the metacarpus/metatarsus. Images were obtained for measurements of the cross-sectional area of the nerve, distances between the nerve and the skin surface, branch of the suspensory ligament (SL), deep digital flexor tendon (DDFT) and superficial digital flexor tendon (SDFT) with limbs supported and elevated. The distance to the skin for forelimbs was higher on the lateral side when the limb was elevated (p < 0.001). The comparisons between supported and elevated limbs on the same side showed longer distances to the skin with the limb supported on the medial side (p < 0.001). Hindlimbs showed longer distances to the skin with the limb supported on the medial face (p = 0.027). The anatomical position of palmar/plantar nerves was similar between the lateral and medial sides of the limb, generally being in contact with the dorsal edge of DDFT. The strategy of elevating the limb during the injection of the low 4- or 6-point block can lead to a higher risk of puncture of the digital sheath.
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Affiliation(s)
| | - Cynthia do Prado Vendruscolo
- Departamento de Clínica Médica, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Anderson Fernando de Souza
- Departamento de Cirurgia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil
| | - André Luis do Valle De Zoppa
- Departamento de Cirurgia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil
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5
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Diffusion of dye after perineural injection of the palmar/plantar nerves in two different sites in horses: an ex-vivo study. Vet Res Commun 2021; 46:283-288. [PMID: 34713307 DOI: 10.1007/s11259-021-09856-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/23/2021] [Indexed: 10/20/2022]
Abstract
This study aimed to evaluate the distribution of dye at two perineural injection sites of the palmar/plantar nerves and describe their anatomical variations of positioning at the level of the distal metacarpus/metatarsus in horses. Two ml of 1% methylene blue solution was injected in 24 limbs (12 forelimbs and 12 hindlimbs) of horse cadavers at two different points: Group 1: between the branch of the suspensory ligament and deep digital flexor tendon, and Group 2: between the deep and superficial digital flexor tendons. This was followed by dissection and evaluation of the solution diffusion. A photographic record and description of the anatomical position of the palmar/plantar nerve were performed. A comparison of diffusion directions in each portion (medial or lateral) between groups showed no statistical difference (P > 0.05), except in the dorsal direction on the medial portion of hindlimbs, which was higher in Group 2 (P = 0.025). The digital flexor tendon sheath was inadvertently injected four times into the forelimbs of Group 2. Both injection sites offered good dye contact with the palmar/plantar nerves, with the position between the deep digital flexor tendon and suspensory ligament branch having a higher contact area, regardless of the limb portion. The anatomical position of the palmar/plantar nerve in the cadaver specimens was similar between the same limb portions.
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6
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Schumacher J, Cole RC, DeGraves FJ, Cofield LG. Comparison of speed of onset and analgesic effect of 2% mepivacaine hydrochloride deposited within or outside the neurovascular bundle at the level of the proximal sesamoid bones in horses with naturally occurring forefoot-related lameness. Am J Vet Res 2020; 81:394-399. [PMID: 32343179 DOI: 10.2460/ajvr.81.5.394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare the speed of onset and analgesic effect of mepivacaine deposited within or immediately outside the neurovascular bundle at the base of the proximal sesamoid bones in horses. ANIMALS 6 horses with naturally occurring forefoot-related lameness. PROCEDURES In a crossover study design, horses were randomly assigned to receive 1 of 2 treatments first, with the second treatment administered 3 to 7 days later. Trotting gait was analyzed with an inertial sensor-based motion analysis system immediately before treatment to determine degree of lameness. Afterward, ultrasound guidance was used to inject 2% mepivacaine hydrochloride around the palmar digital nerves of the affected forelimb at the level of the base of the proximal sesamoid bones either within the subcircumneural space or outside the circumneural sheath. After injection, gait was reevaluated at 5-minute intervals for 45 minutes. RESULTS Mepivacaine deposition outside the circumneural sheath did not resolve lameness in any horse; for 3 horses, the mean time to 70% reduction of initial vertical head movement was 13.3 minutes, and the remaining 3 horses had no such reduction at any point. Mepivacaine deposition within the subcircumneural space resulted in a mean time to 70% reduction of initial vertical head movement of 6.7 minutes and mean time to resolution of lameness of 21.7 minutes. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that when peripheral nerves of horses lie within a sheath, local anesthetic solution should be deposited within the sheath for an effective nerve block. If local anesthetic solution is deposited outside the sheath, the nerve block may yield erroneous results.
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Schumacher J, Boone L. Local anaesthetics for regional and intra‐articular analgesia in the horse. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13235] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J. Schumacher
- Department of Clinical Sciences College of Veterinary Medicine Auburn University Auburn Alabama USA
| | - L. Boone
- Department of Clinical Sciences College of Veterinary Medicine Auburn University Auburn Alabama USA
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8
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Gruyaert M, Pollard D, Dyson SJ. An investigation into the occurrence of, and risk factors for, concurrent suspensory ligament injuries in horses with hindlimb proximal suspensory desmopathy. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M. Gruyaert
- Centre for Equine Studies Animal Health Trust Newmarket Suffolk UK
| | - D. Pollard
- Centre for Preventative Medicine Animal Health Trust Newmarket Suffolk UK
| | - S. J. Dyson
- Centre for Equine Studies Animal Health Trust Newmarket Suffolk UK
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9
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Clements PE, Handel I, McKane SA, Coomer RP. An investigation into the association between plantar distal phalanx angle and hindlimb lameness in a
UK
population of horses. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13186] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- P. E. Clements
- Cotts Farm Equine Hospital Ltd Narberth Pembrokeshire UK
| | - I. Handel
- Royal (Dick) School of Veterinary Studies Division of Veterinary Clinical Studies Hospital for Small Animals Easter Bush Veterinary Centre The University of Edinburgh Roslin Midlothian UK
| | - S. A. McKane
- Cotts Farm Equine Hospital Ltd Narberth Pembrokeshire UK
| | - R. P. Coomer
- Cotts Farm Equine Hospital Ltd Narberth Pembrokeshire UK
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10
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Fowler AW, Gilbertie JM, Watson VE, Prange T, Osborne JA, Schnabel LV. Effects of acellular equine amniotic allografts on the healing of experimentally induced full-thickness distal limb wounds in horses. Vet Surg 2019; 48:1416-1428. [PMID: 31385329 DOI: 10.1111/vsu.13304] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 07/01/2019] [Accepted: 07/17/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To characterize the growth factors contained in equine amniotic membrane allograft (eAM; StemWrap scaffold and StemWrap+ injection) and to evaluate the effect of eAM on equine distal limb wound healing. STUDY DESIGN Prospective experimental controlled study. SAMPLE POPULATION Eight adult horses. METHODS Transforming growth factor (TGF)-β1, vascular endothelial growth factor (VEGF), epidermal growth factor, platelet-derived growth factor-BB, and prostaglandin E2 (PGE2 ) concentrations in StemWrap+ were assessed with enzyme-linked immunosorbent assay. Two full-thickness 6.25-cm2 skin wounds were created on each metacarpus. On one forelimb, one wound was treated with eAM, and the other was left untreated (eAM control). On the contralateral limb, one wound was treated with a silicone dressing, and the other served as negative control. Three-dimensional images were obtained to determine wound circumference and surface area analyses at each bandage change until healed. Excessive granulation tissue was debrided once weekly for 4 weeks. Biopsy samples were taken to evaluate quality of wound healing via histologic and immunohistochemistry assays. RESULTS StemWrap+ contained moderate concentrations of TGF-β1 (494.10 pg/mL), VEGF (212.52 pg/mL), and PGE2 (1811.61 pg/mL). Treatment of wounds with eAM did not affect time to healing or histologic quality of the healing compared with other groups but was associated with increased granulation tissue production early in the study, particularly on day 7. CONCLUSION Application of eAM resulted in increased granulation tissue production while maintaining appropriate healing of experimental wounds. CLINICAL SIGNIFICANCE Use of eAM is likely most beneficial for substantial wounds in which expedient production of large amounts of granulation tissue is desirable.
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Affiliation(s)
- Alexander W Fowler
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina
| | - Jessica M Gilbertie
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
| | - Victoria E Watson
- Department of Pathobiology and Diagnostic Investigation, Michigan State University College of Veterinary Medicine, East Lansing, Michigan
| | - Timo Prange
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina
| | - Jason A Osborne
- Department of Statistics, North Carolina State University, Raleigh, North Carolina
| | - Lauren V Schnabel
- Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina.,Comparative Medicine Institute, North Carolina State University, Raleigh, North Carolina
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McGlinchey L, Agne G, Passler T, Cole R, Schumacher J. An Objective Assessment of the Effect of Anesthetizing the Median Nerve on Lameness Caused by Pain in the Cubital Joint. J Equine Vet Sci 2018; 75:9-13. [PMID: 31002100 DOI: 10.1016/j.jevs.2018.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/16/2018] [Accepted: 12/17/2018] [Indexed: 10/27/2022]
Abstract
The median nerve, along with the ulnar nerve, is often anesthetized when performing a lameness examination in horses. Because of the close proximity of the median nerve to the cubital joint, proximal migration of local anesthetic might ameliorate pain originating from the cubital joint. The objective of this study was to determine if a median nerve block will ameliorate lameness caused by pain in the cubital joint. A forelimb lameness was induced in six healthy horses by injecting 100 ng of recombinant equine interleukin 1 beta (IL-1β) into the cubital joint. The median nerve of the lame leg was anesthetized using 10 mL of 2% mepivacaine hydrochloride. A successful median nerve block was confirmed by loss of skin sensation at the medial aspect of the pastern and typical changes in thermographic images. Gait was assessed before and at 20, 40, and 60 minutes after the median nerve block using an inertial sensor-based motion analysis system (Lameness Locator; Equinosis LLC, Columbia, MO). A full-factorial repeated measures analysis of variance was used to compare treatment effect across time. IL-1β administration resulted in significant transient lameness in all horses (P < .0001). The median nerve block was successfully performed in all horses and did not result in significant improvement (P = .32) of lameness as quantified by the total differential head vector sum. This result has relevant clinical application as it suggests when performing a lameness examination, it is unlikely that blocking the median nerve with 10 mL of local anesthetic will ameliorate pain originating from the cubital joint.
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Affiliation(s)
- Leah McGlinchey
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, AL.
| | - Gustavo Agne
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, AL
| | - Thomas Passler
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, AL
| | - Robert Cole
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, AL
| | - John Schumacher
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, AL
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Gylling SMK, Frandsen SS, Østergaard S, Thomsen MH, Christophersen MT, Krüger T, Jacobsen S. The effect of a compression bandage on the distribution of radiodense contrast medium after palmar digital nerve blocks. Equine Vet J 2018; 51:261-265. [PMID: 30071153 DOI: 10.1111/evj.13000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 07/29/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Studies have shown proximal diffusion of injected drugs in perineural blocks; such diffusion may affect specificity of the nerve block. OBJECTIVES To investigate the effect of a compression bandage applied to the pastern region on proximal diffusion of contrast medium injected over the palmar digital nerves. STUDY DESIGN Experimental study, randomised cross-over design. METHODS Radiodense contrast medium was injected over the lateral and medial palmar digital nerves of the left front limb of nine mature horses. Each horse was injected on two separate occasions, once with a 5 cm wide compression bandage applied proximal to the injection site and once without. The order of the two treatments was randomised with a wash-out period between treatments of at least 7 days. Radiographs were obtained at 5, 10, 20 and 30 min and distribution of the contrast column assessed. RESULTS Proximal distribution of the contrast medium was significantly reduced (P<0.01) with compression bandage. Furthermore, the compression bandage inhibited lymphatic drainage of the injected contrast medium. MAIN LIMITATIONS Clinical effect of the differences in diffusion length was not assessed. CONCLUSIONS The compression bandage reduced proximal diffusion and lymphatic drainage of contrast material causing it to stay localised around the injection site. Use of compression bandages could thus result in increased specificity of the nerve block and potentially prolong its effect.
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Affiliation(s)
- S M K Gylling
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
| | - S S Frandsen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
| | - S Østergaard
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
| | - M H Thomsen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
| | - M T Christophersen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
| | - T Krüger
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
| | - S Jacobsen
- Department of Veterinary Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Taastrup, Denmark
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13
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Coleridge M, Schumacher J, DeGraves F. Comparison of lameness scores after a low 4‐point nerve block to lameness scores after additional desensitisation of the dorsal metatarsal nerves in horses with experimentally induced pain in the metatarsophalangeal joint. EQUINE VET EDUC 2018. [DOI: 10.1111/eve.12942] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - J. Schumacher
- Department of Clinical Sciences Auburn University Auburn Alabama USA
| | - F. DeGraves
- Department of Agriculture Western Kentucky University Bowling Green Kentucky USA
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14
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Pezzanite L, Contino E, Kawcak C. Lameness originating from the proximal metacarpus/tarsus: A review of local analgesic techniques and clinical diagnostic findings. EQUINE VET EDUC 2018. [DOI: 10.1111/eve.12904] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- L. Pezzanite
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine Colorado State University Fort Collins Colorado USA
| | - E. Contino
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine Colorado State University Fort Collins Colorado USA
| | - C. Kawcak
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine Colorado State University Fort Collins Colorado USA
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15
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Barker W. Equine distal limb diagnostic anaesthesia: (1) Basic principles and perineural techniques. IN PRACTICE 2016. [DOI: 10.1136/inp.i567] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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16
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Malton R, Nagy A. Diffusion of radiodense contrast medium after a mid-pastern ring block. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- R. Malton
- Dubai Stable Veterinary Clinic; United Arab Emirates
| | - A. Nagy
- Old Town Dubai United Arab Emirates
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17
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Pilsworth R, Dyson S. Where does it hurt? Problems with interpretation of regional and intra-synovial diagnostic analgesia. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12392] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - S. Dyson
- Centre for Equine Studies; Animal Health Trust; Newmarket Suffolk UK
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18
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Nagy A, Malton R. Diffusion of radiodense contrast medium after perineural injection of the palmar digital nerves. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12369] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - R. Malton
- Dubai Stable Veterinary Clinic; Dubai UAE
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Claunch KM, Eggleston RB, Baxter GM. Effects of approach and injection volume on diffusion of mepivacaine hydrochloride during local analgesia of the deep branch of the lateral plantar nerve in horses. J Am Vet Med Assoc 2014; 245:1153-9. [DOI: 10.2460/javma.245.10.1153] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Contino EK, King MR, Valdés-Martínez A, McIlwraith CW. In vivodiffusion characteristics following perineural injection of the deep branch of the lateral plantar nerve with mepivacaine or iohexol in horses. Equine Vet J 2014; 47:230-4. [DOI: 10.1111/evj.12261] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 02/28/2014] [Indexed: 11/28/2022]
Affiliation(s)
- E. K. Contino
- Gail Holmes Equine Orthopaedic Research Center; Department of Clinical Sciences; Colorado State University; Fort Collins Colorado USA
| | - M. R. King
- Gail Holmes Equine Orthopaedic Research Center; Department of Clinical Sciences; Colorado State University; Fort Collins Colorado USA
| | - A. Valdés-Martínez
- Department of Environmental and Radiological Health Sciences; Colorado State University; Fort Collins Colorado USA
| | - C. W. McIlwraith
- Gail Holmes Equine Orthopaedic Research Center; Department of Clinical Sciences; Colorado State University; Fort Collins Colorado USA
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Jordana M, Martens A, Duchateau L, Vanderperren K, Saunders J, Oosterlinck M, Pille F. Distal limb desensitisation following analgesia of the digital flexor tendon sheath in horses using four different techniques. Equine Vet J 2013; 46:488-93. [DOI: 10.1111/evj.12186] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 08/27/2013] [Indexed: 12/01/2022]
Affiliation(s)
- M. Jordana
- Department of Surgery and Anaesthesiology of Domestic Animals; Faculty of Veterinary Medicine, Ghent University; Merelbeke Belgium
| | - A. Martens
- Department of Surgery and Anaesthesiology of Domestic Animals; Faculty of Veterinary Medicine, Ghent University; Merelbeke Belgium
| | - L. Duchateau
- Department of Comparative Physiology and Biometrics; Faculty of Veterinary Medicine, Ghent University; Merelbeke Belgium
| | - K. Vanderperren
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine, Ghent University; Merelbeke Belgium
| | - J. Saunders
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine, Ghent University; Merelbeke Belgium
| | - M. Oosterlinck
- Department of Surgery and Anaesthesiology of Domestic Animals; Faculty of Veterinary Medicine, Ghent University; Merelbeke Belgium
| | - F. Pille
- Department of Surgery and Anaesthesiology of Domestic Animals; Faculty of Veterinary Medicine, Ghent University; Merelbeke Belgium
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Riggs CM. Diagnosis of lameness - keeping an open mind. EQUINE VET EDUC 2013. [DOI: 10.1111/eve.12029] [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)
- C. M. Riggs
- Department of Veterinary Clinical Services; The Hong Kong Jockey Club; Equine Hospital; China
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Affiliation(s)
- A. R. S. Barr
- School of Clinical Veterinary Science; University of Bristol; Bristol; UK
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SCHUMACHER J, TAINTOR J, SCHUMACHER J, DEGRAVES F, SCHRAMME M, WILHITE R. Function of theramus communicansof the medial and lateral palmar nerves of the horse. Equine Vet J 2012; 45:31-5. [DOI: 10.1111/j.2042-3306.2012.00579.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nagy A, Bodó G, Dyson SJ. Diffusion of contrast medium after four different techniques for analgesia of the proximal metacarpal region: anin vivoandin vitrostudy. Equine Vet J 2012; 44:668-73. [DOI: 10.1111/j.2042-3306.2012.00564.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Seabaugh KA, Selberg KT, Valdés-Martínez A, Rao S, Baxter GM. Assessment of the tissue diffusion of anesthetic agent following administration of a low palmar nerve block in horses. J Am Vet Med Assoc 2011; 239:1334-40. [DOI: 10.2460/javma.239.10.1334] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Morgan R, Dyson S. Incomplete longitudinal fractures and fatigue injury of the proximopalmar medial aspect of the third metacarpal bone in 55 horses. Equine Vet J 2011; 44:64-70. [PMID: 21812806 DOI: 10.1111/j.2042-3306.2011.00371.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
REASONS FOR PERFORMING STUDY Previous descriptions of incomplete longitudinal fractures and fatigue injury of the proximopalmar aspect of the third metacarpal bone (McIII) have focused on diagnostic imaging findings, especially in racehorses. OBJECTIVES To document the case details, clinical features, response to diagnostic analgesia, diagnostic imaging findings and follow-up data in a large group of horses with an incomplete longitudinal fracture or fatigue injury of the proximopalmar medial aspect of the McIII. MATERIALS AND METHODS Horses were included in the study if pain was localised to the proximopalmar aspect of the metacarpal region, with radiological evidence of an incomplete longitudinal fracture or generalised increased radiopacity in the proximopalmar medial aspect of the McIII, or focal increased radiopharmaceutical uptake (IRU) in the proximopalmar aspect of the McIII. Age, breed, gender, height, bodyweight, work discipline, work history, duration of lameness, clinical signs and responses to diagnostic analgesia were recorded. Radiographic and scintigraphic images were assessed subjectively and objectively. RESULTS There were 55 horses representing a broad spectrum of ages and work disciplines, 73% of which had radiological abnormalities. The majority had no localising clinical signs, although 73% of horses with radiological abnormalities showed a characteristic pattern of lameness. Lameness was generally worse in straight lines than in circles. Increased radiopharmaceutical uptake ranged from mild to intense in the lame limb; 14% of nonlame limbs had mild IRU. Of horses for which long-term follow-up was available, 98% returned to full athletic function. CONCLUSIONS AND POTENTIAL RELEVANCE Incomplete longitudinal fractures and fatigue injury of the proximopalmar medial aspect of the McIII may occur in horses of many types and sports disciplines, and are not confined to immature performance horses. They should be considered an important differential diagnosis for proximal metacarpal region pain.
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Affiliation(s)
- R Morgan
- Centre for Equine Studies, Animal Health Trust, Newmarket, UK
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Daniel AJ, Judy CE, Saveraid T. Magnetic resonance imaging of the metacarpo(tarso)phalangeal region in clinically lame horses responding to diagnostic analgesia of the palmar nerves at the base of the proximal sesamoid bones: Five cases. EQUINE VET EDUC 2011. [DOI: 10.1111/j.2042-3292.2011.00246.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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