Agreement among equine veterinarians and between equine veterinarians and inertial sensor system during clinical examination of hindlimb lameness in horses

BACKGROUND

Hindlimb lameness evaluation is known to be challenging. Experience is essential for the ability of equine veterinarians to detect lameness. Nevertheless, even an experienced veterinarian is still subject to bias. Objective lameness detecting methods have been established to aid veterinarians.

OBJECTIVES

1) To estimate the effect of experience on the interobserver agreement and the agreement between a body-mounted inertial sensor system (BMISS) and veterinarians on detecting hindlimb lameness, and 2) to estimate the agreement between the BMISS and highly experienced veterinarians on change in lameness after diagnostic analgesia.

STUDY DESIGN

Cross-sectional study.

METHODS

Twenty-six horses with hindlimb lameness were evaluated in clinical conditions by clinicians and simultaneously measured by the BMISS. Videos of their lameness examination were recorded and shown to 13 veterinarians from three groups of varying experience for evaluation. The interobserver agreement and the agreement between veterinarians and the BMISS were calculated.

RESULTS

Interobserver agreement from all three groups was recorded as 'fair'. The strength of agreement between veterinarians and BMISS was 'fair' for the highly experienced group, 'slight to fair' for the moderately experienced group and 'slight' in the inexperienced group. The BMISS and the highly experienced veterinarians declared a 'strong' agreement in assigning an improvement in lameness after diagnostic analgesia.

MAIN LIMITATIONS

Lameness evaluation through video viewing might be more challenging for some evaluators than live situations.

CONCLUSIONS

Given the task of evaluating videos of horses trotting in a straight line, the more experienced veterinarians did not show more reliability than those with less experience. Due to 1) the moderate agreement between the BMISS and clinicians (highly experienced and moderately experienced) in the live clinical evaluation in determining hindlimb lameness, and 2) the strong association between the BMISS and highly experienced veterinarians in determining improvement of lameness after anaesthesia, therefore the use of the BMISS as a supporting tool for veterinarians is encouraged.

Internal Fixation of Long Bone Fractures in Farm Animals

This study demonstrates that long bone fracture treatment in food and fibre producing animals is in most cases successful. The greatest disadvantage of such treatment are the costs of the surgery and implants.

Evaluation of a standardised radiographic technique of the equine hoof

Radiography of the equine hoof is often used to obtain a diagnosis. Quantitative interpretation, especially for research purposes requires high quality and accuracy of radiographs. The purpose of this study was to describe and evaluate a radiographic technique for the lateromedial (LM) and the dorsopalmar (DP) view of the equine hoof. Ten radiographs for each view from one cadaver limb and from both front feet in a standing horse were taken in order to assess repeatability of the radiographic technique. The method requires easy to use adjustable and portable equipment and strictly defined external radio opaque markers on the hoof capsule. The digitalised radiographs were processed and analysed with the software package Metron PX, measuring 13 parameters in the LM view and 10 parameters in the DP view, respectively. Results show that with few exceptions measurements of these parameters revealed a coefficient of variation that was smaller than 0.05. It was concluded that this easy to use standardised radiographic technique ensures excellent accuracy and repeatability for both the LM and DP view. Hence, this method provides an adequate tool for quantitative assessment of the equine hoof, inter- and intraindividually.

Surgical management of complete diaphyseal third metacarpal and metatarsal bone fractures: clinical outcome in 10 mature horses and 11 foals

REASONS FOR PERFORMING STUDY

Osteosynthesis of third metacarpal (McIII) and third metatarsal (MtIII) bone fractures in horses is a surgical challenge and complications surrounding the repair are common. Retrospective studies evaluating surgical repair, complications and outcome are necessary to increase knowledge and improve success of long bone fracture repair in the horse.

OBJECTIVES

To evaluate clinical findings, surgical repair, post operative complications and outcome of 10 mature horses and 11 foals with McIII or MtIII fractures that were treated with open reduction and internal fixation (ORIF).

METHODS

Medical records were reviewed and follow-up information obtained by means of radiographs and/or telephone questionnaire.

RESULTS

Survival was achieved in 62% of the horses (3 mature/10 foals). On long-term evaluation (> 6 months) 11 horses (2 mature/9 foals) were fit for their intended activity, one mature horse had a chronic low grade lameness, and one foal was lost to follow-up because it was sold. The main fracture types were simple transverse (333%) or simple oblique (28.6%) and 71.4% of the fractures were open, 3 Type I (one mature/2 foals) and 12 type II (7 mature/5 foals). The preoperative assessment revealed inadequate emergency treatment in 10 horses (5 mature/5 foals; 47.6%). Survival rate of horses with open fractures was 12.5% (1/8) in mature and 85.7% (6/7) in foals. Post operative incisional infection (4 mature, 3 foals) was only managed successfully in 2 foals. Fracture instability related to inadequate fracture fixation technique occurred in 4 horses (all mature) and was always associated with unsuccessful outcome.

CONCLUSIONS

Age, bodyweight and infection are strongly associated with outcome in treatment of complete McIII/MtIII fractures.

CLINICAL RELEVANCE

Rigid fixation using plates and screws can be successful in treatment of closed or open, complete diaphyseal McIII/MtIII fractures in mature horses and foals. Instable fixation, infection and a bodyweight > 320 kg are major risk factors for unsuccessful outcome.

Ileal impaction in 22 cows

The clinical signs, diagnosis, treatment and outcome of 22 cows with ileal impaction were investigated using the medical records of bovine patients referred to the Department of Farm Animals, Vetsuisse Faculty, University of Zurich from 1993 to 2003. Only 15 of the cows had signs of colic, which were subtle but slowly increased in severity in some patients. The results of haematological and biochemical analyses were mildly abnormal in only few animals. There was no correlation between the duration of the disorder before admission, the severity of symptoms and the results of the haematological and biochemical analyses. Dilated loops of small intestine in the right dorsal quadrant of the abdomen could be palpated transrectally and imaged via ultrasonography. A definitive diagnosis of ileal impaction was made during exploratory laparotomy by finding the impaction and ruling out other abnormalities. In 19 cows, the obstructing food mass was easily massaged into the caecum, and in three animals an enterotomy was carried out. All cows had an uneventful recovery with no recurrence of the disorder. It is concluded that the cause of the impaction was most likely due to seasonal influences and winter-feeding with a hay based ration. The short and long-term prognosis after surgical intervention was good.

[Do hoof cracks represent a superficial hoof-problem?]

Fifty-four horses with hoof cracks were referred to the Equine Hospital of the University of Zurich, for treatment. The horses were admitted because of lameness or other symptoms caused by the cracks. Deep or complicated quarter cracks were the most common type of cracks diagnosed. Poor conformation and abnormal hoof shape were the most important causes of hoof crack development, whereas injury to the coronary band was a less frequently encountered cause. Effective treatment of this problem includes corrective shoeing, removing horn from the weight-bearing surface as well as from the crack with a Dremel tool and immobilization of the borders of the crack. However, even with such a therapy, the recurrence rate of hoof cracks was with 20% very high.

Ultrasonographic findings in cows with dilatation, torsion and retroflexion of the caecum

Thirty cows with caecal dilatation underwent clinical and ultrasonographic examinations, followed by a right flank laparotomy and surgical correction. The intraoperative findings were compared with the results of the ultrasonographic examination. The appearance, position, dimensions, diameter and nature of the contents of the caecum and proximal and spiral ansa of the colon were determined with a 3.5 MHz linear transducer. The wall of the proximal ansa of the colon and of the dilated caecum closest to the abdominal wall was visible in all the cows and appeared as an echogenic semicircular line immediately adjacent to the peritoneum. The contents of the caecum and of the proximal and spiral ansa of the colon were not visible in 21, 25 and 25 cows, respectively, owing to gas. In the remaining cows, the contents were hypoechogenic to echogenic in appearance. In all of the cows, the dilated caecum was imaged from the right abdominal wall at the level of the tuber coxae. The caecum was imaged from the 12th, 11th and 10th intercostal spaces in 11, five and three cows, respectively. The caecum and proximal ansa of the colon were situated immediately adjacent to the right abdominal wall in 28 cows, but in the other two cows parts of these structures were pushed away from the abdominal wall by the liver or gall bladder. The diameter of the caecum, measured at various sites varied from 7.0 to 25.0 cm. Caecal dilatation was diagnosed on the basis of the results of rectal examinations in 28 of the cows, but in all 30 cows on the basis of the results of the ultrasonographic examinations. Dilatation and caudal displacement of the caecum were diagnosed in 18 cows; dilatation and cranioventral retroflexion of the caecum were diagnosed in six cows, and dilatation and craniodorsal retroflexion of the caecum were diagnosed in two cows. In the four other cows, the direction of the retroflexed caecum could not be determined. The diagnosis of caecal dilatation based on the ultrasonographic findings was confirmed in all the cows during exploratory laparotomy. The results of ultrasonography and exploratory surgery with regard to the position of the dilated and sometimes retroflexed or twisted caecum were in complete agreement in 18 cases, in partial agreement in eight cases, but in four cases did not agree.

Semen characteristics after vasectomy in the ram

The objective of this study was to monitor the changes in semen characteristics in vasectomized rams and to determine if infertility was present 14 days after vasectomy. Experiments were performed using five cross-breed rams, aged between 18 and 30 months. Semen was collected weekly by artificial vagina from 2 months before to 5 months after vasectomy. After sexual rest for 10 days, vasectomy was performed by the cranial midscrotal approach. In all ejaculates the volume, concentration, total sperm number, motility and morphology (normal spermatozoa, loose heads) were determined and sperm viability (SYBR-14/PI) was evaluated in all semen samples collected after vasectomy. In the first ejaculate obtained 14 days post vasectomy all rams showed a significant (P < 0.05) drop in mean volume (from 1.2 to 0.5 mL), total sperm count (from 5176.8 to 51.1 x 10(6)) and morphologically normal sperm (from 84.1 to 15.7%), when compared to the last prevasectomy collection. We could also demonstrate a positive correlation (r = 0.89) between the individual cumulative total number of spermatozoa after vasectomy and the scrotal circumference measured before vasectomy. Sperm motility and viability could never be demonstrated after vasectomy and normal spermatozoa continuously decreased concomitant with an increase in loose heads. On post mortem examination 5 months after surgery, spermatocele formation and multiple sperm granulomas were present in all five rams. Our results show that in the first ejaculate collected by artificial vagina 14 days after vasectomy, no motile and viable spermatozoa could be detected. Despite weekly collections during a 5-month period after sterilization, azoospermia could never be achieved.

Strangulation of the duodenum by the uterus during late pregnancy in two cows

Two Swiss Braunvieh cows in late pregnancy underwent surgery because of a rare form of ileus due to strangulation of the duodenum at its caudal flexure by the gravid uterus. The whole uterus had passed through a gap between the mesoduodenum and duodenum and with increasing weight had led to strangulation of the duodenum. This was possible since the mesoduodenum and both walls of the greater omentum adjacent to its caudal edge were not connected with the duodenum, probably due to a congenital inhibitory malformation. A transsection and an end-to-end anastomosis of the duodenum were necessary in both cases since it was impossible to retract the gravid uterus through the defect. Postoperative recovering was uneventful in both cows, which were discharged after seven and five days respectively and calved normally about two months later.

[Extracorporal shock wave therapy in veterinary medicine]

This article gives a general overview on a new therapy in equine orthopedics. In human medicine extracorporal shock wave therapy (ESWT) is used for lithotripsy of stones of the urologic system and also in orthopedics. In equine medicine the therapy is almost exclusively applied for the treatment of orthopedic problems. The main indications are proximal suspensory desmitis (PSD), lesions of tendons and ligaments, osteoporotic changes and spavin. In this paper the mode of action of shock waves and the different shock wave devices are discussed. Also, some information about an ongoing clinical trial at the Animal Hospital University of Zürich is given.

[Hydrosalpinx in a goat]

A two year old Swiss Alpine goat was referred to our clinic because of sterility. Ultrasound examination revealed a nonechogenic area cranially to the urinary bladder. As hydrometra was suspected, the goat was treated repeatedly with PGF2 alpha. Success of this therapy, however, was unsatisfactory and estrus was therefore induced by progesterone in combination with eCG and the goat mated. As conception failed and ultrasonography remained unchanged, laparoscopy was performed and a fluid filled structure could be located in the region of the right oviduct. After ovariohysterectomy and histo-pathological examination of the genital organs hydrosalpinx was diagnosed on both sides.

Evidence for a parasite-mediated inhibition of abomasal acid secretion in sheep infected with Ostertagia leptospicularis

The acid secretory capacity of the abomasal mucosa was studied in sheep experimentally infected with Ostertagia leptospicularis. The acidity of the abomasal contents, permanently recorded by a pH probe located inside the abomasum, decreased markedly to mean levels between pH 5 and 6. Subcutaneous administration of histamine or carbachol successfully stimulated acid secretion (pH 3.4). The results indicate that the abomasal mucosa harboured a population of functional parietal cells which were also identified immunohistochemically (H(+)/K(+)-ATPase). Ultrastructural investigation before stimulation revealed that the majority of these cells was in a resting state. Despite high serum gastrin levels, the acid secretion was blocked either at the level of the parietal cell or the enterochromaffin-like cell by an unknown factor, possibly mediated by the parasites. This is the first report of a parietal cell dysfunction associated with a nematode infection in the abomasum. It is suggested that the parasites induce changes in their environment which favour their survival and/or increase their reproduction.

Imaging findings in a cow with a retropharyngeally displaced magnet

This report describes the ultrasonographic and radiographic findings and the treatment of a Swiss Brown cow with a retropharyngeal abscess caused by improper administration of a magnet.

Ultrasonographic findings in five cows before and after treatment of reticular abscesses

Five cows with reticular abscesses were examined clinically, haematologically, radiographically and ultrasonographically. They all had clinical signs typical of traumatic reticuloperitonitis, including chronic indigestion, pyrexia, an absence of or reduced ruminal motility, weight loss and a positive reaction to foreign body test. A haematological examination revealed anaemia, increased concentrations of plasma protein and fibrinogen and a decreased clotting time in the glutaraldehyde test. On the basis of the radiographic examination, a tentative diagnosis of reticular abscess was made in four of the cows, because the reticulum was displaced from the peritoneum or because there was an extensive gas-fluid interface in the reticular region. By ultrasonography, a large reticular abscess with a well developed capsule was visible in each of the cows. The abscess was located between the reticulum and ventral peritoneum in two of them, between the reticulumn and right thoracic wall in two and between the reticulum and spleen in the other cow. A foreign body penetrating the abscess could be visualised ultrasonographically in one cow. In two cows, the abscesses were drained through an ultrasound-guided transcutaneous incision. In the other three cows, the abscess was incised and drained from within the reticulum during a rumenotomy. Ultrasonographic examination revealed that the abscess had been completely evacuated in four cows, but only by about two-thirds in the remaining cow. All the cows were clinically healthy when they were discharged.

[Congenital bile duct cysts and liver fibrosis in a foal]

A three-week-old foal was submitted to the clinic because of a minor traumatic injury at the lower jaw. At admission the foal exhibited diarrhea, a distended abdomen and reduced general condition. These findings could not be associated with the injury. On abdominal radiography decreased abdominal detail and a dorsocaudal displacement of the intestine was present. Ultrasonographically multiple fluid-filled cystic structures of several centimeters in diameter were identified. These cystic structures appeared to be associated with the liver. At laparotomy and at necropsy the liver was markedly enlarged and firm and had large, thin-walled, with a bile-like fluid filled cysts, 4-20 centimeters in diameter. Histological lesions were characterized by proliferation of small bile ducts and of interlobular connective tissue as well as focal subacute cholangitis. Gross and histological findings were considered to be consistent with congenital polycystic liver disease and fibrosis with ascending cholangitis.

[Laminitis in cattle: a literature review]

Worldwide afflictions of the claws belong to the economically important diseases in dairy cattle. The significance of laminitis has gained importance in the last years since the condition is regarded as the most important predisposing factor for the development of lesions such as sole ulcer, white line disease and heel horn erosion. Apart from the clinical stages (acute, subacute, chronic, chronic-recurrent) there is also a subclinical form of laminitis which does not cause lameness. It is characterized by soft yellowish sole and heel horn with haemorrhages in the sole and along the white line. Laminitis is a multifactorial event in which nutrition, genetic disposition and the perinatal period, combined with the associated diseases of high-yielding cows, have a particular significance. Currently, two principally different hypotheses on the pathogenesis are discussed. The generally accepted theory bases on a disturbance in the microcirculation of the corium. According to the other theory the circulatory disturbances are secondary to changes which occur in the horn producing cells of the stratum basale of the epidermis. The predisposing factors and the pathogenesis of laminitis are discussed in the light of possible therapeutic and prophylactic measures.