Partial ceratohyoidectomy as surgical treatment for horses with temporohyoid osteoarthropathy: 10 cases (2010-2021)

OBJECTIVE

To describe outcomes of horses with temporohyoid osteoarthropathy (THO) treated with partial ceratohyoidectomy.

ANIMALS

10 client-owned horses.

PROCEDURES

Medical records from 2 institutions were examined for records of horses with THO treated with partial ceratohyoidectomy between 2010 and 2021. History, signalment, clinical signs, diagnostics, medications, and surgery-related details were recorded. Horses with a minimum of 6 months follow-up were recruited for neurologic and imaging examinations in the hospital or field where radiography of the basihyoid-ceratohyoid articulation were performed along with CT, when available.

RESULTS

10 horses with THO were included (9 unilateral; 1 bilateral). Nine planned partial ceratohyoidectomies were performed in 8 horses, whereas 2 horses had preoperatively planned complete ceratohyoidectomies transitioned to partial ceratohyoidectomies during surgery due to intraoperative complications. Postoperative complications occurred mostly in transitioned surgeries (obstructed airway, tongue mobility issues, and incisional hemorrhage), whereas only 1 horse with a planned ceratohyoidectomy had postoperative complication of rhabdomyolysis. All complications resolved before hospital discharge. Neurologic signs improved in all 10 horses, with 2 showing complete resolution. Nine horses were available for radiographic follow-up, 6 of which also had head CT scans. A space between the ceratohyoid and basihyoid bones was measurable on radiography in all 9 horses, and was confirmed on CT. Three horses demonstrated proliferation of either ceratohyoid or basihyoid bones. The 9 horses with unilateral disease returned to previous work, and the horse with bilateral disease was retired.

CLINICAL RELEVANCE

Partial ceratohyoidectomy is a surgical option for treatment of THO that provides similar clinical outcomes to published reports on ceratohyoidectomy.

Targeting Soluble Epoxide Hydrolase and Cyclooxygenases Enhance Joint Pain Control, Stimulate Collagen Synthesis, and Protect Chondrocytes From Cytokine-Induced Apoptosis

Objective: To determine the symptomatic and disease-modifying capabilities of sEH and COX inhibitors during joint inflammation. Methods: Using a blinded, randomized, crossover experimental design, 6 adult healthy horses were injected with lipopolysaccharide (LPS; 3 μg) from E. coli in a radiocarpal joint and concurrently received the non-selective cyclooxygenase (COX) inhibitor phenylbutazone (2 mg/kg), the sEH inhibitor t-TUCB (1 mg/kg) or both (2 mg/kg phenylbutazone and 0.1, 0.3, and 1 mg/kg t-TUCB) intravenously. There were at least 30 days washout between treatments. Joint pain (assessed via inertial sensors and peak vertical forces), synovial fluid concentrations of prostanoids (PGE₂, TxB₂), cytokines (IL-1β, IL-6, TNF-α) and biomarkers of collagen synthesis (CPII) and degradation (C2C) were measured at pre-determined intervals over a 48-h period. The anti-apoptotic effect of COX and sEH inhibitors was determined via ELISA technique in primary equine chondrocytes incubated with TNF-α (10 ng/ml) for 24 h. Apoptosis was also determined in chondrocytes incubated with sEH-generated metabolites. Results: Combined COX and sEH inhibition produced significantly better control of joint pain, prostanoid responses, and collagen synthesis-degradation balance compared to each compound separately. When administered separately, pain control was superior with COX vs. sEH inhibition. Cytokine responses were not different during COX and/or sEH inhibition. In cultured chondrocytes, sEH inhibition alone or combined with COX inhibition, but not COX inhibition alone had significant anti-apoptotic effects. However, sEH-generated metabolites caused concentration-dependent apoptosis. Conclusions: Combined COX and sEH inhibition optimize pain control, attenuate loss of articular cartilage matrix during joint inflammation and cytokine-induced chondrocyte apoptosis.

Systemic and local effects of lidocaine or mepivacaine when used for intravenous regional anaesthesia of the distal limb in standing sedated horses

BACKGROUND

Local anaesthetics are being combined clinically with amikacin in intravenous regional limb perfusion (IVRLP), with limited knowledge on the analgesia provided and its onset and duration of action after tourniquet application and release.

OBJECTIVE

To evaluate the systemic clinical effect, limb withdrawal to nociceptive stimulation, and plasma and synovial fluid concentrations after IVRLP with lidocaine or mepivacaine in standing sedated horses.

STUDY DESIGN

Prospective, controlled, randomised, cross-over study.

METHODS

Six healthy adult horses were sedated and received IVRLP with lidocaine, mepivacaine or saline (negative control), or perineural anaesthesia of the medial and lateral palmar and palmar metacarpal nerves (positive control) in one forelimb with a 3-week washout period between trials. Electrical and mechanical stimuli were used to test nociceptive threshold of the limb before and after IVRLP/perineural anaesthesia. For lidocaine and mepivacaine trials, blood was collected from the jugular vein and synovial fluid from the radiocarpal joint before, during and out to 24 hours after IVRLP. Drug concentrations were measured using high-performance liquid chromatography.

RESULTS

Nociceptive thresholds for lidocaine, mepivacaine and perineural anaesthesia trials were significantly increased compared with saline and baseline values at 10, 20 and 30 minutes, with no differences between anaesthetic trials. During this time, horses had lower heart rates than IVRLP with saline. After tourniquet release at 30 minutes, nociceptive thresholds for lidocaine and mepivacaine trials gradually returned to baselines, whereas perineural anaesthesia trial remained unchanged out to an hour. Plasma lidocaine and mepivacaine concentrations were ≤50 ng/mL while the tourniquet was in place, significantly increasing 10 minutes after tourniquet release. Maximal lidocaine and mepivacaine concentrations in synovial fluid were reached 25 minutes after IVRLP injection.

MAIN LIMITATIONS

Amikacin was not included in the perfusate.

CONCLUSION

Similar to perineural anaesthesia, IVRLP with lidocaine or mepivacaine provides anti-nociception to the distal limb in standing sedated horses while a tourniquet is applied with concentrations remaining below toxic levels in plasma and synovial fluid.

The association between collagen and bone biomarkers and radiographic osteoarthritis in the distal tarsal joints of horses

BACKGROUND

Osteoarthritis (OA) of the distal intertarsal (DIT) and tarsometatarsal (TMT) joints occurs commonly. Synovial fluid (SF) biomarkers of collagen and bone turnover have potential clinical value.

OBJECTIVES

To measure SF biomarker concentrations from DIT and TMT joints in adult horses and determine if they correlate with radiographic OA severity and are higher in joints with radiographic OA compared to controls.

STUDY DESIGN

Cross-sectional.

METHODS

Radiographic OA of DIT and TMT joints was evaluated from adult horses (5-35 years old). Overall radiographic scores divided horses into those with mild or moderate radiographic OA (16 joints from 9 horses) or controls (13 joints from 9 horses). Direct biomarkers of OA (Carboxypropeptide of type II collagen = CPII, carboxy-neoepitope of type II collagen exposed after collagenase-cleavage = C2C, Bone alkaline phosphatase = BAP and Chondroitin sulfate epitope = CS846) were measured via ELISA and CPII/C2C was calculated. Biomarkers were correlated with radiographic findings and concentrations from those with radiographic OA to control joints and were compared.

RESULTS

Concentrations of CPII (R = 0.84, P<0.001), C2C (R = 0.69, P<0.001) and BAP (R = 0.41, P = 0.03) as well as CPII/C2C (R = 0.69, P<0.001) values positively correlated with overall radiographic scores. Adjusted means ± s.d., after controlling for age, for CPII (P<0.001), C2C (P<0.001), CPII/C2C (P = 0.004) and BAP (P = 0.05) were significantly higher in DIT and TMT joints with radiographic OA (CPII: 2174.45 ± 1064.01; C2C: 233.52 ± 51.187; CPII/C2C: 9.01 ± 4.09; BAP: 21.98 ± 15.34) compared to controls (CPII: 594.53 ± 463.05; C2C: 153.12 ± 48.95; CPII/C2C: 3.96 ± 2.38; BAP: 12.76 ± 3.61). CPII (P<0.001), C2C (P = 0.001) and CPII/C2C (P = 0.001) were significantly higher with moderate radiographic OA (CPII: 2444.61 ± 772.78; C2C: 248.90 ± 44.94; CPII/C2C: 9.47 ± 2.97) compared to controls (CPII: 658.38 ± 417.36; C2C: 156.49 ± 47.61; CPII/C2C: 4.15 ± 2.04), with CPII also showing significantly higher concentrations (P = 0.04) with mild radiographic OA compared (1515.00 ± 584.95) to controls (658.38 ± 417.36). There were no differences in CS846 concentrations between radiographic OA and control joints. Age positively correlated with CPII (R = 0.48, P = 0.01) and C2C (R = 0.44, P = 0.02) concentrations.

MAIN LIMITATIONS

Radiographic OA was assessed, not clinical lameness. Controls were not age-matched to those with spontaneous radiographic OA.

CONCLUSIONS

There is an association between collagen (CPII, C2C and CPII/C2C) and bone (BAP) biomarkers and radiographic OA in the distal tarsal joints of horses.

Palmar/plantar approach for radiographic-guided injection of the equine distal interphalangeal joint collateral ligament insertion

There are limited radiographic-guided injection techniques of the insertion of the distal interphalangeal joint (DIPJ) collateral ligaments. The objective of this study was to develop and evaluate a palmar/plantar radiographic-guided injection of the collateral ligament insertion in cadavers. Fifty limbs were used to develop the technique and 24 additional limbs were used to evaluate accuracy. An 18 G, 9 cm spinal needle was placed in the depression between the palmar digital neurovascular bundle and arch of the ungular cartilage with dorsodistal advancement towards the distal phalanx collateral fossa. Radiographs verified ideal needle location on the proximal border of the distal phalanx at the collateral fossa. Dye was injected. Hoof walls were partially removed and collateral ligaments were dissected with needles in place to determine needle and dye location. Accuracy of needle placement into the insertion of the DIPJ collateral ligament was 41/48 (85 per cent), with lower accuracy of dye within the ligament (34/48; 71 per cent). Dye entered the DIPJ in 2/48 injections, but dye entered periligamentous structures in 22/48 (46 per cent) injections. A palmar/plantar radiographic-guided injection of the insertion of the DIPJ collateral ligament had high accuracy rate with low injection rate of the DIPJ in cadavers.

Low- Versus High-Intensity Plyometric Exercise During Rehabilitation After Anterior Cruciate Ligament Reconstruction

BACKGROUND

Plyometric exercise is used during rehabilitation after anterior cruciate ligament (ACL) reconstruction to facilitate the return to sports participation. However, clinical outcomes have not been examined, and high loads on the lower extremity could be detrimental to knee articular cartilage.

PURPOSE

To compare the immediate effect of low- and high-intensity plyometric exercise during rehabilitation after ACL reconstruction on knee function, articular cartilage metabolism, and other clinically relevant measures.

STUDY DESIGN

Randomized controlled trial; Level of evidence, 2.

METHODS

Twenty-four patients who underwent unilateral ACL reconstruction (mean, 14.3 weeks after surgery; range, 12.1-17.7 weeks) were assigned to 8 weeks (16 visits) of low- or high-intensity plyometric exercise consisting of running, jumping, and agility activities. Groups were distinguished by the expected magnitude of vertical ground-reaction forces. Testing was conducted before and after the intervention. Primary outcomes were self-reported knee function (International Knee Documentation Committee [IKDC] subjective knee form) and a biomarker of articular cartilage degradation (urine concentrations of crosslinked C-telopeptide fragments of type II collagen [uCTX-II]). Secondary outcomes included additional biomarkers of articular cartilage metabolism (urinary concentrations of the neoepitope of type II collagen cleavage at the C-terminal three-quarter-length fragment [uC2C], serum concentrations of the C-terminal propeptide of newly formed type II collagen [sCPII]) and inflammation (tumor necrosis factor-α), functional performance (maximal vertical jump and single-legged hop), knee impairments (anterior knee laxity, average knee pain intensity, normalized quadriceps strength, quadriceps symmetry index), and psychosocial status (kinesiophobia, knee activity self-efficacy, pain catastrophizing). The change in each measure was compared between groups. Values before and after the intervention were compared with the groups combined.

RESULTS

The groups did not significantly differ in the change of any primary or secondary outcome measure. Of interest, sCPII concentrations tended to change in opposite directions (mean ± SD: low-intensity group, 28.7 ± 185.5 ng/mL; high-intensity group, -200.6 ± 255.0 ng/mL; P = .097; Cohen d = 1.03). Across groups, significant changes after the intervention were increased the IKDC score, vertical jump height, normalized quadriceps strength, quadriceps symmetry index, and knee activity self-efficacy and decreased average knee pain intensity.

CONCLUSION

No significant differences were detected between the low- and high-intensity plyometric exercise groups. Across both groups, plyometric exercise induced positive changes in knee function, knee impairments, and psychosocial status that would support the return to sports participation after ACL reconstruction. The effect of plyometric exercise intensity on articular cartilage requires further evaluation.

REGISTRATION NUMBER

Clinicaltrials.gov NCT01851655.

Circumferential hoof clamp method of lameness induction in the horse

A circumferential hoof clamp method to induce controlled and reversible lameness in the forelimbs of eight horses was assessed. Peak vertical forces and vertical impulses were recorded using a force plate to verify induced lameness. Video recordings were used by blinded observers to determine subjective lameness using a 0-5 scale and any residual lameness following clamp loosening. Tightening of clamps resulted in consistent, visible lameness in the selected limbs in all horses. Lameness was confirmed by significant decreases from baseline in the peak vertical force (P <0.01). Lameness was also confirmed subjectively by elevated median scores (0 at baseline and 2 during lameness). Lameness was not immediately reversible after clamp loosening (median score 1.5), but horses were not obviously lame after clamp removal and were no different from initial baseline (median score 0.5) approximately 3 days later.

Concentrations of stromal cell-derived factor-1 in serum, plasma, and synovial fluid of horses with osteochondral injury

OBJECTIVE

To determine whether stromal cell-derived factor-1 (SDF-1) concentrations in serum, plasma, and synovial fluid differed among untrained, race-trained, and osteochondral-injured Thoroughbred racehorses.

ANIMALS

22 racehorses without osteochondral injury and 37 racehorses with osteochondral injury.

PROCEDURES

Horses without osteochondral injury were examined before and after 5 to 6 months of race training. Horses with osteochondral injury were undergoing arthroscopic surgery for removal of osteochondral fragments from carpal or metacarpophalangeal or metatarsophalangeal joints (fetlock joints). Serum, plasma, and fetlock or carpal synovial fluid samples were obtained and analyzed for SDF-1 concentration by use of an ELISA.

RESULTS

In horses with fetlock or carpal joint injury, mean synovial fluid SDF-1 concentrations were significantly higher, serum SDF-1 concentrations were significantly lower, and synovial fluid-to-serum SDF-1 ratios were significantly higher than in untrained and trained horses. Synovial fluid SDF-1 concentrations were not significantly different between trained and untrained horses. Plasma SDF-1 concentrations were not different among the 3 groups. Results obtained with serum, compared with synovial fluid and plasma, had better sensitivity for differentiating between osteochondral-injured horses and uninjured horses. In horses with fetlock joint osteochondral injury, serum SDF-1 concentrations were correlated with radiographic and arthroscopic inflammation scores, but not arthroscopic cartilage scores.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that serum SDF-1 concentrations were more sensitive than plasma and synovial fluid concentrations for detection of osteochondral injury in the fetlock or carpal joint of racehorses. Analysis of serum and synovial SDF-1 concentrations in horses with experimentally induced joint injury may help define the onset and progression of post-traumatic osteoarthritis and aid in the evaluation of anti-inflammatory treatments.

Impact of walking surface on the range of motion of equine distal limb joints for rehabilitation purposes

The aim of this study was to evaluate the effect of three footing surfaces on the flexion/extension, and range of motion (ROM) of the carpus, tarsus and fetlocks in the horse. The percentage of stride spent in the stance phase of sound horses at the walk was also measured. Nine sound horses were walked on hard ground (HD), soft ground (SF) and a land treadmill (LT), and five complete gait cycles were recorded by a digital video camera. Retro-reflective markers were placed on the skin at four anatomical locations on the left fore and hind limbs, and data were analyzed using two-dimensional (2D) motion-analysis software. Maximal flexion/extension angles and range of motion were calculated for each joint, and the percentage of the stride spent in stance phase was determined for each stride. Maximal flexion of the tarsus and hind fetlock was greater on LT and SF compared to HD, while maximal flexion of the carpus was greater on LT compared to HD and SF. Maximal extension of the carpus was greater on HD compared to SF and LT, maximal extension of the tarsus was greater on HD and SF compared to LT, and maximal extension of the forelimb and hind limb fetlocks was greater on LT compared to HD and SF. The greatest overall ROM of the carpus and fetlocks was achieved on LT, while the greatest overall ROM of the tarsus was achieved on SF. The stance percentage of the stride for the hind limb was significantly different between all surfaces. In conclusion, walking surface influences flexion/extension of the carpus, tarsus and fetlocks in healthy horses, which should be considered when walking equine rehabilitation cases.

Histopathologic findings in the sacrocaudalis dorsalis medialis muscle of horses with vitamin E-responsive muscle atrophy and weakness

OBJECTIVE

To characterize clinical findings, outcomes, muscle characteristics, and serum or muscle concentrations of α-tocopherol for horses with vitamin E-responsive signs of muscle atrophy and weakness consistent with signs of equine motor neuron disease (EMND).

DESIGN

Retrospective case-control study.

ANIMALS

8 affected (case) adult horses with acute (n = 3) or chronic (5) gross muscle atrophy that improved with vitamin E treatment and 14 clinically normal (control) adult horses with adequate (within reference range; 8) or low (6) muscle concentrations of α-tocopherol.

PROCEDURES

Medical records were reviewed, serum and muscle concentrations of α-tocopherol were measured, and frozen biopsy specimens of sacrocaudalis dorsalis medialis muscle and gluteal muscle were histologically evaluated for pathological changes. Fiber type composition and fiber diameters were assessed in gluteal muscle specimens.

RESULTS

A myopathy that was histologically characterized by redistribution of mitochondrial enzyme stain (moth-eaten appearance) and anguloid atrophy of myofibers was evident in sacrocaudalis dorsalis medialis muscle fibers of the 8 affected horses that had low serum (6/8) or skeletal muscle (5/5) concentrations of α-tocopherol; these histopathologic changes were not found in muscle specimens of control horses with low or adequate muscle concentrations of α-tocopherol. All affected horses regained strength and muscle mass within 3 months after initiation of vitamin E treatment and dietary changes.

CONCLUSIONS AND CLINICAL RELEVANCE

A vitamin E-deficient myopathy characterized histologically by a moth-eaten appearance in the mitochondria and anguloid myofiber atrophy in frozen sections of sacrocaudalis dorsalis medialis muscle biopsy specimens was found in horses with clinical signs of EMND that were highly responsive to vitamin E treatment. This myopathy may be a specific syndrome or possibly precede the development of neurogenic muscle fiber atrophy typical of EMND.

Effect of water depth on amount of flexion and extension of joints of the distal aspects of the limbs in healthy horses walking on an underwater treadmill

OBJECTIVE

To determine the maximum amount of flexion and extension of the carpal, tarsal, metacarpophalangeal, and metatarsophalangeal joints and the percentage duration of the stance and swing phases of the stride for horses walking on an underwater treadmill in various water depths.

ANIMALS

9 healthy adult horses.

PROCEDURES

Zinc oxide markers were placed on the forelimbs and hind limbs of the horses. Video was recorded of horses walking (0.9 m/s) on an underwater treadmill during baseline conditions (< 1 cm of water) or in various amounts of water (level of the metatarsophalangeal, tarsal, and stifle joints). Maximum amount of joint flexion and extension, range of motion (ROM), and the percentage durations of the stance and swing phases of the stride were determined with 2-D motion analysis software.

RESULTS

The ROM was greater for all evaluated joints in any amount of water versus ROM for joints in baseline conditions (primarily because of increases in amount of joint flexion). The greatest ROM for carpal joints was detected in a tarsal joint water depth, for tarsal joints in a stifle joint water depth, and for metacarpophalangeal and metatarsophalangeal joints in metatarsophalangeal and tarsal joint water depths. As water depth increased, the percentage durations of the stance and swing phases of the stride significantly decreased and increased, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

Results of this study suggested that exercise on an underwater treadmill is useful for increasing the ROM of various joints of horses during rehabilitation and that the depth of water affects the amount of flexion and extension of joints.

Vascular perfusion of the dorsal and palmar condyles of the equine third metacarpal bone

REASONS FOR PERFORMING STUDY

Palmar osteochondral disease (POD) is an overload arthrosis that commonly affects fetlock joints of racing Thoroughbreds (TB) but the aetiopathogenesis of the disease has not been well defined.

OBJECTIVES

The aim of this study was to compare India ink perfusion in the dorsal and palmar condyles of the third metacarpal bone (McIII) in both passively flexed and maximally extended fetlock joints from paired equine cadaver limbs.

STUDY DESIGN

Descriptive cadaver study comparing perfusion of condyles of McIII in paired cadaver limbs in flexion (control group) and maximal extension (intervention group).

METHODS

Pairs of forelimbs were acquired from 5 TB horses subjected to euthanasia for reasons unrelated to lameness. Limb pairs were perfused intra-arterially with India ink and then randomly assigned to passive flexion or maximal extension of the fetlock joint. Limbs were sectioned sagittally in 3 mm sections through the fetlock and 12 sections per limb processed using a modified tissue-clearing technique. Sections were subsequently digitally imaged and bone perfusion evaluated with image analysis software.

RESULTS

Greater perfusion of the dorsal condyle than of palmar condyle was observed in 78% of sections from limbs in passive flexion and 92% of maximally extended sections. Perfusion to the palmar aspect of the condyle was significantly decreased (P < 0.0001) when the limbs were placed in maximal extension compared to passive flexion.

CONCLUSIONS

The palmar condyle of McIII had less perfusion than the dorsal condyle when the fetlock joint was in passive flexion and this difference was exacerbated by maximal extension. Based on the anatomical location of POD lesions, perfusion differences between the dorsal and palmar condyles of McIII may be associated with development of these lesions.

Non-terminal animal model of post-traumatic osteoarthritis induced by acute joint injury

OBJECTIVE

Develop a non-terminal animal model of acute joint injury that demonstrates clinical and morphological evidence of early post-traumatic osteoarthritis (PTOA).

METHODS

An osteochondral (OC) fragment was created arthroscopically in one metacarpophalangeal (MCP) joint of 11 horses and the contralateral joint was sham operated. Eleven additional horses served as unoperated controls. Every 2 weeks, force plate analysis, flexion response, joint circumference, and synovial effusion scores were recorded. At weeks 0 and 16, radiographs (all horses) and arthroscopic videos (OC injured and sham joints) were graded. At week 16, synovium and cartilage biopsies were taken arthroscopically from OC injured and sham joints for histologic evaluation and the OC fragment was removed.

RESULTS

OC fragments were successfully created and horses were free of clinical lameness after fragment removal. Forelimb gait asymmetry was observed at week 2 (P = 0.0012), while joint circumference (P < 0.0001) and effusion scores (P < 0.0001) were increased in injured limbs compared to baseline from weeks 2 to 16. Positive flexion response of injured limbs was noted at multiple time points. Capsular enthesophytes were seen radiographically in injured limbs. Articular cartilage damage was demonstrated arthroscopically as mild wear-lines and histologically as superficial zone chondrocyte death accompanied by mild proliferation. Synovial hyperemia and fibrosis were present at the site of OC injury.

CONCLUSION

Acute OC injury to the MCP joint resulted in clinical, imaging, and histologic changes in cartilage and synovium characteristic of early PTOA. This model will be useful for defining biomarkers of early osteoarthritis and for monitoring response to therapy and surgery.

Effects of various presale radiographic findings for yearling Thoroughbreds on 2-year-old racing performance

OBJECTIVE

To determine the effects of various presale radiographic findings for Thoroughbreds sold at a yearling sale on 2-year-old racing performance of those horses.

ANIMALS

397 Thoroughbreds.

DESIGN

Cohort study.

PROCEDURES

Thoroughbreds offered for sale at a Thoroughbred sales facility in Kentucky were selected via a randomization procedure. Effects of various presale radiographic findings on the following measures of 2-year-old racing performance were determined: having started a race and having placed (ie, finished in first, second, or third place) in a race at least once, total amount of money earned, and amount of money earned per start.

RESULTS

Of the 397 horses, 192 (48%) started in at least 1 race during the 2-year-old racing year. The odds of failure to start a race as a 2-year-old were 1.78 times as great for horses with forelimb proximal sesamoid bone osteophytes or enthesophytes as for horses without this finding (95% confidence interval, 1.01 to 3.16). The odds of failure to start a race as a 2-year-old were 2.02 times as great for horses with hind limb proximal phalanx osteochondral fragments as for horses without this finding (95% confidence interval, 0.95 to 4.31), although this result was not significant. Radiographic findings did not have an effect on total amount of money earned, amount of money earned per start, or whether horses placed in a race.

CONCLUSIONS AND CLINICAL RELEVANCE

Presale radiographic detection of forelimb proximal sesamoid bone osteophytes or enthesophytes or hind limb proximal phalanx osteochondral fragments in yearlings were associated with failure to start a race during the 2-year-old racing year in study horses.

Effects of yearling sale purchase price, exercise history, lameness, and athletic performance on purchase price of Thoroughbreds at 2-year-old in-training sales

OBJECTIVE

To determine the effects of yearling sale purchase price, exercise history, lameness, and athletic performance (speed) on purchase price of 2-year-old in-training Thoroughbreds and to compare the distance exercised within 60 days prior to 2-year-old in-training sales between horses with high yearling sale purchase prices versus those with low yearling sale purchase prices and between horses with lameness during training and those without lameness during training.

DESIGN

Prospective study.

ANIMALS

51 Thoroughbreds.

PROCEDURES

Thoroughbreds purchased at a yearling sale were trained prior to resale at 2-year-old in-training sales. Amount of exercise and lameness status during training and speed of horses at 2-year-old in-training sales were determined. Data were analyzed via the Wilcoxon rank sum test and ANOVA.

RESULTS

Median purchase price of horses at 2-year-old in-training sales was $37,000. The 2-year-old in-training sale purchase price was associated with yearling sale purchase price and distance galloped within 60 days prior to and speed recorded at 2-year-old in-training sales.

CONCLUSIONS AND CLINICAL RELEVANCE

Horses with high yearling sale purchase prices typically had high 2-year-old in-training sale purchase prices, had low distances galloped within 60 days prior to 2-year-old in-training sales, and were classified as fast at 2-year-old in-training sales. Lameness alone was not associated with 2-year-old in-training sales purchase price. However, lameness was associated with a low distance galloped before 2-year-old in-training sales, particularly for horses with a high yearling sale purchase price; this finding suggested that yearling sale purchase price can affect training management decisions for horses with lameness.

Steroid diffusion into the navicular bursa occurs in horses affected by palmar foot pain

Palmar foot pain is frequently treated by steroid injections into the distal interphalangeal joint (DIPJ) in the anticipation that the steroid will diffuse to the navicular bursa and palmar foot structures. The object of this study was to determine if triamcinolone acetonide (TA) would in fact be able to locally diffuse from the DIPJ into the navicular bursa in horses affected by palmar foot pain. Both forelimb DIPJs (nine horses) were injected with 10 mg of TA. Navicular bursa fluid samples, both forelimb and one hind limb (systemic control), were analysed for TA with high-performance liquid chromatography/tandem mass spectrometry (HPLC-MS/MS) six hours later. Foot radiographs were graded (0-4) on severity of changes. Forelimb navicular bursa TA concentrations (mean±sd log(10), 3.20±0.56) were significantly higher than systemic control concentrations (mean±sd log(10), 1.89±0.3) (P<0.0001). Horses with a radiographic grade of >2 were four times as likely to have TA log(10) concentrations less than 3.2 (158.49 ng/ml). TA locally diffused from the DIPJ into the navicular bursa in horses affected by palmar foot pain; TA concentrations decreased as radiographic severity increased.

Urinary CTX-II concentrations are elevated and associated with knee pain and function in subjects with ACL reconstruction

OBJECTIVE

Post-traumatic knee osteoarthritis (OA) is prevalent after anterior cruciate ligament reconstruction (ACLR). Biomarkers that identify individuals likely to develop OA, especially symptomatic OA, can help target preventative and therapeutic strategies. This study examined the magnitude and change over time in urinary CTX-II (uCTX-II) concentrations shortly after ACL reconstruction, and, secondarily, the associations with knee pain and function.

DESIGN

Subjects were 28 patients with ACLR and 28 age- and sex-matched controls (CNTRL). Testing was conducted at four time points spaced 4 weeks apart (4, 8, 12 and 16 weeks post-operative in ACLR). Measures included demographics, urine samples, Numeric Pain Rating Scale (NPRS) and International Knee Documentation Committee Subjective Knee Form (IKDC-SKF). uCTX-II concentrations were determined with competitive enzyme-linked immunosorbent assay (ELISA). uCTX-II concentrations at each time point in ACLR were compared to the mean concentration over time in CNTRL, with and without adjustment for body mass index (BMI). Changes over time in each measure and correlations between the slopes of change were examined.

RESULTS

uCTX-II concentrations were significantly higher in ACLR than CNTRL through 16 weeks post-operative when adjusted for BMI. In ACLR, uCTX-II concentrations significantly decreased over time, and the slope was associated with NPRS (r = 0.406, P = 0.039) and IKDC-SKF (r = -0.402, P = 0.034) slopes.

CONCLUSION

uCTX-II concentrations shortly after ACLR were elevated compared to CNTRL and declined over time. Decreasing uCTX-II concentrations were associated with decreasing knee pain and improving function. uCTX-II may have a role as a prognostic marker following ACLR and warrants further investigation.

Associations of horse age, joint type, and osteochondral injury with serum and synovial fluid concentrations of type II collagen biomarkers in Thoroughbreds

OBJECTIVE

To determine the effects of horse age, osteochondral injury, and joint type on a synthesis biomarker and 3 degradative biomarkers of type II collagen in Thoroughbreds.

ANIMALS

Healthy rested adult (3- to 12-year-old) Thoroughbreds (n = 19), yearling (1- to 2-year-old) Thoroughbreds (40), and Thoroughbred racehorses (2 to 7 years old) undergoing arthroscopic surgery for removal of osteochondral fragments that resulted from training or racing (41).

PROCEDURES

Samples of blood and metacarpophalangeal, metatarsophalangeal, or carpal joint synovial fluid (SF) were collected from all horses. Commercially available assays were used to analyze SF and serum concentrations of type II collagen biomarkers of synthesis (carboxy propeptide of type II collagen [CPII]) and degradation (cross-linked C-telopeptide fragments of type II collagen [CTX II], neoepitope generated by collagenase cleavage of type I and II collagen [C1,2C], and neoepitope generated by collagenase cleavage of type II collagen [C2C]).

RESULTS

Osteochondral injury affected concentrations of CPII, CTX II, C1,2C, and C2C in SF, serum, or both, compared with concentrations in healthy adult horses. Compared with adult horses, yearling horses had increased SF or serum concentrations of degradative biomarkers (CTX II, C1,2C, and C2C). Concentrations were higher in carpal than metacarpophalangeal or metatarsophalangeal joints for all biomarkers in osteochondral-injured horses. Variable differences in SF concentrations between joint types were detected in healthy adult and yearling horses.

CONCLUSIONS AND CLINICAL RELEVANCE

Horse age, osteochondral injury, and joint type all significantly affected type II collagen biomarker concentrations in SF and serum of Thoroughbreds.

Evaluation of diffusion of triamcinolone acetonide from the distal interphalangeal joint into the navicular bursa in horses

OBJECTIVE

To determine whether triamcinolone acetonide diffuses from the distal interphalangeal joint (DIPJ) to the navicular bursa, diffusion is direct or systemic, and addition of sodium hyaluronan has an effect on diffusion in horses.

ANIMALS

11 adult horses without forelimb lameness.

PROCEDURES

1 randomly chosen forelimb DIPJ of each horse received an injection of 10 mg of triamcinolone acetonide plus 20 mg of sodium hyaluronan (group 1), and the contralateral forelimb DIPJ received an injection of 10 mg of triamcinolone acetonide plus 2 mL of lactated Ringer's solution (group 2). Synovial fluid samples were taken from both forelimb navicular bursae and 1 hind limb navicular bursa (systemic control group) at 6 hours. Triamcinolone acetonide concentrations in synovial fluid were quantified by use of high-performance liquid chromatography plus tandem mass spectrometry. Data were logarithmically transformed, and contrast analysis was performed on the 3 groups.

RESULTS

Triamcinolone acetonide was detected in navicular bursal samples in all groups. Groups 1 and 2 had significantly greater concentrations of triamcinolone acetonide than the systemic control group. There was no significant difference between groups 1 and 2.

CONCLUSIONS AND CLINICAL RELEVANCE

Triamcinolone acetonide diffused directly from the DIPJ into the navicular bursa in clinically normal horses, and diffusion was not affected by addition of hyaluronan. Injection into the DIPJ with triamcinolone acetonide or a triamcinolone acetonide-hyaluronan combination can potentially be used for treatment of navicular syndrome, but further studies are needed to determine whether triamcinolone acetonide diffuses similarly in horses with navicular syndrome.

Effect of exercise and osteochondral injury on synovial fluid and serum concentrations of carboxy-terminal telopeptide fragments of type II collagen in racehorses

OBJECTIVE

To investigate the effects of exercise and osteochondral injury on concentrations of carboxy-terminal telopeptide fragments of type II collagen (CTX-II) in synovial fluid (SF) and serum of Thoroughbred racehorses and to compare findings with radiographic and arthroscopic scores of joint injury severity.

ANIMALS

78 Thoroughbreds with (n = 38) and without (40) osteochondral injury.

PROCEDURES

Serum and metacarpophalangeal or carpal joint SF samples were collected from noninjured horses before and at the end of 5 to 6 months of race training (pre- and postexercise samples, respectively) and from horses with osteochondral injury (1 joint assessed/horse). Synovial fluid and serum CTX-II concentrations were determined by use of an ELISA. Radiographic and arthroscopic scores of joint injury severity were determined for the injured horses.

RESULTS

The CTX-II concentrations in SF and SF:serum CTX-II ratio were significantly higher for horses with joint injuries, compared with pre- and postexercise findings in noninjured horses. Serum CTX-II concentrations in postexercise and injured-horse samples were significantly lower than values in pre-exercise samples. On the basis of serum and SF CTX-II concentrations and SF:serum CTX-II ratio, 64% to 93% of serum and SF samples were correctly classified into their appropriate group (pre-exercise, postexercise, or injured-joint samples). In horses with joint injuries, arthroscopic scores were positively correlated with radiographic scores, but neither score correlated with SF or serum CTX-II concentration.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that serum and SF CTX-II concentrations and SF:serum CTX-II ratio may be used to detect cartilage degradation in horses with joint injury.

Osteochondral injury increases type II collagen degradation products (C2C) in synovial fluid of Thoroughbred racehorses

OBJECTIVES

To investigate the effects of exercise and osteochondral (OC) injury on type II collagen degradation products (collagenase cleavage neoepitope commercially known as C2C) in synovial fluid (SF) from Thoroughbred (TB) racehorses and to compare these results with radiographic and arthroscopic scores of severity of joint injury.

METHODS

Metacarpophalangeal/metatarsophalangeal (MCP/MTP) and carpal SF was obtained from (1) 20 normal rested horses, (2) the same horses after 5 to 6 months of race training, and (3) 27 horses with OC injury from racing. For group 3, radiographic and arthroscopic scores were determined. Concentrations of SF C2C were determined by ELISA.

RESULTS

SF C2C concentrations in OC injured carpal and MCP/MTP joints were significantly different than rested and exercised joints (P<0.01). However, carpal and MCP/MTP SF C2C concentrations were not significantly different between rested and exercised groups. Arthroscopic scores were significantly higher for OC injured carpal than OC injured MCP/MTP joints (P=0.002). OC injured SF C2C concentrations were positively correlated with radiographic and arthroscopic scores. Arthroscopic scores were positively correlated with radiographic scores. SF C2C concentrations >or= 64 pmol/mL for MCP/MTP joints and >or= 75 pmol/mL for carpal joints discriminated OC injured joints from rested or exercised joints.

CONCLUSION

OC injury caused a significant increase in SF C2C concentrations in carpal and MCP/MTP joints compared to rested and exercised horses. SF C2C concentrations were correlated to severity of joint injury. Based on these findings, SF C2C analysis may be useful for evaluation of joint injury.

A simplified method of determining synovial fluid chondroitin sulfate chain length

OBJECTIVE

To determine whether dimethylmethylene blue (DMMB) analysis, when combined with agarose gel filtration chromatography (Superose 6), can be performed instead of fluorophore-assisted carbohydrate electrophoresis (FACE) to determine chondroitin sulfate (CS) chain length in synovial fluid (SF).

METHODS

SF was obtained from (1) normal horses after 8 weeks of rest, (2) the same horses after 9 months of treadmill training, and (3) horses with osteochondral (OC) injury from racing. SF CS concentrations and chain lengths were determined by gel chromatography and DMMB analysis and compared with previous results determined by FACE analysis on the same samples.

RESULTS

DMMB analysis showed that SF CS peak chain length in the OC injury group increased significantly (18.7 kDa) when compared to rested and exercised normal horses (15.6 kDa). The assay had a positive predictive value of 71% and a negative predictive value of 75% for discriminating between normal and injured joints.

CONCLUSIONS

We report a simple and inexpensive DMMB analysis of SF CS chain length, which, when coupled with Superose 6 chromatography, discriminates between normal and post-injury joints. Similar to our previous FACE analysis results [Brown MP, Trumble TN, Plaas AHK, Sandy JD, Romano M, Hernandez J, et-al. Exercise and injury increase chondroitin sulfate chain length and decrease hyaluronan chain length in synovial fluid. Osteoarthritis Cartilage 2007;15], our DMMB results show an increase in the chain length of the CS in the SF of injured joints.

Exercise and injury increase chondroitin sulfate chain length and decrease hyaluronan chain length in synovial fluid

OBJECTIVES

(1) To investigate the effects of exercise and osteochondral (OC) injury on synovial fluid (SF) chondroitin sulfate (CS) and hyaluronan (HA) concentration and chain length, (2) to compare SF and cartilage CS data from joints with OC fragmentation, and (3) to compare SF CS and HA profiles with those seen in serum from the same horses.

METHODS

Serum and SF were obtained from (1) normal horses after 8 weeks rest, (2) the same horses after 9 months treadmill training, and (3) horses with OC injury from racing. Articular cartilage was also collected from group 3 horses. Concentrations and chain lengths of CS and HA were determined by gel chromatography and fluorophore-assisted carbohydrate electrophoresis.

RESULTS

SF CS peak chain length in the OC injury group increased significantly (18.7kDa) when compared to rested horses (11.6kDa), with exercise producing an intermediate chain length (15.6kDa). Cartilage and serum from the OC injury group had the abnormally long CS chains seen in SF from these horses. Total SF HA was significantly lower in the OC injury group compared to the rested group. Both the OC injury group and the exercised group had significant decreases in SF HA chain length compared to the rested group.

CONCLUSIONS

Chain length of SF CS was increased by exercise and OC injury. Exercise resulted in a modest increase, whereas OC injury caused a marked increase. In contrast to CS, SF HA chain length was decreased by OC injury, and to a lesser extent by exercise. Chain length analysis of SF CS and HA may provide a useful tool for evaluation of joint health.

Effects of zoledronate on markers of bone metabolism and subchondral bone mineral density in dogs with experimentally induced cruciate-deficient osteoarthritis

OBJECTIVE

To evaluate effects of zoledronate on markers of bone metabolism in dogs after transection of the cranial cruciate ligament (CrCL).

ANIMALS

21 adult dogs.

PROCEDURE

Unilateral CrCL transection was performed arthroscopically. Dogs were allocated to 3 groups (control group, low-dose zoledronate [10 microg/kg, SC, q 90 d for 12 months], and high-dose zoledronate [25 microg/kg, SC, q 90 d for 12 months]). Serum osteocalcin (OC), serum bone-specific alkaline phosphatase (BAP), and urine pyridinoline and deoxypyridinoline concentrations were measured at 0, 1, 3, 6, 9, and 12 months after surgery. Bone mineral density (BMD) was determined in the distal portion of the femur and proximal portion of the tibia via computed tomography at each time point. Data were analyzed by a repeated-measures ANOVA.

RESULTS

oledronate inhibited OC in the high-dose group at 9 and 12 months and at 12 months in the low-dose group, compared with the control group. High-dose zoledronate decreased BAP concentrations 3 and 9 months after surgery. In the control group, BMD was decreased in the femoral condyle and caudal tibial plateau. Zoledronate prevented significant BMD decreases starting 1 month after transection, compared with control dogs. In the caudomedial aspect of the tibial plateau, both zoledronate groups had significant increases in BMD after 3 months, compared with control dogs.

CONCLUSIONS AND CLINICAL RELEVANCE

Zoledronate may reduce subchondral bone loss and effect markers of bone metabolism in dogs with experimentally induced instability of the stifle joint and subsequent development of osteoarthritis.

The Use of Nutraceuticals for Osteoarthritis in Horses

In horses, lameness is often attributable to some degree of osteoarthritis (OA), a complex disease process that is highlighted by eventual degradation of articular cartilage. Conventional therapies for OA in horses are designed to relieve pain and discomfort and often include pharmacologic intervention with nonsteroidal anti-inflammatory drugs or intra-articular steroids. Oral administration of nutraceutical products to the horse is common and easy and is perceived to be a benign treatment for OA in horses. The main goal for use of nutraceuticals is to use them in OA cases to attempt to lower the dose of other drugs that are more problematic while potentially preventing further degradation (disease or structure modifying). This article attempts to define a nutraceutical, identifies areas that need to be considered when these products are used, and describes the known scientific effects of the most common compounds contained in currently available equine nutraceuticals.

Orthopedic Disorders in Neonatal Foals

The first month of life is a vulnerable time for foals. They must adjust to their environment while they are still compromised immunologically, and their musculoskeletal system is rapidly growing and adjusting to stresses from an increasing amount of exercise. Therefore, if a foal is born with or acquires an abnormality or disease related to the musculoskeletal system, rapid adjustments must be made to allow the foal to grow and respond so that future athletic performance will not be compromised. Problems must be identified early, which requires thorough examinations. This article summarizes treatment options for orthopedic disorders that present or become clinically evident within the first month of life.

Evaluation of changes in vertical ground reaction forces as indicators of meniscal damage after transection of the cranial cruciate ligament in dogs

OBJECTIVE

To determine whether decreases in peak vertical force of the hind limb after transection of the cranial cruciate ligament (CrCL) would be indicative of medial meniscal damage in dogs.

ANIMALS

39 purpose-bred adult male Walker Hounds.

PROCEDURE

The right CrCL was transected arthroscopically. Force plate measurements of the right hind limb were made prior to and 2, 4, 10, and 18 weeks after transection of the CrCL. Only dogs with > or =10% decreases in peak vertical force after week 2 were considered to have potential meniscal damage. Dogs that did not have > or =10% decreases in peak vertical force at any time point after week 2 were assigned to group 1. Group 2 dogs had > or =10% decreases in peak vertical force from weeks 2 to 4 only. Group 3 and 4 dogs had > or =10% decreases in peak vertical force from weeks 4 to 10 only or from weeks 10 to 18 only, respectively. Damage to menisci and articular cartilage was graded at week 18, and grades for groups 2 to 4 were compared with those of group 1.

RESULTS

The percentage change in peak vertical force and impulse area was significantly different in groups 2 (n = 4), 3 (4), and 4 (4) at the end of each measurement period (weeks 4, 10, and 18, respectively) than in group 1 (27). The meniscal grade for groups 2 to 4 was significantly higher than for group 1. A > or =10% decrease in peak vertical force had sensitivity of 52% and accuracy of 72% for identifying dogs with moderate to severe medial meniscal damage.

CONCLUSIONS AND CLINICAL RELEVANCE

In dogs with transected or ruptured CrCLs, force plate analysis can detect acute exacerbation of lameness, which may be the result of secondary meniscal damage, and provide an objective noninvasive technique that delineates the temporal pattern of medial meniscal injury.

Correlation of prostaglandin E2 concentrations in synovial fluid with ground reaction forces and clinical variables for pain or inflammation in dogs with osteoarthritis induced by transection of the cranial cruciate ligament

OBJECTIVE

To evaluate the temporal pattern of prostaglandin (PG) E2 concentrations in synovial fluid after transection of the cranial cruciate ligament (CCL) in dogs and to correlate PGE2 concentrations with ground reaction forces and subjective clinical variables for lameness or pain.

ANIMALS

19 purpose-bred adult male Walker Hounds.

PROCEDURE

Force plate measurements, subjective clinical analysis of pain or lameness, and samples of synovial fluid were obtained before (baseline) and at various time points after arthroscopic transection of the right CCL. Concentrations of PGE2 were measured in synovial fluid samples, and the PGE2 concentrations were correlated with ground reaction forces and clinical variables.

RESULTS

The PGE2 concentration increased significantly above the baseline value throughout the entire study, peaking 14 days after transection. Peak vertical force and vertical impulse significantly decreased by day 14 after transection, followed by an increase over time without returning to baseline values. All clinical variables (eg, lameness, degree of weight bearing, joint extension, cumulative pain score, effusion score, and total protein content of synovial fluid, except for WBC count in synovial fluid) increased significantly above baseline values. Significant negative correlations were detected between PGE2 concentrations and peak vertical force (r, -0.5720) and vertical impulse (r, -0.4618), and significant positive correlations were detected between PGE2 concentrations and the subjective lameness score (r, 0.5016) and effusion score (r, 0.6817).

CONCLUSIONS AND CLINICAL RELEVANCE

Assessment of the acute inflammatory process by measurement of PGE2 concentrations in synovial fluid may be correlated with the amount of pain or lameness in dogs.

Standing male equine urogenital endoscopic surgery

Standing laparoscopy in the horse was used initially as a diagnostic tool to assist in the diagnosis of a cryptorchid testicle. Now, this technique is also used for treatment of cryptorchid testicles. The focus of this article is the standing laparoscopic cryptorchidectomy, the most common laparoscopic procedure performed on the male equine urogenital tract. Advantages, disadvantages, instrumentation, and general procedure are discussed.

Synovial fluid gelatinase concentrations and matrix metalloproteinase and cytokine expression in naturally occurring joint disease in horses

OBJECTIVES

To determine concentrations of matrix metalloproteinase (MMP)-2 and -9 in synovial fluid; and mRNA expression of MMP-1, -13, and -3; interleukin[IL]-1alpha and beta; and tumor necrosis factor (TNF)-alpha in synovial membrane and articular cartilage from horses with naturally occurring joint disease.

SAMPLE POPULATION

Synovial fluid (n = 76), synovial membrane (59), and articular cartilage (45) from 5 clinically normal horses and 55 horses with joint disease categorized as traumatic (acute [AT] or chronic [CT]), osteochondritis dissecans (OCD), or septic (S).

PROCEDURE

Synovial fluid gelatinase concentrations were analyzed, using zymography. Synovial membrane and articular cartilage mRNA expression for MMP-1, -3, and -13, IL-1alpha and beta, TNF-alpha, type-II collagen, and aggrecan were analyzed, using quantitative reverse transcriptase-polymerase chain reaction.

RESULTS

Synovial fluid pro-MMP-2 concentration was significantly higher in diseased joints than normal joints. Septic joints had significantly higher concentrations of pro and active MMP-9. Stromelysin-1 was expressed in > or = 80% of synovial membrane and articular cartilage samples and was strongly influenced by age. Collagenases were rarely expressed, with MMP-13 expressed only in diseased joints. Interleukin-1beta expression was significantly higher in all OCD samples and was influenced by age. Tumor necrosis factor-alpha expression was significantly higher in cartilage from joints with AT and OCD. There was no correlation between MMP or cytokines and type-II collagen or aggrecan expression.

CONCLUSIONS AND CLINICAL RELEVANCE

Matrix metalloproteinase-2 and -3 are abundant in naturally occurring joint disease and normal joints. Interleukin-1beta and TNF-alpha may be important in the pathogenesis of OCD. Age affects MMP and IL-1beta concentrations.

The application of technetium-99m hexamethylpropyleneamine oxime (99mTc-HMPAO) labeled white blood cells for the diagnosis of right dorsal ulcerative colitis in two horses

The application of 99mTc-HMPAO labeled white blood cells to support the diagnosis of right dorsal ulcerative colitis was studied in two horses with a history and clinical signs consistent with phenylbutazone toxicity. These images were compared to a reference horse unaffected by right dorsal ulcerative colitis. Blood was collected aseptically in heparinized syringes from the patients for in vitro white blood cell (WBC) radiolabeling. The buffy coat was separated out and radiolabeled with 99mTc-HMPAO. The radiolabeled blood was re-injected i.v. and four images of the right and left side of the patient's abdomen were acquired at 4 hours and 20 hours post-injection. Results of the nuclear study revealed no abnormal findings in the abdomen at the four-hour post-injection images in any horse. Images obtained 20 hours post-injection revealed a linear uptake of radiolabeled WBCs in the right cranioventral abdomen in the region of the right dorsal colon in both horses with right dorsal ulcerative colitis. The reference horse had no radiopharmaceutical uptake in this region. This nuclear imaging study was a rapid, non-invasive method to identify right dorsal colon inflammation. These findings not only supported the diagnosis of right dorsal ulcerative colitis, but also facilitated appropriate medical management of each horse.

Laparoscopic intra-abdominal ligation of the testicular artery following castration in a horse

A 364-kg (800-lb) 1-year-old mixed-breed horse was admitted for treatment of uncontrolled bleeding after castration. Multiple attempts to ligate the testicular artery through the scrotal incisions prior to referral had been unsuccessful. Because of the owner's concerns about cost, an attempt was made to control the bleeding by applying pressure to the inguinal region and administering formalin IV. However, hemorrhage continued. A decision was made to use laparoscopy to ligate the testicular artery. The horse was anesthetized and positioned in dorsal recumbency, and a routine ventral laparoscopic approach was used. The horse recovered without further complications. Laparoscopy should be considered for ligation of the testicular artery in horses with uncontrolled bleeding after castration.

Laparoscopic ovariectomy in two standing llamas

Laparoscopic ovariectomy was performed in 2 llamas that were sedated but remained standing, avoiding possible complications associated with general anesthesia. All incisions were made in the left paralumbar fossa. The only intraoperative complications encountered were difficulty in maneuvering the laparoscope ventral to the uterine body in 1 llama because of distension of the urinary bladder, and a tendency to lean on the sidebar of the stocks in the other llama. The only postoperative complication was subcutaneous emphysema, which could be minimized by suctioning excess CO2 from the abdomen at completion of surgery. Laparoscopic ovariectomy was successful in these llamas and allowed direct examination and manipulation of the ovaries even though llamas were standing during surgery.

Epiglottic augmentation for treatment of dorsal displacement of the soft palate in racehorses: 59 cases (1985-1994)

OBJECTIVE

To determine whether epiglottic augmentation, in conjunction with more traditional surgical methods, would be useful in the treatment of dorsal displacement of the soft palate in racehorses.

DESIGN

Retrospective study.

ANIMALS

40 Thoroughbred and 19 Standardbred racehorses.

PROCEDURE

Polytetrafluoroethylene paste was injected submucosally on the lingual epiglottic surface of each horse. In addition, sternothyrohyoideus myectomy or sternothyroideus tenectomy and staphylectomy were performed in most horses.

RESULTS

Racing performance was improved after surgery in 29 of 40 (73%) Thoroughbreds and 10 of 19 (53%) Standardbreds. Twenty-nine (49%) horses won > or = 1 race after surgery.

CLINICAL IMPLICATIONS

Results suggest that epiglottic augmentation, in conjunction with other surgical methods, may be an effective method of treating horses with poor racing performance attributable to dorsal displacement of the soft palate.

Clinical relevance of the microvasculature of the equine proximal sesamoid bone

The blood supply to the proximal sesamoid bone of the equine forelimb was examined in 18 cadaver limbs from adult horses, using x-ray computed tomography and a tissue-clearing (Spalteholz) technique. Results of the study indicated that the proximal sesamoid bones were supplied by multiple branches of the medial and lateral palmar digital arteries, which entered the proximal half of the bones on their non-articular, abaxial surface. After entering the bone, the vessels traverse dorsally, axially, and distally, arborizing into several smaller branches that appear to supply the entire bone. The major branches of these vessels reside in bony canals, the orientation and distribution of which parallel the radiographic lucencies seen in horses with sesamoiditis and correspond to the configuration of apical fracture patterns.

Consideration of anatomic and radiographic features of the caudal pouches of the femorotibial joints of horses for the purpose of arthroscopy

Development of an arthroscopic approach to the caudal pouches of the equine stifle has been necessary because cranial approaches do not allow access to articular lesions in the caudal aspect of the joint. Therefore, the anatomy of the caudal region was examined in 52 cadaver limbs by use of gross dissection (29), x-ray-computed tomography (6), fluoroscopy (8), or arthroscopy (9). Additionally, using arthroscopic techniques developed in equine cadaver limbs, 3 stifles from 2 anesthetized horses were arthroscopically explored. Fluoroscopy was used to verify needle placement for joint injection and filling patterns of each femorotibial joint. The medial femorotibial joint sac (n = 4) held a mean +/- SD 41.67 +/- 5.77 ml of injection fluid, and the lateral femorotibial joint sac (n = 4) held a mean 61.67 +/- 2.89 ml of injection fluid. Vital structures that inadvertently could be damaged during arthroscopy of the caudal pouches of the stifle included the peroneal nerve (located approx 7 cm caudal to the lateral collateral ligament), the popliteal artery and vein (situated directly between the medial and lateral femoral condyles), and the lateral femoral condyle (most often traumatized during arthroscopy). The tendon of the popliteus muscle, which is contiguous with the joint capsule of the caudal pouch of the lateral femorotibial joint, made arthroscopic exploration of this pouch particularly difficult.