A 12-y-old Shetland Pony was presented with a mucus-secreting fistula in the right paralumbar fossa. Surgery was performed to unravel the origin of the fistula. The horse died under anesthesia and ...was forwarded to autopsy. The right kidney was markedly atrophic and fibrotic, consistent with unilateral end-stage kidney. The right ureter was markedly thickened, but with luminal continuity leading into the urinary bladder where a partial obstruction caused by nodular para-ureteral fat necrosis was evident. The lumen of the cutaneous fistula was continuous with the right ureter; therefore, we diagnosed the lesion as a ureterocutaneous fistula. Anomalies of the ureter are uncommon, and ureterocutaneous fistula formation in equids has not been reported previously to our knowledge.
Objective
To describe the palmar arthroscopic approaches to the bovine carpus and document the visible intra‐articular structures in each approach.
Study design
Ex vivo study.
Sample population
...Thirty fresh cadaveric bovine forelimbs.
Methods
Computed tomography (CT) and gross dissection were performed on 4 carpi. Latex models were produced from 6 carpi to define the gross anatomy and arthroscopic portals to the palmar carpal pouches. Ultrasonography and arthroscopy were performed on 20 carpi to document visualization of the local anatomy.
Results
A single palmar pouch was present on both sides of each joint on gross dissection and evaluation of latex models. The relationship between pouches and palmar structures was observed by CT. Small anechoic areas identified on ultrasonography increased after joint distension. Palmar arthroscopy of the antebrachiocarpal joint enabled visualization of the palmar surfaces of radial, intermediate, and ulnar carpal bones; distal radius; ulnar styloid process; palmar radiocarpal ligament; and articulation of accessory and ulnar carpal bones. Palmar arthroscopy of the middle carpal joint enabled inspection of the palmar aspects of ulnar, intermediate, radial, fused second and third and fourth carpal bones, palmar carpometacarpal ligament, and the short lateral collateral ligament. Palmar aspects of the fourth and fifth metacarpal bones were explored through the palmarolateral approach to the middle carpal joint. Instrument portals for each pouch were created under arthroscopic guidance.
Conclusion
Palmar arthroscopy of the adult bovine carpus enabled visualization of the clinically relevant palmar intra‐articular structures.
Clinical significance
Palmar carpal arthroscopy should be considered as an adjunct to dorsal approach for the diagnosis and treatment of bovine carpal diseases.
Pulmonary contusion (PC) is common in severely traumatized patients and can lead to respiratory failure requiring mechanical ventilation (MV). Ventilator-induced lung injury (VILI) might aggravate ...lung damage. Despite underrepresentation of trauma patients in trials on lung-protective MV, results are extrapolated to these patients, potentially disregarding important pathophysiological differences.
Three MV protocols with different positive end-expiratory pressure (PEEP) levels: ARDSnetwork lower PEEP (ARDSnet-low), ARDSnetwork higher PEEP (ARDSnet-high), and open lung concept (OLC) were applied in swine for 24 hours following PC. Gas exchange, lung mechanics, quantitative computed tomography, and diffuse alveolar damage (DAD) score were analyzed. Results are given as median (interquartile range) at 24 hours. Statistical testing was performed using general linear models (group effect) over all measurement points and pairwise Mann-Whitney U tests for DAD.
There were significant differences between groups: PEEP ( p < 0.0001) ARDSnet-low (8 8-10 cmH 2 O), ARDSnet-high (12 12-12 cmH 2 O), OLC (21 20-22 cmH 2 O). The fraction of arterial partial pressure of oxygen and inspired oxygen fraction ( p = 0.0016) was lowest in ARDSnet-low (78 (73-111) mm Hg) compared with ARDSnet-high (375 (365-423) mm Hg) and OLC (499 (430-523) mm Hg). The end-expiratory lung volume (EELV) differed significantly ( p < 0.0001), with highest values in OLC (64% 60-70%) and lowest in ARDSnet-low (34% 24-37%). Costa's surrogate for mechanical power differed significantly ( p < 0.0001), with lowest values for ARDSnet-high (73 58-76) compared with OLC (105 108-116). Diffuse alveolar damage was lower in ARDSnet-high compared with ARDSnet-low (0.0007).
Progression to ARDS, 24 hours after PC, was mitigated by OLC and ARDSnet-high. Both concepts restored EELV. ARDSnet-high had the lowest mechanical power surrogate and DAD. Our data suggest, that ARDSnet-high restored oxygenation and functional lung volume and reduced physiological and histological surrogates for VILI. ARDSnet-low generated unfavorable outcomes, such as loss of EELV, increased mechanical power and DAD after PC in swine. The high respiratory rate in the OLC may blunt favorable effects of lung recruitment.
Stem cells in the form of mesenchymal stromal cells derived from various sources have been identified to have the potential of supporting the therapy of joint disease in the horse, and preliminary ...data has been published about the clinical application of stem cells in horses suffering from clinical joint disease. Furthermore, the horse is recognized to be the ideal large animal model for the preclinical study of cell therapy in joints. The advantage of this species in this respect is the size of the joints, which makes surgical applications practically feasible in analogy to human surgery. Additionally, the horse is the only model species with a cartilage thickness in the knee joint comparable to that of humans. Especially the fact that horses develop clinical joint disease discerns this species from other large animal models like small ruminants. The therapy of clinical disease in model animal species represents the ideal situation for preclinical studies of novel therapeutic strategies. Here, we describe the experimental and clinical approaches to joint disease in the horse.
In horses, colic is associated with relatively high mortality rates. Identification of parameters associated with poor outcome may aid in providing a more accurate prognosis. This study aimed to ...assess the early prognostic value towards survival of the horse based on parameters of the clinical examination.
In a retrospective study (2013-2017), results of the clinical examination of horses with colic were analyzed. Obtained parameters were categorized from physiologic up to different pathophysiologic manifestations. The risk of death was calculated as odds ratios in comparison to normal values of these parameters. Individual score points were obtained and related to the respective outcome. Cut-off values for prognosis and treatment were calculated to distinguish between outcome and treatment group.
A total of 492 colic horses were analyzed, presenting 433 survivors (88 %). Overall, medical treatment was selected in 346 (70.3 %) horses (with 96 % survivors) and surgical treatment (laparotomy) was performed in 146 (29.7 %) horses (69.2 % survivors). An increased likelihood of the outcome "death" was found in horses aged over 20 years (OR = 5.498, p < 0.0005), with colic signs of > 6 hours duration (OR = 3.590, p = 0.035) and, also, for breeds of draft horses (OR = 8.364, p < 0.0005). Horses with significant increases in heart and respiratory rates (OR = 24.294, p < 0.0005 and OR = 20.375, p < 0.0005, respectively) and increased blood lactate concentrations (> 90 mg/dl: OR = 26.390, p < 0.0005) were more likely to succumb to the disease. However, a scoring system failed to show an association between high score points and poor prognosis.
Parameters of the clinical examination as well as the history of the patient may be indicative for the patient's outcome. However, no clear-cut distinction of the evaluated parameters towards survival and treatment options was obtained. A careful investigation of the patient remains mandatory for selection of treatment and a proper assessment of prognosis.
Summary
Equine recurrent uveitis (ERU) is still the leading cause of blindness in horses worldwide. It has a tremendous physical, emotional and economic impact on horses and their owners, ...respectively. This article will review the proposed aetiologies and discuss the complex and enigmatic relationship between ERU and leptospirosis as a cause. Typical clinical signs and ERU classifications will be discussed, and the current state of diagnostic testing evaluated. Much diagnostic data have been collected and published, and our thorough discussion of these results may serve to ease interpretation when routinely evaluating cases. Ultimately, the most current treatment options will be compared with regard to nonrecurrence rates, visual outcomes and associated complication rates.
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