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1.
REASONS FOR PERFORMING STUDY: There is limited information available on the more serious sequellae of idiopathic cheek teeth (CT) fractures. OBJECTIVES: To obtain information on clinical and ancillary diagnostic findings in referred horses with idiopathic CT fractures. METHODS: Details of all horses suffering from idiopathic CT fractures referred to the Equine Hospital at the University of Edinburgh 1999-2005 were examined, and information concerning fracture patterns, clinical and ancillary diagnostic findings, treatments and long-term response to treatments were obtained and analysed. RESULTS: A total of 60 maxillary and 17 mandibular idiopathic CT fractures were diagnosed in 68 horses. Fracture patterns included maxillary CT lateral slab fractures (45%), maxillary CT midline sagittal fractures (16%) and various other patterns of maxillary CT fractures (17%). In the mandibular CT, lateral slab fractures were found (12%) and various other CT fracture patterns were present in 10%. The more centrally positioned CT (maxillary and mandibular Triadan 08s and 09) were preferentially fractured. Clinical signs included quidding in 47% of cases; bitting and behavioural problems (28%); signs of apical infection, including bony swellings and nasal discharge (21%); anorexia/weight loss (15%); halitosis (13%); and buccal food impaction (12%). The treatment of all cases was conservative whenever possible and included corrective rasping of the remaining tooth (46% of cases); oral extraction of the smaller and loose dental fragment (32%) and extraction of the entire fractured tooth by oral extraction (28%) or by repulsion (13%). Prophylactic treatment of adjacent, nonfractured CT with carious infundibula was possibly of value in preventing further midline sagittal maxillary CT fractures. CONCLUSIONS: Horses referred with idiopathic CT fractures frequently have clinical signs of apical infection of the fractured CT and these teeth require extraction, orally if possible. More conservative treatment of idiopathic CT fractures without signs of gross apical infection can resolve clinical signs in most cases. POTENTIAL RELEVANCE: In the absence of apical infection, extraction of only the loose dental fragments of CT with idiopathic fractures is usually successful.  相似文献   

2.
REASONS FOR PERFORMING STUDY: There is limited information on the prevalence of idiopathic cheek teeth (CT) fractures in the general equine population and on which CT are most commonly affected. OBJECTIVES: To obtain information on the prevalence of fracture patterns and clinical details of idiopathic CT fractures. METHODS: Details of cases with idiopathic CT fractures encountered were obtained via a questionnaire sent to suitably experienced veterinary practitioners and equine dental technicians (EDTs). RESULTS: Details of 147 horses that suffered a total of 182 idiopathic CT fractures; and median 0.4% (range 0.07-5.9%) of horses examined were diagnosed with such fractures; 133 maxillary CT and 49 mandibular CT fractures were found; maxillary Triadan 09s and 10s were preferentially fractured (46% of all fractured CT); fracture patterns included maxillary CT slab fractures (through 1st and 2nd pulp chambers) in 87 teeth (48% of all fractured CT), maxillary CT midline sagittal fractures (through the infundibula) in 31 CT; and various other types of maxillary CT fractures in 15 CT. In the mandibular CT, lateral slab fractures (through the 4th and 5th pulp chambers) were found in 28 CT and a variety of other fracture patterns in the other 21 mandibular CT. Clinical signs included quidding in 33% of cases, bitting and behavioural problems (29%) and halitosis (12%), however 39% of horses with idiopathic CT fractures were asymptomatic. Treatments included oral extraction of the smaller dental fragment in 37% of cases, extraction of the entire fractured tooth (9%); removal of sharp edges on the remaining part of fractured tooth (14%); reduction of height of the opposite tooth (4%); other surgical or endodontic treatments, or referral of case for further investigation and treatment (10%); or no specific treatment (39%). Following treatment, 81% of cases were reported to be asymptomatic, 6% had ongoing clinical problems and the outcome was unclear in 13% of cases. CONCLUSIONS: Idiopathic CT fractures are present in approximately 0.4% of horses and may variably cause none to severe clinical signs. Most idiopathic CT fractures respond well to treatment. POTENTIAL RELEVANCE: Understanding of the prevalence, clinical findings and treatment of idiopathic CT fractures will improve management of these disorders.  相似文献   

3.
REASONS FOR PERFORMING STUDY: Talocalcaneal osteoarthritis (TO) is an uncommon cause of moderate to severe hindlimb lameness, on which only isolated case reports have been published to date. OBJECTIVES: To review the clinical features of TO and determine optimal methods for diagnosis, management and prognosis. METHODS: The case records from 4 referral centres of 18 horses showing hindlimb lameness considered, as a result of clinical investigation, to be caused by TO, were reviewed. RESULTS: TO affected mature sports and pleasure horses (age 7-16 years) and caused moderate to severe lameness, usually of sudden onset with no obvious inciting cause. There were few localising signs, other than worsening of lameness by hock flexion. Tarsocrural joint analgesia produced improvement in lameness in 6/11 horses (55%) and perineural analgesia of the tibial and fibular nerves complete soundness in 6/14 horses (43%) in which it was performed; 7/14 horses (50%) showed a further substantial improvement. Radiological findings included subchondral bone lysis and sclerosis and irregular joint space width, seen most obviously in a lateromedial view. Nuclear scintigraphy revealed marked uptake of radiopharmaceutical predominantly plantaromedially in the region of the talus in the 7 horses in which it was performed. Fourteen horses were treated conservatively with box- or pasture-rest, with or without intra-articular corticosteroids, hyaluronic acid or polysulphated glycosaminoglycan, and all remained lame. Intra-articular corticosteroids appeared to have no effect in any horse. Of 10 horses receiving conservative management only, 6 were subjected to euthanasia, 3 were retired and 1 remained in light work, but was still lame. Two horses treated by either partial tibial and fibular neurectomy or subchondral forage failed to regain soundness and were retired. Six horses were treated by surgical arthrodesis of the talocalcaneal joint with 2 or three 5.5 mm AO screws introduced obliquely across the joint from the plantarolateral aspect of the calcaneus, which resulted in improvement in lameness in all cases. CONCLUSIONS: Osteoarthritis of the talocalcaneal joint causes acute onset severe lameness, but clinical findings and diagnostic analgesia often fail to identify precisely the site of pain. Consistent radiographic changes suggested TO was contributing to the lameness and this diagnosis was supported by nuclear scintigraphy. The poor success of conservative treatment (including intra-articular medication) suggests that surgical arthrodesis is the treatment of choice, although the prognosis is still poor for a return to full soundness. POTENTIAL RELEVANCE: The clinical features described should facilitate more accurate diagnosis and prognosis. A novel surgical treatment is described which appears to offer significant improvement in the lameness. Further work is necessary to determine the causes of this condition and more effective management.  相似文献   

4.
Malerupted axially rotated maxillary cheek teeth (CT) were identified as the primary cause of diastemata and severe periodontitis in 3 horses. Diastema widening and periodontal debridement was performed initially in one case but did not resolve clinical signs. Subsequently, all 3 cases underwent extraction of the axially rotated teeth per os without complication. Follow‐up indicated remission of periodontitis and signs of oral pain. In these cases, maxillary CT had erupted in a manner that resulted in axial rotation of CT with undulating buccal and palatal surfaces aligned with the interproximal surfaces of adjacent normally orientated teeth. This resulted in poor interproximal compression and diastemata causing severe periodontitis. Axially rotated maxillary CT and the severe periodontitis that they precipitate, have not been previously described as a discrete dental disease entity.  相似文献   

5.
Objective: To report the technique and results of cheek teeth repulsion in standing, sedated horses. Study Design: Case series. Animals: Horses (n=12), ponies (6). Methods: Medical records (2006–2009) of horses that had cheek tooth repulsion while standing were reviewed. Inclusion criteria included: maxillary or mandibular cheek tooth disease diagnosed by clinical and radiographic examination where attempted oral extraction failed necessitating repulsion. Horses were sedated and a local nerve block performed. Intraoperative radiographs facilitated instrument positioning and ensured repulsion of all dental remnants. Alveolar cavities were packed postoperatively and secondary dental sinusitis treated with lavage. Results: Median horse age was 7 years (range, 1–30 years). Maxillary (n=15) and mandibular (5) cheek teeth were removed successfully. One horse was euthanatized 1 week after tooth removal because of concurrent liver disease and 10 horses (59%) had resolution of discharge after the 1st treatment; 41% of extractions required follow‐up medical or surgical treatment to resolve signs [6/12 maxillary sinusitis and 1/5 persistent mandibular drainage]. Conclusions: Standing repulsion of diseased and fractured cheek teeth is an effective means of resolving clinical signs of dental disease when oral extraction fails. Chronic sinus involvement increased the risk of postextraction surgical treatment for sinusitis.  相似文献   

6.
OBJECTIVE: To determine short- and long-term outcomes, including recurrence rates, for horses with cecal impaction treated medically or surgically. DESIGN: Retrospective case series. ANIMALS: 114 horses. PROCEDURES: Medical records were reviewed for information on signalment, history, clinical findings, treatment (medical vs surgical), and short-term outcome. Information on longterm outcome was obtained through a mail survey and telephone interview with owners. RESULTS: 54 horses were treated medically, 49 horses were treated surgically, and 11 horses were euthanized after initial examination without further treatment. Horses treated surgically were significantly more likely to have signs of moderate or severe pain than were horses treated medically. Forty-four of the 54 (81%) horses treated medically were discharged from the hospital. Twelve of the 49 horses treated surgically were euthanized at surgery because of cecal rupture. Thirty-five of the 37 (95%) horses that were allowed to recover from surgery were discharged from the hospital. In 34 horses treated surgically, typhlotomy without a bypass procedure was performed. Long-term (>or= 1 year) follow-up information was available for 19 horses treated medically and 28 horses treated surgically. Eighteen (95%) and 25 (89%) of the horses, respectively, were alive at least 1 year after treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that medical and surgical treatment were both associated with favorable outcomes in horses with cecal impactions. In this population, typhlotomy alone without cecal bypass was associated with a low recurrence rate. The long-term prognosis for horses that were discharged from the hospital was good.  相似文献   

7.
The objective was to determine the prognostic features and long‐term outcome of withers fractures in horses. Medical records and radiographs of 14 horses with withers fractures from 2 veterinary teaching hospitals were reviewed. Case details, presentation, clinical signs, radiographs, treatment and outcome were assessed. In all cases, withers fractures were found to occur following a fall on the back. Although horses were often presented with severe acute clinical signs, the long‐term prognosis was good, in the absence of neurological signs, and following extended conservative management (an approximate 6 month rest period).  相似文献   

8.
BACKGROUND: Mycotic rhinitis is an uncommon disease in horses with a wide range of clinical signs and treatment options based on case studies of a single or only a few individuals. Moreover, while dogs with mycotic rhinitis appear to respond well to treatment with topical enilconazole, this approach has yet to be reported in horses. OBJECTIVES: The aim of this study was to describe the clinical findings, results of diagnostic investigations, treatment, and outcome in horses with mycotic rhinitis treated with topical enilconazole. ANIMALS: Eight horses were included in the study. METHODS: Medical records from 1995 to 2007 from an equine veterinary teaching hospital were reviewed to identify cases with a diagnosis of mycotic rhinitis. RESULTS: Eleven cases were identified, of which 8 were treated with topical enilconazole. Seven of those 8 horses recovered and had normal appearance of the nasal passages on endoscopic examination. Fungal culture, where positive, yielded only Aspergillus spp. Treatment was readily performed and no adverse effects were noted in these horses. In 5 horses, long-term follow-up revealed complete recovery for an average of 5 years. CONCLUSIONS AND CLINICAL IMPORTANCE: Mycotic rhinitis owing to Aspergillus spp. in horses can be effectively and safely treated with topical enilconazole.  相似文献   

9.
Medical records of 7 adult horses with single or multiple ligament failure of the femorotibial ligaments were reviewed to evaluate signalment, history, diagnostic and treatment methods, outcome, and long-term follow-up information. Acute onset of lameness was recorded for most of the horses. Horses with multiple ligament injury had more severe clinical signs than did horses with single ligament injury. Horses with single ligament injury generally required manipulative tests to localize the lameness to the stifle. In all horses, radiography of the stifle assisted in the diagnosis. Horses either were euthanatized (n = 3) or were treated by stall rest (n = 4) after diagnosis. Of the 4 surviving horses, 2 became successful breeding animals, 1 was awaiting breeding, and 1 was used unsuccessfully as a breeding animal. Necropsy findings in 2 of the 3 horses euthanatized after diagnosis revealed early articular damage in 1 horse 1 day after injury, and degenerative joint disease in the other horse 1 year after injury.  相似文献   

10.
Reasons for performing study: There is minimal published information on equine oromaxillary fistulae that are unrelated to cheek teeth (CT) repulsion or on the conservative treatment of these atypical fistulae. Objectives: To report equine oromaxillary fistulae unrelated to CT extraction and describe their management in standing horses. Methods: Case details of oromaxillary fistulae of atypical aetiology occurring at 2 referral centres between 2002–2006, including their treatment and response to treatment were examined. Results: Nine cases of oromaxillary fistula were recorded, mainly in aged horses (median 22 years). Fistulae were associated with CT diastemata in 7 cases, fractured CT in one and a central defect in a worn CT in another. After removing food and exudate from the sinuses, 6 cases were treated successfully by filling the diastema or dental defect with polymethylmethacrylate (PMMA). Following dental extraction, the other 3 cases were treated successfully by use of PMMA alveolar packing. Conclusion: Older horses can spontaneously develop oromaxillary fistulae, usually secondary to CT diastemata. In the absence of apical infection, this disorder can usually be treated successfully in standing horses by treating the sinusitis and sealing the oral aspect of the diastema with PMMA. Potential relevance: Older horses with sinusitis should be assessed for the presence of CT diastemata and oromaxillary fistulae. If detected, these disorders can be treated successfully in the standing horse.  相似文献   

11.
REASONS FOR PERFORMING STUDY: The spectrum of clinical presentation, methods of diagnosis, management and prognosis in cases of sinunasal cysts (SNCs) requires more extensive study. Despite the extensive nature of SNCs, the prognosis for afflicted horses appears to have improved since earlier studies were conducted. OBJECTIVES: To evaluate prognosis and cosmetic outcome of surgical ablation in 52 cases of SNCs. METHODS: Fifty-two case records (1982-2005) of horses affected with SNCs were retrieved from the archives. Subject details, clinical signs, diagnostic techniques, surgical management and post surgical complications were extracted. Owners and referring veterinarians were contacted to assess the results of treatment. RESULTS: There was no biphasic age distribution. The major presenting signs in descending order of frequency were facial swelling, mucopurulent nasal discharge, nasal airflow obstruction and abnormal respiratory noise. Common endoscopic findings included narrowed nasal meati, a cyst in the nasal cavity and a cyst visible caudal to the nasal septum viewed from the contralateral unaffected nasal meatus. Typical radiological signs included a discrete mass in the sinunasal region, a diffuse increase in opacity over the sinunasal region, free fluid lines, nasal septal deviation, expansion of the ventral conchal sinus and distortion of dental apices. Cyst extirpation using an osteoplastic flap provided a successful outcome. Forty-five of 48 horses showed complete resolution of clinical signs after subtotal or total extirpation of the cyst wall. Follow-up information was not available for the other 3 horses. Thirty-nine of 45 horses had a good to fair cosmetic appearance, judged to be good in 26 horses, fair in 13 and poor in 6. Results confirmed that the prognosis for full recovery has improved since a previous report of 15 cases. CONCLUSIONS AND POTENTIAL RELEVANCE: Equine sinunasal cysts may arise in horses of any age; presenting signs should alert clinicians to their likely presence. A discrete well-circumscribed mass found during radiographic examination provides supporting evidence of a cyst. The vivid yellow, translucent, seromucoid fluid aspirated from cysts is characteristic of the condition.  相似文献   

12.
The accuracy of using radiographs to diagnose cervical facet osteoarthritis (CFA) in horses is undetermined. Further investigation is required to determine the clinical significance of radiographic evidence of CFA, the prevalence of radiographic changes in horses without clinical signs, and the long-term efficacy of intra-articular CFA treatment. The objectives of this study is to compare degenerative changes of the cervical facet joints of the cervical vertebrae on radiographs of horses with clinical signs of CFA with healthy cohort-matched horses, to compare clinical findings between groups, and to obtain follow-up information on the long-term outcome in treated horses. This is a retrospective case-control cohort-matched comparison study of horses treated for cervical facet disease versus horses with no clinical signs of cervical facet disease. Horses diagnosed with CFA and treated with intra-articular injection of corticosteroids were included. Follow-up information on recovery from treatment was obtained via telephone survey of owners/trainers. Healthy horses with no clinical signs of CFA were matched to treated horses by breed, sex, age, and sport as the control group. Two blinded radiologists reviewed cervical spine radiographs for each horse and recorded CFA score and intravertebral/intervertebral measurements. Clinical and radiographic parameters were compared between treatment and control groups. There was a significant difference in CFA grades for C5-6 and C6-7 between horses with presence of clinical signs and healthy horses. However, interobserver agreement between radiologists for grading CFA was moderate and only 56% of values were identical for both observers. Atrophy of the neck was present on clinical examination in most cases in the treatment group. Dressage horses were overrepresented. Overall, 64% of horses returned to their previous level of performance after treatment. Clinical examination data collected for the treatment group were retrospective and were obtained by different clinicians. Eight owners/trainers were not able to be reached for the survey. There was a significant difference in CFA grades for C5-6 and C6-7 between horses with presence of clinical signs and healthy horses. Despite these statistical differences, the clinical diagnosis of CFA based on radiographic grading alone is questionable because of the lack of agreement between the radiologists. To strengthen the diagnosis, clinical signs of facet disease, in particular atrophy of the neck muscles, need to be present to make this diagnosis. Intra-articular corticosteroid injection was effective at allowing most treated horses to return to athletic use..  相似文献   

13.
Objective: To describe surgical technique and outcome in 10 horses with impacted cheek teeth that were removed by a transcortical osteotomy and buccotomy technique. Study Design: Case series. Animals: Horses (n=10) with impacted cheek teeth. Methods: Medical records (2002–2008) of horses with impacted cheek teeth requiring removal were reviewed; surgical technique and outcome were determined. Results: Exodontia of 11 cheek teeth was performed surgically in 10 horses; 3 horses had complications (residual swelling of the mandible) that resolved and all horses returned to their previous use. Conclusions: Transcortical buccotomy technique is effective for removal of incompletely erupted impacted cheek teeth in horses and has a good long‐term prognosis for remission of clinical signs. Clinical Relevance: Transcortical buccotomy approach is an effective technique for removal of unerupted impacted equine cheek teeth.  相似文献   

14.
Objective: To describe the diagnosis and treatment of fractures of the deltoid tuberosity. Study Design: Case series. Methods: Medical records (1992–2009) of 19 horses with radiographic confirmation of deltoid tuberosity fractures were reviewed. Data retrieved included signalment, clinical and diagnostic imaging findings, and treatment. Outcome was determined by telephone questionnaire of owners and referring veterinarians. Results: Most horses were markedly lame on admission and 53% had reduced protraction of the affected limb. All fractures were identified on a cranio45° medial‐caudolateral oblique projection; however, only 32% (6 horses) were detected on a mediolateral projection whereas 86% were evident ultrasonographically. Treatment by local wound care and stall rest resulted in return to athletic function without lameness for 13 of 14 horses that had follow‐up. Conclusions: A cranio45° medial‐caudolateral oblique radiographic view was better than a mediolateral projection for identification of deltoid tuberosity fractures. Ultrasonographic detection of fractures was similar except when gas accumulation obscured the fracture site. Deltoid tuberosity fractures can cause severe lameness but can be treated successfully with conservative management.  相似文献   

15.
OBJECTIVE: To identify clinical signs, underlying cardiac conditions, echocardiographic findings, and prognosis for horses with congestive heart failure. DESIGN: Retrospective study. ANIMALS: 14 horses. PROCEDURE: Signalment; history; clinical signs; clinicopathologic, echocardiographic, and radiographic findings; treatment; and outcome were determined by reviewing medical records. RESULTS: All 14 horses were examined because of a heart murmur; tachycardia was identified in all 14. Twelve horses had echocardiographic evidence of enlargement of 1 or more chambers of the heart. Other common clinical findings included jugular distention or pulsation, crackles, cough, tachypnea, and ventral edema. Nine horses had signs consistent with heart failure for > 6 days. Underlying causes for heart failure included congenital defects, traumatic vascular rupture, pericarditis, pulmonary hypertension secondary to heaves, and valvular dysplasia. Seven horses were euthanatized after diagnosis of heart failure; 5 were discharged but were euthanatized or died of complications of heart disease within 1 year after discharge. The remaining 2 horses were discharged but lost to follow-up. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that congestive heart failure is rare in horses. A loud heart murmur accompanied by either jugular distention or pulsation, tachycardia, respiratory abnormalities (crackles, cough, tachypnea), and ventral edema were the most common clinical signs. Echocardiography was useful in determining the underlying cause in affected horses. The long-term prognosis for horses with congestive heart failure was grave.  相似文献   

16.
OBJECTIVE: To determine clinical signs, results of diagnostic testing, and outcome in horses with internal Corynebacterium pseudotuberculosis infection. DESIGN: Retrospective study. ANIMALS: 30 horses. PROCEDURE: Information pertaining to clinical data, results of diagnostic tests, and costs of hospitalization and treatment was extracted from medical records of affected horses. RESULTS: Internal C. pseudotuberculosis infection was diagnosed on the basis of clinical signs, diagnostic imaging, and clinicopathologic data, including results of serologic tests and bacterial culture. The most common clinical signs were concurrent external abscesses, anorexia, fever, lethargy, weight loss, and signs of respiratory tract disease or abdominal pain. Clinicopathologic abnormalities included a geometric mean reciprocal serum synergistic hemolysin inhibition titer > or = 512, leukocytosis with neutrophilia, hyperglobulinemia, hyperfibrinogenemia, and anemia. Specific organ involvement was diagnosed in 27 of 30 horses. Affected organs included the liver (18 horses), lungs (12), kidneys (7), and spleen (3); multiple organs were affected in 10 horses. Treatment with antimicrobials for a median of 36 days (range, 7 to 97 days) was usually successful, yielding an overall survival rate of 71%. CONCLUSIONS AND CLINICAL RELEVANCE: Early diagnosis and long-term antimicrobial treatment were important for a successful outcome in horses with internal C. pseudotuberculosis infection. Ultrasonographic imaging was an important technique for identifying specific organs affected, aiding in obtaining samples for a definitive diagnosis, and monitoring response to treatment. Pregnant mares with internal infections are at risk for fetal loss. Preexisting chronic organ disease may be associated with a poor prognosis.  相似文献   

17.
A review of 400 horses referred because of dental disorders showed 44 cases to suffer from primary disorders of their incisors and 11 from canine or 1st premolar teeth disorders. The remaining 345 horses suffered from primary disorders of the cheek teeth. Disorders of incisors included traumatic damage to teeth and their supporting bones, retained deciduous, displaced and supernumerary incisors; brachygnathia and abnormalities of wear, with most of the latter disorders being secondary to primary disorders of the cheek teeth Only 3 cases of apical infection of incisors were recognised. Most cases of fractured incisors responded well to conservative therapy. Retained deciduous incisors were extracted, but most cases with supernumerary and displaced incisors, or brachygnathia were treated conservatively. Most disorders of the canine and 1st premolar were developmental displacements that caused bitting problems (abnormalities of head movement associated with the bit), and these cases responded well to extraction of the displaced teeth.  相似文献   

18.
CASE DESCRIPTION: 3 Horses were examined and treated because of sudden onset of signs of abdominal pain. CLINICAL FINDINGS: All horses had a retrosternal (Morgagni) hernia involving the right side of the diaphragm. In each horse, the large colon was incarcerated in a right muscular defect in the diaphragm with a large hernial sac. TREATMENT AND OUTCOME: Definitive surgical repair of the hernia was not performed during the initial celiotomy. The hernia was repaired with mesh herniorrhaphy, but without resection of the hernia sac in 2 horses. For 1 horse, conservative management was applied. In the 2 horses treated with surgical correction, no major postoperative complications developed, and all 3 horses have been free of signs of abdominal pain. CLINICAL RELEVANCE: Horses with retrosternal hernias involving the diaphragm can develop clinical signs of intermittent obstruction of the large colon and chronic colic. In horses, retrosternal diaphragmatic hernias appear to develop exclusively in the right ventral aspect of the diaphragm and could represent an embryologic defect of diaphragm formation. Affected horses can be successfully treated with mesh herniorrhaphy or, in some instances, with conservative management.  相似文献   

19.
REASONS FOR PERFORMING STUDY: There have been no previously published large case series describing short- and long-term outcome of transarterial coil embolisation (TCE) in horses with guttural pouch mycosis (GPM). OBJECTIVES: To describe the clinical and surgical features of horses with GPM presented at the Veterinary School of Lyon during a 28 month period; and to evaluate immediate to long-term results of TCE as a treatment. METHODS: Medical records of all horses with GPM treated with TCE between February 1999 and July 2002 were analysed. To be included in the study, no other surgical or medical treatment for the mycosis was administered. Subject details, case history and results of initial clinical examination and endoscopy were reviewed. For all individuals, evaluation of long-term complications and case evolution was based on owner or trainer interviews between 24 and 41 months after surgery. RESULTS: Thirty-one horses were identified with unilateral (n = 25) or bilateral (n = 6) GPM affecting only the medial (n = 28), only the lateral (n = 2) or both compartments simultaneously (n = 7). Of the 23 individuals presented with epistaxis, 20 showed complete resolution of the problem. Of the 19 horses presented with neurological signs, 2 were subjected to euthanasia for persistence of severe dysphagia. Prognosis for survival was excellent (84%) and prognosis for return at the level expected by the owner or trainer was good (71%). CONCLUSIONS AND POTENTIAL RELEVANCE: TCE of horses affected with GPM is an effective method of preventing haemorrhage and resolving the majority of mycotic lesions without further specific treatment. Treated horses did not present relapse of mycosis during the follow-up period.  相似文献   

20.
Scintigraphy, with 99mTechnetium methylenediphosphonate (99mTc-MDP) and 99mTc-labelled leucocytes, was compared to radiography in the diagnosis of dental disease in the horse in a prospective case-controlled study, comprising 30 horses with clinical signs of dental disease and 30 control horses. In each case, right and left lateral, ventral and dorsal soft tissue and bone phase scintigraphic images were obtained after i.v. injection of 1 GBq/100 kg bwt 99mTc-MDP, using a gamma camera. The same views were acquired in 10 horses with clinical signs of dental disease and 12 control horses after injection of 99mTc-labelled leucocytes. Standard radiographic projections of the paranasal sinuses and of the apices of the maxillary and mandibular teeth were obtained. The scintigraphs and radiographs were assessed subjectively by 2 board-certified surgeons and one board-certified radiologist, with extensive experience of equine radiology, from who the clinical history was withheld. Sensitivity, specificity and kappa, as a measure of agreement, were calculated for the different methods. Bone phase images were also scored subjectively on a scale from 0 to 3 on the basis of isotope uptake over the teeth. Regions of interest were defined over the teeth, and normal teeth compared to diseased counterparts. Total scintigraphic counts were related to the age of the animal and to the disease process. Differences in density ratios between left and right teeth were evaluated using the Mann-Whitney Test. Dental disease was confirmed in 22 horses at surgery or postmortem examination. Horses with dental disease showed a significant increase in scintigraphic activity over the affected tooth compared to the contralateral tooth, with a typical pattern for different diseases. The sensitivity of scintigraphy with 99mTc-MDP proved to be excellent (95.5%), whereas the specificity was moderate (86.4%). In contrast, radiography had excellent specificity (95.0%) and a low sensitivity (51.5%). The greatest sensitivity and specificity were achieved by evaluating radiographs and scintigrams together. The objective scintigraphic density ratios were found to be significantly different between diseased and control horses. The results of this study suggest that, if a density ratio of 1.5 or greater between a suspected diseased tooth and its contralateral number is regarded as abnormal, only 1% false positive diagnoses and 20% false negative diagnoses will occur. In contrast, scintigraphy with 99mTc-labelled leucocytes was not very successful, due to the lack of anatomical detail provided by this technique, which made identification of the diseased tooth impossible. Accurate radiographic interpretation of dental disease presents difficulties, both in terms of missed diagnoses and mistaken diagnoses. Scintigraphy complements radiographic examination of dental structures by providing information important for accurate diagnosis and is, therefore, conceived to be essential for selection of the appropriate treatment for dental disease.  相似文献   

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