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1.
The case records of 49 horses with proximal sesamoid bone fracture were studied. The population consisted of 20 Thoroughbreds, 20 Standardbreds, 5 Quarter Horses, 2 Arabians, and 2 grade horses. The fractured bones were classified into 5 categories: apical fractures, basilar fractures, abaxial fractures, middle one-third fractures, and bilateral comminuted-distracted fractures. Apical fractures occurred most frequently in the Standardbred, with the prevalence of medial fracture being equal to that of lateral fracture. Basilar fractures occurred predominantly in the Thoroughbred, with the highest prevalence in the lateral sesamoid bone of the right front fetlock. Bilateral comminuted-distracted fractures also occurred primarily in the right front fetlock. The prognosis following surgical removal of apical fractures appeared to be superior to that for stall rest alone. The prognosis for basilar fractures was poor.  相似文献   

2.
OBJECTIVE: To evaluate plasma epinephrine and norepinephrine concentrations and serum cortisol concentration in horses with colic and assess the relationship of these variables with clinical signs, routinely measured clinicopathologic variables, and outcome in affected horses. DESIGN: Prospective observational study. ANIMALS: 35 horses with colic. PROCEDURE: Blood samples were collected within 30 minutes of arrival at the veterinary hospital from horses referred because of colic. Plasma and serum samples were analyzed for cortisol, epinephrine, norepinephrine, lactate, and electrolyte concentrations and acid-base variables. Heart rate at admission and outcome (survival or nonsurvival) were recorded. Univariate logistic regression was used to calculate crude (unadjusted) odds ratios and 95% confidence intervals. RESULTS: Of the 35 horses with colic, 26 survived. Higher plasma epinephrine, plasma lactate, and serum cortisol concentrations were significantly associated with increased risk of nonsurvival, but plasma norepinephrine concentration was not associated with outcome. Plasma epinephrine concentration was significantly correlated with heart rate (r = 0.68), plasma lactate concentration (r = 0.87), blood pH (r = -0.83), anion gap (r = 0.74), and base excess (r = -0.81). CONCLUSIONS AND CLINICAL RELEVANCE: The risk of death appears to be greater in colic-affected horses with high circulating concentrations of epinephrine and cortisol. The correlation of epinephrine with other biochemical markers of illness severity and with heart rate indicates that the degree of sympathetic activation in horses with colic can be inferred from routinely measured variables.  相似文献   

3.
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4.
OBJECTIVE: To determine the distribution for limbs and bones in horses with fractures of the proximal sesamoid bones and relationships with findings on palmarodorsal radiographic images. SAMPLE POPULATION: Proximal sesamoid bones obtained from both forelimbs of cadavers of 328 racing Thoroughbreds. PROCEDURE: Osteophytes; large vascular channels; and fracture location, orientation, configuration, and margin distinctness were categorized by use of high-detail contact palmarodorsal radiographs. Distributions of findings were determined. Relationships between radiographic findings and fracture characteristics were examined by use of chi2 and logistic regression techniques. RESULTS: Fractures were detected in 136 (41.5%) horses. Biaxial fractures were evident in 109 (80%) horses with a fracture. Osteophytes and large vascular channels were evident in 266 (81%) and 325 (99%) horses, respectively. Medial bones typically had complete transverse or split transverse simple fractures, indistinct fracture margins, > 1 vascular channel that was > 1 mm in width, and osteophytes in abaxial wing and basilar middle or basilar abaxial locations. Lateral bones typically had an oblique fracture and distinct fracture margins. Odds of proximal sesamoid bone fracture were approximately 2 to 5 times higher in bones without radiographic evidence of osteophytes or large vascular channels, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Biaxial fractures of proximal sesamoid bones were common in cadavers of racing Thoroughbreds. Differences between medial and lateral bones for characteristics associated with fracture may relate to differences in fracture pathogeneses for these bones. Osteophytes and vascular channels were common findings; however, fractures were less likely to occur in bones with these features.  相似文献   

5.
OBJECTIVE: To evaluate the use of arthroscopy as the primary method for removal of large patellar fracture fragments. DESIGN: Retrospective study. ANIMALS: 5 performance horses of various breeds with patellar fractures. PROCEDURE: Clinical signs of lameness, external evidence of injury, and radiography were used to diagnose and determine fracture orientation. Arthroscopy of the stifle joint was performed on the affected limb with the horse positioned in dorsal recumbency and under general anesthesia. Progress after surgery was determined by evaluating medical records and via telephone conversations with owners. RESULTS: 4 of 5 horses had fractures of the medial aspect of the patella and 1 horse had a fracture of the lateral aspect of the patella. There were no postoperative complications with the joint or the arthroscopic portal incisions. Recovery periods ranged from 3 to 5 months. All horses recovered completely from surgery, and performed at the same or higher level of competition as before arthroscopy. CONCLUSIONS AND CLINICAL RELEVANCE: Femoropatellar joint arthroscopy is a favorable means by which evaluation of the stifle joint and removal of large fracture fragments can be achieved with negligible postoperative complications.  相似文献   

6.
OBJECTIVE: To detect subclinical disseminated intravascular coagulation (DIC) in horses with colitis and to determine any association between the diagnosis of subclinical DIC and outcome or occurrence of complications in horses with colitis. DESIGN: Prospective study. ANIMALS: 37 horses admitted to a veterinary teaching hospital for treatment of acute colitis. PROCEDURE: Coagulation profiles were obtained on each horse 0, 24, and 48 hours after admission. Six tests were performed: platelet count, plasma fibrinogen concentration, prothrombin time, activated partial thromboplastin time, antithrombin activity, and serum fibrin degradation products concentration. RESULTS: A clinicopathologic diagnosis of subclinical DIC was made if 3 of the 6 tests had abnormal results at any 1 sample period. No horse had clinical signs of DIC at the time of sampling. Twelve of 37 (32%) horses met the criteria for diagnosis of subclinical DIC within a 1-year period. Outcome was defined as survival or nonsurvival. Five of 12 horses with subclinical DIC and 2 of 25 horses without subclinical DIC did not survive. Crude odds ratio analysis revealed a horse with acute colitis was 8 times as likely to die or be euthanatized if a diagnosis of subclinical DIC was made. CONCLUSIONS AND CLINICAL RELEVANCE: Clinicopathologic evidence of DIC is common and is significantly associated with a poor outcome in horses with acute colitis. Treatment of subclinical DIC may influence outcome in horses with acute colitis.  相似文献   

7.
OBJECTIVE: To characterize clinical signs, clinicopathologic features, treatments, and survival in dogs with naturally acquired foodborne aflatoxicosis. DESIGN: Retrospective case series. ANIMALS: 72 dogs that consumed aflatoxin-contaminated commercial dog food. PROCEDURES: Medical records of affected dogs were reviewed. Between December 2005 and March 2006, dogs were identified as having foodborne aflatoxin hepatotoxicosis on the basis of the history of consumption of contaminated food or characteristic histopathologic lesions (subject dog or a recently deceased dog in the same household or kennel). Recorded information included signalment, clinical features, clinicopathologic test results, treatments, and survival. Data were analyzed by survival status. RESULTS: Most dogs were of large breeds from breeding kennels. No significant differences were found in age or weight between 26 (36%) survivor dogs and 46 (64%) nonsurvivor dogs. Severity of clinical signs varied widely; 7 dogs died abruptly. In order of onset, clinical features included anorexia, lethargy, vomiting, jaundice, diarrhea (melena, hematochezia), abdominal effusion, peripheral edema, and terminal encephalopathy and hemorrhagic diathesis. Common clinicopathologic features included coagulopathic and electrolyte disturbances, hypoproteinemia, increased serum liver enzyme activities, hyperbilirubinemia, and hypocholesterolemia. Cytologic hepatocellular lipid vacuolation was confirmed in 11 dogs examined. In comparisons of clinicopathologic test results between survivor and nonsurvivor dogs, only granular cylindruria (7/21 dogs) consistently predicted death. Best early markers of aflatoxicosis were low plasma activities of anticoagulant proteins (protein C, antithrombin) and hypocholesterolemia. Despite aggressive treatment, many but not all severely affected dogs died. CONCLUSIONS AND CLINICAL RELEVANCE: Serum liver enzyme activities and bilirubin concentration were unreliable early markers of aflatoxin hepatotoxicosis in dogs. Hypocholesterolemia and decreased plasma protein C and antithrombin activities may function as exposure biomarkers.  相似文献   

8.
OBJECTIVE: To characterize an outbreak of West Nile virus (WNV) infection in horses in North Dakota in 2002, evaluate vaccine effectiveness, and determine horse characteristics and clinical signs associated with infection. DESIGN: Retrospective study. ANIMALS: 569 horses. PROCEDURE: Data were obtained from veterinary laboratory records, and a questionnaire was mailed to veterinarians of affected horses. RESULTS: Affected horses were defined as horses with typical clinical signs and seroconversion or positive results of virus isolation; affected horses were detected in 52 of the 53 counties and concentrated in the eastern and northeastern regions of the state. Among affected horses, 27% (n = 152) were vaccinated against WNV, 54% (309) were not, and 19% (108) had unknown vaccination status; 61 % (345) recovered, 22% (126) died, and 17% (98) had unknown outcome. The odds of death among nonvaccinated horses were 3 and 16 times the odds among horses that received only 1 or 2 doses of vaccine and horses that were vaccinated according to manufacturer's recommendations, respectively. Horses with recumbency, caudal paresis, and age > 5 years had higher odds of death, whereas horses with incoordination had lower odds of death, compared with affected horses without these characteristics. CONCLUSIONS AND CLINICAL RELEVANCE: Vaccination appears to have beneficial effects regarding infection and death caused by WNV.  相似文献   

9.
Background: Glucose homeostasis is dysregulated in critically ill humans resulting in hyperglycemia and decreased survival. Hyperglycemia is common in horses presenting with abdominal crisis, and this might be associated with a worse prognosis for survival.
Objective: To determine if hyperglycemia in horses with acute abdominal disease is associated with increased odds of failure to survive to hospital discharge.
Animals: Two hundred and twenty-eight adult horses with acute gastrointestinal disease.
Methods: Observational retrospective study. Records of horses > 1 year of age presenting for treatment of colic over a 3-year period were reviewed. Data collected included age, duration of colic, glucose, heart rate, PCV, total protein, anion gap, cost of hospitalization, breed, sex, pain at admission, diagnosis, whether surgery was performed, and life status at hospital discharge. Potential risk factors for nonsurvival were screened by univariable logistic regression and the best-fitting univariable model was used as the basis for multivariable regression modeling.
Results: Mean blood glucose was 155 mg/dL (8.5 mM) with 45% of the population above the reference range; 16.7% (38 of 228) of horses had severe hyperglycemia (>195 mg/dL; 10.7 mM). Factors associated with increased odds of failure to survive included glucose, severity of pain at admission, heart rate, PCV, anion gap, and diagnosis. The best-fitting multivariable model included glucose and diagnosis, with age included as a confounding variable. The model correctly classified outcome for 92.5% of horses.
Conclusions and Clinical Importance: This study has confirmed prior reports that hyperglycemia is common in horses with colic and is associated with a worse prognosis for survival to hospital discharge.  相似文献   

10.
Fractures of the proximal sesamoid bones (PSBs) range in severity from simple to complex and comminuted and can be articular or nonarticular. The majority of PSB fractures are diagnosed in racehorses, but PSB fractures, especially simple ones, do occur in sport horses undertaking various disciplines. For simple apical, basilar and abaxial articular PSB fractures, surgical removal via arthroscopy carries the best prognosis for return to athletic performance. Removal of apical and abaxial PSB fractures generally result in a favourable prognosis for return to racing but are dependent on the amount of suspensory ligament injury. Removal of basilar PSB fracture fragments results in a less favourable or fair prognosis for return to racing. Mid‐body PSB fractures typically require (lag screw) surgical fixation preferably with arthroscopic guidance and carry a fair to guarded prognosis for return to racing.  相似文献   

11.
Vertebral fractures in horses are relatively common and often occur due to trauma. Clinical signs may range from neck pain and mild neurological dysfunction to tetraplegia and death. Severity of signs and prognosis depends on extent of damage to the spinal cord. In this Case Report, serial radiographs, which track the bony changes associated with fracture healing, were performed over one year. Although surgical techniques have been described to repair fractures to the vertebrae, patients with minimal neurological deficit may have a favourable outcome with conservative medical management, as in this case.  相似文献   

12.
Although short-term survival rates following small intestinal resection reportedly range from 48-88%, there is little information on predicting which horse may or may not survive small intestinal (SI) resection and anastomosis. The aim of this study was to identify factors that contribute to nonsurvival in horses following small intestinal resection. Medical records of horses which recovered from anaesthesia following SI resection were reviewed. Clinical and surgical variables were evaluated for their association with short-term survival using logistic regression and were reported as odds ratios (OR), including the 95% confidence interval (CI), indicating the likelihood of horses not surviving to hospital discharge. Ninety-two records met the criteria for inclusion. Thirty-six (81.8%) of the horses that underwent jejunojejunostomy (JJ) and 34 (70.8%) of the horses that underwent jejunocaecostomy (JC) survived to discharge. Multiple logistic analysis indicated that postoperative ileus (OR = 29.7; 95% CI 2.5-354.6), repeat celiotomy (OR = 18; CI 1.7-187.6), and an elevated heart rate of > or = 60 beats/min (OR = 5.6; CI 1.5-20.6) were the principal factors associated with nonsurvival. A low total plasma protein of <55 g/l (OR = 1.8; CI 0.-7.6) was incorporated in the final model because its inclusion improved the overall validity of the model, Clinicians should be aware of the factors associated with the greatest likelihood of nonsurvival following small intestinal resection, so that they can institute aggressive treatment and accurately inform owners on the likelihood of survival.  相似文献   

13.
REASONS FOR PERFORMING STUDY: Studies on arthroscopic removal of apical proximal sesamoid fracture fragments in Thoroughbred (TB) horses age > or = 2 years have reported a high success rate. However, there are no reports documenting the racing prognosis of TB horses that undergo such surgery as weanlings or yearlings. OBJECTIVES: To describe the incidence of apical proximal sesamoid fractures in immature TB horses, age < 2 years and determine probability and quality of racing performance after arthroscopic removal of such fractures in 151 TB weanlings and yearlings. METHODS: The medical records of TB horses age < 2 years that underwent arthroscopic surgery for removal of apical proximal sesamoid fracture fragments were reviewed. Follow-up information was obtained from race records. Student's t tests were used to compare performance variables of operated racehorses to that of their maternal siblings. RESULTS: Ninety-two percent (139/151) of fractures occurred in the hindlimbs and 8% (11/151) in the forelimbs (fracture of both fore- and hindlimb, n = 1). Horses with forelimb fractures had a greatly reduced probability of racing (55%) compared to those with hindlimb fractures (86%). Overall, 84% of the horses raced post operatively and had performance records similar to that of their maternal siblings, 78% (787/1006) of which raced. CONCLUSIONS: Arthroscopic removal of apical proximal sesamoid fracture fragments in TB weanlings and yearlings carries an excellent prognosis for racing in horses with hindlimb fractures and a reduced prognosis in those with forelimb fractures. Medial fractures of the forelimb carry the worst prognosis. POTENTIAL RELEVANCE: The determination of prognosis increases knowledge on apical sesamoid bone fractures and potential for arthroscopic restoration of the ability to race; and enables the value of yearlings for subsequent sale to be established.  相似文献   

14.
For the past 2 years computed tomography is used at the Veterinary School, University of Zürich. This new imaging modality enables the detection of abnormalities occurring in small and large animals which were previously not visible with imaging techniques. Subjects of this study were a foal and a small pony, both with suspected head trauma. Routine radiography could not explain any of the neurological deficiencies. In the first case a basilar skull fracture along with a focal brain hemorrhage was detected, in the second case multiple basilar skull fractures were seen. The computed tomographic examination after intravenous injection of an iodine-containing contrast medium also revealed epidural hemorrhage. These two cases demonstrate the diagnostic use of computed tomography as an extremely valuable asset when diagnosing head trauma in horses.  相似文献   

15.
OBJECTIVE: To determine the outcome of horses with basal fractures of the proximal sesamoid bone from which a fracture fragment involving a portion of the base of the bone was removed arthroscopically and to determine whether fragment size was associated with outcome. DESIGN: Retrospective study. ANIMALS: 26 horses. PROCEDURE: Dorsopalmar and axial-abaxial lengths of the fracture fragment were measured on the dorsopalmar and mediolateral radiographic views, respectively, and percentage of the base of the sesamoid bone involved was estimated. Fractures were classified as grade 1 (< or = 25% of the base involved) or grade 2 (> 25% but < 100% of the base involved). Outcome was classified as successful if the horse started at least 2 races or unsuccessful if the horse started only 1 race or failed to return to racing. RESULTS: There were 24 racehorses and 2 nonracehorses. Twelve (50%) of the racehorses returned to racing and started at least 2 races. Eight of 14 horses with grade-1 fractures and 4 of 10 horses with grade-2 fractures had a successful outcome. Ten of 16 horses without associated articular disease had successful outcomes, compared with 2 of 8 horses with associated articular disease. However, fragment size and presence of associated articular disease were not significantly associated with outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Horses with basal fractures of the proximal sesamoid bone from which a fracture fragment involving a portion of the base of the bone is removed arthroscopically have a fair prognosis for return to racing.  相似文献   

16.
Colonic luminal pressure (median, range) measured during ventral midline celiotomy in 69 horses with strangulating obstruction (SO) of the large colon (SO; ≥ 270° large colon volvulus; 27 cm H2O: 2 to 80 cm H2O) was greater ( P =.0023) than that measured in 37 horses with nonstrangulating obstruction (NSO) of the large colon (NSO; ≤ 180° volvulus or a nonstrangulating displacement; 18 cm H2O; 6 to 46 cm H2O). Sixty-five percent (45 of 69) of horses with SO and all horses with NSO survived. Survival analysis was restricted to 59 horses with large-colon SO that survived to hospital discharge or met the criteria specified for classification as nonsurvivors. Colonic luminal pressure in nonsurvivors (48.5 cm H2O; 34 to 80 cm H2O) was higher ( P =.0001) than that measured in survivors (18 cm H2O; 2 to 50 cm H2O) of SO. From response operating characteristic curves, a luminal pressure of 38 cm H2O optimized the distribution of horses with SO into survivor and nonsurvivor groups. Sensitivity, specificity, and positive and negative predictive values for a colonic luminal pressure greater than 38 cm H2O in predicting nonsurvival were 0.89, 0.91, 0.72 and 0.97, respectively. Measurement of colonic luminal pressure may be useful for predicting survival in horses with colonic volvulus.  相似文献   

17.
Between January 1977 and June 1980, 38 Standardbred and 23 Thoroughbred horses had fractured distal splint bones removed surgically. Standardbred horses were treated significantly more frequently compared with the hospital population. The incidence of distal splint bone fractures in the front legs was significantly greater (p 0.05) than in the rear legs in both breeds. Associated suspensory desmitis was present in 81% of Standardbred and 67% of Thoroughbred horses at the time of surgery.
The most common radiographic sign was fracture with associated callus. It was not possible to correlate preoperative radiographic signs with presence of associated suspensory desmitis. One Thoroughbred horse developed a large mass of amorphous bone at the surgical site which required a second surgical procedure.
Follow-up information was available on 21 of 38 Standardbred and 17 of 23 Thoroughbred horses. There was no correlation found between preoperative radiographic signs or the location and number of distal splint bone fractures with postoperative results. Twenty-five percent of Standardbreds that had preoperative suspensory desmitis eventually reached at least their previous level of performance. None of the Thoroughbred racehorses with preoperative suspensory desmitis returned to their previous level of performance. Five of 17 Thoroughbred horses were pleasure horses, and all were reported "sound for intended use" following surgery; however, only four of five were used at their previous level of performance.
The significant feature in the prognosis of distal splint bone fractures in this series was the presence of associated suspensory desmitis. Postsurgical performance was limited by the recurrence of suspensory desmitis.  相似文献   

18.
OBJECTIVE: To determine the success rate and whether specific patient and treatment factors influenced the outcome after conservative treatment with a bar shoe with quarter clips of intra-articular fractures of the distal phalanx in horses not used for racing. DESIGN: Retrospective study. SAMPLE POPULATION: Thirty-two client-owned horses. PROCEDURE: Hospital records of horses that had been treated conservatively for intra-articular fractures of the distal phalanx at Skara Equine Hospital or Halland Animal Hospital in Sweden between 1995 and 2001 were reviewed. Racehorses in active training and horses affected with other musculoskeletal diseases were excluded from the study. Follow-up was performed by questionnaire and telephone inquires to the owners 1 to 7 years after injury. RESULTS: Twenty-two horses (69%) returned to their previous or expected level of use and did not wear their bar shoe when they were put back into training. There was no statistically significant correlation between outcome and patient or treatment variables, or bony union of the fracture. CONCLUSIONS AND CLINICAL RELEVANCE: Conservative treatment of intra-articular fractures of the distal phalanx carries a fair prognosis for return to previous or expected level of use in horses not used for racing. Radiographic evidence of fracture healing and age of the patient do not seem to influence the prognosis. Horses not used for racing do not need to be shod with a bar shoe with quarter clips for the rest of their athletic career.  相似文献   

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20.
OBJECTIVE: To identify risk factors for enterolithiasis in horses. DESIGN: Matched case-control study. ANIMALS: 26 horses with enteroliths, 104 horses with other causes of colic that underwent surgery (52 horses, surgical control group) or were treated medically (52 horses, nonsurgical control group). PROCEDURE: Medical records were reviewed for horses with enteroliths and control horses. Information collected included signalment, anamnesis, and findings on physical examination and clinicopathologic testing at admission. Horses with enteroliths and control horses were compared by means of conditional logistic regression to identify factors associated with enterolithiasis. RESULTS: Horses that were fed alfalfa hay, spent < or = 50% of time outdoors, or were Arabian or miniature breeds had an increased risk of developing enteroliths. Horses with enteroliths were more likely to have been hyperbilirubinemic and to have had clinical signs > 12 hours prior to admission. CONCLUSIONS AND CLINICAL RELEVANCE: Breed and diet appear to influence the risk of enterolithiasis; other management factors also may influence development of enteroliths. Duration of clinical signs may be longer and signs may be less severe among horses with enteroliths, compared with horses with other causes of colic.  相似文献   

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