RESUMEN

OBJECTIVE: To correlate substance P content of synovial fluid with prostaglandin E2 content, radiographic evidence of joint abnormality, and anatomic location of the joint for normal and osteoarthritic joints of horses. SAMPLE POPULATION: Synovial fluid from 46 normal joints in 21 horses and 16 osteoarthritic joints in 10 horses. PROCEDURE: Normal and osteoarthritic joints were identified by clinical and radiographic examination, by response to nerve blocks, during scintigraphy or surgery, or by clinicopathologic evaluation. Substance P and prostaglandin E2 contents of synovial fluid were determined by radioimmunoassay. Radio-graphs of joints were assigned a numeric score reflecting severity of lesions. Joints were assigned a numeric score reflecting anatomic location. RESULTS: Median concentrations of substance P and prostaglandin E2 were significantly increased in osteoarthritic joints, compared with normal joints. A significant correlation was found between concentrations of substance P and prostaglandin E2 in synovial fluid, but a correlation was not detected between substance P concentration in synovial fluid and anatomic location of the joint or between radiographic scores of osteoarthritic joints and concentrations of substance P or prostaglandin E2. CONCLUSIONS AND CLINICAL RELEVANCE: A correlation existed between concentrations of substance P and prostaglandin E2 in synovial fluid obtained from normal and osteoarthritic joints. However, content of substance P in synovial fluid cannot be predicted by the radiographic appearance of the joint or its anatomic location. Substance P and prostaglandin E2 may share an important and related role in the etiopathogenesis of osteoarthritis, lending credence to the importance of neurogenic inflammation in horses.

Asunto(s)

RESUMEN

OBJECTIVE: To document anatomic patterns of scintigraphic uptake and related orthopedic disease associated with racing activity in Standardbred horses. DESIGN: Retrospective study. ANIMALS: 64 Standardbred horses evaluated for lameness. PROCEDURE: Medical records at the time of discharge were reviewed, and information regarding signalment; history; results of lameness examination, scintigraphy, and radiography; diagnosis; and treatment were obtained. RESULTS: 274 areas of increased radiopharmaceutical uptake were identified. Scintigrams of 218 limbs (106 forelimbs, 112 hind limbs) were available for review. Seventy-three (33%) scintigrams had increased radiopharmaceutical uptake associated with the proximal sesamoids, 46 of 106 (43%) fore-limb scintigrams had increased uptake associated with the third carpal bone, and 33 of 112 (33%) hind limb scintigrams had radiopharmaceutical uptake associated with the small tarsal bones. Forty-three of 218 (20%) scintigrams had increased uptake associated with the distal aspect of the third metacarpal and metatarsal bones. Abnormal scintigraphic uptake was bilateral in 91 of 139 (65%) forelimb locations and 99 of 134 (74%) hind limb locations with increased radiopharmaceutical uptake. The primary scintigraphically identified classifications of disease were exercise-induced bone remodeling, synovitis or arthritis, and soft-tissue avulsion from bone (66, 17, and 6% of areas with increased radiopharmaceutical uptake, respectively). Of 274 areas with increased radiopharmaceutical uptake, 244 (89%) were believed to be clinically important. CONCLUSIONS AND CLINICAL RELEVANCE: Distinctive patterns of increased radiopharmaceutical uptake were identified that suggested Standardbred horses used for racing may have a predilection to develop orthopedic disease at specific sites that are distinct from those in Thoroughbreds used for racing and horses used for jumping activities.

Asunto(s)

RESUMEN

OBJECTIVE: To determine anatomic patterns and clinical importance of increased radiopharmaceutical uptake in bones of horses used for show jumping, hunting, and eventing. DESIGN: Retrospective study. ANIMALS: 141 horses evaluated because of lameness. PROCEDURE: Medical records were reviewed, and information on results of physical examination, radiography, and scintigraphy were obtained. Scintigrams were evaluated to identify areas of increased radio-pharmaceutical uptake. RESULTS: 834 areas of increased radiopharmaceutical uptake were identified. Scintigraphy of the vertebral column was performed in 78 horses, and 50 had areas of increased radiopharmaceutical uptake involving the spinous processes. Scintigraphy of the proximal phalanx of the forelimb was performed in 88 horses. Similarly, scintigraphy of the proximal phalanx of the hind limb was performed in 99 horses, and scintigrams of 374 proximal phalanges were available for review. One hundred fifty-five scintigrams had areas of increased radiopharmaceutical uptake. Scintigraphy of the tarsal joint was performed in 99 horses, and scintigrams of 198 joints were available for review. Eighty-five had areas of increased radiopharmaceutical uptake. Overall, 214 of 834 areas of increased radiopharmaceutical uptake were definitively associated with lameness. CLINICAL IMPLICATIONS: Results of this study suggest that jumping creates unique stresses on the bones of horses. The distinctive patterns of increased radiopharmaceutical uptake identified in this study suggest that horses used for jumping may have a predilection to develop orthopedic disease at specific sites distinct from those in racehorses.

Asunto(s)

RESUMEN

Seven horses with severe, persistent lameness of sudden onset were evaluated with scintigraphy and/or computed tomography. The lameness was localised to the front fetlock joint in 2 horses and to the tibiotarsal joint in 5 horses. Five of the horses had a history of intra-articular injections of the involved joint prior to presentation. All horses had effusion of the affected joint and were positive to flexion tests. Intraarticular anaesthesia eliminated or improved the lameness in 4 cases and a nerve conduction block proximal to the affected joint improved the lameness in another. Cytology examination of fluid from affected joints identified normal joint fluid (one horse) or elevations in nucleated cell counts of 0.9 x 10(9)/l-36.8 x 10(9)/l and total protein 20-42 g/l (6 horses). The joint fluid of 2 of these horses cultured positive for bacteria. Initial radiographs were either normal (4 cases) or the changes seen were not sufficient to explain the degree of lameness. In the 6 cases where scintigraphy was performed, intense focal isotope uptake was found in the suspected region, which corresponded to the proximal portion of the first phalanx (2 cases), distal tibia (2 cases), or talus (3 cases). Computed tomography (CT) was performed because occult fracture or osteomyelitis was suspected; and knowledge of the precise anatomical location of the lesion was considered necessary to assess the need for surgery and to plan the surgical approach. Hypodense focal lesions with hyperdense haloes were found in the subchondral bone deep to the sagittal groove of the first phalanx (P1) (2 cases) in the cochlea of the distal tibia (2 cases), and in the intertrochlear portion of the talus (3 cases). Communication between the lesion and the joint space was demonstrated by CT in 5 cases. Post mortem examination of one case revealed synovitis and a chronic bone abscess (Brodie's abscess) communicating with the joint space.

Asunto(s)

RESUMEN

Hypoplasia affecting both hind limbs was observed in a neonatal foal. Scintigraphy aided in establishing diagnosis and prognosis. Radiography revealed an abnormally shaped middle phalanx and lack of the distal phalanx and navicular bone in the right hind limb, with an abnormally shaped distal phalanx and navicular bone in the left hind limb. Scintigraphic findings were closely correlated with the radiographic findings. Radiographic and scintigraphic findings were confirmed at postmortem examination.

Asunto(s)

RESUMEN

The uptake of the bone-seeking radiopharmaceutical 99mTc-MDP by damaged skeletal muscle in horses is evaluated. Twenty-four hours following strenuous exercise, 109 racehorses with a history of inadequate athletic performance and subtle lameness were imaged using scintigraphic techniques. Ten horses (9.2 per cent) demonstrated abnormal uptake of the radioisotope within skeletal muscles. A muscle biopsy from one of these horses confirmed that the muscles with increased scintigraphic activity had histologic evidence of rhabdomyolysis. This technique allows localisation and relative quantification of muscle damage and is a valuable aid in the evaluation of the athletic horse.

Asunto(s)

RESUMEN

There is increasing demand on equine practitioners to provide confirmation of their diagnoses. For obscure lameness and for many of the more difficult locomotory problems presented in referral hospitals, the question to be answered is not only how to make the most accurate diagnosis but also how to document the findings so that there is less doubt in the mind of the client. This article describes a quasi algorithmic approach to choosing the best combinations of the increasingly sophisticated imaging methods available for evaluation of orthopedic disease.

Asunto(s)

RESUMEN

When performed on selected clinical cases, ventilation/perfusion scintigraphy provides valuable additional information on regional lung function that is not obtainable from conventional thoracic radiographs. This is particularly true of horses with EIPH, COPD, and those suspected of having some form of small-airway disease. For horses with EIPH, the presence of a perfusion deficit on the scan is considered a key prognostic sign, because it is likely in these cases that irreversible bronchial arterial takeover has occurred in the affected areas of lung. Findings from horses with COPD have improved our understanding of the radiographic patterns of airtrapping and vascular distribution and provided us with a sensitive means of detecting residual bronchial changes in the absence of clinical signs of the disease. Several other scintigraphic parameters such as mucociliary clearance and abscess-avid labeling show promise for future lung imaging on clinical cases but still require further research to develop appropriate techniques for delivery and image analysis.

Asunto(s)

RESUMEN

We live in an age in which highly sophisticated computerized equipment and imaging methods are becoming increasingly available. Demand from clients requires that we as veterinary professionals keep our eyes on the future potential of these technologies for diagnosis and treatment. This article briefly reviews some of the techniques that are just around the corner for the progressive equine practitioner.

Asunto(s)

Asunto(s)

RESUMEN

A cat with posttraumatic stenosis of the terminal part of the thoracic portion of the trachea and carina was successfully treated by balloon dilation of the stenosis during thoracotomy. Thoracotomy was performed at the right fifth intercostal space, and the stenosis was dilated, using a balloon-tipped catheter passed through an endotracheal tube. A 6-week course of orally administered corticosteroids was instituted after surgery. Balloon dilation during thoracotomy is a technically simple procedure for treatment of stenosis of the thoracic portion of the trachea.

Asunto(s)

RESUMEN

An adult male cat was examined because of chronic respiratory tract disease. Results of thoracic radiography indicated overinflation of the right lung, and atelectasis or agenesis of the left lung. Notable aerosol deposition (ventilation) to the right caudal lung lobe was seen by use of pulmonary ventilation scintigraphy. Postmortem findings suggested the primary pathoanatomic lesion was bronchial dysgenesis involving all but the right caudal lung lobe.

Asunto(s)

RESUMEN

Discovering the cause of poor performance in racehorses can often represent a considerable challenge eluding the more common diagnostic techniques available at the racetrack. Application of sports medicine techniques to these problem cases can aid in the diagnosis of poor performance. Central to the development of this capability has been the use of highspeed treadmills, allowing the racehorse to be evaluated in the controlled laboratory setting, at exercise intensities equivalent to those of racing. Video and cinematographic gait analysis can be used in the diagnosis of subtle lameness conditions. Evaluating hoof balance at high speed has also become an important technique for both lameness diagnosis and prevention. Correcting hoof imbalance normalizes the applied stresses on joints, ligaments, and tendons. Abnormal upper airway function resulting in increased resistance to airflow is major cause of poor racing performance. Often this cause of upper airway dysfunction is difficult to evaluate at rest or after exercise. A definitive diagnosis can be made in these cases using treadmill endoscopy to visualize upper airway function during peak exercise. Lower airway function can also affect performance capability. Radiographic and scintigraphic imaging modalities can be used to evaluate both global and regional lung function in cases of suspected pneumonia, EIPH, COPD, or emphysema. Reduced metabolic fitness can be a primary cause of poor performance due to inherent differences in capability, pathologic changes in the major body systems involved in exercise, or inadequate training. Metabolic stress testing can be used to evaluate the level of fitness in these cases. Orthopedic imaging has also become a valuable diagnostic technique for evaluating musculoskeletal injuries. Scintigraphic evaluation of soft tissue and bone and CT scanning are used to localize the source of lameness and to grade the severity of various orthopedic conditions such as arthritis and stress-induced bone disease that are often difficult to categorize with conventional radiography.

Asunto(s)

RESUMEN

Bone scintigraphy was performed as part of an initial diagnostic evaluation of 70 dogs admitted with primary bone tumors during a 2-year period. Tumors involved major long bones of the appendicular skeleton and included 62 osteosarcomas, 6 fibrosarcomas, and 2 chondrosarcomas. All dogs were free of radiographically detectable pulmonary metastases. Bone scintigraphy was not of value in distinguishing among various types of primary tumors. One dog with an ulnar chondrosarcoma had a scintigraphically detectable occult osseous metastasis or synchronous primary tumor, and 1 dog with osteosarcoma had a scintigraphically detectable lymph node metastasis. Pulmonary metastases were not detected scintigraphically. Of the 70 dogs, 44.3% had areas of increased isotope uptake associated with nonneoplastic disease processes.

Asunto(s)

RESUMEN

This study was initiated to determine the rate and characteristics of 99mTc-DTPA clearance from the whole lung in a group of 9 sheep. Submicronic aerosol droplets were delivered to unsedated sheep held in a sling-like frame. Best fits for clearance curves to single- and biexponentials were calculated. The monoexponential T50 for the aerosol clearance was 293 min +/- 74 SD. Background correction was found to have a minimal effect (approx. 10%). Biexponential fitting only marginally improved correlations in the 8 healthy sheep, but in one additional animal with clinical evidence of pneumonia, clearance was faster and biexponential fitting was substantially better. These clearance values in conscious sheep are longer than previous findings with 99mTc-DTPA in anesthetized sheep. There appears to be a wide variation of radioaerosol 99mTc-DTPA lung clearances among different species, sheep exhibiting a comparatively prolonged clearance profile.

Asunto(s)

RESUMEN

Detailed physical and clinical examinations were performed on 26 Thoroughbred racehorses which were used subsequently in a series of studies to investigate the contribution of the pulmonary and bronchial arterial circulations to the pathophysiology of exercise-induced pulmonary haemorrhage (EIPH). Twenty-five of the horses had been retired from race training in Hong Kong during the 1984-85 season, all but four raced that season; one horse had been retired the previous season. The average number of races for the group that season was 4.1 +/- 2 with an average distance of 1502 +/- 216 metres, mean racing speed 15.5 +/- 0.5 metres/sec. Time from last race to necropsy was 177 +/- 155 days, range 12 to 572 days. All but one horse had a known history of either EIPH or epistaxis. Time from last recorded incident of expistaxis (17 horses) to necropsy was 156 +/- 141 days, range 12 to 513 days, with a longer interval since last recorded endoscopic observation of EIPH. Focal abnormal lung sounds were detected in the dorsocaudal lungfields on auscultation during rebreathing in three horses and six had tracheobronchial cytology consistent with previous episodes of pulmonary haemorrhage (haemosiderophages). No other characteristics which might have allowed separation of this group of horses from other Thoroughbred horses recently in race training were identified.

Asunto(s)

RESUMEN

Gross post mortem examinations were performed on the lungs of 26 Thoroughbred horses of known exercise-induced pulmonary haemorrhage (EIPH) status. The most consistent finding was a variable degree of bilaterally symmetrical, dark discolouration of the dorsocaudal regions of the caudal lung lobes. In more severely affected lungs, the stained areas extended cranially along the dorsal surfaces of the lungs, and in some cases affected approximately one third of the lung surface. Discoloured areas of lung were denser than normal, collapsed less readily, often contained trapped air and were slow to inflate. The subpleural bronchial arteries were more prominent in the discoloured regions. Pleural adhesions were noted in two horses but were not related to the discoloured lung regions. It was concluded that the discoloured lesions have a complex pathogenesis and were related directly to previous bouts of EIPH. Associated with them were signs indicating probable partial small airway obstruction, decreased tissue compliance and direct involvement of the bronchial arterial circulation.

Asunto(s)

RESUMEN

The purpose of this study was to use radiographic contrast techniques and special imaging methods to identify and high-light bronchial arterial involvement in lung lesions associated with exercise-induced pulmonary haemorrhage (EIPH) in horses. The lungs from four horses with histories of EIPH were prepared for computerised tomographic scanning and microradiography by perfusing the broncho-oesophageal artery with a mixture of red latex and either barium or iodine contrast materials while the pulmonary supply received only blue latex. Computerised tomographic scan slices of the prepared inflated lungs were obtained from the caudal tip of the lung to the hilus. Microradiography of selected lung slices was also performed on a Faxitron. Diffuse areas of increased density, with preferential bronchial arterial supply noted on the computerised tomographic scans were confirmed by microradiography. Dense focal and diffuse plexuses of markedly hypertrophied and highly branched bronchial arterial networks were identified, centred around certain small airways. The vascular supply to these plexuses was recruited predominantly from neighbouring bronchial vessels, and in some cases, from the enlarged vasa vasorum of pulmonary arteries sending anastomoses to the affected areas. The authors conclude that bronchial vascular lesions in EIPH cases are the likely origin of haemorrhage; that small airway disease is the probable initiating stimulus for bronchial vascular proliferation in these lesions; and that the morphology and nature of the neovascular tissue in these lesions provides the conditions leading to haemorrhage in the lungs of horses with EIPH.

Asunto(s)

RESUMEN

Latex was injected under pressure into bronchial and pulmonary arteries of the inflated lungs of Thoroughbreds and transverse sections taken to calculate the area of lesions resulting from exercise-induced pulmonary haemorrhage. Extensive areas of dense brown haemosiderin varying from 0 to 45 per cent of total lung volume were identified, predominantly in the dorsocaudal lungfields. Bronchial arterial proliferation appeared to have replaced the pulmonary supply in affected areas of the lung. Closely associated with the staining and bronchial arterialisation, there was widespread small airway disease. The most severely affected bronchioles contained thick gelatinous or mucous exudate or mucoid plugs and had grossly thickened walls. These lesions suggest that the source of haemorrhage in exercise-induced pulmonary haemorrhage is from alveolar capillaries anomalously supplied by the bronchial arterial circulation through the development of pathological shunts. Small airway disease is suggested as being of major importance in the pathogenesis of the disease and may have led to the initial proliferation of the bronchial circulation.

Asunto(s)

RESUMEN

Lungs from 19 Thoroughbred racehorses with a history of exercise-induced pulmonary haemorrhage (EIPH) were studied using several forms of microscopy. Light microscopy of paraffin sections revealed three lesions in the caudodorsal region of the lungs from each horse. These correspond with the location of blue to brown stains seen at necropsy. These lesions include sequelae of bronchiolitis, hemosiderophages and increased connective tissue. Much of each of the lungs appeared normal, especially the more cranial or ventral portions. Foci of eosinophil infiltration were found in seven of the 19 lungs examined. With two exceptions, these eosinophilic foci had a different distribution to the three lesions. In areas of severe bronchiolar changes and fibrosis, vascular lesions typical of hypertension were found occasionally. Transmission electron microscopy was used to confirm cell types seen by light microscopy and to examine arterioles for changes characteristic of neovascularisation. Areas of enlarged airspaces from the vascular injected right lungs were examined by scanning electron microscopy. The balance of fibrosis and destruction varied in these areas, but none were as extensive as those seen in chronic obstructive pulmonary disease. The authors hypothesise that bronchiolitis and related neovascularisation are essential components of the aetiology of EIPH.

Asunto(s)