BackgroundMedical treatment of esophageal strictures in horses is limited and the use of balloon dilatation is described in few cases. Long‐term follow up after balloon dilatation and the use of intralesional corticosteroids has not been evaluated.ObjectivesTo describe the use of endoscopic guided, esophageal balloon dilatation in horses for cervical and thoracic esophageal strictures and administration of intralesional corticosteroids at the time of dilatation.AnimalsNine horses from the hospital population with benign esophageal strictures.MethodsRetrospective study: Medical records were reviewed from horses presented to the William R. Pritchard, Veterinary Medical Teaching Hospital at UC Davis from 2002 to 2013. Records were searched using the key words: equine, horse, balloon dilatation, bougienage, and esophageal stricture.ResultsNine horses with esophageal strictures were treated with esophageal balloon dilatation. Five horses survived (survival at writing ranged from 2 to 11 years after discharge) and all nonsurvivors were <1 year of age and presented with concurrent problems or developed complications including megaesophagus, unresolved esophageal obstruction requiring esophagostomy, or severe aspiration pneumonia. Four horses were treated with intralesional corticosteroids with no adverse effects noted in the survivors (n = 3). Four horses available for long‐term follow up were alive at 2, 5, 6, and 11 years after presentation and 3 of these horses were being fed a hay‐based diet.ConclusionsResolution of esophageal strictures in the horse can be performed successfully, safely, and under standing sedation using balloon dilatation. Intralesional corticosteroids might reduce the incidence of recurrent strictures.
Objective: To evaluate the accuracy of ultrasonographic guidance for injection near the ventral rami of the cervical spinal nerves (VRCSN).Study design: Ex vivo study. Sample population: Ten cadavers (n = 40 injections).Methods: Left and right VRCSN at C4/5 and C5/6 were infiltrated at the intervertebral foramen (IVF) under ultrasonographic guidance. A vertically orientated 3.5-MHz curvilinear probe was used to identify the craniocaudal midpoint of the articular process joint (APJ). The probe was moved ventrally until the IVF was identified. An 18-gauge 15-cm-long spinal needle was aimed immediately below the ventral margin of the cranial articular process, where 1 mL of latex was injected. Cadavers were dissected, and the location of the latex was recorded relative to the ventral ramus, the spinal cord, and the vertebral artery.Results: Direct infiltration of the ventral ramus occurred in 73% (29/40) of injections; 15% (6/40) of injections were < 0.5 cm from the ventral ramus, and 13% (5/40) of injections were > 0.5 cm (maximum 1.5 cm). Latex was located at a mean of 2.4 cm (range, 0.8-4) from the spinal cord and 0.9 cm (range, 0-1.5) from the vertebral artery.
Conclusion:Ultrasonographic guidance of perineural injections of the caudal VRCSN was repeatable and accurate, with 88% of injections located within 0.5 cm of the ventral ramus. Iatrogenic damage was limited to one penetration into the vertebral artery.Clinical significance: Ultrasonographic guidance of perineural injections of the caudal VRCSN may be considered by operators experienced in cervical APJ scanning in horses with suspected cervical spinal nerve compression.
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