Objective: To describe a surgical technique for thyroidectomy in horses with thyroid neoplasia under standing sedation and local anesthesia.Study design: Retrospective study.Animals: Client-owned horses (n 5 10).Methods: Medical records of horses with a history of thyroid enlargement were included in the study if thyroid gland enlargement was treated surgically via hemi-or bilateral thyroidectomy, with the horse standing and sedated. Data derived from follow-up clinical examination, performance level, recurrence, and cosmetic outcome were evaluated.Results: Thyroid enlargement was unilateral in 8 and bilateral in 2 horses. Histopathological findings included adenomas (5/10), adenocarcinomas (2/10), cystic hyperplasia (2/10), and C-cell adenoma (1/10). No major complications were encountered during or after surgery. All horses resumed their previous level of exercise within 6 weeks. Recurrence was diagnosed in 1 horse, 7 months after excision, and a second surgery was required. Recurrent laryngeal nerve neuropathy and seroma formation subsequent to surgery were not recorded in any of the cases.Conclusion: Thyroidectomy can safely be performed with the horse standing and sedated with local anesthesia.Clinical relevance: Performing standing thyroidectomy does not increase intraoperative or postoperative complications and could be considered for horses with thyroid enlargement amenable to surgery.
Summary Background Manica flexoria (MF) tears are a well‐recognised cause of lameness in horses presenting with effusion of the digital flexor tendon sheath (DFTS). Ultrasonography (US) is a commonly used first line imaging modality during examination of horses presented with DFTS effusion. However, its reported sensitivity for detection of MF tears is low. Objectives To describe a novel US technique to predict the location of the MF tear. Study design Prospective descriptive observational study. Methods Twenty‐two horses (23 limbs) diagnosed with MF tears were included in the study. A standardised US protocol including examination with the limb weight bearing and non‐weight bearing was used. Furthermore, with the limb held in flexed position digital pressure was simultaneously applied to the medial and lateral proximal DFTS outpouchings in axial direction. The aim was to create turbulence of the synovial fluid within the DFTS and improve visualisation of the torn MF. The US examination was performed by one experienced operator and one junior clinician. All horses underwent tenoscopic examination. Results In all cases MF tear was diagnosed during tenoscopic examination of the DFTS. The location of the MF tear was correctly predicted in 91.3% (21/23) of the limbs. The main features used to predict location of the MF tear included floatation of the torn fibres of the MF within the synovial fluid, increased distance between DDFT and SDFT on the side at which the MF was torn and recoiling of the MF on the side contralateral to the tear. Main limitations Relatively small number of cases included. Conclusions The novel US technique was useful to identify the location of MF tear and facilitate identification of the previously described ultrasonographic features consistent with tears of the MF. The agreement between operators was perfect as from the data analysis.
A 12-year-old Warmblood mare was presented with an acute onset left hindlimb lameness associated with generalised soft tissue swelling of the entire limb and medial saphenous vein (MSV) thrombophlebitis. A presumptive diagnosis of extremity compartment syndrome (ECS) was made. Due to the clinical deterioration, emergency fasciotomy of the crural fascia and biopsy was performed. Histological and immunohistochemical examination of the samples confirmed a diagnosis of leiomyosarcoma likely originating from the tunica media of the MSV. This report is the first to describe an unique combination of ECS and thrombophlebitis associated with a leiomyosarcoma in a horse.
Objectives This article evaluates and compares the diffusion pattern of radiopaque contrast medium following perineural analgesia of the deep branch of the lateral plantar nerve performed using two different techniques: weight-bearing or flexed. Study Design This was an in vivo experimental study. Methods Eight horses were enrolled. Perineural injection of the right and left deep branch lateral plantar nerves was performed with a weight-bearing or flexed technique, using radiopaque contrast medium (iohexol). Radiographic evaluation was performed after 5 (T5), 15 (T15) and 30 (T30) minutes. The diffusion of contrast medium was assessed independently by two blinded readers who analysed the extension of the main contrast medium bulk and the maximum diffusion of contrast medium in both proximal and distal directions. The effect of time and technique employed on contrast medium diffusion was assessed using two-way analysis of variance for repeated measures (p ≤ 0.05). Results There was no significant difference in the diffusion of the contrast medium between the two techniques at T15. However, at T30 the weight-bearing technique resulted in a significantly increased diffusion in the proximal direction (p = 0.02). In one case, belonging to the weight-bearing group, contrast medium was identified within the tarsal sheath. There was no evidence of contrast medium in the tarsometatarsal joint of any horse, regardless of the technique used. Conclusions The two techniques resulted in a similar diffusion at T15. However, the use of a weight-bearing technique resulted in a significant increase in proximal contrast medium diffusion 30 minutes after injection.
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