This case report describes the clinical findings, diagnosis and treatment of a 14-year-old Warmblood gelding with suture exostosis. The horse was referred to our clinic because of bilateral swelling in the region of the frontal and nasal bone junction and bilateral epiphora. Epiphora was the main concern for the owner and the reason for further investigation and treatment. Radiographic examination showed extensive bone proliferation on the dorsal frontal and nasal bones. Computed tomographic (CT) images further characterised the periosteal proliferation as new bone formation and localised it along the frontonasal and frontolacrimal suture lines. Computed tomographic images also showed pathological changes of both lacrimal ducts. A chronic fracture was suspected to be the cause of the periosteal proliferation, and surgical treatment using 2 small 2.4 Unilock plates was chosen to stabilise the suture between the frontal and nasal bones. The swelling decreased and the epiphora resolved by 6 months post operatively. A CT examination 2 years later showed complete healing. (arrows) are stable and bone proliferations along the nasofrontal suture associated with the chronic fracture have disappeared. (b) Three-dimensional reconstruction computed tomography image 2 years after surgery showing normal structure of the suture. The implants (arrows) and the trepanation hole (arrowhead) are visible.
Fig 7: (a) Transverse computed tomography image at the level of the second molars two years after surgery; bone window; left side to the right of the image. There is chronic sinusitis with bone sclerosis of the right rostral maxillary sinus. The right lacrimal duct (arrowhead) appears normal. Implants
BackgroundSkin malformations that resembled manifestations of Ehlers-Danlos-Syndrome were described in a variety of domestic animals during the last century as cutis hyperelastica, hyperelastosis cutis, dermatosparaxis, dermal/collagen dysplasia, dermal/cutaneous asthenia or Ehlers-Danlos-like syndrome/s. In 2007, the mutation responsible for Hereditary Equine Regional Dermal Asthenia (HERDA) in Quarter Horses was discovered. Several case reports are available for similar malformations in other breeds than Quarter Horses (Draught Horses, Arabians, and Thoroughbreds) including four case reports for Warmblood horses. Since 2013, a genetic test for the Warmblood Fragile Foal Syndrome Type 1 (WFFS), interrogating the causative point mutation in the equine procollagen-lysine, 2-oxoglutarate 5-dioxygenase 1 (PLOD1, or lysyl hydroxylase 1) gene, has become available. Only limited data are available on the occurrence rate and clinical characteristics of this newly detected genetic disease in horses. In humans mutations in this gene are associated with Ehlers-Danlos Syndrome Type VI (kyphoscoliotic form).Case presentationThis is the first report describing the clinical and histopathological findings in a foal confirmed to be homozygous positive for WFFS. The Warmblood filly was born with very thin, friable skin, skin lesions on the legs and the head, and an open abdomen. These abnormalities required euthanasia just after delivery. Histologic examination revealed abnormally thin dermis, markedly reduced amounts of dermal collagen bundles, with loosely orientation and abnormally large spaces between deep dermal fibers.ConclusionWFFS is a novel genetic disease in horses and should be considered in cases of abortion, stillbirth, skin lesions and malformations of the skin in neonatal foals. Genetic testing of suspicious cases will contribute to evaluate the frequency of occurrence of clinical WFFS cases and its relevance for the horse population.
This technique of castration with an inguinal approach had a low incidence of complications at the site of surgery compared with other methods. An inguinal approach and leaving the vaginal tunic in situ may cause less soft tissue trauma than a scrotal approach.
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