Distal extremity wounds are a significant clinical problem in horses and humans and may benefit from mesenchymal stem cell (MSC) therapy. This study evaluated the effects of direct wound treatment with allogeneic stem cells, in terms of gross, histologic, and transcriptional features of healing. Three full‐thickness cutaneous wounds were created on each distal forelimb in six healthy horses, for a total of six wounds per horse. Umbilical cord‐blood derived equine MSCs were applied to each wound 1 day after wound creation, in one of four forms: (a) normoxic‐ or (b) hypoxic‐preconditioned cells injected into wound margins, or (c) normoxic‐ or (d) hypoxic‐preconditioned cells embedded in an autologous fibrin gel and applied topically to the wound bed. Controls were one blank (saline) injected wound and one blank fibrin gel‐treated wound per horse. Data were collected weekly for 6 weeks and included wound surface area, thermography, gene expression, and histologic scoring. Results indicated that MSC treatment by either delivery method was safe and improved histologic outcomes and wound area. Hypoxic‐preconditioning did not offer an advantage. MSC treatment by injection resulted in statistically significant increases in transforming growth factor beta and cyclooxygenase‐2 expression at week 1. Histologically, significantly more MSC‐treated wounds were categorized as pro‐healing than pro‐inflammatory. Wound area was significantly affected by treatment: MSC‐injected wounds were consistently smaller than gel‐treated or control wounds. In conclusion, MSC therapy shows promise for distal extremity wounds in horses, particularly when applied by direct injection into the wound margin. stem cells translational medicine 2018;7:98–108
Injuries of the intercarpal ligaments are an important cause of lameness in performance horses. The purpose of this prospective cadaver study was to determine whether computed tomography (CT) arthrography would be a feasible method for visualizing and characterizing intercarpal ligaments in the horse. One cadaver limb from each of eight nonlame horses was collected immediately after euthanasia. For each limb, overlapping 2.0 mm CT images were acquired before and after injection of iodinated contrast medium into the antebrachiocarpal joint, middle carpal joint, and carpal sheath. Spin echo magnetic resonance imaging (MRI) sequences were acquired in three planes using a 1.5 Tesla MRI scanner in three limbs. Following MRI, colored resin was injected into the synovial structures of these three limbs, limbs were frozen, and anatomic sections were obtained in three planes. Findings from CT arthrograms were compared to findings from precontrast CT, MRI, anatomic slices, and arthroscopy. Medial and lateral palmar intercarpal ligaments, radiocarpal and transverse intercarpal ligaments, and palmar carpal ligament were visible in CT arthrograms of all limbs. The proximal and distal entheses of all ligaments were readily identifiable. Findings indicated that CT arthrography is feasible for visualizing intercarpal ligaments and may be a useful adjunct imaging technique for diagnosing lameness due to suspected carpal ligament injury in horses.
Postoperative hemoperitoneum is a rare complication of exploratory celiotomy in horses that should be considered when there are signs of abdominal discomfort and declining hematocrit in the early postoperative period. Prognosis is guarded because of potential sequelae of septic peritonitis and adhesion formation.
Summary This case report describes retroperitoneal and subserosal emphysema as the primary indication of a caecal perforation associated with an episode of colic. Feed contamination was not noted on repeated peritoneal fluid samples or within the peritoneal cavity at the time of surgery; however, subserosal and retroperitoneal emphysema at the base of the caecum was identified during surgical exploration, which later corresponded to retroperitoneal caecal perforation at necropsy examination.
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