No abstract

Most horses affected by headshaking (HS) are diagnosed with idiopathic trigeminal-mediated headshaking (i-TMHS) when no underlying disease is found. Diagnosis is made by the exclusion of differentials considering history, clinical signs, and diagnostic investigations. Therefore, in horses presented with headshaking, many diagnostic procedures and therapies are conducted. Retrospectively, the digital patient records of 240 horses with HS were analysed regarding the impact of diagnostic procedures on diagnosis, therapy, and outcome. Horses were extensively examined using a standardised protocol including clinical (ophthalmologic, orthopaedic, neurologic, dental) examination, blood analysis, and imaging techniques (endoscopy, radiographs, computed tomography (CT), and magnetic resonance imaging). Many findings were revealed but were of clinical relevance in only 6% of the horses. These horses were, therefore, diagnosed with secondary headshaking (s-HS). In addition, all of these horses demonstrated a positive outcome. The CT of the head revealed 9/10 of the clinically relevant findings. Other diagnostic procedures had no major additional impact. Conclusively, the diagnostic investigation of horses with HS should aim at differentiating i-TMHS from s-HS. The clinical relevance of findings should be verified through diagnostic anaesthesia or targeted therapy depending on risks, invasiveness, and expected benefits. To reduce the multitude of examinations, diagnostic investigations should focus on the CT of the head in those horses with suspicion of i-TMHS based on typical history, clinical signs, and physical examination.

SummaryThis report describes the successful treatment of a traumatic splenic abscess by transabdominal drainage under ultrasonographic guidance. The gelding presented for investigation of recurrent pyrexia, mild abdominal pain and weight loss after a penetrating trauma to the caudolateral abdomen 5 weeks previously. At this stage, the abdominal wall had healed and a splenic abscess was diagnosed. Before treatment, mature adhesions between the abdominal wall and the spleen were confirmed by diagnostic laparoscopy in the standing horse. Transabdominal ultrasound‐guided drainage was performed, followed by intralesional placement of a balloon catheter for 2 weeks and a silicone drain for an additional week. Postoperatively, the horse was treated with intralesional and systemic antibiotics. The healing process was unremarkable and the horse was discharged 4 weeks postoperatively. At 10 months post‐surgery, after the body condition score had normalised, the horse returned to its previous level of performance.