Clinical, ultrasonographic and pathological aspects of iatrogenic thrombophlebitis in a mare - case report

Abstract

A 7-year-old quarter horse mare showed swelling of the tongue, head and neck region, dyspnea, and red urine after eight days of administration of intravenous medications by the animal's handler. The horse was referred to the University Veterinary Hospital of the Federal University of Pará and, at the clinical examination, showed apathy, edema in the head, neck, and tongue region, which was slightly cyanotic and with loss of epithelium in the dorsal region. The maxillary, linguofacial and external jugular veins were bilaterally engorged, firm to palpation and with cord-shaped appearance, with extension of the head to the entrance to the thoracic cavity. Ultrasound examination showed a thrombi with a hyperechoic and heterogeneous appearance that completely obstructed the vessel. The horse died five days after entering the Hospital and at necropsy it was observed: maxillary, linguofacial and external jugular veins bilaterally filled with firm, dark red to blackish thrombi; ulcerated areas in the final third of the esophagus and the stomach; lighter areas on the surface of the kidneys and dark areas at the corticomedullary junction. Based on clinical, ultrasonographic and necropsy findings, iatrogenic thrombophlebitis was diagnosed, associated with repeated injections of drugs administered intravenously.