[Show abstract][Hide abstract] ABSTRACT: Reasons for performing studyPrevious surveys have reported mare and foal survival after correction of uterine torsion varies from 60-84% and 30-54%, respectively. Furthermore, resolution via a standing flank laparotomy (SFL) has been associated with better foal, but not mare, survival.Objectives
To compare the success of SFL with other correction methods (e.g. midline or flank laparotomy under general anaesthesia; correction per vaginam).Study designRetrospective analysis of clinical records.Methods
Data on correction technique, stage of gestation, degree of rotation, survival and subsequent fertility for 189 mares treated for uterine torsion (UT) at 3 equine referral hospitals in the Netherlands during 1987-2007 were analysed.ResultsMean stage of gestation at diagnosis was 283 days (range 153-369) with the majority of UTs (77.5%) occurring before Day 320 of gestation. After UT correction, 90.5% of mares and 82.3% of foals survived to hospital discharge, between 3 and 39 days later, and to foaling. Multivariable logistic regression indicated that correction method and stage of gestation at UT affected survival of foals and mares. For foals, survival was 88.7% after SFL compared to 35.0% after other methods (P = 0.001). When UT occurred at <320 days, 90.6% of foals survived, compared to 56.1% at ≥320 days (P = 0.007). For mare survival, an interaction between stage of gestation and correction method was detected (P = 0.02), with higher survival after SFL (97.1%) than other methods (50.0%) at <320 days of gestation (P<0.01). When UT occurred at ≥320 days, mare survival did not differ between techniques (76.0% vs. 68.8; P = 0.6). Of 123 mares that were bred again, 93.5% became pregnant; fertility did not differ between mares treated by SFL (93.9%) and other techniques (87.5%; P = 0.9).ConclusionsSFL is the surgical technique of choice for resolving uncomplicated (i.e. no co-existing gastrointestinal lesions) equine UT except when the stage of gestation exceeds 320 days.
[Show abstract][Hide abstract] ABSTRACT: The occurrence of unexpectedly high numbers of horses with neurological signs during two outbreaks of strangles required prompt in-depth researching of these cases, including the exploration of magnetic resonance imaging (MRI) as a possible diagnostic technique.
To describe the case series and assess the usefulness of MRI as an imaging modality for cases suspected of space-occupying lesions in the cerebral cavity.
Four cases suspected of suffering from cerebral damage due to Streptococcus equi subsp. equi infection were examined clinically, pathologically, bacteriologically, by clinical chemistry (3 cases) and MRI (2 cases). In one case, MRI findings were compared to images acquired using computer tomography (CT).
In all cases, cerebral abscesses positive for Streptococcus equi subsp. equi were found, which explained the clinical signs. Although the lesions could be visualised with CT, MRI images were superior in representing the exact anatomic reality of the soft tissue lesions.
The diagnosis of bastard strangles characterised by metastatic brain abscesses was confirmed. MRI appeared to be an excellent tool for the imaging of cerebral lesions in the horse.
The high incidence of neurological complications could not be explained but possibly indicated a change in virulence of certain strains of Streptococcus equi subsp. equi. MRI images were very detailed, permitting visualisation of much smaller lesions than demonstrated in this study and this could allow prompt clinical intervention in less advanced cases with a better prognosis. Further, MRI could assist in the surgical treatment of brain abscesses, as has been described earlier for CT.