[Show abstract][Hide abstract] ABSTRACT: Treatment of tendon disease with multipotent mesenchymal stromal cells (MSC) is a promising option to improve tissue regeneration. To elucidate the mechanisms by which MSC support regeneration, longitudinal tracking of MSC labelled with superparamagnetic iron oxide (SPIO) by magnetic resonance imaging (MRI) could provide important insight. Nine equine patients suffering from tendon disease were treated with SPIO-labelled or nonlabelled allogeneic umbilical cord-derived MSC by local injection. Labelling of MSC was confirmed by microscopy and MRI. All animals were subjected to clinical, ultrasonographical, and low-field MRI examinations before and directly after MSC application as well as 2, 4, and 8 weeks after MSC application. Hypointense artefacts with characteristically low signal intensity were identified at the site of injection of SPIO-MSC in T1- and
-weighted gradient echo MRI sequences. They were visible in all 7 cases treated with SPIO-MSC directly after injection, but not in the control cases treated with nonlabelled MSC. Furthermore, hypointense artefacts remained traceable within the damaged tendon tissue during the whole follow-up period in 5 out of 7 cases. Tendon healing could be monitored at the same time. Clinical and ultrasonographical findings as well as T2-weighted MRI series indicated a gradual improvement of tendon function and structure.
Full-text · Article · Jan 2016 · Stem cell International
[Show abstract][Hide abstract] ABSTRACT: Original title: Vergleich rektaler und sonographischer Untersuchungsbefunde bei der Kolik des Pferdes
The examination of patients suffering from an acute abdomen routinely comprises both clinical and rectal examinations, and is ever more frequently accompanied by an ultrasonographic abdominal examination. The aim of the study was to compare the findings as defined through rectal examination with the results of the ultrasonographic examination for different forms of colic.
Material and methods:
In a retrospective study, the patient records of the Large Animal Clinic of the University of Leipzig from 2012 and 2013 were analysed, and those of horses suffering from colic were included. Diagnoses made through rectal and ultrasonographic examination were grouped and compared with the diagnoses made during colic surgery or pathologic examination, which served as the gold standard. Horses that underwent conservative treatment had a definitive diagnosis assigned only in cases where a pathognostic rectal finding defined the diagnosis. Based on these data, sensitivity, specificity and positive and negative predictive values were calculated for both techniques.
Ultrasonography was more sensitive than rectal examination in cases of small intestinal occlusion (97.1% vs. 50.7%), torsion of the large colon in the long axis (63.2% vs. 26.3%) and dislocation of the large colon into the nephrosplenic space (90.9% vs. 72.7%). Rectal examination was more sensitive than ultrasonographic examination in cases of other types of dislocation of the large colon (96.5% vs. 8.8%) and of constipations of the large colon (93.6% vs. 29.8%).
Conclusion and clinical relevance:
In cases of severe diseases, including small intestinal occlusions and torsions of the large colon, ultrasonography helps to better identify and more precisely diagnose conditions that in most cases require abdominal surgery than rectal examination. Therefore, under hospital conditions, it is highly advisable to include ultrasonography in the routine examination of the equine acute abdomen. However, this technique does not replace the traditional rectal examination, which is superior in the diagnosis of dislocations and constipations of the large colon as well as diseases of the caecum.
Gegenstand und Ziel:
Neben der routinemäßigen Untersuchung des Kolikpatienten (klinische inklusive rektale Untersuchung), kommt zunehmend die Sonographie zur Anwendung. Ziel der Studie war, die Befunde der rektalen Untersuchung mit denen der sonographischen Untersuchung bei unterschiedlichen Kolikerkrankungen zu vergleichen.
Material und Methoden:
In einer retrospektiven Studie wurden die Patientendaten von Pferden mit Koliksymptomen der Jahre 2012 und 2013 der Chirurgischen Tierklinik Leipzig ausgewertet. Die anhand der
rektalen und sonographischen Untersuchung gestellten Verdachtsdia -gnosen wurden gruppiert und den Diagnosen (Goldstandard) der operativen Behandlung bzw. der pathologischen Untersuchung gegenübergestellt. Bei konservativ behandelten Tieren wurde nur bei eindeutigem rektalem Befund eine definitive Diagnose formuliert. Für beide diagnostische Verfahren erfolgte die Ermittlung von Sensitivität, Spezifität, positivem und negativem Vorhersagewert. Ergebnisse:Bezüglich der Diagnostik des Dünndarmverschlusses erwies sich die sonographische Untersuchung als deutlich sensitiver als die rektale Befunderhebung (97,1%; 50,7%). Eine bessere Sensitivität erzielte die sonographische Untersuchung auch bei der Längsachsendrehung des großen Kolons (63,2% vs. 26,3%) und bei der Verlagerung des großen
Kolons in den Milz-Nieren-Raum (90,9% vs. 72,7%). Im Fall von Kolonverlagerungen bzw. Verstopfungen des großen Kolons war die rektale Untersuchung weitaus sensitiver als die sonographische Untersuchung (96,5% vs. 8,8%) bzw. (93,6% vs. 29,8%). Schlussfolgerung
und klinische Relevanz: Besonders schwerwiegende Erkrankungen, wie der Dünndarmverschluss und die Längsachsendrehung des großen Kolons, werden mithilfe der Sonographie sicherer erkannt als durch die rektale Untersuchung. Deshalb sollte unter Klinikbedingungen auf die sonographische Untersuchung des Kolikpatienten nicht
verzichtet werden. Bei der Diagnostik von Verlagerungen und Verstopfungen des großen Kolons sowie von Blinddarmerkrankungen erweist sich hingegen die transrektale Palpation gegenüber der Ultraschall -untersuchung überlegen.
[Show abstract][Hide abstract] ABSTRACT: Aim of the study is the analysis of cases of laparotomy in foals with an anamnesis of intestinal or extraintestinal disease at the Large Animal Clinic for Surgery, University of Leipzig. Clinical files of the years 2001 until 2011 were screened for cases of foals up to one year of age, which had undergone laparotomy for intestinal disease, uroperitoneum or umbilical disease. Parameters for evaluation were signalement, season of admission, diagnosis, surgical therapy, surgical complications and success of surgical therapy. 98 foals had undergone laparotomy, of which over two thirds were colts. The predominant breed were Warmbloods (70,4%), while the predominant age was the neonate foal (59,2%). Suckling foals represented 32,7% of the patients, whereas weanling foals were the smallest fraction (8,2%). Predominant diagnoses were meconium impaction (20,4%), umbilical disease (19,4%) and ileus of the small intestine (17,3%). Surgical interventions were classified little invasive in 37,8% of the cases and invasive in 44,9%. Intro-operative death or euthanasia supra tabulam due to bad prognosis was recorded in 17,3% of the cases. Post-operative complications occurred in 28 foals. Re-laparotomy had to be performed in 9 foals. Of the 98 foals which underwent laparotomy, 70 could be discharged from the hospital. Survival rates were 71,4% on the basis of all cases and 86,4% on the basis of a completed laparotomy. Highest survival rates were recorded when conglobate or meconium impaction caused the indication for surgery, while small intestinal ileus and congenital malformation were the diagnoses yielding the worst outcome.
[Show abstract][Hide abstract] ABSTRACT: Tumours of the thyroid gland are rare in the equine species. In literature varying clinical signs and diagnostic findings are described in single reports and case series. Reported clinical signs are related to upper airway compression or thyroidal metabolic activity. A considerable risk of laryngeal hemiplegia is described when horses were treated with hemithyroidectomy . To review 11 horses referred with a unilateral thyroid neoplasia in order to describe clinical presentation, diagnostic findings, treatment and outcome. Histopathology was performed on all resected thyroid lobes. Retrospective case series. Records from horses with histologically confirmed thyroid tumours treated with unilateral thyroid lobe resection were reviewed (2003–2013). Short-term outcome was defined for 2 weeks after surgery. Owners’ questionnaire was performed for evaluation of long-term outcome defined as a minimum of 6 months. Affected horses were aged between 6 and 21 years. In contrast to literature the majority of tumours were adenocarcinomas (9/11), mainly found in mares (8/9). Histology revealed follicular and parafollicular (C-cell) mixed growth pattern of the carcinomas. Tumour size, growth rate and sonographic appearance did not correlate to histological characteristics. Ventral displacement of the thyroid lobe and close preparation along the thyroid capsule during surgical resection are inevitable to avoid damage to laryngeal nerves. Seroma formation was the only observed short-term complication. No long-term complications occurred. Hemithyroidectomy is regarded the treatment of choice in horses with a unilateral thyroid lobe neoplasia with excellent long-term prognosis. High incidence of malignant tumours particularly in mares has to be considered. Tumour characteristics can only be derived from histopathology and immunhistochemistry. Ethical animal research: Ethical committee oversight not currently required by this congress: retrospective study of clinical records. Explicit owner informed consent for participation in this study was not stated. Sources of funding: None. Competing interests: None.
[Show abstract][Hide abstract] ABSTRACT: To describe a surgical technique for thoracoscopy and report visible anatomy within the thoracic cavity of standing cattle.
Adult clinically healthy Holstein-Friesian cows (n = 15).
Each cow had four thoracoscopic examinations. Initially, the left hemithorax was examined after passive lung collapse, then again 24 hours later after CO2 insufflation. The right hemithorax was examined 24 hours later after passive lung collapse and again 24 hours later after CO2 insufflation.
CO2 insufflation did not significantly improve visibility within the pleural space. Collapsed lung, aorta, esophagus, diaphragm, and azygos vein were readily viewed; however, the pericardial region was not consistently visible. Minor laceration of the lung occurred in 1 cow with adhesions, otherwise there were no intra- or postoperative complications. All cows recovered without signs of discomfort. No local swelling or emphysema occurred at the portals.
Thoracoscopy can be safely performed on healthy standing cattle.
Full-text · Article · Dec 2013 · Veterinary Surgery
[Show abstract][Hide abstract] ABSTRACT: The tarsal sheath is a relatively large structure and has an exposed position on the medial aspect of the hock in horses. Because of that, it may be affected by various diseases. The precise knowledge of anatomical location, extend and relationship to surrounding structures and diagnostic modalities is an important prerequisite to diagnose those conditions. The goal of the present study was to illustrate and document the anatomical details in cadaver limbs. Furthermore, a retrospective analysis of all cases with tarsal sheath involvement pre- sented to the Large Animal Clinic for Surgery, Faculty of Veterinary Medicine, University of Leipzig in a seven year period (2005-2011) was performed. A detailed anatomical description of the tarsal sheath based on our own evaluation as well as literature findings is presented. It was noted that the description of the anatomical situation in the present literature is neither consistent, nor precise and partly outdated. Among patients presented to our hospital, diseases of the tarsal sheath have a low incidence (0.3 %). Based on the clinical findings, most cases could be allocated to one of four groups: 1) acute to chronic, subclinical aseptic tenosynovitis, 2) chronic, clinical apparent, asep- tic tenosynovitis, 3) acute, septic tenosynovitis due to laceration, and 4) acute tenosynovitis secondary due to cellulitis. Some conditions warrant immediate and comprehensive treatment whereas other conditions have a low clinical relevance and may heal on their own. Prognoses for life, for full athletic function as well as cosmetic appearance of the hock vary considerably among the diseases affecting the tarsal sheath.
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to investigate and compare the direct pulmonary effect of sedation alone and of thoracoscopy in with romifidine and butorphanol sedated standing horses. Three series of measurements were performed in ten healthy adult horses aged between 4 and 22 years. The first series of measurements were made solely under the influence of sedation and analgesia using romifidine or levomethadone, in order to differentiate between drugs and thoracoscopy induced effects later. The second run was carried out under right-side and the third under left-sided thoracoscopy of the horses. Respiratory rate, expiratory tidal volume, expiratory minute ventilation and end-expiratory carbon dioxide level were recorded at 7 constant time points. Points 1 to 4 corresponded to preoperative, 5 and 6 to intraoperative and 7 to postoperative time points. Since there were no statistically significant differences between measured values during left- and right-sided thoracoscopies, results were combined in a single series. Mean respiratory rate values from patients at time points 5 and 6 (e.g. during thoracoscopy) were significantly higher than those when animals were only sedated (14.4±5.3 min -1 and 8.5±2.7 min-1; 15.7±4.5 min -1 and 8.3±2.5 min-1). During thoracoscopic examination, there was a decrease in the expiratory tidal volume, with lowest values recorded at time points 5 and 6. Mean expiratory tidal volume was significantly lower at time points 5 and 6 (during thoracoscopy) (1034.8± 192.9 ml/100kg and 958.2± 190.8 ml/100kg) than in the "only sedation" run at the same times (1538.5±384.7 ml/100kg and 1437.0±268.9 ml/100kg, respectively). Accordingly to the increase in respiratory rate, mean expiratory minute ventilation during thoracoscopy increased significantly. Mean end-expiratory carbon dioxide levels decreased significantly during thoracoscopy. In summary, the pneumothorax concomitant to thoracoscopic examination induced a negative influence on pulmonary function. Tachypnea, decreased expiratory tidal volume and decreased end-tidal carbon dioxide levels were typical changes.
[Show abstract][Hide abstract] ABSTRACT: In addition to the conventional occurrence of ethmoid hematomas at the ethmoid bone, they can also be found occasionally within the nasal sinuses. Diagnostics in this region are difficult. The purpose of this study was the description of the MR-appearance of progressive ethmoid hematomas in different locations in three horses. The diagnosis was made on a clinical basis and in two cases following histology. In all horses a similar signal characterization was defined. The main finding in all sequences used was an inhomogenous, hypointense to signal void area, containing blood and its degradation products. The swelling showed intracanalicular (intranasal/intrasinusoid) expansion, but invasive, destructive growth could not be observed. Progressive ethmoid hematomas have a uniform appearance in MRI. If suspected, T2* weighted sequences are recommendable. MRI-examination is considered to be a substantial contribution for differential diagnosis in cases of paranasal sinus involvement.
No preview · Article · Nov 2012 · Der Praktische Tierarzt
[Show abstract][Hide abstract] ABSTRACT: In the present report the use of thoracoscopic examinations in the horse is described in a series of six cases. In detail, equine patients presented with the following diagnoses: pneumonia, thoracic injury, pleural rupture, diaphragmatic injury, pleuritis and rib fracture. History, clinical findings, blood analysis, radiographic and sonographical findings as well as therapy and outcome were documented. In particular, clinical parameters and selected parameters of the blood gas analysis were of interest. Besides the usefulness of thoracoscopy as a diagnostic tool it could be shown that this technique is safely applicable even in patients with affected pulmonary function.
No preview · Article · Oct 2012 · Der Praktische Tierarzt
[Show abstract][Hide abstract] ABSTRACT: The objective of this study was to determine the influence of thoracoscopy on the standing horse in relation to heart rate and selected blood gas parameters under sedation and analgesia with Romifidin and Levomethadon. Measurements were conducted in ten healthy horses aged from four to 22 years in three ways. The first measurements were performed to evaluate the animals in regard to the sedative and analgesic effects of the pharmaceuticals Romifidin and Levomethadon alone. These results were then used as a baseline to compare the effects of thoracoscopy under Romifidine and Levomethadon on selected clinical parameters. The second measurements were taken during thoracoscopy performed from the right side and the third set of measurements was taken during a thoracoscopy via a left sided approach. Heart rate, arterial partial pressure of oxygen, arterial partial pressure of carbon dioxide, arterial pH values and other clinical parameters were collected at seven fixed time points. Time points 1 to 4 corresponded to the pre-thoracoscopic period, time points 6 and 6 to the period during thoracoscopy and time point 7 was directly after thoracoscopy. Statistical evaluation indicated that there were no significant differences between the right and left thoracoscopic measurements which allowed values from both sides to be combined. During the thoracoscopy the horses demonstrated typical signs of sedation, one horse began coughing and five had laboured breathing. The mean heart rate of sedated plus thoracoscopy horses were significantly above that of the sedated horses at intervals five and six (31.9±3.8 min"1 respectively 28.2 + 4.1 min'1 and 35.6±4,7 min"' respectively 28.7±4,7 min"1). Horses undergoing thoracoscopy had a drop in arterial partial pressure of oxygen with the lowest value noted at measurement points five and six. At these two points the arterial partial oxygen pressure was significantly lower in the sedated and thoracoscopied horses as in the simply sedated horses (10.98±1.02 kPa respectively 12.65±0.63 kPa and 9.82+0.77 kPa respectively 13.37±0.53 kPa). The arterial partial carbon dioxide pressure and the arterial pH values did not fluctuate to any extent during the thoracoscopic procedure. Thoracoscopy in healthy, sedated horses seems to be well tolerated. During the duration of these procedures the selected parameters were only slightly altered. No horse showed any signs of a critical condition. There was a temporal decrease of the arterial oxygen partial pressure during thoracoscopy. Therefore a blood gas monitoring is recommended.
[Show abstract][Hide abstract] ABSTRACT: The report describes a case of Equine Multinodular Pulmonary Fibrosis in a Shire Horse mare. The mare was referred to the Large Animal Clinic for Surgery at the Veterinary Faculty of Leipzig due to anorexia and emaciation. Case history, laboratory results as well as the sonographic, radiographic and thoracoscopic findings are documented in detail. An unsuccessful attempt for treatment was performed but because of the progressive character of the clinical signs, the mare had to be euthanized subsequently. The diagnosis of Equine Multinodular Pulmonary Fibrosis in association with Equine Herpesvirus type 5 (EHV-5) was made in accordance to post mortem examination, histopathology, immunohistochemistry and molecular biological results.
No preview · Article · May 2012 · Der Praktische Tierarzt
[Show abstract][Hide abstract] ABSTRACT: To report successful use of stent repair for a chronically injured parotid duct in a thoroughbred colt.
A 2-year-old thoroughbred colt.
Chronic injury to the parotid duct was identified 4-cm caudal to the facial vessel notch on the ventral border of the right mandible. After careful surgical dissection of the surrounding firm fibrous tissue, the defect was temporarily stented using an 8-Fr human ureteral catheter (223600 ERU(®) SOFT URETERAL(®) , Laboratoires pharmaceutique, Betschdorf, France) to bridge the tissue loss. The rostral end of the catheter exited the oral cavity through a buccotomy stab incision at the level of the second premolar tooth of the maxilla.
Primary wound healing occurred and the stent was maintained for 5 weeks with saliva drainage visible when the colt was fed. After stent removal, function was restored with good cosmesis.
A tissue defect in the parotid duct can be repaired successfully by temporary use of a stent until wound healing occurs.
Full-text · Article · Apr 2012 · Veterinary Surgery
[Show abstract][Hide abstract] ABSTRACT: 15 normal, healthy horses aged between 4 and 22 years underwent left and right thoracoscopic examination. Horses were sedated and restrained in stocks. Examinations were done with passive collapse of the lung and under carbon dioxide insufflation in the thorax. Thoracoscopy was well tolerated by the horses. Standing thoracoscopy provided good visualization of the dorsal and lateral structures of the thorax. In standing position, passive collapse of the lung allowed examination of the thoracic vertebrae, dorsal parts of the ribs, intercostal vessels and muscles, sympathic trunk, thoracic duct, right azygos vein, aorta, oesophagus, dorsal and lateral surfaces of caudal lung lobes as well as caudodorsal part of the diaphragm. Under carbon dioxide insufflation pericardium could be visualized in all horses. Thoracoscopy is a minimal invasive technique and can be safely performed in the standing, sedated horse, but development of a bilateral pneumothorax is possible.