M. Scandella

Development of a technique for continuous perineural blockade of the palmar nerves in the distal equine thoracic limb

OBJECTIVE To develop a technique for placing continuous peripheral nerve block (CPNB) catheters adjacent to palmar nerves in horses and to evaluate the effect of low-volume local anesthetic (LA) infusion on nociception in the distal equine thoracic limb. STUDY DESIGN In vitro and in vivo laboratory investigation. STUDY MATERIAL AND ANIMALS: Forty-two thoracic limbs from 22 equine cadavers and five horses. METHODS Thoracic limb specimens were dissected to find landmarks for catheter insertion adjacent to medial and lateral palmar nerves. Based on the anatomy of the proximal metacarpus, a technique for placing palmar CPNB catheters was developed and the potential for catheter dislodgement studied in vitro by fluoroscopic visualization during passive carpal flexion and dye injection following simulated limb motion. The feasibility of CPNB catheter instrumentation in standing, sedated horses was tested in five animals, with ultrasound control. Electrical and mechanical stimulation thresholds and response latencies for hoof withdrawal responses (HWR) were determined following saline or LA infusion. RESULTS Medial and lateral CPNB catheters were inserted percutaneously 2 and 4-5 cm, respectively, distal to the accessory carpal bone and advanced for approximately 7 and 10 cm, respectively, to place the tip just proximal to the communicating branch of the nerves. Catheters were placed correctly in 88% and 85% of cadaver limbs. In the standing horses, LA infusion not only increased HWR thresholds and latencies to noxious mechanical or electrical stimulation but also caused vasodilation and limb swelling over time. CONCLUSION The technique, developed in vitro, for placing and maintaining palmar CPNB catheters in the equine thoracic limb was successfully applied in vivo. Catheters were well tolerated but LA infusion may cause limb swelling, suggesting a need for further exploration of drug and infusion regimens. CLINICAL RELEVANCE Continuous perineural LA infusion along palmar nerves may develop into an effective analgesic technique in horses suffering from lower limb pain.

Spinal epidural abscess in two calves.

OBJECTIVE To report clinical signs, diagnostic and surgical or necropsy findings, and outcome in 2 calves with spinal epidural abscess (SEA). STUDY DESIGN Clinical report. ANIMALS Calves (n=2). METHODS Calves had neurologic examination, analysis and antimicrobial culture of cerebrospinal fluid (CSF), vertebral column radiographs, myelography, and in 1 calf, magnetic resonance imaging (MRI). A definitive diagnosis of SEA was confirmed by necropsy in 1 calf and during surgery and histologic examination of vertebral canal tissue in 1 calf. RESULTS Clinical signs were difficulty in rising, ataxia, fever, apparent spinal pain, hypoesthesia, and paresis/plegia which appeared 15 days before admission. Calf 1 had pelvic limb weakness and difficulty standing and calf 2 had severe ataxia involving both thoracic and pelvic limbs. Extradural spinal cord compression was identified by myelography. SEA suspected in calf 1 with discospondylitis was confirmed at necropsy whereas calf 2 had MRI identification of the lesion and was successfully decompressed by laminectomy and SEA excision. Both calves had peripheral neutrophilia and calf 2 had neutrophilic pleocytosis in CSF. Bacteria were not isolated from CSF, from the surgical site or during necropsy. Calf 2 improved neurologically and had a good long-term outcome. CONCLUSION Good outcome in a calf with SEA was obtained after adequate surgical decompression and antibiotic administration. CLINICAL RELEVANCE SEA should be included in the list of possible causes of fever, apparent spinal pain, and signs of myelopathy in calves.

Topographic comparative study of paranasal sinuses in adult horses by computed tomography, sinuscopy, and sectional anatomy

Clinical and radiographic investigations of paranasal sinuses in horses are difficult due to the complex anatomy of these regions, the lack of patognomonic symptoms, and the low sensitivity of conventional diagnostic techniques. The aim of this study was to produce an anatomical atlas to support computed tomography (CT) and sinuscopy of the paranasal sinuses of the adult horse. Transverse, sagittal, and dorsal CT images were acquired, and sinuscopy with both rigid and flexible endoscopes was performed. The heads were frozen and sectioned using a band saw, with the cuts aligned as close as possible with the CT transverse slices. Each CT image was compared with its corresponding anatomical section and sinuscopy image to assist in the accurate identification of specific structures.

Use of magnetic resonance imaging in the diagnosis of bone marrow edema in the equine distal limb: six cases.

Use of magnetic resonance imaging in the diagnosis of bone marrow edema in the equine distal limb: six cases D. D. Zani & D. De Zani & M. Biggi & M. Scandella & O. Travetti & M. Di Giancamillo Published online: 4 July 2009 # Springer Science + Business Media B.V. 2009

Tenoscopy of the navicular bursa: a new therapeutic approach for horses affected by palmar pain syndrome. Endoscopic technique review and personal experiences

Tenoscopy of the navicular bursa has been recently introduced as a diagnostic and therapeutic treatment in cases of palmar foot pain syndrome. A deep digital flexor tendon transthecal approach was suggested in 1999, and the endoscopic technique has been reviewed. Smith and coworkers have recently reported good and promising results. An anatomic cadaver limb study was performed, and the endoscopic technique was evaluated. Subsequently, a 14-year-old Argentine mare, affected by palmar foot pain syndrome, was treated. Clinical data, MRI and endoscopic findings, and a 6-month follow-up evaluation are reported.