Robert J. Hunt

Osteomyelitis of the Patella in Eight Foals

OBJECTIVE To describe the characteristics of osteomyelitis lesions of the patella and to report short- and long-term outcome after treatment in 8 foals. STUDY DESIGN Retrospective case series. ANIMALS Foals (n = 8). METHODS Medical records (2003-2007) and radiographs of foals that had osteomyelitis of the patella were reviewed. Inclusion criteria included clinical, radiographic, and surgical findings consistent with osteomyelitis of the patella, and a long-term follow-up of >15 months. Information acquired included signalment, hematologic and serum biochemical profile results, clinical and radiographic signs, surgical technique and perioperative treatment. Follow-up radiographs were evaluated and outcome was determined from veterinary examination, race records, and telephone questionnaire. RESULTS Six foals survived long term (15 months-4 years); all had intralesional and systemic antimicrobial therapy, along with synovial lavage and antimicrobial medication. All were sound and achieved either yearling sales (n=3), show hunter or racing (2). Two foals died in the short term from renal failure and suppurative peritonitis secondary to cecal perforation, 1 remaining lame with suppurative osteonecrosis confirmed at necropsy. This foal was not administered intralesional antimicrobial therapy. CONCLUSIONS Prompt medical and surgical therapy for osteomyelitis of the patella can result in a good prognosis for soundness and a potential athletic career. Concurrent septicemia or other systemic perinatal disease can result in prolonged therapy and delayed recovery.

Duodenojejunal mesenteric rents: Survival and complications after surgical correction in 38 broodmares (2006-2014).

Objectives: To describe short‐term and long‐term survival of horses with duodenojejunal mesenteric rents, and to examine the association of selected preoperative, intraoperative, and postoperative factors with survival or colic after discharge, in horses with duodenojejunal mesenteric rents. Study Design: Retrospective case series. Animals: Horses undergoing surgery for correction of small intestinal lesions secondary to duodenojejunal mesenteric rents (n = 38). Methods: Medical records (2006‐2014) of horses admitted to a referral hospital in Kentucky were reviewed. Data for preoperative and intraoperative findings, postoperative complications, and short‐term survival to discharge were recorded Long‐term (>12 months) survival was determined by follow‐up telephone query. Association of factors with survival and colic after discharge was determined using logistic regression. Results: All 38 horses were Thoroughbred broodmares. Short‐term survival was 76% overall and 88% among horses that recovered from general anesthesia. Long‐term survival was 74% overall and 97% for mares that survived to discharge. All long‐term survivors and 85% of mares that recovered from general anesthesia returned to use for breeding. The odds of survival were significantly higher for horses ≤10 years of age (OR = 6.2; 95% CI, 1.1‐34.4). Failure to close the rent was associated with increased odds of colic after discharge, but had no effect on survival. Conclusion: Short‐term and long‐term survival was high relative to prior reports and mares surviving to discharge following mesenteric rent surgery had an excellent prognosis for long‐term survival. Based on our data, closure of rents is recommended to prevent recurrence of colic, but may be unnecessary for survival.

Case-control study of risk factors for pasture-and endocrinopathy-associated laminitis in North American horses

OBJECTIVE To investigate risk factors for the development of pasture- and endocrinopathy-associated laminitis (PEAL) in horses and ponies in North America. DESIGN Case-control study. ANIMALS 199 horses with incident cases of PEAL and 351 horses from 2 control populations (healthy horses [n = 198] and horses with lameness not caused by laminitis [153]) that were evaluated in North America between January 2012 and December 2015 by veterinarian members of the American Association of Equine Practitioners. PROCEDURES North American members of the American Association of Equine Practitioners were contacted to participate in the study, and participating veterinarians provided historical data on incident cases of PEAL, each matched with a healthy control and a lameness control. Conditional logistic regression analysis was used to compare data on PEAL-affected horses with data on horses from each set of controls. RESULTS Horses with an obese body condition (ie, body condition score ≥ 7), generalized or regional adiposity (alone or in combination), preexisting endocrinopathy, or recent (within 30 days) glucocorticoid administration had increased odds of developing PEAL, compared with horses that did not have these findings. CONCLUSIONS AND CLINICAL RELEVANCE The present study identified several risk factors for PEAL that may assist not only in managing and preventing this form of laminitis, but also in guiding future research into its pathogenesis.

Routine Orthopedic Evaluation in Foals

In order to recognize abnormalities on the physical evaluation, it is mandatory to understand normal developmental variations of the musculoskeletal system. Many abnormalities are self-limiting and, therefore, it is important to recognize which problems require intervention for a successful outcome and which may be complicated by treatment. The importance of a complete and thorough physical evaluation cannot be overemphasized and is the most productive diagnostic tool for recognizing most abnormalities of the skeletal system whether as a component of an after-foaling examination or for lameness or conformation evaluation in foals of all ages.