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Summary Reasons for performing study Fibrotic myopathy can cause incapacitating gait abnormalities. Transection of the fibrotic mass followed by early post operative exercise is the best treatment for fibrotic myopathy. A laser may be used to transect the fibrotic mass. Assessment of the effectiveness of therapies for fibrotic myopathy has been limited to subjective evaluation. Objectives To objectively assess gait abnormalities associated with fibrotic myopathy before and after laser fibrotomy followed by early post operative exercise. Methods Kinematic evaluation of horses with fibrotic myopathy walking and trotting on a treadmill was used to investigate hindfeet trajectories (n = 8) and lameness (n = 5) before and after laser fibrotomy. Hoof flight trajectory length (HFTL), relative protraction length (%PL), maximum hoof height during swing (MXHH), hoof height at end of protraction (HHpro) and retraction (HHret) were measured and differences between fibrotic myopathy affected and nonaffected limbs were calculated. Lameness was quantified by measuring maximum and minimum pelvic height differences between right and left halves of the stride. Results Before surgery the foot of the fibrotic myopathy affected limb had abnormal trajectories characterised as increased HFTL, MXHH and HHpro and decreased %PL and HHret and the 5 horses objectively evaluated for lameness were lame in the fibrotic myopathy affected limb. Immediately after surgery the difference between affected and nonaffected limbs decreased for HFTL, %PL and HHpro. Six to 11 weeks after surgery, the HFTL difference increased but was still smaller than before surgery, which was interpreted as partial recurrence of the gait abnormality; all horses objectively evaluated for lameness were either improved (n = 1) or not lame (n = 4) in the previously affected, operated limb. Conclusions Fibrotic myopathy affects the foot flight and leads to asymmetric vertical excursion of the pelvis. Laser fibrotomy followed by early post operative exercise can minimise these abnormalities. Potential relevance Laser fibrotomy combined with early post operative exercise is a viable therapy for fibrotic myopathy.

Summary Reasons for performing study: Previous studies have suggested that agreement between equine veterinarians subjectively evaluating lameness in horses is low. These studies were limited to small numbers of horses, evaluating movement on the treadmill or to evaluating previously-recorded videotape. Objectives: To estimate agreement between equine practitioners performing lameness evaluations in horses in the live, over ground setting. Methods: 131 mature horses were evaluated for lameness by 2–5 clinicians (mean 3.2) with a weighted-average of 18.7 years of experience. Clinicians graded each limb using the AAEP lameness scale by first watching the horse trot in a straight line only and then after full lameness evaluation. Agreement was estimated by calculation of Fleiss' (κ). Evaluators agreed if they picked the same limb as lame or not lame regardless of the severity of perceived lameness. Results: After only evaluating the horse trot in a straight line clinicians agreed whether a limb was lame or not 76.6% of the time (κ= 0.44). After full lameness evaluation clinicians agreed whether a limb was lame or not 72.9% of the time (κ= 0.45). Agreement on forelimb lameness was slightly higher than on hindlimb lameness. When the mean AAEP lameness score was >1.5 clinicians agreed whether or not a limb was lame 93.1% of the time (κ= 0.86), but when the mean score was ≤1.5 they agreed 61.9% (κ= 0.23) of the time. When given the task of picking whether or not the horse was lame and picking the worst limb after full lameness evaluation, clinicians agreed 51.6% (κ= 0.37) of the time. Conclusions: For horses with mild lameness subjective evaluation of lameness is not very reliable. Potential relevance: A search for and the development of more objective and reliable methods of lameness evaluation is justified and should be encouraged and supported.

Objective—To determine clinical history, structures involved, treatment, and outcome of lacerations of the heel bulb and proximal phalangeal region (pastern) in horses. Design—Retrospective study. Animals—101 horses. Procedures—Medical records of horses with lacerations of the heel bulb and pastern were reviewed, and follow-up information was obtained. Results—75 horses were Quarter Horses. Most horses were not treated with antimicrobial drugs prior to referral. Mean ± SD time from injury to referral was 24 ± 45 hours (range, 1 to 168 hours). Lacerations were most frequently caused by contact with wire or metal objects. In 17 horses, lacerations involved synovial structures; the distal interphalangeal joint was most commonly affected. One horse was euthanatized after initial examination. Wound treatment consisted of cleansing, lavage, debridement, lavage of affected synovial structures, suturing of fresh wounds, and application of a foot bandage or cast. Fifty-six horses were treated with systemically administered antimicrobial drugs. Follow-up information was collected for 61 horses. Fifty-one horses returned to their intended use and had no further complications; 10 horses had complications associated with the wound, and of those horses, 5 were euthanatized and 1 horse died from an unrelated cause. Horses with lacerations that involved synovial structures had worse outcomes than horses with lacerations that did not involve synovial structures. Conclusions and Clinical Relevance—Horses that sustain heel bulb lacerations can successfully return to their intended use. Involvement of the distal interphalangeal joint is associated with poor prognosis. (J Am Vet Med Assoc 2005;226:418–423)

A 20-year-old Thoroughbred mare was evaluated because of a 2-year history of infertility. The mare had normal estrous cycles and had been bred 7 times by different stallions. Ultrasonographic examination revealed a homogeneous hyperechoic intramural mass in the tip of the right uterine horn; the mass was also detected via hysteroscopy Unilateral ovariectomy and partial hysterectomy were performed by use of a hand-assisted laparoscopic technique. Leiomyoma was diagnosed via histologic examination of the mass. Unilateral ovariectomy and partial hysterectomy are recommended in mares with leiomyoma in a uterine horn, especially if the tumor is associated with infertility. The hand-assisted laparoscopic technique allows direct visualization of abdominal structures and accurate placement of ligatures without applying tension on the broad ligament, and eliminates the risks and costs of general anesthesia.

Case Description—A 4-month-old Missouri Fox Trotter colt was examined for a 5-week history of head tilt after treatment for suspected pulmonary Rhodococcus equi infection. Clinical Findings—Computed tomography revealed osteolysis of the occipital, temporal, and caudal portion of the parietal bones of the left side of the cranium. A soft tissue mass compressing the occipital region of the cerebral cortex and cerebellum was associated with the osteolytic bone. Treatment and Outcome—A rostrotentorial-suboccipital craniectomy approach was performed to remove fragmented occipital bone, debulk the intracranial mass, and obtain tissue samples for histologic examination and bacterial culture. All neurologic deficits improved substantially within 3 days after surgery. Bacterial culture of the resected soft tissue and bone fragments yielded R equi. Clinical Relevance—Intracranial surgery in veterinary medicine has been limited to dogs and cats; however, in select cases, extrapolation of surgical techniques used in humans and small animals can assist with intracranial procedures in horses.

Objective—To determine the frequency of and risk factors for complications associated with casts in horses. Design—Multicenter retrospective case series Animals—398 horses with a half-limb or full-limb cast treated at 1 of 4 hospitals Procedures—Data collected from medical records included age, breed, sex, injury, limb affected, time from injury to hospital admission, surgical procedure performed, type of cast (bandage cast [BC; fiberglass tape applied over a bandage] or traditional cast [TC; fiberglass tape applied over polyurethane resin-impregnated foam]), limb position in cast (flexed, neutral, or extended), and complications. Risk factors for cast complications were identified via multiple logistic regression. Results—Cast complications were detected in 197 of 398 (49%) horses (18/53 [34%] horses with a BC and 179/345 [52%] horses with a TC). Of the 197 horses with complications, 152 (77%) had clinical signs of complications prior to cast removal; the most common clinical signs were increased lameness severity and visibly detectable soft tissue damage Cast sores were the most common complication (179/398 [45%] horses). Casts broke for 20 (5%) horses. Three (0.8%) horses developed a bone fracture attributable to casting Median time to detection of complications was 12 days and 8 days for horses with TCs and BCs, respectively. Complications developed in 71%, 48%, and 47% of horses with the casted limb in a flexed, neutral, and extended position, respectively. For horses with TCs, hospital, limb position in the cast, and sex were significant risk factors for development of cast complications. Conclusions and Clinical Relevance—Results indicated that 49% of horses with a cast developed cast complications.

Objective— To adapt the multiple osteochondral autograft technique for treatment of a subchondral cystic lesion (SCL) of the proximal medial trochlear ridge (MTR) of the equine talus and assess long term outcome. Study Design— Case report. Animals— Quarter horse stallion with SCL of the proximal MTR of the talus. Methods— Osteochondral autograft techniques used in dogs and humans were adapted and optimized in equine cadavers. A horse with a SCL of the MTR of the talus was treated by osteochondral autografting. Three osteochondral autografts were harvested from the distal lateral trochlear ridge of the talus in the affected tarsus. No curettage or debridement of the osteochondral lesion was performed. Three recipient beds were predrilled and osteochondral autografts were press-fit into the proximal MTR of the talus. Outcome was assessed by radiography, telephone interview of the owner, and direct observation during training. Results— Postoperative radiographs indicated excellent filling of the osteochondral defect and graft-articular surface congruency. No complications were encountered after surgery. At 10 months after surgery, the horse successfully re-entered reining training, and continued to be sound and performing athletically 2 years after surgery. Conclusion— Osteochondral autografting deserves consideration and further evaluation as a primary treatment option for SCL of the proximal MTR of the talus in horses. Clinical Relevance— Based on the outcome of this case, osteochondral autografting appears to be a safe, valuable and realistic option for treating SCL of the proximal MTR of the talus in equine athletes.

Objective— To compare stiffness and strength of a dynamic condylar screw plate combined with dorsal broad dynamic compression plate (DCS–bDCP) fixation with double broad dynamic compression plate (dbDCP) fixation used to repair oblique distal fractures of adult equine radii. Study Design— Experimental. Sample Population— Adult equine radii (n=10 pair). Methods— An unconstrained three-dimensional loading–measurement system was used to determine stiffness of a 50 mm long intact, and then DCS–bDCP or dbDCP-plated osteotomized/ostectomized segment of radii when subjected to a nondestructive sequence of compression, torsion, and lateral-to-medial (LM), medial-to-lateral (ML), cranial-to-caudal (CrCa), and caudal-to-cranial (CaCr) bending. Uniform load over the entire length of construct identified its weakest characteristics during torsion and LM and CrCa bending to failure. Results— No difference was observed between osteotomized/ostectomized DCS–bDCP and dbDCP construct stiffness for all 6 loading modes, and strength for all 3 failure loads. Ostectomized DCS–bDCP and dbDCP construct stiffness was significantly lower than osteotomized radii, the latter approaching intact for axial, LM, and CrCa bending. Most frequent failure was bone fracture through exit site of a screw located adjacent to osteotomy/ostectomy. Conclusions— DCS–DCP and dbDCP constructs had comparable strength and stiffness when repairing osteotomies/ostectomies in equine adult radius bone. Fracture reduction increased stiffness that approached intact bone for loads that placed the unplated side in compression. Clinical Relevance— DCS–bDCP and dbDCP constructs are comparable in stiffness and strength when applied to oblique distal diaphyseal osteotomies/ostectomies in equine radius bone. However, the DCS's localized effect on distal epiphyseal structure because of additional bone removal remains to be investigated under in vivo articular loading conditions.

The purpose of this investigation was to design and verify the capabilities of an in vitro loading-measurement system that mimics in vivo unconstrained three dimensional (3D) relative motion between long bone ends, applies uniform load components over the entire length of a test specimen, and measures 3D relative motion between test segment ends to directly determine test segment construct stiffness free of errors due to potting-fixture-test machine finite stiffness. Intact equine cadaveric radius bones, which were subsequently osteotomized/ostectomized and instrumented with bone plates were subjected to non-destructive axial, torsion, and 4-point bending loads through fixtures designed to allow unconstrained components of non-load associated 3D relative motion between radius ends. 3D relative motion between ends of a 50 mm long test segment was measured by an infrared optical tracking system to directly determine its stiffness. Each specimen was then loaded to ultimate failure in either torsion or bending. Cortical bone cross-section diameters and published bone biomechanical properties were substituted into classical mechanics equations to predict the intact test segment theoretical stiffness for comparison and thus loading-measurement system verification. Intact measured stiffness values were the same order of magnitude as theoretically predicted. The primary component of relative motion between ends of the test segment corresponded to that of the applied load with the other 3D components being evident and consistent in relative magnitude and direction for unconstrained loading of an unsymmetrical double plate oblique fracture configuration. Bone failure configurations were reproducible and consistent with theoretically predicted. The 3D loading-measurement system designed: a) mimics unconstrained relative 3D motion between radius ends that occurs in clinical situations, b) applies uniform compression, torsion, and 4-point bending loads over the entire length of the test specimen, c) measures interfragmentary 3D relative motion between test segment ends to directly determine stiffness thus being void of potting-fixture-test machine stiffness error, and d) has the resolution to detect differences in the 3D motion and stiffness of intact as well osteotomized-instrumented and ostectomized-instrumented equine radii.

Olecranon fracture is a common orthopedic problem in juvenile horses. Prognosis for complete fracture healing when various methods of internal fixation are used is good; however, the impact of olecranon fracture stabilization on the likelihood that foals will start on a racecourse is unknown. Medical records of foals undergoing internal fixation for an olecranon fracture were reviewed. The dam’s foaling records were obtained and lifetime racing records were then retrieved for both the affected foals and 1 of their siblings. Twenty-two of 24 repaired fractures healed completely, subsequently, 16 of the foals started in at least 1 race. Statistical calculations suggest that when compared with their siblings, the occurrence of olecranon factures requiring internal fixation in juvenile racehorses will not significantly reduce the likelihood that they will race; however, the siblings had significantly more lifetime race starts and higher career earnings.