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Formalin was injected into an ethmoidal hematoma in an 18-year-old Arabian gelding. Abnormal neurologic signs were observed within minutes of the injection. The horse did not respond favorably to medical treatment of the neurologic signs and was euthanatized. Postmortem examination revealed erosion and necrosis of the ventral cribriform plate, which appeared to have allowed the injected formalin to reach the rostral portion of the frontal lobe of the brain. Endoscopy and radiography had been performed prior to euthanasia, but neither delineated the cribriform lesion. Before treating large progressive ethmoidal hematomas with formalin, it may be beneficial to perform computed tomography to assess the extent of damage caused by the lesion.

A 9-year-old pregnant mare was referred for evaluation of a nonhealing wound of 8 weeks' duration on the lateral aspect of the left forelimb. A soft tissue mass encircled the proximal two thirds of the metacarpus; radiography revealed a moderate periosteal reaction affecting metacarpal bone i.v. Histologic and immunohistochemical examinations revealed eosinophilic granulomatous inflammation and Pythium sp in the soft tissues. The mare was treated for 12 days with antimicrobials, medicated wound dressings, debridement, and i.v. administration of sodium iodide; radiography revealed progression of the bone lesions. The mare was treated by regional arterial perfusion with miconazole and excision of affected soft tissues and the distal two thirds of metacarpal bone i.v. The mare recovered without complications and gave birth to a healthy foal. Regional perfusion of antifungal agents provides high concentrations in soft and osseous tissues and permits use of low dosages of agents administered by other routes, which reduces cost, adverse effects, and teratogenic effects.

Objective: To estimate sensitivity and accuracy of subjective evaluation of mild lameness in horses during treadmill locomotion and to correlate subjective evaluation with kinematic analysis., Animals: 19 lame and 5 clinically normal horses., Procedure: Lameness was evaluated by subjective score and kinematic analysis before and after palmar digital nerve block (PDNB). Evaluations were made by 6 clinicians and 7 interns or residents. Within- and between-observer agreement analyses (kappa values) were calculated and compared, using a Student's t-test. Pearson's product-moment correlation coefficients were calculated between clinician's change in score and the change in kinematic variables after PDNB., Results: Within-observer agreement was within the range expected for conditions of moderate diagnostic difficulty. Within-observer agreement was higher for clinicians than for interns or residents. Between-observer agreement was acceptable for scores within 1 value of each other. Between-observer agreement of change in lameness score after PDNB was poor. When kinematic variables were ranked with each clinician's subjective change in score, only 2 were among the top 3 for the majority of clinicians. Asymmetry of vertical head movement between contralateral forelimb stance phases and the point of maximum hoof height during swing decreased as lameness subjectively improved., Conclusion: Mild lameness may be difficult to evaluate during treadmill locomotion. Although clinicians were more repeatable in their subjective evaluation of lameness than interns or residents, they were not more reliable at detecting the true state of lameness., Clinical Relevance: Lack of agreement between clinician scoring of mild lameness emphasizes the need to use more objective measures for quantifying lameness.

Objective: To compare the biochemical, histochemical, and immunohistochemical profiles of articular cartilage from horses with naturally acquired distal tibial osteochondrosis (OC) with cartilage from a similar location in clinically normal horses., Animals: 9 affected horses (group 1, 16 OC lesions) and 4 control horses (group 2, 8 normal osteochondral specimens)., Procedure: OC specimens were collected during arthroscopic removal of the fragment, and control specimens were collected by aseptic osteotomy. Uronic acid, total protein, total glycosaminoglycan (GAG), chondroitin sulfate (CS), and keratan sulfate (KS) contents were determined. Histomorphologic, histochemical, and immunohistochemical examinations were performed on specimens after snap freezing at -80 C and cryosectioning. Monoclonal antibodies (MAB) 3B3 and 5D4 were applied for location of epitopes of CS and KS, respectively., Results: OC lesions had significantly lower quantity of uronic acid, total GAG, and CS, compared with normal cartilage. OC cartilage had significantly less intense staining with toluidine blue, along with irregular cellularity and tidemark characteristics, compared with normal cartilage. Monoclonal antibodies 3B3 and 5D4 stained OC cartilage, whereas MAB 5D4 did not stain control cartilage. Additionally, MAB 3B3 and 5D4 stained the fibrous tissue that was found firmly attached to the OC lesion located between the parent distal portion of the tibia and OC fragment., Conclusion: OC cartilage lesions of the distal intermediate ridge of the tibia in horses are biochemically, histochemically, and immunohistochemically distinct from normal cartilage from the same location. Results may reflect the inability of the chondrocyte of the developing joint to alter matrix components that would allow proper maturation and differentiation into bone.

OBJECTIVE--To document plasma, urine, and synovial fluid disposition of 2 common intra-articularly administered steroid preparations, methylprednisolone acetate (MPA) and isoflupredone acetate (IPA). DESIGN--Descriptive investigation. SAMPLE POPULATION--100 mg of MPA or 4 mg of IPA was administered to 2 groups of 4 healthy sound radiographically normal female horses. PROCEDURE--Blood samples were collected at time 0 (before) and 2, 4, 6, 8, 10, 12, 24, 36, 48, 72, and 96 hours after administration of the designated steroid. Complete urine collection for measurement of designated steroid was accomplished by use of occluding 28-F balloon catheters. Synovial fluid samples were aseptically aspirated from the injected and contralateral uninjected tarsocrural joint at time 0 and 8, 24, 48, 240, and 672 hours after administration of the designated steroid. All samples were screened by ELISA to detect parent drug or metabolite equivalent, with a sensitivity of 2.5 ng/ml for MPA and 0.1 ng/ml for IPA. If drug was detected by ELISA in the plasma or synovial fluid, the samples were further quantified and specified, using HPLC with a lower limit of quantification (10 ng/ml). RESULTS--Between 2 and 12 hours after administration, plasma contained < 10 ng of MPA or IPA/ml (parent drug or metabolite equivalent), as intermittently detected by ELISA. Parent drug or metabolite equivalent was detected in the urine for 24 and 72 hours after injection of IPA and MPA, respectively. Synovial fluid from the contralateral joint contained no detectable MPA or IPA at any sample collection time. Median half-life for MPA, as detected by HPLC, was 10.3 hours (range, 6.1 to 10.6) in the synovial space. Median half-life for methylprednisolone, as detected by HPLC, was 10.4 (range, 9.9 to 32.1) hours. CONCLUSIONS--Both steroids appeared to be rapidly hydrolyzed to their respective ester forms, as detected by HPLC. The ELISA appeared to be a useful screening tool for detection of corticosteroids in this variety of body fluids.

Medical records of 17 horses in which a distal sesamoid bone fracture was diagnosed between 1982 and 1992 were reviewed. There were 8 Standardbreds, 6 Quarter Horses, 2 Thoroughbreds, and 1 Arabian. Mean age was 4.7 years. A forelimb was affected in 15 horses, and a hind limb was affected in 2. All horses were lame, and most were grade III/V lame at the trot. In all horses, the diagnosis was confirmed by means of radiography. Five horses were treated with stall rest alone; 5 underwent neurectomy; 4 were treated with stall rest and corrective shoeing; and 1 was treated with stall rest and external coaptation. The other 2 horses were euthanatized. Two Quarter Horses, 1 treated with stall rest and corrective shoeing and the other treated with stall rest and external coaptation, returned to use as halter horses, and 2 Standardbreds treated with stall rest alone returned to racing, but at a lower level than they had raced prior to injury. One horse that underwent neurectomy could be used for pleasure riding. Long-term rest may be important in achieving a successful outcome. Pleasure horses would appear to have a better prognosis for return to use after a distal sesamoid bone fracture than do performance horses.