Standing CT and clinical progression of equine cholesterol granulomata

CHOLESTEROL granulomata – benign choroid plexus masses often detected at equine postmortem examinations – are sometimes associated with central neurological signs (Ivoghli and others 1977, Johnson and others 1993, Jackson and others 1994, King 1997). Antemortem diagnosis was impossible until advent of magnetic resonance imaging (Maulet and others 2008) and CT (Vink-Nooteboom and others 1998, Vanschandevijl and others 2008). These two cases are the first to illustrate diagnosis using standing (unanaesthetised) CT (CT Lightspeed QX/i; GE medical systems) and describe the long-term follow-up of one case, revealing that the prognosis for some cases is fair. Case 1: A 12-year-old Irish Draught cross gelding was presented with a 10-day history of intermittent lethargy and abnormal head carriage. On presentation, episodes of generalised muscle rigidity and ataxia were noticed by the owner; the horse was obtunded with reduced tongue tone and drooping of the lower lip and reluctant to flex or extend the neck and back. Neurological signs had improved following administration of methylprednisolone, penicillin and flunixin meglumine. On presentation to the Royal Veterinary College, the horse was obtunded; menace responses were reduced bilaterally, but pupillary light reflexes were intact. Mild superficial gluteal muscle fasciculations were evident. The horse had an exaggerated guarding response to deep palpation of the neck at C5 to C7. The neuroanatomical localisation suggested forebrain involvement, but based on cervical discomfort on …