Diagnosis and management of solar penetrations

[Sole abscess (Pododermatitis purulenta superficialis) in a Bactrian camel - diagnosis, treatment, and healing process]

An approximately 14-year-old female Bactrian camel was referred to the University Clinic for Ruminants with left hindlimb lameness of two weeks duration. All findings of the general clinical examination were within normal limits. Orthopedic examination revealed a left supporting limb lameness score of 2 with moderate weight-shifting and reluctance to bear weight on the lateral toe at walk. The camel was sedated (0.24 mg/kg BW xylazine i.m.+1.92 mg/kg BW ketamine i.m., 0.04 mg/kg BW butorphanol) and rolled in lateral recumbency for further investigations. Sonographic examination of the cushion of the left hindlimb revealed an abscess of diameters of 11×2.3 cm impinging both digits between the sole horn and lateral and medial cushions. The abscess was opened under local infiltration anesthesia after a 5×5 cm incision at the central sole area, the abscess capsule removed with a sharp curette and the abscess cavity flushed. The wound was then bandaged. Postoperative treatment consisted of bandage changes every 5-7 days. For these procedures the camel was repeatedly sedated. At the first change the xylazine dosage was the same for surgery, and sequentially the dosage could be reduced (0.20 mg/kg BW i.m.), but finally increased for the last dressing changes (0.22 mg/kg BW i.m.). Ketamine dosages were also reduced slightly throughout the hospitalization period (1.51 mg/kg BW i.m.), enabling a reduction of the recovery period duration. After 6 weeks of regular bandage changes the wound had healed completely with a new horn layer and showing no lameness the camel could be discharged.

CT more accurately detects foreign bodies within the equine foot than MRI or digital radiography

Identification and characterization of foreign bodies in the distal limb of horses poses a diagnostic challenge. The aims of this prospective experimental cadaver study were to describe the appearance of five foreign body materials within the equine hoof using CT, MRI, and digital radiography (DR) and to compare interrater agreement among three reviewers. Fifty foreign bodies consisting of five materials were implanted at a solar location or a coronary location in 25 equine cadaver feet. The images were reviewed by three equine veterinarians experienced in advanced imaging interpretation, who were blinded to the material of the foreign body. Foreign bodies were graded on visibility and appearance. Sensitivity and specificity were calculated for accurate identification of the different materials. Interrater agreement was assessed using Fleiss' kappa. Computed tomography had higher visibility score, sensitivity/specificity, and interrater agreement for detection of all materials; particularly slate, glass, and dry wood, compared to the other imaging modalities. Soaked wood and plastic had lower sensitivity (31-33%) on CT with a similar attenuation of the two materials. Foreign bodies were often visible on MRI, although with similar appearance and unclear details. On DR, only slate and glass were visible. The interrater agreement for identifying the correct material was almost perfect for slate, glass, and dry wood (κ = 0.92-1.00) and poor for plastic and soaked wood (κ < 0.20) on CT. Interrater agreement was poor for all materials on MRI and DR (κ < 0.20), with the except for fair (κ = 0.28) for slate on DR and moderate (κ = 0.28) for soaked wood on MRI.

Factors associated with prolonged treatment days, increased veterinary visits and complications in horses with subsolar abscesses

There is a lack of epidemiological studies about equine subsolar (hoof) abscesses even though they are among one of the most common causes of acute, severe lameness. The goals of this study were to (1) describe the equine subsolar abscess patient population of the University of Pennsylvania's New Bolton Center's Field Service and (2) to determine the factors that are associated with increased veterinary visits, prolonged treatment and complications. Descriptive statistics were performed on data collected from 160 cases of equine subsolar abscess. Inferential statistics were performed on a subset of those cases. No significant results were identified in relation to an increased number of veterinary visits. Poisson regression of days of treatment revealed that abscesses diagnosed in the summer (incidence rate ratio (IRR)=9.42, P<0.001) and abscesses found at the coronary band (IRR=3.21, P<0.001) were more likely to be treated for longer. Presence of a draining tract (IRR=0.73, P=0.017) and a higher lameness (IRR=0.30, P=0.01 for grade 3, IRR=0.1, P<0.001 for grades 4 and 5) score at presentation resulted in shortened treatment times. Abscesses affecting multiple portions of the digit were associated with an increased chance of complication. The study presented here is the first retrospective study on subsolar abscesses to the authors' knowledge.