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Quam VG, Belacic ZA, Long S, Rice HC, Dhar MS, Durgam S. Equine bone marrow MSC-derived extracellular vesicles mitigate the inflammatory effects of interleukin-1β on navicular tissues in vitro. Equine Vet J 2024. [PMID: 38587145 DOI: 10.1111/evj.14090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 03/13/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Safe, efficacious therapy for treating degenerate deep digital flexor tendon (DDFT) and navicular bone fibrocartilage (NBF) in navicular horses is critically necessary. While archetypal orthobiologic therapies for navicular disease are used empirically, their safety and efficacy are unknown. Mesenchymal stem cell-derived extracellular vesicles (EV) may overcome several limitations of current orthobiologic therapies. OBJECTIVES To (1) characterise cytokine and growth factor profiles of equine bone marrow mesenchymal stem cell (BM-MSC)-derived extracellular vesicles (BM-EV) and (2) evaluate the in vitro anti-inflammatory and extracellular matrix (ECM) protective potentials of BM-EV on DDFT and NBF explant co-cultures in an IL-1β inflammatory environment. STUDY DESIGN In vitro experimental study. METHODS Cytokines (IL-1β, IL-6, IL-10, IL-1ra and TNF-α) and growth factors (TGFβ1, VEGF, IGF1 and PDGF) in equine BM-EV isolated via ultracentrifugation and precipitation methods were profiled. Forelimb DDFT and NBF explant co-cultures from seven horses were exposed to media alone, or media containing 2 × 109 ± 0.1 × 109 particles/mL or 10 μg/mL BM-EV (BM-EV), 10 ng/mL interleukin-1β (IL-1β), or IL-1β + BM-EV for 48 h. Co-culture media IL-6, TNF-α, MMP-3, MMP-13 concentrations and explant sulphated glycosaminoglycan (sGAG) content were quantified. RESULTS IL-6, IGF1 and VEGF concentrations were 102.1 (37.61-256.2) and 182.3 (163.1-226.3), 72.3 (8-175.6) and 2.4 (0.1-2.6), 108.3 (38.3-709.1) and 211.4 (189.1-318.2) pg/mL per 2 × 109 ± 0.1 × 109 particles/mL or 10 μg/mL 10 μg of BM-EV isolated via ultracentrifugation and precipitation methods, respectively. Co-culture media MMP-3 in BM-EV- (p = 0.03) and BM-EV + IL-1β-treated (p = 0.01) groups were significantly lower than the respective media and IL-1β groups. DDFT explant sGAG content of BM-EV (p = 0.003) and BM-EV + IL-1β groups were significantly higher compared with IL-1β group. MAIN LIMITATIONS Specimen numbers are limited, in vitro model may not replicate clinical case conditions, lack of non-MSC-derived EV control group. CONCLUSIONS Equine BM-EV contains IL-6 and growth factors, IGF1 and VEGF. The anti-inflammatory and ECM protective potentials of BM-EV were evident as increased IL-6 and decreased MMP-3 concentrations in the DDFT-NBF explant co-culture media. These results support further evaluation of BM-EV as an acellular and 'off-the-shelf' intra-bursal/intrasynovial therapy for navicular pathologies.
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Affiliation(s)
- Vivian G Quam
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
- Ballarat Veterinary Practice Equine Clinic, Miners Rest, Victoria, Australia
| | - Zarah A Belacic
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Sidney Long
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Hilary C Rice
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
| | - Madhu S Dhar
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee, USA
| | - Sushmitha Durgam
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA
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Mienaltowski MJ, Callahan M, Gonzales NL, Wong A. Examining the Potential of Vitamin C Supplementation in Tissue-Engineered Equine Superficial Digital Flexor Tendon Constructs. Int J Mol Sci 2023; 24:17098. [PMID: 38069418 PMCID: PMC10707379 DOI: 10.3390/ijms242317098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/26/2023] [Accepted: 12/01/2023] [Indexed: 12/18/2023] Open
Abstract
Because equine tendinopathies are slow to heal and often recur, therapeutic strategies are being considered that aid tendon repair. Given the success of utilizing vitamin C to promote tenogenesis in other species, we hypothesized that vitamin C supplementation would produce dose-dependent improvements in the tenogenic properties of tendon proper (TP) and peritenon (PERI) cells of the equine superficial digital flexor tendon (SDFT). Equine TP- and PERI-progenitor-cell-seeded fibrin three-dimensional constructs were supplemented with four concentrations of vitamin C. The gene expression profiles of the constructs were assessed with 3'-Tag-Seq and real-time quantitative polymerase chain reaction (RT-qPCR); collagen content and fibril ultrastructure were also analyzed. Moreover, cells were challenged with dexamethasone to determine the levels of cytoprotection afforded by vitamin C. Expression profiling demonstrated that vitamin C had an anti-inflammatory effect on TP and PERI cell constructs. Moreover, vitamin C supplementation mitigated the degenerative pathways seen in tendinopathy and increased collagen content in tendon constructs. When challenged with dexamethasone in two-dimensional culture, vitamin C had a cytoprotective effect for TP cells but not necessarily for PERI cells. Future studies will explore the effects of vitamin C on these cells during inflammation and within the tendon niche in vivo.
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Affiliation(s)
- Michael J. Mienaltowski
- Department of Animal Science, College of Agricultural & Environmental Sciences, University of California Davis, Davis, CA 95616, USA
| | - Mitchell Callahan
- Department of Animal Science, College of Agricultural & Environmental Sciences, University of California Davis, Davis, CA 95616, USA
| | - Nicole L. Gonzales
- School of Veterinary Medicine, University of California Davis, Davis, CA 95616, USA
| | - Angelique Wong
- Department of Animal Science, College of Agricultural & Environmental Sciences, University of California Davis, Davis, CA 95616, USA
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Hewitt‐Dedman CL, Biggi M, Van Zadelhoff C, Schwarz T, Reardon RJM, Taylor SE. Imaging findings and clinical outcome of foot pain attributable to insertional deep digital flexor tendon injury and/or fluid signal within the flexor surface of the distal phalanx. EQUINE VET EDUC 2022. [DOI: 10.1111/eve.13503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C. L. Hewitt‐Dedman
- Royal (Dick) School of Veterinary Studies and Roslin Institute The University of Edinburgh Roslin UK
| | - M. Biggi
- VetCT St John’s Innovation Centre Cambridge UK
| | - C. Van Zadelhoff
- Royal (Dick) School of Veterinary Studies and Roslin Institute The University of Edinburgh Roslin UK
| | - T. Schwarz
- Royal (Dick) School of Veterinary Studies and Roslin Institute The University of Edinburgh Roslin UK
| | - R. J. M. Reardon
- Royal (Dick) School of Veterinary Studies and Roslin Institute The University of Edinburgh Roslin UK
| | - S. E. Taylor
- Royal (Dick) School of Veterinary Studies and Roslin Institute The University of Edinburgh Roslin UK
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Garrett KS. When radiography and ultrasonography are not enough: the use of computed tomography and magnetic resonance imaging for equine lameness cases. J Am Vet Med Assoc 2022; 260:1113-1123. [PMID: 35544423 DOI: 10.2460/javma.22.03.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
MRI and CT have enhanced our diagnostic abilities for equine lameness beyond what is available using radiography and ultrasonography. This has allowed veterinarians to better prognosticate and treat lameness conditions, improving patient outcomes. This article discusses the basic principles behind MRI and CT, their advantages and disadvantages, the different types of equipment available for clinical use in horses, the typical diagnostic workup prior to pursuing advanced imaging, and common regions where MRI and CT are used clinically. The companion Currents in One Health by Spriet, AJVR, July 2022, discusses even more advanced equine imaging in the form of positron emission tomography. Combined, these future directions of MRI, CT, and positron emission tomography may include improved ability to image standing horses or screen for injury prevention.
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Z-Bar Shoeing Demonstrates Potential for Long-Term Foot Pain Management during an Exercise Training Regimen in a Show Jumping Pony with Uniaxial Palmar Pain. Case Rep Vet Med 2022; 2022:8468403. [PMID: 35465448 PMCID: PMC9020972 DOI: 10.1155/2022/8468403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/13/2022] [Accepted: 03/16/2022] [Indexed: 11/17/2022] Open
Abstract
Z-bar shoeing has been implemented to relieve uniaxial palmar pain arising from the structures in the affected region. However, there have been no reports on the long-term application of the z-bar shoe during exercise training regimens. A 10-year-old mixed-breed show jumping pony presented with an occasional short stride and abnormal rhythm while turning during routine exercise for three months. Gait analysis conducted by trotting off on both hard and soft surfaces showed no lameness in the straight line on both types of surfaces. However, right forelimb lameness was detected with moderate and slight pain accompanying hard surface lunging in clockwise and counterclockwise directions, respectively. Sequential examination of uniaxial perineural anaesthesia confirmed that the pony suffered from medial palmar pain on the right foreleg. Mild distal border irregularity of the navicular bone was also observed radiographically. The z-bar shoe was designed relative to the palmar digital anaesthesia and subsequently applied on the lame leg. The pony demonstrated a marked reduction in lameness severity immediately post-Z-bar shoeing. Physical exercise was resumed a few days after the shoeing practice. The pony underwent routine exercise training while continuously fitting with the Z-bar shoe for 24 weeks without recurrent lameness or complications. Application of z-bar shoe showed the potential for long-term foot pain management during an exercise training regimen in a show jumping pony with uniaxial palmar pain.
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Quam VG, Altmann NN, Brokken MT, Durgam SS. Zonal characterization and differential trilineage potentials of equine intrasynovial deep digital flexor tendon-derived cells. BMC Vet Res 2021; 17:138. [PMID: 33794882 PMCID: PMC8015054 DOI: 10.1186/s12917-021-02793-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/08/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Intrasynovial deep digital flexor tendon (DDFT) injuries occur frequently and are often implicated in cases of navicular disease with poor outcomes and reinjuries. Cell-based approaches to tendon healing are gaining traction in veterinary medicine and ultimately may contribute to improved DDFT healing in horses. However, a better understanding of the innate cellular characteristics of equine DDFT is necessary for developing improved therapeutic strategies. Additionally, fibrocartilaginous, intrasynovial tendons like the DDFT are common sites of injury and share a poor prognosis across species, offering translational applications of this research. The objective of this study is to isolate and characterize tendon-derived cells (TDC) from intrasynovial DDFT harvested from within the equine forelimb podotrochlear bursa. TDC from the fibrocartilaginous and tendinous zones are separately isolated and assessed. Flow cytometry is performed for mesenchymal stem cell (MSC) surface markers (CD 29, CD 44, CD 90). Basal tenogenic, osteogenic and chondrogenic markers are assessed via quantitative real time-PCR, and standard trilineage differentiation is performed with third passage TDC from the fibrocartilaginous (fTDC) and tendinous (tTDC) zones of DDFT. RESULTS Low-density plating isolated homogenous TDC populations from both zones. During monolayer passage, both TDC subpopulations exhibited clonogenicity, high in vitro proliferation rate, and fibroblast-like morphology. fTDC and tTDC were positive for MSC surface markers CD90 and CD29 and negative for CD44. There were no significant differences in basal tenogenic, osteogenic or chondrogenic marker expression between zones. While fTDC were largely restricted to chondrogenic differentiation, tTDC underwent osteogenic and chondrogenic differentiation. Both TDC subpopulations displayed weak adipogenic differentiation potentials. CONCLUSIONS TDC at the level of the podotrochlear bursa, that potentially could be targeted for enhancing DDFT injury healing in horses were identified and characterized. Pending further investigation, promoting chondrogenic properties in cells administered exogenously into the intrasynovial space may be beneficial for intrasynovial tendon regeneration.
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Affiliation(s)
- Vivian G Quam
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH, USA
| | - Nadine N Altmann
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH, USA
| | - Matthew T Brokken
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH, USA
| | - Sushmitha S Durgam
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, 601 Vernon L. Tharp Street, Columbus, OH, USA.
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Sullivan SN, Altmann NN, Brokken MT, Durgam SS. In vitro Effects of Methylprednisolone Acetate on Equine Deep Digital Flexor Tendon-Derived Cells. Front Vet Sci 2020; 7:486. [PMID: 32851046 PMCID: PMC7419577 DOI: 10.3389/fvets.2020.00486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 06/29/2020] [Indexed: 11/25/2022] Open
Abstract
Primary deep digital flexor tendon (DDFT) pathologies and those accompanying degenerative changes of navicular bone fibrocartilage are major causes of lameness associated with navicular disease. Intrasynovial corticosteroids are mainstay in the treatment due to the anti-inflammatory effects, but their effect on DDFT cell biosynthesis are unknown. The objective of this in-vitro study was to investigate the effects of methylprednisolone acetate (MPA) on cells isolated from the dorsal fibrocartilaginous region of forelimb DDFTs (DDFT-derived cells) of 5 horses (aged 11–17 years). Non-adherent aggregate cultures were established from third passage cells over a 72 to 96-h duration prior to treating with medium containing 0 (control), 0.05 and 0.5 mg/mL MPA for 24 h. Tendon and cartilage extracellular matrix (ECM) related gene expression, cell aggregate and culture medium GAG contents, culture medium collagen and MMP-3 and−13 concentrations were measured. After 24 h of treatment, only the higher MPA concentration (0.5 mg/mL) significantly down-regulated tendon ECM related genes; whereas, both MPA doses significantly down-regulated cartilage ECM related genes. MPA treatment did not affect the total GAG content of DDFT-derived cells or total GAG, soluble collagen and MMP-3 and−13 contents in culture medium compared to untreated controls. Future studies to determine the response of DDFT-derived cells with longer exposure times to corticosteroids and in the presence of inflammatory cytokines are necessary. These results are a first step in assessing the effects of intrasynovial medications on equine DDFT, for which currently no information exists.
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Affiliation(s)
- Stasia N Sullivan
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
| | - Nadine N Altmann
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
| | - Matthew T Brokken
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
| | - Sushmitha S Durgam
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
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8
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Koch DW, Barrett MF, Jackman BR, MacDonald D, Goodrich LR. Comparison of lameness outcomes in horses with acute or chronic digital lameness that underwent magnetic resonance imaging. N Z Vet J 2020; 68:283-288. [PMID: 32248754 DOI: 10.1080/00480169.2020.1750499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Aims: To compare the outcome, in terms of lameness score or return to athletic function, of horses with acute vs. chronic digital lameness that underwent magnetic resonance imaging (MRI) of the distal limb and to compare the proportion of horses that received intra-articular therapy of the distal interphalangeal (DIP) joint and pattern of diagnostic analgesia in these groups. Methods: This is a retrospective study of horses (n = 95) with acute (≤12 weeks; n = 46) or chronic (>12 weeks; n = 49) digital lameness that underwent MRI of the distal limb from 2009-2016, at two equine referral centres in the USA. Criteria for inclusion in the study were that a majority of lameness localised distal to the fetlock, and that lameness assessments for ≥12 months following MRI could be obtained from the medical record or the owner could be interviewed regarding their horse's athletic function. Outcome was characterised by an improvement score where 2 = return to work at a previous or higher level or lameness improved by one grade or more, 1 = return to work at a lower level or lameness improved by less than one grade, and 0 = did not return to work or lameness grade worsened. Whether horses had received intra-articular therapy of the DIP joint and the pattern of diagnostic analgesia prior to MRI was also obtained from medical records or by interviewing the owner. Results: There was a difference (p = 0.004) in the proportion of horses assigned to improvement scores of 0, 1 and 2 between horses with acute or chronic lameness. There was no evidence of a difference in the likelihood of having received intra-articular therapy of the DIP joint prior to MRI between horses with chronic or acute lameness (p = 0.085). Similarly, there was no evidence of a difference in the pattern of diagnostic analgesia prior to MRI between the two groups (p = 0.94). Eighty-two percent of owners of horses with acute and 62% of those with horses with chronic lameness had a positive opinion of the utility of MRI as a diagnostic modality. Conclusion: In a population of horses with digital lameness undergoing MRI, a difference in the outcome, in terms of lameness score or return to athletic function was identified between horses with acute lameness compared to those with chronic lameness. Clinical relevance: Horses with digital lameness that undergo MRI when the lameness is acute may have an improved prognosis due to accurate diagnosis and earlier application of appropriate therapy.
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Affiliation(s)
- D W Koch
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - M F Barrett
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | | | | | - L R Goodrich
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
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Gutierrez-Nibeyro SD, Werpy NM, Gold SJ, Olguin S, Schaeffer DJ. Standing MRI lesions of the distal interphalangeal joint and podotrochlear apparatus occur with a high frequency in warmblood horses. Vet Radiol Ultrasound 2020; 61:336-345. [PMID: 32162431 DOI: 10.1111/vru.12855] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 01/12/2020] [Accepted: 01/19/2020] [Indexed: 11/30/2022] Open
Abstract
Foot pain is a common presenting complaint in Warmblood horses. The aim of this retrospective, cross-sectional study was to determine the spectrum of foot lesions detected by magnetic resonance imaging (MRI) in Warmblood horses used for dressage, jumping, and eventing. The medical records of 550 Warmblood horses with foot pain that were scanned using standing MRI were reviewed and the following data were recorded: signalment, occupation, lameness, diagnostic analgesia, imaging results, treatments, and follow-up assessments. Associations between standing MRI lesions and chronic lameness following treatment were tested. Abnormalities of the navicular bone (409 horses, 74%), distal interphalangeal joint (362 horses, 65%), and deep digital flexor (DDF) tendon (260 horses, 47%) occurred with the highest frequency. The following abnormalities were significantly associated (P < .05) with chronic lameness following conservative therapy: moderate to severe MRI lesions in the trabecular bone of the navicular bone, mild or severe erosions of the flexor surface of the navicular bone, moderate sagittal/parasagittal DDF tendinopathies, and moderate collateral sesamoidean desmopathies. Also, identification of concurrent lesions of the DDF tendon, navicular bone, navicular bursa, and distal sesamoidean impar ligament was associated with chronic lameness after conservative therapy. Development of effective treatment options for foot lesions that respond poorly to conservative therapy is necessary.
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Affiliation(s)
- Santiago D Gutierrez-Nibeyro
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois
| | | | | | - Silvia Olguin
- College of Veterinary Medicine, University of La Plata, La Plata, Buenos Aires, Argentina
| | - David J Schaeffer
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois
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Kirkpatrick CJ, Ernst NS, Trumble TN. Palmar/plantar approach for radiographic-guided injection of the equine distal interphalangeal joint collateral ligament insertion. Vet Rec 2019; 184:527. [PMID: 30842259 DOI: 10.1136/vr.105027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 11/26/2018] [Accepted: 01/28/2019] [Indexed: 11/03/2022]
Abstract
There are limited radiographic-guided injection techniques of the insertion of the distal interphalangeal joint (DIPJ) collateral ligaments. The objective of this study was to develop and evaluate a palmar/plantar radiographic-guided injection of the collateral ligament insertion in cadavers. Fifty limbs were used to develop the technique and 24 additional limbs were used to evaluate accuracy. An 18 G, 9 cm spinal needle was placed in the depression between the palmar digital neurovascular bundle and arch of the ungular cartilage with dorsodistal advancement towards the distal phalanx collateral fossa. Radiographs verified ideal needle location on the proximal border of the distal phalanx at the collateral fossa. Dye was injected. Hoof walls were partially removed and collateral ligaments were dissected with needles in place to determine needle and dye location. Accuracy of needle placement into the insertion of the DIPJ collateral ligament was 41/48 (85 per cent), with lower accuracy of dye within the ligament (34/48; 71 per cent). Dye entered the DIPJ in 2/48 injections, but dye entered periligamentous structures in 22/48 (46 per cent) injections. A palmar/plantar radiographic-guided injection of the insertion of the DIPJ collateral ligament had high accuracy rate with low injection rate of the DIPJ in cadavers.
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Affiliation(s)
- C Jordan Kirkpatrick
- Veterinary Population Medicine, University of Minnesota College of Veterinary Medicine, St Paul, Minnesota, USA
| | - Nicolas S Ernst
- Veterinary Population Medicine, University of Minnesota College of Veterinary Medicine, St Paul, Minnesota, USA
| | - Troy N Trumble
- Veterinary Population Medicine, University of Minnesota College of Veterinary Medicine, St Paul, Minnesota, USA
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Dau SL, Azevedo MS, de La Corte FD, Brass KE, Ceni F, Cantareli C. Management of chronic foot lameness with 2% ammonium chloride on the palmar digital nerves. EQUINE VET EDUC 2018. [DOI: 10.1111/eve.12972] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S. L. Dau
- Department of Large Animal Clinics School of Veterinary Medicine Federal University of Santa Maria Santa Maria RS Brazil
| | - M. S. Azevedo
- Department of Large Animal Clinics School of Veterinary Medicine Federal University of Santa Maria Santa Maria RS Brazil
| | - F. D. de La Corte
- Department of Large Animal Clinics School of Veterinary Medicine Federal University of Santa Maria Santa Maria RS Brazil
| | - K. E. Brass
- Department of Large Animal Clinics School of Veterinary Medicine Federal University of Santa Maria Santa Maria RS Brazil
| | - F. Ceni
- Department of Large Animal Clinics School of Veterinary Medicine Federal University of Santa Maria Santa Maria RS Brazil
| | - C. Cantareli
- Department of Large Animal Clinics School of Veterinary Medicine Federal University of Santa Maria Santa Maria RS Brazil
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12
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Gutierrez-Nibeyro SD, McCoy AM, Selberg KT. Recent advances in conservative and surgical treatment options of common equine foot problems. Vet J 2018; 237:9-15. [PMID: 30089549 DOI: 10.1016/j.tvjl.2018.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 05/09/2018] [Accepted: 05/15/2018] [Indexed: 12/25/2022]
Abstract
Foot problems are very common causes of lameness in horses. With the recent diagnostic advances to evaluate and treat foot pathology as well as to monitor response to therapy, it is now possible to more accurately evaluate the effectiveness of many of these treatments. This review details some of the recent advances of the most common conservative and surgical treatment options for foot problems in horses, including an overview of evidence on the efficacy to support the use of these treatment options and on factors that may affect prognosis.
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Affiliation(s)
- S D Gutierrez-Nibeyro
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA.
| | - A M McCoy
- Department of Clinical Veterinary Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA
| | - K T Selberg
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
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13
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Bergren AL, Abuja GA, Bubeck KA, Spoormakers TJP, García-López JM. Diagnosis, treatment and outcome of cranial nuchal bursitis in 30 horses. Equine Vet J 2017; 50:465-469. [DOI: 10.1111/evj.12787] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 10/29/2017] [Indexed: 11/30/2022]
Affiliation(s)
- A. L. Bergren
- Department of Clinical Sciences; Tufts University; Cummings School of Veterinary Medicine; North Grafton Massachusetts USA
| | - G. A. Abuja
- Rhinebeck Equine L.L.P; Rhinebeck New York USA
| | - K. A. Bubeck
- Department of Clinical Sciences; Tufts University; Cummings School of Veterinary Medicine; North Grafton Massachusetts USA
| | - T. J. P. Spoormakers
- Department of Equine Sciences of Veterinary Medicine; Utrecht University; Utrecht The Netherlands
| | - J. M. García-López
- Department of Clinical Sciences; Tufts University; Cummings School of Veterinary Medicine; North Grafton Massachusetts USA
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Dau S, Azevedo M, Corte FDL, Brass K, Gallio M, Ceni F, Lubini B. Response of three digital anesthetic technics in horses with forelimb hoof lameness. ARQ BRAS MED VET ZOO 2017. [DOI: 10.1590/1678-4162-9155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT The presented study aimed to assess objectively the response of distal interphalangeal joint (DIJ), navicular bursa (NB) and deep digital flexor tendon sheath (DDFTS) anesthesia in horses with forelimb hoof lameness; and evaluate if the presence of radiographic abnormalities on navicular bone could interfere on blocks’ results. Fifteen horses with lameness improvement above 70% after palmar digital nerve (PDN) block were selected for this study. Blocks were assessed separately on five consecutive trials at seven different time-points. The fifth trial was performed to evaluate the influence of exercise on preexisting lameness. Most of horses (73.33%) presented pain related to the podotrochlear apparatus based on clinical and lameness exam and blocks’ responses. NB and DIJ anesthesia differed on the frequency of horses with lameness improvement above 70% only at 10min (p=0.03), and both differed from DDFTS block until 30’(p<0.05). The blocks’ response was variable along the time and the highest means for NB, DIJ and DDFTS were observed at 5-10 minutes (’), 15-20’ and 10-15’ respectively.Exercise had low interference on lameness intensity since no improvement above 50% was observed and an increase on lameness intensity over time was identified in seven horses. Variable grades of navicular bone radiographic lesions were observed in 14 horses, although these lesions had no interference on blocks’ response (p>0.05). The NB and DIJ blocks had similar responses and both were superior to DDFTS anesthesia, coincident with a major prevalence of podotroclear apparatus abnormalities in this equine population.
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Affiliation(s)
- S.L. Dau
- Universidade Federal de Santa Maria, Brazil
| | | | | | - K.E. Brass
- Universidade Federal de Santa Maria, Brazil
| | - M. Gallio
- Universidade Federal de Santa Maria, Brazil
| | - F. Ceni
- Universidade Federal de Santa Maria, Brazil
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15
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Abstract
There has been great progress in the understanding of basic neurobiologic mechanisms of pain, but this body of knowledge has not yet translated into new and improved analgesics. Progress has been made regarding pain assessment in horses, but more work is needed until sensitive and accurate pain assessment tools are available for use in clinical practice. This review summarizes and updates the knowledge concerning the cornerstones of pain medicine (understand, assess, prevent, and treat). It highlights the importance of understanding pain mechanisms and expressions to enable a rational approach to pain assessment, prevention, and management in the equine patient.
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Schramme M. Treatment of tendinopathy in the foot - what have we learned so far? EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- M. Schramme
- Clinéquine; VetAgro Sup; Campus Vétérinaire de Lyon; University of Lyon; France
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17
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Humbach KE, Gutierrez-Nibeyro SD. Desmotomy of the accessory ligament of the deep digital flexor tendon for treatment of chronic deep digital flexor tendinopathy in three Quarter Horses. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12713] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- K. E. Humbach
- Department of Clinical Veterinary Medicine; College of Veterinary Medicine; University of Illinois; Urbana Illinois USA
| | - S. D. Gutierrez-Nibeyro
- Department of Clinical Veterinary Medicine; College of Veterinary Medicine; University of Illinois; Urbana Illinois USA
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18
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Whitfield CT, Schoonover MJ, Holbrook TC, Payton ME, Sippel KM. Quantitative assessment of two methods of tiludronate administration for the treatment of lameness caused by navicular syndrome in horses. Am J Vet Res 2016; 77:167-73. [PMID: 27027711 DOI: 10.2460/ajvr.77.2.167] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine effects of 2 tiludronate administration protocols on measures of lameness in horses with navicular syndrome (NS). ANIMALS 12 horses with bilateral forelimb NS. PROCEDURES Horses were randomly assigned to receive tiludronate (1 mg/kg), diluted in 5 L of isotonic electrolyte solution and delivered through a jugular vein catheter (systemic treatment group; n = 6), or tiludronate (0.1 mg/kg), diluted with saline (0.9% NaCl) solution to a total volume of 35 mL and delivered into the lateral digital vein of each forelimb with an IV regional limb perfusion (IVRLP) technique (IVRLP group; 6). Mean peak vertical ground reaction force (pVGRF) measured with a stationary force plate and subjective lameness scores (SLSs) were recorded before (day -1) and at predetermined time points after tiludronate administration on day 0. Mean pVGRFs (standardized as percentage body weight of force) and mean SLSs for the most lame forelimb and for both forelimbs of horses in each group were compared with day -1 values to determine treatment effect. RESULTS Mean pVGRF for both forelimbs and for the most lame forelimbs of systemically treated horses were significantly increased on days 120 and 200, compared with day -1 results. No significant difference in mean pVGRF was observed for IVRLP-treated horses. The SLSs were not improved at any time point following systemic treatment and were improved only on day 120 following IVRLP. CONCLUSIONS AND CLINICAL RELEVANCE Tiludronate (1 mg/kg, IV) as a single systemic treatment appeared to be beneficial for horses with NS, but no horses were judged as sound during the study period. Additional research on IVRLP with tiludronate is needed before this method can be recommended.
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White NA, Barrett JG. Magnetic Resonance Imaging-Guided Treatment of Equine Distal Interphalangeal Joint Collateral Ligaments: 2009-2014. Front Vet Sci 2016; 3:73. [PMID: 27656645 PMCID: PMC5011138 DOI: 10.3389/fvets.2016.00073] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Accepted: 08/23/2016] [Indexed: 12/22/2022] Open
Abstract
Objectives To determine the outcome of treating distal interphalangeal joint collateral ligament (DIJCL) desmopathy using magnetic resonance imaging (MRI)-guided ligament injection. Methods Medical records of 13 adult horses diagnosed with DIJCL desmopathy using low-field MRI and treated by MRI-guided ligament injection of mesenchymal stem cells and/or platelet-rich plasma (PRP) were reviewed. Information collected included signalment, MRI diagnosis, treatment type, time to resolution of lameness, and level of exercise after treatment. Results Collateral ligament inflammation was diagnosed as a cause of lameness in 13 horses. MRI was used to guide the injection of the injured DIJCL. All lameness attributed to DIJCL desmopathy resolved with the resulting level of performance at expected (10) or less than expected (3). Conclusion and clinical relevance Injection of the DIJCL can be safely completed in horses standing in a low-field magnet guided by MRI as previously demonstrated in cadaver specimens. The positive response in all horses suggests that administration of stem cells or PRP along with rest and appropriate shoeing may be a safe and useful treatment for DIJCL desmopathy.
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Affiliation(s)
- Nathaniel A White
- Marion duPont Scott Equine Medical Center, Virginia-Maryland College of Veterinary Medicine, Virginia Tech , Leesburg, VA , USA
| | - Jennifer G Barrett
- Marion duPont Scott Equine Medical Center, Virginia-Maryland College of Veterinary Medicine, Virginia Tech , Leesburg, VA , USA
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20
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Development and Evaluation of Ultrasound-Guided Navicular Bursa Injection Using the Palmarodistal Digital Approach in Horses: an Ex Vivo Study. J Equine Vet Sci 2015. [DOI: 10.1016/j.jevs.2015.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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21
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McGill SL, Gutierrez-Nibeyro SD, Schaeffer DJ, Hartman SK, O'Brien RT, Joslyn SK. SALINE ARTHROGRAPHY OF THE DISTAL INTERPHALANGEAL JOINT FOR LOW-FIELD MAGNETIC RESONANCE IMAGING OF THE EQUINE PODOTROCHLEAR BURSA: FEASIBILITY STUDY. Vet Radiol Ultrasound 2015; 56:417-24. [PMID: 25857430 DOI: 10.1111/vru.12255] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 01/14/2015] [Indexed: 11/27/2022] Open
Abstract
Abnormalities of the deep digital flexor tendon, navicular bone, and collateral sesamoidean ligament can be difficult to visualize using magnetic resonance imaging (MRI) if bursal fluid is absent. The use of saline podotrochlear bursography improves podotrochlear apparatus evaluation, however, the technique has disadvantages. The objective of this prospective feasibility study was to describe saline arthrography of the distal interphalangeal joint as an alternative technique for improving MRI visualization of the deep digital flexor tendon, navicular bone, collateral sesamoidean ligament, and podotrochlear bursa, and to compare this technique with saline podotrochlear bursography. Eight paired cadaver forelimbs were sampled. Saline podotrochlear bursography or saline arthrography techniques were randomly assigned to one limb, with the alternate technique performed on the contralateral limb. For precontrast and postcontrast studies using each technique, independent observers scored visualization of the dorsal aspect of the deep digital flexor tendon, palmar aspect of the navicular bone, collateral sesamoidean ligament, and podotrochlear bursa. Both contrast techniques improved visualization of structures over precontrast MR images and visualization scores for both techniques were similar. Findings from this study demonstrated that saline arthrography is feasible and comparable to saline podotrochlear bursography for producing podotrochlear bursa distension and separation of the structures of the podotrochlear apparatus on nonweight bearing limbs evaluated with low-field MRI. Clinical evaluation of saline arthrography on live animals is needed to determine if this technique is safe and effective as an alternative to saline podotrochlear bursography in horses with suspected pathology of the podotrochlear apparatus.
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Affiliation(s)
- Shannon L McGill
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
| | | | - David J Schaeffer
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
| | - Susan K Hartman
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
| | - Robert T O'Brien
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
| | - Stephen K Joslyn
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
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22
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Gutierrez-Nibeyro SD, Werpy NM, White NA, Mitchell MA, Edwards RB, Mitchell RD, Gold SJ, Allen AK. Outcome of palmar/plantar digital neurectomy in horses with foot pain evaluated with magnetic resonance imaging: 50 cases (2005-2011). Equine Vet J 2014; 47:160-4. [DOI: 10.1111/evj.12262] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 02/26/2014] [Indexed: 11/27/2022]
Affiliation(s)
- S. D. Gutierrez-Nibeyro
- Department of Veterinary Clinical Medicine; College of Veterinary Medicine; University of Illinois; Urbana Illinois USA
| | - N. M. Werpy
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville Florida USA
| | - N. A. White
- Marion duPont Scott Equine Medical Center; Leesburg Virginia USA
| | - M. A. Mitchell
- Department of Veterinary Clinical Medicine; College of Veterinary Medicine; University of Illinois; Urbana Illinois USA
| | - R. B. Edwards
- Fairfield Equine Associates; Newtown Connecticut USA
| | | | - S. J. Gold
- BW Furlong & Associates; Oldwick New Jersey USA
| | - A. K. Allen
- Virginia Equine Imaging; The Plains Virginia USA
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23
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Hunter BG, Huber MJ, Nemanic S. The use of computed tomography to diagnose bilateral forelimb tendon pathology in a horse with unilateral lameness. EQUINE VET EDUC 2014. [DOI: 10.1111/eve.12166] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- B. G. Hunter
- Department of Clinical Sciences; Oregon State University College of Veterinary Medicine; Corvallis USA
| | - M. J. Huber
- Department of Clinical Sciences; Oregon State University College of Veterinary Medicine; Corvallis USA
| | - S. Nemanic
- Department of Clinical Sciences; Oregon State University College of Veterinary Medicine; Corvallis USA
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24
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Gutierrez-Nibeyro SD, Santos MP, White NA, Brown JA, Adams MN, McKnight AL, Schaeffer DJ. Effects of intrabursal administration of botulinum toxin type B on lameness in horses with degenerative injury to the podotrochlear apparatus. Am J Vet Res 2014; 75:282-9. [PMID: 24564314 DOI: 10.2460/ajvr.75.3.282] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the safety and short-term efficacy of intrabursal administration of botulinum toxin type B (BTXB) to alleviate lameness in horses with degenerative injury to the podotrochlear apparatus (PA). ANIMALS 10 Quarter Horses with degenerative injury to the PA. PROCEDURES Degenerative injury to the PA was confirmed with diagnostic analgesia and imaging. Then, BTXB (3.8 to 4.5 U/kg) was injected into the podotrochlear (navicular) bursa of each horse. Three horses were used in a safety evaluation. Subsequently, video recordings of lameness evaluations were obtained for 7 client-owned horses 5 days before (baseline) and 7 and 14 days after BTXB treatment and used to determine the effect of BTXB injection on lameness; 1 horse was removed from the study 8 days after BTXB treatment. Three investigators who were unaware of the treated forelimbs or time points separately reviewed the recordings and graded the lameness of both forelimbs of the horses. RESULTS Improvement in lameness of the treated forelimbs was detected at 1 or both time points after BTXB administration in all horses. However, all horses had some degree of lameness at the end of the study. Two horses developed transient increases in lameness 48 to 72 hours after treatment; lameness resolved uneventfully. CONCLUSIONS AND CLINICAL RELEVANCE Intrabursal injection of BTXB temporarily alleviated chronic lameness in horses with degenerative injury to the PA, without causing serious short-term adverse effects. Further investigation into the potential use of BTXB in horses affected by degenerative injury to the PA is warranted.
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Affiliation(s)
- Santiago D Gutierrez-Nibeyro
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61802
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25
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Lamb MM, Barrett JG, White NA, Werre SR. ACCURACY OF LOW-FIELD MAGNETIC RESONANCE IMAGING VERSUS RADIOGRAPHY FOR GUIDING INJECTION OF EQUINE DISTAL INTERPHALANGEAL JOINT COLLATERAL LIGAMENTS. Vet Radiol Ultrasound 2013; 55:174-81. [DOI: 10.1111/vru.12109] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 07/22/2013] [Indexed: 11/29/2022] Open
Affiliation(s)
- Megan M. Lamb
- Marion duPont Scott Equine Medical Center; Virginia-Maryland Regional College of Veterinary Medicine; Virginia Tech University; VA 24601
| | - Jennifer G. Barrett
- Marion duPont Scott Equine Medical Center; Virginia-Maryland Regional College of Veterinary Medicine; Virginia Tech University; VA 24601
| | - Nathaniel A. White
- Marion duPont Scott Equine Medical Center; Virginia-Maryland Regional College of Veterinary Medicine; Virginia Tech University; VA 24601
| | - Stephen R. Werre
- Laboratory for Study Design and Statistical Analysis; Virginia Tech University; VA 24601
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26
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Charles EM, Rantanen NW. An approach to imaging algorithms for equine lameness diagnosis. Vet Clin North Am Equine Pract 2012. [PMID: 23177126 DOI: 10.1016/j.cveq.2012.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Tremendous growth and advancement in equine diagnostic imaging necessitates a systematic approach to the application of these modalities to lameness diagnosis. This systematic approach must include attention to the history, physical and clinical examinations, and parameters set forth by the client. It also must include an understanding of which imaging modality is most appropriate given the details of the case. This article presents a basic framework with an underlying algorithmic foundation that can be applied when selecting imaging modalities during lameness evaluation and includes case examples demonstrating application of the approach.
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Affiliation(s)
- Elizabeth M Charles
- Western University of Health Sciences, College of Veterinary Medicine, PO Box 38, Temecula, CA 92593, USA.
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27
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Young AC, Dimock AN, Puchalski SM, Murphy B, Spriet M. Magnetic resonance and radiographic diagnosis of osseous resorption of the flexor surface of the distal phalanx in the horse. Equine Vet J 2012:3-7. [DOI: 10.1111/j.2042-3306.2012.00675.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A. C. Young
- Pritchard Veterinary Medical Teaching Hospital; University of California; Davis California USA
| | - A. N. Dimock
- Pritchard Veterinary Medical Teaching Hospital; University of California; Davis California USA
| | - S. M. Puchalski
- Department of Surgical and Radiological Sciences; University of California; Davis California USA
| | - B. Murphy
- Department of Pathology, Microbiology and Immunology; School of Veterinary Medicine; University of California; Davis California USA
| | - M. Spriet
- Department of Surgical and Radiological Sciences; University of California; Davis California USA
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28
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Biggi M, Dyson S. Hind foot lameness: results of magnetic resonance imaging in 38 horses (2001-2011). Equine Vet J 2012; 45:427-34. [PMID: 23145906 DOI: 10.1111/j.2042-3306.2012.00686.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 08/19/2012] [Indexed: 11/30/2022]
Abstract
REASONS FOR PERFORMING STUDY The distribution of lesions detected using magnetic resonance imaging (MRI) of hind feet has not been reported. OBJECTIVE To evaluate type and distribution of lesions detected using MRI in hind feet of lame horses and to compare the findings with those reported in front feet; to document follow-up information. METHODS Horses were selected if hindlimb lameness was abolished by plantar nerve blocks performed at the base of the proximal sesamoid bones. Magnetic resonance images were acquired using either a low-field or a high-field magnet, and all images were evaluated retrospectively by both authors. A primary diagnosis was defined as the most likely cause of lameness, based also on clinical findings and results of other imaging techniques. If ≥3 structures were equally affected, the horse was classified as having multiple injuries. Follow-up information was collected by telephone questionnaire; outcome was classified as return to former level of athletic function, working at a lower level or retired. RESULTS Thirty-eight horses were included. Primary collateral sesamoidean ligament (CSL) injury was identified in 9 horses. Nine horses had multiple injuries, 8 had primary bone pathology, 5 had collateral desmopathy of the distal interphalangeal joint, one had primary deep digital flexor tendonitis, 2 had navicular bone pathology and 4 had lesions involving other structures within the foot. Seven horses were subjected to euthanasia shortly after diagnosis; 6 as a result of poor prognosis and one as a result of post anaesthetic complications, 4 of which had primary bone lesions, 2 multiple lesions and one distal interphalangeal joint pathology. Follow-up information was available for 24 horses. Eleven horses returned to previous performance and 2 to a lower level of performance; 9 horses were retired because of recurrent lameness. Five of 8 horses with CSL injury returned to previous performance and 2 to a lower level. CONCLUSIONS AND POTENTIAL RELEVANCE Collateral sesamoidean ligament injury and primary bone pathology are commonly observed on MRI examination of hind feet, and the prognosis is reasonable.
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Affiliation(s)
- M Biggi
- Centre for Equine Studies, Animal Health Trust, Lanwades Park, Kentford, Suffolk, UK
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Manfredi JM, Boyce M, Malone ED, Anderson C, Anderson LB, Trumble TN. Steroid diffusion into the navicular bursa occurs in horses affected by palmar foot pain. Vet Rec 2012; 171:642. [PMID: 23136308 DOI: 10.1136/vr.101075] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Palmar foot pain is frequently treated by steroid injections into the distal interphalangeal joint (DIPJ) in the anticipation that the steroid will diffuse to the navicular bursa and palmar foot structures. The object of this study was to determine if triamcinolone acetonide (TA) would in fact be able to locally diffuse from the DIPJ into the navicular bursa in horses affected by palmar foot pain. Both forelimb DIPJs (nine horses) were injected with 10 mg of TA. Navicular bursa fluid samples, both forelimb and one hind limb (systemic control), were analysed for TA with high-performance liquid chromatography/tandem mass spectrometry (HPLC-MS/MS) six hours later. Foot radiographs were graded (0-4) on severity of changes. Forelimb navicular bursa TA concentrations (mean±sd log(10), 3.20±0.56) were significantly higher than systemic control concentrations (mean±sd log(10), 1.89±0.3) (P<0.0001). Horses with a radiographic grade of >2 were four times as likely to have TA log(10) concentrations less than 3.2 (158.49 ng/ml). TA locally diffused from the DIPJ into the navicular bursa in horses affected by palmar foot pain; TA concentrations decreased as radiographic severity increased.
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Affiliation(s)
- J M Manfredi
- Veterinary Population Department, University of Minnesota, 1365 Gortner Ave, St Paul, MN 55108, USA.
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Parkes RS, Richard Newton J, Dyson SJ. An investigation of risk factors for foot-related lameness in a United Kingdom referral population of horses. Vet J 2012; 196:218-25. [PMID: 23122618 DOI: 10.1016/j.tvjl.2012.09.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Revised: 09/06/2012] [Accepted: 09/12/2012] [Indexed: 11/29/2022]
Abstract
Lameness relating to the foot of the horse is common, but the majority of information concerning risk factors for injury is anecdotal. The objectives of this study were to investigate risk factors for foot-related pain in a referral population of horses, with particular reference to injury/disease of the podotrochlear apparatus (PTA), by comparison with the remainder of the clinic population. It was hypothesised that there would be an increased risk of foot pain associated with breed, work discipline, age, height and bodyweight (BW). A retrospective study of all horses examined at a referral centre between 2001 and 2010 was performed using univariable and multivariable logistic regression analyses. There were 4618 horses investigated, 1132 of which had foot pain. There was increased risk of foot pain in multivariable analyses (all categories combined) in horses aged 6-9 and 10-15 years (OR = 1.60 and 1.72, respectively), compared with horses <6 years old, in show jumpers (OR = 1.44) compared with dressage horses, Thoroughbred cross-breeds (OR = 1.53) compared with Warmbloods and in horses with a BW:height ratio in the upper two quartiles (3.45-3.71 or >3.71; OR = 1.55 and 1.44, respectively), compared with the lowest quartile (<3.19). Racehorses had reduced risk for all types of foot pain combined (OR = 0.13) compared with dressage horses. Risk factors for PTA injury were age (10-15 years, OR = 2.12; >15 years, OR = 3.36, compared with <6 years old), BW:height ratio (>3.45-3.71 (OR = 2.75), >3.71 (OR = 2.06), compared with <3.19) and Thoroughbred cross-breed (OR = 1.73) compared with Warmbloods. Show jumpers had an increased risk of PTA and other injuries (OR = 2.29) when compared with dressage horses. Age, breed, work discipline and BW:height ratio influenced the risk of foot pain, but other factors probably also play a role.
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Affiliation(s)
- Rebecca S Parkes
- Centre for Equine Studies, Animal Health Trust, Lanwades Park, Newmarket, Suffolk CB8 7UU, UK
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Barr A. Treatment of equine synovial pain: developing an evidence base. Vet Rec 2012. [DOI: 10.1136/vr.e7924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Alistair Barr
- School of Veterinary Science; University of Bristol; Langford House Langford Bristol BS40 5DU UK
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Vanel M, Olive J, Gold S, Mitchell RD, Walker L. Clinical significance and prognosis of deep digital flexor tendinopathy assessed over time using MRI. Vet Radiol Ultrasound 2012; 53:621-7. [PMID: 22741926 DOI: 10.1111/j.1740-8261.2012.01961.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Accepted: 05/21/2012] [Indexed: 11/30/2022] Open
Abstract
Deep digital flexor (DDF) tendinopathy is one of the most frequent causes of foot lameness and the prognosis is guarded. The progress of lesion healing may be followed by magnetic resonance (MR) imaging to formulate a prognosis and to adapt the rehabilitation program. We assessed the correlation of outcome with total tendon damage and temporal resolution of MR abnormalities. Images from 34 horses with DDF tendinopathy that had undergone at least two low-field standing MR examinations of the foot (mean 2.5 ± 1.3 times) were reviewed. No horse having a T1-GRE hyperintense lesion over 30 mm in length or over 10% tendon cross-sectional area returned to its previous activity level. Horses with concomitant lesions had worse outcome than horses with DDF tendinopathy only (P = 0.005). In all horses including those with excellent outcome, the lesion persisted, even mildly, in T1-GRE and PD images. Horses with tendon lesion resolution on STIR-FSE and T2-FSE images on recheck examination had a better outcome (P = 0.0004 and P = 0.002, respectively), and all horses that returned to their previous level of performance had complete resolution of signal hyperintensity on the STIR-FSE sequence. Although rehabilitation remains multifactorial, characteristics of DDF tendinopathy and concomitant lesions on first and recheck MR examinations allow refining the prognosis.
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Affiliation(s)
- Maïa Vanel
- Diagnostic Imaging Department, University of Montreal, Saint-Hyacinthe, QC, Canada
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SMITH MRW, WRIGHT IM. Endoscopic evaluation of the navicular bursa: Observations, treatment and outcome in 92 cases with identified pathology. Equine Vet J 2011; 44:339-45. [DOI: 10.1111/j.2042-3306.2011.00443.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vallance SA, Bell RJW, Spriet M, Kass PH, Puchalski SM. Comparisons of computed tomography, contrast-enhanced computed tomography and standing low-field magnetic resonance imaging in horses with lameness localised to the foot. Part 2: Lesion identification. Equine Vet J 2011; 44:149-56. [PMID: 21696428 DOI: 10.1111/j.2042-3306.2011.00386.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
REASONS FOR PERFORMING STUDY No previous study compares computed tomography (CT), contrast-enhanced computed tomography (CECT) and standing low-field magnetic resonance imaging (LFMRI) to detect lesions in horses with lameness localised to the foot. This study will help clinicians understand the limitations of these techniques. OBJECTIVES To determine if CT, CECT and LFMRI would identify lesions within the distal limb and document discrepancies with lesion distribution and lesion classification. METHODS Lesions in specific structures identified on CT and MR images of feet (31 limbs) from the same horse were reviewed and compared. Distributions of lesions were compared using a Chi-squared test and techniques analysed using the paired marginal homogeneity test for concordance. RESULTS Lesions of the deep digital flexor tendon (DDFT) were most common and CT/CECT identified more lesions than LFMRI. Deep digital flexor tendon lesions seen on LFMRI only were frequently distal to the proximal extent of the distal sesamoid and DDFT lesions seen on CT/CECT only were frequently proximal to the distal sesamoid. Lesions identified on LFMRI only were core (23.3%) or splits (43.3%), whereas lesions identified only on CT were abrasions (29.8%), core (15.8%), enlargement (15.8%) or mineralisation (12.3%). Contrast-enhanced CT improved lesion identification at the DDFT insertion compared to CT and resulted in distal sesamoidean impar ligament and collateral sesamoidean ligament vascular enhancement in 75% of cases. Low-field MRI and CT/CECT failed to identify soft tissue mineralisation and bone oedema, respectively. CONCLUSIONS AND POTENTIAL RELEVANCE Multiple lesions are detected with CT, CECT and LFMRI but there is variability in lesion detection and classification. LFMRI centred only on the podotrochlear apparatus may fail to identify lesions of the pastern or soft tissue mineralisation. Computed tomography may fail to identify DDFT lesions distal to the proximal border of the distal sesamoid.
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Affiliation(s)
- S A Vallance
- Veterinary Medical Teaching Hospital Department of Surgical and Radiological Sciences Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, USA
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