Standing gustatory papillae biopsy procedure for antemortem diagnosis of equine grass sickness

OBJECTIVE

Diagnosing equine grass sickness (EGS) requires histopathological evidence of chromatolysis and/or neuronal loss in peripheral autonomic ganglia. Previous investigators performed postmortem biopsies of gustatory papillae located on the tongue and found chromatolytic subgemmal neurons in all 13 EGS horses. The present study aimed to design a standardized lingual biopsy sampling method through a transbuccal approach in healthy standing horses and assess the quality of the obtained samples, to allow antemortem diagnosis of EGS in clinical cases.

ANIMALS

6 healthy horses.

METHODS

A transbuccal approach was performed bilaterally in 6 healthy standing horses. After having reached a deep level of sedation, horses were placed in stocks and a Günther mouth gag was inserted. Local anesthesia followed by a vertical full thickness incision was performed on both cheeks. Foliate papillae biopsies were carried out using an arthroscopic rongeur inserted through each incision site under oral endoscopic control. Tongue movements were restricted with diazepam. Histological assessment of taste buds and subgemmal plexi neurons was performed using H&E-stained longitudinal sections.

RESULTS

The procedure was well tolerated in all horses. Minor complications observed were a transient facial paralysis, some incisional fluid collection, and abscesses. Ten samples (10/12) were suitable for assessment of neuronal perikarya.

CLINICAL RELEVANCE

This procedure was safe for subgemmal plexus biopsy in healthy standing horses. The obtained samples were adequate as long as they were neatly cut lengthwise for inclusion. The technique was also used for 2 clinical cases and revealed the complete absence of neuronal perikarya, confirming chronic EGS.

Outcomes and Complications Associated with Superior and Inferior Subpalpebral Lavage Treatment Systems Placed in 61 Equine Eyes (2004-2021)

Painful eye conditions are a therapeutic challenge in horses. Subpalpebral lavage (SPL) treatment systems allow topical aqueous medications to be conveniently, safely, and frequently administered to the ocular surface. The aim of this retrospective study was to describe the outcomes and the complications associated with the location of the SPL treatment systems, in the superior or inferior eyelid in horses in a university practice. Clinical records of all horses admitted to the National Veterinary School of Alfort between January 2004 and October 2021, in which a SPL treatment system was used to administer the topical ophthalmic medications, were reviewed. Sixty horses were included in the study representing 61 SPL treatment systems. Uneventful outcomes occurred in 53 cases (86.9%) and complications were recorded in 8 cases (13.1%). Seven complications were reported for upper eyelid systems (23.3%) and 1 complication for lower eyelid systems (4.2%). The complication rates were not significantly different between these two locations (P= .06). The complications identified were iatrogenic corneal ulceration, palpebral abscess, overgrowth of conjunctiva over the footplate, and palpebral cellulitis. Median duration of SPL treatment system use was 7.5 days. The easier placement and removal and the lower incidence of complications identified in our study encourage the authors to favor the lower fornix for subpalpebral lavage treatment systems within our equine hospital.

Standing Hand-Assisted Laparoscopic Diagnosis and Treatment of a Rare Case of Uterine Adenocarcinoma in an 18-Year-Old Mare

An 18-year-old French Trotter mare was presented to the Clinique Equine, Ecole Nationale Vétérinaire d'Alfort, for exploration of a 3-month-duration vaginal bleeding. A transrectal ultrasound examination identified a mass within the right uterine horn wall, which had been suspected during transrectal palpation. It was described as a firm heterogeneous intramural mass (7 × 12 cm) in the right uterine horn, located few centimeters cranially to the bifurcation. Hysteroscopy confirmed the ulcerated and irregular shape of the mass. A standing hand-assisted flank laparoscopy was performed to carry out a partial ovariohysterectomy. Two days after surgery, the mare presented with acute and severe signs of colic and was euthanized. Postmortem examination revealed a 720° small intestine volvulus at the mesenteric root, a left dorsal displacement of the large colon, and iliac and tracheobronchial lymph node hypertrophy. Histopathological examination of the removed uterine mass revealed a well-differentiated and infiltrating uterine adenocarcinoma, with lymph node metastasis. Uterine neoplasia, especially adenocarcinoma, is uncommon in the mare and can be successfully removed using a standing hand-assisted laparoscopic technique, which avoids the risks associated with general anesthesia and allows a histologic diagnosis of malignancy. In such cases, though, initial staging and identification of metastasis remain a challenge that will influence the treatment strategy.