Walking on Eggshells
A 17 year old Quarter Horse gelding was noted to be laying down quietly in sternal more often over the last couple weeks by his owners. He had continued to eat, drink, and pass manure normally. When walking, he would take slow short timid steps and acted like he was walking on eggshells. On exam he had a slightly elevated heart rate of 48 bpm, with normal thoracic and abdominal auscultation. The gelding had abnormal fat deposits with a large neck crest and tail-head fat that was moderate to severe. He had bounding digital pulses in both front feet and was very sore to hoof testers on both front toe regions. Radiographs were approved and one view of the set is shown below. What does this horse have?
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Answer
This horse has laminitis with rotation- if this process is not addressed this rotation can become life threatening. Additionally, he has a long toe contributing to increased breakover or tension on this area. Laminitis is the inflammation of the connection of the sensitive and insensitive laminar layers of the foot resulting from the disruption of blood flow. This is the layer that secures the coffin bone to the hoof wall. If the inflammation is severe enough this can cause separation of this layer leading to rotation of the coffin bone towards the sole. If unchecked this can progress to penetrating the sole of the foot which is an end of life scenario. Laminitis can also be referred to as founder though typically founder indicates more chronicity. Typically laminitis affects both front feet simultaneously, but can also affect one or all feet. The most well-known reason for founder is “grain-overload” which can also extend to rapid change in diet, higher sugars and starches (treats/fruits/etc). Similarly “grass founder” is also well known and occurs most often on any rapidly growing pasture and especially between late morning and later afternoon in the spring or early summer. Other reasons for laminitis include retained placenta, excessive concussion, support limb laminitis (excessive weight placed on one leg due to injury on another), severe illness/fever/colic/toxemia/sepsis, exposure to black walnut shavings, or uncontrolled metabolic/endocrine disease (such as Cushing’s). Predisposing factors can also include metabolic/endocrine disease (such as Cushing’s disease or insulin resistance), obesity, lack of proper foot care, sudden severe increase in work-load, sudden change in diet especially if higher in sugars and starches, high stress environment, or previous laminitis episodes. Other signs of laminitis not mentioned above include sawhorse stance- front legs extended forwards and back legs camped underneath, or can be as subtle as a minor head nod. Treatment involves addressing the underlying cause, pain medications, foot care (it is very important to get your farrier involved as soon as possible), monitoring progression with radiographs, and keeping deep sand or shavings or cushioned boots to support the foot. |
Seeing StonesA four year old male castrated Nigerian Dwarf goat presented for three day history of stranguria, (straining to urinate). Owner had not noticed urination and was unsure if he was straining to defecate or urinate. Only a few fecal pellets had been observed. He was lethargic and uninterested in eating hay. Additional he was noted to grind his teeth and vocalize. No moisture was noted on prepuce even during episodes of straining. A single lateral radiograph was taken.
What condition does this wether have and how is it corrected? |
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Answer
This goat has urolithiasis or obstruction of the urethra with a bladder stone. (Only bladder stones evident in this radiograph). The formation of urinary stones are a result of nutrition, management, and the individual health/genetics of each individual animal. A variety of different stones can form in goats based on the type of diet they consume. Additionally, dehydration can also cause precipitation of minerals into stones. High concentrate grain diets are commonly high in phosphorus and low in calcium creating calculi. Additionally diets high in calcium, such as alfalfa, can predispose goats/sheep to calcium carbonate calculi. The small ruminant (goat/sheep) male is more predisposed to stone blockages due to anatomy as they have a sigmoid shape to their urethra and stones often get lodged in the curved portion. Additionally, male small ruminants who are castrated at a young age have smaller urethral diameter due to lack of hormones produced by the testes.
If left untreated, stones blocking urination results in bladder or urethral rupture and ultimately death of the animal. Signs to look for if you suspect your goat is blocked include straining to urinate or defecate, vocalization with urination, posturing, and no signs of urine around the prepuce or in the pen, inappetence, or depressed demeanor. Stones should be one of the top things to consider in a sick castrated goat or sheep.
Treating small ruminants for stones is much different that treating a dog, horse, or human. Ruminants have an urethral recess which is located in the region of where the urethra curves around the brim of the pelvis. This blind pouch is difficult to bypass and invariably entered when trying to pass a catheter into the bladder. Performing this procedure is frequently unsuccessful and results in trauma to the area possibly causing urethral rupture or narrowing. For these reasons this procedure is rarely attempted or successful. This leaves the small ruminant who is completely blocked (not passing any urine) really one option which is surgical management. There are several different types of surgical management based on stone location and progression of disease. Additionally, it is good to keep in mind that animals who have had problems with urolithiasis in the past will be more predisposed in the future and every effort should be made to manage at home appropriately.
Key points to remember if you have a castrated male goat.
1: Do not feed grains (commercial product pelleted diets are okay though likely unnecessary). If you have to feed pelleted rations make sure the calcium to phosphorus ratio is in the range of 2:1 or 2.5:1.
2: Do not feed alfalfa hay
3: Do not allow grazing of clover unless for specific health requirements and consider using a urinary acidifier.
4: In cold weather provide warm clean water and closely monitor for any decreased water consumption- you can also add in salt for additional water consumption.
5: Consider a loose goat mineral specifically formulated for goats
This goat has urolithiasis or obstruction of the urethra with a bladder stone. (Only bladder stones evident in this radiograph). The formation of urinary stones are a result of nutrition, management, and the individual health/genetics of each individual animal. A variety of different stones can form in goats based on the type of diet they consume. Additionally, dehydration can also cause precipitation of minerals into stones. High concentrate grain diets are commonly high in phosphorus and low in calcium creating calculi. Additionally diets high in calcium, such as alfalfa, can predispose goats/sheep to calcium carbonate calculi. The small ruminant (goat/sheep) male is more predisposed to stone blockages due to anatomy as they have a sigmoid shape to their urethra and stones often get lodged in the curved portion. Additionally, male small ruminants who are castrated at a young age have smaller urethral diameter due to lack of hormones produced by the testes.
If left untreated, stones blocking urination results in bladder or urethral rupture and ultimately death of the animal. Signs to look for if you suspect your goat is blocked include straining to urinate or defecate, vocalization with urination, posturing, and no signs of urine around the prepuce or in the pen, inappetence, or depressed demeanor. Stones should be one of the top things to consider in a sick castrated goat or sheep.
Treating small ruminants for stones is much different that treating a dog, horse, or human. Ruminants have an urethral recess which is located in the region of where the urethra curves around the brim of the pelvis. This blind pouch is difficult to bypass and invariably entered when trying to pass a catheter into the bladder. Performing this procedure is frequently unsuccessful and results in trauma to the area possibly causing urethral rupture or narrowing. For these reasons this procedure is rarely attempted or successful. This leaves the small ruminant who is completely blocked (not passing any urine) really one option which is surgical management. There are several different types of surgical management based on stone location and progression of disease. Additionally, it is good to keep in mind that animals who have had problems with urolithiasis in the past will be more predisposed in the future and every effort should be made to manage at home appropriately.
Key points to remember if you have a castrated male goat.
1: Do not feed grains (commercial product pelleted diets are okay though likely unnecessary). If you have to feed pelleted rations make sure the calcium to phosphorus ratio is in the range of 2:1 or 2.5:1.
2: Do not feed alfalfa hay
3: Do not allow grazing of clover unless for specific health requirements and consider using a urinary acidifier.
4: In cold weather provide warm clean water and closely monitor for any decreased water consumption- you can also add in salt for additional water consumption.
5: Consider a loose goat mineral specifically formulated for goats
Got Hair?
A 22 year old gelding with history of weight loss, topline muscle atrophy and attitude change over previous 3 months was seen. Hair coat appear longer than previous years, especially, on limbs. What disease could cause these symptoms? What further testing could be done to diagnose this condition?
A 22 year old gelding with history of weight loss, topline muscle atrophy and attitude change over previous 3 months was seen. Hair coat appear longer than previous years, especially, on limbs. What disease could cause these symptoms? What further testing could be done to diagnose this condition?
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Answer
The horse had blood drawn for TRH test. A blood sample was drawn and 1ml of TRH was administered intravenously. 10 minutes later another blood sample was drawn. The test was submitted to Cornell Veterinary Diagnostic Laboratory. The test results came back as initial ACTH was 5.78 pg/ml normal range is 9-35 pg/ml and 10 minute ACTH was 246pg/ml normal range was 9-110 pg/ml. This would be considered a positive test for pituitary pars intermedia dysfunction or PPID. After 90 days on medication 1mg pergolide orally once daily a repeat TRH test was performed and the initial ACTH was 5.54pg/ml and 10 minute ACTH was 28.6pg/ml. These means he is receiving a therapeutic dose of Pergolide. |
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We recommend annual blood testing for ACTH and/or TRH testing for our patients with PPID. Horses that have been diagnosed with PPID should be fed a low starch diet less than 12%. We recommend that you have your hay tested and also monitor the starch content in any grain.
If weight gain is needed we recommend a fat supplement in addition to low starch senior pellet. Also recommend having an annual dental exam as horses with PPID or more prone to dental problems. In addition regular hoof trimming or shoeing is also very important, and should be done every 6 to 8 weeks. This is important because horses with PPID have an increased risk of developing laminitis(founder).
If weight gain is needed we recommend a fat supplement in addition to low starch senior pellet. Also recommend having an annual dental exam as horses with PPID or more prone to dental problems. In addition regular hoof trimming or shoeing is also very important, and should be done every 6 to 8 weeks. This is important because horses with PPID have an increased risk of developing laminitis(founder).
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Seeing Touble
A 3 year old quarter horse mare was noted to have squinting of her left eye with most of her eye shut, and copious tearing with some white ocular discharge. Due to pain she was resistant to let her owner touch it to allow closer evaluation. She is in a dry lot with 2 other horses, and is fed grass hay. After sedation and blocking the nerves around the eye, evaluation was allowed. What is wrong with this eye and what is the likelihood this will heal even with intense management? For horses who have eye problems and are difficult to treat- what system can be used?
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This mare has a descemetocele which is an extremely severe ulceration of the cornea. Basically there is one cell layer separating this eye from rupture. Corneal ulcerations are common in horses due to their prominent eye placement and should always be viewed as an emergency as innocuous looking scrapes can turning into melting ulcerations (as pictured above) very quickly. Melting ulcers occur when the body’s or a bacteria’s enzymes get out of control and cause degeneration of the surrounding ocular tissue. To identify an ulceration veterinarians use fluorescein dye which sticks to the ulceration and allows it to be more visible. Signs of more mild ulcerations include tearing, holding the eye halfway shut or not fully open. Sometime the ulcer can only be seen with staining. A painful eye should always be evaluated as soon as possible (even if it means that dreaded ER fee). Some horses will not allow medication of the eye due to pain level or behavioral issues. In these cases a subpalpebral lavage system (SPL) which consists of placing a small disk that is attached to tubing through the eyelid which then allows you to medicate from the horse’s withers as it travels through the tubing to the disk in the eyelid. The SPL system is easy to place and can be very beneficial for medication purposes. For this mare the severity of her ulceration led to globe rupture within 24 hours even after placing an SPL- at this point the eye was removed. There are multiple other therapies for ulcerations (including conjunctival flaps) and the complications that arise in each case- if you feel your horse has a painful eye give us a call as soon as possible.
Somethings in my Eye
A 15 year old Tennessee Walker gelding presents for right ocular discharge, squinting, and cloudiness of the outside of his cornea. The owner feels that this has occurred suddenly and occasionally a fleshy pink tissue can be seen when he looks to the left. The gelding is a new horse to the herd and has pink skin around both of his eyes. Pictures of the lesion are below as well as other images from horses with the same diagnosis.
What do you suspect this horse has? (The first two pictures are of our patient, the second two pictures are of horses with the same diagnosis in similar and different presentations).
What do you suspect this horse has? (The first two pictures are of our patient, the second two pictures are of horses with the same diagnosis in similar and different presentations).
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Answer
Squamous cell carcinoma is the most common cancer of the equine eye and surrounding structures. Due to Colorado’s sunny weather, UV exposure as well as inherent increased individual susceptibility and lack of periocular pigmentation, squamous cell carcinoma is commonly seen in our practice. This can manifest as a large pink tissue growing anywhere on the eye- either on the actual cornea, on the white part of the eye (sclera) on the eyelids or on the third eyelid. Occasionally, it can appears as only ulceration of the lid margins, or unhealthy looking skin around the eye or pink film over the cornea. Breeds that have more inherent risk include Belgians, Clydesdales, other draft breeds, Appaloosas, and Paints. There are a variety of different treatments for squamous cell carcinomas some of which can be performed by your regular veterinarian and others which require a board certified equine ophthalmologist. If your horse has an abnormal growth or abnormal appearing skin near his or her eye the best way to decide appropriate treatment is taking a sample of this tissue (a biopsy) and sending this to a pathologist to confirm the type of mass or if the tissue is abnormal on the cellular level. Prevention is the best course of action and can be done by having your horse wear a UV rated fly mask (ex. Guardian fly mask or Equine Sun Visor ESV Maxx) and has yearly veterinary visits to screen for any abnormalities.
Squamous cell carcinoma is the most common cancer of the equine eye and surrounding structures. Due to Colorado’s sunny weather, UV exposure as well as inherent increased individual susceptibility and lack of periocular pigmentation, squamous cell carcinoma is commonly seen in our practice. This can manifest as a large pink tissue growing anywhere on the eye- either on the actual cornea, on the white part of the eye (sclera) on the eyelids or on the third eyelid. Occasionally, it can appears as only ulceration of the lid margins, or unhealthy looking skin around the eye or pink film over the cornea. Breeds that have more inherent risk include Belgians, Clydesdales, other draft breeds, Appaloosas, and Paints. There are a variety of different treatments for squamous cell carcinomas some of which can be performed by your regular veterinarian and others which require a board certified equine ophthalmologist. If your horse has an abnormal growth or abnormal appearing skin near his or her eye the best way to decide appropriate treatment is taking a sample of this tissue (a biopsy) and sending this to a pathologist to confirm the type of mass or if the tissue is abnormal on the cellular level. Prevention is the best course of action and can be done by having your horse wear a UV rated fly mask (ex. Guardian fly mask or Equine Sun Visor ESV Maxx) and has yearly veterinary visits to screen for any abnormalities.
Runny Nose and Oral Health
A 20 year old QH mare is presented with right sided nasal discharge of a couple weeks with foul odor. She has not had her teeth floated in a couple years. On oral examination she had an area of feed packing on the first upper right molar which revealed a fractured crown. Due to the abnormal nasal discharge and abnormal oral findings radiographs were taken.
A 20 year old QH mare is presented with right sided nasal discharge of a couple weeks with foul odor. She has not had her teeth floated in a couple years. On oral examination she had an area of feed packing on the first upper right molar which revealed a fractured crown. Due to the abnormal nasal discharge and abnormal oral findings radiographs were taken.
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The mare has dental root infection of the 109 or first upper right molar. As the roots of this tooth communicate with the maxillary sinus a secondary sinus infection has occurred. Additionally, a fractured tooth can be painful as well as contribute to infection. Treatment consisted of removal of the fractured tooth, flushing of the sinus, packing of the extraction site with dental impression material to avoid infection and placement on pain medications and antibiotics. The impression material will be removed at recheck in 2-3 weeks.
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