The Horse

DEC 2018

The Horse:Your Guide To Equine Health Care provides monthly equine health care information to horse owners, breeders, veterinarians, barn/farm managers, trainer/riding instructors, and others involved in the hands-on care of the horse.

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TheHorse.com | The Horse December 2018 11 Tendon and Ligament Mineralization: Cause for Concern? Tendons and ligaments are meant to stretch and flex. But sometimes they harden—this "mineralization" occurs when hard material forms within the structure. But this isn't necessarily bad news, re- searchers say. "Our study has shown that mineralization can be present and not cause lameness," said Etienne O'Brien, BVM&S, Cert VA, Cert EP, PhD, MVM, MRCVS, of the Royal Veterinary Col- lege (RVC), in the U.K. And when there's mineralization, it doesn't necessarily mean it's the cause or only cause of lameness. In a recent study O'Brien and Roger Smith, PhD, DEO, FHEA, Dipl. ECVS, FRCVS, also of the RVC, looked at tendon and ligament mineralization in 27 cases presented to their hospital. Mineralization was most common in the deep digital flexor tendon (DDFT) and in the suspensory ligament branches. Of all horses that came to the hospital during the same time period, 10% with DDFT injuries and 7% with suspensory ligament branch injuries had mineralization in those structures. Furthermore, the researchers found inconsistencies between mineralization and lameness. Sometimes there was mineraliza- tion in a sound horse or no mineralization in a lame one. Ultrasound exams didn't help determine which mineralization cases were likely related to lameness and which weren't, O'Brien said. However, Doppler technology—which shows blood flow rates as different colors—seems to give some interesting insight, which researchers could examine further, he said. It's still not clear why mineralization occurs, O'Brien said. While there might be some association between previous injury and tendon mineralization, the connections aren't well-understood. Some clinicians have sug- gested it's related to steroid use, but that didn't appear to be the case for the horses in the current study. Fortunately, mineralization can shrink, espe- cially in the suspensory ligament branches. "In the future … it may be appropriate to adopt some of the treatments used to resolve tendon mineralization in humans in selected equine patients, too," he said. For the time being, however, it's important for veterinarians to be aware of what miner- alization could mean on a practical level, he said, and to know how to diagnose it. "Mineralization is reasonably common, and it can be bilateral (in both limbs of a pair)," O'Brien said. "But mineralization is not invari- ably a contributor to lameness. So keep an open mind and look for other lesions, also." Read more at TheHorse.com/161199. —Christa Lesté-Lasserre, MA Ozone to Treat Necroulcerative Dermatitis Ozone therapy refers to administering medical ozone—a mixture of no less than 95% O 2 and no more than 5% O 3 . Doctors first used it during World War I to prevent infections in soldiers with gan- grene and ulcers. Since then, veterinarians have used it in animals, including horses. History: A 6-year-old American Trotter racing mare developed superficial digital flexor tendinitis in her left forelimb (inset photo). Her owner treated the injury using local cold therapy, a non-steroidal anti-inflammatory ointment, and pressure bandaging. The next day he noticed soft-tissue swelling and, a few days later, the mare developed a large skin wound. The owner cleaned the wound daily with antiseptic soap and saline solution for five days, but it worsened. Examination and Diagnosis: The veterinarian observed a large skin wound with areas of necrosis (tissue death), granulation tissue (proud flesh), crusts, and moderate foul-smelling secretion (pictured). The veterinarian performed a tissue biopsy to reach a definitive diagnosis of diffuse necroulcerative dermatitis. Treatment: The veterinarian recommended treating the wound with topical ozonated saline solution, exposing it to ozone externally via gazation in plastic bags and applying ozonated sunflower oil to the wound's edges. Find out whether treatment was successful at TheHorse.com/162230. —Raquel Y.A. Baccarin, DVM, PhD, WEVA Regional Ambassador for Brazil and South America Treating Cranial Nuchal Bursitis Equine veterinarians often treat a condition medically before opting for surgery. But skipping straight to surgery appears most effective when treating most horses with cranial nuchal bursitis (inflammation of the nuchal ligament bursae, located near the horse's poll). José M. García-López, DVM, Dipl. ACVS, ACVSMR, of Tufts University's Cummings School of Veterinary Medicine, said the worst outcomes involved treating horses medically first and then surgically if medical treatment failed. If, on ultrasound, the bursa is fluid-filled, anti-inflammatory injections can be helpful. But if the area appears significantly inflamed with debris within the bursa, he's found that medical management is not only inef- fective but also makes surgery more difficult and increases the likelihood of complications and the possibility of revision surgery. For additional news items, see TheHorse.com/News 'Heliox' Ventilation Improves Surgery Outcomes When veterinarians place a horse under general anesthesia on his side or back for surgery, it puts considerable pressure on internal organs, sometimes leading to partial lung collapse. Despite using oxygen-rich ventilation, blood oxygen levels can fall to dangerous levels during lengthy procedures. University of Pennsylvania School of Veterinary Medicine researchers compared several existing ventilation strategies to see which best mitigated results. They found that horses receiving "heliox"—a combination of helium and oxygen—while under anesthesia did better than those receiving pure oxygen. "The results are clear in healthy horses; what we'd like to do in the near future is see if we can extend this to other species or compromised animals," said Klaus Hopster, DVM, DrMedVet. weva COURTESY DR. RAQUEL Y.A. BACCARIN

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