Septicemia can be a tragic illness in neonatal and young foals. Sick foals may manifest a variety of clinical symptoms all related to a common infection and its systemic effects. While the pathogenesis of this disease is the same as for adult equids, the clinical signs seen can be very different. The rapid changes seen in foal are reflective of their low endogenous reserves of glucose and innate immune mediators as well as the poor ability to self-regulate their metabolism. The neonatal immune system is reliant on maternal antibodies at birth and development of the foal's own system takes a significant amount of time. This non-competent immune system changes how the foal responds to infection when compared to the adult. Clinical signs in septic foals include tachycardia, tachypnea, depression, anorexia, colitis, and fever. Less commonly, foals may show petechiation, swollen joints, anterior uveitis, and coma. This article is the first of a two part series on neonatal sepsis and will present a review on the neonatal immune system, the pathophysiology of sepsis, and the range of clinical signs seen in foals.
Equine primary hyperparathyroidism is rare compared with the condition in human medicine where it is often encountered and represents the most common explanation for hypercalcemia in the outpatient setting. Primary hyperparathyroidism results from a hyperfunctioning parathyroid gland and surgical treatment (parathyroidectomy) is typically curative. Successful surgical removal of a diseased parathyroid gland can be challenging in horses as both normal and hyperfunctioning glands are difficult to localize. Identification of surgical targets using ultrasonography and/or Technetium-99m sestimibi scintigraphy are useful for this purpose in both the human and equine contexts. However, these localization approaches are not aways effective. Moreover, not all patients are candidates for general anesthesia and surgery and the costs associated with diagnostic localization and parathyroidectomy may be prohibitive for some owners. This commentary presents information about primary hyperparathyroidism in the event that it is not treated and strives to review aspects of the disease when left untreated from the human medical context.
Urethral diverticula have been described in other species. Congenital anomalies of the urinary tract in horses are rare. A 26-year-old gelding presented with complaints of abdominal discomfort and dysuria. Urine dribbling was reported since several years. General clinical examination was within normal limits. Rectal palpation showed a distended bladder, which was emptied spontaneously after manipulation. Urine cytology showed an increased white blood cell count and presence of bacteria. Bacterial culture however remained sterile. Cystoscopy identified two symmetrical urethral diverticula dorsal to the entrance of the bladder, lined with normal epithelium. Mucosa of the bladder, urethra and two diverticula were hyperemic with evidence of urine accumulation in both diverticula. Ultrasound, abdominal and transrectal, did not identify the diverticula. Treatment included trimethoprim-sulfamides and meloxicam. After 2 weeks, the owner reported resolution of clinical signs. It is unclear if the diverticula in this case were congenital or acquired. In humans it is described that urethral diverticula can be asymptomatic and incidental findings. Surgical intervention has been described in small animal and human medicine with complete resolution of clinical signs, however in this case was not possible due to financial restraints.
Due to the length of the reserve crown and roots of equine cheek teeth, especially in younger horses, their extraction (exodontia) can be a challenging procedure with the potential for many types of post-extraction complications to develop. The prevalence of post-extraction complications is greatly influenced by the exodontia technique used, with unacceptably high levels of complications with the traditional repulsion technique and conversely, low levels of complications with oral extraction performed by skilled operators. Recent objective studies on post-exodontia problems in horses have also highlighted some risk factors for the development of post-extraction problems including exodontia of rostral mandibular teeth in young horses, and exodontia of teeth with apical infections The recent recognition that some non-healing post-extraction equine alveoli suffer from a disorder very similar to dry socket in humans, may help clinicians to recognise, treat and possibly help prevent this disorder.
This report describes the evisceration of the jejunum following acute dehiscence of the abdominal wall in an 18 year old gelding which had undergone treatment for suspected sarcoids on the ventral abdomen with a topical caustic/chemotherapy agent 6 weeks previously. The sarcoid lesions appeared to be responding appropriately to the topical therapy until the day of presentation. The jejunum was safely contained in an abdominal bandage and the horse underwent emergency referral before immediate anaesthesia and further assessment. The horse was euthanased at the owners’ request following a guarded prognosis.