Clinical Case Review

Posted on by

CURRENT STEM CELL RESEARCH

Andy Hoffman, D.V.M., D.V.Sc., D.A.C.V.I.M., Professor, Director, Lung Stem Cell Laboratory and Jose Garcia-Lopez, DVM, DACVS, Associate Professor.

The clinical scenario:

Charger, a 9-year-old Oldenburg gelding, presented to clinicians at the Hospital for Large Animals at the Cummings School of Veterinary Medicine at Tufts University for non-resolving hind limb lameness. During evaluation, Charger displayed excessive toe dragging of the rear limbs and abduction (outward swinging) of the right hind. When trotting, Charger exhibited a 2 out of 5 (0= sound; 5= non-weight bearing) right hind limb lameness, with a positive upper limb flexion test (indicating pain in the upper portion of the leg). Continue reading →

Clinicians and Staff

Posted on by

CURRENT STEM CELL RESEARCH

José Garcia-Lopez – VMD, Diplomate ACVS

Dr. Garcia-Lopez

Dr. Garcia-Lopez

A fascination with equine athletes and sports medicine drew Dr. Jose Garcia-Lopez to join the faculty of the Cummings School of Veterinary Medicine and its Hospital for Large Animals, where he specializes in lameness, orthopedic and respiratory surgery for its equine patients.

Dr. Garcia-Lopez’s areas of clinical expertise and interests include orthopedic and upper respiratory surgery, as well as innovative lameness evaluation using advanced imaging techniques such as nuclear scintigraphy, MRI and CT. He further focuses and advances novel treatment modalities, which include procedures using Stem-cell, PRP (Platelet Rich Plasma) and IRAP (Interleukin-1 Receptor Antagonist Protein) therapy. In addition, his area of research expertise includes development and testing of new instrumentation and implants used in equine orthopedic surgery. He continues to improve and develop new techniques and instrumentation which aid in management and treatment of fractures and joint injuries.

Andrew Hoffman – DVM, DVSc, Diplomate ACVIM

Dr. Hoffman

Dr. Hoffman

 

Dr. Andrew Hoffman is a Professor in the Department of Clinical Sciences and Director of Regenerative Medicine.   His research interests include the fundamental biology of stem and progenitor cells and their potential application in cell therapeutics.  Projects in the Regenerative Medicine Laboratory involve over 12 faculty and 5 trainees with a focus on the safety and efficacy of stem cells used for treatment of autoimmune diseases and traumatic injuries to tissues. ”

Topics of Discussion

Posted on by

CURRENT STEM CELL RESEARCH

Andy Hoffman, D.V.M., D.V.Sc., D.A.C.V.I.M., Professor, Director, Lung Stem Cell Laboratory and Jose Garcia-Lopez, DVM, DACVS, Associate Professor.

Understanding Stem Cell Potency: Can the Veterinary Profession Do Better?

Stem cells have now captivated the veterinary profession and for good reason.  These cells produce a vast array of molecules that promote repair and regeneration of damaged tissue. The signals produced by stem cells are so numerous and complex that they cannot yet be reproduced in the laboratory.  Harnessing their potential is the central focus for many laboratories around the world. The hope is that stem cells will revitalize tissue in healing wounds, and reduce inflammation, fibrosis, and auto-immunity. It’s a tall order but there is good evidence from animal models that stem cells or their derivatives can accomplish these goals.  Continue reading →

Topics of Discussion

Posted on by
Reply

The Problem with Puncture Wounds

It is uncanny how some of the smallest, seemingly innocuous wounds can become the most life-threatening. Those located around synovial structures (joints, tendon sheaths and bursas) often fall into this category. Early recognition of synovial structure involvement followed by aggressive therapy wins the battle in many cases, but not all. The statistics are worse when recognition or therapy is delayed. Having owners who are caring but also knowledgeable about limb anatomy is an important first step. Owners are often the first responder – making the decision on whether to contact their veterinarian.  It is an easy decision to make when blood is spurting, flesh is hanging, or bone is visible but not so easy when the wound is a puncture or just an inch or so in length. Perhaps some of the following information will be helpful in highlighting the importance of small but badly placed wounds. Continue reading →

Topics of Discussion

Posted on by
Reply

Septic Arthritis, Tenosynovitis, and Bursitis 

Infection of synovial structures may involve joints (septic arthritis), tendon sheaths (tenosynovitis) or a bursa (bursitis), which is a fluid-filled cavity situated within tissues exposed to friction. The infection occurs when microorganisms are given time to colonize the space after a penetrating wound, a joint injection, following surgery or following a spread of bacteria via the blood stream (hematogenous infection).  Although common in the foal, hematogenous spread is rare in the adult horse but has been reported to occur (< 10% of cases). Therefore, synovial infection should be considered as a potential differential diagnosis in any horse with sudden onset of lameness, synovial effusion (fluid buildup) and fever.  Horses with drainage through communicating wounds will generally be less lame than those without drainage.  Therefore, it is important to rule out possible synovial structure communication with a wound at the time of injury rather than wait to see if the horse becomes lame.  Many times, these horses do not become significantly lame until 7-10 days later when the overlying wound has closed sufficiently to prevent synovial drainage. Continue reading →

Clinicians and Staff

Posted on by
Reply

Patricia Provost – VMD, MS, DACVS

Dr. Patricia Provost

Whether mentoring future veterinarians, treating sick or lame horses and other large animals, or performing research for the advancement of veterinary care, Dr. Patricia Provost joined Tufts to make a difference in the lives of animals. Dr. Provost is a board-certified surgeon (Diplomate of the American College of Veterinary Surgeons (ACVS) Continue reading →

Clinical Case Review

Posted on by
1

The Case of a “Street Nail”

The contrast material fills the navicular bursa.

Nagel, a four year old Quarter Horse gelding, presented to the Tufts Hospital for Large Animals at the Cummings School of Veterinary Medicine after stepping on a nail, which entered the outer aspect of his right hind sole. Initial home treatments included daily foot soaks, phenylbutazone (an anti-inflammatory) and a course of antibiotics. Unfortunately, Nagel’s lameness returned despite his owner’s supportive and diligent home care. Radiographs taken by the referring veterinarian showed a penetrating wound that was tracking to the navicular bursa, with a small volume of gas observed within the bursa. Contrast injection into the site of nail puncture confirmed a communication of the wound with the navicular bursa. At that time, Nagel was referred to Tufts for exploratory arthroscopy. Continue reading →

Innovation

Posted on by
Reply

Regional Limb Perfusion

Regional Limb Perfusion (RLP)

Regional limb perfusion (RLP) is a technique which provides a high concentration of an antibiotic to the soft tissues, joints, and bones of the limbs. The antibiotic used would be very expensive if given at a dose appropriate for the entire horse but the cost of the drug is more affordable since it is delivered into a superficial leg vein below the level of a tourniquet, and the benefits great. Drug concentrations achieved generally exceed that required to kill many types of bacteria and persist locally in the tissues for an extended period of time. This makes RLP a practical adjunctive treatment for septic conditions affecting the extremities (the knee and hock and below). Continue reading →

Topics of Discussion

Posted on by
Reply

Environmental Management of IAD

IAD is an inflammatory condition of the airways that is triggered by exposure to a high level of particulates in the air, such as dust, mold, pollen and spores. Studies have shown that feeding – especially hay and pelleted feed – is the most important contributor to inhaled dust. Other important sources are cleaning stalls and sweeping the aisles. Exposure can be reduced by Continue reading →

Topics of Discussion

Posted on by
Reply

What is Inflammatory Airway Disease [IAD]?

IAD is a disease of the airways which disturbs normal lung function (most often causing exercise intolerance) in addition to acting as a source of irritation (causing cough). Clinical signs are associated with swelling or obstruction and thus narrowing of the lower airways, which prevents air from reaching the maximum number of air sacs (alveoli) for gas exchange. In horses suffering from IAD, the airways are narrower because of inflammatory secretions, excessive mucus and fibrous tissue. In order to overcome the resulting increase in airway resistance, the horse has to work harder to achieve each breath and ultimately becomes exercise intolerant.

Horses with IAD most commonly present with a Continue reading →