Septic arthritis/osteomyelitis is a manifestation of septicemia (widespread infection) in foals. Approximately one-quarter of the foals presented to Tufts Hospital for Large Animals with a suspicion of sepsis also present with or develop evidence of septic arthritis. Cohen and colleagues recognize infectious arthritis as a cause of death in 12.5% of foals (8-31 days of age) in Texas. The problem arises from hematogenous (through the bloodstream) seeding of the synovium (joint lining) and the physis/epiphysis (actively growing bones in the joints) with bacteria. Foals may present with one or multiple joints affected. Continue reading
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
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
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
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
Why is Lung Function Testing useful?
Over the past decade, pulmonary lung function testing (PFT) has gained increasing importance in veterinary patients, due to its ability both to characterize and quantify the patient’s lung dysfunction using non-invasive techniques. This is particularly important during the early diagnosis of respiratory disease and the evaluation of treatment responses. The Cummings School of Veterinary Medicine has pioneered the development of non-invasive lung function testing in animals, including horses, dogs, llamas and alpacas.
Our Lung Function Laboratory, under the leadership of Dr. Andrew Hoffman and operation by Drs. Melissa Mazan and Daniela Bedenice, is a nationally recognized Continue reading
Equine Metabolic Syndrome, In Depth
While the two cases in this month’s Clinical Case Review are quite different in terms of severity of lameness at the time of presentation, as well as their current prognosis for soundness (good for case 1; poor-to-fair for case 2), they share common themes. First, both horses display the hallmarks of Equine Metabolic Syndrome (EMS) as a predisposing feature. They are both overweight; have crested necks; their body condition scores are higher than expected considering the low dietary intake being fed prior to laminitis; and they both lose weight reluctantly in spite of being fed meager rations. Additionally, both horses have elevated blood insulin but normal to high normal glucose. This is the case for most insulin resistant horses because pancreatic insulin secretion increases to normalize blood glucose levels.
Equine Metabolic Syndrome
Equine Metabolic Syndrome, described by Dr. Nicholas Frank in this Concensus Statement in the Journal of Veterinary Internal Medicine, should be suspected in any horse or pony that is predisposed to obesity. These animals are often described as “easy keepers” because weight gain occurs with pasture grazing and obesity persists after caloric restriction. Genetics are likely to play an important role Continue reading