tag:blogger.com,1999:blog-3505227892172418852024-03-13T11:37:07.552-04:00Michael Porter, Equine VeterinarianA mobile, equine veterinary specialist that's focused on treating the performance horse and providing advanced prepurchase exams in Florida and southern Georgia. Dr. Porter provides lameness exams on horses including digital radiography and ultrasound. Lameness-related therapies include PRP, IRAP, shockwave,and stem cell treatments. In addition, Dr. Porter's specialty allows him to examine horses for chronic weight loss, colic, cough, and neurologic symptoms.Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.comBlogger133125tag:blogger.com,1999:blog-350522789217241885.post-4909267138846699252019-09-30T13:22:00.002-04:002019-10-03T13:42:09.162-04:00Signs of Hock Problems in Your HorseNoticing your horse isn't bringing their back legs under them like they use to? Not getting quite as must spring off the ground when approaching a fence? Is your horse pulling down in the bit more than usual? It may not be that your horse is not in the shape they use to be; those could be signs of hock problems.<br />
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While you may prefer to hear that your horse needs a boost in his training regime, hock problems don't mean the end to you and your horse's success. When noticed earlier enough, there are steps you can take to prolong your horse's career.<br />
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<h2>
What is the Hock?</h2>
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The hock joint isn't just one thing, rather an area.<br />
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The hock links the lower leg bones to the tibia in a horse's upper leg. It consists of four basic joints and multiple bones and ligaments.<br />
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The upper joint (the tibiotarsal joint) is responsible for extensions and the majority of the hock mobility. The bottom three joints <a href="https://thalequine.com/the-equine-hock-what-horse-owners-should-know/" target="_blank">handle the remaining movement (about 10%).</a><br />
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With so many working parts, wear and tear is typical and expected —especially in working horses. No one breed is more prone to hock problems. Instead, breeds that are taken out of their historical use (like asking a draft horse to be a jumper) are more susceptible to hock injuries and problems.<br />
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<h2>
Signs of Hock Problems in Horses</h2>
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With hock problems ailing all breeds, it's important to keep an eye for signs. What is lameness shouldn't be mistaken for laziness. While not preventable, when noticed and treated early enough hock problems won't stop your horse in their tracks.<br />
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Here are a few common signs of hock problems in horses.<br />
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<h3>
Stiffness</h3>
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Or rather stiffness at the start of a ride that eventually goes away. When a horse is suffering from a hock problem, all of the ligaments in the joint tense up and become tighter, trying to protect the joints and bones.<br />
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This tightness will eventually be worked out as your horse stretches and moves.<br />
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<h3>
Shifting Their Weight</h3>
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Not all hocks are created equal — even in one horse.<br />
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With hock problems, your horse wants the weight off of their bad hock even when standing.<br />
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Shifting weight while standing isn't always a sign of hock problems as it's natural to change weight on and off a leg while standing. However, if you notice your horse always takes the pressure off a particular leg, it's worth checking out.<br />
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<h3>
Changes in Gait</h3>
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Pain alters the movement of any animal. With pain in the back legs, horses will shorten their gait to take weight off their back. If the pain is severe, they may even shift more weight onto their forelegs, ending up in a hunched position.<br />
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<h3>
Less Spring in Their Jump</h3>
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When approaching a fence, horses shift their weight into their hind in, allowing them to spring off of the ground and clear the fence.<br />
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Horses with hock problems are reluctant to do that. In developing injuries, they may still jump, but with less spring. Keep an eye out if your horse gradually begins hanging their back legs and catching rails.<br />
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With horses in severe pain from a hock injury, they may start refusing. If your horse wasn't in the habit of stopping before fences and you cannot figure out why they are starting too, take a look at their hocks.<br />
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<h3>
Changes in the Appearance of Their Hock Joint</h3>
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One of the apparent signs of hock problems is a change in the hock's appearance.<br />
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The hock joint has a particular, recognizable anatomy. If you notice any deviations from this or notice swelling, tenderness or heat at the hock, it's time to call your vet.<br />
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<h2>
Treating Hock Problems</h2>
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While it always breaks your heart when your horse is in pain, the good news is that hock injuries can be addressed.<br />
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While not 100% treatable, there are different injections and exercises that will reduce pain and tenderness. With working horses, hock injections are relatively common. Using naturally-occurring injections that act as anti-inflammatories, vets can reduce swelling and discomfort, allowing you and your horse back in the ring.<br />
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Hock problems are common in horses — especially working horses. Knowing the signs of hock problems can give you the time to address them with your vet before they take over your horse's career.<br />
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Have questions? Think your horse is suffering from a hock injury? <a href="http://phdveterinaryservices.com/projects/phd/contact.cfm" target="_blank">Give PHD Veterinary Services a call at 352-258-3571.</a>Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com012215 NW 122nd Terrace, Alachua, FL 32615, USA29.767178 -82.4714514.2451435000000011 -123.780045 55.289212500000005 -41.162857tag:blogger.com,1999:blog-350522789217241885.post-46439629670184465132019-09-17T15:42:00.001-04:002019-09-17T15:57:38.336-04:00Preventing Colic in HorsesColic.<br />
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It's one word that strikes fear in most horse owners — and for good reason! A horse with no outward signs of distress can find themselves in trouble just a few hours later.<br />
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With colic in horses causing significant issues, you may be wondering if there are ways of preventing colic. The good news is yes. With a little work, you can help keep your horse happy, healthy, and hopefully colic-free.<br />
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First, let's take a quick look at what colic in horses is and why it happens.
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<h2>
<span style="color: #0b5394;">
What is Colic?</span></h2>
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From horses to humans, colic is a broad term that refers to any abdominal pain.<br />
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The severity of colic in horses depends on what is causing it. It could be spasmodic colic (or gas colic) caused by excessive gas in your horse's digestion. Or it could be impaction colic with several different causes that are entirely disrupting your horse's digestion.<br />
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The severity of colic also dictates a veterinarian's ability to assist. If caught early enough, it may take some medication and slow walks around the barn. If severe, it means going into surgery to remove the impaction.<br />
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If your horse is <a href="https://www.acvs.org/large-animal/colic-in-horses" target="_blank">showing the below signs and symptoms of colic</a>, call your vet immediately.
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<ul>
<li>Rolling or Wanting to Lie Down</li>
<li>Lack of Appetite</li>
<li>Lack of Defecation</li>
<li>Lack of Normal Gut Sounds</li>
<li>The Appearance of Being Bloated</li>
<li>Pawing & Signs of Anxiety</li>
<li>Increased Heart Rate (normal is 28-44 beats/minute)</li>
<li>Profuse Sweating </li>
</ul>
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Colic is quite common and is a broad term. But, there are some things you can do to help reduce your horse's risk.<br />
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<h2>
<span style="color: #0b5394;">
Tips for Preventing Colic in Horses</span></h2>
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Like most things in the world, colic is not 100% preventable. But, you can go a long way in helping prevent severe colic in your horse.<br />
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<h3>
<span style="color: #0b5394;">
Stay Consistent With Feed, Portions and Times</span></h3>
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A potentially common cause of colic is a sudden change in diet, like food type or portion sizes. While changes in diet are sometimes necessary, it's important not be in a constant state of change.<br />
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During these shifts, it's best to switch the diet gradually over the week with incremental increases and changes. Small changes allow your horse's digestion to become accustomed to the new grains and food.<br />
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<h3>
<span style="color: #0b5394;">
Keep Your Horse Moving and Active</span></h3>
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A moving horse is a happy horse. And that unrestricted movement during turnout allows a horse's digestion and intestines to stretch out and do their jobs.<br />
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With each step your horse takes while socializing or grazing, the food in their gut is moving as well increasing the rate of breakdown and mobility in their system. A horse that is kept in a stall at all times, will have a hard time moving enough to help boost their digestion.<br />
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<h3>
<span style="color: #0b5394;">
Always Have Fresh Water for Your Horse</span></h3>
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Like moving, water helps your horse's digestion, and with preventing colic.<br />
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When a horse (or any animal) becomes dehydrated, digestion becomes harder and more taxing on the animal's system. A horse that is turned out or kept in the stall without access to clean water is at higher risk of impaction, one of the more severe types of colic in horses.<br />
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Preventing colic in horses isn't always possible, but the above tips can go a long way in helping keep your horse (and their digestion) happy. Have questions? Think your horse is at risk for colic? <a href="http://phdveterinaryservices.com/projects/phd/contact.cfm" target="_blank">Give us a PHD Veterinary Services in Florida a call at 352-258-3571</a>.Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0Alachua, Florida 3261527.449790548863771 -81.8261722500000131.9277560488637704 -123.13476625000001 52.971825048863771 -40.517578250000014tag:blogger.com,1999:blog-350522789217241885.post-67376162431391508282015-04-30T22:24:00.002-04:002015-04-30T22:24:19.226-04:00Chronic Arytenoid Chondritis in a HorseA twenty year-old quarterhorse gelding presented to PHD veterinary services for a complaint of chronic coughing and exercise intolerance. There was no nasal discharge noted during the physical exam however the amount of air that was exiting the nares during expiration was subjectively reduced. An endoscopic exam was performed to evaluated the nasal passages, pharynx and larynx. In Figure 1, a "normal" airway of a horse is pictured. There is a large opening within the larynx (green arrow) which corresponds to the opening to the proximal trachea which provides air into the lungs. The small blister-like structures seen along the dorsal pharyngeal wall are common in young horses and considered lymphatic tissues. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgcsZouZCQJbB7vRfM5SgOR2d4uCQipMZRWbar7EAJfdgdYLpqySvsHQDSwN2Blk844NycoBcucl1EkBRjwRI33XtXIPDdM33k7wn9lzTtsQIs9DNOlr0tn-91eNdo40N7BcfZe1AUuzPI8/s1600/DSC00005.JPG" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgcsZouZCQJbB7vRfM5SgOR2d4uCQipMZRWbar7EAJfdgdYLpqySvsHQDSwN2Blk844NycoBcucl1EkBRjwRI33XtXIPDdM33k7wn9lzTtsQIs9DNOlr0tn-91eNdo40N7BcfZe1AUuzPI8/s1600/DSC00005.JPG" height="240" width="320" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkXhlBMT6zooeisEh8wM-tw-06shUbrG0Fz6GjwRF17r4Hp_JXt9mAVyw63UDofgc6D4fmHNqJ0SW3OCKgo9SZJu6tB6c2ZfCChPrQNet4F4yeOXkMbqM-IB3cm0fLSUVMsmrbAiuVE_49/s1600/arytenoid+chondritis+pic+2.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkXhlBMT6zooeisEh8wM-tw-06shUbrG0Fz6GjwRF17r4Hp_JXt9mAVyw63UDofgc6D4fmHNqJ0SW3OCKgo9SZJu6tB6c2ZfCChPrQNet4F4yeOXkMbqM-IB3cm0fLSUVMsmrbAiuVE_49/s1600/arytenoid+chondritis+pic+2.jpg" height="239" width="320" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgcsZouZCQJbB7vRfM5SgOR2d4uCQipMZRWbar7EAJfdgdYLpqySvsHQDSwN2Blk844NycoBcucl1EkBRjwRI33XtXIPDdM33k7wn9lzTtsQIs9DNOlr0tn-91eNdo40N7BcfZe1AUuzPI8/s1600/DSC00005.JPG" style="margin-left: auto; margin-right: auto;"></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 1</td></tr>
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In Figure 2, the endoscopic images correspond to the 20 year-old horse with a cough and exercise intolerance. Notice the airway (green arrow) is significantly reduced compared to the "normal horse" in Figure 1. The clinically relevant anatomy includes the arytenoid cartilage (blue stars), vocal cords (red cross), and the laryngeal cicatrix (yellow arrows). In this horse, the arytenoid cartilage is thicker than normal and the vocal cords are adhered to each other. In addition, a thick scar or cicatrix has developed between the arytenoid cartilage and the epiglottis. Hence, the cause for the recurrent cough and exercise intolerance is due to a significant reduction in the airway at the level of the larynx. The airway reduction is caused by the narrowing of the laryngeal opening due to cicatrix formation between the arytenoid cartilage and between the vocal cords.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4ll0wceEZS-UHuHnOzTkG7xQjugK0-VeDgYouDYZhrywZFfz5lZ9MaZdopIXiN9FybiSNnb39gOL38iV3I8L4QkFykZ4pXN4focELK3nzYQ4nO_ApAeW5m7vkfuuSO4oky8ikHndolDSe/s1600/arytenoid+chondritis+pic1.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4ll0wceEZS-UHuHnOzTkG7xQjugK0-VeDgYouDYZhrywZFfz5lZ9MaZdopIXiN9FybiSNnb39gOL38iV3I8L4QkFykZ4pXN4focELK3nzYQ4nO_ApAeW5m7vkfuuSO4oky8ikHndolDSe/s1600/arytenoid+chondritis+pic1.jpg" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 2</td></tr>
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The cause for the cicatrix formation is likely chronic inflammation of the arytenoids otherwise known as arytenoid chondritis. Arytenoid chondritis is most common in older horses and often results in severe narrowing of the airway at the level of the larynx. The cause of the inflammation is not well known and these horses are often treated with a throat spray that consists of an antibiotic, anti-inflammatory product and a corticosteroid. Usually, medical management with throat spray is not suffice and the long term prognosis for these horses is guarded unless a permanent tracheostomy is performed. Surprisingly, if the surgery is a success, horses with this condition tend to thrive in their environment as long as they do not go swimming!!<br /> This case represents a good example of the need for endoscopic exam of horses with recurrent coughs and/or exercise intolerance. Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-27190491281904832822015-04-11T11:51:00.000-04:002015-04-11T11:51:01.332-04:00PHD Veterinary Services New Van!!After driving 333000 miles in 5 years, the original PHD veterinary services van died in Orlando. Five weeks later, the new and improved van has been set up and is ready for business!! This van has an additional 16 inches in length for more stuff!!We are looking forward to getting this van on the road and coming to see you and your horse in the near future!!<br />
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<br />Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-51854014208139958332015-03-19T20:08:00.000-04:002015-03-19T20:10:41.955-04:00Equine Ophthalmologist: Dr. Brenden MangenWhen it comes to examining and treating equine ocular disease, there is no substitute for a veterinary ophthalmologist. Until recently, this typically required transporting the horse to a referral facility such as the University of Florida. <b>PHD Veterinary Services is very excited to share the news that there is now a board certified veterinary ophthalmologist available for horses in north central Florida AND that he will come see your horse on the farm. </b>Dr. Brendan Mangan is employed by Affiliated Veterinary Specialist <a href="http://avspethospitals.com/index.php">(Affiliated Veterinary Specialist)</a><span style="color: red;"></span> in Gainesville, Florida. Currently, he is evaluating equine patients on Fridays at veterinary hospitals AND on the farm! Please have your veterinarian contact him with any questions regarding equine patients that would benefit from the expertise of a veterinary ophthalmologist!! PHD veterinary services strongly endorses his specialty services!!<br />
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Dr. Mangan grew up in upstate New York, but moved to Colorado to obtain his veterinary degree at Colorado State University in 2003. From 2003 to 2004 he pursued further training as an intern in small animal medicine and surgery at the Cornell University Hospital for Animals in Ithaca, New York. In 2007 he completed a 3 year residency program in veterinary ophthalmology and a M.S. in clinical sciences at Colorado State University. Dr. Mangan started and operated an equine ophthalmology referral practice in San Diego, California from 2007 to 2011. He returned to the east coast to work as an Assistant Professor of Ophthalmology at the University of Florida from 2011 to 2014. He joined Affiliated Veterinary Specialists at the Gainesville location in August of 2014 and provides medical and surgical care for both horses and small animals.<br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjN3gb_NbOU7e69Hd4i0nnX-IhUEvII_K3BaRZoc9SfYsksQ1ZWImBxZlfU9J_pgbuozuqKWVTF7mDYZyCyoUb-aPjLrBbNWkLqjm5ySn2U9r_vBH2xML6cQnbHk6avQEqKg-zQsDy6IdCP/s1600/2015-03-19+16.52.34.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjN3gb_NbOU7e69Hd4i0nnX-IhUEvII_K3BaRZoc9SfYsksQ1ZWImBxZlfU9J_pgbuozuqKWVTF7mDYZyCyoUb-aPjLrBbNWkLqjm5ySn2U9r_vBH2xML6cQnbHk6avQEqKg-zQsDy6IdCP/s1600/2015-03-19+16.52.34.jpg" height="300" width="400" /></a><br />
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Contact information:<br />
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Dr. Brendan Mangan, DVM, MS, DACVO<br />
Affiliated Veterinary Specialists<br />
7314 W. University Avenue<br />
Gainesville, Florida 32607<br />
352-672-6718<br />
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<br />Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-6969069671340286842015-02-27T11:53:00.001-05:002015-02-27T11:53:12.899-05:00Subcutaneous Pythiosis in a Horse.A 10 year-old warmblood gelding presented to PHD veterinary services for the complaint of a swollen left front fetlock that was associated with a chronic draining wound. The recent history included a biopsy of the wound and diagnosis of pythiosis per histopathology. The gelding was treated with a single dose of a systemic pythiosis vaccine. In Figures 1 and 2 the yellow arrows are pointing to the firm swelling that is directly on the backside (palmar aspect) of the fetlock joint. In addition, the red arrow in Figure 2 corresponds to the chronic draining wound. The gelding was sensitive to direct pressure over the swelling, passive flexion of the fetlock and was mildly lame at the trot. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiDgqbGAQ-MpTOBzFrCZSt1m0-cPKZBet2Oc_5Y-KetOZsT7mfAvakn6w9RIGexq0geUXKXOphxMWZJ_fQNOQhbpnt_jJt0RC85Ph2cMhm8YOiDWDH7wxT9ukaFGrPpRvcsKOC0ifKAcj7U/s1600/pythiosis+pic+3.jpg" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiDgqbGAQ-MpTOBzFrCZSt1m0-cPKZBet2Oc_5Y-KetOZsT7mfAvakn6w9RIGexq0geUXKXOphxMWZJ_fQNOQhbpnt_jJt0RC85Ph2cMhm8YOiDWDH7wxT9ukaFGrPpRvcsKOC0ifKAcj7U/s1600/pythiosis+pic+3.jpg" height="400" width="225" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 1</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjl9BwHBMzXVidgmbj0cuW1L9_fMIVoV-FzNxUPPrtZFoIk-yWGI4shrvSFe1hZ3Gi3J-U7jPYJ2uhwH7j8zPOTPDLmXHzalqNfDC-d2uddI8GKUIkakqCA93CNAIyy_tgXPtreGG4ax2De/s1600/pythiosis+pic+4.png" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjl9BwHBMzXVidgmbj0cuW1L9_fMIVoV-FzNxUPPrtZFoIk-yWGI4shrvSFe1hZ3Gi3J-U7jPYJ2uhwH7j8zPOTPDLmXHzalqNfDC-d2uddI8GKUIkakqCA93CNAIyy_tgXPtreGG4ax2De/s1600/pythiosis+pic+4.png" height="400" width="298" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 2</td></tr>
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An ultrasound exam was performed of the area in question. The firm swelling consisted of multiple fluid filled structures along with focal areas of apparent mineralization. The structure appeared embedded within the distal annular ligament; however the superficial flexor tendon (SDF) and the deep digital flexor tendon (DDF) appeared to be normal. In Figure 3 the yellow arrows are highlighting the fluid filled structures. This case is a very unusual presentation for pythiosis in a horse. The majority of cases present with an external lesion as seen in Figure 4. As external lesions there are several treatment options which involve aggressive surgical de-bulking and various topical medications. The pathogen responsible for this condition is found in stagnant water and invades superficial abrasions that might be present any where on the horse. Hence the lower limbs are most commonly affected but it has been diagnosed in the naso-pharynx and GI track of horses. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhZrv8UBo3OnDjw4hEtsVIZSmf3cJLOuh58pQJEeGucX_1dg5K5KmyT5Ha4fukQEJMVFiOIMf0rEmnX0-kqwcbLQI67A9la2PoCyMEm8EIpp1Ghdp6rGkjMvgJmto_UXFDel3vmEg5ULCEy/s1600/pythiosis+pic+1.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhZrv8UBo3OnDjw4hEtsVIZSmf3cJLOuh58pQJEeGucX_1dg5K5KmyT5Ha4fukQEJMVFiOIMf0rEmnX0-kqwcbLQI67A9la2PoCyMEm8EIpp1Ghdp6rGkjMvgJmto_UXFDel3vmEg5ULCEy/s1600/pythiosis+pic+1.jpg" height="186" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 3</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjYqa_F44k3otul6mngWnHVl7rz4AFAssrwRJ9VLRquiQq-VZ38orrutWt_WqIy8TetBcXEFfSd7-2QCxvQ1APOobB1sfeCjUcG1Ll2C7tyCK0FE5jFkn-ijIX5VXCujZaYaVP_eLlh0ASE/s1600/2014-04-03+10.16.23.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjYqa_F44k3otul6mngWnHVl7rz4AFAssrwRJ9VLRquiQq-VZ38orrutWt_WqIy8TetBcXEFfSd7-2QCxvQ1APOobB1sfeCjUcG1Ll2C7tyCK0FE5jFkn-ijIX5VXCujZaYaVP_eLlh0ASE/s1600/2014-04-03+10.16.23.jpg" height="300" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure4</td></tr>
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Because of the complicated location of the lesion in this horse, we elected to treat with a potent anti-fungal medication known as Amphotericin B. The medication was administered through a vein in the lower limb using regional limb perfusion. This technique maximizes the local perfusion of the soft tissues with the medication and minimizes the systemic effect of the medication. <br /><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjDtVo3ZklBw3e50xiD3F-VikFALwrzjv570Fqt2RH-JjZlPpOlDCwhhpv4GSeEI0foBoDOc_t4F5PvGG7B4S5q15QjJX7LXzfPIZNP-ooQwx8uwYNYUVJso6ZuclhaECqPgDe0zLbamLPv/s1600/mbp+pic.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjDtVo3ZklBw3e50xiD3F-VikFALwrzjv570Fqt2RH-JjZlPpOlDCwhhpv4GSeEI0foBoDOc_t4F5PvGG7B4S5q15QjJX7LXzfPIZNP-ooQwx8uwYNYUVJso6ZuclhaECqPgDe0zLbamLPv/s1600/mbp+pic.jpg" height="320" width="202" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 5</td></tr>
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The lesion was re-evaluated 30 days after the initial treatment and there was approximately 40-50% reduction in size of the lesion. However, after 60 days, the lesion appeared to resume growth and a second treatment with Amphotericin B was recently administered. In addition, the gelding as received 2 vaccines against the pythiosis and will likely receive another. Because of the location, surgery is not an option for this horse hence the systemic therapy is our best option at this point. The case is on -going and the blog will be updated as we go!!<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEibsWG-DU9I9njhtC9CHIW5G3it5VLJJ2C0zD2PW601uKxCA6P6jsULiuUyZnOYSh0wnNpoudLNQnsGdpwIhb8ipGZrr_I4AbrjNcECiYTRBG6Yo9qhiBfa1psaHiaChBqAY2OUCGiv-12k/s1600/pythiosis+pic+2.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEibsWG-DU9I9njhtC9CHIW5G3it5VLJJ2C0zD2PW601uKxCA6P6jsULiuUyZnOYSh0wnNpoudLNQnsGdpwIhb8ipGZrr_I4AbrjNcECiYTRBG6Yo9qhiBfa1psaHiaChBqAY2OUCGiv-12k/s1600/pythiosis+pic+2.jpg" height="232" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 6</td></tr>
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Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-66451192300304982042015-02-20T09:20:00.001-05:002015-02-20T09:20:06.541-05:00Severe Navicular Disease in a Horse.<br />
.A 10 year-old thoroughbred gelding presented to PHD veterinary services for the complaint of intermittent forelimb lameness. The gelding was purchased several months following a prepurchase exam performed by a local veterinarian. The buyer opted for NO radiographs at the time of the prepurchase considering that the horse was sound. Unfortunately, within several months after purchase, the gelding developed a lameness in the right front foot which was intermittent. The client contacted PHD veterinary services for foot radiographs and a lameness exam. The lameness exam noted NO lameness in the forelimbs but rather a mild to moderate lameness in both hind limbs after flexing the upper limbs (hocks/stifles). The gelding was not positive to hoof testers in either forelimb. A radiographic exam was elected to document the palmar angle and sole thickness in both front feet. The image in Figure 1 is a lateral image of the right front foot and Figure 2 is a lateral image of the left front foot. The yellow arrows are highlighting the navicular bone of each foot. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhVRGpG0I64KpiIFOzif442uxwuVy9oba9_6x2gJVy1VKA3eBTi7gvazdHpXl2LB-qX4473DtzPN23oCdhSYB1x__v0rv8JedYbvR8y-Wbl7Crpex_gtS8930C6WzjrZ3F4sGDLleRmgqSZ/s1600/navicular+pic+3.png" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhVRGpG0I64KpiIFOzif442uxwuVy9oba9_6x2gJVy1VKA3eBTi7gvazdHpXl2LB-qX4473DtzPN23oCdhSYB1x__v0rv8JedYbvR8y-Wbl7Crpex_gtS8930C6WzjrZ3F4sGDLleRmgqSZ/s1600/navicular+pic+3.png" height="192" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 1</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEges01_Jqu5rht_HIk20IoZkJB1WMRKKppqlHHowATRikssYFUC32bBxWBtYB2viyAshd9aSPuXdTV5PPUBIVEHUN92Xsaw46iIrL13eQDjwjBeGywTxdoPNvsmZvYoDwt9gQhRiN9J_yEA/s1600/navicular+pic+4.jpg" style="margin-left: auto; margin-right: auto;"><img alt="" border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEges01_Jqu5rht_HIk20IoZkJB1WMRKKppqlHHowATRikssYFUC32bBxWBtYB2viyAshd9aSPuXdTV5PPUBIVEHUN92Xsaw46iIrL13eQDjwjBeGywTxdoPNvsmZvYoDwt9gQhRiN9J_yEA/s1600/navicular+pic+4.jpg" height="238" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 2</td><td class="tr-caption" style="text-align: center;"><br /></td><td class="tr-caption" style="text-align: center;"><br /></td><td class="tr-caption" style="text-align: center;"><br /></td><td class="tr-caption" style="text-align: center;"><br /></td><td class="tr-caption" style="text-align: center;"><br /></td><td class="tr-caption" style="text-align: center;"><br /></td><td class="tr-caption" style="text-align: center;"><br /></td></tr>
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Interestingly, the lateral image of the suspect foot (right front) appeared normal however the lateral radiograph of the left front foot was highly abnormal. The navicular bone of the left front foot was flattened and completely sclerotic when compared to the navicular bone of the right front.foot. Additional views of the navicular bone are imaged in Figures 3 and 4. In Figure 3, the skyline projection of the navicular bone suggests severe deterioration of the bone and what appears to be a chronic fracture of the navicular bone (yellow arrow). The flexor surface of the navicular bone is very irregular.<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiHT-asHSl4CSl5gkhtaWYL-wlPEH-7XdHUVoacwIYv1F8VHod5y8iGEAmIC5PFtF2wW4BFA0stzLoKo4zN-555zlBy7TJvRWHOc0unzst4koubKONzjgNM3t15BdY9eymoVLoYNFHdqZ2w/s1600/navicular+pic+1.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><br /></a></div>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiHT-asHSl4CSl5gkhtaWYL-wlPEH-7XdHUVoacwIYv1F8VHod5y8iGEAmIC5PFtF2wW4BFA0stzLoKo4zN-555zlBy7TJvRWHOc0unzst4koubKONzjgNM3t15BdY9eymoVLoYNFHdqZ2w/s1600/navicular+pic+1.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiHT-asHSl4CSl5gkhtaWYL-wlPEH-7XdHUVoacwIYv1F8VHod5y8iGEAmIC5PFtF2wW4BFA0stzLoKo4zN-555zlBy7TJvRWHOc0unzst4koubKONzjgNM3t15BdY9eymoVLoYNFHdqZ2w/s1600/navicular+pic+1.jpg" height="267" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 3</td></tr>
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In Figure 4, the distal border of the navicular bone is imaged. The yellow dotted line outlines the navicular bone and the yellow arrows are pointing to the many dark circles which are consistent with areas of lysis and/or cyst formation. The findings in Figures 3 and 4 are consistent with SEVERE degeneration and likely chronic fracture of the navicular bone. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEitwoeRAuvEcEsYUrs02mJv2uZE4kaaUm4fIR3FYADwBUp0J3GWmCJkc7VtNYgUWSsvR5NgKngaQY057CxY1e9T_4gWyVIzS4Eh3aU1dEkHQRtV9jmlQ9LtDz_Y0nw0JpE1W7CDDZ975ukO/s1600/navicular+pic+2.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEitwoeRAuvEcEsYUrs02mJv2uZE4kaaUm4fIR3FYADwBUp0J3GWmCJkc7VtNYgUWSsvR5NgKngaQY057CxY1e9T_4gWyVIzS4Eh3aU1dEkHQRtV9jmlQ9LtDz_Y0nw0JpE1W7CDDZ975ukO/s1600/navicular+pic+2.jpg" height="304" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure4</td></tr>
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These findings are NOT consistent with the physical exam findings of a sound horse or the history unless this horse has had the nerves, which provide innervation to the foot, surgically transected (nerved). At the time of the exam, the gelding did demonstrate sensation to the skin along the heel bulbs however there were small scars consistent with a previous surgery over the neuro-vascular bundles. Considering how normal the right front navicular bone appears, the degeneration of the left front navicular bone is most likely due to a septic process from a penetrating foreign body that resulted in infection of the navicular bone or a traumatic fracture. Regardless of the cause, these radiographic findings are suffice to retire this horse from forced exercise and hope that he remains comfortable for an extended period of time. This case represents another example of the benefit of simple foot radiographs as part of all prepurchase exam.Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-4194078735561780602015-02-12T20:29:00.002-05:002015-02-12T20:31:08.013-05:00Ionophore-free Horse Feed Mills<b>The two bags of horse feed shown below were produced in IONOPHORE-FREE mills!!</b> Why is this important?? <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjECGfHFwoa9rSa8Oz35EsI2543Uvxjr1znGzD-gd4qHxPXvkdXMF401_zVNZlaUH-VDNl7uuooHrZEfvgr-YqFO6TS6MlaWvKREYqGTVEps_LoL66O2-uzG3udZz40hSVYiLU6qq0zlm4A/s1600/purina+pic.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjECGfHFwoa9rSa8Oz35EsI2543Uvxjr1znGzD-gd4qHxPXvkdXMF401_zVNZlaUH-VDNl7uuooHrZEfvgr-YqFO6TS6MlaWvKREYqGTVEps_LoL66O2-uzG3udZz40hSVYiLU6qq0zlm4A/s1600/purina+pic.jpg" /></a> <a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhBLJvZCkpttLSuOtt2l922uxNADqOmc8iAeyO84mN_70d2SS_rBBPhhSd7mxzqLObD18tHU3h_XQ4_chI-_ep21KEMuRM9bfrDS9mkni1BGjsbqgDhPrQ4XzC-JVwpFTeJBdo-o18Vly7t/s1600/seminole.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhBLJvZCkpttLSuOtt2l922uxNADqOmc8iAeyO84mN_70d2SS_rBBPhhSd7mxzqLObD18tHU3h_XQ4_chI-_ep21KEMuRM9bfrDS9mkni1BGjsbqgDhPrQ4XzC-JVwpFTeJBdo-o18Vly7t/s1600/seminole.jpg" /></a>In the past year there has been at least two well publicized cases of horses ingesting feed that was contaminated with a common supplement for cattle known as ionophores. The first case involved a barn full of horses in south Florida which ingested contaminated feed. Initially, three horses died however the remainder of the 22 horses were expected to eventually die due to the toxin in their feed.<a href="http://www.sun-sentinel.com/local/broward/fl-sick-horses-davie-20141121-story.html" target="_blank"><span style="color: yellow;">http://www.sun-sentinel.com/local/broward/fl-sick-horses-davie-20141121-story.html </span> </a>The story is heart breaking however it could have been prevented.<br />
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Recently, there was another reported incident of horses becoming ill and dying from contaminated feed.<span style="color: yellow;"><span style="color: yellow;"> <a href="http://www.poisonedpets.com/deadly-horse-feed-still-sale-adm-alliance-refuses-pull-feed/" target="_blank"><span style="color: yellow;">http://www.poisonedpets.com/deadly-horse-feed-still-sale-adm</span>-<span style="color: yellow;">alliance-refuses-pull-feed</span>/</a></span> </span>. Once again, the feed appeared to be contaminated with the supplement for cattle, ionophores. Ionophores are extremely toxic to horses and attack the muscle of the heart. If the horse does not succumb initially, it is likely that the diseased heart muscle will slowly weaken resulting in heart failure and death.. How can horse owners and trainers avoid the possibility of such a tragic occurrence?? By purchasing horse feed from ionophore-free mills. Most feed companies produce feed for various types of livestock including cattle and horses. In addition, it is common practice for some feed companies to produce cattle and horse feed in the same facility. These feed companies practice techniques to "flush" the cattle supplements out of the system prior to producing the horse feed. Clearly, there is room for error. The solution is to buy feed from documented, ionophore-free mills. <b>If your horse feed representative is not capable of saying the words "ionophore-free mill" then its time for a change in feed!!!</b><br />
<br />Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-67608307315021236502015-02-02T09:45:00.001-05:002015-02-02T09:45:34.631-05:00Proximal Suspensory Desmitis in a HorseA 10 year-old warm-blood gelding presented to PHD veterinary services for the complaint of forelimb lameness. During the lameness exam, it was noted that the gelding was moderately lame in the right front limb and the lameness appeared worse when the horse was lunged at the trot in a circle to the left. Palpation of the limb noted only mild response to pressure over the proximal suspensory ligament (back side of the limb, just below the carpus). A series of nerve and joint blocks were performed to isolate the source of the lameness. Once the proximal suspensory ligament was "blocked" the horse's lameness improved significantly. Therefore, an ultrasound exam was performed of the soft tissue structures of the right limb with emphasis on the proximal suspensory ligament. Figures 1 and 2 correspond to the proximal suspensory ligament. The yellow line outlines the body of the proximal suspensory ligament in cross-section and the blue arrows a bright (hyperechoic) lesion within the suspensory ligament. The area of increased brightness or echogenicity is consistent with an enthysophyte. In addition, the enthysophyte was surrounded by an area of decreased echogenicity consistent with edema or active inflammation. An enthysophyte is a abnormal bony projections at the site of attachment between a tendon/ligament at bone. In this case, between the proximal suspensory ligament and the third metacarpus (cannon bone). <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhYK3RGlC1JWaGd9jVviYZIqwAfzQxaVS6iNLr9thFx4RNkxYKfLhfkhBn-hzZZBX_FUtyWvyJNEvrkS1ZQK75vfxNzVm2r3mcKiwbnSXvmrKNkA8wpTWvXhlJqBR9BI1ebC0Y2t7g1fvWo/s1600/disco+pic+1.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhYK3RGlC1JWaGd9jVviYZIqwAfzQxaVS6iNLr9thFx4RNkxYKfLhfkhBn-hzZZBX_FUtyWvyJNEvrkS1ZQK75vfxNzVm2r3mcKiwbnSXvmrKNkA8wpTWvXhlJqBR9BI1ebC0Y2t7g1fvWo/s1600/disco+pic+1.jpg" height="320" width="290" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure1</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiVccxprAMAWX3J6eYtTaf73Ex9iuzo3_tnxpCTu6p9aiIczwDZn37cmh7YJka-dyuKVe9BYhWGQJ1z97pw8q88X1liTbyQs-VY3tkG_Hn8Xh63yn_-7AzgxbJ8Q-Vmx0jXLFhacvLx0uJ5/s1600/disco+pic+2.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiVccxprAMAWX3J6eYtTaf73Ex9iuzo3_tnxpCTu6p9aiIczwDZn37cmh7YJka-dyuKVe9BYhWGQJ1z97pw8q88X1liTbyQs-VY3tkG_Hn8Xh63yn_-7AzgxbJ8Q-Vmx0jXLFhacvLx0uJ5/s1600/disco+pic+2.jpg" height="320" width="308" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 2</td></tr>
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In a similar case, the horse was subjected to a CT (computed tomography) exam and the enthysophytes appear as small, spikes (blue arrows) which are projecting into the body of the suspensory ligament (yellow outline). From this view is understanding why these horses have chronic and recurring forelimb lameness issues. The presence of enthysophytes tends to worsen the prognosis with regards to return to "full" work. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgv76J18TydwN2CwHaVNfV3jyg1p87OoHNK4qqOHp0HerIoU1uYDi32D3hzmUM6IyVOPtyVmWzIH9JTK2voO5ayPgIvXOcFB1EXjoHo_7s0hBftLJKGfHZHuUWYpdGHM-JJ2k7YVnB6kmfy/s1600/disco+pic+4.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgv76J18TydwN2CwHaVNfV3jyg1p87OoHNK4qqOHp0HerIoU1uYDi32D3hzmUM6IyVOPtyVmWzIH9JTK2voO5ayPgIvXOcFB1EXjoHo_7s0hBftLJKGfHZHuUWYpdGHM-JJ2k7YVnB6kmfy/s1600/disco+pic+4.jpg" height="250" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure3</td></tr>
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The above mentioned gelding was treated with rest, multiple PRP (platelet rich plasma) injections, and shockwave treatment. He is currently sound however his prognosis remains guarded for full return to work and show.Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-6016870287578510292015-01-17T13:40:00.004-05:002015-01-17T13:40:38.646-05:00Eye Lid Tumor in a DonkeyA 2 year-old female donkey presented to PHD Veterinary services for the complaint of multiple tumors surrounding the left and right eye. The tumors have been present for several months and have been treated by surgical debulking and intra-lesional injections with a variety of chemotherapy agents. However, the tumors continue to return. There is a golf ball size tumor just below the right eye and the left eye is nearly closed due to the tumor's involvement of the entire eye lid!<br />
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The plan for this donkey involves biopsy of the tumors followed by local treatment with an immune stimulant that contains mycobaterial cell wall extract. PHD veterinary services will be working with Dr. Brendan Mangan from Affiliated Veterinary Specialist in Gainesville, Florida. Dr. Mangan is a board certified ophthalmologist with extensive experience treating such cases! Dr. Mangan suspects that these tumors are sarcoids and not squamous cell carcinomas. Certainly, an unusual presentation for sarcoids in a young donkey!! Dr. Mangan submitted several core biopsies this week for confirmation and began treatment with the mycobaterial cell wall extract. <br />
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After the initial treatment with the immune stimulant, Dr. Mangan plans to surgically remove the tumors surrounding both eyes! Thereafter, it is likely that the injection of the local immune stimulant will be repeated along with focal cryotherapy. The biopsy results and follow-up pics will be added to this post next week so stay tuned!!!<br />
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<br />Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-90308647116278781882015-01-10T16:38:00.000-05:002015-01-10T16:44:47.611-05:00Sarcoids in a HorseThe following images represent 3 different cases of sarcoid tumors in horses. The images in Figure 1 and 2 are that of sarcoid tumors on a horse's hind limb. The tumors had been removed several times before however they continue to re-develop. The sarcoid tumors in this case have been treated by surgical resection and a topical anti-sarcoid medication called Xxterra. This gelding will require additional surgical debulking and more aggressive post-operative treatment with cryotherapy AND chemotherapy agents. Prognosis is guarded due to the large tumor size and the location of the sarcoid tumors.<br />
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<tr><td class="tr-caption" style="text-align: center;">Figure 1</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgayYXqNzUdwEmH9RhFedHJ2QbOifOSCSFDvkEGYV-d5vZdoSv9HkVmqKS_-CUo_dqzBouSxd7nhZKcf9mwZiYve-6h8BbSW9xXjHvSSbWpaAs7v8ve1u0bWqmC1uRjU-IwdNmrDiwKqAr3/s1600/2015-01-05+15.37.29.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgayYXqNzUdwEmH9RhFedHJ2QbOifOSCSFDvkEGYV-d5vZdoSv9HkVmqKS_-CUo_dqzBouSxd7nhZKcf9mwZiYve-6h8BbSW9xXjHvSSbWpaAs7v8ve1u0bWqmC1uRjU-IwdNmrDiwKqAr3/s1600/2015-01-05+15.37.29.jpg" height="400" width="300" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 2</td></tr>
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In Figures 3,4 and 5, the sarcoid tumor in this horse is located along the sheath of the gelding and is flatter compared to the sarcoid tumors in the horse in Figures 1 and 2. This sarcoid was treated with multiple injections of a chemotherapy agent known as cisplatin. There was minimal response to the chemotherapy agent hence this sarcoid tumor will likely require surgical debulking followed by additional chemotherapy treatment.<br />
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<tr><td class="tr-caption" style="text-align: center;">Figure 3</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Figure 4</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiCUBqcgfU64o5iuHGJ2TWft74mjfuVymXL3zuZp34oY3ZIceyIP9cftfS3_Q05wR1654tazrXkKdmBslXHvpN-2L_YfXpf8CTD1c9bgn_2nwp7jjpecty3DzKWQHHKUO1uvqpiNsiVIOZv/s1600/2015-01-10+16.12.25.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiCUBqcgfU64o5iuHGJ2TWft74mjfuVymXL3zuZp34oY3ZIceyIP9cftfS3_Q05wR1654tazrXkKdmBslXHvpN-2L_YfXpf8CTD1c9bgn_2nwp7jjpecty3DzKWQHHKUO1uvqpiNsiVIOZv/s1600/2015-01-10+16.12.25.jpg" height="180" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 5</td></tr>
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The gelding in Figure 6 and 7 was suffering from a horrible sarcoid that weighed more than 2 pounds and was dangling from his right ear. The sarcoid was removed by surgical debulking and the ear was treated with both injectable cisplatin and cryotherapy (liquid nitrogen). The image in Figure 7 is several months after the initial surgical debulking. To date, there does NOT appear to be any re-development of the sarcoid tumor.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgJ0OyZrPqYROwlrfNgyi2HqCnSO-ewR5RUYku2MvMiWzo2CqOK41zK-ukYoThpkfpUc0S5WuTwDJiLe7gYzGgb84uu1AylbbdPsWuO30AgCo5fqE8pgTh4pznzzuShwV4WScvWCKy2Jkcq/s1600/2014-04-23+16.59.27.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgJ0OyZrPqYROwlrfNgyi2HqCnSO-ewR5RUYku2MvMiWzo2CqOK41zK-ukYoThpkfpUc0S5WuTwDJiLe7gYzGgb84uu1AylbbdPsWuO30AgCo5fqE8pgTh4pznzzuShwV4WScvWCKy2Jkcq/s1600/2014-04-23+16.59.27.jpg" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 6</td></tr>
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<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgy004-kD-HRJfjb9qaHnQrqxCkx9PHIBpIeUGUGqd_z6qAhfWNIQo0VD92vJYzH1YgOE4PLIgE80kURyfiDbsOuB54bN5MNw9tZGP463sF-ucyclSlk3dtQexm4Kg7MfOHFKoMJGkU8_H3/s1600/2014-09-03+16.26.23.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgy004-kD-HRJfjb9qaHnQrqxCkx9PHIBpIeUGUGqd_z6qAhfWNIQo0VD92vJYzH1YgOE4PLIgE80kURyfiDbsOuB54bN5MNw9tZGP463sF-ucyclSlk3dtQexm4Kg7MfOHFKoMJGkU8_H3/s1600/2014-09-03+16.26.23.jpg" height="320" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 7</td></tr>
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These 3 cases represent the diversity of the appearance and location of sarcoid tumors in horses! However, what they have in common is the aggressive and persistent nature of sarcoid tumors in horses. As such, the take home message of these cases is that sarcoid tumors should be identified EARLY and treated as AGGRESSIVELY as possible. There is no ONE treatment that is typically suffice for treatment but rather a combination of surgical debulking, chemotherapy and cryotherapy!Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-9902643744498324202015-01-02T15:48:00.000-05:002015-01-02T15:48:13.310-05:00Gastric ulceration in HorsesTwo adult horses presented to PHD Veterinary Services this Fall/winter for very different complaints yet the same disease process. Horse #1 was a 10 year-old gelding that presented for the complaint of rearing under saddle and refusing to go forward. Horse #2 was a 5 year-old mare that presented for the complaint of recurrent low grade colic after eating. A gastroscopy was performed on both horses and both horses were diagnosed with gastric ulcers. In Figure 1, the area of ulceration is within the blue circle and the ulcerated tissue is highlighted by the red arrows. The ulcers in Figure 1 correspond to the horse which was rearing and the ulcers scored a 3 out of 5 with 5 being severe. In Figure 2 and 3, the ulcers appear less severe (score 2/5) and correspond to the horse that was demonstrating abdominal pain after eating. Interestingly, the gastric ulcers in the horse that was rearing under saddle appear worse than the horse with recurring symptoms of colic.<br />
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,<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHrG1adCOJZyLzB3qbqoKjeCH9SqVJOf3JQ84yFIGhgik7458EFigyyxrTih1ZeY5CIdFdsDkeGdyJrgrahGTi3eNnPi0mwFWrc0YOqUM6NGc7kQpaHo08GO0KF19Iz-IrH6CKPiykMJ-T/s1600/ulcer+pic+1.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHrG1adCOJZyLzB3qbqoKjeCH9SqVJOf3JQ84yFIGhgik7458EFigyyxrTih1ZeY5CIdFdsDkeGdyJrgrahGTi3eNnPi0mwFWrc0YOqUM6NGc7kQpaHo08GO0KF19Iz-IrH6CKPiykMJ-T/s1600/ulcer+pic+1.jpg" height="241" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 1</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhnetsJpLHa_SJ6Ey9KJa6VZ7o7IjB34nTnF6QSXhPo3fnOi9aZEFHT-okpgXJ1cBwGfXL583aTFKE682MI7KgliPRmUcAwU9_Rfy9tz0XfiapQ5RjJRNyIlFP7edsEbIieV7JR4n3eTw4M/s1600/ulcer+pic+4.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto; text-align: center;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhnetsJpLHa_SJ6Ey9KJa6VZ7o7IjB34nTnF6QSXhPo3fnOi9aZEFHT-okpgXJ1cBwGfXL583aTFKE682MI7KgliPRmUcAwU9_Rfy9tz0XfiapQ5RjJRNyIlFP7edsEbIieV7JR4n3eTw4M/s1600/ulcer+pic+4.jpg" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 2</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhHyO0jsO3sfsMAYIqMKnhzZYWCpz3sDKfWWk_ech4wK0NyKcD-MsWaX9mcBba3RA7YypZdPZCIYGLRJqx8x8eyqk44waM9iTxfKqHojTyxDjM3wAl6Ny72MWpO_c7BEJOkUJ-FyeUKBsQI/s1600/ulcer+pic+2.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhHyO0jsO3sfsMAYIqMKnhzZYWCpz3sDKfWWk_ech4wK0NyKcD-MsWaX9mcBba3RA7YypZdPZCIYGLRJqx8x8eyqk44waM9iTxfKqHojTyxDjM3wAl6Ny72MWpO_c7BEJOkUJ-FyeUKBsQI/s1600/ulcer+pic+2.jpg" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 3</td></tr>
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In Figure 4, a "normal stomach" is imaged through gastroscopy. The horse's stomach can be divided into the glandular stomach (darker red tissue) and the non-glandular stomach (lighter tissue). The junction of the two types of tissue (yellow arrows) is called the margo plicata. Most gastric ulcers in horses occur at the margo plicata and in the non-glandular stomach immediately adjacent to the margo plicata.<br />
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Listed below are a list of clinical symptoms which can fit with gastric ulcers in horses:<br />
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1- Recurring colic<br />
2: Weight loss and failure to thrive<br />
3: Poor performance<br />
4: Sudden change in behavior<br />
5: Unwilling to go forward<br />
6: Rearing under saddle<br />
7: Increased sensitivity to brushing/touching of abdominal and flank area<br />
8: Repeated straining to urinate: parking-out for geldings and tail flagging for mares<br />
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The take home message is that gastric ulcers can present in many different ways and should always be considered when evaluating horses for performance/behavior issues.Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-16820981977751092722014-12-06T09:42:00.001-05:002014-12-06T09:42:18.176-05:00Chronic Foot Abscess in a HorseA fifteen year old gelding presented to PHD veterinary services for the complaint of recurrent foot abscesses. Over the past 2 months, the gelding has suffered from 2 abscesses in the same foot. Physical exam revealed a draining abscess from the outside (lateral) margin of the sole and the horse was lame at the walk. A radiographic study of the foot was performed. In Figure 1, the lateral view of the foot is represented. There is no evidence of laminitis and there appears to be adequate sole depth (>1cm). However, careful examination of the palmar (bottom) portion of the coffin bone revealed an area of radiolucency in the bone (yellow circle and yellow arrows). <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhx5T0KkItllVcmJx_6xrN0o3Ol2bzcuAH34AiD-MTF2H0FkMHHU6EDOPbUtf-JpPhh0xLVJtGi8JHrm-WkfWZgvWeYnMhh2r4ESys53_AlF4II3R0e4EBKc6kV6mut_iAO8Tv3aiLxW2lY/s1600/foot+infection+1.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhx5T0KkItllVcmJx_6xrN0o3Ol2bzcuAH34AiD-MTF2H0FkMHHU6EDOPbUtf-JpPhh0xLVJtGi8JHrm-WkfWZgvWeYnMhh2r4ESys53_AlF4II3R0e4EBKc6kV6mut_iAO8Tv3aiLxW2lY/s1600/foot+infection+1.jpg" height="216" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 1</td></tr>
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In Figure 2, the same radiolucency can be seen in the outside (lateral) portion of the coffin bone (yellow arrows and circle) AND is associated with the radiolucency (blue arrows) immediately below it which is the current abscess that is draining from the bottom of the foot.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhcHautnH9yHTcLNP8D9DFEBsFE3QSI4PMQQNvW7PyOjKwfXHsgGCJ2sfRC7UEy7w8IN6I66xEkXnCrwsWKrZC4ZmBVrpDR89uOqvHbx59eL4p5MhT8APiliv1uj6UzTxnMhxBAkLzW_bsQ/s1600/foot+infection+2.jpg.png" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhcHautnH9yHTcLNP8D9DFEBsFE3QSI4PMQQNvW7PyOjKwfXHsgGCJ2sfRC7UEy7w8IN6I66xEkXnCrwsWKrZC4ZmBVrpDR89uOqvHbx59eL4p5MhT8APiliv1uj6UzTxnMhxBAkLzW_bsQ/s1600/foot+infection+2.jpg.png" height="278" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 2</td></tr>
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In Figure 3, the downwardly projected radiograph clearly identifies the defect within the coffin bone (yellow arrow and yellow circle). In addition, the full extent of the abscess is noted by the blue arrows which nearly encompass the entire lateral aspect of the sole. The "black hole" noted inside the yellow circle corresponds to a region of the coffin bone which as been invaded by infection or possibly a tumor. The most likely scenario is a chronic abscess which has resulted in osteomyelitis (bone infection) of the coffin bone. Further diagnosis and treatment will involve a veterinary surgeon and exploration of the coffin bone defect. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgZ1t0AEvXgngQg7ekS3EGGJxG6-n1UfAeRYzsKUWyqskN4IPBv41UvCqO-tgdM4QmSxJ88A6NN1vGcQFYyJGJMBPDmPEPID7KeNSaeSSZT6-z-rZBrwCmZfSdQwaENbOwZ943HPz946hAg/s1600/foot+infection+3.jpg.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgZ1t0AEvXgngQg7ekS3EGGJxG6-n1UfAeRYzsKUWyqskN4IPBv41UvCqO-tgdM4QmSxJ88A6NN1vGcQFYyJGJMBPDmPEPID7KeNSaeSSZT6-z-rZBrwCmZfSdQwaENbOwZ943HPz946hAg/s1600/foot+infection+3.jpg.png" height="320" width="269" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 3</td></tr>
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Typically, foot abscesses do NOT result in a bone infection. However, if the initial abscess is not treated aggressively with disinfecting foot soaking and proper bandaging, it is possible to have such a complication. I typically recommend 7 days of epsom salt solution soaking along with bandaging the foot with a variety of "packing" material. In the case of large sub-solar abscesses, I strongly recommend the use of a hospital plate or specialized boot.Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-11528620667065364612014-11-14T10:54:00.002-05:002014-11-14T10:55:25.829-05:00Hock Arthritis in a HorseA 14 year-old gelding presented to PHD veterinary services for the complaint of left hind limb lameness. The lameness had been noted for 6 months with minimal clinical improvement after several months of pasture rest. On presentation the gelding was a grade 3/5 lame in the left hind limb when trotted in a straight line. Flexion of the lower limb and upper limb did NOT worsen the lameness. In addition, the lameness did NOT worsen when lunged in either direction. Physical exam of the left hind limb did not identify any swelling or joint effusion however the gelding's range of motion of the hock joint was reduced. Radiographic evaluation of the limb was elected as the best option for identifying the source of lameness in this horse. In Figure 1 and 2, the lower hock joints are identified as the following: PIT= proximal intertarsal joint, DIT= distal intertarsal joint, and TMT= tarsal metatarsal joint. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi62ImEySOJyvfUhIgL2FiJXQBu7LSYY-FtZYTaf2PTgEXpoZFKinoH7f9gBqBHUwuAlThn3HcswQ0YfFzy4xm6aoxAyruOSyUY4EX1NeWIJkilECnF3_-sQvyNpre4usjVoB-kSx_H-ShE/s1600/hock+pic+3.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi62ImEySOJyvfUhIgL2FiJXQBu7LSYY-FtZYTaf2PTgEXpoZFKinoH7f9gBqBHUwuAlThn3HcswQ0YfFzy4xm6aoxAyruOSyUY4EX1NeWIJkilECnF3_-sQvyNpre4usjVoB-kSx_H-ShE/s1600/hock+pic+3.jpg" height="320" width="282" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 1</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzgmxHrqCH02R28-jvwI94XRNFeHNZmOEP75GVogpjBPvKRT3xnxKBL7SN9w91MBIEcugkAZ2SfWnBY5aaZGTTXwFMwVhUIcTcqVur1ZNDstjDGD6iu9pMBV46coerhbVoPuS_gCGU7bBr/s1600/hock+pic+4.jpg.png" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhzgmxHrqCH02R28-jvwI94XRNFeHNZmOEP75GVogpjBPvKRT3xnxKBL7SN9w91MBIEcugkAZ2SfWnBY5aaZGTTXwFMwVhUIcTcqVur1ZNDstjDGD6iu9pMBV46coerhbVoPuS_gCGU7bBr/s1600/hock+pic+4.jpg.png" height="320" width="247" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 2</td></tr>
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In Figure 3, the lower hock joints are circled in blue and the yellow arrows are highlighting areas of significant arthritis across the front of the lower hock joints. For comparison, in Figure 4, the right hock is imaged in a radiograph and there is no evidence of arthritis in any of the hock joints. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1Yb0hDQu0WSA38E9Y7LRCjfNflq58cV1OE0nGUkzuel5aZIT9bA9v_YGIns9yirvs-Cc7WotVD2LLSPHUIxtu09tba0-2Mid7Jr5sCdPOwzaLeyhCLVv7uAZvriP1iTULFyfSzfoYVDSJ/s1600/hock+pic+1.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1Yb0hDQu0WSA38E9Y7LRCjfNflq58cV1OE0nGUkzuel5aZIT9bA9v_YGIns9yirvs-Cc7WotVD2LLSPHUIxtu09tba0-2Mid7Jr5sCdPOwzaLeyhCLVv7uAZvriP1iTULFyfSzfoYVDSJ/s1600/hock+pic+1.jpg" height="320" width="273" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure3</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdYzER2yX82_5CvRov35KH6pRVH-2f4Q-y_gHd5KsQyphBoCiHqxrI9GEx_svUgAT_spIbaQ6Mj8YNPxeNS4tmuTe9PydWxx2L0CQ3E6ka-dovgIC7uMSE-GyKVh-2bXC9DMPCSxcoU7Yv/s1600/Dakota+hock+rads0005.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdYzER2yX82_5CvRov35KH6pRVH-2f4Q-y_gHd5KsQyphBoCiHqxrI9GEx_svUgAT_spIbaQ6Mj8YNPxeNS4tmuTe9PydWxx2L0CQ3E6ka-dovgIC7uMSE-GyKVh-2bXC9DMPCSxcoU7Yv/s1600/Dakota+hock+rads0005.jpg" height="320" width="228" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 4</td></tr>
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<br />
In Figure 4, the front of the lower hock joints appear disfigured
(yellow arrows) by the advanced arthritis present. In addition,
there is evidence of arthritis in the most proximal hock joint
(tibio-tarsal joint) which significantly worsens the prognosis for this
horse (Figure 4, red arrow). <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgkSbPmauFaRLK3o2D-PY3AZMBGS5Flr8c9FMbO78s1S7H3_vL8_REiDbiIRZHe3sl8yYLTzwLMyHPKcbBQlQ9nIWQG9jAv1ZAWOoIL48HdrAeLapIKX0A49_c-bGL7ae3AV86BcKcp5bkQ/s1600/hock+pic+3.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgkSbPmauFaRLK3o2D-PY3AZMBGS5Flr8c9FMbO78s1S7H3_vL8_REiDbiIRZHe3sl8yYLTzwLMyHPKcbBQlQ9nIWQG9jAv1ZAWOoIL48HdrAeLapIKX0A49_c-bGL7ae3AV86BcKcp5bkQ/s1600/hock+pic+3.png" height="232" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 4</td></tr>
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The cause of such advanced arthritis in only one hock suggests trauma or a previous infection. Unfortunately, the full history of this horse was not available. Recommendations included a daily anti-inflammatory medication and intra-articular therapy with corticosteroids. Prognosis is guarded for soundness due to the involvement of the tibio-tarsal joint and the degree of arthritis noted in the lower hock joints. <br />
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Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-7830309862223155062014-10-10T15:43:00.000-04:002014-10-10T15:43:00.525-04:00Fractured Tail Bone in a HorseA seven year-old gelding presented for a history of recent trauma via a pasture mate over the region of the tail head. The gelding was able to move his tail however there was firm swelling around the region and he was tender to palpation (Figure 1 and 2). Physical exam performed 2 weeks after the injury was first noted revealed moderate swelling yet no pain on palpation. In addition, the tail had a normal range of motion and there was normal tail anal tone. <br />
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<tr><td class="tr-caption" style="text-align: center;">Figure 1</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Figure 2</td></tr>
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A radiographic exam was performed and a mildly displaced fracture of the first coccygeal bone was identified. In Figure 3, the vertebrae in the center of the image has what appears to be a cap on the spinous process which represents the mildly displaced fracture. In Figure 4, the coccygeal vertebrae in question is magnified and the fractured bone is highlighted with the red arrows. The yellow arrow in Figure 4 identifies the fracture line through the spinous process of the first coccygeal vertebrae.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixo3eUBfOO_9hwyVdskpQyGMbu_pjSHWNyNiS1UHJ9pFbHQn6gOROiCwLhITelWK9xkQJv_AKuMl2hZsN5do9QYnXku_giX0z3Sq3yjBWmHLVOzsvUNisZ4h9CNsN0k9jYkBViaDhjugkx/s1600/fractured+cc10001.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEixo3eUBfOO_9hwyVdskpQyGMbu_pjSHWNyNiS1UHJ9pFbHQn6gOROiCwLhITelWK9xkQJv_AKuMl2hZsN5do9QYnXku_giX0z3Sq3yjBWmHLVOzsvUNisZ4h9CNsN0k9jYkBViaDhjugkx/s1600/fractured+cc10001.jpg" height="238" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 3</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Figure 4</td></tr>
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The fracture will heal with time and there should not be any negative, long term effects from this injury. However, there remains a concern of the development of a sequestrum (de-vitalized bone) at the fracture site. A sequestrum would develop if the fracture resulted in loss of blood supply to the fractured fragment. This would result in the likely development of a draining fistula as the body attempts to reject the sequestrum. The gelding will be given several weeks of rest and relaxation before returning to light riding. A follow-up radiographic exam will be performed in 2-4 months.<br />
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<br />Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-7627020944460129862014-09-26T17:05:00.000-04:002014-10-24T14:54:59.790-04:00Fungal Plaque in a HorseA 7 year-old gelding presented to PHD veterinary services for the complaint of mild epistaxis (bloody nasal discharge). Endoscopic exam of the nasal passages identified a golden colored mass (Figure 1) that was covered in blood and was located within the opening to the ethmoid turbinates. The mass was diagnosed as an ethmoid hematoma based on location, appearance, and behavior. The client was given the option of surgical removal or treatment with intra-lesional doses of formalin. Based on the relatively small size of the ethmoid hematoma it was decided to attempt treating 1-2x with formalin and if there was not complete resolution then surgical resection would be pursued. <br />
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<tr><td class="tr-caption" style="text-align: center;">Figure 1</td></tr>
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Four weeks after the first injection of formalin, a follow-up endoscopy noted significant reduction in the size of the ethmoid hematoma (Figure 2) and what appeared to be a second mass deeper within the ethmoid turbinates. The second ethmoid hematoma was not visualized during the initial exam because the first ethmoid hematoma was blocking the view! Based on these findings, the second ethmoid hematoma was injected with formalin in a similar fashion as the original ethmoid hematoma.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjqrRZe3eG6Bk-a8nR45CJqZxQU4bpHg4si8SFwh1hTKeFXATQCDVJr6EXAOGKJhf7bRQJmUg8zexAECTzM4NLe3Uzzd1c3Gx71e99OVXQjaek9BO3pY08FdHZDTyN7DDPgwTONxipynwZV/s1600/DSC00003.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjqrRZe3eG6Bk-a8nR45CJqZxQU4bpHg4si8SFwh1hTKeFXATQCDVJr6EXAOGKJhf7bRQJmUg8zexAECTzM4NLe3Uzzd1c3Gx71e99OVXQjaek9BO3pY08FdHZDTyN7DDPgwTONxipynwZV/s1600/DSC00003.JPG" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 2</td></tr>
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Six weeks after the second formalin injection the client reported that there was a slight yet persistent bloody discharge from the affected nares. Endoscopic exam revealed what appears to be a fungal plaque (black/white/yellow) adhered to the site of the ethmoid hematoma (Figure 3 and 4). This is an unusual finding and may prove to be a challenging complication. Fungal plaques have a predilection for vascular tissue and can infect the upper airway of horses. Fungal infection within the guttural pouch of a horse is well documented and can result in a catastrophic hemorrhage if not diagnosed and treated early. Fungal infection within the ethmoid turbinates is not common in my experience. Often these fungal plaques do NOT respond to systemic anti-fungal medication and must be either removed or treated aggressively with topical medication. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgmYRZhZyUG8lQXWi5aU2ncjEv9Nw1GaVNPy3De3qLOnl_0GotWneSdvz6p2zeraC8zElbQNFwbXuSSdtyKJJRqC0AwoarZNx-fY8PgWoxaE8j_b2fCwFWEz-33ygPmTCebfV0w8gYAaQuB/s1600/DSC00008.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgmYRZhZyUG8lQXWi5aU2ncjEv9Nw1GaVNPy3De3qLOnl_0GotWneSdvz6p2zeraC8zElbQNFwbXuSSdtyKJJRqC0AwoarZNx-fY8PgWoxaE8j_b2fCwFWEz-33ygPmTCebfV0w8gYAaQuB/s1600/DSC00008.JPG" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 3</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiEZl6IuHE26w1uI0UXBAeidhcy6Cr2rKAmgWh6q2GtuCciFVqC3Jvrge691kMRw8d6ZVCPEkETNm7_dQHNZREAbOWSkvabp2TkJ-aH5Aq-aOsbi66ecdR618fVJq-eDYu0Qx5WPLc-EvQF/s1600/DSC00001.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiEZl6IuHE26w1uI0UXBAeidhcy6Cr2rKAmgWh6q2GtuCciFVqC3Jvrge691kMRw8d6ZVCPEkETNm7_dQHNZREAbOWSkvabp2TkJ-aH5Aq-aOsbi66ecdR618fVJq-eDYu0Qx5WPLc-EvQF/s1600/DSC00001.JPG" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 4</td></tr>
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The current clinical plan for this horse is medication with oral anti-fungal medication for several weeks. If there is no change, the fungal plaques will be treated with topical anti-fungal medication. Stay tuned....<br />
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Finally after 4 weeks of anti-fungal medication, there is no evidence of a fungal plaque and there is NO evidence of an ethmoid hematoma (Figure 5). The ethmoid turbinates are visible for the first time in this horse since the initial exam. Although there is no evidence of an existing ethmoid hematoma, these tumors commonly reoccur hence the gelding will be monitored closely for the next 12 months. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiwfPesiVLSinlWQQNK8mhpBHlUtoezs_vmxoC8vxNoWdNHSwQTJscFi_sITfTBKGkJpwbzq7C2pLBiPsPRtGSvEt2QozgTTncFnLvJXP2-ZfXz1q75bMp79Fir9K7l_3X0teri7DKIE1M9/s1600/DSC00005.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiwfPesiVLSinlWQQNK8mhpBHlUtoezs_vmxoC8vxNoWdNHSwQTJscFi_sITfTBKGkJpwbzq7C2pLBiPsPRtGSvEt2QozgTTncFnLvJXP2-ZfXz1q75bMp79Fir9K7l_3X0teri7DKIE1M9/s1600/DSC00005.JPG" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 5</td></tr>
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Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-4941684674746156942014-09-19T16:34:00.002-04:002014-09-19T16:34:46.767-04:00Coffin bone rotation and Sinking in a donkey.Sadly, I share the story of my very own donkey named "Lollipop". She is approximately 12 years old and every summer gets a bit foot sore when the green grass is lush. Through benign neglect and some luck, she has recovered every year with just a few days of phenylbutazone treatment! This year has been different. She has been lame in left front foot for over 2 months. Initially, she was lame in both front feet and I kept her feet supported with impression material and bandages. After 30 days of foot bandages, I switched to Soft Ride boots with removable orthotics designed for acutely foundered horses. The donkey remained lame in the left front foot hence I broke down and radiographed both front feet. On the day that the radiographs were taken, I noted that the entire coronary band was soft and painful in the left front foot!!<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiBdgT0FUOd0a1g6pQ_xEkElhGxvCuQWO3vV-9VCX_8A2ubggEACd3HfS6UZv9rF96fWbeT1wCti587nNRDatFAhUYjkjnRM_So8oxFcb9LROthJ59rvKkQ40QslXRSqjb5Q0iG2sZRdC2g/s1600/loli+foot+rads0001.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiBdgT0FUOd0a1g6pQ_xEkElhGxvCuQWO3vV-9VCX_8A2ubggEACd3HfS6UZv9rF96fWbeT1wCti587nNRDatFAhUYjkjnRM_So8oxFcb9LROthJ59rvKkQ40QslXRSqjb5Q0iG2sZRdC2g/s1600/loli+foot+rads0001.jpg" height="249" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 1</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiC-NlxFP4ukyVs-Vbt3HrX3FAOiu5NDZ3BkdZ02D_fsCzPyXJBqtCDL5F0NZPKZEzmPAniRc6xK41xTic-hf-h4HQ_0CVnAuQIXatNDG0XmmfmkQXJU95ttmvp-bEtEq9BsYn4h6oiUFok/s1600/loli+foot+rads0002.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiC-NlxFP4ukyVs-Vbt3HrX3FAOiu5NDZ3BkdZ02D_fsCzPyXJBqtCDL5F0NZPKZEzmPAniRc6xK41xTic-hf-h4HQ_0CVnAuQIXatNDG0XmmfmkQXJU95ttmvp-bEtEq9BsYn4h6oiUFok/s1600/loli+foot+rads0002.jpg" height="241" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 2</td></tr>
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.Figure 1 is a radiographs of the left front foot and Figure 2 is of the right front foot. There is evidence of chronic laminitis in both front feet with coffin bone rotation and pedal bone lysis. However, the most concerning observation was the radiographic evidence of coffin bone "sinking", predominantly in the left front foot. This occurs when the lamina becomes detached all the way around the foot and can result in the entire hoof sloughing off the foot!! In Figure 3 and 4, the red line corresponds to the coronary band and the blue arrow is the distance from the coronary band to the coffin joint. In Figure 3 (left front foot), the blue arrow is longer than the blue arrow in Figure 4. This would suggest that the entire bony column has "sunk" into the hoof capsule. This would also explain why the coronary band was soft and painful. In essence, Lollipop is trying to lose her hoof! If this was to happen she would likely require humane euthanasia!!<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhmNVsJmpKBBzG-1UmQA7afKWbBUdMewrvaBVzXovAS14HqLxrKBoKWzgzO_bxKxhsmH7qYMMpKN_qVf4eNGTQ3yhAsFgI90GGy74tlaFxpFwsH_ssHBUSIKeVS_Ps8eTTqtMU5asu2JtEm/s1600/loli+pic+1.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhmNVsJmpKBBzG-1UmQA7afKWbBUdMewrvaBVzXovAS14HqLxrKBoKWzgzO_bxKxhsmH7qYMMpKN_qVf4eNGTQ3yhAsFgI90GGy74tlaFxpFwsH_ssHBUSIKeVS_Ps8eTTqtMU5asu2JtEm/s1600/loli+pic+1.jpg" height="251" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 3</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhPg-UZ60gd-UQc514zb7nVJFrwnB3KfjfFa2PtpnwCJpqy6Bosl3wZ6JmgW6RhgWuPKO0fM5CJuLvOeAt2e_Ek6UCbIO4nC4lp_sXX6cu1YtnyzWgLmfcrLasDToCj0C5vopiA7foVS_Q_/s1600/loli+pic+3.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhPg-UZ60gd-UQc514zb7nVJFrwnB3KfjfFa2PtpnwCJpqy6Bosl3wZ6JmgW6RhgWuPKO0fM5CJuLvOeAt2e_Ek6UCbIO4nC4lp_sXX6cu1YtnyzWgLmfcrLasDToCj0C5vopiA7foVS_Q_/s1600/loli+pic+3.jpg" height="253" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 4</td></tr>
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Due to the severity of her condition, she is now locked up in a stall and I have placed her left front foot in a cast. The cast will hopefully stabilize the foot/hoof and allow time for healing of the lamina. She is comfortable on 1/2 gram of phenylbutazone 2x per day and other than being annoyed about the stall confinement, she appears stable. Stay tuned and keep her in your thoughts and prayers!!<br />
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Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-5948946095793434022014-08-30T08:40:00.005-04:002014-08-30T08:40:55.869-04:00Fractured Scapula in a HorseA 5 year-old miniature horse presented to PHD Veterinary services for the complaint of forelimb lameness. The mini had been charged and mounted by a full grown horse 4 weeks prior and subsequently the mini was a grade 4 out 5 lame in the right forelimb at the walk. The referring veterinarian examined the mini on the day of the injury and radiographed the shoulder joint. There were no radiographic abnormalities noted. Although the lameness was slowly resolving, the owner and referring veterinarian elected for an ultrasound of the shoulder region. On presentation, the mini was a grade 3/5 lame in the right forelimb at the walk. There was a firm swelling over the center of the right scapula and the mini was painful to direct pressure. There was no muscle atrophy noted and the ambulation of the limb was normal. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh8apj883jucUGvzeXbhdntNFPWrIOo1x2uEcSSFModAlkJqigdl49Mx-9WS3zXXDFFWcIRMA_fxHHojFc6WbL1pD4Dc0I6lS5WsU8VTJ3IXi8K2f6JM3kIvGesrKhO1cfi-ntAENAU9F6q/s1600/scapula+1.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh8apj883jucUGvzeXbhdntNFPWrIOo1x2uEcSSFModAlkJqigdl49Mx-9WS3zXXDFFWcIRMA_fxHHojFc6WbL1pD4Dc0I6lS5WsU8VTJ3IXi8K2f6JM3kIvGesrKhO1cfi-ntAENAU9F6q/s1600/scapula+1.jpg" height="258" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 1</td></tr>
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In Figure 1, the spine of the scapula is imaged. The white structures correspond to bone. The yellow arrows point to multiple bone fragments. These ultrasound findings suggest that the spine of the scapula was crushed when the full grown horse mounted the mini. The image in Figure 2 corresponds to an equine scapula and the yellow arrows highlight the spine of the scapula as it extends nearly the length of the scapula. In addition to the bone fragments of the spine of the scapula, the longitudinal scan of the scapula in Figure 3 suggests a fracture of the body of the scapula. There is a "step" or interruption of the bony margin which is indicated by the red arrow in Figure 3. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjAcLq-xoyfC3ZML9rMABgV9pKQboa1IFrDfkWq-E6w57dKXg3mXRsVfB1hV1fABjYlod0F6Dg03nmwcZe4PJCZaI6NP4GrDDd-PjUXxdC0nSHJYd5cdfLnh9rU3MjyTULYlRHKG8ne-jQ8/s1600/scapula+4.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjAcLq-xoyfC3ZML9rMABgV9pKQboa1IFrDfkWq-E6w57dKXg3mXRsVfB1hV1fABjYlod0F6Dg03nmwcZe4PJCZaI6NP4GrDDd-PjUXxdC0nSHJYd5cdfLnh9rU3MjyTULYlRHKG8ne-jQ8/s1600/scapula+4.jpg" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 2</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjuT4MhFliW6BOg4FYH_EL2eJcViwXuQ45uAysAwhQWloSBF9TQDUoOshTsNJEhBWhgFzfYufavAhPDp8TqgwhW5k14sINpp2acYk6EZi4FELvsnw6T2m72Cn9zVOhG3JQP1kczc5SEkYfa/s1600/scapula+2.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjuT4MhFliW6BOg4FYH_EL2eJcViwXuQ45uAysAwhQWloSBF9TQDUoOshTsNJEhBWhgFzfYufavAhPDp8TqgwhW5k14sINpp2acYk6EZi4FELvsnw6T2m72Cn9zVOhG3JQP1kczc5SEkYfa/s1600/scapula+2.jpg" height="172" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 3</td></tr>
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In Figure 4, the abnormal scapula (left image) is compared to the normal scapula (right image). Clearly, there are multiple bone fragments present at the site of the fractured scapula. The prognosis for this mini is good given time to heal. The mini is developing a firm, bony callous over the fracture site to stabilize the scapula and it's soundness has improved since the injury. It remains possible that the mini may develop a sequestrum (dead bone) due to the multiple bone fragments which would result in a draining wound. In addition, the fracture of the body of the scapula will need significant time to stabilize before the mini can return to full soundness. This type of injury would likely be more serious in a full size horse due to the weight of the horse. In addition, the radial and suprascapular nerves are often involved in these types of injuries resulting in muscle atrophy and difficulty in proper ambulation of the limb. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi4S0ypEk75Rt9aKqe41V2LJ04pf_GJ7Wvslzky-1vzvgiwpWAfla0ILvGaPdHKn_GARAkUKctPJGe4T3l4FcbVhGGLNItCfrmNelFIdfQtXz4w0xBzP2u6crbhEG8MaMaDSCCsmX4BNOG9/s1600/scapula+3.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi4S0ypEk75Rt9aKqe41V2LJ04pf_GJ7Wvslzky-1vzvgiwpWAfla0ILvGaPdHKn_GARAkUKctPJGe4T3l4FcbVhGGLNItCfrmNelFIdfQtXz4w0xBzP2u6crbhEG8MaMaDSCCsmX4BNOG9/s1600/scapula+3.jpg" height="193" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 4</td></tr>
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Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-38526003632570444972014-08-16T10:40:00.000-04:002014-08-16T10:40:18.465-04:00Drug Testing and Prepurchase Exams for HorsesA 10 year old, warm-blood mare presented to PHD veterinary services for a prepurchase exam. The standard exam, complete with limb flexion was performed and the mare was found to be completely sound and negative to limb flexion. The buyer requested baseline radiographs of both hocks and both front feet. In addition, it was strongly recommended that a drug screen of the mare's blood be performed for the detection of sedatives, anti-inflammatory medications and corticosteroids. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhdEg0pRwXgCE786nvEZNk0hqLDa44bpLVwnStVoAagjgrMv09YlYymc_5NCZpnPRte0l6msxODy_XAMh3V4EzOqmdlGFsD4VyscA-aFhITG4DlTSZ_cF38fPGrMX7kFkv2KE9QnokSZBzs/s1600/hock+djd2.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhdEg0pRwXgCE786nvEZNk0hqLDa44bpLVwnStVoAagjgrMv09YlYymc_5NCZpnPRte0l6msxODy_XAMh3V4EzOqmdlGFsD4VyscA-aFhITG4DlTSZ_cF38fPGrMX7kFkv2KE9QnokSZBzs/s1600/hock+djd2.jpg" height="320" width="276" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 1</td></tr>
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Although the mare was sound and did not resent limb flexion, there was radiographic evidence of advanced osteoarthritis of the lower hock joints. In Figures 1,2, and 4, the yellow arrows are pointing to radiographic changes consistent with arthritis along the front or dorsal aspect of the lower hock joints. There is new bone growth (osteophytes) and joint space narrowing. In addition, in Figure 3, the blue arrows are pointing to the area of sclerosis surrounding the lower hock joints which suggests chronicity of the arthritis and the apparent "fusion" of the distal hock joints. These radiographic changes are advanced and are surprising considering that the mare was sound for the prepurchase exam. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjgU3YWH5oNQ7o5xC48RBD3yYs9geVMJF3dgE_VnA9WmAPov-2pe-VZrIMEJ-pZMeiASjDIEWcXcKa3nLdj7tLM-Mpnu2aYL5oRyS_VYsMT9jKcfUYrIC1y-aFUIg3ACvPPAkBB0sc67tFn/s1600/hock+djd3.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjgU3YWH5oNQ7o5xC48RBD3yYs9geVMJF3dgE_VnA9WmAPov-2pe-VZrIMEJ-pZMeiASjDIEWcXcKa3nLdj7tLM-Mpnu2aYL5oRyS_VYsMT9jKcfUYrIC1y-aFUIg3ACvPPAkBB0sc67tFn/s1600/hock+djd3.jpg" height="171" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 2</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsgK7cMtNdjR25_HESEYfVu0AhrVE9KkOOZYqLPI1xyMB5wkPLOuXViuKI70uhUToA_3ybTimMiuo4zjxw5LpUGM4nh_VMSDhTNiMYFTAYOZ19vga0SrMTg-aGItruHI771lz7rBCmonde/s1600/hock+djd4.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgsgK7cMtNdjR25_HESEYfVu0AhrVE9KkOOZYqLPI1xyMB5wkPLOuXViuKI70uhUToA_3ybTimMiuo4zjxw5LpUGM4nh_VMSDhTNiMYFTAYOZ19vga0SrMTg-aGItruHI771lz7rBCmonde/s1600/hock+djd4.jpg" height="320" width="291" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 3</td></tr>
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Even though the mare was sound, I did NOT pass this horse for sale and intended use based on radiographic findings and advised the buyer to at least wait for the drug screen results prior to making their decision! The standard drug screen takes approximately 5-7 days for results to be reported. Interestingly, the mare's blood tested positive for high doses of an anti-inflammatory medication which likely explains why this horse was sound and negative to limb flexion even though she has advanced arthritis in the lower hock joints. This case represents yet another example of the importance of drug testing and base line radiographs for prepurchase exams!! Admittedly, it is a financial slippery slope once you begin the radiographic exam regarding how many areas to evaluate, however; areas of high probablity such as the hocks and front feet should always be considered!<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjA2uFfR3RHHaQDn6N5dbo3UZ3Md9YE25OYm65GazigphnxzfQCRRPc01vvAlHTh7NEhmB4HtONuGoHVEF7ioLaUjthVkiAiCugxH8d1N-kuDhXTt2zKh3JUP5cZHsHKkc1qsJBm5ecGMV7/s1600/hock+djd+1.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjA2uFfR3RHHaQDn6N5dbo3UZ3Md9YE25OYm65GazigphnxzfQCRRPc01vvAlHTh7NEhmB4HtONuGoHVEF7ioLaUjthVkiAiCugxH8d1N-kuDhXTt2zKh3JUP5cZHsHKkc1qsJBm5ecGMV7/s1600/hock+djd+1.jpg" height="320" width="289" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 4</td></tr>
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<br />Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-44845341030067113442014-08-09T09:42:00.002-04:002014-08-09T09:42:24.338-04:00Allergic Airway Disease in horses.In the past 30 days (July 8 - August 8) I have examined 10 horses for the complaint of coughing and poor performance. The horses have ranged in age from 8 to 19 years of age. There has been no commonality with regards to sex or breed. However, they all live in Florida and it is the hottest month of the year! Through a series of diagnostics which include a re-breathing exam, upper airway endoscopy, and trans-tracheal wash, all 10 horses have been diagnosed with allergic airway disease (AKA: heaves or COPD). None of these horses had previously been diagnosed with this condition. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhCu09IhP3R2PX5O5vRCW-u6q-uoFu94dhPqpTY-Yf5RblvM8YdYPWqt4gagNL09Oer3nSK0cSZJE-VlV53LaVtwEW1urGZYgKV_KZLhu_2Ww8_9ySeioNnJHGzbfpphK1-sbNP0gWlxEo4/s1600/DSC00001.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhCu09IhP3R2PX5O5vRCW-u6q-uoFu94dhPqpTY-Yf5RblvM8YdYPWqt4gagNL09Oer3nSK0cSZJE-VlV53LaVtwEW1urGZYgKV_KZLhu_2Ww8_9ySeioNnJHGzbfpphK1-sbNP0gWlxEo4/s1600/DSC00001.JPG" height="300" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Upper trachea with large amounts of sputum present.</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgN4GURgMmRsd0Lnw7cBDZ-9Wh1K8ph7qsgwu9tMDPxYRJWgCqRA6Bb9Wc6bVDd7-2ABN8OkajdRsk9RMJYMrCjD19z3MiAvJ6vFgTPu1ZW_k79Ci4wz_Sed3JRZtwbwAsXnFk6Oa58XOlB/s1600/DSC00003.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgN4GURgMmRsd0Lnw7cBDZ-9Wh1K8ph7qsgwu9tMDPxYRJWgCqRA6Bb9Wc6bVDd7-2ABN8OkajdRsk9RMJYMrCjD19z3MiAvJ6vFgTPu1ZW_k79Ci4wz_Sed3JRZtwbwAsXnFk6Oa58XOlB/s1600/DSC00003.JPG" height="300" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Lower trachea with thickened mucosa due to chronic inflammation</td></tr>
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Allergic airway disease in horses typically results in coughing, increased respiratory effort, increased "abdominal" breathing, exercise intolerance and weight loss. If not managed properly, the condition worsens from year to year and can result in the death of the horse!! I have posted a blog previously discussing this disease and how it should be diagnosed and treated. Please click on the link below to read my blog from last year regarding this condition.<br />
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<a href="http://michaelporterdvm.blogspot.com/2013/10/respiratory-disease-in-horse.html" target="_blank">Allergic Airway Disease in a Horse</a><br />
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<br />Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-84363163179935405902014-07-25T11:08:00.000-04:002014-07-25T11:08:28.195-04:00Collapsing Trachea in a Miniature HorseA three year-old miniature stallion presented to PHD Veterinary Services for the complaint of open mouth breathing and a "honking" sound during respiration. At presentation, the stallion was agitated and was continuously pawing at his muzzle with his mouth open. The stallion was mildly sedated for the endoscopic exam and interestingly, his breathing became more normal. The most proximal trachea (Figure 1) appeared normal in diameter however the lumen quickly became narrowed (Figure 2). The trachea was nearly completely collapsed for approximately 6 cm at the level of the thoracic inlet. Distal to this area, the trachea appeared normal (Figure 3).<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgSrCQ1HiV_jpfP4Tdzh0RpAbu3tziZFbI8Ry7TjEsAifkXJtMfDB9Ctf9wQTdr5huHtxh83RyNmLfrSGm9uUNB_gpqs0bb98SvNKmjyJPTvQJomXnHAnSfitEX5drt8wv-QVW-B-Yrj8uS/s1600/DSC00016.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgSrCQ1HiV_jpfP4Tdzh0RpAbu3tziZFbI8Ry7TjEsAifkXJtMfDB9Ctf9wQTdr5huHtxh83RyNmLfrSGm9uUNB_gpqs0bb98SvNKmjyJPTvQJomXnHAnSfitEX5drt8wv-QVW-B-Yrj8uS/s1600/DSC00016.JPG" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 1</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhpNfZkpXOIhXV7WnC4cMtEELEEQi0BiJuQv8JoBdPGCTMJwYltECZQvAvh5r-RdMFH3E3kpHNjSATW59GA_AYN9jVVA2Rc_JNUY6ax82fSmDUlYLp8lKp0qEHsIJqIdE-skttFz8NZoc6B/s1600/DSC00005.JPG" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhpNfZkpXOIhXV7WnC4cMtEELEEQi0BiJuQv8JoBdPGCTMJwYltECZQvAvh5r-RdMFH3E3kpHNjSATW59GA_AYN9jVVA2Rc_JNUY6ax82fSmDUlYLp8lKp0qEHsIJqIdE-skttFz8NZoc6B/s1600/DSC00005.JPG" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 2</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhRLX_-CKVSP0QfMz3mMVGcR36K5-Uz-_y_XVfsxpzFGBJdUxIyrtfoSA23jce2bAzNWJgecRcEuSMpUyRk92IOLHVeJPlKI5Q1H1X-q3L6CycMI00ElMIEqLz7-z-ukY3AldWfYY685lPw/s1600/DSC00013.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhRLX_-CKVSP0QfMz3mMVGcR36K5-Uz-_y_XVfsxpzFGBJdUxIyrtfoSA23jce2bAzNWJgecRcEuSMpUyRk92IOLHVeJPlKI5Q1H1X-q3L6CycMI00ElMIEqLz7-z-ukY3AldWfYY685lPw/s1600/DSC00013.JPG" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 3</td></tr>
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Normally, the lumen of the trachea is continuous, extending from the larynx to the primary bifurcation of the trachea (Figure 4). Unfortunately, the miniature horse breed is predisposed to the condition known as collapsing trachea. The condition is often diagnosed shortly after birth or can develop later in life if the horse is allowed to gain excessive weight. A common clinical complaint is that of a "honking" sound during heavy respiration. The severity of the collapsing trachea depends on the location and the extent of the narrowed lumen. The closer the area of collapse is to the chest cavity, the worse the prognosis. There are reported cases of collapsing tracheas in miniature horses that were repaired via intra- and extra-luminal stents. Unfortunately, they are short term fixes and often do not provide a long term solution. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi-jYEYHqMeK2g0pX6Bo3YkdLNsobsLBT8uqeUlCIrkdK6vv0vZuERDlYScqYW8bTsOiAPPShXd58mI6TA5smxJUwB4vfyiiI2FJNi84P9MalSD-jb2G2Ma9agKFvN4zCHMM2ef2SHFBWsw/s1600/DSC00009.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi-jYEYHqMeK2g0pX6Bo3YkdLNsobsLBT8uqeUlCIrkdK6vv0vZuERDlYScqYW8bTsOiAPPShXd58mI6TA5smxJUwB4vfyiiI2FJNi84P9MalSD-jb2G2Ma9agKFvN4zCHMM2ef2SHFBWsw/s1600/DSC00009.JPG" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 4</td></tr>
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Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-6273851789909240512014-07-11T12:05:00.000-04:002014-07-11T12:05:00.384-04:00Keratoma in a horse!!<br />
A 10 year-old gelding presented to PHD veterinary services for a history of recurrent abscesses in the left front foot. Over a period of 6 months, the gelding developed 3 distinct abscesses which ruptured at the coronary band. At presentation the gelding was mildly lame and there was no active drainage from the most recent abscess rupture. A radiographic exam was performed to determine if there was a radiographic explanation for the development of multiple foot abscesses in the same foot. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqqOqb2F_TnfwUDQZZQGKoJ3Nn6zw6DnyZEF6K8BsML6si4wS0g92QTRuq56UgZHfdoztyR4tOb_ucQr1d7mCXhy0rFLRD2H-9mBL15xNpTMHIs0fkX5OVy_9SdAgaGBsf-bSMvmN-36Fl/s1600/keratoma+pic+2.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqqOqb2F_TnfwUDQZZQGKoJ3Nn6zw6DnyZEF6K8BsML6si4wS0g92QTRuq56UgZHfdoztyR4tOb_ucQr1d7mCXhy0rFLRD2H-9mBL15xNpTMHIs0fkX5OVy_9SdAgaGBsf-bSMvmN-36Fl/s1600/keratoma+pic+2.jpg" height="237" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 1</td></tr>
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The most notable finding in the radiographic exam was evidence of coffin
bone rotation (Figure 1 and 2). In Figure 2, the red dotted lines
should be parallel. The red line on the left corresponds to the dorsal
hoof wall and the red line on the right corresponds to the dorsal aspect
of the coffin bone. The reason they are not parallel is because the red line on the right has rotated in a down ward direction approximately 10-12 degrees. Evidence of coffin bone rotation suggests a history
of laminitis or founder and this might explain the recurring foot
abscesses. In addition, the yellow lines in Figure 1 highlight the hoof
wall defect which developed secondary to the recurrent foot abscesses.
There are thin areas that appear radiolucent (black lines) which extend from the
dorsal hoof wall defect (yellow lines) down towards the bottom of the
foot. These radiolucent lines may correspond to remnants of draining tracts
from the recent abscesses. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgPNDvGV0tnQsOBUWVLbMUabI3xfFYyQwFuz7W9evalb3fT87CjwUvnQGfxHQZ3IVaL-AFCo6Sb0PdLoFtVBk4N6d3kyAEdqRd_RTX5ScvRrVVj1BEDIrPLVZFdLiXwzYSGW7hd_8f4ax4G/s1600/keratoma+pic+3.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgPNDvGV0tnQsOBUWVLbMUabI3xfFYyQwFuz7W9evalb3fT87CjwUvnQGfxHQZ3IVaL-AFCo6Sb0PdLoFtVBk4N6d3kyAEdqRd_RTX5ScvRrVVj1BEDIrPLVZFdLiXwzYSGW7hd_8f4ax4G/s1600/keratoma+pic+3.jpg" height="237" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 2</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwtgqjF-so_GLd4ct0S-WRvM7Ew6X5tipo2Ol2qtw07AZvAfS2rhvIKfKbJV-jdEBLMoyK5bPfs6ALzTOJ-u_beu1wQ9PABV_gBirT-oORuTcWg_8wDwMwPkjT7-KIGpNfbVYhGHiJ8tHu/s1600/keratoma+pic+1.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjwtgqjF-so_GLd4ct0S-WRvM7Ew6X5tipo2Ol2qtw07AZvAfS2rhvIKfKbJV-jdEBLMoyK5bPfs6ALzTOJ-u_beu1wQ9PABV_gBirT-oORuTcWg_8wDwMwPkjT7-KIGpNfbVYhGHiJ8tHu/s1600/keratoma+pic+1.jpg" height="158" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 3</td></tr>
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In Figure 3, the radiographic beam is aimed downward through the hoof and coffin bone. The image on the left is the left foot and the image on the right is the right foot. The yellow dotted circles correspond to the tip of the coffin bone that appears to be more radiolucent (less bone) in the left foot compared to the right foot. This would suggest some sort of pathological process affecting the tip of the coffin bone in the left foot. The possibilities for these radiographic changes include laminitis, chronic abscess with bone infection (osteomyelitis), and keratoma. An MRI study of the foot was strongly recommended to determine the cause and provide key information for likely surgical exploration. <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhIXHct81dzP71VqWcTbdzSWkwzSWSTjihsulr37JaF_7ebqOAohdOm9fjdUqejx8zJcHI7W4fs9LrUreYcZY7m23Mhm8tE-vFPeO26HQsKHj90FqtCSBtdI9RJJAbUFelH7Tf6sRtCdIJN/s1600/keratoma+pic+4.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhIXHct81dzP71VqWcTbdzSWkwzSWSTjihsulr37JaF_7ebqOAohdOm9fjdUqejx8zJcHI7W4fs9LrUreYcZY7m23Mhm8tE-vFPeO26HQsKHj90FqtCSBtdI9RJJAbUFelH7Tf6sRtCdIJN/s1600/keratoma+pic+4.jpg" height="192" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 4</td></tr>
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The gelding was referred to the University of Florida for MRI of the front feet. A large area of concern was highlighted in the MRI that was either a chronic abscess or a keratoma. Subsequently, a partial hoof wall resection was performed by Dr. Andrew Smith and his surgical team at University of Florida's college of veterinary medicine (Figure 4). Once the hoof wall was removed, a large keratoma (yellow dotted lines) was identified and removed. A keratoma consists of a benign tumor of keratin or horn-producing cells. The keratoma will grow between the coffin bone and the hoof wall causing distortion of the hoof wall, recurrent foot abscesses, and laminitis. Surgical resection is the only option but should be preceded by an MRI to identify the keratoma and its dimensions. Prognosis is good for a full recovery assuming the entire keratoma is removed at the time of surgery. <br />
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Special thanks to the Dr. Andrew Smith and the University of Florida's radiology department!<br />
<br />Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-15729250808538643792014-06-20T09:40:00.002-04:002014-06-20T09:40:23.239-04:00Summer Sore Time is here!!Although I have already written a blog concerning summer sores in horses (go to: http://michaelporterdvm.blogspot.com/2013/06/habronemiasis-summer-sore-in-horse.html) , the condition is a recurring one and it deserves another visit!! Below are several images from different horses that suffer from recurring habronemiasis or equine summer sores. The horse in Figure 1 suffers from recurring habronemiasis in all 4 limbs, whereas the horse in Figure 2 recently developed summer sores along his sheath!! These summers sores are medium in size and treatable with topical and systemic medication. However the horse in Figure 3 is suffering from a horrible summer sore of his lower limb that has not been treated but allowed to grow unabated and permanently disfigure the limb. It is frustrating to the horse owner that these lesions tend to return every year with the return of flies however if treated early and aggressively, management of this condition is quite do-able!! <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjQnINX_czv0TOPZ_jdG79kd_ZrEjurXGrT3iteU-9ibJ2DUKSw9upGM9-1bdMdREqdh-vC6vCA5__OyAJDsz1sSxBOFxptTZLPc0cJChd21aAJEuMxqqJNs7Bk1Pv19eAA0k70tQBNQkA/s1600/2013-11-06+14.31.29.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjjQnINX_czv0TOPZ_jdG79kd_ZrEjurXGrT3iteU-9ibJ2DUKSw9upGM9-1bdMdREqdh-vC6vCA5__OyAJDsz1sSxBOFxptTZLPc0cJChd21aAJEuMxqqJNs7Bk1Pv19eAA0k70tQBNQkA/s1600/2013-11-06+14.31.29.jpg" height="320" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 1</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjuQEg0IFDuav0iBOG1mtNrwsUqHnfzdFurX8xR26RPkpfyiqsB3G1SmEkLvoq2Z67DTCydXVZUeDQ0v3Nj5nPGRX5Rj9s5iOI-oyA1h90HNVdS65HzOO5Xf5bbPVWh3a0mHn98BFQ_cRpY/s1600/2013-11-06+14.31.41.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjuQEg0IFDuav0iBOG1mtNrwsUqHnfzdFurX8xR26RPkpfyiqsB3G1SmEkLvoq2Z67DTCydXVZUeDQ0v3Nj5nPGRX5Rj9s5iOI-oyA1h90HNVdS65HzOO5Xf5bbPVWh3a0mHn98BFQ_cRpY/s1600/2013-11-06+14.31.41.jpg" height="320" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 2</td></tr>
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For horses with recurring or first time habronemiasis, I recommend the following:<br />
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1: Systemic treatment with a dewormer containing Ivermectin. Treat twice, approximately 3-4 weeks appart.<br />
2: Topical treatment with Dr. Porter's summer sore cream!!<br />
3: If the summer sore is excessively large or in a location that is difficult to treat with topical medication, I recommend systemic therapy with corticosteroids. I prefer to medicate with a tapering dose of oral prednisolone over 30 days. <br />
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It is critical that the barn management incorporate a fly control program of their choosing. In addition, horses which suffer from recurring summer sores need to be treated the moment there is any redness or mild irritation present in the old summer sore sites!! If treated early, the lesion will typically respond favorably to topical medication without the need for systemic corticosteroids! <br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhGuF-H6L2W1BzMAFAuPsYD1mznE6on9dF9SgemaBBK-rqvSb_MN43LGZOyjkecpze9bl7tjH2_RjJY-jFOtGDWfb14D0SYpu1ud4QNnP442gxIsrsntP3UqrD-JbpEyZCETaD11oL52oFd/s1600/2014-04-03+10.16.23.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhGuF-H6L2W1BzMAFAuPsYD1mznE6on9dF9SgemaBBK-rqvSb_MN43LGZOyjkecpze9bl7tjH2_RjJY-jFOtGDWfb14D0SYpu1ud4QNnP442gxIsrsntP3UqrD-JbpEyZCETaD11oL52oFd/s1600/2014-04-03+10.16.23.jpg" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 3</td></tr>
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<br />Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-84108444226269661192014-06-13T08:40:00.001-04:002014-06-13T08:40:22.534-04:00Fractured Spinous Processes in a HorseA 10 year-old gelding arrived to a horse show and was seriously injured during the unloading from the trailer. The rear gate was lowered and the horse remained standing in the trailer with the "butt bar" in place (Figure 1). For some unknown reason, the horse panicked and attempted to unload with the butt bar in place. The horse became trapped below the butt bar and struggled for several minutes before the owner was able to release the bar. Within moments of the event, the horse's withers became swollen and very sensitive to the touch. The gelding was treated with systemic anti-inflammatory agents and returned home in the trailer WITHOUT the butt bar!<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgv9MlhBUXoFT_KjEUfyQr_j03zFr7eoSJVn4ucmqfxBDSTnhFv40vBC2mYbw20L1ST8i64TxPAllyJTLBHFGcXA5Lj2DGWfTh2U6NfzDUMzvQgs2yPEcIZwWZgEaSKWw-0R4WXPyF89Mgs/s1600/2014-06-12+21.51.12.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgv9MlhBUXoFT_KjEUfyQr_j03zFr7eoSJVn4ucmqfxBDSTnhFv40vBC2mYbw20L1ST8i64TxPAllyJTLBHFGcXA5Lj2DGWfTh2U6NfzDUMzvQgs2yPEcIZwWZgEaSKWw-0R4WXPyF89Mgs/s1600/2014-06-12+21.51.12.jpg" height="240" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 1</td></tr>
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Two weeks after the injury, the gelding presented to PHD veterinary services for a radiographic evaluation of the withers. In Figure 2, the green line outlines the withers of the horse. The bone-like fingers projecting upward below the green line are the spinous processes which make up the withers. On physical exam there was minimal swelling over the withers however the horse was very sensitive to any pressure and there appeared to be a "dip" in the very bottom of the withers (yellow arrows).<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhM0HpTHHeSSBhn6tGugerezp_jH6tOtQpuzlzc63gMDBTwCch8rpBW1j_BFFi2EmGslxXB0Okgsu6diMQZvSdTHJrOQ5l53CAcgbKBNudpD22hefLfixjKaWviP4y08Dz6mOIkxPl2Vip2/s1600/spinous+process+5.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhM0HpTHHeSSBhn6tGugerezp_jH6tOtQpuzlzc63gMDBTwCch8rpBW1j_BFFi2EmGslxXB0Okgsu6diMQZvSdTHJrOQ5l53CAcgbKBNudpD22hefLfixjKaWviP4y08Dz6mOIkxPl2Vip2/s1600/spinous+process+5.jpg" height="203" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 2</td></tr>
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Radiographic evaluation of the "dip" in the withers confirmed multiple fractures of 3 spinous processes (yellow arrows in Figure 3). The first spinous process that is fractured appears to be in several fragments and displaced from its normal position. The second spinous process appears fractured but not displaced and the third process appears to have an avulsion of the most proximal aspect of the spinous process. Although it is likely that these fractures will heal in time and be some what stable, the current concern is the development of a frustrating condition known as fistulated withers. This occurs when a piece of fractured bone becomes devitalized of blood supply and subsequently "dies" becoming a sequestrum. The body's natural response is to rid itself of the sequestrum and will develop a draining wound that originates from the sequestrum. These wounds do NOT resolve until the sequestrum has been removed and this can be extremely challenging from a surgical stand point. Currently there is not evidence of a sequestrum however it will take several weeks/months to determine if one will develop. Prognosis for return to riding will depend the development of fistulated withers and how comfortable the horse is once the fractures have stabilized.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgMEV1zI5sUgYS8ub4YOBFYgC5Rfo3crdXK8ktGhfXkqd52c-fsOMyW3kI25P13Ijz-7RstnsRGZ9xWaD6_QKOFUw2f6wLNy8IvjLg5_v93ys5T7cp8t-M7hwqP1ahrNY2VzoSrhcmJl1oG/s1600/spinous+process+2.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgMEV1zI5sUgYS8ub4YOBFYgC5Rfo3crdXK8ktGhfXkqd52c-fsOMyW3kI25P13Ijz-7RstnsRGZ9xWaD6_QKOFUw2f6wLNy8IvjLg5_v93ys5T7cp8t-M7hwqP1ahrNY2VzoSrhcmJl1oG/s1600/spinous+process+2.jpg" height="302" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Figure 3</td></tr>
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<br />Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0tag:blogger.com,1999:blog-350522789217241885.post-20110371869600726262014-06-06T10:13:00.000-04:002014-06-06T10:13:34.582-04:00Rehabilitation of horses through controlled swimming!!The images below were taken at The Sanctuary Sports Therapy and Rehabilitation Center in Ocala Florida. The horse that is entering the water and swimming across the equine swimming pool is in the process of being rehabilitated for a ligament injury. This horse has already under gone 8 weeks of strict stall confinement and several doses of extra-corporeal shockwave treatment for his injury. Horses that have spent extensive time in stall confinement are at risk of re-injury or a new injury once they are returned to work. This is because the are out of condition yet willing to run, buck, jump, and generally misbehave!! Unfortunately, most horses lack a good sense of self preservation!! <br />
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Depending on the type of injury, low-impact exercise is advantageous for rehabilitating horses after a lengthy confinement. Unfortunately, due to their significant weight and relatively small cross-sectional area of their hooves, horses tend to stress their musculoskeletal structure even at the walk. In addition, many can be fractious and unsafe to handle and/or ride after an extensive period of confinement. As such, swimming provides an excellent form of exercise that is very low-impact and safe. Fortunately, most horses enjoy swimming and are quick learners!!<br />
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My recommendation for horses returning from a lengthy period of stall confinement includes 30 days of swimming for 20 minutes, 4-6 days per week. In addition, the horse will be hand-walked for 10-20 minutes per day. The remainder of time the horse remains in stall confinement. In my opinion, this is far superior to simply turning the horse out in a small paddock for 30 days.<br />
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<br />Michael Porter DVMhttp://www.blogger.com/profile/12412742032789747934noreply@blogger.com0