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Topic:Computed Tomography

Computed Tomography (CT) in horses is an advanced imaging technique used to obtain detailed cross-sectional images of equine anatomy. This non-invasive method utilizes X-ray technology combined with computer processing to create detailed images of bones, soft tissues, and other internal structures. CT is particularly useful for diagnosing complex conditions in the head, neck, and limbs of horses, offering enhanced visualization compared to traditional radiography. The technique is valuable for identifying fractures, dental issues, sinus diseases, and other abnormalities. This page compiles peer-reviewed research studies and scholarly articles that explore the applications, advancements, and clinical implications of computed tomography in equine medicine.
Computed tomography of the equine caudal spine and pelvis: Technique, image quality and anatomical variation in 56 clinical cases (2018-2023).
Equine veterinary journal    October 10, 2024   Volume 57, Issue 5 1265-1278 doi: 10.1111/evj.14422
Ogden NKE, Winderickx K, Bennell A, Stack JD.Cross-sectional imaging improves the diagnostic accuracy of complex anatomical regions. Computed tomography (CT) of the pelvis and caudal spine in a large group of live horses and ponies has not been previously reported. Objective: To describe the procedure for acquiring CT images of horses' caudal spine/pelvis under general anaesthesia (GA) and to detail the image quality, artefacts and anatomical variations in this region. Methods: Retrospective case series. Methods: Horses with CT of the caudal spine/pelvis were included. Horses under 6 months and CT examination performed post-mortem were...
Ultrasonographic assessment of equine metacarpal cartilage thickness is more accurate than computed tomographic arthrography. Hoey S, Fogarty U, McAllister H, Puggioni A, Cloak B, Richard H, Skelly C, Laverty S.Articular cartilage can be directly imaged using ultrasonography. The fetlock is a common site of osteochondrosis, with the sagittal ridge of the third metacarpal bone most commonly affected. In osteochondrosis, cartilage thickening may be an initial finding. This postmortem study investigated the ability of ultrasonography to accurately measure the dorsodistal articular cartilage of the third metacarpal bone in young horses, compared to computed tomographic arthrography (CTA) and histological measurements. A total of 33 metacarpophalangeal joints from 18 horses between the ages of 12 days and...
A multi-task learning model for clinically interpretable sesamoiditis grading.
Computers in biology and medicine    September 25, 2024   Volume 182 109179 doi: 10.1016/j.compbiomed.2024.109179
Guo L, Tahir AM, Hore M, Collins A, Rideout A, Wang ZJ.Sesamoiditis is a common equine disease with varying severity, leading to increased injury risks and performance degradation in horses. Accurate grading of sesamoiditis is crucial for effective treatment. Although deep learning-based approaches for grading sesamoiditis show promise, they remain underexplored and often lack clinical interpretability. To address this issue, we propose a novel, clinically interpretable multi-task learning model that integrates clinical knowledge with machine learning. The proposed model employs a dual-branch decoder to simultaneously perform sesamoiditis grading ...
Radiation exposure during simulated equine head and limb fan beam standing computed tomography appears safe for personnel using lead shielding.
Journal of the American Veterinary Medical Association    September 20, 2024   Volume 263, Issue 1 63-70 doi: 10.2460/javma.24.06.0424
Veitch KE, Szczykutowicz TP, Brounts SH, Ergun DL, Muir P, Loeber SJ.To evaluate the radiation dose to personnel locations during simulated head and limb scans with a novel equine standing CT (sCT) system. Methods: Measurements were made with the use of a helical fan beam sCT system (Equina; Asto CT Inc). Scatter radiation was measured in different positions in the sCT room to mimic the location of the control operator, horse handler, and lead rope handler during simulated equine head and limb imaging. Operator/handler dose was quantified at each location using entrance air kerma measured with a spherical ionization chamber and electrometer. Results: Radiation ...
Intra-arterial contrast enhanced computed tomography of the deep digital flexor tendon and palmar veins in the distal forelimb in Jeju horses: Evaluating contrast-enhancing factors.
Equine veterinary journal    September 19, 2024   doi: 10.1111/evj.14408
Lee S, Shin KY, Lee K, Seo JP.Few studies have investigated the adequate contrast enhancement (CE) evaluation depending on concentration, volume, and rate of administration of contrast media (CM) and the scan parameters in equine contrast enhanced computed tomography (CECT). Objective: To investigate CE of the deep digital flexor tendon (DDFT) and veins depending on the computed tomography (CT) voltage and concentration, volume, and rate of CM administration during intra-arterial CECT of equine distal forelimbs. Methods: In vivo experiments. Methods: Six horses underwent 54 CT scans. First, the CE of DDFT and veins was eva...
A hybrid repair strategy for full-thickness cartilage defects: Long-term experimental study in eight horses. Fugazzola MC, De Ruijter M, Veraa S, Plomp S, van Buul W, Hermsen G, van Weeren R.The objective of this study was to evaluate a non-resorbable implant for the focal repair of chondral defects in eight adult horses with 12-month follow-up. The bi-layered construct composed of a polycarbonate-urethane-urea biomaterial which was printed in 3D fashion onto a bone anchor was implanted into surgically created osteochondral defects into the femoropatellar joints of eight horses. The analysis of post-mortem outcomes were compared to defects treated with microfracture in the same animal on the contralateral femoropatellar jointfemoropatellar joint. The overall macroscopic scoring af...
Advancements in Subchondral Bone Biomechanics: Insights from Computed Tomography and Micro-Computed Tomography Imaging in Equine Models.
Current osteoporosis reports    September 14, 2024   doi: 10.1007/s11914-024-00886-y
Malekipour F, Whitton RC, Lee PV.This review synthesizes recent advancements in understanding subchondral bone (SCB) biomechanics using computed tomography (CT) and micro-computed tomography (micro-CT) imaging in large animal models, particularly horses. Results: Recent studies highlight the complexity of SCB biomechanics, revealing variability in density, microstructure, and biomechanical properties across the depth of SCB from the joint surface, as well as at different joint locations. Early SCB abnormalities have been identified as predictive markers for both osteoarthritis (OA) and stress fractures. The development of sta...
Use of a new aiming compression device and technique for the repair of navicular bone fractures in horses: A cadaveric study.
Veterinary surgery : VS    August 16, 2024   Volume 54, Issue 1 98-106 doi: 10.1111/vsu.14152
Pudert T, Fries GF, Lotz H, Röcken M, Cruz AM.To assess the use of a newly developed aiming compression device (ACD) for screw insertion in non-fractured navicular bones (NB) in cadavers. Methods: Cadaveric study. Methods: A total of 10 cadaveric front limbs of adult horses. Methods: Placement of a 3.5 mm cortical screw in non-fractured NB under radiographic guidance was performed in 10 cadaver limbs in a standing position. An ACD was used to stabilize the NB and to guide the drilling process. Preparation and surgical time as well as the number of radiographic images were noted. A postoperative scoring system was used to assess screw pl...
Comparison of radiography and computed tomography for identification of third metacarpal structural change and associated assessment of condylar stress fracture risk in Thoroughbred racehorses.
Equine veterinary journal    August 14, 2024   doi: 10.1111/evj.14131
Irandoust S, O'Neil LM, Stevenson CM, Franseen FM, Ramzan PHL, Powell SE, Brounts SH, Loeber SJ, Ergun DL, Whitton RC, Henak CR, Muir P.Catastrophic injury has a low incidence but leads to the death of many Thoroughbred racehorses. Objective: To determine sensitivity, specificity, and reliability for third metacarpal condylar stress fracture risk assessment from digital radiographs (DR) and standing computed tomography (sCT). Methods: Controlled ex vivo experiment. Methods: A blinded set of metacarpophalangeal joint DR and sCT images were prepared from 31 Thoroughbreds. Four observers evaluated the condyles and parasagittal grooves (PSG) of the third metacarpal bone for the extent of dense bone and lucency/fissure and assigned...
Quantitative microCT imaging of a whole equine placenta and its blood vessel network.
Placenta    July 31, 2024   Volume 154 216-219 doi: 10.1016/j.placenta.2024.07.313
Laundon D, Proudley E, Basford PJ, Katsamenis OL, Chatelet DS, Cleal JK, Gostling NJ, Chavatte-Palmer P, Lewis RM.Placental structure is linked to function across morphological scales. In the placenta, changes to gross anatomy, such as surface area, volume, or blood vessel arrangement, are associated with suboptimal physiological outcomes. However, quantifying each of these metrics requires different laborious semi-quantitative methods. Here, we demonstrate how, with minimal sample preparation, whole-organ computed microtomography (microCT) can be used to calculate gross morphometry of the equine placenta and a range of additional metrics, including branching morphometry of placental vasculature, non-dest...
Management of paracondylar process fracture in three horses.
Equine veterinary journal    July 18, 2024   Volume 56, Issue 6 1193-1200 doi: 10.1111/evj.14202
Beldeanu S, Tay MCA, Daniel C, Dosi MCM, Hahn CN, James O, Townsend NB, Liuti T, Schwarz T, Parkinson NJ.Fractures of the paracondylar process of the occipital bone may cause headshaking, neck pain and neurologic deficits. The condition is being recognised more frequently with increasing availability of computed tomography. However, to date only limited information is available as to presentation, treatment, surgical approach and outcome. Objective: To describe the clinical signs, imaging findings, treatment, surgical approach and outcome in three horses diagnosed with paracondylar process fracture. Methods: Retrospective case series. Methods: Clinical records and diagnostic images of affected ca...
An anatomical study of the subarachnoid space surrounding the trigeminal ganglion in horses-in preparation for a controlled glycerol rhizotomy in equids.
Frontiers in veterinary science    July 18, 2024   Volume 11 1424890 doi: 10.3389/fvets.2024.1424890
Becker R, Haenssgen K, Precht C, Khoma OZ, Hlushchuk R, Koch C, Kaessmeyer S, de Preux M.Equine trigeminal-mediated headshaking is a painful neuropathic disorder comparable to trigeminal neuralgia in humans. The selective destruction of pain fibers within the trigeminal ganglion, called rhizotomy, is the surgical treatment of choice for idiopathic trigeminal neuralgia refractory to medical treatment in humans. The human trigeminal ganglion is enclosed by a dural recess called the Meckel's or trigeminal cave, in which the ganglion is surrounded by a cerebrospinal fluid (CSF)-filled subarachnoid space. During glycerol rhizotomy, glycerol is percutaneously injected in this CSF-filled...
Cone beam computed tomography and cross-sectional anatomy of the region of the fetlock in the horse (Equus caballus).
Anatomia, histologia, embryologia    July 5, 2024   Volume 53, Issue 4 e13079 doi: 10.1111/ahe.13079
Bierau J, Rott P, Röcken M, Staszyk C.This study aimed to delineate the detailed anatomy of the metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints in healthy horses using cone beam computed tomography (CBCT). The fetlock region of 15 cadaveric forelimbs and 14 cadaveric hindlimbs from nine adult horses without orthopaedic disease underwent CBCT scanning. Additionally, arthrography CBCT scans were conducted following intra-articular injection of a radiopaque contrast medium containing blue epoxy resin dye. Subsequently, limbs were frozen and sectioned to visualize anatomical structures in sectional planes corresponding ...
Computed tomographic angiography of a presumed acquired transhepatic portosystemic shunt in a miniature horse filly. Iranmanesh M, Sato AF, Tenney W, Brinker EJ, Cortez K, Mazan M.A 1-year-old Miniature Horse filly was presented for chronic lethargy and hyporexia. Elevated liver enzymes, bile acids, and ammonia were noted on bloodwork. The primary differential diagnosis was a portosystemic shunt (PSS). Three-phase computed tomographic angiography findings were consistent with a transhepatic portosystemic shunt. Percutaneous liver biopsy confirmed severe diffuse hepatic changes, most likely due to chronic pyrrolizidine alkaloid toxicosis, and medical management was elected. Based on an extensive literature review, this is the first report of a transhepatic portosystemic ...
Clinically relevant doses of tiludronate do not affect bone remodelling in pasture-exercised horses.
Equine veterinary journal    June 25, 2024   Volume 57, Issue 2 513-521 doi: 10.1111/evj.14119
Tippen SP, Metzger CE, Sacks SA, Allen MR, Mitchell CF, McNulty MA.Bisphosphonates are widely used in equine athletes to reduce lameness associated with skeletal disorders. Widespread off-label use has led to concern regarding potential negative effects on bone healing, but little evidence exists to support or refute this. Objective: To investigate the influence of clinically relevant doses of tiludronate on bone remodelling and bone healing. Methods: Randomised, controlled in vivo experiments. Methods: Each horse had a single tuber coxae biopsied (Day 0), then were divided into a treatment (IV tiludronate) or control (IV saline) group. Treatments were admini...
A Paleopathological Find on a La Tène Horse Skeleton Discovered in Rescue Archaeological Diggings in the Area of the Olympic Pool, Alba Iulia (CX 143 Pit).
Animals : an open access journal from MDPI    June 13, 2024   Volume 14, Issue 12 1775 doi: 10.3390/ani14121775
Gudea A, Stan FG, Irimie A, Mârza S, Martonos CO, Gal A.The reconstruction of past life based on archaeozoology is a challenging domain that offers a range of valuable details concerning former human and animal populations. Additionally, the ancient era is a source of information for human and veterinary medicine, as well as for other biological sciences. This report highlights a pathological lesion identified during the investigation of a horse skeleton from a pit dated La Tène in Alba County (Romania). The left scapula with lesions was collected from the skeleton of a buried 7-8-year-old male horse. The aforementioned bone underwent gross, radio...
Mechanical Properties and Failure Mode of Proximal Screw Fixation Technique Using Locking Compression Plate for Proximal Interphalangeal Arthrodesis in Horses: An Ex Vivo Study.
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    June 4, 2024   doi: 10.1055/s-0044-1787680
de Souza AF, Pereira CAM, Costa C, Fürst A, Kümmerle JM, De Zoppa ALV. The aim of this study was to measure the mechanical properties and failure mode of an model of proximal interphalangeal arthrodesis in horses with different methods of proximal screw fixation using a locking compression plate. Methods:  Pastern joint arthrodesis with a 3-hole 4.5-mm narrow locking compression plate was performed on 20 forelimbs of equine cadavers, randomized into four groups based on the fixation method and type of proximal screw used: unicortical cortex, bicortical cortex, unicortical locking, bicortical locking. Single-cycle axial compression testing was conducted unti...
Three-Dimensional Segmentation of Equine Paranasal Sinuses in Multidetector Computed Tomography Datasets: Preliminary Morphometric Assessment Assisted with Clustering Analysis.
Sensors (Basel, Switzerland)    May 30, 2024   Volume 24, Issue 11 3538 doi: 10.3390/s24113538
Borowska M, Lipowicz P, Daunoravičienė K, Turek B, Jasiński T, Pauk J, Domino M.The paranasal sinuses, a bilaterally symmetrical system of eight air-filled cavities, represent one of the most complex parts of the equine body. This study aimed to extract morphometric measures from computed tomography (CT) images of the equine head and to implement a clustering analysis for the computer-aided identification of age-related variations. Heads of 18 cadaver horses, aged 2-25 years, were CT-imaged and segmented to extract their volume, surface area, and relative density from the frontal sinus (FS), dorsal conchal sinus (DCS), ventral conchal sinus (VCS), rostral maxillary sinus ...
[Navicular bone fractures in horses: Prognosis after conservative and surgical treatment].
Schweizer Archiv fur Tierheilkunde    May 29, 2024   Volume 166, Issue 6 309-320 doi: 10.17236/sat00425
Stucki G, Fürst AE, Jackson MA.The aim of this retrospective study is to describe and compare conservative and surgical treatment of navicular fractures in horses. An attempt is made to identify critical points that can favorably influence the prognosis of this orthopedic disease. All horses treated for a navicular fracture at the Equine Clinic, Vetsuisse Faculty, University of Zurich between 2005 and 2017 were included in this study. The severity of lameness at initial examination, radiographic assessment, hoof conformation, treatment (conservative or surgical), complications and outcome were determined from the medical re...
Case report: Equine metacarpophalangeal joint partial and full thickness defects treated with allogenic equine synovial membrane mesenchymal stem/stromal cell combined with umbilical cord mesenchymal stem/stromal cell conditioned medium.
Frontiers in veterinary science    May 22, 2024   Volume 11 1403174 doi: 10.3389/fvets.2024.1403174
Reis IL, Lopes B, Sousa P, Sousa AC, Rêma A, Caseiro AR, Briote I, Rocha AM, Pereira JP, Mendonça CM, Santos JM, Lamas L, Atayde LM, Alvites RD....Here, we describe a case of a 5-year-old show-jumping stallion presented with severe lameness, swelling, and pain on palpation of the left metacarpophalangeal joint (MCj). Diagnostic imaging revealed full and partial-thickness articular defects over the lateral condyle of the third metacarpus (MC3) and the dorsolateral aspect of the first phalanx (P1). After the lesion's arthroscopic curettage, the patient was subjected to an innovative regenerative treatment consisting of two intra-articular injections of equine synovial membrane mesenchymal stem/stromal cells (eSM-MSCs) combined with umbilic...
Surgical treatment of headshaking by removal of a paracondylar process fragment via modified hyovertebrotomy approach: A detailed anatomical and surgical description in an adult horse.
Veterinary surgery : VS    May 13, 2024   Volume 53, Issue 5 942-949 doi: 10.1111/vsu.14102
Spiesshofer P, Hawkins AE, Berner D, Previdelli RL, Fiske-Jackson AR.To describe, in detail, the relevant anatomy and surgical approach to access the paracondylar process (PCP) and report its application in a clinical case of headshaking. Methods: A seven-year-old, mixed breed mare. Methods: Experimental study/case report. Methods: A seven-year-old mixed breed mare was presented for investigation of acute onset progressing violent headshaking, resulting in the horse falling on multiple occasions. The horse was highly reactive to palpation over the right PCP. Standing computed tomographic (CT) investigation and ultrasonographic examination of the head detected a...
Magnetic Resonance Imaging, Computed Tomographic and Radiographic Findings in the Metacarpophalangeal Joints of 31 Warmblood Showjumpers in Full Work and Competing Regularly.
Animals : an open access journal from MDPI    May 9, 2024   Volume 14, Issue 10 1417 doi: 10.3390/ani14101417
Nagy A, Dyson S.There is a limited description of magnetic resonance imaging (MRI) and no information on computed tomographic (CT) findings in the fetlock of non-lame, non-racing sports horses. This study aimed to document comparative CT, MRI and radiographic findings in the metacarpophalangeal joints of showjumpers in full work. Clinical and gait assessments, low-field MRI, fan-beam CT and radiographic examinations of both metacarpophalangeal joints were performed on 31 showjumpers. Images were analysed descriptively. In most limbs (53/62, 85.5%), there were CT and MRI changes consistent with densification i...
Micro-computed tomography reveals high-density mineralised protrusions and microstructural lesions in equine stifle joint articular cartilage.
Equine veterinary journal    May 8, 2024   Volume 57, Issue 1 203-216 doi: 10.1111/evj.14100
Ducrocq M, Kamus L, Richard H, Beauchamp G, Janvier V, Laverty S.Stifle osteoarthritis (OA) lesions are most common in the medial femorotibial (MFT) compartment. Their characterisation and mapping will inform equine veterinarians towards an accurate diagnosis of OA. Objective: Investigate and map micro-CT (μCT) changes in the hyaline articular cartilage (HAC) in the medial femoral condyle (MFC) and medial tibial plateau (MTP). Methods: Ex vivo cadaveric. Methods: Stifles (n = 7 OA and 17 control [CO]) were retrieved from a tissue bank. The MFC and MFT were imaged with μCT. Regions of interest (ROIs) were cranial (MFCcr; MTPcr) and caudal (MFCca; MTPca...
Preliminary study of proton magnetic resonance spectroscopy to assess bone marrow adiposity in the third metacarpus or metatarsus in Thoroughbred racehorses.
Equine veterinary journal    May 3, 2024   doi: 10.1111/evj.14086
Hewitt-Dedman CL, Kershaw LE, Schwarz T, Del-Pozo J, Duncan J, Daniel CR, Cillán-García E, Pressanto MC, Taylor SE.Magnetic resonance spectroscopy (MRS) has been used to investigate metabolic changes within human bone. It may be possible to use MRS to investigate bone metabolism and fracture risk in the distal third metacarpal/tarsal bone (MC/MTIII) in racehorses. Objective: To determine the feasibility of using MRS as a quantitative imaging technique in equine bone by using the H spectra for the MC/MTIII to calculate fat content (FC). Methods: Observational cross-sectional study. Methods: Limbs from Thoroughbred racehorses were collected from horses that died or were subjected to euthanasia on racecourses...
Refractory pneumonia caused by Prevotella heparinolytica: a case report.
Journal of medical case reports    April 30, 2024   Volume 18, Issue 1 213 doi: 10.1186/s13256-024-04538-8
Sun J, Xu X, Gao S, Pan Q, Liu Z, Huang Y, Lian Y.Prevotella heparinolytica is a Gram-negative bacterium that is commonly found in the oral, intestinal, and urinary tracts. It has been extensively studied in lower respiratory tract infections in horses, which has heparinolytic activity and can secrete heparinase and further induces virulence factors in cells and causes disease. However, no such cases have been reported in humans. Methods: A 58-year-old male patient from China presented to the respiratory clinic in Suzhou with a productive cough producing white sputum for 20 days and fever for 3 days. Prior to this visit, a chest computed to...
Micro-CT and histological examination of accessory canals in 34 equine cheek teeth.
Frontiers in veterinary science    April 10, 2024   Volume 11 1396871 doi: 10.3389/fvets.2024.1396871
Korsós SA, Staszyk C, Boone M, Josipovic I, Vogelsberg J, Vlaminck L.Accessory canals and apical deltas have been extensively studied in human dentistry. Their clinical role as a difficult to clean reservoir for bacteria during endodontic treatments has been well described. Many papers describe in detail the pulp anatomy of equine dentition but little attention has been given to their apical ramifications. The goal of this paper is to describe the presence and anatomy of these accessory canals and apical deltas in healthy equine cheek teeth and discuss their possible relevance in the light of equine endodontics. To accomplish this, 15 maxillary and 19 mandibula...
Characterization of Normal Bone in the Equine Distal Limb with Effective Atomic Number and Electron Density Determined with Single-Source Dual Energy and Detector-Based Spectral Computed Tomography.
Animals : an open access journal from MDPI    March 30, 2024   Volume 14, Issue 7 1064 doi: 10.3390/ani14071064
Steiner J, Richter H, Kaufmann R, Ohlerth S.Single-source dual energy (SSDECT) and detector-based spectral computed tomography (DBSCT) are emerging technologies allowing the interrogation of materials that have different attenuation properties at different energies. Both technologies enable the calculation of effective atomic number (EAN), an index to determine tissue composition, and electron density (ED), which is assumed to be associated with cellularity in tissues. In the present prospective observational study, EAN and ED values were determined for 16 zones in normal subchondral and trabecular bone of 37 equine cadaver limbs. Using...
Review of the clinical diagnosis of sacroiliac dysfunction in horses – challenges and limitations.
Veterinary journal (London, England : 1997)    March 29, 2024   106106 doi: 10.1016/j.tvjl.2024.106106
Walter LJ, Stack JD, Winderickx K, Davies HMS, Simon O, Franklin SH.Sacroiliac dysfunction (SID) is a condition seen in horses associated with poor performance that affects hind limb gait and impulsion. The condition comprises pain and dysfunction but there lacks clarity around the aetiopathogenesis and whether SID encompasses abnormal joint pathology, abnormal joint movement, abnormal regional biomechanical function, joint laxity and pain, or various combinations of these that may vary over time. Clinical assessment remains challenging for equine clinicians due to the deep location of the sacroiliac joint (SIJ) and surrounding structures which limits access f...
Contrast arthrography of the equine temporomandibular joint.
Frontiers in veterinary science    March 18, 2024   Volume 11 1368131 doi: 10.3389/fvets.2024.1368131
Kim CS, Reisbig NA, Carmalt JL.Disorders of the equine temporomandibular joint (TMJ) cause clinical problems and detailed investigations of this joint are becoming more common. Specialist radiographic projections have the potential to highlight osseous abnormalities; however, the ability to assess the intra-articular soft tissue structures is currently limited to computed tomography (with, or without contrast enhancement) or magnetic resonance imaging. Both modalities are expensive and not readily accessible. Unassigned: To develop a technique of contrast arthrography of both compartments of the equine TMJ in cadavers and t...
A transmandibular lateral transsphenoidal navigated surgical approach to access a pituitary macroadenoma in a warmblood mare.
The veterinary quarterly    February 23, 2024   Volume 44, Issue 1 1-10 doi: 10.1080/01652176.2023.2300947
de Preux M, Precht C, Guevar J, Graubner C, Thenhaus-Schnabel S, Buser L, Lukes A, Koch C.A 16-year-old warmblood mare was referred with a progressive history of behavioral changes and left-sided blindness. Following neuroanatomical localization to the forebrain, magnetic resonance imaging of the head revealed a well-delineated, 4.5 cm in diameter, round pituitary mass causing marked compression of the midbrain and optic chiasm. Euthanasia was recommended but declined by the owners. Veterinary specialists and a human neurosurgeon collaboratively prepared for surgical case management. A novel navigated transmandibular lateral transsphenoidal approach was developed to access the re...