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Topic:Lymphoma

Lymphoma in horses is a type of cancer that originates in the lymphoid tissues, which are part of the immune system. It involves the uncontrolled proliferation of lymphocytes, a type of white blood cell. Lymphoma can affect various organs and systems in horses, including the lymph nodes, spleen, liver, gastrointestinal tract, and skin. Clinical signs may vary depending on the location and extent of the disease, and may include weight loss, lethargy, swelling of lymph nodes, and abnormal blood work. Diagnosis often involves a combination of clinical examination, imaging, and biopsy. This page compiles peer-reviewed research studies and scholarly articles that explore the pathogenesis, diagnosis, treatment options, and prognosis of lymphoma in equine patients.
Multicentric lymphoma in a donkey with intestinal and bone marrow involvement.
BMC veterinary research    February 15, 2024   Volume 20, Issue 1 57 doi: 10.1186/s12917-024-03903-5
Paraschou G, Xue C, Egan R, Bolfa P.Lymphoma is a common neoplasm in horses but is reported much less commonly in donkeys. In this case report, we describe the macroscopic, microscopic and immunohistochemical features of a multicentric lymphoma with intestinal and bone marrow involvement. Methods: A geriatric female donkey with history of chronic lameness was found dead. Post-mortem examination revealed advanced emaciation, periodontal disease, left front foot laminitis and multiple, soft, white to yellow tan intestinal transmural masses, up to 12 cm in diameter. Cytology suggested a round cell intestinal neoplasm. The femur of...
Head and neck squamous cell carcinoma with heterotopic ossification, lymphovascular invasion, and nodal and pulmonary metastases in a 23-year-old Morgan gelding.
The Canadian veterinary journal = La revue veterinaire canadienne    July 3, 2023   Volume 64, Issue 7 627-632 
Townsend KS, Johnson PJ, Kuroki K.Primary squamous cell carcinoma of the head and neck occurs in the skin or squamous epithelial lining tissues of the oral cavity, pharynx, larynx, and sinonasal tract. Although it is a common tumor in horses, distant metastatic spread to the lung is rare. This report describes a case of metastatic pulmonary squamous cell carcinoma in a 23-year-old Morgan gelding. The clinical signs displayed by this gelding in some ways mimicked the typical presentation of equine multinodular pulmonary fibrosis or thoracic lymphoma. The postmortem diagnosis in this case was head and neck squamous cell carcinom...
An Unusual Cause of Femoral Nerve Paresis in a Horse: Disseminated B Cell Lymphoma With Plasmacytoid Differentiation and Direct Neuronal Invasion.
Journal of equine veterinary science    April 27, 2023   Volume 126 104502 doi: 10.1016/j.jevs.2023.104502
Barton CK, Hughes KL, Cowan C, Nout-Lomas YS, Nelson BB.A 21-year-old Quarter Horse mare presented with a chronic, progressively worsening left pelvic limb lameness of 3 weeks duration. The initial examination identified a consistent lameness at a walk. Neurological examination showed sensory and gait abnormalities consistent with left femoral nerve dysfunction. The horse minimally advanced the leg cranially and had a shortened stride length at the walk. During the stance phase, the heels of the left hind foot did not contact the ground and the horse quickly took weight off of the limb. Diagnostic imaging (ultrasound and nuclear scintigraphy) exami...
T-cell-rich, large B-cell lymphoma in the brain of a horse. Rissi DR, Avery AC, Burnett RC.T-cell-rich, large B-cell lymphoma (TCRLBCL) is the most commonly diagnosed type of lymphoma in horses. Here we describe the clinical signs, neuropathology, immunohistochemistry (IHC), and PCR for antigen receptor rearrangement (PARR) analysis results of a TCRLBCL in the brain of an 8-y-old male Quarter Horse that was euthanized after acute anorexia, tremors, head pressing, falling, blindness, incoordination, and seizures. Autopsy revealed a firm, smooth, pale-yellow mass that expanded both lateral ventricles and the adjacent subcortical white matter. Histologically, the mass consisted of a de...
Colonic T-cell-rich, large B-cell lymphoma associated with equid herpesvirus 5 infection and secondary trans-colonic fistula in a horse. Acevedo HD, Hassebroek AM, Leventhal HR, Duhamel GE, Carvallo FR.A 17-y-old Rocky Mountain gelding was presented to the Virginia-Maryland Veterinary Teaching Hospital because of a 4-wk history of anorexia, weight loss, lethargy, and fever of unknown origin. Abdominal ultrasound revealed lymphadenomegaly of the abdominal and colonic lymph nodes, thickening of the wall of the large colon, and a mass associated with the large colon. The horse was euthanized given a poor prognosis. On autopsy, an ~20-cm diameter mass was found within the mesocolon between the right ventral and right dorsal colon. The mass had invaded through the colonic walls and formed a fistu...
Association of globulin concentrations with prognosis in horses with lymphoma.
Frontiers in veterinary science    January 9, 2023   Volume 9 1086010 doi: 10.3389/fvets.2022.1086010
Wensley FM, Berryhill EH, Magdesian KG.Lymphoma is the most common hemopoietic neoplasia in horses. Common clinicopathologic abnormalities in equine lymphoma include hyperglobulinemia, hypoalbuminemia, hyperfibrinogenemia, anemia, thrombocytopenia and lymphocytosis. Hypoglobulinemia has been reported in other species with lymphoma, however it has not been well-described in horses. The objectives of this study were to examine the prevalence of hypoglobulinemia in equine lymphoma, and to identify prognosis and clinicopathological abnormalities associated with serum globulin concentrations. Unassigned: Ninety-six horses with lymphoma ...
Markers for internal neoplasia in the horse.
Veterinary medicine and science    December 10, 2022   Volume 9, Issue 1 132-143 doi: 10.1002/vms3.1042
Drozdzewska K, Gehlen H.The diagnosis of internal neoplasia in horses is challenging. Increased production of hormones physiologic for adult animals (e.g., adrenocorticotropin, norepinephrine, and erythropoietin) or typical for the foetal phase (alpha-fetoprotein, anti-Müllerian hormone, and parathyroid-hormone-related protein) might aid in tumour diagnostics. Thymidine kinase-1 and alkaline phosphatase are examples of intracellular enzymes, whose activity in the blood may increase in some neoplasia cases. Furthermore, inappropriate production of abnormal monoclonal or autologous antibodies can accompany lymphoma an...
Lymphomatosis as a Cause of Abdominal Pain and Distension in Two Adult Horses.
Journal of equine veterinary science    December 9, 2022   Volume 120 104193 doi: 10.1016/j.jevs.2022.104193
Perry LR, Butler AJ, John E, Martinson S, Buote M, Foote K, Burton S, Stoughton WB.Two equine patients presented separately with severe abdominal distention, colic, lethargy, and decreased appetite. An ante-mortem diagnosis of lymphoma was reached in each case based on peritoneal fluid cytology. Due to a poor prognosis, the horses were humanely euthanized. Post-mortem examination with histology and immunohistochemistry confirmed both cases as lymphoma: alimentary B-cell lymphoma of the distal jejunum and cecum in one case, and T-cell lymphoma of the cecum in the second case. Both cases exhibited extensive metastasis with peritoneal and pleural serosae covered in small nodule...
Cutaneous epitheliotropic T-cell lymphoma in a donkey – a case report.
BMC veterinary research    July 11, 2022   Volume 18, Issue 1 267 doi: 10.1186/s12917-022-03365-7
Kondratjeva J, Julien F, Coutelier C, Humeau L, Moog F, Combarros D, Fourquaux I, Pressanti C, Delverdier M, Moore PF, Cadiergues MC.Cutaneous epitheliotropic T-cell lymphoma is a malignant tumour of the skin already reported in humans, dogs, cats, horses, and other species, but not previously in donkeys. The standard diagnosis is based on clinical, morphological and immunophenotypic data. Differentiation of malignant versus benign proliferation of lymphocytes is crucial; in ambiguous cases T-cell receptor gamma (TRG) molecular clonality should be tested. In the present paper, we report a case of mycosis fungoides diagnosed in a donkey whose diagnosis was based on clinical, histological and immunohistochemical aspects and a...
Molecular characterization of equine thymidine kinase 1 and preliminary evaluation of its suitability as a serum biomarker for equine lymphoma.
BMC molecular and cell biology    December 14, 2021   Volume 22, Issue 1 59 doi: 10.1186/s12860-021-00399-x
Wang L, Unger L, Sharif H, Eriksson S, Gerber V, Rönnberg H.Thymidine kinase 1 (TK1) plays a key role in the synthesis of deoxythymidine triphosphate (dTTP) and is thus important for DNA replication and cell proliferation. The expression of TK1 is highest during S-phase, and it is rapidly degraded after mitosis. In cancer cells, TK1 is upregulated, resulting in leakage of excess TK1 into the blood. Consequently, serum TK1 has been used as a diagnostic and prognostic cancer biomarker, mainly in human medicine. The aims of this work were to characterize equine TK1 and to evaluate its suitability as a serum biomarker for equine lymphoma. Results: Equine T...
Clinical performance of a commercially available thymidine kinase 1 assay for diagnosis of lymphoma in 42 hospitalized horses (2017-2020).
Journal of veterinary internal medicine    August 6, 2021   Volume 35, Issue 5 2495-2499 doi: 10.1111/jvim.16239
Moore C, Stefanovski D, Luethy D.Antemortem definitive diagnosis of lymphoma in horses is often difficult. Thymidine kinase 1 (TK1) assay is a potentially useful biomarker for lymphoma in horses. Objective: To report the clinical performance of a commercially available TK1 assay for diagnosis of lymphoma in horses. We hypothesized that there would be no association between serum TK1 activity and a diagnosis of lymphoma in horses. Methods: Forty-two hospitalized horses, 14 with a definitive diagnosis of lymphoma, 4 with other neoplasia, and 24 with inflammatory disease. Methods: Retrospective medical record review, groups were...
Nonclassified Lymphoma as a Cause of Radial Nerve Paralysis in a Horse.
Journal of equine veterinary science    January 6, 2021   Volume 98 103371 doi: 10.1016/j.jevs.2021.103371
Barba M, Groover ES, Bailey J, Cole R, Christopherson P, Cattley R.A 4-year-old American Quarter Horse gelding was evaluated for acute non-weight-bearing lameness of the right thoracic limb with swelling in the right shoulder region. Physical examination revealed radial nerve paralysis of unknown etiology. The primary differential diagnosis was musculoskeletal trauma. Ultrasonography of the right shoulder region identified a heterogeneous mass that extended from the point of the shoulder to the thoracic inlet. Cytologic analysis of fluid collected by fine needle aspirate of the mass was consistent with large cell lymphoma. Based on the cytological findings, l...
Facial nerve paralysis in 64 equids: Clinical variables, diagnosis, and outcome.
Journal of veterinary internal medicine    April 6, 2020   Volume 34, Issue 3 1308-1320 doi: 10.1111/jvim.15767
Boorman S, Scherrer NM, Stefanovski D, Johnson AL.Facial nerve paralysis (FNP) in equids is not well described in the veterinary literature. Objective: To investigate the causes of FNP and associations among clinical variables, diagnosis, and outcome. Methods: Sixty-four equids presenting with FNP between July 2000 and April 2019. Cases of postanesthetic FNP were excluded. Methods: Medical records were retrospectively reviewed. Variables were evaluated for associations with outcomes (diagnosis and case outcome) using logistic regression. Results: The most common cause of FNP was trauma (n = 20). Additional diagnoses included central nervous s...
Equine Intestinal Lymphoma: Clinical-Pathological Features, Immunophenotype, and Survival.
Veterinary pathology    March 23, 2020   Volume 57, Issue 3 369-376 doi: 10.1177/0300985820906889
Bacci B, Stent AW, Walmsley EA.Lymphoma is the most common intestinal neoplasm in horses, but its clinical-pathological features are poorly characterized. Primary intestinal lymphoma was diagnosed in 20 horses on biopsy samples and further confirmed by postmortem examination in 16 cases. Lymphoma was found in the small intestine in 12 of 20 (60%), in the colon in 5 of 20 (25%), and in both small and large intestines in 3 of 20 (15%) cases. Gross findings included thickening of the intestinal wall (45%), mural nodules or masses (30%), and both thickening and nodules (10%). Cases were classified according to the human World H...
An atypical presentation of multi-systemic B-cell lymphoma in a horse.
The Canadian veterinary journal = La revue veterinaire canadienne    March 16, 2019   Volume 60, Issue 3 300-304 
Torrent A, Kilcoyne I, Johnson A, Affolter VK, Berryhill E, Aleman M.This report describes an unusual presentation of multicentric B-cell lymphoma with central and peripheral nerve involvement in a horse that was presented with acute onset, severe, multiple limb lameness, and muscle atrophy. This case highlights the importance of including neoplasia in the differential list in horses presenting for severe limb lameness associated with muscle atrophy, muscle fasciculations, and weakness. Présentation atypique d’un lymphome à cellules B multisystémique chez un cheval. Ce rapport décrit la présentation inhabituelle d’un lymphome à cellules B multicentriq...
Clinical and immunophenotypic findings in 4 forms of equine lymphoma.
The Canadian veterinary journal = La revue veterinaire canadienne    January 18, 2019   Volume 60, Issue 1 33-40 doi: 10.1111/eve.12850
Miglio A, Morelli C, Gialletti R, Lauteri E, Sforna M, Marenzoni ML, Antognoni MT.The clinical, histological, and immunophenotypic findings are presented for 4 horses affected by different types of lymphoma. Diagnoses of a monomorphic epitheliotropic intestinal T-cell lymphoma, a diffuse splenic large B-cell lymphoma, a peripheral T-cell lymphoma, and a T-cell rich large B-cell lymphoma of the third eyelid were made. Constatations cliniques et immunophénotypiques pour quatre formes de lymphomes équins. Les constatations cliniques, histologiques et immunophénotypiques sont présentées pour quatre chevaux affectés par différents types de lymphome. Des diagnostics d’un...
Retrospective evaluation of clinical outcome after chemotherapy for lymphoma in 15 equids (1991-2017).
Journal of veterinary internal medicine    January 12, 2019   Volume 33, Issue 2 953-960 doi: 10.1111/jvim.15411
Luethy D, Frimberger AE, Bedenice D, Byrne BS, Groover ES, Gardner RB, Lewis T, MacDonald VS, Proctor-Brown L, Tomlinson JE, Rassnick KM, Johnson AL.Prognosis associated with lymphoma in horses is poorly characterized, and treatment is often palliative. Long-term outcome after chemotherapy for horses with lymphoma is not well documented. Objective: To report long-term outcome of horses with lymphoma treated with chemotherapy. Methods: Fifteen equids. Methods: Retrospective case series. Medical record search and call for cases on the ACVIM listserv for horses treated with chemotherapy for lymphoma. Results: Fifteen cases with adequate data were identified. Complete remission was achieved in 5 horses (33.3%), partial response was achieved in...
Clinical features and outcome in horses with severe large intestinal thickening diagnosed with transabdominal ultrasonography: 25 cases (2003-2010).
Journal of the American Veterinary Medical Association    June 19, 2018   Volume 253, Issue 1 108-116 doi: 10.2460/javma.253.1.108
Biscoe EW, Whitcomb MB, Vaughan B, Dechant JE, Magdesian KG.OBJECTIVE To describe clinical features and outcome of horses with severe large intestinal thickening diagnosed with transabdominal ultrasonography. Methods: Retrospective case series. ANIMALS 25 horses. PROCEDURES Medical records of horses that underwent transabdominal ultrasonography between 2003 and 2010 were reviewed. Horses were included if the wall of the large intestine was ≥ 9 mm thick in any of 6 abdominal zones. RESULTS Median age was 13 years (range, 3 to 28 years). Horses were initially examined because of colic, diarrhea, inappetence, weight loss, lethargy, fever, or hematuria. ...
[A case of leptomeningeal melanomatosis with acute paraplegia and multiple cranial nerve palsies].
Rinsho shinkeigaku = Clinical neurology    November 28, 2017   Volume 57, Issue 12 769-774 doi: 10.5692/clinicalneurol.cn-001092
Hattori K, Matsuda N, Murakami T, Ito E, Ugawa Y.A 62-year-old man with acute paraplegia was transferred to our hospital. He had flaccid paraplegia and multiple cranial nerve palsies, such as mydriasis of the left pupil, abduction palsy of the left eye, hoarseness and dysphagia, but no meningeal irritation signs. MRI of the spinal canal showed swellings of the conus medullaris and the cauda equine, and also contrast enhancement of the spinal meninges. The cerebrospinal fluid (CSF) showed pleocytosis and protein increment. The lymph node was swollen in his right axilla. The biopsy specimen from the right axillary lymph node revealed metastasi...
Blindness associated with nasal/paranasal lymphoma in a stallion.
The Journal of veterinary medical science    February 5, 2017   Volume 79, Issue 3 579-583 doi: 10.1292/jvms.16-0537
Sano Y, Okamoto M, Ootsuka Y, Matsuda K, Yusa S, Taniyama H.A 29-year-old stallion presented with bilateral blindness following the chronic purulent nasal drainage. The mass occupied the right caudal nasal cavity and right paranasal sinuses including maxillary, palatine and sphenoidal sinuses, and the right-side turbinal and paranasal septal bones, and cribriform plate of ethmoid bone were destructively replaced by the mass growth. The right optic nerve was invaded and involved by the mass, and the left optic nerve and optic chiasm were compressed by the mass which was extended and invaded the skull base. Histologically, the optic nerves and optic chia...
Extreme lymphocytosis with myelomonocytic morphology in a horse with diffuse large B-cell lymphoma.
Veterinary clinical pathology    December 21, 2016   Volume 46, Issue 1 64-71 doi: 10.1111/vcp.12435
Meichner K, Kraszeski BH, Durrant JR, Grindem CB, Breuhaus BA, Moore PF, Neel JA, Linder KE, Borst LB, Fogle JE, Tarigo JL.An 11-year-old, 443-kg Haflinger mare was presented to the North Carolina State University Veterinary Teaching Hospital with a 2-week history of lethargy and a 3-day duration of anorexia, pyrexia, tachycardia, and ventral edema. Severe pitting edema, peripheral lymphadenopathy, and a caudal abdominal mass were noted on physical examination. An extreme leukocytosis (154.3 × 103 /μL) and microscopic hematologic findings suggestive of myelomonocytic leukemia were observed. Serum protein electrophoresis revealed a monoclonal gammopathy and urine protein electrophoresis revealed a monoclonal ligh...
Neoplasia in 125 donkeys (Equus asinus): literature review and a survey of five veterinary schools in the United States and Canada. Davis CR, Valentine BA, Gordon E, McDonough SP, Schaffer PA, Allen AL, Pesavento P.A diagnosis of neoplasia was noted in 125 of 357 donkeys (35%) in our review of medical records from 5 veterinary schools in the United States and Canada. Equine sarcoid was the most common tumor in our study, accounting for 72% of all tumors and 82% of cutaneous tumors. Soft-tissue sarcomas were the second most common skin tumors. All other types of neoplasia were rare. Important differences in the occurrence of neoplasia in donkeys compared to horses included the rarity or absence of squamous cell carcinoma in any organ system and gray horse melanoma. Lymphosarcoma, the most common malignant...
Peritoneal fluid immunocytochemistry used for the diagnosis of a possible case of equine gastrointestinal B-cell lymphoma.
The Canadian veterinary journal = La revue veterinaire canadienne    June 2, 2016   Volume 57, Issue 6 601-604 
Duran MC, Starrak G, Dickinson R, Montgomery J.After physical examination, ultrasonographic evaluation of thorax and abdomen, and peritoneal fluid analysis, gastrointestinal neoplasia with suspected diffuse peritoneal metastasis was diagnosed in a 17-year-old Arabian gelding. The owner elected euthanasia and declined postmortem examination. Immunocytochemistry analysis of the peritoneal fluid resulted in a diagnosis of B-cell lymphoma. Immunocytochimie du liquide péritonéal utilisée pour le diagnostic d’un cas possible de lymphome gastro-intestinal à cellules B. Après un examen physique, une évaluation échographique du thorax et d...
Hairy cell-like leukemia in a 9-year-old Friesian mare.
The veterinary quarterly    November 25, 2015   Volume 36, Issue 2 105-108 doi: 10.1080/01652176.2015.1110427
Achten-Weiler M, Veldhuis Kroeze EJ, Boerma S, van der Kolk JH.No abstract available
What’s New in Old Horses? Postmortem Diagnoses in Mature and Aged Equids.
Veterinary pathology    October 12, 2015   Volume 53, Issue 2 390-398 doi: 10.1177/0300985815608674
Miller MA, Moore GE, Bertin FR, Kritchevsky JE.Postmortem findings in 241 equids admitted to a teaching hospital that were at least 15 years old at autopsy were reviewed (1) to determine disease prevalence, (2) to compare the cause of death (or euthanasia) in equids 15 to 19 years of age (n = 116) with that in equids ≥20 years of age (n = 125), and (3) to catalog coexisting lesions in equids with pituitary pars intermedia dysfunction (PPID). Breed and sex were evenly distributed between the age groups. Death or euthanasia was attributed to disease of the digestive system (41.5%), pituitary gland (12.9%), locomotor system (10.0%), nervous...
ULTRASONOGRAPHIC FINDINGS IN 13 HORSES WITH LYMPHOMA. Janvier V, Evrard L, Cerri S, Gougnard A, Busoni V.Ultrasonography and radiography are commonly used for staging of lymphoma in horses, however there is little published information on imaging characteristics for horses with confirmed disease. The purpose of this retrospective, case series study was to describe ultrasonographic and radiographic findings for a group of horses with a confirmed diagnosis of lymphoma. A total of 13 horses were sampled. Lymphadenopathy (8/13), peritoneal effusion (6/13), splenic (6/13), and hepatic (5/13) lesions were the most frequently identified. The predominant splenic and hepatic ultrasonographic lesions were ...
Clinical Research Abstracts of the British Equine Veterinary Association Congress 2015.
Equine veterinary journal    September 17, 2015   Volume 47 Suppl 48 28 doi: 10.1111/evj.12486_63
Lotstra RJ, van den Broek J, Power T, Marr CM, Wijnberg ID.Atrial fibrillation is a common equine arrhythmia. Quinidine alone, or with digoxin are common treatments. Studies on outcome in Warmblood populations in which duration of the AF is often unknown are limited. Objective: To identify the factors that are associated with the success of full treatment cardioversion with oral medication, and establish whether there are differences in these factors between institutions. Methods: Retrospective case series using patient records of Equine University Clinic of Utrecht University and Rossdales Equine Hospital, Newmarket. Methods: Forty-nine horses treate...
Applied Protein and Molecular Techniques for Characterization of B Cell Neoplasms in Horses.
Clinical and vaccine immunology : CVI    August 26, 2015   Volume 22, Issue 11 1133-1145 doi: 10.1128/CVI.00374-15
Badial PR, Tallmadge RL, Miller S, Stokol T, Richards K, Borges AS, Felippe MJ.Mature B cell neoplasms cover a spectrum of diseases involving lymphoid tissues (lymphoma) or blood (leukemia), with an overlap between these two presentations. Previous studies describing equine lymphoid neoplasias have not included analyses of clonality using molecular techniques. The objective of this study was to use molecular techniques to advance the classification of B cell lymphoproliferative diseases in five adult equine patients with a rare condition of monoclonal gammopathy, B cell leukemia, and concurrent lymphadenopathy (lymphoma/leukemia). The B cell neoplasms were phenotypically...
Disseminated lymphoma with large granular lymphocyte morphology diagnosed in a horse via abdominal fluid and transtracheal wash cytology.
Veterinary clinical pathology    May 4, 2015   Volume 44, Issue 3 437-441 doi: 10.1111/vcp.12262
Mastrorilli C, Cesar F, Joiner K, Wooldridge AA, Christopherson PW.A 22-year-old Tennessee Walking Horse mare was presented to the Auburn University Large Animal Teaching Hospital with a 3-day history of lethargy, anorexia, and mild signs of colic. The mare had a several-month history of weight loss and refractory cough. Physical examination revealed an increased respiratory rate, and crackles and wheezes were heard on thoracic auscultation. Thoracic ultrasonographic examination showed disseminated, minor, bilateral comet tail-like lesions on the parietal pleural surfaces. Abdominal ultrasonographic examination was unremarkable. Trans-rectal palpation reveale...
Suspected malignant transformation of B lymphocytes in the equine cornea from immune-mediated keratitis.
Veterinary ophthalmology    April 28, 2015   Volume 19, Issue 2 172-179 doi: 10.1111/vop.12275
Vallone LV, Neaderland MH, Ledbetter EC, Dubielzig RR.To describe clinical, in vivo confocal microscopic, histopathologic, polymerase chain reaction assay for antigen receptor rearrangement (PARR) and immunohistochemical features of a horse with suspected malignant transformation of corneal B lymphocytes in immune-mediated keratitis (IMMK) and to also report surgical management and adjunctive treatment including topical and radiation therapies. Methods: A 15-year-old Oldenburg gelding was examined for presumptive progressive stromal IMMK of the right eye which became refractory to medical management. Corneal in vivo confocal microscopy revealed...
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