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Topic:Prognosis
Prognosis in horses refers to the prediction of the likely outcome or course of a disease or injury in equine patients. It involves assessing various factors such as the nature and severity of the condition, the horse's overall health, and response to treatment. Prognostic evaluations help veterinarians and horse owners make informed decisions regarding treatment options, management strategies, and potential recovery. The process often incorporates clinical assessments, diagnostic tools, and historical data to estimate the chances of recovery or progression. This page compiles peer-reviewed research studies and scholarly articles that explore methodologies, factors influencing prognostic outcomes, and the implications of prognostic evaluations in equine veterinary practice.
Equine keratomycoses in California from 1987 to 2010 (47 cases). Equine keratomycosis in the western USA has received little study, probably owing to its low prevalence. Objective: To determine clinical features, predominant fungal isolates, treatment modalities and outcomes of horses with keratomycosis in California and compare these with results from different geographic regions. Methods: Records of horses presented to the University of California-Davis Veterinary Medical Teaching Hospital (UCD-VMTH) with confirmed keratomycosis between 1987 and 2010 were reviewed for this retrospective study. Information retrieved from the record included background, oph...
A retrospective study of horses investigated for weight loss despite a good appetite (2002-2011). Weight loss despite a good appetite is a frequent diagnostic challenge for equine veterinarians; however, there are few objective reports and little descriptive information regarding risk factors and prognostic indicators. Objective: To provide a descriptive epidemiological analysis of horses evaluated for weight loss despite a good appetite and evaluate relationships between historical and clinicopathological findings and final outcome (survival vs. nonsurvival) to identify risk factors and prognostic indicators. Methods: Medical records of horses referred for investigation of weight loss des...
Liver lobe torsion in six horses. 6 horses were determined to have torsion of a liver lobe at 4 referral institutions over a 21-year period. Results: Clinical findings were nonspecific but often included signs of marked inflammation. Two of the 6 horses were examined because of colic, and 2 were assessed because of peritonitis that failed to respond to treatment; the remaining 2 horses were examined because of nonspecific clinical signs that included inappetence, lethargy, and weight loss. The results of laboratory tests were widely variable, and values for liver enzyme activities were typically within reference limits or only...
Pyogranulomatous lesion causing neurological signs localised to the sacral region in a horse. This case report describes neurological signs associated with a pyogranulomatous lesion within the sacral vertebral canal of a horse. The clinical findings included urinary overflow incontinence and reduced anal, perianal and tail tone. The horse failed to respond to medical management and a guarded prognosis for return to athletic performance initiated the decision for euthanasia.
Return to use and performance following exploratory celiotomy for colic in horses: 195 cases (2003-2010). There are few objective data on return to use and performance in horses following colic surgery. Objective: To investigate return to functional use of horses following colic surgery and factors associated with a negative outcome. Methods: The North Carolina State University Equine Colic Database was reviewed for horses that underwent exploratory celiotomy for colic (2003-2010). Horses were excluded from the study if they survived <6 months, had no intended use preoperatively, or if further data were not available at attempted follow-up. Information retrieved included history, background, us...
Intussusception in horses. Intussusception is thought to be associated with abnormal motility in the intestinal tract. The clinical signs vary depending on the associated intestinal damage. Therefore, intussusception should be included in the differential diagnosis for any horse with acute or chronic colic. A diagnosis may be made by ultrasonography or rectal palpation, but exploratory laparotomy is the predominant method. Treatment varies according to the location of the intussusception, but all treatments involve surgical intervention. The prognosis for intussusception can be good if the condition is diagnosed and tre...
Serum cardiac troponin I concentrations in horses with cardiac disease. To measure the cardiac troponin I (cTnI) concentration in horses and determine whether it could be used in the diagnosis of myocardial disease, as well as determining the association between cTnI and survival. Methods: Prospective, observational study. Methods: Physical examination, echocardiography, telemetric electrocardiography and postmortem were used to diagnose cardiac disease. Diagnoses were grouped as myocardial disease, structural heart disease or lone arrhythmia. Blood samples were collected at admission for cTnI analysis and the results were compared with those for 18 healthy horses...
Indwelling cephalic or saphenous vein catheter use for regional limb perfusion in 44 horses with synovial injury involving the distal aspect of the limb. To describe indwelling cephalic or saphenous vein catheter use for intravenous regional limb perfusion (ID-IV-RLP) to treat horses with synovial injury (contamination/infection) of the distal aspect of the limb. Methods: Retrospective case series. Methods: Horses (n = 44; 45 limbs) treated with proximal ID-IV-RLP. Methods: Horses had ID-IV-RLP using a cephalic (21 limbs) or saphenous (24 limbs) vein. Amikacin was the most frequently used antibiotic. Number of perfusions ranged from 3 to 21 (median 7). A cast was applied to 14 injured limbs (1 tube cast, 1 full-limb cast, 2 foot casts, and 10 h...
RACK1, a clue to the diagnosis of cutaneous melanomas in horses. Melanocytic proliferations are common in horses but the diagnosis of malignancy is not always straightforward. To improve diagnosis and prognosis, markers of malignancy are needed. Receptor for activated C kinase 1 (RACK1) protein may be such a marker. RACK1 was originally found to characterize malignant melanocytic lesions in the Melanoblastoma-bearing Libechov minipig (MeLiM) and, later, in human patients. Our purpose was to investigate the value of RACK1 in the classification of cutaneous melanocytic proliferations in horses. Results: Using immunofluorescence, we report here that both MITF ...
Association between radiographic pattern and outcome in foals with pneumonia caused by Rhodococcus equi. Our objective was to characterize the association between types of radiographic findings and outcome in foals with pneumonia caused by Rhodococcus equi. Admission lateral thoracic radiographs of 62 foals with culture-confirmed R. equi pneumonia were reviewed retrospectively. A scoring system was developed to individually assess the severity of alveolar pattern, interstitial pattern, tracheobronchial lymphadenopathy, pleural effusion, and the number of nodular opacities and cavitary lesions. Individual scores were added to obtain a total radiographic score ranging from 0 (normal) to 22. Forty-t...
Clinical significance and prognosis of deep digital flexor tendinopathy assessed over time using MRI. Deep digital flexor (DDF) tendinopathy is one of the most frequent causes of foot lameness and the prognosis is guarded. The progress of lesion healing may be followed by magnetic resonance (MR) imaging to formulate a prognosis and to adapt the rehabilitation program. We assessed the correlation of outcome with total tendon damage and temporal resolution of MR abnormalities. Images from 34 horses with DDF tendinopathy that had undergone at least two low-field standing MR examinations of the foot (mean 2.5 ± 1.3 times) were reviewed. No horse having a T1-GRE hyperintense lesion over 30 mm in l...
Parameters influencing prevalence and outcome of tendonitis in Thoroughbred and Arabian racehorses. Flexor tendonitis and suspensory desmitis are among most prevalent musculoskeletal injuries observed in racehorses. The aim of this study was to determine which horse and race-related parameters can help to diminish the possibility of injury or--when injury has occurred--to evaluate the potential for the horse to continue a successful career after convalescence. Special attention was given to the comparison of Arabian and Thoroughbred racehorses. 187 horses with ultrasonographically visible lesions were included in the study. Following parameters were analyzed: structure (Superficial Digital F...
Evaluation of L-lactate and cardiac troponin I in horses undergoing emergency abdominal surgery. To evaluate changes in plasma cardiac troponin I (cTnI) and L-lactate (LLt) as prognostic indicators in horses undergoing emergency abdominal surgery. Methods: Prospective observational study. Methods: Veterinary teaching hospital. Methods: Thirty-four horses undergoing emergency abdominal surgery. Methods: Serial blood sampling during various times during hospitalization (hospital admission, and 12, 24, 48, and 72 h postoperatively) evaluating cTnI and LLt concentrations. Results: All horses required surgery for correction of a strangulating (n = 29) or nonstrangulating obstruction (n = 5) of...
Episodic blindness and ataxia in a horse with cholesterinic granulomas. An 11-year-old Oldenburg mare presented following three episodes of acute, transient blindness, ataxia, and disorientation within the preceding 7 months. Clinical improvement, including return of vision, occurred within 1 week of initiating corticosteroid therapy for each of the three episodes. However, mild right-sided miosis was a consistent finding on ophthalmic examinations. Routine clinicopathologic testing revealed no significant abnormalities, and testing of cerebral spinal fluid for selected infectious diseases was unrewarding. Computed tomography of the brain demonstrated a hyperatten...
Results of computed tomography in horses with ethmoid hematoma: 16 cases (1993-2005). To determine whether CT provides unique information about the treatment or prognosis for horses with ethmoid hematoma (EH). Methods: Retrospective case series. Methods: 16 horses with EH. Methods: Horses with a diagnosis of EH that had undergone a diagnostic CT study were included. Clinical features, treatment, outcome, radiographic and CT images, and histologic specimens were reviewed. Results: CT provided new diagnostic information that affected treatment in 10 of 16 horses. Bilateral disease occurred in 8 of 16 horses and was undetected in 5 horses prior to CT. Paranasal sinus involvement o...
Association of admission L-lactate concentration in hospitalised equine neonates with presenting complaint, periparturient events, clinical diagnosis and outcome: a prospective multicentre study. Admission L-lactate concentration is a useful and commonly measured biomarker not previously prospectively evaluated in a large multicentre study of critically ill neonatal foals. Objective: To evaluate overall outcome and the association of survival and L-lactate concentration at admission ([LAC]ADMIT) by periparturient history, presenting complaint and clinicians' major diagnosis for ill neonatal foals. Methods: Thirteen university and private equine referral hospitals enrolled 643 foals over the 2008 foaling season. Case details, historical, clinical and clinicopathological data were entere...
Dysphagia associated with presumed pharyngeal dysfunction in 16 neonatal foals. Dysphagia due to pharyngeal dysfunction occurs in human neonates and is associated with prematurity and hypoxic episodes. This syndrome probably occurs in neonatal foals but has not been reported. Objective: The objectives of this study were to describe 1) a series of neonatal foals with dysphagia due to pharyngeal dysfunction; 2) the progression, treatment and resolution of the dysphagia; 3) the comorbidities; and 4) the prognosis for life and athleticism for affected foals. Methods: Records from 3 referral equine hospitals were reviewed from neonatal foals with dysphagia of pharyngeal origin...
The importance of ultrasonographic pneumatosis intestinalis in equine neonatal gastrointestinal disease. Recognising the presence of a necrotising component of the gastrointestinal disease may be clinically useful in ill equine neonates. Objective: To study the importance of abdominal sonograms in neonatal foals suffering from gastrointestinal conditions and to describe the clinical features of necrotising gastrointestinal disease. Objective: There is a subgroup of neonates with sonographically detectable pneumatosis intestinalis (PI), reflecting a necrotising disease. Methods: Records of foals aged < or = 7 days hospitalised from 2005 to 2009 with signs of gastrointestinal disease were evalua...
Use of pelvic flexure biopsy scores to predict short-term survival after large colon volvulus. To (1) determine if histologic scores of pelvic flexure biopsies can predict short-term survival in horses with large colon volvulus (LCV) and (2) identify clinical variables predictive of short-term survival. Methods: Case series. Methods: Horses (n = 28) with LCV (≥ 360°). Methods: Medical records (January 2000-February 2008) of 28 horses were reviewed and clinical data recorded. Pelvic flexure biopsies were reviewed by 2 board-certified veterinary pathologists, unaware of clinical history and outcome, using 2 scoring systems. Exact logistic regression analysis was used to determine the r...
Diagnostic frequency, response to therapy, and long-term prognosis among horses and ponies with pituitary par intermedia dysfunction, 1993-2004. Pituitary pars intermedia dysfunction (PPID) is common in older horses. Objective: To determine diagnosis frequency, prognostic factors, long-term survival, and owner satisfaction with treatment. Methods: Medical records from horses diagnosed with PPID, 1993-2004. Methods: A retrospective cohort design with data collected from the Veterinary Medical Data Base (VMDB) and a cohort of 3 VTHs. Proportional accessions, annual incidence, and demographics were compared for all accessions. During the same period, a subset of medical records (n = 44) was extracted and owners (n = 34) contacted to obtai...
Retrospective study of 103 presumed cases of tick (Ixodes holocyclus) envenomation in the horse. Review 103 cases of presumed tick envenomation in horses. Methods: Retrospective study. Methods: Variables, including date of presentation, age, breed, weight, presence of ticks, gait and respiration scores, duration of recumbency, treatment, outcome and complications were recorded. A series of univariable screening tests were performed and used in a multivariable logistic regression model. Results: There were a total of 103 cases affecting 10 breeds, aged between 1 week and 18 years of age. Horses >6 months old and weighing >100 kg had a higher odds of death than those...
Extraocular lymphoma in the horse. To describe the clinical findings and prognosis for extraocular lymphoma in the horse. Methods: Retrospective medical records study of horses diagnosed with third eyelid, corneoscleral, conjunctival, and/or eyelid lymphoma from multiple academic and private veterinary institutions. Data collected from the medical records included signalment, clinical descriptions of the extraocular lesions, treatment, and treatment outcomes. Nonparametric statistical analysis was performed with Fischer's exact tests. Results: Extraocular lymphoma involving the eyelid, third eyelid, cornea, sclera, and/...
Methiocarb poisoning of a horse in Australia. Snail bait poisoning is rare in horses. Cases have been reported, but clinical signs and subsequent prognostic indicators have been poorly documented and must be extrapolated from cases in companion animals. We describe in detail the poisoning of a horse that consumed a lethal dose of the carbamate, methiocarb. There are currently no guidelines for treating equine methiocarb toxicoses, but the principles of management are based on supportive therapy.
Hydrallantois in the mare–a report of five cases. Hydrallantois in the mare is a very rare condition, and clinical reports help to gather information to elucidate its pathogenesis, treatment options and prognosis. Five different cases of hydrallantois in the mare are reported in this article, all with the involvement of placentitis. The five mares were presented because of acute distention of the abdomen, dyspnoea, stiff gait and a lack of appetite. After a gradual release of the excessive amount of allantoic fluid, an abortion was induced in all five mares. The foals were either born dead or euthanized. The mares recovered quickly. One mare ...
Caudal anaesthesia of the infraorbital nerve for diagnosis of idiopathic headshaking and caudal compression of the infraorbital nerve for its treatment, in 58 horses. Idiopathic headshaking is often a facial pain syndrome, but a diagnostic protocol has not been described. In a previous study, caudal compression of the infraorbital nerve for treatment offered a fair success rate, but low case numbers and short follow-up time were limitations. Objective: To describe a diagnostic protocol for headshaking, examining the role of bilateral local analgesia of the posterior ethmoidal nerve (PET block). To report longer-term follow-up after surgery of the original cases and further cases and to determine whether changes to the technique influence success rates and c...
European outbreaks of atypical myopathy in grazing horses (2006-2009): determination of indicators for risk and prognostic factors. Appropriate management of atypical myopathy (AM) requires the establishment of an accurate diagnosis and prognosis. Furthermore, preventive measures to avoid AM need to be refined. Objective: The aims of the study were as follows: 1) to improve the diagnosis of AM; 2) to identify prognostic predictors; and 3) to refine recommended preventive measures based on indicators of risk factors. Methods: An exploratory analysis of cases in Europe between 2006 and 2009 reported to the Atypical Myopathy Alert Group was conducted. Based on clinical data, reported cases were allocated into 2 groups: ...
Precision of a photogrammetric method to perform 3D wound measurements compared to standard 2D photographic techniques in the horse. Methods of 3D wound imaging in man play an important role in monitoring of healing and determination of the prognosis. Standard photographic assessments in equine wound management consist of 2D analyses, which provide little quantitative information on the wound bed. Objective: 3D imaging of equine wounds is feasible using principles of stereophotogrammetry. 3D measurements differ significantly and are more precise than results with standard 2D assessments. Methods: Repeated specialised photographic imaging of 4 clinical wounds left to heal by second intention was performed. The intraoperator ...
Interpreting lactate measurement in critically ill horses: diagnosis, treatment, and prognosis. In hospitalized horses, hypovolemia and the resulting decrease in tissue perfusion is the most common cause of hyperlactatemia. Therefore, measurement of blood lactate concentration can be a useful tool for guiding fluid therapy. Similarly, measuring blood lactate concentration can be used to assess the need for and adequacy of transfusions in horses receiving whole blood. Inflammatory leukocytes within closed body cavities consume glucose and produce lactate. Simultaneous measurement of blood lactate concentration and lactate concentration of peritoneal, pleural, or synovial fluid has been us...
Transection of the lateral and long digital extensor tendons in racehorses. To report on the outcome of wounds to the hindlimb of racehorses, and horses with the intended use of racing, where both the long digital extensor (LoDE) and lateral digital extensor (LaDE) tendons had been completely transected. Methods: Retrospective case series. Methods: Records of all horses admitted with hindlimb lacerations between 2002 and 2009 were examined for cases where both the LoDE and LaDE tendons in the hindlimb had been severed, and specifically in horses intended to be used for racing. Outcome was assessed via retrieval of race records and via telephone questioning of the owne...
Trans-arterial coil embolization of the internal carotid artery in standing horses. To develop transarterial coil embolization (TACE) for occlusion of the internal carotid artery (ICA), in normal standing horses, and to evaluate it use for prevention of hemorrhage in horses with guttural pouch mycosis (GPM). Methods: Prospective study. Methods: Normal horses (n = 8) and 5 with GPM. Methods: Horses had TACE of the ICA in standing position under fluoroscopic guidance. Four normal horses were euthanatized 2 weeks after TACE for morphologic assessment and 4 were followed for 6 months. The 5 clinically affected horses were evaluated for long-term (10-12 months) success rate and co...
