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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.
Osteomyelitis of the patella in eight foals. To describe the characteristics of osteomyelitis lesions of the patella and to report short- and long-term outcome after treatment in 8 foals. Methods: Retrospective case series. Methods: Foals (n = 8). Methods: Medical records (2003-2007) and radiographs of foals that had osteomyelitis of the patella were reviewed. Inclusion criteria included clinical, radiographic, and surgical findings consistent with osteomyelitis of the patella, and a long-term follow-up of >15 months. Information acquired included signalment, hematologic and serum biochemical profile results, clinical and radiographic...
Sacroiliac injuries in horses. This article reviews the pathology, diagnosis, and treatment of sacroiliac joint injuries. These injuries can be acute or chronic and can involve soft tissue structures surrounding the joint or the bony structures of the joint. The several diagnostic modalities for sacroiliac injuries vary in usefulness and accessibility. Treatment of sacroiliac problems is usually supportive and nonspecific and includes the use of antiinflammatory medications and an appropriate exercise regimen. The prognosis depends on the cause, but severe injuries can limit a horse's future athletic activity.
[Surgical removing of an ectopic tooth in an Iceland mare]. Ectopic teeth occur because of failure of the first branchial cleft to close during development and are found mostly in young horses. Such dentigerous cysts are often located at the base of the ear, forming a notable swelling with a fistula, as it was the case with the two year old Iceland mare «Runa». In order to confirm the diagnosis, x-ray images were taken, which is also necessary to locate the ectopic tooth correctly. While operating, the whole cystic membrane should be removed and it is important to prevent adjacent nerves and blood vessels from damage. Prognosis for complete healing a...
Short-term cast immobilisation is effective in reducing lesion propagation in a surgical model of equine superficial digital flexor tendon injury. Larger superficial digital flexor tendon (SDFT) injuries have a poorer prognosis than smaller lesions. During the inflammatory phase enlargement of the initial lesion is frequently noted, with biomechanical loading being recently proposed to play an important role. Objective: To evaluate the effect of lower limb cast immobilisation on tendon lesion propagation in an equine model of surgically induced SDFT injury. Methods: Core lesions were surgically induced in both front SDFTs of 6 young mature horses. At the end of surgery, one leg was randomly placed in a lower limb cast and the other leg (...
Evaluation and management of the recumbent adult horse. Evaluation and management of recumbent horses are challenging. Familiarity with disorders that can result in recumbency will facilitate more rapid diagnosis and more appropriate formulation of a prognosis. With rapid and appropriate diagnosis, appropriate treatment can be pursued and, with good nursing care, can result in a favorable outcome.
Attempted medical management of suspected ascending colon displacement in horses. To determine the success of medical management of suspected displacement of the ascending (large) colon in horses. Methods: Retrospective case series. Methods: Horses (n = 127) with suspected large colon displacement. Methods: Medical records (January 1998-September 2008) of horses admitted for colic were reviewed. Suspected large colon displacement was diagnosed from clinical examination and in some cases, subsequent surgical examination. Medically managed horses were exercised and administered intravenous fluids and analgesia. Horses with suspected left dorsal displacement (LDD) of the large...
Colic in competing endurance horses presenting to referral centres: 36 cases. Colic is a common reason for elimination from equine endurance competitions and has recently been identified as the leading cause of mortality in this group of horses. Hydration and electrolyte derangements are often severe, but are probably related to endurance exercise and not necessarily the episode of colic. Better understanding of the causes of colic and the expected outcome is needed to guide treatment decisions in endurance horses. Objective: To describe the history, case details, clinical examination, laboratory, treatment and outcomes for horses presenting to equine referral centres f...
Axial speed of sound for the monitoring of injured equine tendons: a preliminary study. Equine superficial digital flexor tendons (SDFT) are often injured, and they represent an excellent model for human sport tendinopathies. While lesions can be precisely diagnosed by clinical evaluation and ultrasonography, a prognosis is often difficult to establish; the knowledge of the injured tendon's mechanical properties would help in anticipating the outcome. The objectives of the present study were to compare the axial speed of sound (SOS) measured in vivo in normal and injured tendons and to investigate their relationship with the tendons' mechanical parameters, in order to assess the ...
Advanced imaging of the nervous system in the horse. Neuroimaging underwent a dramatic revolution during the past few decades due to the development of new technologies that produce exquisite images of patient morphology and function, new technologies that store and distribute information more efficiently, and research that has improved understanding of pathogenesis and effective clinical use of new imaging methods. Advanced equine neuroimaging is a specialized field with unique challenges associated with patient size, availability of equipment, using equipment designed for humans, small sample size for various diseases, and issues associated wi...
Penetrating injuries to the frog (cuneus ungulae) and collateral sulci of the foot in equids: 63 cases (1998-2008). Objective-To determine the outcome of penetrating injuries to the central region of the foot in equids and identify factors that may affect treatment and outcome. Design-Retrospective case series. Animals-63 equids (61 horses, 1 pony, and 1 mule). Procedures-Records of equids incurring puncture wounds through the frog (cuneus ungulae) or collateral sulci of the foot between 1998 and 2008 were reviewed. Evaluated factors that were hypothesized to affect outcome included signalment, degree of lameness, foot affected, duration between injury and admission, and treatment. Injuries were graded from...
The relationship between serum calcium concentration and outcome in horses with renal failure presented to referral hospitals. Hypercalcemia is common in horses with renal failure, but it is not known whether it impacts prognosis. Objective: The primary objective of this study was to determine whether hypercalcemia was associated with decreased likelihood of survival to discharge in horses with renal failure. Secondary objectives were to determine whether hypercalcemia was more common in acute (ARF) or chronic renal failure (CRF), whether feeding alfalfa was associated with hypercalcemia, and whether serum creatinine concentration was associated with survival. Methods: Medical records of 63 horses presented to referra...
Serial measurement of lactate concentration in horses with acute colitis. Serial measurement of lactate concentration is utilized for therapeutic and prognostic purposes in human critical care. The prognostic value of serial lactate measurement in equine acute colitis warrants investigation. Objective: Serial lactate concentrations are predictive of outcome in horses with colitis. Methods: A total of 101 horses with colitis. Methods: Retrospective study. Plasma L-lactate concentrations were measured at admission and at 4-8 and 24 hours after admission. Associations between admission, early (4-8 hours) and late (24 hours) lactate concentrations, and survival status w...
Clinical implications of high liver enzyme activities in hospitalized neonatal foals. To determine whether high liver enzyme activities were negatively associated with outcome in sick neonatal foals as compared with foals that did not have high liver enzyme activities. Methods: Retrospective case-control study. Methods: 147 foals < 30 days old with high γ-glutamyltransferase activity, high sorbitol dehydrogenase activity, or both (case foals) and 263 foals < 30 days old with γ-glutamyltransferase and sorbitol dehydrogenase activities within reference limits (control foals). Methods: Medical records were reviewed for information on signalment, physical examination findin...
Histological and immunohistochemical studies of changes in myenteric plexuses and in interstitial cells of Cajal associated with equine colic. In this study we investigated the histological changes of the myenteric plexuses and interstitial cells of Cajal (ICC) in gut samples from horses with colic to try to find results useful in the prognostic evaluation of enteric lesions. A morphologic and quantitative study of myenteric ganglia, ganglion cells and neuronal chromatolytic and necrotic changes of 24 horses with colic was performed. For ganglion cells, enteroglial cells and ICC immunolabeling was also performed to identify cell functional disorders. A significant increase of neuronal chromatolysis and necrosis occurred in horses suf...
Paranasal sinus disease in horses. The paranasal sinus system of horses is complex, comprising six pairs of sinuses. Disease processes that can develop in the sinuses include ethmoid hematomas, cysts, neoplasia, and bacterial and fungal infections. Horses that develop paranasal sinus disease vary widely in age. A significant number of clinical conditions involving the paranasal sinuses require a combination of diagnostic tests to determine the specific pathologic process. Because of the anatomic location of the paranasal sinuses and associated chronic conditions that affect many patients, many disease processes involving the pa...
Equine recurrent uveitis: treatment. Equine recurrent uveitis has traditionally been treated with medical management to reduce ocular inflammation and control pain during a single episode. Newer management methods include surgical options such as cyclosporine implantation and vitrectomy. These methods were developed not only to control inflammation but also to eliminate the underlying cause of uveitis in order to prevent recurrence.
Management of hindlimb proximal suspensory desmopathy by neurectomy of the deep branch of the lateral plantar nerve and plantar fasciotomy: 155 horses (2003-2008). Neurectomy of the deep branch of the lateral plantar nerve and plantar fasciotomy have become accepted as methods of treatment of proximal suspensory desmopathy (PSD), but there are limited long-term studies documenting the outcome. Objective: To describe long-term follow-up in horses with PSD alone or with other injuries contributing to lameness and poor performance, including complications, following neurectomy and fasciotomy. Methods: Follow-up information was acquired for 155 horses that had undergone neurectomy and fasciotomy for treatment of PSD between 2003 and 2008. Success was classif...
Endoscopic evaluation of the navicular bursa: observations, treatment and outcome in 92 cases with identified pathology. Diagnostic navicular bursoscopy has been described in limited cases. Review of greater numbers is needed to define its contribution to case management and prognostic values. Objective: To report: 1) clinical, diagnostic and endoscopic findings in a series of cases, 2) surgical techniques and case outcomes and 3) prognostic values. The authors hypothesise: 1) lameness localising to the navicular bursa is commonly associated with dorsal border deep digital flexor tendon (DDFT) lesions, 2) endoscopy allows extent of injuries to be assessed and treated, 3) case outcome relates to severity of DDFT ...
Factors associated with survival of epiploic foramen entrapment colic: a multicentre, international study. Epiploic foramen entrapment (EFE) has been associated with reduced post operative survival compared to other types of colic but specific factors associated with reduced long-term survival of these cases have not been evaluated in a large number of horses using survival analysis. Objective: To describe post operative survival of EFE cases and to identify factors associated with long-term survival. Methods: A prospective, multicentre, international study was conducted using clinical data and long-term follow-up information for 126 horses diagnosed with EFE during exploratory laparotomy at 15 cli...
Implications of urine F2-isoprostane metabolite concentration in horses with colic and its potential use as a predictor for surgical intervention. F2-isoprostanes have been used extensively to quantify lipid peroxidation in association with risk factors in various diseases. Horses with colic may have intestinal ischaemia and/or inflammation characterised by oxidative stress and increased production of isoprostanes. Objective: To gather preliminary data regarding the feasibility of using urine F2-isoprostanes and isoprostane metabolites as early screening tools for the presence of gastrointestinal disease requiring surgical intervention in horses and ultimately develop a stall-side test capable of identifying these horses as early as poss...
Peritoneal and plasma D-lactate concentrations in horses with colic. To evaluate the association between peritoneal fluid and plasma d-lactate concentration with variables used in the diagnosis and prognosis of horses with colic. Methods: Clinically healthy horses (n=6) and 90 horses with colic. Methods: Prospective cross-sectional study. Methods: D-lactate concentration was determined in peritoneal fluid and plasma of all horses. Information on other blood and peritoneal fluid variables, signalment, results from the physical examination, outcome, need for surgery, lesion location, and type was retrieved from medical records. Results: Peritoneal D-lactate conce...
Equine paranasal sinus disease: a long-term study of 200 cases (1997-2009): treatments and long-term results of treatments. There is limited objective information available on the treatment and the long-term response to treatment of the different types of equine sinus disease. Objective: To document the treatments and long-term response to these treatments in 200 cases of equine sinus disease (1997-2009). Methods: The treatments of horses affected with subacute primary sinusitis (n = 52); chronic primary sinusitis (n = 37); dental sinusitis (n = 40); sinus cyst (n = 26); traumatic (n = 13); dental-related oromaxillary fistula (n = 8); sinus neoplasia (n = 10); mycotic sinus disease (n = 7); and intrasinus progressi...
Equine rhabdomyolysis. A 1.5-year-old Quarter Horse gelding with a history of chronic nasal discharge and leukocytosis presented with signs of increased lethargy and muscular pain. The horse quickly became recumbent and unable to rise and was euthanized due to a poor prognosis. At necropsy, severe bilateral guttural pouch empyema was observed, as well as numerous well-demarcated areas of pallor within the skeletal muscles of all major muscle groups. Polymerase chain reaction testing of the guttural pouch exudate confirmed an infection with Streptococcus equi subsp. equi, and an S. equi-associated immune-mediated rha...
Arthroscopic surgery of the middle carpal joint in trotting Standardbreds: findings and outcome. To describe the injuries in the middle carpal joint of trotting Standardbred racehorses in relation to future racing and to review the use of synovectomy in clinical cases. Methods: Review of medical records and racing statistics of clinical cases. Results: Sixty-six percent of horses undergoing arthroscopic surgery of the middle carpal joints returned to racing, but there were only weak associations between future racing success and findings at surgery. Lesions in the middle carpal joint were similar to what have previously been described, but there were no recorded injuries to the intermedia...
Low-field standing magnetic resonance imaging findings of the metacarpo/metatarsophalangeal joint of racing Thoroughbreds with lameness localised to the region: a retrospective study of 131 horses. The metacarpo/metatarsophalangeal (MCP/MTP) joint is a common site of lameness in the Thoroughbred racehorse. Radiographs may fail to show pathology consistent with the degree of lameness. With a high incidence of stress fractures occurring in the distal third metacarpal/metatarsal (MC3/MT3) condyles and proximal phalanx, a definitive diagnosis as to the nature of the pathology is essential. Objective: To describe the low-field magnetic resonance imaging (MRI) findings in Thoroughbred racehorses with MCP/MTP joint pain scanned under standing sedation. Methods: The MR images and clinical record...
Management and outcome of fractures of the distal phalanx: a retrospective study of 285 horses with a long term outcome in 223 cases. A multicentre study of 285 cases was performed to enhance the management of distal phalangeal fractures on the basis of clinical evidence. The outcome after treatment was available for 223 of the cases. Horses with a non-articular type I fracture had a better prognosis (91.7%) for return to original or expected level of use than horses with an articular type II or III fracture (69.6% and 74.1%, respectively). The prognosis for types IV and V fractures was fair (57.7% and 57.1%, respectively) and for type VI good (80%). Horses with a hindlimb fracture had a significantly greater chance of a suc...
Peritonitis in horses: 55 cases (2004-2007). Factors associated with the outcome of peritonitis in horses are seldom described. The objectives of this study were to determine the common clinical signs and clinicopathologic findings and to reveal prognostic factors associated with the outcome of peritonitis in equine patients. Data were examined in a retrospective manner in 55 horses diagnosed with and treated for peritonitis. The most common clinical and clinicopathologic findings were tachycardia (94%), increased amount of peritoneal fluid on ultrasound (84%), altered mucous membranes (82%), bacteria noted on the direct smear (67%), hyp...
Nonseptic tenosynovitis of the digital flexor tendon sheath caused by longitudinal tears in the digital flexor tendons: a retrospective study of 135 tenoscopic procedures. Longitudinal tears (LTs) of the digital flexor tendons are an important cause of chronic tenosynovitis of the digital flexor tendon sheath (DFTS). The origin of those marginal tears is not yet fully understood. The long-term outcome after medical and surgical treatment is guarded. Objective: To determine the prevalence of LTs of the digital flexor tendons in a large population of horses undergoing diagnostic tenoscopy of the DFTS and to assess the outcome of surgical treatment and the factors influencing the outcome. Methods: Medical records of 130 horses with chronic tenosynovitis of the DFTS...
Putative intestinal hyperammonaemia in horses: 36 cases. Intestinal hyperammonaemia (HA) has been infrequently reported in individual horses; however, there have been no studies describing clinical and laboratory data as well as short- and long-term outcome in a larger number of cases. Objective: To describe clinical and laboratory data and short- and long-term outcome in a large group of horses with intestinal HA. Methods: Multi-centred, retrospective study; case records of horses with HA were reviewed and any horse with a clinical or post mortem diagnosis of intestinal HA was included. Hyperammonaemia was defined as a blood ammonium (NH(4) (+)) co...
Racing prognosis after cumulative stress-induced injury of the distal portion of the third metacarpal and third metatarsal bones in Thoroughbred racehorses: 55 cases (2000-2009). To evaluate the diagnostic features, results of free-choice exercise treatment, prognosis, and postinjury racing performance of Thoroughbred racehorses with cumulative stress-induced bone injury (CSBI) of the distal portion of the third metacarpal and third metatarsal bones (MC3/MT3). Methods: Retrospective case series. Methods: 55 Thoroughbred racehorses with CSBI of the distal portion of MC3/MT3. Methods: Data on signalment, history, and radiographic, scintigraphic, and lameness examination findings were reviewed. Horses with lameness localized to the distal portion of MC3/MT3, and that did ...
