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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.
Retrospective study of subchondral sclerosis and lucency in the third carpal bone of Standardbred trotters. The aim was to investigate radiographic findings of subchondral sclerosis and subchondral lucency in the dorsoproximal-dorsodistal (DPr-DDi) projection of the third carpal bone (C3) in relation to clinical appearance and to prognosis for racing. In a retrospective study, case records of 89 Standardbred trotters diagnosed with traumatic carpitis confirmed with intra-articular anaesthesia were examined. Records included data on degree of lameness at presentation and after flexion tests and a radiographic examination of the carpus, including a DPr-DDi projection of the C3. Subchondral lucency was...
[Evaluation of intravenous immunotherapy with purified F(ab’)2 fragments (Viperfav)]. To assess early clinical and biological prognosis factors in viper envenomings, and assess efficacy of Viperfav immunotherapy. Viperfav contains purified F(ab')2 fragments of equine antibodies. Methods: A retrospective case review study of viper envenomings collected by two poison centers in France, treated or not treated by Viperfav, was conducted. Two hundred seven cases of viper bites including 119 moderate or severe envenomings (Grade II and III, recorded in adults and children and collected from 1992 to 1997 were included. Before treatment, clinical gradation and early biological severity...
Tenoscopic examination and proximal annular ligament desmotomy for treatment of equine “complex” digital sheath tenosynovitis. To determine the outcome of horses with "complex" digital tenosynovitis treated by tenoscopic proximal annular ligament desmotomy and resection of synovial masses or adhesions, or both, within the digital sheath. Methods: Retrospective evaluation. Methods: Twenty-five horses with a clinical and ultrasonographic diagnosis of palmar or plantar proximal annular ligament constriction and ultrasonographic evidence of synovial masses or adhesions within the digital tendon sheath. Methods: Each horse had tenoscopic surgery for annular ligament desmotomy combined with adhesiolysis and/or synovial mass...
Repeated manual evacuation for treatment of rectal tears in four horses. Horses with tears that involve all layers of the rectum except the mesocolon (grade IIIb) have a poor prognosis for survival because of the difficulty in treating these wounds and the propensity for them to progress to full perforations (grade IV). Most treatments for grade-IIIb rectal tears involve surgery of some kind, but not all grade-IIIb rectal tears require surgical intervention. We report on 4 horses with grade-IIIb rectal tears that were evaluated via palpation per rectum and endoscopy. Two of 4 horses were admitted with signs consistent with shock and endotoxemia, and evaluation of a...
Laminitis in the horse: a review. Laminitis has been a recognized disease since early Greek and Roman times, but it is still bothering both practitioners and scientists. In the last decade a lot of new fundamental research has been done to elucidate the pathogenesis of laminitis. New insights into the pathogenesis, the predisposing factors (including nutritional overload, endotoxaemia, shock, management, etcetera), clinical and radiological signs, differential diagnosis, therapy, and prognosis of the disease are described. The data, however, are not always in agreement with each other, giving further proof of the complexity of...
Prognostic factors affecting survival of 507 horses with joint disease: (1983 to 1990). Between July 1, 1983 and December 31, 1990, risk factors were determined for all horses with joint disease presented to a referral center, of being discharged, of ever becoming sound, or of being alive at 3 mo follow-up. Logistic multiple-regression models were done separately for foals (< or = 4 mo), yearlings (> 4-24 mo) and racing or nonracing adult horses (> 24 mo). The breakdown in this study was 53 foals, 87 yearlings, 141 nonracing adults, and 226 racing adults. Thirty-one foals (58%), 68 yearlings (78%), 119 non-racing adults (84%), and 213 racing adults (94%) were discharged. Foals wi...
Factors associated with prognosis for survival and athletic use in foals with septic arthritis: 93 cases (1987-1994). To identify factors affecting the prognosis for survival and athletic use in foals with septic arthritis. Methods: Retrospective study. Methods: 93 foals with septic arthritis. Methods: Medical records were reviewed to obtain clinical findings, laboratory test results, radiographic findings, treatment method, and outcome. Race records for Thoroughbreds and Standardbreds were evaluated to determine whether foals subsequently raced and whether they raced successfully. Results: 43 foals had 1 affected joint, 44 foals had multiple affected joints, and number of affected joints was not recorded for...
Factors involved in the prognosis of equine laminitis in the UK. The significance of clinical and radiological parameters as prognostic indicators for laminitis, 'founder' and 'sinking syndrome' was studied using case records of 216 horses and ponies. Five animals were destroyed without treatment and were not included in the results of the study. One hundred and sixty-two (77%) animals returned to athletic soundness; 7 animals (3%) did not regain full athletic function, 42 animals (20%) died or were destroyed. Cases were assigned to 4 groups on the basis of initial clinical examination alone. These groups were laminitis, acute founder, 'sinker' and chronic ...
Tumor necrosis factor and interleukin-6 activity and endotoxin concentration in peritoneal fluid and blood of horses with acute abdominal disease. The purpose of this study was to evaluate the diagnostic and prognostic significance of tumor necrosis factor-alpha (TNF) and interleukin-6 (IL-6) activities and endotoxin concentration in blood and peritoneal fluid of 155 adult horses with acute abdominal disease (colic). Samples also were obtained from 20 healthy adult horses. Blood and peritoneal fluid supernatant TNF and IL-6 activities and endotoxin concentration were significantly greater in horses with colic, compared with healthy horses. In horses with colic, the peritoneal fluid endotoxin concentration and TNF and IL-6 activities were...
Small intestine strangulation by components of the spermatic cord in two geldings. Two adult Quarter Horse geldings were evaluated for signs of abdominal pain. Both horses had signs of depression and distended small intestines on abdominal palpation per rectum. Abdominal exploratory surgery was performed on both horses. In each instance, small intestine was found to be strangulated by components of the spermatic cord. Both horses were euthanatized because of a poor prognosis. Although not commonly observed, incarceration of intestine by components of the spermatic cord should be considered as a cause of small intestine strangulation in male horses. Early recognition of this ...
Nonsurgical management of type II fractures of the distal phalanx in 48 standardbred horses. To evaluate nonsurgical management of type II fractures of the distal phalanx in Standardbred horses. Methods: Retrospective study of 48 affected horses. Results: Most fractures occurred on the lateral palmar process of the left forelimb or the medial palmar process of the right forelimb; 81% of horses were considered sound enough to return to training and 63% raced. Of those returning to racing, 41% competed in > 10 races, 37% in 2 to 10 races and 22% in only 1 race. There was no difference in performance before and after fracture. Twenty-four of 25 horses had a bar shoe fitted for > 50...
Chyloperitoneum and abdominal adhesions in a miniature horse. Chyloperitoneum is a potential cause of colic in horses. Although rare in horses, chyloperitoneum can develop secondary to tearing of mesenteric adhesions and rupture of mesenteric lymphatic vessels. The prognosis for horses with chyloperitoneum depends on the underlying cause and the response to treatment.
Clinical presentation, diagnosis, and prognosis of acute laminitis. The purpose of this article is to describe the clinical features present in the patient affected with acute laminitis. The variations in the stance and characteristic lameness of the acute disease are described in relation to the disease severity and limb involvement. The elements of establishing a diagnosis including clinical history, physical and radiologic evaluation, and differential diagnosis are discussed. Difficulties and criteria used in establishing a prognosis of the acute phase patient are defined.
The digital pathologies of chronic laminitis. This review indicates that the patient-to-patient uniqueness commonly seen in chronic laminitis represents the variable presence of the digital pathologies. Although some degree of mechanical failure is always present, the secondary metabolic and growth dysplasias, vascular pathologies, and sepsis may or may not be evident. The presence and severity of these pathologies appear to have a more significant impact on the prognosis of individual cases than does the displacement of the distal phalanx. It should be reiterated that it is often the combined presence of these individual pathologies that...
Clinical presentation, diagnosis, and prognosis of chronic laminitis. This article focuses on the initial assessment of the horse affected with chronic laminitis. Variations in the clinical presentation and primary considerations in making a differential diagnosis are included. The elements of a clinical history essential to sound, therapeutic management, and prognosis are summarized. The physical and radiographic assessment of the digital lesions and diagnostic approaches to the common systemic aspects of the disease are presented and discussed.
Detection of a radiographically occult fracture of the lateral palmar process of the distal phalanx in a horse using computed tomography. A horse with a suspected injury of the distal phalanx was examined using radiography at day two and 19 after the onset of the lameness, with no definite diagnosis. Using computed tomography an incomplete fracture of the lateral wing of the distal phalanx was diagnosed at day 25. Based on computed tomography it was determined that the fracture probably did not enter the joint or involve the palmar cortex throughout its length which were of prognostic importance. The day following the CT examination a new oblique radiographic projection was made. In this radiography which was based on, and never...
Results of treatment of 145 fractures of the third metacarpal/metatarsal condyles in 135 horses (1986-1994). The objectives of this study were to correlate condylar fracture characteristics and type of treatment with subsequent capacity for athletic ability, and to determine the characteristics of healing that affect prognosis after fracture fixation. Medical records, post operative radiographic studies and race records were examined for 135 horses sustaining 145 fractures. Sixty-five percent of horses overall started in a race post injury (SPI) in a mean time of 9.7 months with a mean of 13.7 races post injury. Having raced pre-injury did not confer an advantage to starting post injury, though nonst...
Characterisation of the type and location of fractures of the third metacarpal/metatarsal condyles in 135 horses in central Kentucky (1986-1994). The objective of this retrospective study was to provide a detailed description of the characteristics of condylar fractures represented in a population of 135 horses who sustained 145 fractures. Records and radiographic studies were examined. Fifty-nine percent of the horses were male and the majority Thoroughbreds. The distribution of fractures was 37% incomplete-nondisplaced, 30% complete-nondisplaced and 32% complete-displaced. The right front was more likely to sustain a complete-displaced fracture, whereas the left front was more likely to sustain an incomplete-nondisplaced fracture. For...
Physeal growth retardation leads to correction of intracarpal angular deviations as well as physeal valgus deformity. Retrospective analysis of the radiographs of horses with carpal valgus, presented to the Iowa State University Veterinary Teaching Hospital from 1987-1996, were used to compare 2 methods of geometric analysis for finding the total angle of deviation. The pivot point angle method and the individual joint angle method were found to be comparable for determining the total angle of deviation. The individual joint angle method was used to analyse individual carpal joint angles and physis angle in joints with carpal valgus, as well as the changes that occurred in response to surgical correction. Mul...
Apical fracture of the proximal sesamoid bone in standardbred horses: 43 cases (1990-1996). To determine whether fracture fragment dimensions, suspensory ligament damage, and racing status at the time of injury were associated with outcome in Standardbred horses with apical fracture of the proximal sesamoid bone. Methods: Retrospective study. Methods: 43 Standardbred racehorses. Methods: Medical records, racing records, and radiographs were reviewed, and ultrasonographic findings were scored. Measurements of the fractured portion of the proximal sesamoid bone were made. Results: Seventy-four percent (32/43) of horses were pacers, and 26% (11/43) were trotters. Statistical differences...
Fractures of the rostral portion of the mandible and maxilla in horses: 89 cases (1979-1997). To compare fracture locations, repair methods, complications, and outcomes of horses with fractures of the rostral portions of the mandible and maxilla. Methods: Retrospective study. Methods: 89 horses with fractures of the rostral portions of the mandible and maxilla. Methods: Medical records and radiographs were reviewed. Fractures were categorized by fracture location and stability. Postoperative complications and long-term outcome were determined by clinical examination and telephone interviews with horse owners. Results: 4 fracture types were recognized. Fractures involving just the alveo...
Nonsurgical treatment of suprascapular nerve injury in horses: 8 cases (1988-1998). To determine the outcome of horses with suprascapular nerve injury treated with stall rest alone. Methods: Retrospective case series. Methods: 8 horses. Methods: Information on signalment, history, limbs affected, severity of lameness, degree of muscle atrophy, gait abnormalities, and results of radiography and electromyography was obtained from medical records. All horses were treated with stall rest. Follow-up information on severity of lameness, gait abnormalities, degree of muscle atrophy, time between injury and resolution of gait abnormalities, and outcome was obtained during reexaminati...
Inflammatory bowel disease in horses: 11 cases (1988-1998). To determine clinical and surgical abnormalities in, and long-term outcome of, horses that undergo surgery because of colic secondary to inflammatory bowel disease (IBD). Methods: Retrospective study. Methods: 11 horses. Methods: Medical records of horses that had undergone abdominal surgery and in which IBD had been diagnosed on the basis of histologic examination of intestinal biopsy specimens were reviewed. Results: 5 horses were examined because of acute colic and 6 were examined because of chronic colic. At surgery, all 11 horses had edematous or hemorrhagic bowel segments suggestive of I...
The neurology and enterology of equine grass sickness: a review of basic mechanisms. Autonomic dysfunction constitutes a prominent clinical feature of equine grass sickness (EGS). Significant injury to the nervous control of the alimentary system is life threatening, partly because of dysphagia but also because of the failure of the unique regulatory mechanisms in equine digestion involving water and electrolyte balance. The neuropathology also indicates the presence of a somatic polyneuropathy. The morphological features of EGS are similar to those of excitotoxic neuronal degeneration, which resembles neuronal apoptosis. It is difficult to ascertain from published accounts th...
Spinal ligament pathology. Young elite athletes, particularly horses used for jumping, are at a relatively high risk for injury to the ligaments associated with the axial skeleton. Extreme back flexion appears to be a contributing factor to ligament damage. Back pain due to injury of the ligaments of the axial skeleton has often been considered to be secondary to lower limb injury, to the extent that a separate definitive diagnosis, treatment, and prognosis were unnecessary. Diagnostic imaging, ultrasound in particular, has demonstrated ligamentous damage that can be the limiting factor in return to previous athletic us...
Comparison of medical and surgical treatment for impaction of the small colon in horses: 84 cases (1986-1996). To characterize clinical findings and compare effects of treatment and outcome for horses treated medically or surgically for impaction of the small colon. Methods: Retrospective study. Methods: 84 horses with impaction of the small colon. Methods: Medical records were reviewed for history, physical examination findings, laboratory values, treatment, response to treatment, complications, out-come, and necropsy findings. Results: 47 horses were treated medically and 37 horses were treated surgically. Significant differences between groups were not identified for duration of clinical signs, phys...
Deep digital flexor tenotomy as a treatment for chronic laminitis in horses: 35 cases (1988-1997). To determine long-term prognosis for horses with laminitis treated by deep digital flexor (DDF) tenotomy and to identify factors affecting success of the surgical procedure. Methods: Retrospective study. Methods: 35 horses with laminitis treated by DDF tenotomy between 1988 and 1997. Methods: Information was obtained from individual medical records and follow-up telephone interviews with owners and referring veterinarians. Cumulative proportions of horses that survived 6 months and 2 years after tenotomy were determined. Effect of Obel grade of lameness on 6-month and 2-year survival and effec...
Characteristics and risk factors for failure of horses with acute diarrhea to survive: 122 cases (1990-1996). To characterize horses with acute diarrhea and determine risk factors for failure to survive. Methods: Retrospective study. Methods: 122 adult horses admitted for acute diarrhea at the teaching hospital between Jan 1, 1990 and Dec 31, 1996. Methods: Medical records of horses with acute diarrhea were reviewed to abstract information regarding signalment, history, physical examination, clinicopathologic testing, treatment, and outcome. Results: 91 of 122 (74.6%) horses lived and were discharged from the hospital. Horses with history of administration of antimicrobials for a problem preceding dia...
Paranasal sinus cyst as a cause of stridor in a standardbred colt. Sinus cysts are epithelium-lined, fluid-filled cavities that can occur in the paranasal sinuses of horses. Extensive damage to the permanent tooth buds was a significant feature in this case. The sequellae of these abnormalities, although not apparent at the time of presentation, remain an important consideration for prognosis.
