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.
Musculoskeletal system neoplasia. Tumors of the musculoskeletal system are rare in horses; however, they must be taken seriously. Diagnosis requires observation of clinical signs, radiographic findings, and histological examination. Veterinarians must realize prognosis is not favorable for most tumors; however, some of these tumors can be treated or at least ameliorated. Tumors discussed in this article include: osteoma and osteosarcoma; osteoblastoma; chondrosarcoma; fibroma and fibrosarcoma; plasma cell myeloma; synovioma; rhabdomyosarcoma and tumors metastatic to the musculoskeletal system.
Radiation therapy in the horse. This article covers the principles and applications of radiation therapy in horses. The goal in treating tumors by irradiation is tumor control with minimum treatment complications. Various treatment techniques are available to achieve this goal. The prognosis depends on many factors such as the extent and location of the tumor, tumor type and tumor cell proliferation. Radiation therapy is a very effective treatment modality for equine tumors but logistical reasons limit its impact in equine oncology.
Neoplasia of the respiratory tract. Tumors of the equine respiratory tract occur infrequently. An accurate diagnosis of neoplasia of the respiratory tract is critical because the prognosis is usually grave. The clinical signs and diagnostic procedures are discussed for tumors of the nasal and paranasal sinuses, nasopharynx/larynx, guttural pouch and thorax including lung, pleura, and thymus.
Urinary tract neoplasia. This article is a review of reports on neoplasia of the equine urinary tract. Clinical signs associated with equine patients with urinary tract neoplasia are summarized along with a description of diagnostic methods used in such patients. The prognosis for treatment of urinary tract neoplasia is guarded. A review of the limited treatments that have been reported to date are also provided in this article.
Cecocolic and cecocecal intussusception in horses: 30 cases (1976-1996). To determine the prognosis in horses with cecocolic or cecocecal intussusception. Methods: Retrospective study. Methods: 30 horses with cecocolic intussusception or cecocecal intussusception. Methods: Information on history, physical examination findings, and laboratory values was summarized from the medical records. Laboratory data included results of hematologic examination, serum biochemical analysis, and peritoneal fluid color, total nucleated cell count, and total protein concentration. A one-year follow-up via the telephone was used to determine long-term survival. Results: Horses ranged...
Postcastration eventration in 18 horses: the prognostic indicators for long-term survival (1985-1995). Castration of horses is considered a common and routine surgical procedure, but the potential for complications is high. By far the most serious of these is eventration. The objectives of this study were to determine the long-term survival of horses undergoing surgical treatment of indirect (1) inguinal eventration of the small intestine following castration, and to identify prognostic indicators for survival. The case records of 18 horses undergoing surgical treatment of postcastration eventration (PCE) between 1985 and 1995 were reviewed. Follow-up information was obtained by telephone inter...
Septic osteitis of the distal phalanx: findings and surgical treatment in 18 cases. Eighteen cases of septic osteitis of the distal phalanx were diagnosed clinically and confirmed at surgery over a 6 year period (1990-1996). Focal bone lysis was the most common radiographic finding. Sequestra were identified in 4 horses, one of which was associated with a fractured plantar process. All the horses were treated surgically with open debridement. The septic process recurred in 4 horses: one was subjected to euthanasia due to navicular bursa infection, secondary to a pathological fracture, the other 3 horses responded to further debridement. A pathological fracture occurred in ano...
Incomplete ossification of the tarsal bones in foals: 22 cases (1988-1996). To determine outcome for foals with incomplete ossification of the tarsal bones and to determine whether clinical and radiographic abnormalities at the time of initial examination were associated with outcome. Methods: Retrospective study. Methods: 22 foals. Methods: Information on signalment, history, owner's initial complaint, clinical findings, whether tarsus valgus was evident, and radiographic abnormalities was obtained from medical records. Radiographic lesions were classified as type I (i.e., incomplete ossification with < 30% collapse of the affected bones) or type II (incomplete ossif...
Shoulder joint luxation in large animals: 14 cases (1976-1997). To determine clinical and radiographic findings in and treatment and outcome of large animals with shoulder joint luxations. Methods: Retrospective study. Methods: 5 horses, 3 goats, 1 calf, 1 sheep, 1 Himalayan tahr, 1 pot-bellied pig, 1 reindeer, and 1 white-tailed deer. Methods: Medical records and radiographs were reviewed to determine signalment, history, physical examination findings, type of luxation, treatment, and outcome. Owners and referring veterinarians were contracted for follow-up information. Results: Goats, sexually intact males, and animals < 1 year old were overrepresente...
Arthroscopic removal of abaxial fracture fragments of the proximal sesamoid bones in horses: 47 cases (1989-1997). To determine the outcome of horses after arthroscopic removal of abaxial fracture fragments of the proximal sesamoid bone and association of fracture grade with outcome. Methods: Retrospective study. Methods: 47 horses. Methods: Information obtained from dorsopalmar and dorsoplantar radiographic views of metacarpophalangeal and metatarsophalangeal joints was used to classify fractures as grade 1 ( 25 mm long) and type 1 (abaxial) and type 2 (apical-abaxial). Outcome was determined by whether the horse returned to its intended use, raced in the same class or higher (racehorses), or performed sa...
Complete fractures of the third metacarpal or metatarsal bone in horses: 25 cases (1980-1996). To compare treatments of complete fractures of the third metacarpal (MC) or metatarsal (MT) bone in horses and to identify factors that could impact prognosis. Methods: Retrospective case series. Methods: 25 horses with fractures of the third MC or MT bone that were treated by use of internal fixation, external coaptation, or both. Methods: Medical records from the Veterinary Medical Data Base of horses treated for fractures of third MC or MT bone at Texas A&M University from 1980 to 1994 and Purdue University from 1980 to 1996 were reviewed. Information on signalment, results of physical ...
Dental physical examination. The objectives of the equine dental physical examination are to detect and quantify oral and dental disorders, to propose and carry out their treatment, and to implement management programs. The veterinarian should be able to offer a prognosis and to detail any future treatment or management plans that may be required. These objectives should take into account the cost of these procedures, and the veterinarian should be prepared to offer a cost-benefit analysis of the problem and the proposed cures.
Herpesvirus myeloencephalopathy in horses: 11 cases (1982-1996). To determine results of CSF analysis in horses with equid herpesvirus myeloencephalopathy (EHM) and to determine whether results of CSF analysis were associated with outcome. Methods: Retrospective study. Methods: 11 horses. Methods: Medical records of all horses admitted to the veterinary teaching hospital between February 1982 and March 1996 in which EHM was diagnosed were reviewed. Results: 7 horses were < or = 4 years old; 8 were admitted during January, February, or March. Six horses were febrile prior to admission, but none was febrile on the day of admission. Five horses had been sta...
Associations between physical examination, laboratory, and radiographic findings and outcome and subsequent racing performance of foals with Rhodococcus equi infection: 115 cases (1984-1992). To determine whether physical examination, laboratory, or radiographic abnormalities in foals with Rhodococcus equi infection were associated with survival, ability to race at least once after recovery, or, for foals that survived and went on to race, subsequent racing performance. Methods: Retrospective study. Methods: 49 Thoroughbreds and 66 Standardbreds admitted to 1 of 6 veterinary teaching hospitals between 1984 and 1992 in which R equi infection was positively diagnosed. Methods: Results of physical examination, laboratory testing, and thoracic radiography were reviewed. Indices of raci...
Longitudinal fractures of the condyles of the third metacarpal and metatarsal bones in racehorses: 224 cases (1986-1995). To determine type, distribution, and radiographic appearance of condylar fractures of the third metacarpal bone (MC-3) or third metatarsal bone (MT-3) in Thoroughbreds (TB), Standardbreds (SB), and Arabians, to assess long-term outcome of horses in which fractures were repaired surgically, and to identify variables associated with prognosis for return to racing. Methods: Retrospective study. Methods: 224 horses with 233 fractures. Methods: Medical records and radiographs obtained before and after treatment were reviewed. Racing performance before and after treatment was determined by reviewing...
Enterocolitis associated with Clostridium perfringens infection in neonatal foals: 54 cases (1988-1997). To identify clinical signs, physical examination findings, results of diagnostic tests, treatments administered, and clinical outcome of neonatal foals with enterocolitis associated with Clostridium perfringens infection. Methods: Retrospective study. Methods: 54 neonatal foals. Results: Most foals had acute onset of obtunded mentation, colic, or diarrhea and developed leukopenia, neutropenia, an abnormally high number of band neutrophils, toxic WBC, and hypoproteinemia within 24 hours after admission, despite high serum IgG concentrations (> 800 mg/dl). Abdominocentesis and abdominal radiogra...
Role of prokinetic drugs for treatment of postoperative ileus in the horse. All horses undergoing coeliotomy for an acute abdominal crisis are at risk of developing ileus and should receive therapy aimed at promoting gastrointestinal function by restoring fluid and electrolyte balance. Adequate analgesia and prevention against peritonitis, bacteraemia and endotoxaemia should be provided. Horses that at the time of surgery have a strangulating or non-strangulating small intestinal obstruction should be considered to be at greater risk of developing a persistent ileus that is refractory to treatment than those horses with lesions involving the large intestine. In horses...
A retrospective study of mortality associated with general anaesthesia in horses: elective procedures. A retrospective analysis examined mortality associated with all procedures requiring general anaesthetic, performed at the Philip Leverhulme Large Animal Teaching Hospital, during the five-year period from February 1991 to December 1995. The study involved details relating to 2276 equine general anaesthetics and a variety of patient variables were examined. Within a group of 1279 animals undergoing anaesthesia for elective procedures, 46 (3.6 per cent) died or were euthanased owing to a poor prognosis or financial implications. Mortality relating directly to the surgery or anaesthesia occurred...
Cobalt 60 radiotherapy for treatment of squamous cell carcinoma of the nasal cavity and paranasal sinuses in three horses. Three adult horses underwent aggressive treatment of squamous cell carcinoma of the nasal cavity and paranasal sinuses, using course-fractionated cobalt 60 radiotherapy. Squamous cell carcinoma of the nasal cavity and paranasal sinuses is not commonly diagnosed in horses. Historically, horses with this type of neoplasm have not been treated or have undergone some form of surgery. The prognosis for long-term survival or cure has been poor. Long-term results of cobalt 60 radiotherapy were good to excellent and exceeded those usually reported for horses treated surgically. On the basis of these r...
Hemostatic and fibrinolytic indices in neonatal foals with presumed septicemia. Thirteen coagulation tests evaluating hemostatic and fibrinolytic indices and serum cytokine and plasma endotoxin concentrations were obtained in 34 foals with a positive sepsis score (septic group) and 46 age-matched healthy foals. Compared to healthy foals, the prothrombin, activated partial thromboplastin, and whole blood recalcification times were significantly longer in septic foals. The fibrinogen and fibrin degradation products concentrations, percent plasminogen, alpha-2 antiplasmin, and plasminogen activator inhibitor activities, and tumor necrosis factor and interleukin-6 activities ...
Mycosis fungoides in a horse. A 17-year-old Quarter Horse mare was examined to determine the cause of a vulvar mass. Differential diagnoses for the swollen, ulcerated tissue included hypersensitivity reaction to insect stings or bites and cutaneous neoplasia. During the next 4 months, the mass enlarged involving the skin of the perineum and ventral aspect of the abdomen with secondary dependent edema of both hind limbs. Histologic examination of biopsy and necropsy specimens revealed changes consistent with a diagnosis of mycosis fungoides (cutaneous T-cell lymphoma). Diagnostic features included invasion of neoplastic lym...
Pericarditis in horses: 18 cases (1986-1995). To determine clinical signs of pericarditis in horses and to determine whether there were any relationships among clinical signs, echocardiographic findings, treatment, and outcome. Methods: Retrospective study. Methods: 18 horses. Results: Physical examination was performed on 16 horses. Cardiovascular abnormalities included tachycardia (n = 16), pericardial friction rub (10), venous distention (7), murmur (7), muffled heart sounds (6), weak arterial pulse (6), jugular pulse (6), and edema (5). Twelve horses also had respiratory abnormalities; the most common was dull lung sounds, ventrally, ...
Primary hyperparathyroidism with osteodystrophia fibrosa of the facial bones in a pony. A 17-year-old pony mare was admitted for evaluation of progressive enlargement of the facial bones during the preceding 9 months. Laboratory testing revealed that the pony had hypercalcemia, hypophosphatemia, high urinary fractional excretion of phosphorus, and high serum concentration of intact parathyroid hormone (185.1 pmol/L; reference range, 0.25 to 2.0 pmol/L). On the basis of these findings, a diagnosis of primary hyperparathyroidism was made by ruling out nutritional secondary hyperparathyroidism, chronic renal disease, and pseudohyperparathyroidism resulting from neoplasia. Although p...
Computed tomographic evaluation of comminuted middle phalangeal fractures in the horse. Comminuted fractures of the middle phalanx have been well described in the horse. Choice of treatment, surgical planning and prognosis have traditionally been based upon evaluation of radiographs. However, the complex nature of comminuted fractures makes radiographic interpretation difficult. Computed tomography (CT) allows the production of cross-sectional images with spatial separation of structures which are superimposed on survey radiographs. This allows accurate assessment of the number and direction of fracture lines within the bone. In this paper we report the use of CT in the evaluatio...
Hypereosinophilia in a horse with intestinal lymphosarcoma. Paraneoplastic eosinophilia is reported in dogs, cats, and humans. Hypereosinophilia (an eosinophil count greater than 1.5 x 10(9) L) is often associated with metastasis and a poor prognosis. This report describes a case of paraneoplastic hypereosinophilia in a pony. Neoplasia should be included in the differential diagnoses in a horse with eosinophilia.
Bacterial endocarditis in horses: ten cases (1984-1995). A retrospective study of 10 horses with bacterial endocarditis was performed in order to describe the echocardiographic findings in horses with bacterial endocarditis, in conjunction with clinical signs and post mortem findings, and to evaluate the usefulness and the formulation of a prognosis. Echocardiographic and post mortem examinations were performed in 7 horses. Post mortem examination alone was performed in 2 horses and echocardiographic examination alone performed in one horse. No breed or sex predilection was obvious. Mean age +/- s.d. was 2.12 +/- 3.32 years. Predominant clinical sig...
Superficial digital flexor tendonitis in thoroughbred race horses: outcome following non-surgical treatment and superior check desmotomy. This study documents the results of non-surgical treatment and treatment by superior check desmotomy in Thoroughbred racehorses with superficial digital flexor (SDF) tendonitis. Methods: A prospective study was made of 124 thoroughbred racehorses with unilateral or bilateral SDF tendonitis. Methods: The flexor tendons were assessed by physical and ultrasonographic examination before treatment, and the lesions detected in affected tendons were characterised according to lesion type, length and cross-sectional area. Ninety three horses were managed non-surgically and 31 by superior check desmoto...
Surgery of the small intestine. Although earlier reports describe a poor prognosis for small intestinal surgery in the horse, there is growing evidence that the short-term survival rate can exceed 80%. In addition to advancements in surgery and aftercare, early referral contributes considerably to the improved prognosis. Surgical procedures that restore anatomic and physiologic continuity to close to normal can minimize postoperative complications. Jejunojejunostomy carries a better prognosis than jejunocecostomy, probably because the latter involves anastomosis between two intestinal segments with dissimilar functions. Care...
Diseases and surgery of the large colon. Displacements and intraluminal obstructions of the large colon carry a good to excellent prognosis for long-term recovery, and surgery for these diseases is rarely followed by short-term or long-term complications. Entrapment of the large colon over the renosplenic ligament is amenable to medical therapies so that surgery can be avoided in many cases. However, preoperative diagnosis of all nonstrangulating diseases of the large colon can be difficult. Vascular diseases of the large colon, such as thromboembolic diseases and large colon volvulus, are more difficult to treat and carry a poorer p...
Management of rectal tears. Rectal tears have important medicolegal implications, and severe tears have a poor prognosis. Prompt diagnosis, immediate application of first aid measures, early referral, use of appropriate definitive treatments, and aggressive aftercare will improve the prognosis. The grade of rectal injury will determine the definitive treatment, but there are few guidelines to determine which treatment is best in each case. Bypass procedures, such as colostomy and indwelling rectal liner, have their own advantages and disadvantages, but can facilitate healing and prevent life-threatening complications if ...