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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.
Analysis of hemostasis in horses with colic. Eight tests of hemostasis were measured in 233 horses with colic. Blood samples were obtained at admission and for 4 consecutive days of hospitalization. Data were analyzed retrospectively by outcome, by broad-category diagnosis group, by small intestinal disorder, and by smaller categories for comparing specific diseases. Nonsurviving horses and horses with the most severe forms of intestinal ischemia had changes interpreted as hypercoagulative, the intensity of which was increased on the first and second mornings (sample times 2 and 3) after admission, when most significant differences for r...
Extensor tendon lacerations in horses: 50 cases (1982-1988). Medical records of 50 horses with extensor tendon lacerations affecting 53 limbs over 7 years (1982 to 1988) were reviewed to determine the clinical features and prognosis for athletic soundness after treatment. Mean and median ages were 4.8 and 3 years, respectively. Eighty-nine percent of the injuries involved the hind limbs, with approximately equal distribution between the right and left limbs. Hind limb lacerations involved the long digital extensor tendon (28 limbs), lateral digital extensor tendon (3 limbs), or both tendons (16 limbs). Forelimb lacerations involved the common digital ex...
Peritonitis in horses: 67 cases (1985-1990). Peritonitis was diagnosed in 67 horses between 1985 and 1990: 14 horses developed septic peritonitis after intestinal rupture, 25 horses developed peritonitis after abdominal surgery, and 28 horses had peritonitis not associated with intestinal rupture or abdominal surgery. Forty of 67 horses (59.7%) did not survive. Nonsurvivors had higher heart rates (P = 0.01), RBC count (P = 0.039), serum creatinine concentration (P = 0.036), PCV (P = 0.007), and anion gap (P = 0.005); lower venous blood pH (P = 0.002); and a greater number of bacterial species cultured from peritoneal fluid samples (P = 0...
Factors affecting the clinical outcome of injuries to the superficial digital flexor tendon in National Hunt and point-to-point racehorses. Ultrasonographic examination was used to define the severity of injuries to the superficial digital flexor tendon in 73 National Hunt or point-to-point racehorses and the factors influencing the outcome of the cases were examined. Thirty-four of the horses (46 per cent) returned to work with an average time out of training of 13.5 months. The rate of recurrence of the injury was 35 per cent. The severity of the lesions was related to the outcome; all the mildly affected horses returned to work, with 63 per cent of them racing and an average time out of training of 10.2 months; 50 per cent of t...
Conservative management of femoral diaphyseal fractures in four foals. Femoral fractures in young horses can occur as a result of severe trauma and generally have a poor prognosis despite treatment. Four young horses with femoral diaphyseal fractures were managed with conservative treatment consisting of prolonged rest, analgesics, hind limb support, and corrective farriery. A favorable outcome in the form of pasture soundness with potential for limited athletic usefulness was obtained in 3 out of the 4 cases. This report supports the use of conservative treatment of selected diaphyseal femoral fractures in young horses.
Neoplasia. Equine tumors are rather uncommon; however, of the body regions, the head is a relatively common location for neoplasia, including sarcoids and squamous cell carcinomas of the skin, tumors of the sinus/nasal cavity, and bony tumors of the head. Tumors discussed in the article include odontogenic and bony tumors; sarcoids; tumors of the guttural pouch and pharyngeal and oral mucosa; tumors of the larynx; and tumors of the paranasal sinuses and nasal passages. In general, tumors involving deeper structures of the head carry a poor prognosis; however, some tumors such as sarcoids, ossifying fibro...
Equine Cushing’s disease. In the horse, adenomata of the pairs intermedia of the pituitary gland have been associated with the distinct clinical entity of Cushing's disease which arises largely as a result of excessive secretion of adrenocorticotropin (ACTH) or other proopiomelanocortin (POMC) peptides. Pars intermedia peptide secretion is under dopaminergic control and compounds such as pergolide or bromocriptine, which are dopamine agonists, can palliate the clinical signs. A variety of endocrinological abnormalities, relevant to both pathogenesis and diagnosis, may be demonstrated in equine Cushing's disease, includ...
A retrospective evaluation of laminitis in horses. Case records of 202 horses treated for laminitis were reviewed with the intent of determining the long-term outcome and correlating this with digital radiographic findings and with the degree of pain associated with the laminitis. At long-term follow-up 57 horses had returned to athletic soundness (Group 1), 20 horses were intermittently lame (Group 2), 19 horses had permanent severe lameness (Group 3), 97 were dead (Group 4), and 9 were lost to follow up. Using simple regression analysis, functional outcome did not correlate with the degree of rotation (R2 = 0.004) or the presence of distal d...
Incarceration of the small intestine in the epiploic foramen. Report of 19 cases (1983-1992). The medical records of 19 horses referred for colic and subsequently found (18 confirmed, 1 suspected) to have small intestinal incarceration through the epiploic foramen were reviewed. These horses were of various ages and breeds; they had clinical signs of colic for an average duration of 13.5 hours before examination. Seventeen horses had nasogastric reflux, and 15 had palpable small intestinal distention. Three horses were killed during surgery because of severe intestinal damage. Of the remaining 16 horses, 13 required intestinal resection and anastomosis. The length of incarcerated small...
Small intestinal incarceration through the lateral ligament of the urinary bladder in a horse. Small intestinal incarceration through the lateral ligament of the urinary bladder was diagnosed in a 14-year-old, 569-kg, castrated Quarter Horse. The incarceration was corrected by ventral midline celiotomy. Approximately 70 cm of the middle portion of the jejunum was resected and end-to-end, single-layer anastomosis was performed. After surgery, the horse developed signs of adynamic ileus and lameness in the right forelimb. The horse developed laminitis in all 4 feet within 24 hours of surgery. The horse was euthanatized because of poor prognosis for survival. At necropsy, a 4.5-cm rent was...
Ocular trauma. Horses with ocular trauma frequently present as emergency cases. This article provides a succinct review of various adnexal and globe injury issues. Accurate case assessment, management, prognosis, and follow-up considerations are presented.
Ocular neoplasia. Except for two neoplasms, notably SCC and sarcoid, ocular and periocular tumors are uncommon in horses. The practitioner must accurately determine the type of tumor by histopathology so appropriate treatment and a legitimate prognosis can be offered. The first attempt at treatment has the greatest chance to result in a cure; an aggressive treatment regimen therefore should be selected from the start.
Prognostic indicators for horses with duodenitis-proximal jejunitis. 75 horses (1985-1989). The medical records of 75 horses with duodenitis-proximal jejunitis (DPJ) were reviewed. Ages, physical parameters, laboratory values, and treatment data were compared between horses surviving DPJ and horses not surviving DPJ (Table 1). Fifty of 75 horses (66.6%) survived. Sixty-six horses (88.0%) were managed with medical treatment alone and nine horses (12.0%) were managed with medical treatment plus surgical intervention. Using a logistic regression model, the association of each of the 19 physical and laboratory parameters with death was evaluated retrospectively in the 75 horses. Three pa...
[B-mode, M-mode and Doppler sonographic findings in mitral valve insufficiency of horses]. B- and M-mode echocardiography was performed on 38 horses. 34 patients had systolic heart murmur with the point of maximal intensity over mitral valve. Additionally, 17 of these patients were examined with the pulsed wave doppler echocardiography (Vingmed 200). In 26 patients with cardiac murmur and in 4 patients without cardiac murmur a mitral valve insufficiency was diagnosed by echocardiography. In 8 horses with a systolic murmur over mitral valve M- and B-mode evaluation could not reveal a haemodynamic importance of the murmur. The diagnosis of MVI was based on a dilation of left atrium wi...
Open drainage, intra-articular and systemic antibiotics in the treatment of septic arthritis/tenosynovitis in horses. Open drainage was used to treat 26 horses with persistent or severe septic arthritis/tenosynovitis. Infected synovial structures were drained through a small (3 cm) arthrotomy incision that was left open and protected by a sterile bandage. Joint lavage was performed in all 26 horses. In addition to systemic antibiotics, 23 of these horses were also treated with intra-articular antibiotics; amikacin (17 horses), gentamycin (2 horses), cefazolin (2 horses), and 2 horses were injected at different times with gentamycin and amikacin. The infection was eliminated from the involved synovial structur...
Stabilization of a proximal femoral physeal fracture in a filly by use of cancellous bone screws. A Salter-Harris type-II fracture of the proximal portion of the right femur in a 2-month-old filly was reduced and stabilized with three 6.5-mm-diameter, 100-mm-long cancellous bone screws through a dorsal approach to the right coxofemoral joint. The screws were removed after 11 months because the filly became lame in the affected limb. The surgical wounds dehisced despite preventive measures, most likely because of tightness of skin in the coxal region. Seven years after the original injury, the horse could perform vigorous paddock exercise without any disability. Early internal fixation of p...
Chronic obstructive pulmonary disease: Usefulness of clinical signs, bronchoalveolar lavage, and lung biopsy as diagnostic and prognostic aids. We examined 18 horses with clinical signs of chronic obstructive pulmonary disease (COPD) using physical examination, cytological and bacteriological evaluation of bronchoalveolar fluid, and percutaneous lung biopsy. In 16 cases, histological examination of lung tissue confirmed the diagnosis of COPD. Two horses were excluded: one had uncomplicated bacterial pneumonia and in the other a satisfactory lung biopsy could not be obtained. In horses with COPD, the most common historical complaint was coughing, which was reported in 88%. The most frequently detected abnormal finding on physical exami...
Resection and anastomosis for treatment of strangulating volvulus of the large colon of horses. Strangulating volvulus of the large colon was treated by resection and anastomosis of the colon in 9 horses. Tissue specimens were obtained at the site of the resection for histologic evaluation. An attempt was made to correlate the appearance of the colon at the time of surgery to the histologic evaluation and the eventual outcome. Six of the 9 horses (66%) survived. This is in contrast to a reported survival of 34.7 to 36% after decompression and reduction of colonic volvulus. Survival after surgery could not be predicted on the basis of visual assessment or histologic examination.
Medical evaluation of the eye relevant to purchase. Performance and pleasure horses depend upon their ability to see and assess the environment. Thus, the veterinarian must be able to examine the eyes and recognize abnormalities so that the owner or purchaser can be informed about the visual status and prognosis for the horse's vision. If the veterinarian encounters suspicious or abnormal findings during the examination, a more detailed examination and/or referral to a veterinary ophthalmologist can be recommended to the owner or purchaser.
[A horse with osteochondrosis. Now what?]. Based on three clinical cases, the history and the clinical and radiological aspects of osteochondrosis in horses are discussed. The prognosis, therapy and consequences with regard to athletic soundness and use for breeding are described.
Cryptococcosis in seven horses. The clinical, radiographic and post-mortem findings in 6 horses with cryptococcal pneumonia and one horse with an abdominal cryptococcal granuloma are described. In pulmonary cryptococcosis, the lesions were either diffuse and multiple, with bilateral lung involvement, or localised mainly to the dorsocaudal region of one lung. The cases of diffuse multiple cryptococcosis were thought to be associated with haematogenous spread of the fungus after gastrointestinal infection and dissemination from regional lymph nodes. The localised form of the disease was thought to have been associated with inh...
[Weak viability syndrome in newborn foals. Retrospective studies of the etiological clarification and chance for recovery]. This review of therapeutic results involved 115 foals with delayed viability syndrome (DVS). The foals were up to four days old. It could be shown that prognosis quoad vitam depended very much on the severity of illness, which could be determined primarily by the foals' ability to stand (SA) and secondly by the presence of the suckling reflex (SR). Those foals that were (still) able to stand--while the suckling reflex was/was not present (anymore) (SA+, SR+; SA+, SR-)--had good prospects of recovery regardless of the causal disease. The chances for survival were significantly poorer if the foa...
Immunotherapy of periocular squamous cell carcinoma with metastasis in a pony. A 5-year-old Pony of America mare was referred for evaluation of inflamed upper and lower right eyelids. Squamous cell carcinoma of the eyelids and ulcerative keratitis secondary to self-trauma were diagnosed. Initial treatment of the eyelid neoplasia with 2 applications of cryotherapy failed to resolve the lesions, and immunotherapy with bacillus of Calmette-Guerin (BCG) was instituted. Multiple injections of BCG over a 17-week period resulted in progressive shrinkage of the tumor mass, but regional metastasis to the ipsilateral submandibular lymph node occurred. Six months later, ocular neop...
Long-term effects of desmotomy of the accessory ligament of the deep digital flexor muscle in standardbreds: 23 cases (1979-1989). Desmotomy of the accessory ligament of the deep digital flexor muscle (inferior check desmotomy) permitted Standardbred foals affected with flexural deformities to reach their full athletic potential. Long-term effects of inferior check desmotomy were examined in 23 Standardbreds over a 10-year period. Six of 11 foals that were treated surgically either raced 6 times and obtained a race record or were training sound (if yearlings). All 12 horses with flexural deformity that did not receive an inferior check desmotomy had an unfavorable outcome (no race record). Foals that had surgery performed...
Prognostic variables for survival of neonatal foals under intensive care. The costly nature of intensive care for neonatal foals prompted a study of predictive variables for survival in a referral hospital. Applying stepforward logistic regression to parameters that differed significantly (P less than 0.10) between survivors (S) and nonsurvivors (NS) in a retrospective study (n = 56), two variables retained statistical significance [anion gap (AG, P = 0.0047) and venous PO2 (PvO2, P = 0.0342)], thus forming the basis for a predictive equation for survival: the Pn (probability of NS) = eA/(1 + eA) where A = -1.46 - 0.107 (PvO2) + 0.213 (AG). The predictive equation w...
Persistent thrombocytopenia in a case of equine infectious anemia. Persistent thrombocytopenia was detected in a horse with equine infectious anemia (EIA). The thrombocytopenia was considered to be immune-mediated, developing secondary to infection with EIA virus. Epistaxis, petechial hemorrhages, subcutaneous hematomas, and edema resolved after treatment with corticosteroids; however, the owners requested that the mare by euthanatized because of infection with EIA virus. Although clinical signs attributable to immune-mediated thrombocytopenia may resolve with appropriate treatment, horses with immune-mediated thrombocytopenia secondary to EIA have a guarded ...
Cytology of polychrome-stained equine synovial fluid smears. Comparison with clinical findings, histologic specimens, Wright-Giemsa-stained smears and outcome. Polychrome-stained equine synovial fluid specimens from 34 normal joints and 129 joints with clinical abnormalities were examined cytologically. The smears from joints with abnormalities were categorized as within normal limits (4.7%), slight abnormality (27.9%), proliferative synovitis (21.7%), neutrophilic pattern (20.2%), elongated cell pattern (10.1%), other moderate to marked abnormality (11.6%) and unsatisfactory (3.9%). Cytologic abnormalities that were not restricted to a single category included spindle cells, crystals, stellate cells and cartilage fragments. Multinucleate cells and m...
Racing performance of Thoroughbred horses after arthroscopic surgery of the carpus. The case record, and subsequent racing performance, of 110 horses that had undergone arthroscopic surgery of the carpus, were reviewed. Of these, 87% resumed racing, with 43% able to win at least one race, after surgery. Horses with chip fractures from the distal radius had the best prognosis, while horses with sagittal fractures of the third carpal bone had the poorest. The performance of horses with bilateral lesions was similar to those with unilateral lesions. It was concluded that arthroscopic surgery was a suitable technique for the diagnosis and treatment of carpal lesions in the horse....
Nuclear imaging techniques for equine respiratory disease. When performed on selected clinical cases, ventilation/perfusion scintigraphy provides valuable additional information on regional lung function that is not obtainable from conventional thoracic radiographs. This is particularly true of horses with EIPH, COPD, and those suspected of having some form of small-airway disease. For horses with EIPH, the presence of a perfusion deficit on the scan is considered a key prognostic sign, because it is likely in these cases that irreversible bronchial arterial takeover has occurred in the affected areas of lung. Findings from horses with COPD have impro...
