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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.
Surface oximetry for intraoperative assessment of colonic viability in horses. Surface oximetry was used to evaluate viability of the ascending colon in 60 horses with naturally occurring colonic volvulus or displacement. Tissue surface oxygen tension (PsO2) was measured on the serosal surface of the pelvic flexure after anatomic correction of the colonic obstruction. Horses with PsO2 > 20 mm of Hg were predicted to have viable colon; whereas, horses with PsO2 < or = 20 mm of Hg were predicted to have nonviable colon. Results of surface oximetry were compared with final outcome. For surface oximetry, sensitivity (ability to accurately identify colon that was nonvia...
[Prognostic parameters in equine colic]. A retrospective study was performed on 271 horses with colic referred to the I. Medizinische Tierklinik within a period of 2 years, to examine the prognostic value of different clinical and diagnostic laboratory parameters by Student's t-test and the Chi-quadratic test. The following quantitative parameters presented a highly significant prognostic value (P < 0.0001): capillary refill time, pulse rate, heart rate, respiratory rate, hematocrit, hemoglobin concentration, blood lactate, base excess and anion gap. The intensity of colic signs, the degree of disturbance of the patient's gen...
Arthroscopic removal of a fragment from an intercondylar eminence fracture of the tibia in a two-year-old horse. A 2-year-old Standardbred colt was admitted because of lameness of the left hind limb. Physical examination revealed marked effusion of the left femoropatellar and femorotibial joints and grade IV/V lameness of the left hind limb. Radiography of the left stifle revealed a complete fracture of the medial tubercle of the intercondylar eminence of the tibia. Arthroscopy was used to provide diagnostic, therapeutic, and prognostic information. A cranial approach to the medial compartment of the femorotibial joint was performed. Manipulation of the medial tubercle revealed it to be unstable, but a d...
Ultrasonographic evaluation and long-term follow-up of flexor tendonitis/desmitis in the metacarpal/metatarsal region in Dutch warmblood horses and standardbred racehorses. Over a 2 year-period, the ultrasonographic localization and distribution of flexor tendinous and ligamentous injuries, the long-term follow-up, and the outcome were studied in 101 Dutch Warmblood horses (DW) with a mean age of 8.7 years and in 71 Standardbred racehorses (ST) with a mean age of 5.2 years. The ratio between forelimb and hind limb flexor tendonitis/desmitis in the DW-group was 4:1 and in the ST-group group 4:3. In the DW-group, tendonitis/desmitis of the suspensory ligament (32%), the superficial digital flexor tendon (29%), the distal carpal check ligament (17%) of the forelimb ...
Update on neonatal septicemia. Septicemia is the second most commonly diagnosed problem in the equine neonate, superseded only by the problem of inadequate transfer of maternal antibodies. This article reviews the factors that may put a foal at high risk for developing sepsis, the diagnostic tools used to identify these animals, some of the sequelae of sepsis, and the therapeutic modalities available to the clinician.
Blood cell deformability in horses with intestinal colic. Hematologic and rheologic variables were examined in a group of 13 horses with intestinal colic and a control group of 6 horses. All horses had been recently transported to the veterinary teaching hospital, and blood samples were obtained during initial examination. There were no significant differences in blood neutrophil count or plasma fibrinogen concentration between the groups, and PCV was significantly increased in horses with intestinal colic. Cell filterability was measured by passing uniform concentrations of blood, erythrocytes, and neutrophils through micropore filters. There were n...
Tetanus in the horse: a review of 20 cases (1970 to 1990). The case records of 20 horses with tetanus referred to the Ontario Veterinary College-Veterinary Teaching Hospital between 1970 and 1990 were reviewed. The fatality rate was 75%. There was a strong association with previous vaccination and survival (P = .03). Most of the animals had been injured an average of 9 days (range 2 to 21 days) prior to development of clinical signs. Hyperesthesia and prolapse of the third eyelid were the most common clinical signs. Treatment regimens varied during hospitalization; however, all horses received parenteral penicillin, tranquilizers, tetanus toxoid, and ...
Clinical use and characteristics of the corticosteroids. Corticosteroids possess potent anti-inflammatory activity and are commonly injected intra-articularly for local relief of inflammatory lesions in performance horses. However, the suppression of anabolic activity in the joint may lead to an increased rate of joint breakdown. Complications associated with intra-articular corticosteroid therapy include septic arthritis, which is usually due to inadvertent joint contamination at the time of corticosteroid injection, and steroid arthropathy, which is characterized by an accelerated rate of joint destruction and radiographic evidence of severe degen...
Articular fracture of the dorsoproximolateral aspect of the third metatarsal bone in five standardbred racehorses. Articular fracture of the dorsoproximolateral aspect of the third metatarsal bone (MT3) caused an acute onset of lameness in 5 horses; however, 3 of the horses had historical and radiographic or scintigraphic evidence of chronic tarsal and metatarsal disease before fracture. The pathogenesis of dorsoproximolateral fracture of MT3 remains unclear, but the fracture may occur as a result of the formation of abnormal bone in the proximal aspect of MT3. The prognosis for racing in horses with this fracture appears to be guarded.
Plasma endotoxin concentrations in clinically normal and potentially septic equine neonates. Plasma endotoxin concentrations were measured at 1 to 2 and 5 to 6 days of age in clinically normal foals and in potentially septic neonatal foals admitted to North Carolina State University's Veterinary Teaching Hospital for a variety of conditions. In 1 to 2 and 5 to 6 day old normal foals, median plasma endotoxin concentrations were 2.17 (range, 1.61-2.54; n = 6) and 2.89 (range, 2.61-3.50; n = 7) endotoxin units/mL (EU/mL), respectively. Median plasma endotoxin concentration in potentially septic foals with negative blood cultures or gram positive isolates (n = 8) was 2.73 (range, 0.59-4.0...
Desmitis of the accessory ligament of the deep digital flexor tendon in the horse: clinical and ultrasonographic features. A report of 24 cases. The clinical and ultrasonographic features of desmitis of the accessory ligament of the deep digital flexor tendon (carpal check ligament) are reported in a series of 24 horses. Lameness associated with the carpal check ligament especially was found in Warmblood riding horses ranging in age from 6 to 18 years with a mean age of 11.3 years. The most striking clinical feature was a firm, painful swelling medially and laterally in the proximal and/or mid metacarpal region, corresponding with the dorsoproximal-palmarodistal oblique direction of the carpal check ligament. Sonographically swelling o...
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...
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...
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.
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...
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.
