CT diagnosis of pituitary abscess, suppurative meningitis, and atlanto-occipital septic arthritis in a pony.

The abstract describes a medical case in which a 15-year-old pony exhibited acute neurological symptoms. Using various diagnostic tests and imaging processes like CT scans, the vet clinicians found the pony had pituitary abscess, meningitis, and a severe joint infection in the skull and neck. The results provided insight into the pony’s condition and facilitated the hard decision to euthanize.

Background

• The research describes the diagnosis process of a pony presented with acute neurological signs. The pony was diagnosed with a pituitary abscess, meningitis, and septic arthritis in the atlanto-occipital joint. The atlanto-occipital joint is located between the base of the skull (occipital bone) and the first cervical vertebra (Atlas).

Procedural Details

• The team carried out a neurological examination, which hinted at a brainstem lesion. Subsequent blood laboratory tests detected an ongoing inflammatory process.
• An upper respiratory endoscopy, which visualizes the inside of the upper respiratory tract, pinpointed a suppurative lesion (a pus-filled wound) at the dorsal aspect of the right guttural pouch. Guttural pouches are air-filled sacs located on the sides of a horse’s head, connected to the Eustachian tubes.

Diagnostic Findings

• The next stage in the examination was a computed tomography (CT) scan. The images obtained from the CT scan lined up with the suspected conditions: pituitary abscess (a pus-filled infection in the pituitary gland located at the base of the brain), meningitis (the inflammation of the protective membranes covering the brain and spinal cord), and septic arthritis in the atlanto-occipital joint (a joint infection caused by bacteria).
• Post CT scan findings, the conjectured diagnosis was then confirmed through cultures of cerebrospinal and synovial fluid (the protective fluid present in joints) and a necropsy (an autopsy on animals).

Impact of CT Scan on Decision Making

• Computed tomography played a crucial role in this clinical case by providing vital information to identify the cause of the pony’s neurological signs.
• Without the CT scan findings, the precise diagnosis and hence the final decision made by the owner regarding euthanasia might not have been possible.