FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Vet Q / Development of two surgical approaches to the pituitary glan...
The veterinary quarterly2017; 38(1); 21-27; doi: 10.1080/01652176.2017.1415488

Development of two surgical approaches to the pituitary gland in the Horse.

Abstract: Current treatment of equine pituitary pars intermedia dysfunction (PPID) requires daily oral medication. Minimally invasive surgical palliation of this condition is appealing as a single treatment to alleviate the clinical signs of disease, dramatically improving the welfare of the horse. Objective: To develop a surgical approach to the equine pituitary gland, for subsequent treatment of PPID. Methods: A cadaver study to develop methodology and a terminal procedure under anaesthesia in the most promising techniques. Methods: Four surgical approaches to the pituitary gland were investigated in cadaver animals. A ventral trans-basispheniodal osteotomy and a minimally invasive intravenous approach via the ventral cavernous sinus progressed to live horse trials. Results: Technical complications prevented the myeloscopic and trans-sphenopalatine sinus techniques from being successful. The ventral basisphenoidal osteotomy was repeatable and has potential if an intra-operative imaging guidance system could be employed. The minimally invasive approach was repeatable, atraumatic and relatively inexpensive. Conclusions: A minimally invasive surgical approach to the equine pituitary gland is possible and allows for needle placement within the target tissue. More work is necessary to determine what that treatment might be, but repeatable access to the gland has been obtained, which is a promising step.
Get Full Text
Publication Date: 2017-12-09 PubMed ID: 29219746PubMed Central: PMC6831024DOI: 10.1080/01652176.2017.1415488Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article discusses the development of two innovative surgical approaches to treat equine pituitary pars intermedia dysfunction (PPID) in horses, which currently requires daily oral medication. The study presents a ventral trans-basispheniodal osteotomy and a minimally invasive intravenous approach as potential surgical treatments to improve the welfare of the horse.

Objective of the Research

  • The aim was to create surgical methods to access the horse’s pituitary gland, with a possibility to treat the PPID condition in the future. This came as an alternative to the daily oral medication currently being used.

Research Methods

  • The research started with cadaver studies to design proper methodology before progressing to live animal trials.
  • The researchers explored four different surgical procedures to the pituitary gland using cadaver animals.
  • The most promising techniques, the ventral trans-basispheniodal osteotomy and a minimally invasive intravenous approach via the ventral cavernous sinus, were tested on live horses.

Research Results

  • Technical difficulties encountered during the trial phase obstructed the success of the myeloscopic and trans-sphenopalatine sinus techniques.
  • The ventral basisphenoidal osteotomy showed promise and repeatability, indicating a potential for success if it’s paired with an intra-operative imaging guidance system during the process.
  • On the other hand, the minimally invasive intravenous approach proved repeatable, non-traumatic, and relatively cheaper compared to other methods.

Conclusion

  • The study concludes that a minimally invasive surgical approach to the equine pituitary gland is feasible, which allows for needle placement within the target tissue.
  • Though the research provides a promising step towards a viable surgical treatment for PPID, further development is needed to determine the exact treatment that could be applied after gland access is acquired.

Cite This Article

APA
Carmalt JL, Scansen BA. (2017). Development of two surgical approaches to the pituitary gland in the Horse. Vet Q, 38(1), 21-27. https://doi.org/10.1080/01652176.2017.1415488

Publication

The veterinary quarterly
ISSN: 1875-5941
NlmUniqueID: 7909485
Country: England
Language: English
Volume: 38
Issue: 1
Pages: 21-27

Researcher Affiliations

Carmalt, James L
  • a Department of Large Animal Clinical Sciences , Western College of Veterinary Medicine , University of Saskatchewan , Saskatoon , Canada.
Scansen, Brian A
  • b Department of Clinical Sciences , Colorado State University , Fort Collins , CO , USA.

MeSH Terms

  • Animals
  • Cadaver
  • Cushing Syndrome / surgery
  • Cushing Syndrome / veterinary
  • Horse Diseases / surgery
  • Horses
  • Minimally Invasive Surgical Procedures / methods
  • Minimally Invasive Surgical Procedures / veterinary
  • Pituitary ACTH Hypersecretion / surgery
  • Pituitary ACTH Hypersecretion / veterinary
  • Pituitary Diseases / surgery
  • Pituitary Diseases / veterinary
  • Pituitary Gland, Intermediate / surgery
  • Surgery, Veterinary / methods

References

This article includes 46 references
  1. Alexander SL, Irvine CH, Donald RA. Short-term secretion patterns of corticotropin-releasing hormone, arginine vasopressin and ACTH as shown by intensive sampling of pituitary venous blood from horses.. Neuroendocrinology 1994 Sep;60(3):225-36.
    pubmed: 7969780doi: 10.1159/000126755google scholar: lookup
  2. Alexander SL, Irvine CH, Donald RA. Dynamics of the regulation of the hypothalamo-pituitary-adrenal (HPA) axis determined using a nonsurgical method for collecting pituitary venous blood from horses.. Front Neuroendocrinol 1996 Jan;17(1):1-50.
    pubmed: 8788568doi: 10.1006/frne.1996.0001google scholar: lookup
  3. Allen JR, Barbee DD, Boulton CR, Major MD, Crisman MV, Murnane RD. Brain abscess in a horse: diagnosis by computed tomography and successful surgical treatment.. Equine Vet J 1987 Nov;19(6):552-5.
    pubmed: 3504767doi: 10.1111/j.2042-3306.1987.tb02672.xgoogle scholar: lookup
  4. Benredouane K, Lepage O. Trans-arterial coil embolization of the internal carotid artery in standing horses.. Vet Surg 2012 Apr;41(3):404-9.
    pubmed: 22224979doi: 10.1111/j.1532-950x.2011.00918.xgoogle scholar: lookup
  5. Biller BM, Grossman AB, Stewart PM, Melmed S, Bertagna X, Bertherat J, Buchfelder M, Colao A, Hermus AR, Hofland LJ, Klibanski A, Lacroix A, Lindsay JR, Newell-Price J, Nieman LK, Petersenn S, Sonino N, Stalla GK, Swearingen B, Vance ML, Wass JA, Boscaro M. Treatment of adrenocorticotropin-dependent Cushing's syndrome: a consensus statement.. J Clin Endocrinol Metab 2008 Jul;93(7):2454-62.
    pmc: PMC3214276pubmed: 18413427doi: 10.1210/jc.2007-2734google scholar: lookup
  6. Bons J, Cornips E, Zwam W van, Schaper N, Menheere P. ACTH measurements during surgery for Cushing's disease: a feasibility study. 2014.
  7. Budu V, Mogoantă CA, Fănuţă B, Bulescu I. The anatomical relations of the sphenoid sinus and their implications in sphenoid endoscopic surgery.. Rom J Morphol Embryol 2013;54(1):13-6.
    pubmed: 23529304
  8. Cappabianca P, Cavallo LM, Solari D, Stagno V, Esposito F, de Angelis M. Endoscopic endonasal surgery for pituitary adenomas.. World Neurosurg 2014 Dec;82(6 Suppl):S3-11.
    pubmed: 25496632doi: 10.1016/j.wneu.2014.07.019google scholar: lookup
  9. Cornelisse CJ, Schott HC 2nd, Lowrie CT, Rosenstein DS. Successful treatment of intracranial abscesses in 2 horses.. J Vet Intern Med 2001 Sep-Oct;15(5):494-500.
    pubmed: 11596739doi: 10.1892/0891-6640(2001)015<0494:stoiai>2.3.co;2google scholar: lookup
  10. Edwards GB, Greet T. Disorders of the guttural pouches (Auditory tube diverticuli). 2007; In: McGorum BC, Dixon PM, Robinson NE, Schumacher J, editors. Equine respiratory medicine and surgery. St. Louis: (MO: ): Elsevier Saunders; p. 419–436.
  11. Freeman DE, Donawick WJ. Occlusion of internal carotid artery in the horse by means of a balloon-tipped catheter: clinical use of a method to prevent epistaxis caused by guttural pouch mycosis.. J Am Vet Med Assoc 1980 Feb 1;176(3):236-40.
    pubmed: 7364634
  12. Freeman DE. Guttural pouch. 1992; In: Auer JA, editor. Equine surgery. Philadelphia: (PA: ): W.B. Saunders; p. 480–488.
  13. Fulton IC, Anderson BH, Stick JA, Robertson JT. Larynx. 2012; In: Auer JA, Stick JA, editors. Equine surgery. 4th ed.St. Louis: (MO: ): Elsevier Saunders; p. 592–623.
  14. Garm O. Luftposeempyemer og deres behandling. Skand. Vet. Tidskr. 1946;26:401–423.
  15. Irvine CH, Alexander SL. A novel technique for measuring hypothalamic and pituitary hormone secretion rates from collection of pituitary venous effluent in the normal horse.. J Endocrinol 1987 May;113(2):183-92.
    pubmed: 3585231doi: 10.1677/joe.0.1130183google scholar: lookup
  16. Irvine CH, Hunn R. Long term collection of pituitary venous blood in the unrestrained horse. NZ Med J. 1984;97:735.
  17. Jane JA Jr, Han J, Prevedello DM, Jagannathan J, Dumont AS, Laws ER Jr. Perspectives on endoscopic transsphenoidal surgery.. Neurosurg Focus 2005 Dec 15;19(6):E2.
    pubmed: 16398479doi: 10.3171/foc.2005.19.6.3google scholar: lookup
  18. Janicek JC, Kramer J, Coates JR, Lattimer JC, Lacarrubba AM, Messer NT. Intracranial abscess caused by Rhodococcus equi infection in a foal.. J Am Vet Med Assoc 2006 Jan 15;228(2):251-3.
    pubmed: 16426201doi: 10.2460/javma.228.2.251google scholar: lookup
  19. Jindal G, Gemmete J, Gandhi D. Interventional neuroradiology applications in otolaryngology, head and neck surgery.. Otolaryngol Clin North Am 2012 Dec;45(6):1423-49.
    pubmed: 23153756doi: 10.1016/j.otc.2012.08.010google scholar: lookup
  20. Joshi SM, Cudlip S. Transsphenoidal surgery.. Pituitary 2008;11(4):353-60.
    pubmed: 18369724doi: 10.1007/s11102-008-0094-6google scholar: lookup
  21. Kaiser UB. Cushing's disease: towards precision medicine.. Cell Res 2015 Jun;25(6):649-50.
    pmc: PMC4456621pubmed: 25930709doi: 10.1038/cr.2015.53google scholar: lookup
  22. Kasemsiri P, Carrau RL, Ditzel Filho LF, Prevedello DM, Otto BA, Old M, de Lara D, Kassam AB. Advantages and limitations of endoscopic endonasal approaches to the skull base.. World Neurosurg 2014 Dec;82(6 Suppl):S12-21.
    pubmed: 25496622doi: 10.1016/j.wneu.2014.07.022google scholar: lookup
  23. Kelly MA. Managing a Pet's chronic illness: factors that influence psychosocial adjustment. 2014; [PhD thesis]. Chicago (IL): University of Illinois.
  24. Kramer J, Coates JR, Hoffman AG, Frappier BL. Preliminary anatomic investigation of three approaches to the equine cranium and brain for limited craniectomy procedures.. Vet Surg 2007 Jul;36(5):500-8.
    pubmed: 17614932doi: 10.1111/j.1532-950x.2007.00297.xgoogle scholar: lookup
  25. Lau D, Rutledge C, Aghi MK. Cushing's disease: current medical therapies and molecular insights guiding future therapies.. Neurosurg Focus 2015 Feb;38(2):E11.
    pubmed: 25639313doi: 10.3171/2014.10.focus14700google scholar: lookup
  26. Leitenbacher J, Herbach N. Age-related Qualitative Histological and Quantitative Stereological Changes in the Equine Pituitary.. J Comp Pathol 2016 Feb-Apr;154(2-3):215-24.
    pubmed: 26810844doi: 10.1016/j.jcpa.2015.11.006google scholar: lookup
  27. Lepage OM, Piccot-Crézollet C. Transarterial coil embolisation in 31 horses (1999-2002) with guttural pouch mycosis: a 2-year follow-up.. Equine Vet J 2005 Sep;37(5):430-4.
    pubmed: 16163945doi: 10.2746/042516405774479960google scholar: lookup
  28. Locatelli A. Destruction in-situ of the horse pituitary-gland by laser ray. Bulletin de l'Académie vétérinaire de France 1984;57:171–176.
  29. Mamelak AN, Owen TJ, Bruyette D. Transsphenoidal surgery using a high definition video telescope for pituitary adenomas in dogs with pituitary dependent hypercortisolism: methods and results.. Vet Surg 2014 May;43(4):369-79.
    pubmed: 24467302doi: 10.1111/j.1532-950x.2014.12146.xgoogle scholar: lookup
  30. Matsuda Y, Nakanishi Y, Mizuno Y. Occlusion of the internal carotid artery by means of microcoils for preventing epistaxis caused by guttural pouch mycosis in horses.. J Vet Med Sci 1999 Mar;61(3):221-5.
    pubmed: 10331192doi: 10.1292/jvms.61.221google scholar: lookup
  31. McAllister ES. Guttural pouch disease. 1978; In: Proceedings of the Annual Convention of AAEP. Vol. 23 p. 251–258.
  32. McClellan NR, Mudge MC, Scansen BA, Jung SS, Russell D. Coil embolization of a palatine artery pseudoaneurysm in a gelding.. Vet Surg 2014 May;43(4):487-94.
    pubmed: 24702505doi: 10.1111/j.1532-950x.2014.12174.xgoogle scholar: lookup
  33. McFarlane D. Equine pituitary pars intermedia dysfunction.. Vet Clin North Am Equine Pract 2011 Apr;27(1):93-113.
    pubmed: 21392656doi: 10.1016/j.cveq.2010.12.007google scholar: lookup
  34. McIlwraith CW, Turner AS. Equine surgery: advanced techniques. 1987; Philadelphia: (PA: ): Lea & Febiger.
  35. Meij BP, Voorhout G, van den Ingh TS, Hazewinkel HA, Teske E, Rijnberk A. Results of transsphenoidal hypophysectomy in 52 dogs with pituitary-dependent hyperadrenocorticism.. Vet Surg 1998 May-Jun;27(3):246-61.
    pubmed: 9605236doi: 10.1111/j.1532-950x.1998.tb00123.xgoogle scholar: lookup
  36. Miller BA, Ioachimescu AG, Oyesiku NM. Contemporary indications for transsphenoidal pituitary surgery.. World Neurosurg 2014 Dec;82(6 Suppl):S147-51.
    pubmed: 25496626doi: 10.1016/j.wneu.2014.07.037google scholar: lookup
  37. Millington WR, Dybdal NO, Dawson R Jr, Manzini C, Mueller GP. Equine Cushing's disease: differential regulation of beta-endorphin processing in tumors of the intermediate pituitary.. Endocrinology 1988 Sep;123(3):1598-604.
    pubmed: 2456916doi: 10.1210/endo-123-3-1598google scholar: lookup
  38. Prange T, Derksen FJ, Stick JA, Garcia-Pereira FL. Endoscopic anatomy of the cervical vertebral canal in the horse: a cadaver study.. Equine Vet J 2011 May;43(3):317-23.
    pubmed: 21492209doi: 10.1111/j.2042-3306.2010.00170.xgoogle scholar: lookup
  39. Prange T, Carr EA, Stick JA, Garcia-Pereira FL, Patterson JS, Derksen FJ. Cervical vertebral canal endoscopy in a horse with cervical vertebral stenotic myelopathy.. Equine Vet J 2012 Jan;44(1):116-9.
    pubmed: 21696435doi: 10.1111/j.2042-3306.2011.00395.xgoogle scholar: lookup
  40. Prange T, Derksen FJ, Stick JA, Garcia-Pereira FL, Carr EA. Cervical vertebral canal endoscopy in the horse: intra- and post operative observations.. Equine Vet J 2011 Jul;43(4):404-11.
    pubmed: 21496080doi: 10.1111/j.2042-3306.2010.00310.xgoogle scholar: lookup
  41. Sakes A, Arkenbout EA, Jelínek F, van der Kolk JH, Breedveld P. Design of an endovascular morcellator for the surgical treatment of equine Cushing's disease.. Vet Q 2015;35(3):165-9.
    pubmed: 25946649doi: 10.1080/01652176.2015.1047676google scholar: lookup
  42. Thompson RJ, Gustafson KE. Adaptation to chronic illness. 1996; Washington: (DC: ): American Psychological Association.
  43. van der Kolk JH, Heinrichs M, van Amerongen JD, Stooker RC, in de Wal LJ, van den Ingh TS. Evaluation of pituitary gland anatomy and histopathologic findings in clinically normal horses and horses and ponies with pituitary pars intermedia adenoma.. Am J Vet Res 2004 Dec;65(12):1701-7.
    pubmed: 15631037doi: 10.2460/ajvr.2004.65.1701google scholar: lookup
  44. Vanschandevijl K, Gielen I, Nollet H, Vlaminck L, Deprez P, van Bree H. Computed tomography-guided brain biopsy for in vivo diagnosis of a cholesterinic granuloma in a horse.. J Am Vet Med Assoc 2008 Sep 15;233(6):950-4.
    pubmed: 18795858doi: 10.2460/javma.233.6.950google scholar: lookup
  45. Vitums A. Observations on the equine hypophysial protal system.. Zentralbl Veterinarmed C 1975 Jun;4(2):149-61.
    pubmed: 1166718doi: 10.1111/j.1439-0264.1975.tb00633.xgoogle scholar: lookup
  46. Vitums A. Development of the venous drainage of the equine hypophysis cerebri.. Anat Histol Embryol 1978 Jun;7(2):120-8.
    pubmed: 151511doi: 10.1111/j.1439-0264.1978.tb00662.xgoogle scholar: lookup

Citations

This article has been cited 1 times.
  1. de Preux M, Precht C, Guevar J, Graubner C, Thenhaus-Schnabel S, Buser L, Lukes A, Koch C. A transmandibular lateral transsphenoidal navigated surgical approach to access a pituitary macroadenoma in a warmblood mare. Vet Q 2024 Dec;44(1):1-10.
    doi: 10.1080/01652176.2023.2300947pubmed: 38393300google scholar: lookup
Subscribe to our newsletter
Join 99,344 horse owners like you who receive our email updates on horse health and nutrition.