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Case of the week  !!!

The last case listed below has been on for so long it may have been better to call it the case of the decade.

Case Study One:  

Goulburn Valley Equine Hospital deals with several thousand horses each year. As such, many horses present with unusual and rare disorders. On this page we will keep you updated with some of the more interesting cases.

A 19-year-old Thoroughbred gelding presented with sudden onset, non-weight bearing lameness in the right hind limb.

 What is your diagnosis and how would you treat this animal?  

Radiography confirmed distal luxation of the patella. The patella was replaced into its normal anatomical location under general anaesthesia.  To our knowledge, this is a rare manifestation of patellar luxation, only reported once previously in the equine literature. The animal was discharged from hospital and is sound at the trot 9 months after initial injury. 

Case Study Two:
A 6-month-old thoroughbred colt was presented for a slow-growing, palpable mass on the lateral aspect of the left stifle.

Ultrasonographic examination indicated that the mass was not associated with any supporting structures.  It was decided that this mass should be surgically removed.

 The mass was removed ‘en bloc’ and sent for histopathological examination. A vascular hamartoma was diagnosed.  Hamartomas are an ill-defined group of lesions which are not neoplastic, appear before or soon after birth, grow with the individual and consist of a single type of cell or mixture of tissues.Vascular hamartomas are defined as disorganized and excessive proliferations of vascular tissue which, due to their limited growth, are considered developmental malformations rather than true neoplasms. Usually, the use of the term "hamartoma" implies the presence of the lesion at birth, with subsequent growth corresponding with that of the animal but ceasing with maturity. This indicates that successful removal of a hamartoma will be confirmed when the animals potential for further growth has stopped.

Hamartomas have been reported in the liver, brain, ovary, rectum and limbs of equines. However the diagnosis of hamartomas is uncommon in the horse and indeed in domestic animals.

Original case of the week (decade)

This miniature pony came in with unusual signs.

It was hiccupping while the owners looked on in anxiety.

The pony wasn't too distressed but the owners where quite worried.

Have a look at the video (it will take 10-30 seconds to load).

Any idea of the problem?

The veterinary term for the condition is 'synchronous diaphragmatic flutter' (aka thumps). It occurs as a result of phrenic nerve being stimulated as it crosses the heart. The phrenic nerve seems particularly sensitive to changes in electrolyte concentrations. The condition is quite commonly associated with low calcium levels. In endurance horses it is electrolyte loss that causes the problem in non exercising horses it is less clear. However treatment with calcium almost always will make the problem disappear. Beware that the inciting cause such as an illness or something else may still be present.