Veterinary Clinics of North America-Equine Practice最新文献

This comprehensive review outlines the anatomy, diagnostic methods, pathophysiology, treatment, and prognosis of common equine upper airway disorders. It discusses the structure and function of the larynx and pharynx, and details diagnostic tools such as endoscopy and ultrasound. Major conditions-recurrent laryngeal neuropathy, arytenoid chondropathy, epiglottic entrapment, dorsal displacement of the soft palate, and nasopharyngeal collapse-are described with emphasis on their etiology, clinical signs, and management options for optimizing performance outcomes.

Congenital cervical vertebral anomalies in horses are structural changes in the neck vertebrae that develop during the fetal stage. These anomalies can vary in their severity and effects. Some horses may not show any clinical signs and can live normally, while others may develop serious problems such as spinal cord compression. This compression can lead to issues like ataxia or even paralysis, affecting the horse's mobility and quality of life. Recognizing and diagnosing these anomalies early are very important, as it helps guide decisions about the best treatment options and overall management for the affected horse's health and well-being.

Equine neurosurgery is a challenge for many surgeons, particularly when central nervous system (CNS) disease is not addressed through ventral cervical stabilization, the most performed neurosurgical procedure. Advances in diagnostic imaging, minimally invasive instrumentation, and computer-assisted surgery are expanding therapeutic possibilities beyond cervical vertebral compressive myelopathy, including radiculopathy, vertebral fractures, and intracranial or intraspinal masses. Emerging techniques-such as percutaneous foraminotomy, facet fixation, targeted decompression, novel implant systems, and exploratory cranium approaches offer opportunities to address neural pathology more precisely. As experience is gained from these innovative approaches, they hold promise to improve outcomes for horses with CNS disease.

The horse's head and neck account for about 10% of body weight, and this, combined with the fact that they are cantilevered in front of the trunk, produces considerable leverage around the joints at the base of the neck. During locomotion, the neck is moved primarily by gravitational and inertial forces controlled by eccentric-concentric cycles of contraction in the topline muscles assisted by energy-saving, stretch-recoil cycles in the nuchal ligament. The functional part of the nuchal ligament is the caudal funicular region and the lamellae to the second cervical vertebra that acts as the point of suspension for the entire neck.

Ventral cervical stabilization remains the primary surgical approach, in general, for horses with spinal cord compression. Advancements in volumetric imaging offer a more comprehensive understanding of central nervous system dysfunction elucidating that other modes of compression exist. Minimally invasive instrumentation and computer-assisted surgery are expanding therapeutic possibilities for cervical vertebral compressive myelopathy, radiculopathy, vertebral fractures, and intracranial or intraspinal masses. Emerging techniques-such as articular process joint fixation, targeted decompression, and novel implant systems-offer opportunities to addres spinal pathology more precisely. As technologies evolve and are validated, they hold promise to broaden surgical options and enhance outcomes.

Numerous ocular diseases cause visual impairment and induce ocular pain that may be associated with undesired behaviors in horses. Horses with ocular pain, indicated by the presence of blepharospasm, blepharoedema, ocular discharge or rubbing the eye, should be rested from work to avoid worsening the ocular disease and to avoid undesired behaviors associated with pain or vision impairment. Horses with ocular disease are frequently head shy. Some stoic horses may not have obvious outward clinical signs despite significant visual impairment, and as such, undesired behaviors such as spooking, balking, headshaking, or rearing may be indications of an ocular problem.