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 The MEDS service non-equine patients...
 Infiltrative bowel disease in a...
 Fungal grannuloma in a horse






Group Title: MEDS quarterly
Title: MEDS quarterly. Vol. 1. Iss. 2
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Permanent Link: http://ufdc.ufl.edu/UF00078184/00002
 Material Information
Title: MEDS quarterly. Vol. 1. Iss. 2
Series Title: MEDS quarterly
Physical Description: Serial
Language: English
Creator: Mobile Equine Diagnostic Service, College of Veterinary Medicine, University of Florida
Affiliation: University of Florida -- College of Veterinary Medicine
Publisher: Mobile Equine Diagnostic Service, College of Veterinary Medicine, University of Florida
 Subjects
Subject: University of Florida.   ( lcsh )
Spatial Coverage: North America -- United States of America -- Florida
 Record Information
Bibliographic ID: UF00078184
Volume ID: VID00002
Source Institution: University of Florida
Holding Location: University of Florida
Rights Management: All rights reserved, Board of Trustees of the University of Florida

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Table of Contents
    The MEDS service non-equine patients of the quarter
        Page 1
    Infiltrative bowel disease in a Paso Fino mare
        Page 2
    Fungal grannuloma in a horse
        Page 3
        Page 4
Full Text




















The MEDS Service Non-Equine

Patients of the Quarter
Message from Porter...

Time is flying by and MEDS
continues to grow. Although
we spend greater than 90% of
our time with equine patients,
occasionally MEDS is called to
see some non-equine patients.
A special thanks to the VETS
and Sea World for making
MEDS a part of their health-
care program.


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"Curley" the lame camel "Bully" the lame bull
















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Infiltrative Bowel Disease in a Paso

Fino Mare

Student Case Study #1
By: Natalie Lamneck, Class of 2006

A six year old Paso Fino broodmare presented to the MEDS service with
a history of chronic weight loss. The current farm managers always had a
difficult time keepingweight on the nervous mare in the past years, even with
an excellent appetite and a high quality diet. Recently, the farm manager had
noticed an increase in weight loss despite a strong appetite. At presentation,
the mare's body condition score was 3/9 yet the remainder of her physical
exam was normal. A chemistry panel revealed moderate hypoalbuminemia.
Transabdominal ultrasound noted moderate to severe thickening of the
small intestinal wall, ranging from 0.70cm to 0.90cm. In addition, the liver
appeared smaller than normal in that it could only be visualized on the right
side of the horse at the most ventral aspect of the 8th and 9th intercostal
space.

However, on the left
side the liver was
visualized adjacent
to the spleen and
the echogenicity
was hypoechogenic
compared to the
spleen.

Liver enzymes and
bile acid results
were within normal
limits for this
mare. Based on the
hypoalbuminemia Thickened Small Intestine
and the thickened small intestine a tentative diagnosis of infiltrative bowel
disease (IBD) was made. Infiltrative bowel disease in horses includes
plasmacytic-lymphocytic enteritis, eosinophilic enteritis, granulocytic
enteritis, and lymphoma. This condition is characterized by the infiltration
of inflammatory cells, such as plasma cells, lymphocytes, macrophage, and
eosinophils, throughout the small and large intestine. Clinical symptoms
of IBD include but are not limited to weight loss, chronic diarrhea, chronic
low-grade colic, hypoproteinemia, and generalized dermatitis. In addition
to serum analysis of albumin levels and abdominal ultrasound, intestinal
biopsy and D-xylose absorption tests can be performed to confirm the
diagnosis of IBD.

Treatment for IBD may include change in diet, deworming, and/or immune
suppressive medication. In this case, intestinal biopsy was not performed
and the mare was started on treatment. Her treatment included change to a
senior feed and immunosuppressive dose of prednisolone and azathioprine
with a follow-up exam in 30 days.









Fungal Granuloma in a Horse

Student Case Study #2
By: Kelly Taylor, Class of 2006

A 13 year old Thoroughbred gelding presented with a 2 month history
of bloody nasal discharge from both nostrils. Endoscopy per the RDVM
noted an inflamed and mildly ulcerated nasopharynx. A daily throat wash
treatment was prescribed and a follow up endoscopy with the MEDS unit
was scheduled for 4 weeks later. Prior to the second endoscopy, the physical
exam was within normal limits except for a mild amount of bloody nasal
discharge coming from both nostrils. The second endoscopy revealed a nasal
mass along the pharyngeal aspect of the soft palate (within the nasopharynx)
and extending rostrally into both nasal passages.

The mass was locally extensive, lobulated, erythematous, and contained
yellow coral like lesions suggestive of "kunkers". The mass was sensitive
to touch as well. Several biopsies were taken through the endoscope and
submitted for culture and histopathology. The culture results were pending
at the time of this news letter however the histopathology results confirmed
the clinical diagnosis of granulomatous rhinitis. Fungal staining of the
tissue revealed the presence of intralesional fungal hyphae along with severe
eosinophilic rhinitis.

Possible infectious agents that would be consistent with this histopathology
include Pythiosis spp, Aspergillus spp, Conidiobolus spp, and Cryptococcus
spp. Treatment for fungal granulomas include surgical debulking, laser
therapy, cryotherapy, intralesional anti-fungal treatment, topical anti-fungal
treatment, and systemic anti-fungal treatment. In addition, the use of anti-
pythiosis vaccines has been advocated, especially in non-surgical cases. Due
to location of this fungal granuloma surgical debulking was not an option
hence the gelding was started in anti-fungal treatment consisting of oral
Fluconazole.

Depending on the final culture results, anti-pythiosis vaccination will be
instituted to address the possibility of pythiosis. A follow-up endoscopy is
scheduled for 30 days after initiating the Fluconazole treatment.


NasoDharvnx









Mobile Equine Diagnostic Service
Veterinary Medical Center
P.O. Box 100136
Gainesville, FL 32610-0136
(352) 392-4700 ext. 4036


UFVMC
University of Florida Veterinary Medical Center


A special thanks to the
Jacksonville area referring
veterinarians


Several months prior to kicking off the MEDS program I met with about a dozen veterinarians from the
Jacksonville area. After introducing the program it was evident that there was an interest in a mobile
program from the University that would work directly through the referring veterinarian. Since then the
Jacksonville area has become a weekly stop for the MEDS program. Although Marion County receives
most of the state-wide attention as the "horse capitol of the state", Jacksonville and its surrounding
counties are full of horses and great veterinarians. These veterinarians have been very supportive of the
MEDS program. In particular, Dr. Peggy Fuller has been a regular participant in the MEDS program and
I am very appreciative of her consistent efforts to make MEDS a success in the Jacksonville area.


SI Jacksonville Area
Referring Veterinarians


Dr. Peggy Fuller
Dr. Alan Weldon
Dr. Mace Barton
Dr. Tammy Jordan
Dr. Erin Emmans
Dr. Susan Thoma
Dr. Shane Henry


Dr. Richard Nancarrow
Dr. Wendy Cusick
Dr. Dawn McClane
Dr. Gary Shelton
Dr. Matt Shaere
Dr. Pam Tredinick
Dr. Tom Nauman


To make an appointment with MEDS please call (352) 392-4700 ext. 4036 or
contact Dr. Michael Porter via email at PorterMi@mail.vetmed.ufl.edu


~~* '




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