Ethnoid hematoma in a mare
 Rhodococcus pneumonia in a...

Group Title: MEDS quarterly
Title: MEDS quarterly. Vol. 1. Iss. 4.
Full Citation
Permanent Link: http://ufdc.ufl.edu/UF00078184/00004
 Material Information
Title: MEDS quarterly. Vol. 1. Iss. 4.
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
Subject: University of Florida.   ( lcsh )
Spatial Coverage: North America -- United States of America -- Florida
 Record Information
Bibliographic ID: UF00078184
Volume ID: VID00004
Source Institution: University of Florida
Holding Location: University of Florida
Rights Management: All rights reserved, Board of Trustees of the University of Florida


This item has the following downloads:

v1iss4 ( PDF )

Table of Contents
    Ethnoid hematoma in a mare
        Page 1
        Page 2
    Rhodococcus pneumonia in a foal
        Page 3
        Page 4
Full Text

Message from Porter...

MEDS completed the academic year
of 2005-06 with a significant growth
in case load. In addition, the Class of
2006 was the first group veterinary
students with access to the MEDS
rotation throughout their senior
year. Due to the high demand from
veterinary students for rotations on
MEDS, the service will be expanding
by a second MEDS clinician and
vehicle for the summer of 2007.

Go Gators!

Hematoma~ in aii1

Pnemona in a

Ethmoid Hematoma in a Mare

Student Case Study #1
By: Rachel Davis, DVM Class of 2006

A 7-year-old Trakehner mare was referred for evaluation of a recurrent unilateral
to bilateral serosanguinous nasal discharge. The mare had been diagnosed
and treated several months previously with a sinus infection by the referring
veterinarian. At presentation, a unilateral, mucopurulent nasal discharge was
noted. Small amounts of blood were present within the discharge. Radiographs
of the skull revealed a soft tissue mass in the area of the ethmoid conchae.
In addition, endoscopy of the left nasal passage revealed a large, smooth,
yellow-green mass within the area of the left ethmoid turbinate. A biopsy was
performed through the endoscope and the results were consistent with an
ethmoid hematoma.

This mare was treated with repeated injections of formalin directly into the
mass through the endoscope. The treatments were approximately 30-45 days
apart and several treatments were required before complete resolution of the
ethmoid hematoma. Ethmoid hematomas are expansile masses that most
commonly develop from the mucosal lining of the ethmoid conchae. The cause
of the condition is unknown. Clinical signs include mild, intermittent epistaxis,
mucopurulent discharge, facial swelling, stertorous breathing, and halitosis. If
the hematoma reaches a large size it may extend into the pharynx and result
in bilateral signs as well as coughing and dysphagia. Growth of ethmoid
hematomas is generally slow and may take months to years before clinical signs
are grossly evident. Diagnosis is dependent on endoscopy, skull radiographs,
and biopsy of the mass. Treatment options include surgical resection, laser
therapy, cryotherapy, and trans-endoscopic injection of formaldehyde. Formalin
treatment is considered relatively safe and effective however at least 5 treatments
are typically required for complete resolution of disease.

Please see page 2 for images related to this case study...


The Foundation for The Gator Nation

Figure 1: Endoscopic approach to the left
nasal passage. Note the smooth, yellow mass
within the opening to the ethmoturbinates.
Mass is consistent with an ethmoid

Figure 3: The same ethmoid hematoma
that has reduced in size following 2
treatments allowing for visualization of the

Figure 2: The same ethmoid hematoma after
2 treatments with intra-lesional formalin

Figure 4: Lateral radiograph of the skull
noting a large, soft tissue mass in the caudal
aspect of the nasal passage (white arrows).

"Serenity Muris", a 3 month old Arabian filly
presented with a 3 week history of tachypnea, i
dyspnea, fever, lethargy, and an intermittent cough.
Clinical signs failed to improve following a varied 8
antibiotic treatment schedule, which included the
use of Penicillin, Trimethoprim Sulfa, and Rifampin.
Physical exam revealed Muris to be tachypneic,
with an increased abdominal effort to respiration,
tachycardic, mildly dehydrated, and posses a
bilateral nasal discharge. Ultrasound revealed
extensive abscessation with ventral consolidation -
of the lungs and increased echogenicity, indicating
gas accumulation, was seen in the biliary tree of
the cranial liver lobes. Significant abnormalities
in the blood work included a neutrophilia, --
hyperfibrinogenemia, and increased liver
enzymes and bile acids. Cytological analysis of
a transtracheal wash revealed abundant mature Figure 5: Trans-thoracic ultrasound of a 3 month old
nondegenerative neutrophils, of which, several foal: Note the large, fluid filled abscess along the
contained intracytoplasmic coccobacillus, highly pleural surface of the caudal lung lobe.
suspicious for Rhodococcus equi.

Rhodococcus equi is a gram-positive coccobacillus that is an intracellular pathogen of macrophages. It is a saprophytic
inhabitant of the soil and inhalation of R. equi laden dust particles is the most important route of acquisition. Along with
a chronic suppurative bronchopneumonia with
S- abscessation and suppurative lymphadenitis,
R. equi has been shown to cause multifocal
ulcerative enterocolitis and typhlitis, non-septic
polysynovitis, aseptic arthritis and osteomyelitis,
uveitis, ulcerative lymphangitis, cellulitis,
subcutaneous abscesses, panopohthalmitis,
nephritis, cranial and renal abscesses. Hepatic
abscesses have not been documented at this
point, but may explain the liver disease present
in this case. The combination of Rifampin with a
macrolide, such as Clarithromycin, Azithromycin,
or Erythromycin, is the treatment of choice for
R. equi infections and has been shown to have
an 88% survival success rate. Earlier recognition
of the disease, followed by isolation and
treatment, as well as decreasing the size of the
infective challenge by proper environmental and
management practices may be the best way to
Figure 6: Lateral radiograph of the same foal after 30 management practices may be the best way to
days of treatment: Note some improvement however reduce losses associated with R. equi pneumonia.
days of treatment: Note some improvement however
an abscess-like structure remains evident in the caudal
lung field.

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

Veterinary Medical Center

In 2004, the University of Florida's College of Veterinary Medicine unveiled plans to create a unique medical
diagnostic and treatment system that could be put to use by any equine or food animal veterinarian in
Florida. This system would mobilize the cutting-edge technology and the extensive medical expertise
found at UF's Veterinary Medical Center and put it within the reach of veterinarians in the field. The new
service would give veterinarians new resources, new tools, and new allies in their mission to improve
animal healthcare.

Today, the Mobile Equine Diagnostic Service (MEDS) is a reality, and it is creating new treatment options
for animal patients everywhere. MEDS works for your veterinarian, using digital and satellite technology
to put the resources of the University of Florida and the experience of the Veterinary Medical Center
faculty at his or her command. Thanks to the state-of-the-art MEDS truck, digital radiography, ultrasound,
endoscopy, specialist consultations and more can now be utilized anywhere from urban veterinary
hospitals to the most remote pastures of Florida.

Dr. Porter and MEDS are dedicated to keeping this service available and affordable for those who need
it. The ingenuity and cooperation of veterinarians like yours has made MEDS possible, but it needs your
support to succeed and expand. MEDS, the MEDS truck, and the veterinarians, specialists, students,
and nurses who make it work, are all supported entirely by the care they provide and by donations from
friends, animal lovers, and people who want to help make veterinary medicine better. We like to call these
people "Friends of MEDS."
For more info regarding how to make a charitable donation to the Friends of MEDS Fund please contact:
Dr. Michael B. Porter @ 352-392-4700 ext 4036

Go Gators! Karen Hickok Development Office, College of Veterinary Medicine, (352) 392-4700 ext 5213

University of Florida Home Page
© 2004 - 2010 University of Florida George A. Smathers Libraries.
All rights reserved.

Acceptable Use, Copyright, and Disclaimer Statement
Last updated October 10, 2010 - - mvs