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Biomedical subjects

G M Baxter

Publications and source records attributed to G M Baxter.

At least 73 records · Page 4Linked to original sources

Percutaneous drainage of an abscess in the lateral neck region of a horse.

A large abscess in the lateral neck region of a horse was treated with percutaneous drainage. The abscess was localized with ultrasonography and aspirated by use of a 7.7-cm spinal needle. A stainless-steel guide wire was passed through the needle, and tissue dilators were used to enlarge the percutaneous hole. A multiperforated polyvinylchloride catheter that was placed within the abscess cavity permitted aspiration and lavage of the abscess. The abscess resolved over the next 10 days with no complications. Percutaneous abscess drainage is commonly performed in people and may have application in veterinary medicine.

Abscess↗

Modified transfixation pinning of compound radius and ulna fracture in a heifer.

A 405-kg heifer sustained a compound fracture of the distal portion of the radius and ulna after being hit by a car. The fracture was thoroughly debrided, lavaged, and reduced with the heifer under general anesthesia. The fracture was immobilized with a modified walking cast, using 2 fully threaded 6.4-mm (outside diameter) Steinmann pins placed through the proximal portion of the radius. The pins were incorporated into a full-limb fiberglass cast, and a 0.5-cm X 2.25-cm aluminum walking bar was positioned medially and laterally on the limb. The modified walking cast was removed after 7 weeks, and the fracture healed without complication. The transfixation pins and aluminum walking bar helped reduce the strong compressive and rotational forces at the fracture site. The modified walking cast can potentially be used for fixation of a variety of fractures in large animals.

Animals↗

Osteochondritis dissecans of the medial trochlear ridge of the talus in a calf.

Osteochondritis dissecans of the proximal aspect of the medial trochlear ridge of the talus was found to be causing lameness and tarsocrural joint effusion in a male Limousin calf. Arthroscopy via a dorsolateral approach was unsuccessful in revealing the lesion in this calf. A caudomedial arthrotomy or medial malleolar osteotomy, which can be used to gain access to lesions of the medial trochlear ridge in dogs, was not attempted. The lameness gradually worsened, and the calf was slaughtered.

Animals↗

Severe hypercarbia resulting from inspiratory valve malfunction in two anesthetized horses.

Severe hypercarbia was documented by arterial blood gas analysis in 2 adult horses anesthetized for exploratory laparotomy. Both horses appeared to be adequately anesthetized, but continued to breathe against the ventilator. In both cases, the inspiratory valve on the anesthesia machine was found to be stuck open, permitting expired CO2 to return to the inspiratory limb of the anesthetic circuit and to be inhaled with the next breath. Correction of the malfunctioning valve alleviated the hypercarbia. Problems with the flow valves of the anesthesia machine should be suspected when anesthetized horses breathe against the ventilator and develop severe hypercarbia.

Anesthesia↗

Colour Doppler ultrasound of the post-phlebitic limb: sounding a cautionary note.

Colour Doppler ultrasound is accurate in the diagnosis of acute lower limb venous thrombosis. Some patients, however, will re-present with recurrent lower limb swelling following the acute event, and ultrasound may also become the primary imaging modality in these patients. We, therefore, undertook a prospective study of 20 patients with a diagnosis of deep venous thrombosis proven initially on both venography and ultrasound. Sixteen patients had thrombosis in the femoro-popliteal segment and four patients had isolated calf vein thrombosis. Patients with above knee thrombosis were scanned at 1, 3 and 6 months and those with isolated calf lesions at intervals of 1 week, 1 and 3 months. Results showed that in cases of above knee thrombosis, only 50% of patients showed complete recanalization by 6 months. The remaining 50%, by this time, showed only partial recanalization of thrombus, the features of which cannot be distinguished from acute non-occlusive thrombus. With respect to the four cases of isolated calf vein thrombosis, one case showed evidence of popliteal extension of thrombus, which by 3 months had fully recanalized. The remaining three cases recanalized completely without further thrombus extension. These results show that interpretation of the ultrasonic features of the post-phlebitic limb may be difficult in patients who re-present with lower limb swelling. Based on this study, we would advise routine scanning of all patients with above knee venous thromboses at 6 months to provide a baseline scan, permitting more accurate ultrasonic assessment of any future thrombotic events. This study also highlights the question of whether isolated calf vein thrombosis can safely be regarded as a benign entity.

Adult↗

Acute renal vein thrombosis in renal allografts: new Doppler ultrasonic findings.

We report two cases of renal vein thrombosis in renal transplants, both diagnosed by Doppler ultrasound. In both cases Doppler ultrasound showed complete absence of venous flow. In addition, the arterial signal showed a sharp systolic peak with a notch on the reverse diastolic component resembling an 'inverted M', a finding previously undescribed. This arterial waveform was present at both hilar and interlobar level. We postulate that this 'inverted M' sign may be more specific for renal vein thrombosis in that it may represent non-occlusive thrombus, despite the lack of detectable venous flow, whereas the previously described plateau-like reverse diastolic flow seen in some cases of renal vein thrombosis, also occurs in severe allograft rejection and is therefore a non-specific sign.

Acute Disease↗

In vitro responses of equine digital vessels to dopamine and fenoldopam.

The in vitro responses of isolated vascular preparations of digital arteries and veins obtained from healthy anaesthetised horses were determined for dopamine and fenoldopam. The digital vessels were harvested, cut into 4 mm vascular segments, suspended in tissue baths and attached to force-displacement transducers. Dose-response studies between 10(-8) and 10(-4)M concentrations were performed for all drugs. The change in tension of each vascular ring was measured in grams of force. The reactivity between palmar and plantar digital vessels and baseline vascular responses were determined for dopamine. The vascular responses of dopamine were compared to in vitro data for other known vasoconstrictor agents. The mechanism of vasoconstriction induced by dopamine was further defined using prazosin, a specific competitive alpha-1 adrenoceptor antagonist. The vasodilating ability of fenoldopam, a dopamine-1 (DA-1) receptor agonist, was also determined using noradrenaline- preconstricted vascular segments from palmar digital vessels. The effective concentration to produce 50 per cent of the maximal response (EC50) and the maximal contraction in grams of force per milligram of the vascular ring (g/mg) were calculated. There were no differences in the reactivity between the palmar and plantar digital vessels. Dopamine produced intense constriction in arteries and veins but only at very high molar concentrations. Prazosin decreased significantly the sensitivity of the veins to dopamine (increased the mean EC50 values) but not the arteries. Prazosin had no effect on the maximal contractions of the vessels. Fenoldopam produced very little relaxation of either the arteries or veins. These results suggest that dopamine produces constriction in equine digital arteries and veins and that the constriction is only partially mediated by alpha-1 adrenoceptors.(ABSTRACT TRUNCATED AT 250 WORDS)

2,3,4,5-Tetrahydro-7,8-dihydroxy-1-phenyl-1H-3-ben↗

Comparison of colour Doppler ultrasound with venography in the diagnosis of axillary and subclavian vein thrombosis.

The primary imaging technique in suspected venous occlusive disease has for many years been contrast venography. Recent studies have shown ultrasound with the addition of colour Doppler imaging to be a suitable alternative method in the diagnosis of lower limb venous thrombosis. We have applied these techniques to the upper limb venous system, and have performed a prospective study of 19 patients (30 limbs) comparing colour Doppler ultrasound with venography in the diagnosis of axillary and subclavian vein thrombosis, for which colour Doppler ultrasound has a sensitivity and specificity of 100%. If vein stenosis is included, the sensitivity falls to 89%. We propose that colour Doppler ultrasound is a suitable first-line alternative to venography in the diagnosis of axillary and subclavian vein thrombosis. In addition to showing the major venous drainage of the upper limb, ultrasound routinely assesses patency of the internal jugular vein, which is, on occasion, of clinical relevance when determining possible future sites of venous access. If, however, colour Doppler ultrasound is normal then bilateral upper limb venography is indicated to exclude a more central venous problem or localized stenotic lesion.

Adolescent↗

Effects of exploratory laparotomy on plasma and peritoneal coagulation/fibrinolysis in horses.

Plasma and peritoneal fluid samples were collected before and after surgery from 6 horses undergoing a ventral midline exploratory laparotomy and from 6 anesthetized control horses. Coagulation/fibrinolytic components measured in the plasma and peritoneal fluid of these horses included the functional activity of antithrombin III, alpha-2 antiplasmin, plasminogen, and protein C, and the concentrations of fibrinogen and fibrin degradation products. Peritoneal fluid antithrombin III, fibrin degradation products, and plasminogen values were significantly increased after surgery (over time) in principal horses. Compared with control horses, postoperative peritoneal fluid from horses undergoing laparotomy had significantly increased antithrombin-III activity at 12 and 72 hours, alpha-2 antiplasmin activity at 24 hours, fibrin degradation product concentrations at 6, 12, 24, 72, 96, and 144 hours, plasminogen activity at 6, 12, 24, 48, 72 and 96 hours, and protein-C activity at 12, 24, 72, and 96 hours. There were no significant changes in the peritoneal fibrinogen concentration in principal horses. Plasma plasminogen activity was significantly decreased at 24 hours after surgery in principal horses, compared with controls. Changes were minimal in the remaining plasma coagulation/fibrinolytic components of horses undergoing laparotomy. Plasma and peritoneal fluid values of anesthetized control horses did not change.

Animals↗

Colour Doppler ultrasound in deep venous thrombosis: a comparison with venography.

Colour Doppler ultrasound is a new technical development allowing simultaneous grey scale imaging and a dynamic colour flow vascular image. To date, many real time ultrasonic studies have been assessed in the diagnosis of lower limb venous thrombosis and have been shown to be accurate in the femoral and popliteal segments. A double blind prospective study comparing colour Doppler with contrast venography in the diagnosis of lower limb thrombosis was performed in a group of 40 patients. Of the study group, 26 venograms were negative and 27 ultrasound examinations were negative. Of the 14 positive venograms there was one false negative colour doppler scan which missed a calf and lower popliteal thrombosis. Two cases of isolated calf vein thrombosis were successfully detected by colour Doppler. Overall, the sensitivity and specificity for detection of lower limb venous thrombosis, including calf vein assessment, were 93% and 100% respectively. Colour Doppler is easy to perform; the average scanning time being 15 minutes for complete assessment of a unilateral lower limb venous system. Spontaneous flow is evident in the femoropopliteal segment, whilst proximal calf vein flow can only be appreciated with the aid of distal compression. Eccentric thrombus and partially recanalized thrombus can be shown. Although the number of isolated calf vein thromboses was small, early experience suggests colour Doppler may be useful in the assessment of proximal calf vein patency.

Adult↗

Breeding soundness of beef bulls after circumcision: 33 cases (1980-1986).

Case records of 33 beef bulls that had preputial prolapses and underwent circumcisions were reviewed. Data retrieved included age, breed, duration of preoperative medical treatment, complications of surgery, length of time from surgery to first breeding, ability of bull to copulate, duration of active breeding, and complications resulting in breeding unsoundness. The mean age of all bulls was 3.5 years (1 to 7 years). Breeds represented included Santa Gertrudis (n = 13), Beefmaster (n = 8), Brangus (n = 7), Brahman (n = 4), and Angus (n = 1). The mean duration of medical treatment before surgery for all bulls was 16.4 days (2 to 38 days). There was no statistically significant difference between the mean duration of medical treatment before surgery between bulls that became breeding sound (16 days), compared with those that were breeding unsound (19 days). However, bulls requiring more than 14 days of medical treatment before surgery were approximately 3 times (relative risk, 2.8) more likely to develop postoperative complications than those bulls requiring 14 days of treatment or less. Eleven bulls (33%) developed one or more postoperative complications. The complications resolved in 4 bulls, but 7 were never able to breed. Of these 7 bulls, 4 had problems directly related to the circumcision, 2 had extensive fibrosis of the prepuce already present at surgery, and 1 was discharged from the hospital with no apparent complications but was never able to breed. Twenty-five of the 33 bulls (76%) were breeding sound for 1 or more years after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

In vitro reactivity of digital arteries and veins to vasoconstrictive mediators in healthy horses and in horses with early laminitis.

The in vitro reactivity of vasoconstrictive mediators that are implicated in acute laminitis was determined in palmar and plantar digital arteries and veins obtained from healthy horses and in palmar digital vessels of horses with early laminitis (Obel grade I). To obtain baseline reactivity data, 3 experiments were conducted, using healthy horses: (1) the reactivity of palmar and plantar digital arteries and veins to angiotensin II, norepinephrine, and 5-hydroxytryptamine (serotonin) were compared; (2) the direct effects of bacterial endotoxin on vascular reactivity were assessed; and (3) the reactivity of palmar digital arteries and veins to angiotensin II, norepinephrine, prostaglandin F2 alpha (PGF2 alpha), serotonin, and a thromboxane-endoperoxide analog (U46619) were determined. The vascular reactivity of these same 5 vasoconstrictors then was determined in horses with early laminitis and was compared with data from healthy (control) horses. Obel grade-I laminitis was experimentally induced in horses, using carbohydrate overload. Dose responses were conducted for each agent at concentrations between 10(-8)M and 10(-4)M. The potency of a drug was defined as the mean effective concentration necessary to induce 50% of maximal contraction (EC50). There were no differences in EC50 concentrations and in maximal contractions between forelimb and hind limb arteries and veins for angiotensin II, norepinephrine, and serotonin. Incubation with endotoxin had no effect on the reactivity of arteries and veins to angiotensin II, norepinephrine, and serotonin.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiotensin II↗

Ileal impaction in the horse: 75 cases.

Records of 75 horses with ileal impactions were examined retrospectively. There was a sex predilection towards mares. Arabians were over-represented compared to the hospital population. The average age was 8.3 years. Abdominal pain was observed in 96% of horses. Nasogastric reflux was present in 56% of horses, small intestinal distention was found on rectal palpation in 96% and an ileal impaction in 25%. Exploratory celiotomy was performed in 69 horses, the mass was reduced by extramural massage in 67 horses, and ingesta was removed via enterotomy in 2. Jejunocecostomies were performed in 47 horses. Twenty-five horses developed postoperative ileus, and 11 developed laminitis. Twenty-seven horses survived. Significant differences (p less than 0.05) between survivors and non-survivors were found for rectal temperature (37.7 and 38.2 degrees C, respectively), plasma protein concentration (7.8 and 8.9 g/dl, respectively) and anion gap (15 and 21.3 mEq/l, respectively). Survival decreased with increasing duration of clinical signs. Enterotomy, enterectomy, and/or jejunocecostomy performed during surgery had a deleterious effect on survival.

Animals↗

Persistent urachal remnant causing intestinal strangulation in a cow.

A persistent urachal remnant causing small intestinal strangulation was found on exploratory laparotomy in a 2-year-old cow with colic. The persistent urachus consisted of a thin cord-like band that was attached ventrally to the umbilical region and caudally to the apex of the bladder. The band had formed an internal loop and had strangulated 6 to 8 cm of the distal portion of the ileum. The persistent urachus was detached manually at the umbilicus, ligated at the apex of the bladder, and removed; intestinal resection was not necessary. The urachal remnant was probably a congenital abnormality that may have become stretched during pregnancy, forming an internal hernial loop.

Animals↗

Effect of aspirin on ex vivo generation of thromboxane in healthy horses.

Different dosages of aspirin were administered (by nasogastric tube) to 3 groups of 5 healthy adult horses to determine the minimal effective dosage needed to decrease serum thromboxane B2 (TxB2) concentrations and to determine the duration of this decrease. When compared with their base-line serum TxB2 concentrations, horses in group 1 (given 5 mg/kg) had a 71% decrease in TxB2 concentrations at 24 hours after aspirin was given and a 86% decrease at 48 hours; serum TxB2 concentrations were back to base-line values by 120 hours. Horses in group 2 (given 10 mg/kg) had a 60% decrease in TxB2 concentrations at 24 hours after aspirin was given, an 84% decrease at 48 hours, a 48% decrease at 96 hours, and an 18% decrease at 6 days. Horses in group 3 (given 20 mg/kg) had a 68% decrease in TxB2 concentrations at 24 hours, a 93% decrease at 72 hours, an 87% decrease at 96 hours, and a 70% decrease at 6 days after aspirin treatment was given. All groups had a statistically significant decrease in TxB2 concentrations (P less than 0.05) by 12 hours after aspirin was given, which persisted 96 hours for group 1 and throughout the study for groups 2 and 3. The maximal TxB2 decrease was similar among the 3 groups (90% decrease from base line), and there were no significant differences among the TxB2 concentrations between 24 and 72 hours after treatment was given.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Equine laminitis caused by distal displacement of the distal phalanx: 12 cases (1976-1985).

Clinical data from 12 cases of equine laminitis characterized by distal displacement of the distal phalanx (P3) were reviewed. Clinical features of horses that survived the syndrome were compared with the nonsurvivors to obtain prognostic indicators. Animals affected included 8 Quarter Horses, 2 Welsh ponies, 1 Thoroughbred, and 1 Arabian. Eight of the animals were females (67%), 2 were stallions, and 2 were geldings. The mean age of affected animals was 8.6 years (2 to 14 years), and the mean body weight was 442 kg. The survivors weighed less than the nonsurvivors (384 kg vs 473 kg, respectively), suggesting that body weight may be of prognostic value for horses affected with distal displacement of P3. Ten of the 12 animals (83%) were admitted because of a disorder other than laminitis, but subsequently developed laminitis during the treatment period. All affected animals had clinical evidence of endotoxemia and/or sepsis before the onset of laminitis. Cavitation or depression of the dorsal coronary band was detected in all animals and was the most reliable clinical indicator of distal displacement of P3. Five horses had fluid (blood or serum) ooze from their coronary bands and 2 of these sloughed one or more of their hooves. Necropsy findings of the 8 horses that were euthanatized included severe hemorrhagic, congested laminae and complete detachment of P3 from the hoof wall. Histologic examination of affected laminae revealed vascular thrombosis and multifocal areas of hemorrhage and necrosis. Radiography failed to reveal distal displacement of P3 in 8 animals, but the remaining 4 animals had an accentuation of the dorsal proximal hoof wall and cavitation of the coronary band visible on lateral radiographs.

Animals↗

The effect of oral isoxsuprine and pentoxifylline on digital and laminar blood flow in healthy horses.

OBJECTIVE: To quantitate blood flow in the palmar digital artery and dorsal laminae of the hoof in standing, unmedicated, nonsedated horses, and in horses treated with oral isoxsuprine, oral pentoxifylline, and intravenous acetylpromazine as a positive control. STUDY DESIGN: Experimental study; treatments administered in a random cross-over design. ANIMALS: A total of 6 healthy horses selected with at least one nonpigmented forelimb hoof wall and determined to be free of laminitis. METHODS: All horses were instrumented with a flow probe placed around one palmar digital artery under general anesthesia and a laser doppler flow probe placed within a hole in the dorsal hoof wall to measure digital blood flow and laminar perfusion respectively. Baseline readings of palmar digital blood flow and laminar perfusion were recorded before and between treatments. Horses were randomly assigned to one of two groups and treated with either isoxsuprine (1.2 mg/kg, orally twice daily for 10 days) or pentoxifylline (4.4 mg/kg, orally every 8 hours for 10 days) in a random cross-over design. Digital blood flow (DBF) and laminar perfusion (LP) were measured on days 2, 5, 7, and 10 of treatment. Horses also received acetylpromazine as a positive control (0.066 mg/kg, intravenously) during the washout period, and measurements were taken every 15 minutes until measurements returned to baseline readings. Data were analyzed by using repeated measures ANOVA. RESULTS: Digital blood flow (11.2 to 97.7 mL/min) and laminar perfusion (1.0 to 11.1 Capillary Perfusion Units) differed between horses. No statistically significant increases in DBF or LP were detected over the 10 day treatment period with either isoxsuprine or pentoxifylline. Acepromazine resulted in a significant increase (P = .0007) in DBF for approximately 75 minutes beginning 15 minutes after treatment. A mild but insignificant increase in LP was identified after acetylpromazine treatment. CONCLUSION: Neither isoxsuprine nor pentoxifylline increased blood flow to the digit or dorsal laminae in healthy horses. Acepromazine caused an increased blood flow to the digit. Based on the results of this study acetylpromazine potentially would have a greater effect on improving digital blood flow than oral isoxsuprine or pentoxifylline when treating ischemic conditions of the foot in horses.

Acepromazine↗