Clinical Implications and Hospital Outcome of Immune-Mediated Myositis in Horses.

BackgroundImmune-mediated myositis (IMM) is a cause of rhabdomyolysis, stiffness, and muscle atrophy predominantly affecting Quarter horses. Limited information is available with regard to outcome, prognostic indicators, and associations with concurrent diseases.Hypothesis/objectivesTo report outcomes and associations between outcome and clinical and laboratory parameters, and presence of concurrent illness.AnimalsSixty-eight horses; 52 Quarter horses and related breeds and 16 other breeds.MethodsRetrospective cohort study (1991-2014). Medical records of horses with histological diagnosis of IMM were reviewed. Data recovery included signalment, laboratory variables, therapy, and outcome. Logistic regression was used to quantify the association between potential prognostic factors and survival to discharge.ResultsQuarter horses were younger (mean < 4 years, range 3 months-21 years) than other breeds (mean < 10 years, range 1-23 years). Pathogens causing concurrent or recent infection included S. equi equi, S. equi zooepidemicus, C. pseudotuberculosis, Anaplasma phagocytophilum, herpes virus-1, and influenza. The most common clinical signs consisted of rapidly progressive diffuse symmetrical muscle atrophy (80%), stiff gait (74%), and fever (44%). All horses that received medical therapy immediately upon admission survived to discharge (survival proportion = 87%). Leucocytosis was a common finding (60%). Horses with concurrent fever and other illness had a poor prognosis for hospital discharge.Conclusions and clinical importanceHorses with IMM can have a favorable outcome. Horses with concurrent fever and another illness had decreased probability of survival to discharge

Rotator cuff repair augmentation with platelet rich plasma

Rotator cuff tendon tears are a common source of shoulder pain and combine both traumatic and degenerative issues. Despite multiple surgical techniques to improve bone to tendon healing, recurrent tearing of the rotator cuff is still a significant postoperative issue. Platelet-rich plasma (PRP) is a fraction of whole blood containing powerful growth factors and cytokines. Basic science and preclinical studies suggest PRP may be useful for tendon repair or regeneration. Rotator cuff studies, however, have produced conflicting results based on PRP formulation, surgical technique, and size of the tendon tear. This chapter explores and summarizes the available evidence to determine the efficacy of arthroscopic rotator cuff repair in patients with full-thickness rotator cuff tears who were concomitantly treated with PRP