CAPTIVATING  CASES 
 Issue 25   -   August 2016

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We are excited to announce the addition of Dr. Jared Sharp to the Animal Imaging team!

   
We are excited to announce that Dr. Jared Sharp has recently joined the team at Animal Imaging.
Dr. Sharp grew up on a farm in Dayton, Oregon, managing Quarter Horses, Dorset sheep, and assisting in day to day farm activities. Dr. Sharp received his DVM from Oregon State University in June of 2015.  He was on the Dean's list, was voted outstanding senior student and was active in many university, state and national veterinary organizations.  Dr. Sharp recently completed a one-year internship at Idaho Equine Hospital, in Nampa Idaho. 
Dr. Sharp has always had a keen interest in imaging and sports medicine, both at Oregon State University and at Idaho Equine. He will be involved in all aspects of equine and companion animal case load management at Animal Imaging, including scintigraphy, MRI, CT, myelography, radiology, anesthesiology, and sports medicine.
Our goal at Animal Imaging is to become an imaging extension of your practice. Dr. Sharp will help us to meet that goal.
CT Imaging of the Equine Head
Patient History

A 6-year-old Quarter Horse gelding was presented to Animal Imaging in May 2016 for a CT examination of the skull. The horse had a recent history of a fracture of the left mandible after getting his head caught in his stall. Multiple fracture lines were identified on radiographs and a CT examination was then requested to obtain more information of the extent and involvement of the fractures.
On physical examination, the left masseter muscle was severely swollen. There was a slight deviation of the mandibular incisors with respect to the maxillary incisors. All vital parameters were within normal limits.
 
Findings
 
CT Findings:

A CT examination of the skull was performed under standing sedation. There is a comminuted and complex fracture of the left ramus of the mandible. There is no involvement of the temporomandibular joint. There is moderate soft tissue swelling and there are small areas of gas adjacent to the fracture.
    
Fracture of the left vertical ramus of the mandible with minimal displacement.
Fracture of the rostral left mandible. The caudal portion of the fracture involves the alveolar bone of teeth 306 and 307. 
There is also an oblique fracture in the left rostral mandible, beginning rostroventrally in the interdental space, just caudal to tooth 304 and extends dorsocaudally to tooth 307. No dental fractures are appreciated. Similarly, there is also gas foci surrounding this fracture, suggesting it may communicate with the oral cavity, skin surface, or guttural pouch. 
 

Oblique fracture of the rostral left mandible. Soft tissue swelling and gas foci.

 

3D CT reconstruction illustrating the configuration of the fractures of the left mandibular ramus and oblique fracture of the rostral left mandible. 

 
Conclusions:

1. Moderately comminuted fracture of the left mandibular ramus with soft tissue swelling and gas foci in the surrounding soft tissue
 
2. Oblique fracture of the left rostral mandible with gas foci in the surrounding soft tissue
 
A board certified surgeon was consulted and conservative management was recommended. Stall rest with feeding only a slurry of equine senior feed was recommended to decrease the mechanical stress placed on the fractures from grinding hay. After 4 weeks of being on the slurry diet, soaked hay could gradually be reintroduced. Broad spectrum antimicrobials were recommended for a four-week period. Provided the fractures remain stable and no further displacement occurs, a good prognosis is expected.  A recent follow-up exam by the rDVM revealed clinical improvement.


 
 
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