Received: 8 February 2022 | Accepted: 28 June 2023 DOI: 10.1111/eve.13862_1
C A S E R E POR T
Ulnar fracture deriving from metastasis of a primary hepatoblastoma in a Thoroughbred weanling
Denise Mc Sweeney 1 | Rebecca E. Ruby 2 | Catherine Murphy 1 | Dwayne Rodgerson 1
1 Hagyard Equine Medical Institute , Lexington , Kentucky , USA 2 University of Kentucky Veterinary Diagnostic Laboratories , Lexington , Kentucky , USA
Correspondence : Denise Mc Sweeney Email:
denise.mcsweeney@
wsu.edu
SUMMARY An 8- month- old Thoroughbred filly presented for surgical repair of type 4 comminuted fracture of the right olecranon. On presenta- tion, the filly was non weight bearing on the right forelimb. The filly had a rough hair coat with areas of hair loss and an overall moderate body condition. Fixation of the fracture with an orthopaedic plate and screws was attempted. During the repair, acute intraoperative haem- orrhage occurred with no apparent laceration of large vasculature. An 8- hole dynamic compression plate was contoured to the olecranon, however, the ulnar bone was soft in consistency, with several sites failing to facilitate adequate engagement of the screws. Following surgery, the filly was weight bearing on the affected limb. She was
placed on phenylbutazone (2.2 mg/kg bwt i.v. q12), gentamicin sul- fate (6.6 mg/kg bwt i.v. q24) and penicillin G potassium (22,000 iu/kg bwt i.v. q8). Forty- eight hours post- operatively the filly ' s level of com- fort deteriorated. Intramuscular butorphanol tartrate (Torbugesic®, Zoetis) at a dose of 0.1mg/kg bwt q4h was added to the treatment plan. Her comfort improved but could not be adequately maintained. Five days following surgery radiographs revealed a new fracture of the ulna at the level of the most distal screw. Euthanasia was elected. On necropsy, over 90% of the ulna was abnormal with dark red dis- coloration of the medulla and similar material within the humeral– radial joint and surrounding soft tissues. Within the right liver lobe, a 10 × 8 × 8 cm, well- demarcated, partially encapsulated mass was pre- sent. Histopathological examination of the liver mass and long bones was consistent with a primary teratoid hepatoblastoma with metasta- sis to the right ulna, right and left humerus, femur, tibia and right radius. Upon discussion of the necropsy results with the farm manager, the filly was reported to have had an unusually full coat and ‘pot belly’ at birth and failed to thrive.
K E YWORDS horse , hepatoblastoma , metastasis , olecranon , pathologic fracture
Key points
• Hepatoblastoma is extremely rare in horses. • Metastasis of hepatoblastoma to long bones in a horse has not previously been described.
FIGURE 1 Grossly abnormal right ulna, with cavitation throughout the trabecular region. Necrosis and remodelling of the bone caused by metastasis of hepatoblastoma (white arrows).
• In previously reported cases of equine hepatoblastoma, the animals have been described as ‘pot- bellied’ with poor coat and weight loss, however, these are nonspecific clini- cal signs which could be attributed to any number of dis- eases in a juvenile horse.
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2023 The Authors. Equine Veterinary Education published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
Equine Vet Educ. 2024;36:9.
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