News Notes

Sialolith in Horse’s Cheek Diagnosed During Imaging Practice Run

By Rob Warren, UC Davis

Four years ago, the medical team at the William R. Pritchard Veterinary Medical Teaching Hospital, part of UC Davis College of Veterinary Medicine, removed a sialolith from the right side of Joe Juice’s face. He recovered quickly and returned to the Davis Center for Equine Health’s (CEH) teaching herd.

Sialolithiasis, the formation of salivary stones, typically forms around a small foreign body that finds its way into the salivary duct, and grow as layers of calcium are added over time—similar to the formation of enteroliths. As they get larger, they can rub on the insides of the cheeks, causing ulcerations, which can lead to inflammation, infection and difficulty eating. If saliva production becomes altered, digestion may be affected.

About 24% of sialoliths return after surgical removal.

Around the time the CEH care team suspected a second sialolith, the hospital’s Diagnostic Imaging Service was preparing to open the All Species Imaging Center. Part of that preparation included training sessions imaging various animals on the new equipment, including the large bore equine computed tomography (CT) scanner.

Since Joe Juice already needed imaging to confirm the sialolith, his veterinary team decided to use him as a training model for the new equine CT scanner. His scan revealed a large, oval, mineral opaque structure measuring about 2×3×6 cm within the soft tissues of his cheek, consistent with a sialolith.

A model patient, Joe Juice’s “sialolith was definitively diagnosed with the standing CT, giving surgeons a clear and concise assessment of the growth,” said Mathieu Spriet, DVM, MS, the director of Imaging Services at the VMTH.

This new equine CT scanner, the first of its kind in California, allows for more diagnostic capabilities for horses and other large animals. Imaging capabilities using the previous CT scanner were limited to the limbs and head of fully anesthetized horses. This scanner is integrated onto a platform that can be moved both vertically and horizontally allowing head and distal limb scans to be performed on standing horses using only sedation. This technological innovation, combined with the large bore of the scanner, allows for CT imaging of the stifles, pelvis and entire vertebral column.

Scott Katzman, DVM, DACVS, the chief of the Equine Surgery and Lameness Service, and equine surgery residents Stephanie Ortiz, DVM, and David Orozco-Lopez, DVM, removed his sialolith a few weeks later under standing sedation without complication. Joe Juice was returned to CEH shortly after surgery and resumed his normal physical activity.

Dr. Katzman said the case demonstrates the value of routine check ups. “It’s also a great example of what we’re able to do with sedated standing procedures, instead of full anesthesia.” MeV

This article was first published on the UC Davis website. https://bit.ly/4ajvuvK-MeV It has been edited for style.