Complete Resolution Of Clinical Signs Research Articles

Presumed post-traumatic subdural hygroma in a 2.5-year-old spayed female Chihuahua.

A 2.5-year-old spayed female Chihuahua dog was presented with chronic cervical pain and exhibited a "prayer-like position" following a history of a 4-meter fall. CT and MRI revealed a moderate right-sided enlargement of the subdural space with cerebrospinal fluid, consistent with a subdural hygroma, appearing connected to a quadrigeminal cistern dilation. Percutaneous transfontanellar external drainage of the subdural fluid accumulation did not prevent its re-accumulation, and the dog was managed medically, leading to the complete resolution of clinical signs. The subdural hygroma was suspected to be secondary to the previous trauma.

Effect of corticosteroids on ischemia-reperfusion injury of deep inferior epigastric perforator flap after re-exploration for anastomosis thrombosis: A prospective randomized trial

Patients undergoing breast reconstruction with the deep inferior epigastric perforator (DIEP) flap are at risk of arterial and venous thrombosis, necessitating flap salvage surgery. However, this carries the risk of ischemia-reperfusion injury (IRI) and potential significant partial or complete flap loss. The objective of this study was to evaluate the potential benefit of corticosteroids in reducing IRI related complications in DIEP flaps that are returned to the operation theater for attempted salvage after venous or arterial failure.A double-blinded prospective randomized study was conducted between January 2012 and January 2023 on patients scheduled for secondary unilateral breast reconstruction using the DIEP flap technique. Patients were included if they developed post-operative venous or arterial flap thrombosis and experienced DIEP flap IRI following operative take-back and anastomosis revision. The treatment group (TG) received a 5-day course of corticosteroids, while the control group (CG) did not receive any specific treatment. Forty-six patients were enrolled in the study. In the CG, two cases of total flap loss and eight cases of partial flap necrosis were observed, while the TG had only 1 case of partial flap necrosis (p < 0.05). The complete resolution of clinical signs of IRI occurred within 13 ± 2.1 days for the TG and 21 ± 3.5 days for the CG (p = 0.00001). The TG had a significantly shorter hospital stay (11.13 ± 0.38 days) compared with the CG (15.47 ± 1.27 days; p < 0.0001). Targeted corticosteroid therapy following a salvage procedure for vascular thrombosis in DIEP flaps has shown promise as an effective treatment for subsequent IRI. This approach may be considered as a viable option for managing IRI in free flaps. However, further studies involving a larger number of patients are required to substantiate our hypothesis.

Clinical manifestations, endoscopic findings and outcomes of tonsillar fossa foreign bodies in dogs: seven cases (2020-2023).

Clinical presentation and outcomes of dogs with tonsillar foreign bodies are not described in the literature. The objective of this case series is to describe the presence, clinical manifestations, endoscopic findings and outcomes of foreign bodies in the palatine tonsillar fossa of dogs. Medical records of dogs in which tonsillar fossa foreign bodies were removed by endoscopy between 2020 and 2023 at a referral centre were reviewed. Dogs were included if complete medical records were available. Seven dogs were included. Among all clinical signs reported, acute onset of throat clearing occurred in all dogs. Palatine tonsil enlargement and protrusion from the tonsillar fossa were observed in four of seven dogs. Foreign bodies were removed under endoscopic guidance in all dogs; a vegetal foreign body was found in all but one dog (6/7). Complete resolution of clinical signs was reported in the five dogs for which follow-up information was available. The tonsillar fossa is a rare but possible location for foreign bodies in dogs and should be explored even in the absence of macroscopic lesions of the tonsils, since some dogs could have a normal palatine tonsil appearance. Acute throat clearing should raise the suspicion of tonsillar fossa foreign bodies. The prognosis appears good after removal.

Successful Use of Dupilumab in the Treatment of Acquired Perforating Dermatosis Associated with Atopic Dermatitis

Acquired reactive perforating collagenosis is a rare cutaneous disorder characterised by the extrusion of abnormal connective tissue trough epidermidis and/or follicular units. Reactive perforating collagenosis is often associated with systemic diseases in which pruritus is a common symptom (e.g., diabetes and chronic kidney disease). Less commonly, it has been associated with chronic inflammatory dermatoses, including atopic dermatitis, as in this case. In this report, we describe the exceptional case of a 35‐year‐old man affected by acquired reactive perforating collagenosis associated with atopic dermatitis who was resistant to conventional topical and systemic treatment and experienced complete resolution of clinical signs and symptoms after 12 weeks of treatment with dupilumab. In our patient, the severe pruritus induced by atopic dermatitis likely contributed to the development of acquired perforating collagenosis lesions, which are thought to be a reactive response to chronic scratching and repetitive injury to the skin. Chronic pruritus in atopic dermatitis is known to be driven by type 2 cytokines, including IL‐4 and IL‐13, and dupilumab, a monoclonal antibody inhibiting IL‐4 and IL‐13 signalling, has been shown to be effective in the treatment of moderate to severe atopic dermatitis as well as other type 2‐driven pruritic dermatological conditions. This case supports the potential use of dupilumab for the treatment of reactive perforating dermatosis.

Monensin toxicosis in a dog with initial apparent recovery followed by severe relapse

AbstractThis case report describes successful intensive care management of a toxic myopathy in a 7‐month‐old, female, entire springer spaniel secondary to presumed monensin intoxication. The dog was seen chewing a monensin capsule, and was subsequently presented to the local veterinary practice with generalised weakness, ataxia, hypersalivation and pyrexia. Intravenous lipid emulsion‐activated charcoal and intensive fluid therapy were administered. Bloodwork identified a marked increase in serum creatine kinase activity (226,554 iu/L; reference range: 0–400 iu/L). The patient was discharged the following day after initial hospitalisation, with a complete resolution of clinical signs. Five days after exposure, a rapid deterioration required veterinary assessment at the referral hospital. The patient recovered and was discharged after 9 days of hospitalisation. This case report describes recurrence of clinical signs of monensin toxicosis after initial improvement. However, with aggressive emergency care, symptomatic therapy and intense monitoring, a positive outcome was achieved.

Caso antemortem de insuficiência valvar atrioventricular em dragão barbudo (Pogona vitticeps) – relato de caso

An atrioventricular valve insufficiency is a common form of cardiac disorder in mammals, whereas it has rarely been reported in reptiles. A two-year-old male bearded dragon (Pogona vitticeps) was presented with acute onset of lethargy, inappetence and general weakness, increased respiratory effort, dark skin color, and arched back. A gastrointestinal foreign body was suspected, but radiography showed coelomic fluid accumulation. Ultrasound heart examination revealed turbulent blood flow at the level of the atrioventricular valves. Electrocardiography by modified Einthoven lead system (lead configuration 1) as described for Squamata, did not show significant changes. A tentative diagnosis of congestive heart failure as a result of valvulopathy was made. Treatment consisted of parenteral furosemide and fluid administration and assisted feeding with appropriate food intended for adult bearded dragons. The patient was weekly evaluated and successfully recovered over the four months. Echocardiography and electrocardiography were repeated 12 months later. The prescribed treatment was successful with complete resolution of clinical signs, and long-term surveillance of the bearded dragon (Pogona vitticeps).

Endometrial polyp in a spayed female dog

AbstractEndometrial polyps are rare benign uterine masses exclusively reported in geriatric, entire, female dogs or spayed female dogs with ovarian remnant syndrome. A 12‐year‐old, female, ovariohysterectomised cocker spaniel was presented for hyporexia, progressive muco‐haemorrhagic vulval discharge, and an ultrasonographically detected caudal abdominal mass. Thoracic and abdominal computed tomography revealed that the mass originated from the uterine stump, with no evidence of metastasis. Surgical excision of the mass was performed, and histopathology of the mass was consistent with an endometrial polyp. The dog was confirmed to be neutered based on the absence of ovarian remnant found on computed tomography and during surgery, and the negative results of both anti‐Mullerian hormone test and human chorionic gonadotropin stimulated progesterone test. The dog fully recovered with complete resolution of clinical signs at 2‐week, 6‐month and 18‐month rechecks. The presenting case highlights the first reported case of an endometrial polyp in a spayed female dog.

Successful surgical outcome of persistent right aortic arch and aberrant left subclavian artery in a 3‐month‐old kitten

AbstractA 3‐month‐old, domestic, long‐haired cat presented dull and lethargic with a history of failure to thrive and persistent postprandial regurgitation. A barium oesophagram performed by the referring veterinarian identified a megaoesophagus terminating at the level of the fourth intercostal space. Computed tomography angiography confirmed the suspected vascular ring anomaly, classified as a persistent right aortic arch with a concurrent aberrant left subclavian artery. Surgical ligation and transection of the ligamentum arteriosum, while sparing the aberrant left subclavian artery via a left fourth intercostal thoracotomy, resulted in resolution of the oesophageal compression and clinical signs postoperatively. Follow‐up 22 weeks postoperatively showed marked improvement in weight and body condition score, with no regurgitation following the introduction of a solid consistency commercial diet. This report describes the complete resolution of clinical signs following surgical correction of this form of vascular ring anomaly while sparing the aberrant left subclavian artery, without the need for long‐term dietary or feeding modification.

Outcomes in dogs with congenital extrahepatic portosystemic shunts treated with surgical ligation or medical management.

The objective of this study was to evaluate differences in outcomes in dogs treated for extrahepatic portosystemic shunts (EHPSS) by either complete suture ligation, partial suture ligation or medical management. This wasa retrospective, single institutional study. Dogs (n = 152) with EHPSS treated with suture ligation (n = 62), surgery with no ligation (n = 2), or medical management (n = 88). Medical records were reviewed for data on signalment, treatment variables, complications, and outcome. Kaplan-Meier plots were generated to assess survival across groups. Cox's proportional hazard models were used to assess the relationship between survival times and multiple predictor variables. For outcomes of interest, backwards, stepwise regression was performed (p < 0.05). Complete suture ligation was possible in 46/64 (71.9%) of dogs where surgical attenuation was attempted. One dog was euthanized following partial suture ligation due to suspected portal hypertension. Dogs with complete suture ligation of the EHPSS had a significantly longer median survival time (MST) compared to the medical management group (MST not reached vs. 1730 days [p < 0.001]). Complete resolution of clinical signs (without the need for further medical treatment or dietary changes) was achieved in 16/20 (80.0%) dogs with complete suture ligation and 4/10 (40.0%) dogs with partial suture ligation of their EHPSS. Suture ligation (complete or partial) for the treatment of EHPSS, where clinically possible, yielded the best clinical outcome and increased longevity compared to medical management in this study. While medical management for the treatment of EHPSS in dogs is a valid treatment option, better clinical outcomes are achieved with surgical intervention.

Intraoral Formation of a Rigid Obturator for the Treatment of Dental Fistulae and Draining Tracts in the Horse.

A retrospective cohort study to describe a novel use of a mechanically retained, rigid obturator (RO) to manage maxillary and mandibular persistent pathologic oral communications (PPOCs). This study included 22 horses with PPOC with at least 6 months of follow-up after treatment with a RO. The RO was made with a flowable, bis-acryl-based composite resin. Medical records were analyzed, including case details, obtained imaging, surgical reports, and follow-up information. There were 10 horses that had follow-up examinations by the authors and 8 horses by the referring veterinarian; in 4 horses, follow-up information was obtained by informal telephone interviews with the owner. Complete resolution of clinical signs was obtained in 21 of 22 (95.5%) horses, with confirmed healing of the PPOC in 15 of 22 (68.2%) horses. Complications were noted in 7 of 22 (31.8%) cases. Complications included: complete loss of RO (2 horses), fracture/defect of the RO (2 horses), displaced/shifted RO (1 horse), and incomplete seal of the PPOC (2 horses). All complications were resolved by repairing or replacing the RO. The RO placement is a successful, noninvasive, easily repeatable treatment for PPOC.

Cervical vertebral veins and caudal cerebral sinuses thrombosis secondary to corticosteroid therapy for an immune‐mediated polyarthritis in a dog

AbstractA 3‐year‐old, crossbreed dog was presented for an acute onset of cervical pain 6 weeks after the initiation of corticosteroid treatment for an immune‐mediated polyarthritis. Except for cervical hyperesthesia, neurological examination was unremarkable. Computed tomography revealed thrombosis of cervical vertebral venous structures and caudal cerebral sinuses. The dural sac containing the cervical spinal cord was moderately to severely compressed. A decrease in antithrombin activity was measured and assumed to be caused by secondary altered production due to corticosteroid therapy as well as important active thrombosis. The hypercoagulable state was most likely caused by chronic corticosteroid administration as a treatment of immune‐mediated polyarthritis. Complete resolution of clinical signs and venous lesions was achieved by tapering off corticosteroids and initiating gabapentin and antithrombotic treatment (clopidogrel and rivaroxaban).

Perioperative complications and outcomes following partial ear canal ablation and lateral bulla osteotomy in pet rabbits: 20 cases (2009-2021).

To investigate the perioperative complications and outcomes of rabbits undergoing partial ear canal ablation and lateral bulla osteotomy for treatment of chronic otitis. Surgical logbooks were searched to identify rabbits that underwent partial earcanal ablation and lateral bulla osteotomy between December 2009 and September 2021. Datacollected included signalment, history, clinical signs, historical and current medical management,physical examination findings, preoperative diagnostic imaging and aural bacterial culture results, surgical procedure information, duration of hospitalisation, complications and final outcome. Twenty rabbits with chronic, medically unresponsive otitis underwent 27 partial ear canal ablation and lateral bulla osteotomies. Ten rabbits had pre-existing neurologic deficits and 17 had an ear base abscess at the time of surgery. A total of 13 (65%) rabbits developed at least one complication, either in the perioperative period or between discharge and recheck. Three of these rabbits (15%) underwent revision surgery for persistent or recurrent ear base abscess. Complete resolution of clinical signs ultimately occurred in 12 (60%) rabbits. Three (15%) rabbits showed improved but not completely resolved clinical signs (three facial asymmetry). Five (25%) rabbits died of causes potentially related to chronic otitis and/or partial ear canal ablation and lateral bulla osteotomy; two of these rabbits had undergone revision surgery. Although this study reports a high complication rate (65%), most complications resolved, with 15 (75%) rabbits having a good to excellent final outcome. Since the majority ofrabbits in this study had chronic and severe ear disease, further studies are required todetermineif surgical intervention earlier in the disease process could result in a lower complicationrate.

Advanced Platelet-rich Fibrin-mediated Regeneration of Necrotic Immature Permanent Teeth: A Clinico-radiographic Observational Study.

The objective of the study was to assess the regenerative potential of advanced platelet-rich fibrin (APRF) in the regenerative treatment of necrotic immature permanent teeth (NIPT) in the maxillary incisor region. After institutional review board clearance, 10 children aged between 8 and 14 years with NIPT in the maxillary incisor region undergoing APRF treatment were enrolled in a prospective clinico-radiographic exploratory observational study. Baseline clinical, radiographic, and vitality testing before the start of treatment were noted. Patients were followed up at 3, 6, and 12 months posttreatment. After 3, 6, and 12 months of follow-up, all patients (100%) showed complete resolution of clinical signs and symptoms. All patients (100%) showed periradicular healing, and 9 out of 10 patients (90%) showed a clear hard tissue bridge formation at various levels in the root canal on postoperative radiographs. None of the patients (0%) showed a positive response to vitality testing. APRF is a promising biomaterial in regenerative endodontic treatment (RET). Future randomized trials can be planned to establish superiority or equivalence to conventional PRF. Wakhloo T, Shukla S, Chug A, et al. Advanced Platelet-rich Fibrin-mediated Regeneration of Necrotic Immature Permanent Teeth: A Clinico-radiographic Observational Study. Int J Clin Pediatr Dent 2022;15(4):402-406.

Surgical treatment of a five‐structure dentigerous cyst in a Warmblood filly

SummaryThis article describes a unilateral extracranial dentigerous cyst containing five dental structures in a 3‐year‐old Warmblood filly that caused drainage from below the left pinna and behavioural changes due to pain. Initial diagnosis was made using radiographs and further diagnostic imaging in the form of computed tomography was used for effective surgical planning. This highlighted the proximity of the cyst to the calvarium. All the structures were surgically removed using an osteotome and mallet. During surgery, a defect was made in the calvarium leading to a small haemorrhage, which was successfully controlled. The external auditory canal was accidentally entered during the procedure; closure was achieved and no postoperative infection was experienced. The structures were histologically confirmed to be dental in origin. On telephone and photographic follow‐up, the horse showed excellent cosmetic results, with no neurological or motor deficits and complete resolution of clinical signs.

Surgical treatment of deep neck infections in 19 dogs.

Describe clinical features, treatment, and outcomes in dogs with deep neck infections. 19 dogs undergoing surgical treatment of deep neck infections from January 1, 2015, through December 31, 2020. Retrospective record review was conducted, with data collected including clinical signs; neutrophil-to-lymphocyte ratio (NLR); diagnostic imaging, surgical, and histopathologic findings; and follow-up. Spearman correlation and Wilcoxon rank sum were used to compare variables to NLR. All dogs had cervical swelling, and 9 were febrile. On CT, a distinct mass or abscess (7/13) or abscessed lymph node (4/13) was common, with contrast enhancement (10/13), fluid tracking (8/13), and displacement of the trachea, pharynx, or larynx (6/13) also frequently seen. Foreign material was suspected on CT for 4 dogs and was identified at surgery or histopathology for 4 dogs, only 1 of which was suspected on CT. Histopathology most commonly revealed pyogranulomatous inflammation (14/15). Increasing NLR was moderately correlated to a decreased duration of clinical signs before presentation (ρ = -0.548; P = .035) and an increased length of hospitalization (ρ = 0.645; P = .009). Bacterial culture was submitted for all dogs, and polymicrobial infections were common (8/19). Broad-spectrum empirical antimicrobials were commonly prescribed. Change in antimicrobial treatment based on culture was uncommon (3/19). All dogs survived to hospital discharge; 18 dogs with long-term follow-up had complete resolution of clinical signs. CT was useful to plan for surgery, and surgical treatment resulted in resolution of clinical signs in all dogs with long-term follow-up available. Empirical antimicrobial treatment, such as amoxicillin-clavulanic acid or ampicillin-sulbactam, should be considered.

Computed tomography findings in horses presented with signs of head-shaking.

Trigeminal nerve-mediated head-shaking (TNMH) in horses is a diagnosis made by exclusion. Computed tomography (CT) is frequently used to identify any disease process that could cause the clinical signs of head-shaking. Although abnormalities are frequently identified, it is unknown whether treatment of these conditions improves clinical signs. To ascertain the clinical significance of CT findings in horses presented with a complaint of head-shaking. Retrospective case series. CT and patient records were reviewed and all abnormal findings and any treatments subsequently carried out was recorded. A questionnaire was sent to referring veterinarians and owners were contacted by telephone to establish whether treatment of the identified condition improved clinical signs. This study included 103 horses presented for head CT with the complaint of head-shaking with follow-up information obtained for 84 horses (81.6%). The diagnosis of TNMH was based on a combination of positive maxillary nerve block and/or response to treatment for TNMH. Although TNMH was the most common diagnosis with 62 horses (60.2%) affected, in 22 horses (21.4%), a primary disease process was identified and treatment of the condition eliminated signs of head-shaking. Clinically relevant primary diseases included dental fracture, primary sinusitis, temporo-mandibular joint arthritis, nuchal bursitis, musculoskeletal pathologies, basisphenoid fracture, otitis externa and a mass affecting the infra-orbital nerve. Some clinical information was missing and follow-up information was not obtained in all cases. CT was perceived as a useful diagnostic tool by most veterinarians, ruling out significant abnormalities. In over 20% of the cases, a treatable primary condition was identified leading to complete resolution of clinical signs.

Stereotactic body radiation therapy as an alternative to adrenalectomy for the treatment of pheochromocytomas in 8 dogs.

The objective of this report is to describe the use and outcome of stereotactic body radiation therapy (SBRT) for treatment of pheochromocytomas in 8 dogs. Pheochromocytomas are an uncommon but challenging tumour to manage. Adrenalectomy is the standard of care for treatment of pheochromocytomas in both animals and humans; however, unpredictable catecholamine secretion from the tumour and vascular and local invasion of the tumour and thrombi can pose life-threatening perioperative and anaesthetic risks. SBRT has been investigated as an alternative to adrenalectomy in human patients with pheochromocytomas. Eight dogs with clinical signs, an adrenal mass, and cytology and/or urine normetanephrine/creatinine ratios consistent with pheochromocytoma were treated with SBRT in lieu of adrenalectomy. Three dogs presented with acute hemoabdomen. Seven dogs had caval tumour invasion, 3 with extension into the right atrium. Following SBRT, all dogs had complete resolution of clinical signs and reduced urine normetanephrine/creatinine ratio and/or tumour size. No significant anaesthetic complications were encountered. Acute radiation toxicity was limited to grade I gastrointestinal signs in 3 dogs and resolved within 1-2 days of symptomatic therapy. Five of 8 dogs were alive at the time of follow up, with a median follow up time of 25.8months. SBRT resulted in a favourable outcome and mitigated the life-threatening risks of adrenalectomy in these 8 dogs. SBRT may be a safe and effective alternative to adrenalectomy for pheochromocytomas in dogs with non-resectable tumours, or for owners averse to the risks of surgery.

Laparoscopic sleeve gastrectomy with Rossetti fundoplication: long-term (5-year) follow-up.

Gastroesophageal reflux disease (GERD), including erosive esophagitis, is highly prevalent in the obese population. Barrett's esophagus is the consequence of untreated GERD. Laparoscopic sleeve gastrectomy is one of the most frequently performed bariatric procedures. This study presents results after 5 years of follow-up of combined LSG and Rossetti fundoplication for the treatment of GERD, esophagitis, and Barrett's esophagus in patients with morbid obesity. To evaluate long-term results after sleeve gastrectomy with Rossetti fundoplication. Public university hospital in Italy. Since January 2015, more than 450 patients with obesity underwent sleeve gastrectomy with a Rossetti fundoplication procedure as part of prospective studies underway at our center performed by 4 different expert bariatric surgeons. Currently, 127 patients have a follow-up of 5 years or more. Mean patient age was 42.9 ± 10.3 years, and mean body mass index was 42.4 ± 6.1 kg/m². In total, 74.8% of patients were experiencing GERD before surgery. In 29 of 127 patients (22.8%), preoperative gastroscopy showed signs of esophagitis and/or Barrett's esophagus. In particular, 23 of 127 patients (18.1%) had grade A esophagitis, 2 of 127 (1.6%) had grade B, 2 of 127 (1.6%) had grade C, and 2 of 127 (1.6%) had Barrett's esophagus. Mean operative time was 51 ± 21 minutes. No intraoperative complications or conversions were reported. A regular postoperative course was seen in 91.3% of patients. Sixty months after surgery, more than 95% of patients did not experience any reflux symptoms. Percent total weight loss at follow-up was comparable with that with sleeve gastrectomy. Endoscopic follow-up demonstrated improvement of esophagitis lesions (including Barrett's esophagus) present in the preoperative setting. Laparoscopic sleeve gastrectomy with Rossetti fundoplication is well tolerated, feasible, and safe in patients with obesity, providing adequate weight loss results and complete resolution of clinical signs of GERD. We have recorded an improvement in esophagitis lesions present at preoperative gastroscopy and complete resolution of Barrett's esophagus within 5 years of follow-up.

Tracheal resection and anastomosis in a dog with an osteochondroma

AbstractA 2‐month‐old golden retriever was presented with a history of intermittent wheezing and inspiratory stridor. Previous thoracic radiographs revealed the presence of a discrete opacity partially obscuring the trachea at the level of the thoracic inlet. Through tracheoscopy, a smooth, broad‐based intratracheal mass was visualised just past the thoracic inlet that made up about 80% of the tracheal diameter. Histological examination of biopsies obtained during this procedure was consistent with tracheal osteochondroma. The mass was removed by resection and anastomosis of the trachea through a cervical approach. Histopathology of the excised mass confirmed the prior diagnosis of osteochondroma. Re‐evaluation and repeat thoracic radiographs 6 months postoperatively showed complete resolution of clinical signs and no evidence of recurrent disease. This case demonstrates that tracheal resection and anastomosis can be a viable and curative surgical procedure for some masses, including osteochondromas, within the trachea.

Nasal Epidermal Inclusion Cyst in a horse: Case Report

Nasal epidermal inclusion cysts, previously known as “atheroma” or “sebaceous cyst”, are cutaneous lesions that occur in the caudodorsal aspect of the nasal diverticulum, between the epithelium of the diverticulum and the skin of the nostril. They are mostly benign, asymptomatic, non-painful, and are primarily of cosmetic significance. Nasal epidermal inclusion cysts are rather rare in horses in contrast with other species or humans. According to our knowledge, nasal epidermal inclusion cysts have not previously been reported across the Mediterranean basin. A 12-year-old, Warmblood gelding was presented to the Equine unit, Aristotle University of Thessaloniki for evaluation of a facial swelling on the right side of the nose. The swelling was first observed 2 years before presentation and had progressively increased in size. On presentation, the horse was bright, alert, responsive and all parameters of the clinical examination were within normal limits. The presence of a large, fluctuating cyst, of approximately 6cm in diameter was noted on the caudodorsal aspect of the right nasal diverticulum. Based on the location and clinical characteristics, a diagnosis of nasal epidermal inclusion cyst was made, and surgical removal was elected. Following anesthesia, a linear skin incision up approximately 8cm long, directly over the epidermal inclusion cyst was made through the skin and subcutaneous tissues. The cyst was dissected from the surrounding tissues, drainage of the wound into the false nostril was done by making a 2-cm incision from the defect into the false nostril and the operating site was thoroughly lavaged. The horse was re-examined 2 months later and showed complete resolution of clinical signs with no complications. The surgical wound had closed completely leaving no obvious scar. The horse was still blemish - free two years after surgery.