Jugular vein stenosis should be inclused in the differential diagnosis of jugular congestion: 2 cases

Introduction

In horses, jugular vein dilatation and congestion is generally caused by thrombophlebitis. Venous stenosis is well known in human medicine but jugular vein stenosis has not been described in horses.

Aim of the study

The purpose of this study was to report that jugular vein stenosis should be considered as differential diagnosis for venous congestion in horses.

Material and methods

Two horses were presented with a non-painful dilatation of the right jugular vein. One horse had received a jugular catheter 9 months before and jugular congestion developed 4 weeks later. The second horse showed jugular congestion since 6 weeks but no injections had been given in the months before. On ultrasound the vein reduced in size 10cm proximal to the thoracic inlet with a markedly thickened intima and media suggesting fibrosis. The size of the lumen at the level of the stenosis was only 1 and 2.3mm. The length of the stenosis was about 15mm. After enoxaparin treatment, dilatation was performed with a 10mm percutaneous transluminal angioplasty catheter. The vein was dilated 3 times with progressively increasing pressures up to 12 bar. The stenotic diameter increased to 4.7 and 4.0 mm with reduction in venous congestion. Aftercare included anti-inflammatory and anti-thrombotic therapy.

Conclusion

Jugular vein stenosis does occur in horses and may occur in the absence of IV injection. Percutaneous transluminal angioplasty of the jugular vein is feasible but more research in a larger group of horses is needed.