Although one of Vincent van Gogh’s most famous paintings, Starry Night, might have a peaceful and familiar air to it, the starry sky pattern seen on some equine hepatic (liver) ultrasounds is everything but van Gogh. It’s more obscure and less preferred because it often points to a horse health problem.

To help equine practitioners gain a better understanding of this uncommon finding, Kelly Carlson, DVM, Dipl. ACVIM, presented a review of this pattern and associated findings at the 2011 American Association of Equine Practitioners convention, held Nov. 18-22 in San Antonio, Texas.

"The starry sky pattern is an unusual and dramatic ultrasonographic appearance of the equine liver characterized by numerous small hyperechoic foci, some of which cast an acoustic shadow," explained Carlson, of Rood & Riddle Equine Hospital, in Lexington, Ky.

In their retrospective review, Carlson and her colleagues aimed to better characterize all aspects of the ultrasonographic pattern. They reviewed the case records and ultrasonographic images of 18 adult horses (of mixed ages and breeds) in which the starry sky pattern was found