Retrospective analysis of postoperative complications following surgical treatment of ileal impaction in horses managed with manual decompression compared to jejunal enterotomy.

Objective: The objective of this study was to compare the occurrence of post-operative complications and survival to discharge in horses with ileal impactions resolved by manual decompression compared with jejunal enterotomy. Animals: A total of 121 client-owned horses undergoing surgical correction of an ileal impaction at three teaching hospitals. Materials and methods: Data from the medical records of horses undergoing surgical correction of an ileal impaction was retrospectively collected. Post-operative complications, survival to discharge, or post-operative reflux present were evaluated as dependent variables and pre-operative PCV, surgery duration, pre-operative reflux, and type of surgery were evaluated as independent variables. Type of surgery was divided into manual decompression (n = 88) and jejunal enterotomy (n = 33). Results: There were no significant differences in development of minor complications, development of major complications, presence of post-operative reflux, amount of post-operative reflux, and survival to discharge between horses that were treated with manual decompression and those treated with distal jejunal enterotomy. Pre-operative PCV and surgery duration were significant predictors of survival to discharge. Conclusions and clinical relevance: This study showed that there are no significant differences in post-operative complications and survival to discharge in horses undergoing distal jejunal enterotomy versus manual decompression for correction of ileal impaction. Pre-operative PCV and duration of surgery were found to be the only predictive factors of survival to discharge. Based on these findings, distal jejunal enterotomy should be considered earlier in horses with moderate to severe ileal impactions identified at surgery.

Effect of single and double hemitenotomy on equine deep digital flexor tendon length and strength in experimental load challenges.

OBJECTIVE: To evaluate a double hemitenotomy (DHT) technique as an alternative to complete deep digital flexor (DDFT) tenotomy. STUDY DESIGN: Experimental ex vivo study. SAMPLE POPULATION: Isolated DDFTs (n = 30) and cadaveric forelimbs (n = 16). METHODS: In part 1, 15 isolated DDFT pairs were used. Two hemitenotomies were created in 1 DDFT while the other served as reference. Monotonic tensile load was applied. Tendon lengthening, load reduction, and load at failure were recorded. In part 2, 16 cadaveric forelimb pairs were subjected to DHT followed by complete tenotomy (CT) under monotonic compressive load. Differences between DHT and controls were assessed with Wilcoxon signed rank tests or Friedman tests. RESULTS: In isolated tendons and cadaveric forelimbs, DHT resulted in DDFT lengthening (median, +1.9 mm and + 3.05 mm) and load reduction (median, -16.7 and -11.2 kg). Less lengthening was achieved with DHT compared to CT (P = .008). Load reduction did not occur between DHT and CT was observed during compressive testing (P = 1). Load reduction following the first hemitenotomy incision was smaller when compared to the second (P = .022). Isolated DHT tendons failed at a tensile load of 195 kg, while no intact tendons failed (P = .0001). CONCLUSION: Double hemitenotomy was comparable to CT in load reduction. It reduced tensile strength, but load at failure was similar or exceeded the estimated DDFT load at stance. CLINICAL SIGNIFICANCE: Hemitenotomy may be a useful alternative for surgical management of horses with laminitis, but in vivo studies are needed to confirm these findings.

Partial parotid sialoadenectomy in a horse with parotid ductal carcinoma: Surgical description and case report.

OBJECTIVES: To describe the surgical findings, histopathological features, and long-term outcome for a horse with parotid salivary carcinoma. STUDY DESIGN: Case report ANIMALS: Twelve year old American Quarter Horse gelding. METHODS: The gelding was presented for a 10 × 10 cm swelling below the base of the right ear. Ultrasonographic examination revealed a mass involving the right parotid salivary gland. Incisional biopsy was consistent with parotid carcinoma. The tumor was marginally excised. The lateral wall of the guttural pouch was excised with the mass and was reconstructed with a porcine small intestinal submucosal (SIS) sheet. Cisplatin beads were implanted in the wound bed prior to closure. Firocoxib (0.1 mg/kg orally, daily, every 24 h) treatment was initiated. RESULTS: Postoperative complications included right-sided facial nerve paralysis, difficulty with deglutition of fibrous feeds, and surgical site dehiscence. Wound healing was achieved by second intention. Partial improvement in nerve function was observed within the first 6 months. At 12 months postparotidectomy, no sign of tumor reoccurrence or metastatic disease was present, and the gelding returned to work. CONCLUSION: Partial parotid sialoadenectomy was performed with a favorable long-term outcome. Regional anatomic knowledge is crucial.

Minimally invasive tenotomy of the tibial insertion of the semitendinosus muscle: An ex vivo study in horses.

OBJECTIVE: To describe a minimally invasive technique for semitendinosus tenotomy with ultrasonographic guidance and to evaluate procedural complications. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Cadaveric equine hind limbs (n = 16). METHODS: A stab incision was performed distocaudal to the tibial insertion of the semitendinosus muscle with ultrasonographic assistance. After transection of the tendon with an arthroscopic retrograde knife, the tendon edges palpably retracted, and complete transection was confirmed by ultrasound. Limbs were dissected to confirm the degree of tendon transection and to identify iatrogenic trauma to surrounding soft tissues. RESULTS: Tenotomy was complete in all limbs, resulting in a palpable gap forming between tendon edges. Superficial iatrogenic laceration to the underlying gracilis muscle (n = 2) or gracilis fascia (n = 1) was apparent in 3 of 16 limbs. CONCLUSION: Ultrasound-assisted tenotomy of the tibial insertion of the semitendinosus muscle was reliably performed in a minimally invasive fashion with minor iatrogenic damage. CLINICAL SIGNIFICANCE: Minimally invasive tenotomy of the semitendinosus muscle can be performed with ultrasonographic assistance and should be considered as an alternative technique for surgical management of fibrotic semitendinosus myopathy.

Meningitis After Tooth Extraction and Sinus Lavage in a Horse.

A five-year-old Thoroughbred mare was evaluated because of chronic, malodorous, unilateral nasal discharge, and suspected maxillary cheek tooth root abscess. Skull radiographs revealed bilateral sinusitis suspected secondary to tooth root abscessation of 109 and 210. Following oral extraction of 109, bilateral conchofrontal sinus trephination and lavage; fever, tachycardia, and cervical stiffness developed. A lumbosacral cerebrospinal fluid tap was performed, and a presumptive diagnosis of bacterial meningitis was made. Targeted therapy consisted of antibiotic treatment with penicillin, enrofloxacin, and metronidazole, as well as antiinflammatory treatment with flunixin meglumine, dexamethasone, and dimethyl sulfoxide. Following the resolution of fever, tachycardia, and cervical stiffness, the second abscessed tooth, 210, was extracted. The mare was discharged receiving enrofloxacin. Twelve months later, the mare continued to do well with no residual signs of meningitis. Bacterial meningitis should be regarded as a life-threatening, although rare, the complication of dental or sinus surgery in horses. Early diagnosis and therapy may result in a successful outcome.

Evaluation of clinical and tenoscopic findings in the carpal flexor sheath of horses.

OBJECTIVE To evaluate clinical and tenoscopic findings in a large group of horses undergoing surgery of the carpal flexor sheath (CFS) and determine whether any of the presurgical clinical signs were associated with tenoscopic findings. ANIMALS 242 horses that had undergone diagnostic and therapeutic tenoscopy of the CFS because of aseptic tenosynovitis. PROCEDURES Medical and tenoscopic video records (when available) of 242 horses undergoing tenoscopy of the CFS at a single equine clinic between January 2005 and June 2014 were reviewed. Tenoscopic findings were categorized as present or absent, and tears in the deep digital flexor tendon (DDFT) were subjectively graded according to severity. Logistic regression analysis was used to examine whether presurgical clinical findings were associated with intraoperative tenoscopic findings. RESULTS 242 horses (411 limbs) were evaluated by use of tenoscopy. An exostosis was detected in 228 horses (379 limbs) and was often multipartite. Most exostoses were found medial to, or within, the sagittal plane at the caudal margin of the scar on the distal physis of the radius. Effusion in the CFS was associated with tears in the DDFT. Other presurgical clinical findings were not predictive of intrathecal findings. CONCLUSIONS AND CLINICAL RELEVANCE Synovial effusion was predictive of DDFT lesions within the CFS but was not predictive of the severity of lesions. Further studies will be necessary to determine whether any tenoscopic findings are associated with reduced athletic performance and to assess the effect of surgical intervention in affected horses.

Racing performance of Standardbred trotting horses undergoing surgery of the carpal flexor sheath and age- and sex-matched control horses.

OBJECTIVE To determine factors affecting race speed in Swedish Standardbred horses undergoing surgery of the carpal flexor sheath (CFS), to investigate whether preoperative racing speed was associated with specific intraoperative findings and whether horses returned to racing, and to compare the performance of horses undergoing surgery of the CFS with that of age- and sex-matched control horses. ANIMALS 149 Swedish Standardbred trotters undergoing surgery of the CFS and 274 age- and sex-matched control horses. PROCEDURES Medical records of CFS horses were examined. Racing data for CFS and control horses were retrieved from official online records. Generalizing estimating equations were used to examine overall and presurgery racing speeds and the association of preoperative clinical and intraoperative findings with preoperative and postoperative speeds. Multivariable regression analysis was used to examine career earnings and number of career races. Kaplan-Meier survival analysis was used to compare career longevity between CFS and control horses. RESULTS CFS horses were significantly faster than control horses. The CFS horses that raced before surgery were slower as they approached the surgery date, but race speed increased after surgery. There were 124 of 137 (90.5%) CFS horses that raced after surgery. No intrathecal pathological findings were significantly associated with preoperative racing speed. Career longevity did not differ between CFS and control horses. CONCLUSIONS AND CLINICAL RELEVANCE Horses undergoing surgery of the CFS had a good prognosis to return to racing after surgery. Racing careers of horses undergoing surgery of the CFS were not significantly different from racing careers of control horses.