The Veterinary clinics of North America. Equine practice.
Publisher:
W.B. Saunders,
Frequency: Three no. a year
Country: United States
Language: English
Start Year:1985 -
ISSN:
0749-0739 (Print)
1558-4224 (Electronic)
0749-0739 (Linking)
1558-4224 (Electronic)
0749-0739 (Linking)
Impact Factor
1.1
2022
| NLM ID: | 8511904 |
| (DNLM): | SR0053812(s) |
| (OCoLC): | 11078671 |
| LCCN: | sn 84006968 |
| Classification: | W1 VE929F |
The management of open joint injuries. The prognosis for returning horses with open joint injuries to athletic function is most closely related to the duration of the injury prior to treatment. Prompt diagnosis and appropriate therapy should yield a favorable result. Delayed diagnosis or inappropriate therapy that allow the wound to progress to an infected state makes the likelihood of return to athletic function poor. Refractory joint infection can occur despite early diagnosis and prompt appropriate therapy. The development of these infections is undoubtedly increased by tissue loss and gross contamination. Appropriate antibiotic...
Skin grafting of the horse. Free autogenous skin grafting of the horse is indicated for wounds too large to heal by contraction and epithelization. Techniques of pinch, punch, tunnel, and sheet grafting are described. Allografting and storage of skin for delayed grafting are discussed.
Upper gastrointestinal surgery for ulcer disease in foals. The goals of surgical therapy in foal gastroduodenal ulcer disease are the elimination of abdominal pain, healing of mucosal ulcerations, and prevention of complications. Gastrojejunostomy has been used with success in both pyloric and duodenal ulcerations that have progressed to gastric outflow obstruction. Gastrojejunostomy has resulted in rapid healing of gastritis and esophagitis and resolution of aspiration pneumonia and biliary stasis without recurrence of duodenal ulceration.
Management of rectal injuries. Diagnosis, evaluation, and management of the various grades of rectal tears is discussed. Surgical techniques, which include direct closure, diverting colostomies, and placement of temporary rectal liners, are detailed. Also, rectal prolapses and various methods of repair are outlined.
Perioperative medical care for equine abdominal surgery. Rational perioperative management improves the success rate of abdominal surgery. Important aspects of management are discussed, including principles of fluid therapy, nutrition, intravenous catheterization, antimicrobial prophylaxis, and the use of nonsteroidal anti-inflammatory medication. Current advances in the area of immunotherapy are mentioned.
Determination of intestinal viability. Operations for intestinal ischemia are frequently done by veterinarians. In equine surgery those conditions commonly producing ischemia are intussusception, volvulus, bowel obstructions, and incarcerated hernias. In an attempt to predict intraoperative bowel viability after the restoration of circulation, a variety of adjuvant methods have been investigated. There is little question that of the techniques currently available, sodium fluorescein injected intravenously approaches the ideal in predicting nonviability in humans and in most animal models. Furthermore, it is safe, takes little opera...
Large colon resection. With large colon resection and anastomosis, up to 95 per cent of the length of the large colon has been successfully removed. A hand-sewn end-to-end anastomosis is effective for lesions in the left dorsal colon and pelvic flexure. Transection and a side-to-side anastomosis with stapling equipment is most effective for extensive resections (greater than 50 per cent). Horses with extensive colon resection (95 per cent) have permanent deficiencies of water absorption and digestion of cellulose and protein. Fermentative capacity is reduced, owing to decreased particulate matter retention time in t...
Surgical diseases of the equine cecum. Cecal impaction and cecal perforation, the two most common equine cecal diseases, are thought to develop after slowing or interruption of a single progressive motility pattern, which begins in a pacemaker area near the apex, occurs once every 3 minutes, and propels ingesta from the cecum to the right ventral colon. Rectal examination in horses with cecal impaction is the most useful technique to grade the severity of the condition. Medical treatment is undertaken if the impaction is judged to be mild to moderate. Surgical correction of cecal impaction in severe cases requires a ventral midline...
Effects of pharmacological agents on gastrointestinal motility. The control mechanisms of gastrointestinal motility are complex. Extrinsic neurohormonal effects modulate an intrinsic system, often called the "gut brain," composed of nervous and neuropeptide components. To exert pharmacologic influence on GI motility, use is made of agents that mimic the external control system. Agents that stimulate opioid receptors, block adrenoceptors, block or facilitate acetylcholine action, or antagonize the action of prostaglandins are used to effect changes in GI motility. The major indications for pharmacologic intervention are to increase motility in constipation,...
Prevention of large colon displacements and volvulus. Results of these studies have demonstrated that colopexy of the left large colon to the abdominal wall is a relatively simple and quick procedure that is permanent 1 year after surgery. The technique does not appear to be associated with long-term weight loss or abdominal pain after surgery. It has been used in pregnant mares, both experimentally and clinically, without apparent complications. In addition, horses used for pleasure-riding and show hunting have returned to performance and have not had complications. Large colon resection is a useful technique, especially for animals with strangu...
Diagnostic and prognostic procedures for equine colic surgery. Evaluation of the horse with colic has always been challenging since the patient's large size precludes many of the diagnostic imaging procedures commonly used in human medicine. Diagnostic methods such as radiography, laparoscopy, endoscopy, and peritoneal fluid analysis can serve to increase the accuracy of presurgical evaluation. Prognosis in individual cases can be best predicted by careful analysis of selected clinicopathological data, physical examination findings, and surgical biopsies. However, no predictive model is 100 per cent accurate, and clinicians must continue to rely on clinic...
Intestinal healing and methods of anastomosis. Optimal intestinal healing occurs when like layers of the intestinal wall are aligned. Hand-sewn, double-layer, end-to-end anastomosis that apposes the mucosa and produces slight inversion of the seromuscular layer is recommended to minimize adhesion formation and provide reasonable alignment of the intestinal layers. Stapled, everted, triangulated, end-to-end anastomosis is not recommended because of extensive adhesion formation and poor healing of the intestinal layers. The preferred stapled techniques create an inverting, side-to-side stoma between the bowel segments.
Large colon resection. With large colon resection and anastomosis, up to 95 per cent of the length of the large colon has been successfully removed. A hand-sewn end-to-end anastomosis is effective for lesions in the left dorsal colon and pelvic flexure. Transection and a side-to-side anastomosis with stapling equipment is most effective for extensive resections (greater than 50 per cent). Horses with extensive colon resection (95 per cent) have permanent deficiencies of water absorption and digestion of cellulose and protein. Fermentative capacity is reduced, owing to decreased particulate matter retention time in t...
Normal intestinal motility. Perhaps because of the inherent difficulty in using horses as experimental animals, only a relatively small amount of data is as yet available regarding normal equine gut motility. However, it is clear that the horse is fundamentally similar to other mammalian species studied. The neural and humoral control of gut activity requires much exploration; it is likely that, in the horse, some of this information will be derived during the investigation of the effects of various substances that might have clinical relevance. This is alluded to in the chapter that follows (The Effects of Pharmacologic...
The pathophysiology of intestinal damage: effects of luminal distention and ischemia. Intestinal edema, luminal distention, and ischemia are common pathologic processes involved in producing the intestinal damage found during surgical exploration for acute abdominal disorders in the horse. The severity of intestinal edema depends on the degree of altered intravascular forces and changes in capillary permeability. Capillary hydrostatic pressure rises as the less pliable venules and veins become occluded during intestinal obstruction. Concurrently, the production of various endogenous products that damage the vascular wall leads to increases in capillary permeability and protein ...
Clinical examination of the equine foot. The foot is the most common source of limb pain. The problems vary from simple to quite complex. An accurate diagnosis is dependent upon a thorough and detailed knowledge of anatomy and of what is available in the way of ancillary examination techniques. The correction of most foot problems requires an appreciation of a multitude of factors and a thorough knowledge of farrier science.
Fractures of the distal phalanx in the horse. Fractures of the distal phalanx are an important cause of lameness referrable to the foot. Depending on the fracture configuration and articular involvement, conservative or surgical treatment may be required. Fractures of the distal phalanx have been divided into six categories based on fracture configuration. Discussion of clinical features, management, and prognosis for horses with distal phalangeal fractures is presented for each fracture type.
Diagnosis and treatment of the navicular syndrome in horses. Navicular syndrome can be treated in a variety of ways. This is related to the fact that it has a variety of causes. Prognostically, most horses will improve with treatment. One can expect about 50 per cent of the horses to become useably sound for 1 year, no matter what treatment is used. The disease is progressive, and affected horses eventually will need to be retired because of lameness. The author's therapeutic approach is to utilize shoeing as the primary therapy. Shoeing is performed to correct structural problems and to ensure that shoeing is physiologically sound. Nonsteroidal anti-in...
The treatment of laminitis in horses. The structural and vascular anatomy of the healthy equine foot is compared with the pathologic changes in the foot of horses with acute and chronic laminitis. The structural and vascular abnormalities present in the foot of horses with laminitis are demonstrated in order to explain the abnormal manner in which their feet grow. The medical, surgical, dietary, and endocrine management of acute and chronic laminitis is discussed. Various forms of hoof trimming beneficial to the reestablishment of normal digital perfusion, normal hoof growth, and normal spatial orientation among the distal phalanx...
Miscellaneous conditions of the equine foot. The etiology, clinical presentation, radiographic findings, diagnostic criteria, differential diagnoses, treatment, and prognosis are reviewed for several clinically important conditions of the equine foot. These include pedal osteitis, sheared heels, distal sesamoid bone (navicular) fractures, subchondral bone cyst of the distal phalanx, distal interphalangeal joint subluxation, congenital phalangeal hypoplasia, bipartite and tripartite distal sesamoid bones, keratoma, ossification of the cartilages of the distal phalanx (sidebones), necrosis of the cartilages of the distal phalanx (quittor),...
Management of lacerations and avulsion injuries of the foot and pastern region and hoof wall cracks. The causes, clinical signs and various approaches to treatment of injuries involving the foot and pastern regions are reviewed, and the prognosis for each type of injury is discussed.
Clinical anatomy of the equine foot. A review of investigations of the functional anatomy of the equine foot is presented. Emphasis is placed on the relationships of structures involved in the major diseases of the foot.
Penetrating wounds, abscesses, gravel, and bruising of the equine foot. Foot-associated lamenesses are common diagnostic challenges for the equine practitioner. This article reviews the commonly occurring penetrating and concussive solar injuries of the equine foot. Diagnostic and therapeutic approaches for the management of these conditions are suggested. With proper treatment, many of these serious injuries will show excellent results.
Pathophysiology of navicular syndrome. Navicular syndrome is a degenerative disorder of the distal half of the flexor surface of the proximal sesamoid bone that is predisposed by faulty foot conformation. In horses that become symptomatic, the faulty conformation results in sustained application of nonphysiologic pressure by the deep digital flexor tendon against the flexor cortex of the bone. This force stimulates an intense bone remodeling response in order to attenuate the pressure. An unfortunate sequela of this response is active hyperemia and edema formation in the medullary cavity of the bone. The edema is organized by fibro...
Pathophysiology of acute laminitis. This article reviews research findings relating to the pathophysiology of acute laminitis in horses. The data presently available suggest that the onset of the condition may be due to constriction of the postcapillary vessels in the digit, leading to increased capillary hydrostatic pressure and movement of fluid into the interstitial space.
Radiographic examination of the equine foot. A complete radiographic examination of the equine foot consists of properly exposed, processed, and positioned radiographs. For radiographic interpretation, in addition to knowing radiographic signs of disease, a knowledge of normal radiographic anatomy and possible insignificant anatomic variations is necessary.
Conditions of the interphalangeal joints. The various conditions of the interphalangeal joint are presented; these include degenerative joint disease and osteochondral chip fractures of the proximal interphalangeal joint, fractures of the middle phalanx affecting proximal and/or distal interphalangeal joints, subluxation and osteochondrosis of the proximal interphalangeal joint, and arthrosis of the distal interphalangeal joint.