Topic:Complications
Complications in horses refer to unexpected medical or surgical issues that arise during the course of treatment or recovery. These complications can affect various systems within the horse's body and may result from underlying conditions, medical interventions, or environmental factors. Common complications in equines include laminitis, colic, infections, and respiratory issues. Each complication presents distinct clinical challenges and requires careful management to mitigate adverse outcomes. This section compiles peer-reviewed research studies and scholarly articles that explore the incidence, etiology, management strategies, and outcomes associated with complications in equine health.
Complications of nasogastric intubation in horses: nine cases (1987-1989). Pharyngeal or esophageal trauma was diagnosed in 9 horses after nasogastric intubation. Evidence of trauma (edema or ulceration) was detected in the pharynx of 3 horses and in the esophagus of 6 horses. Complications associated with nasogastric intubation were first observed in 5 horses while they were intubated and in 4 horses after extubation. Clinical signs of pharyngeal or esophageal trauma were similar, and included salivation, bruxism, coughing, and nasal discharge. Treatment, including extubation, enteral feeding through a small nasogastric tube, or esophagostomy distal to the affected ...
Surgical treatment of colic in American miniature horses: 15 cases (1980-1987). A study of 15 American miniature horses (AMH) that underwent surgical treatment for colic was performed. Information obtained from the medical records included signalment, clinical signs, type and location of gastrointestinal lesion, and postoperative complications. All 15 AMH had intraluminal obstructions, attributable to feed impactions (11 horses), enteroliths (2), and sand (2). The most common location of obstruction was the small colon, which was involved in 9 of the 15 cases. All 15 AMH survived and were discharged from the hospital. Six of the 15 AMH underwent subsequent surgical treatm...
Temporal effects of plasmapheresis on serum proteins in horses. The temporal response of blood and serum proteins to chronic plasmapheresis was determined in 8 horses used in a commercial antibody enterprise. Plasmapheresis of between 4 and 11 L induced significant decreases in total protein, albumin, and IgG values. With the exception of a high hematocrit value for the first postplasmapheresis blood sample, there were no changes in erythrocyte or leukocyte measurements, and no changes in the proportions of serum protein in an electrophoretic profile. Regression equations generated for recovery of proteins after plasmapheresis indicated a return to preplas...
Surgical treatment of dorsal cortical fractures of the third metacarpal bone in thoroughbred racehorses: 53 cases (1985-1989). Between January 1985 and May 1989, 53 Thoroughbred horses (mean age 3.2 years) were surgically treated for dorsal cortical fractures of the third metacarpal bone (MC III). All horses were treated with cortical drilling through the fracture line (osteostixis). Diagnosis of the fractures was confirmed by xeroradiography. Lifetime racing records were obtained for all horses. Forty-seven horses returned to racing after surgery (89%). The mean time between surgery and the first race was 6.8 months. Horses had a mean of 10.9 starts before surgery and 16.1 starts after surgery. The mean earnings per ...
Loop colostomy for management of rectal tears and small-colon injuries in horses: 10 cases (1976-1989). Loop colostomy was performed in 10 horses as treatment for grade-III rectal tears (n = 6 horses), small-colon infarction (n = 2 horses), perirectal abscess and stenosis (n = 1 horse), and small-colon stricture (n = 1 horse). In 7 horses, the colostomy was constructed through a single incision low in the left flank, with closure of the incision around the stoma (single-incision technique). In 3 horses, 2 of which had colostomy performed as a standing procedure, the selected segment of small colon was placed from a flank incision into a separate, small incision low in the left flank (double-inci...
Horner’s syndrome in ten horses. Ten cases of equine Horner's syndrome were reviewed. None of the clinical signs in this series were transient (<48 hours). Sweating and ptosis were consistently observed by the attending clinician in over half of the affected horses. Enophthalmos and prolapse of the third eyelid were not reported consistently. The average duration of the clinical signs was 4.94 months and ranged from 14 days to 15 months. Eight of the ten horses developed associated complications, some of which affected performance. Airway obstruction and impedance of passage of a fiberoptic endoscope due to nasal mucosal e...
Long-term outcome of tooth repulsion in horses. A retrospective study of 61 cases. The records of 61 horses undergoing tooth repulsion for treatment of alveolar periostitis were reviewed. Seventeen of 36 horses (47%) in which maxillary teeth were removed had serious postoperative complications, such as infection of a second tooth, bone sequestration, chronic sinusitis, draining tracts, retained dental packing, feed impaction of the alveolus or sinus, suture-line dehiscence, or skin-flap sloughs. Eight horses required at least one additional surgical procedure. Eight of 25 horses (32%) in which mandibular teeth were removed had serious postoperative complications, and four ho...
Anesthetic management of an incisional dehiscence in recovery following exploratory laparotomy in a horse. A 5-year old Arabian mare fell during recovery from general anesthesia after an exploratory laparotomy. This fall resulted in dehiscence of the abdominal closure, and a substantial amount of intestines were exteriorized. Chemical and manual restraints were rapidly used to prevent trauma to the exposed intestines. A second general anesthesia was initiated to clean the intestines and close the incision. Multiple anesthetic problems were encountered, including arterial hypotension and hypoxemia. The horse recovered from the second general anesthesia and surgery, and all complications gradually re...
Corticocancellous bone biopsy from the 12th rib of standing horses. Unicortical corticocancellous bone biopsy specimens 4.5 mm and 6.5 mm in diameter were obtained without long-term complications from the 12th rib in eight standing horses. However, the bone specimens were unsuitable for histologic or histomorphometric evaluation. In in vitro comparisons of biopsy specimens 6.5 mm and 12 mm in diameter, and of unicortical and transcortical biopsy specimens, 12 mm transcortical specimens yielded the most cancellous bone. Transcortical bone biopsy specimens 12 mm in diameter were obtained from eight horses by using power-assisted trephination. The surgical proced...
Brachygnathia in horses: 20 cases (1979-1989). The medical records of 20 horses admitted to the veterinary medical center with a diagnosis of brachygnathia over a 10-year period (1979 to 1989) were reviewed. The study included 18 foals and 2 adult horses. Males were affected 5.7 times more frequently than females. The amount of disparity between the mandible and premaxilla varied between 0.75 and 3 cm. Sixteen foals were treated surgically with the temporary application of premaxillary tension band devices. Thirteen of the 16 surgical cases were available for follow-up evaluation. All of the surgically treated animals had improved incisive...
Follow-up of 28 horses with third metacarpal unicortical stress fractures following treatment with osteostixis. The results of 31 intracortical dorsal metacarpal stress fractures in 28 horses following unicortical osteostixis were reviewed. The incidence was predominately in the middle third of the lateral aspect of the left metacarpus, and males were affected more commonly. Approximately half of the surgical procedures were performed with the horse in the standing position. The mean times to return to training and racing were 4.25 and 6.9 months respectively. There was no correlation between time taken to return to racing and position of surgery. Complications experienced included lack of suture remova...
Resection and anastomosis of the small colon in four horses. Resection and anastomosis of the small colon was performed on 4 horses with vascular lesions (strangulating lipoma, mesenteric tear, dissecting haematoma) or functional obstruction (stricture) of this area of the bowel. The anastomoses were performed using a variety of suture materials in 2 layers. An appositional, full-thickness, simple, interrupted pattern was used in the first layer in all cases and oversewn with either a Cushing pattern (3 cases) or a Utrecht pattern (1 case). Post-operative complications associated with suture material and surgical technique were not seen. All horses were...
Salmonella typhimurium abscess as a postoperative complication in a horse with colic. An 11-year-old, 430-kg fox-trotter stallion was referred for evaluation of colic. A right-sided inguinal hernia was diagnosed. At exploratory laparotomy, the ileum was found to be herniated through the right inguinal canal. Compromised small intestine was resected, jejunocecal anastomosis was performed, and the horse was castrated. Three days after surgery, the stallion would not bear weight on the left hind limb. The musculature of the left thigh region became swollen. Aspiration of the left thigh region yielded serosanguineous fluid from which Salmonella typhimurium was isolated. Ultrasonogr...
Standing urogenital surgery. Caslick's, episioplasty, urethroplasty, cervical, and rectovestibular laceration repair are, by preference, performed in the standing patient. Normal castration is performed routinely uneventfully in the standing patient. The duration of the procedures and the ease with which they are accomplished in a standing horse of normal temperament make general anesthesia unnecessary. More invasive procedures, such as removal of urinary bladder calculi in male horses or removal of a neoplastic ovary in a mare, can be accomplished in a standing patient but serious consideration should be given to the use...
[Postanesthetic complications in the horse. Evaluation of anesthesia in the last 28 years (1962-1989)]. The anesthesia routine in the horse is briefly explained. 35 postanesthetic complications resulted from the total of 4364 cases of anesthesia. They are evaluated by means of the duration of anesthesia, the time of paresis, the exemplary courses of enzymes as well as the distribution of race and sex and their ratio towards all cases of anesthesia. Finally a list of demands concerning the operative and postoperative phases is compiled to minimize postoperative myositis (PAM) and lameness (PAL).
Renosplenic entrapment of the large colon in horses: 33 cases (1984-1989). Between 1984 and 1989, 33 horses were diagnosed with renosplenic entrapment of the large colon. Duration of colic, signalment, physical findings, and laboratory values were determined, and treatment methods were evaluated. Nonsurgical correction was attempted in 22 of the horses with suspected renosplenic entrapment of the large colon and was successful in 11 cases. Survival and complication rates also were determined. Nonsurgical correction is a viable alternative to immediate surgery for renosplenic entrapment of the large colon, if cases are selected properly.
Evaluation of transabdominal ultrasound-guided amniocentesis in the late gestational mare. Serial transabdominal amniocentesis was performed on eight mares in late gestation. Ultrasonography was used to identify the two placental fluid sacs and the foetus. A biopsy guide attached to the transducer allowed visualisation of the needle path during insertion. Amniotic fluid was obtained in 85 per cent of the attempts, although as mares approached parturition substantial pools of amniotic fluid were more difficult to locate. Two mares aborted during the study probably because of complications of the procedures, whereas six mares produced normal foals at term. The abortions preclude clini...
Use of phacofragmentation for cataract removal in horses: 12 cases (1985-1989). The medical records of 12 horses that had cataracts removed by use of phacofragmentation were reviewed. Cataracts were removed from 16 eyes in horses ranging in age from 2 months to 15 years. Complications after surgery included corneal ulcers in 13 eyes, diffuse corneal edema in 5 eyes, and uncontrollable uveitis in 3 eyes. Follow-up information was obtained in all horses from 1 month to 3.5 years after surgery. Visual results were judged good by owners or veterinarians in 10 of the horses.
Idiopathic cecal rupture in foals after anesthesia for gastric endoscopy. Cecal rupture has been reported as a complication of tape-worm infestation or parturition in horses. Often it occurs with no apparent predisposing factors. Spontaneous rupture on the medial surface of the cecum occurred in 2 of 19 foals, 12 to 24 hours after gastric endoscopy. The sites of rupture were identical in both foals. Rupture occurred despite prior deworming, withholding of food and water before anesthesia, and care in induction of anesthesia and recovery. Surgeons should be aware of the potential of cecal rupture in horses anesthetized for elective surgery.
Small-intestinal volvulus as a complication of acquired inguinal hernia in two horses. Volvulus of the small intestine was diagnosed as a complication of acquired inguinal herniation in 2 horses. One of the horses continued to have signs of pain after reduction of the hernia. The volvulus was diagnosed at a second surgery, but the intestine was devitalized, and the horse was euthanatized. Ventral midline exploratory surgery was performed on the second horse, in conjunction with an inguinal approach. The small-intestinal volvulus was diagnosed and corrected at this time. It is suggested that ventral midline abdominal exploration be performed when acquired inguinal herniation caus...
Regional anesthesia. Organ toxicity from local anesthetic agents is rare. This makes these agents an attractive option in the high-risk patient. Complications associated with local anesthetics are related to overdosage. Overdosage with local anesthetic agents administered epidurally may cause motor paralysis and hind-limb weakness. Systemic signs of local anesthetic overdosage include changes in central nervous system activity (excitement or depression), muscle tremors, and hypotension. Because the dose required to produce these effects in the horse is high (12 mg/kg), this complication is uncommon. Few side effec...
General anesthesia for horses with specific problems. We have discussed anesthetic techniques, special considerations, and expected complications involved in anesthetizing horses for abdominal, orthopedic, and head and neck surgery, and myelography and have described expected physiologic dysfunction that may require changes in anesthetic technique or supportive measures. The objective is high-quality patient care and reduction in anesthesia-related morbidity and death.
Supportive therapy in the anesthetized horse. In conclusion, vigilant supportive care is necessary to prevent morbidity and death in the anesthetized horse. Because some of the equipment and drugs are specialized and the consequences of some postanesthetic complications are severe, availability of those items must be confirmed prior to anesthesia. Proper positioning and padding will help to reduce the incidence of postanesthetic myopathy-neuropathy syndrome in these large patients. Adequate tissue perfusion is important and can be achieved by controlling anesthetic depth, increasing intravascular volume with fluid administration, and by a...
Cecocolic intussusception in horses: 11 cases (1979-1989). Over a 10-year period, cecocolic intussusception was diagnosed in 11 of 842 horses undergoing surgical treatment for colic at the New York State College of Veterinary Medicine. Eight horses died or were euthanatized because of poor prognosis determined at surgery or because of postoperative complications. Three horses recovered without complication after manual reduction of the intussusception and partial typhlectomy, using an intestinal stapling device.
Treatment of equine leg wounds using skin grafts: Thirty-five cases, 1975-1988. A retrospective study was conducted on 35 equine patients with lower leg wounds that were managed utilizing skin graft procedures. Two pinch graft, five punch graft, seven tunnel graft, eight split-thickness mesh graft and thirteen full-thickness mesh expansion graft procedures were performed in the initial treatment. The average wound size was 188 cm(2). Twentyfour cases had pregrafting complications: 10 wounds developed sequestra; three wounds were grossly contaminated and infected; and 11 cases developed granulation tissue complications prior to grafting. Graft failure following the initial...
Surgical stapling for repair of a rectal tear in a horse. A grade-4 rectal tear in a mare was successfully repaired per rectum, using a surgical stapling device. The mare had only minor postoperative complications. This technique has some advantages over previously described procedures, but should be reserved for use in selected cases.
Problem wounds of the horse. Three clinical cases are presented to illustrate some of the problems that may complicate the treatment of wounds in horses. The three examples are a lower limb laceration, a chronic draining chest wound, and complications associated with a fiberglass cast. The use of ancillary diagnostic aids such as arthrocentesis, diagnostic nerve blocks, radiographs, and ultrasonography are indicated to assess change to deeper structures.
Ischemic optic neuropathy and blindness after arterial occlusion for treatment of guttural pouch mycosis in two horses. Ischemic optic neuropathy accompanied by blindness was induced in 2 horses after surgical occlusion of the external and internal carotid and greater palatine arteries, performed as part of the management of guttural pouch mycosis. The blindness was acute and unilateral and may have been caused by ischemic retinal damage. Vascular occlusion is a recommended procedure for treatment of guttural pouch mycosis. Retinal damage and blindness are a possible complication if all possible sources of hemorrhage are occluded.
Surgical repair of ruptured trachea in a horse. An Arabian mare was referred with traumatically induced complete transection of the trachea. A temporary airway was established through the open wound at the site of the rupture. Resection of devitalized tissue including 3 tracheal ring segments, and anastomosis of the tracheal ends was subsequently performed under general anesthesia. Wound healing was complicated by a peritracheal abscess, which responded successfully to drainage and antibiotic administration.