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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.
Treatment of equine keratomycosis, part 2: reporting common systemic and ocular complications to enhance decision-making for equine clinicians and owners. The primary aims were to provide descriptive data on systemic and ocular complications associated with the treatment of equine keratomycosis. The secondary aims were to determine if complication rates differ between treatment types or are related to surgical and anesthetic factors. Methods: The study was a retrospective evaluation of 126 cases between 2004 and 2020 with confirmed fungal infection and recorded incidence of complications during hospitalization and surgical intervention if pursued. Additional information recorded included the size of the donor graft if utilized, time under genera...
Closed laceration of the trachea, esophagus and guttural pouches in a mare caused by blunt trauma. A mare was admitted for progressive swelling of the neck, lethargy and anorexia. Radiography revealed perilaryngeal, peritracheal, and periesophageal emphysema. Endoscopy revealed pharyngeal and tracheal roof collapse, and a small laceration on the trachea. Treatment with antimicrobials, fluids, and flunixin was initiated. To prevent exacerbation of the emphysema, temporary tracheostomy was performed. Clipping for the tracheostomy revealed a hoofprint mark on the ventral neck. Subsequent endoscopies revealed laceration of the esophagus and guttural pouch septum communicating with the visceral ...
Treatment of a urethral stricture by image-guided placement of a custom-made absorbable stent in a standing, sedated horse. A 10-year-old Irish Sport Horse gelding developed complications from a general anesthesia resulting in sling support and recurrent urinary catheterization. The horse subsequently presented signs of dysuria and pollakiuria, was diagnosed with sabulous cystitis, and developed a urethral stricture from the repeated catheterizations, which was confirmed on urethroscopy. Clinical signs persisted despite conservative management with topical corticosteroids and urethral bougienage with balloon dilators. An image-guided approach was used to treat the stricture with a custom-made polydioxanone stent pl...
Equine Melanoma Updates. Melanomas are very common in older gray horses, with 80% of gray horses having at least 1 melanoma by 15 years of age. Historically considered a benign disease, it is now known that up to 66% of lesions will eventually metastasize. Melanomas may also cause local problems due to abscessation, ulceration, and interference with function of the affected areas. Treatment can be limited by size and location, but surgical resection, where possible, is likely to be the treatment of choice.
Esophageal perforation diagnosis, treatment, complications, and outcome in a Standardbred colt. A 4.5-month-old Standardbred colt presented for neck swelling and fever. Endoscopy and contrast radiography identified a full thickness esophageal perforation. Surgical intervention with fasciotomies and placement of an esophageal feeding tube was elected. Intensive postoperative treatment was carried out with broad-spectrum antibiotics, gastroprotectants and probiotics, calculated feeding plan, esophagostomy and fasciotomy site lavages, care, and cleaning. Complications included recurrent bilateral pneumothorax and development of an incomplete fistula at the esophagostomy site following remov...
Peri-anaesthetic complications in 1798 equids undergoing high-field elective orthopaedic MRI at a tertiary referral hospital. Antimicrobial prophylaxis for elective orthopaedic magnetic resonance imaging (MRI) in equids is a topic of debate among practitioners and can have negative detrimental effects on patients if used unnecessarily. Objective: To describe the complications with elective orthopaedic MRI of horses, mules, and donkeys under general anaesthesia without the use of peri-anaesthetic antimicrobial prophylaxis at a single large tertiary referral centre. We hypothesised that horses, mules, and donkeys undergoing general anaesthesia for elective orthopaedic MRI, without antimicrobial prophylaxis, will not be...
Low-dose intravitreal injection of 4 mg preservative-free gentamicin and superficial lamellar keratectomy combined with modified Gundersen grafts to control chronic heterochromic iridocyclitis and secondary keratitis in horses. To describe a combined treatment approach for heterochromic iridocyclitis and secondary keratitis (HIK) in horses. Methods: A total of 15 horses (16 eyes). Methods: Sixteen eyes from 15 horses (mean age 14.1 years, range 6-26 years) received low-dose (4 mg) intravitreal preservative-free gentamicin injection (IVGI) and modified Gundersen grafts with standing sedation and local anesthesia following a clinical diagnosis of HIK. Additional therapies of suprachoroidal triamcinolone (8 mg) injection, episcleral bromfenac implants, and suprachoroidal cyclosporine implants were performed in i...
Emergency Standing Laparoscopic Treatment of Uncontrolled Post-Castration Hemorrhage in Two Geldings. Persistent hemorrhage of testicular vessels is a potentially life-threatening complication of equine castration. Frequently, general anesthesia is required to retrieve and ligate the bleeding vasculature when standing wound packing and retrieval of the spermatic cord are unsuccessful. We propose standing laparoscopic ligation of the testicular arteries via the paralumbar fossa as a rapid, effective means of halting hemorrhage while avoiding castration site trauma as well as the cardiovascular and recovery risks of general anesthesia. Methods: Two geldings, 6 and 9 months old, presented for eme...
Mastectomy in ten mares: indications, surgical technique, complications, and long-term outcome. To describe the indications for and surgical technique of mastectomy of mares and to describe the outcome of 10 mares that underwent mastectomy in a retrospective case series. Methods: 10 mares having disease of one or both mammary glands. Methods: Medical records (1995 to 2022) from 2 university teaching hospitals were searched to identify mares that had undergone unilateral or bilateral mastectomy. Data regarding history, signalment, diagnostic tests, preoperative treatment, surgical procedure, and postoperative management were reviewed. Follow-up information was obtained by interviewing the...
Transcorneal aspiration for management of primary iris cysts in the standing horse. Equine primary iris cysts are usually incidental findings but, if associated with clinical signs, may require intervention. The use of laser (Nd:Yag or diode) has been reported but requires specialised equipment. Transcorneal aspiration has not been previously evaluated in the standing horse. To review outcomes of standing transcorneal aspiration of primary iris cysts (STAPIC) in horses. Horses were identified from electronic patient records from 2018 to 2024 across four collaborating centres. Clinical presentation and outcomes were identified and reported using descriptive statistics. Eightee...
A scoping review on intraoperative and postoperative surgical castration complications in domesticated equids. Castration is the most common surgical procedure in domesticated equids; surgical techniques used and perioperative management vary considerably. Objective: To identify and chart the current evidence on perioperative complications associated with different methods of surgical castration in domesticated equids. Methods: Joanna Briggs Institute systematic scoping review. Methods: CAB Abstracts, Medline and Embase databases were searched using terms related to equine castration complications. Two authors independently and blindly screened publications against eligibility criteria. Data on study m...
Use of wound infusion catheters for delivery of local anesthetic following standing partial ostectomy of thoracolumbar vertebral spinous processes in horses is not associated with increased surgical site infections. Wound infusion catheters (WICs) have been used in humans and some veterinary species for post-operative local anesthetic administration following a variety of surgical procedures, aiming to reduce post-operative analgesia requirements and improve patient comfort. Benefit in reduction in pain, post-operative analgesia requirements and length of hospital stay are well documented in humans, but use of WICs may not have been widely adopted in veterinary species due to the concern of increased complications, such as dehiscence or surgical site infection (SSI), creating a barrier to their use. This ...
Piezoelectric device use in sinus osteotomy for equines is feasible but may extend time to accomplish frontonasal bone flap. Sinus osteotomy is currently performed in equine surgery with conventional surgical methods, such as trephines and oscillating bone saw, leading to subsequent trauma to the bone during cutting. Piezoelectric devices are now used in maxillofacial surgery in humans as a standard tool as it is less traumatic than the oscillating bone saw and shortens the healing period. The aim of this study was to show that the piezoelectric device can be used for equine sinus surgery, compare its use with the oscillating bone saw, and describe the outcome of cases involving osteotomy performed with a piezoelect...
[Navicular bone fractures in horses: Prognosis after conservative and surgical treatment]. The aim of this retrospective study is to describe and compare conservative and surgical treatment of navicular fractures in horses. An attempt is made to identify critical points that can favorably influence the prognosis of this orthopedic disease. All horses treated for a navicular fracture at the Equine Clinic, Vetsuisse Faculty, University of Zurich between 2005 and 2017 were included in this study. The severity of lameness at initial examination, radiographic assessment, hoof conformation, treatment (conservative or surgical), complications and outcome were determined from the medical re...
Retrospective evaluation of the effects of a single intraoperative dose of dexamethasone in horses undergoing exploratory laparotomy for small intestinal lesions (2008-2019): 240 cases. To determine the effect of a single intraoperative dose of dexamethasone on the risk of postoperative reflux (POR) in horses undergoing small intestinal surgery and to investigate its association with incisional complications and short-term survival. Methods: Retrospective cohort study over an 11-year period (2008-2019). Methods: UK-based private referral center. Methods: Two hundred and forty client-owned horses >6 months of age undergoing exploratory laparotomy for treatment of a small intestinal lesion. Methods: Ninety-seven horses received a single intraoperative dose of dexamethasone ...
Risk assessment in equine anesthesia: a first evaluation of the usability, utility and predictivity of the two-part CHARIOT. An accurate risk score that can predict peri-anesthetic morbidity and mortality in equine patients could improve peri-operative management, outcome and client communication. Unassigned: Three hunded horses underwent pre-anesthetic risk assessment using the American Society of Anesthesiologists-Physical Status augmented with equine-specific diseases (ASA-PS-Equine), a multifactorial 10-part rubric risk scale (10-RS), and a combination of both, the Combined horse anesthetic risk identification and optimization tool (CHARIOT). Intra-and post-anesthetic complications, the recovery phase and mortal...
Surgical Closure of Equine Abdomen, Prevention, and Management of Incisional Complications. Although rarely fatal, complications of ventral midline laparotomy incision in equine patients increase hospitalization cost and duration and may jeopardize return to athletic function. Therefore, many techniques have been developed to reduce their occurrence and expedite their resolution when they occur. Our technique of celiotomy incision closure includes the use of tension sutures (vertical U mattress) of polyglactin 910 on the linea alba, which is then apposed by polyglactin 910 interrupted sutures or a simple continuous pattern suture with a stop midway before routine closure of the super...
Involvement of veterinary students in the placement of intravenous catheters in adult horses in a teaching hospital does not significantly increase the rate of catheter complications. To determine whether student involvement in intravenous catheter (IVC) placement increases the risk for complications and to report the rate and types of complications associated with IVCs in adult horses in a university teaching hospital. Methods: 455 IVCs placed in 394 horses. Methods: Data relevant to IVC placement and removal were retrieved from an electronic medical record search including records of adult horses from January 1 to December 31, 2022. Data retrieved from records included the role of the individual who prepared the site and placed the IVC, site of IVC placement, and type of ...
Phacoemulsification Combined with Pars Plana Vitrectomy: Outcome in Horses with Acquired Cataracts Associated with Uveitis. Cataracts resulting from equine recurrent uveitis (ERU) or other forms of uveitis are usually associated with rapid progression. ERU is the most common ocular disease cause of blindness and cause of cataracts in horses. The necessity for the posterior capsulorhexis (PC) during phacoemulsification (PE) is controversial. This study aimed to evaluate vision and complications after PE combined with pars plana vitrectomy (PPV) in horses with uveitis-associated cataracts and compare the PE technique with and without posterior capsulorhexis. Methods: Thirty-two eyes of 28 horses with uveitis-associat...
Expression pattern of germ cell markers in cryptorchid stallion testes. Cryptorchidism affects spermatogenesis and testis development, often resulting in stallion subfertility/infertility. This study aims to identify the specific germ cells impacted by cryptorchism in stallions. In a previous study, we found that PGP9.5 and VASA are molecular markers expressed in different germ cells within stallions. Herein, we assessed the heat stress-induced response of spermatogonial stem cells (SSCs) in the seminiferous tubules (ST) of cryptorchid stallion testes (CST) and normal stallion testes (NST). This goal was accomplished by comparing PGP9.5 and VASA expression pattern...
Factors associated with development of post-operative reflux in horses with large colon volvulus and association with complications and outcomes. Post-operative reflux (POR) is rare following large colon volvulus (LCV) but does occur despite the absence of a small intestinal lesion. The prevalence, risk factors and association with survival of POR after LCV are currently unknown. Objective: To determine the prevalence of POR in horses with an LCV and its association with survival. A further objective was to assess factors which may predict POR. The hypothesis was that horses with POR following LCV surgery have a worse outcome for survival compared to those without POR. Methods: A retrospective cross-sectional study. Methods: Clinical da...
Long-term performance of show-jumping horses and relationship with severity of ataxia and complications associated with myeloencephalopathy caused by equine herpes virus-1. Equine herpesvirus myeloencephalopathy (EHM) has severe impact on the sport horse population. Objective: Study the influence of EHM on the likelihood of affected horses to return to their previous performance and investigate the association of clinical variables with prognosis. Methods: Twenty-six horses positive for equine herpesvirus type 1 (EHV-1) were admitted to a veterinary teaching hospital (VTH) during a natural EHM outbreak at an international jumping event. Methods: Data collected from the VTH, the International Equestrian Federation, and surveys completed by the riders and horse own...
Extracellular Vesicles Isolated from Equine Adipose-Derived Stromal Stem Cells (ASCs) Mitigate Tunicamycin-Induced ER Stress in Equine Corneal Stromal Stem Cells (CSSCs). Corneal ulcers, characterized by severe inflammation of the cornea, can lead to serious, debilitating complications and may be vision-threatening for horses. In this study, we aimed to investigate the role of endoplasmic reticulum (ER) stress in corneal stem progenitor cell (CSSC) dysfunction and explore the potential of equine adipose-derived stromal stem cell (ASC)-derived extracellular vesicles (EVs) to improve corneal wound healing. We showed that CSSCs expressed high levels of CD44, CD45, and CD90 surface markers, indicating their stemness. Supplementation of the ER-stress-inducer tunicam...
Anaesthesia-related morbidity associated with recumbent, low-field magnetic resonance imaging of horses. Medical records from 2009 to 2021 from a private equine referral hospital in Rochester, NH, USA were analysed for cases that underwent general anaesthesia for low-field MRI of the distal limb. These were used to determine peri-anaesthetic morbidity and mortality. Unassigned: Two hundred and forty-three anaesthetic episodes were recorded in horses undergoing low-field MRI. The peri-anaesthetic complication rate prior to discharge was 6.2% (15/243). No patients experienced a fatal complication. Ninety two of the 243 patients had multiple sites imaged, 90/243 received pre-anaesthetic dantrolene, ...
Splenic hematoma and hemoperitoneum in a Thoroughbred racehorse after racing. To describe the clinical presentation of a Thoroughbred filly with acute hemoperitoneum from a splenic source immediately after racing. Methods: A 3-year-old Thoroughbred filly used for racing and that had raced shortly before presentation to the hospital. Unassigned: On presentation, the filly was quiet, alert, and responsive with a heart rate of 76 beats/min, pale mucous membranes, and absent borborygmi. All other physical examination parameters were within normal limits. Abdominal ultrasound was performed and revealed echogenic free abdominal fluid and a splenic hematoma. Abdominocentesis y...
Severe orbital hematoma with third eyelid swelling and prolapse following a blind maxillary nerve block in a horse. A 20-year-old quarter horse gelding was presented for routine dental examination. Periodontal disease and luxation of tooth 108 was diagnosed and oral extraction was planned. After an unsuccessful blind maxillary nerve block, it was elected to perform the procedure under total intravenous anesthesia. Following recovery, a focal superficial corneal ulcer, severe retrobulbar swelling, mild exophthalmos, and marked swelling and prolapse of the third eyelid (nictitating membrane) were observed. Clinical signs persisted beyond 48 h despite the use of systemic anti-inflammatories and topical ocular ...
Twenty-four hour continuous transvenous temporary right ventricular pacing in healthy horses. The ability to perform transvenous temporary cardiac pacing (TV-TP) is critical to stabilize horses with symptomatic bradyarrhythmias. Reports of successful TV-TP in horses are limited, and only briefly describe short-term pacing. Objective: To describe temporary, medium-term (24 h) transvenous right ventricular pacing in awake horses using a bipolar torque-directed pacing catheter. Methods: Six healthy adult institutional teaching horses. Methods: Prospective experimental study with 2 immediately successive TV-TP lead placements in each horse with a target location of the RV apex. One place...
A retrospective comparison of postoperative outcomes in ovariectomised jennies (Equus asinus) treated with phenylbutazone or flunixin meglumine. Clinically, flunixin meglumine (FM) and phenylbutazone (PBZ) are preferentially selected for the treatment of visceral and musculoskeletal pain, respectively, in horses. In donkeys, there is no information to support or refute this conventional conjecture. Objective: To compare postoperative outcomes in a group of jennies treated with intravenous FM or oral PBZ. Methods: Fourteen jennies unilaterally ovariectomised by standing left flank laparotomy. Methods: Retrospective cohort study. Methods: Data from medical records of ovariectomised jennies (case details, weight, non-steroidal anti-inflam...
Conductivity of mammary gland secretions is a sensitive and specific predictor of parturition in mares. Accurate prediction of parturition is paramount to ensuring monitoring of delivery and preventing complications. Assessing the pH and electrolytes of the mammary gland secretions (MGS) helps detect impending parturition. As conductivity is related to electrolyte concentrations and pH, it could be a useful alternative for predicting impending parturition; however, this hypothesis warrants a critical assessment. Objective: To assess the ability of conductivity, pH, and Brix in the MGS to predict parturition and to investigate their associations. Methods: Field study. Methods: The MGS of peripart...
