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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.
Equine non-septic tenosynovitis: A systematic literature review of site-specific pathological lesions, outcomes and surgical complications. Non-septic tenosynovitis is a clinically relevant and often performance limiting musculoskeletal injury in the horse. Objective: To review the published literature to determine which tendon sheaths are commonly affected by non-septic tenosynovitis and to describe the most frequently reported pathological lesions, outcomes, and surgical complications in equine non-septic tenosynovitis. Methods: Systematic review. Methods: Literature searches were conducted in July 2021 from the online search engines PubMed, Scopus, Web of Science Core, VetMed Resource and ProQuest Theses & Dissertations. Th...
Computed tomographic imaging and surgical management of distal insertional avulsion fragments of the caudal cruciate ligament in four horses. To describe cases with caudal cruciate ligament (CdCL) avulsion fragments diagnosed based on computed tomography (CT) examination and report on arthroscopic fragment removal. Methods: Four Warmblood horses with hindlimb lameness and osseous fragments located in the caudal medial femorotibial joint (mFTJ). Methods: Short case series. Methods: CT and arthroscopic evaluation of the caudal mFTJ were performed. The caudal mFTJ and the insertion of the CdCL on the tibia were assessed and removal of the avulsion fragments was attempted in three horses using a cranial intercondylar approach. Results: ...
Phenylbutazone concentrations in synovial fluid following administration via intravenous regional limb perfusion in the forelimbs of six adult horses. Pain management is critical to equine welfare with non-steroidal anti-inflammatory drugs (NSAID) commonly used in horses. However, systemic NSAID use is limited by harmful gastrointestinal and renal side effects. Intravenous regional limb perfusion (IVRLP) is a technique used in horses that produces high, local antibiotic concentrations while limiting systemic circulation. NSAID-IVRLP would be a novel method of local pain management while limiting systemic NSAID side effects. To date, NSAID-IVRLP administration has not been reported in horses. This study aimed to identify the pharmacokinetics ...
Comparison of equine paranasal sinus trephination complications and outcome following standing computed tomography, radiography and sinoscopy guided approaches for the treatment of sinusitis. The recent availability of standing computed tomography (CT) for equine paranasal sinus disease has enhanced diagnosis and enabled more targeted surgery compared to radiography and sinoscopy. To date, there have been no studies which have critically evaluated the benefit of preoperative CT versus radiography and sinoscopy on complications and outcome in horses undergoing sinus trephination. Methods: Retrospective study. Methods: A total of 229 equids. Methods: The medical records of equids (229) presented for sinusitis treated via trephination that had CT, radiography and/or sinoscopy at time ...
Indications for the removal of implants after fracture healing: A comparison between human and veterinary medicine. Indications for implant removal after fracture healing are still under debate in both human and veterinary medicine. Although hardware removal is a common procedure, it should not be undertaken lightly. Intra and post-operative complications are common and a thorough evaluation of the risks and benefits should be performed. This review aimed to collect and summarise published data on the indications for implant removal in small animals, compare the collected data with human and equine medicine, and investigate the existence of guidelines for this purpose. There is no international...
Do post-surgical multiresistant urinary infections occur in horses? Case of unilateral pyelonephritis caused by extended-spectrum beta-lactamase-producing bacteria as a complication of cystotomy. Pyelonephritis is a serious condition that is rarely described in horses. In contrast, urinary tract infections are common in humans and small animals, and multi-drug-resistant urinary infections are an emerging threat. In this report, we describe a horse with unilateral pyelonephritis caused by extended-spectrum beta-lactamase-producing bacteria belonging to the Enterobacter cloacae complex. [Correction added on 9 August 2023, after first online publication: The preceding sentence was corrected.] An 11-year-old Swedish warmblood gelding was diagnosed with a cystolith and a cystotomy through a...
Laparoscopic cryptorchidectomy using a resorbable self-locking loop device in dorsally recumbent horses. To report the use and feasibility of a self-locking resorbable loop device for cryptorchidectomy. Methods: Clinical prospective study. Methods: Twenty horses. Methods: Horses suspected to have an abdominal testicle/s after admission work-up were enrolled. Horses were anesthetized in dorsal recumbency and a standard laparoscopic technique was performed. The looped device was inserted into the abdomen, glided around the testis/cord and tightened. Then, the spermatic cord was transected prior testis removal. Surgical procedure details and remarks, perioperative complications and total surgical ti...
Repeat Celiotomy-Current Status. Repeat celiotomy can be lifesaving in horses with a surgically treatable postoperative obstruction, although guidelines for its use are lacking, except for uncontrollable postoperative pain. Overdiagnosis of ileus as the cause of postoperative obstruction could delay a second surgery so the disease progresses beyond a manageable level of severity. Although many horses respond favorably to repeat celiotomy, complications can be severe and life threatening, such as incisional infection and adhesions. Repeat celiotomy does not seem to exacerbate postoperative ileus, despite additional surgical ma...
Subarachnoid hemorrhage and axonal degeneration after C1-C2 cervical centesis in 2 horses. Ultrasound-guided cervical centesis has gained popularity as a method for collecting cerebrospinal fluid (CSF) from standing horses. There are anecdotal reports of neck stiffness, regional swelling, sensitivity to palpation, and fever after the procedure. We report 2 horses with complications that occurred within days of C1-C2 centesis and ultimately resulted in euthanasia. Both C1-C2 centesis were performed routinely, with CSF cytologic analysis providing no evidence of blood contamination. Post-mortem examination revealed equine degenerative myeloencephalopathy as the primary disorder causin...
Intraoral Formation of a Rigid Obturator for the Treatment of Dental Fistulae and Draining Tracts in the Horse. A retrospective cohort study to describe a novel use of a mechanically retained, rigid obturator (RO) to manage maxillary and mandibular persistent pathologic oral communications (PPOCs). This study included 22 horses with PPOC with at least 6 months of follow-up after treatment with a RO. The RO was made with a flowable, bis-acryl-based composite resin. Medical records were analyzed, including case details, obtained imaging, surgical reports, and follow-up information. There were 10 horses that had follow-up examinations by the authors and 8 horses by the referring veterinarian; in 4 horses, ...
Short-Term Survival and Postoperative Complications Rates in Horses Undergoing Colic Surgery: A Multicentre Study. The occurrence of colic could be influenced by the characteristics of a population, geographical area, and feeding management. The aim of this study was to report the short-term postoperative complications and survival rates and to identify factors that might affect the outcome of horses that underwent colic surgery in three Italian surgical referral centres. Data of horses subjected to colic surgery in three referral centres (2018-2021) were analysed. Comparisons of the outcomes were performed using a Mann-Whitney or a Chi square test. Areas under the receiver operating characteristic (ROC) c...
Development of a classification system for equine postoperative complications and its application in a cohort of 190 horses undergoing emergency laparotomy. Accurate reporting of postoperative complications is paramount to understanding procedural outcomes, comparing procedures and assuring quality improvement. Standardising definitions of complications in equine surgeries will improve the evidence of their outcomes. To this end, we proposed a classification for postoperative complications and applied it to a cohort of 190 horses undergoing emergency laparotomy. Methods: A classification system for postoperative complications in equine surgery was developed. Medical records of horses that underwent equine emergency laparotomy and recovered from an...
Benefits of cyanoacrylate mesh closure following exploratory laparotomy in horses. Skin closure of laparotomy incisions using topical 2-octyl cyanoacrylate (2-OCA) mesh provides a secure bactericidal barrier in humans, which may reduce the risk of postoperative incisional complications. However, the benefits of using this mesh have not been objectively assessed in horses. Methods: From 2009 to 2020, three methods of skin closure were used following laparotomy for acute colic, including metallic staples (MS), suture (ST) and cyanoacrylate mesh (DP). The closure method was not randomised. Owners were contacted 3 months or more after the surgery to record any postop...
Standing Surgical Management of Splint Bone Fractures in 13 Horses: A Comparison to Management Under General Anaesthesia. The aim of this article was to describe the technique and outcomes of standing surgical management of splint bone fractures and to compare outcome variables and hospitalization cost to a group with similar fractures treated under general anaesthesia. Methods: It is a single-institution retrospective study. Surgical technique, surgical time, hospitalization cost and complications were retrieved from the medical records of horses treated surgically for splint bone fractures (2008-2020). Owner telephone follow-up provided data about athletic outcome, client satisfaction and cosmetic appeara...
Complications following diagnostic and therapeutic sacroiliac joint region injections in horses: A study describing clinicians’ experiences. There are no detailed data on complications of sacroiliac (SI) joint region injections or on the variability of the methods and circumstances of injections among clinicians. Objective: To describe complications following diagnostic, therapeutic and combined SI joint region injections and the details of how these are routinely performed by a large number of clinicians. Methods: Cross-sectional questionnaire survey. Methods: Clinicians (members of American and European specialist colleges and veterinarians known to the authors), invited by email, who had performed ≥1 SI joint region injection,...
Use of a new device for inversion of the necrotic ileal stump in the caecum in four horses. In jejunocaecal anastomosis leaving a necrotic ileal stump has been implicated in complications and poor outcomes. Elective inversion of the necrotic stump using a nasogastric tube has been previously described, although this procedure can be cumbersome and can cause caecocolic orifice occlusion. Objective: To describe the use of a new device for elective inversion of necrotic ileal stumps. Methods: Case report. Methods: Details of the four horses that underwent intestinal resection and anastomosis with elective inversion of the ileal stump were retrieved from their medical records. For each c...
Complications in Laparoscopic Access in Standing Horses Using Cannula and Trocar Units Developed for Human Medicine. First cannulation is a critical manoeuvre in equine laparoscopy. This retrospective study aimed at the comparison of the frequency and type of complications detected when using different human laparoscopy devices for laparoscopic access in standing horses, and the influence of body condition in such complications. Forty-four procedures were included, and retrieved data comprised cannula insertion technique, body condition, and type and frequency of complications. Laparoscopic access techniques were classified into five groups: P: pneumoperitoneum created using Veress needle prior to cannulatio...
Standing equine cheek tooth extraction: A multivariate analysis of the effect of antibiotics on the risk of post-operative complications. Commonly, cheek tooth extraction performed in standing horses using perioperative prophylactic antibiotics, results in low post-operative complication rates. However, no studies have documented the relevance of perioperative antibiotics to the risk of post-operative complications. Objective: To examine the association between perioperative antibiotics and post-operative complications after standing cheek tooth extraction. Methods: Retrospective cohort study. Methods: Information from clinical records and follow-up questionnaires relating to horses subjected to cheek tooth extractions between S...
Postoperative sinusitis and pneumonia following exploratory celiotomy for treatment of colic in horses. Sinusitis and pneumonia following exploratory celiotomy in horses were studied, evaluating associations between these 2 respiratory complications and selected pre-, peri-, and post-operative variables. The incidence of sinusitis was 2.5% (8/318) and pneumonia 3.5% (11/318). These respiratory complications were associated with peri-operative reflux, longer antimicrobial treatment, and longer hospitalization. . La sinusite et la pneumonie consécutives á une coeliotomie exploratoire chez le cheval ont été étudiées, afin d’évaluer les associations entre ces deux complications respiratoire...
Complications following transcutaneous cecal trocarization in horses with a cattle trocar and a cecal needle. Percutaneous decompression of the cecum is a procedure that could be considered for horses with cecal gas distension. The aim of this study was to identify complications such as peritonitis and clinically relevant peritonitis (CRP) after transabdominal cecal trocarization in healthy horses using a cattle trocar and a cecal needle. Mixed breed horses were assigned to three groups (n = 6): horses that underwent trocarization with a cecal needle (G1) or a cattle trocar (G2), and a control group (CG) without cecal trocarization. The same horses were used in each group, respecting a three-month was...
Mid-term performance of decellularized equine pericardium in congenital heart surgery. The aim was to report mid-term performance of decellularized equine pericardium used for repair of various congenital heart defects in the pediatric population. Methods: A retrospective review of all patients undergoing patch implantation between 2016 - 2020 was performed. Patch quality, surgical handling, hemostasis and early patch-related complications were studied on all patients. Mid-term performance was observed in patients with ≥12 months follow-up and intact patch at discharge (without reoperation/stent implantation). Results: A total of 201 patients with median age of 2.5 years [inte...
[Unilateral mandibular fracture in horse – Treatment with fixateur externe, a complication during implant removal and procedure for removal of implant fragments]. The first part of this case report describes the surgical treatment of a unilateral mandibular fracture in the standing horse by using a fixateur type I. By the time of implant removal, the fracture had completely healed. However, during implant removal, an implant failure of 2 of the 4 implants occurred with fragments remaining in the bone. The second part of the report focuses on the development of a special surgical instrument that was designed for removal of the implant fragments. Furthermore, the surgical method allowing the entire extirpation of the fragments within a second surgery is d...
Caudal epidural catheterization for pain management in 48 hospitalized horses: A descriptive study of demographics, complications, and outcomes. The placement of caudal epidural catheters in horses has become more frequent as a multi-modal analgesic strategy. Despite its integration into clinical practice, there are limited reports describing the use of caudal epidural catheterization for prolonged use in horses. The purpose of this study was to characterize the hospitalized caseload undergoing epidural catheterization for long-term epidural analgesic administration, to report the response to epidural therapy and observed complications, and to describe patient outcomes. Medical records of hospitalized equine patients that underwent pla...
Scoping review: Occurrence and definitions of postoperative complications in equine colic surgery. Postoperative complications frequently occur following equine colic surgery but there is a lack of consistency in their definitions and reporting. Objective: To perform a scoping review to identify current evidence on the definitions and classifications of postoperative complications in equine colic surgery. Methods: Evidence review. Methods: A scoping review was conducted in CAB, Web of Science, Scopus and PubMed databases using a PCC (Population-equids, Concept-complications, adverse events, sequelae, failure to cure, technical failure, disease progression and Context-postoperative period af...
Occurrence and Definitions of Intra and Postoperative Complications Related to Laparoscopy in Equids: A Scoping Review. Laparoscopy is a common approach in equine surgery and has the advantage of improved visibility and diagnostic accuracy, decreased morbidity and hospitalization time. However, despite the numerous benefits, there can be intraoperative and postoperative complications which could have important welfare and economic consequences. The aim of this study was to perform a scoping review to identify current evidence on the occurrence, definition and classification of intra and postoperative complications in equine laparoscopy. A scoping review was conducted in scientific databases. Peer-reviewed scien...
Single-incision drilling technique to achieve hemiepiphysiodesis of the distal metacarpus – complications and outcome in 207 foals with metacarpophalangeal varus deformities. To report the outcome of foals treated for metacarpophalangeal varus deformity with a single-incision drilling technique for hemiepiphysiodesis of the distal lateral metacarpal physis. Methods: Retrospective case-control cohort study. Methods: Thoroughbred foals (n = 207), 171 age- and sex-matched maternal siblings. Methods: Medical records (2017-2020) were reviewed for signalment, limb(s) treated, location of the surgery, and any reported complications. Follow-up radiographs obtained for the yearling sale were assessed for abnormalities. Horses were matched to maternal siblings using an onl...
