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Topic:Post-Operative Period
The post-operative period in horses refers to the timeframe following surgical procedures during which the animal undergoes recovery and rehabilitation. This period involves careful monitoring and management to ensure proper healing and to minimize complications. Key aspects of the post-operative period include pain management, wound care, and the prevention of infections. Horses may require restricted movement, dietary adjustments, and regular veterinary evaluations to assess recovery progress. This page compiles peer-reviewed research studies and scholarly articles that explore the management strategies, physiological responses, and outcomes associated with the post-operative period in equine patients.
Minimally invasive cranial ostectomy for the treatment of impinging dorsal spinous processes in 102 standing horses. To describe a minimally invasive cranial ostectomy for the treatment of impingement of dorsal spinous processes (DSPs) in the standing horse. Methods: Retrospective study. Methods: One hundred two horses with impinging DSPs. Methods: The case records of all horses that had the described technique between 2011 and 2019 were reviewed. All sites of impinging DSPs were treated under standing sedation and local anesthesia. The minimally invasive cranial ostectomy of the caudal DSP was performed with bone rongeurs through multiple small incisions. Results: Of the 102 horses treated with this techniq...
Development and Formative Evaluation of a Low-Fidelity Equine Castration Model for Veterinary Education. Entrustable Professional Activities (EPAs) are units of activity that early-stage professionals perform in the workplace that necessitate simultaneous integration of multiple competencies. EPA #6 requires students to perform a common surgical procedure on a stable patient, including pre-operative and post-operative management. Castration is one of the most common surgeries performed by equine primary care practitioners and is considered an "entry-level competency" for veterinary graduates entering equine private practice, however, to our knowledge there are no equine castration models availabl...
Postoperative Ileus: Comparative Pathophysiology and Future Therapies. Postoperative ileus (POI), a decrease in gastrointestinal motility after surgery, is an important problem facing human and veterinary patients. 37.5% of horses that develop POI following small intestinal (SI) resection will not survive to discharge. The two major components of POI pathophysiology are a neurogenic phase which is then propagated by an inflammatory phase. Perioperative care has been implicated, namely the use of opioid therapy, inappropriate fluid therapy and electrolyte imbalances. Current therapy for POI variably includes an early return to feeding to induce physiological motil...
Primary Uterine Hemangiosarcoma in a Thoroughbred: A Case Report. A 1.8-year-old maiden Thoroughbred filly, without previous history of mating or reproductive management, was referred for clinical inspection due to the presence of sanguineous vaginal discharge and severe abdominal pain. Transrectal palpation indicated uterine asymmetry, and transrectal ultrasonography revealed a mass near the cervix measuring 8.3 cm in diameter, with heterogeneous echogenicity, a trabeculated center, and a well-defined hyperechoic border. Smaller masses surrounded the larger uterine mass. During the examination, the mare expelled a uterine mass through the vulva. Histologica...
Arthroscopic evaluation of the synovial membrane and its relationship with histological changes and biomarkers in equine joint disease. The synovial membrane (SM) presents itself with distinctive characteristics during arthroscopic procedures in cases of osteoarthritis (OA) as well as osteochondritis dissecans (OCD) in horses. Most of the arthroscopic findings of the SM are limited to a description of a nonspecific inflammation state. In the present study, the macroscopic and histological aspects of the SM in OA and OCD horses were compared to those of healthy horses. The expression of interleukin (IL) in SM was also investigated. Besides, the concentrations of ILs and keratan sulfate (KS) in the synovial fluid (SF), and the m...
Survival and racing performance after surgical treatment of rib fractures in foals. To evaluate the short and long-term outcomes of foals treated surgically for fractured ribs and variables that may affect outcome. Methods: Retrospective. Methods: Seventy-three equine neonates with surgically repaired fractured ribs. Methods: Medical records were reviewed to include sex, breed, the side of thorax affected, number of ribs fractured, co-morbidities directly associated with rib fracture, and surgical technique used. Short-term outcome was defined as survival to discharge. Long-term outcome was whether or not they started a race. Race records of maternal siblings were obtained fo...
The effects of xylazine or detomidine when used as a pre-anesthetic sedative on recovery quality and duration in horses undergoing elective equine castration. The purpose of this prospective, blinded, randomized clinical trial was to compare the effects of low dose detomidine to xylazine on recovery quality and duration in a castration procedure. Horses were administered either detomidine [0.015 mg/kg body weight (BW)] or xylazine (1.1 mg/kg BW) intravenously (IV) before IV induction with ketamine (2.2 mg/kg BW) and diazepam (0.05 mg/kg BW). Two anesthesiologists who were unaware of treatment allocation scored the recoveries using a simple descriptive scale (with a low number representing the most desirable recovery) and recoveries were timed. Horse...
Demographic, preoperative and anaesthesia-related risk factors for unsatisfactory recovery quality in horses undergoing emergency abdominal surgery. To determine demographic, preoperative and anaesthesia-related variables that may be associated with unsatisfactory recovery quality in horses undergoing emergency abdominal surgery (colic) in an equine teaching hospital. Methods: Retrospective case series. Methods: A total of 313 horses. Methods: The anaesthetic records of horses admitted for surgical treatment of colic between 2005 and 2018 were examined. Overall quality of recovery was assessed as dangerous, poor, fair, good or excellent. The following categories were constructed as a dichotomic variable: unsatisfactory recovery (poor and d...
Acute abdominal dehiscence following laparotomy: A multicentre, international retrospective study. Incisional complications are a common cause of morbidity following laparotomy. Although uncommon, acute abdominal dehiscence (AAD) is a potentially fatal post-operative complication. However, few AAD cases are described in the literature. Objective: To describe common features of cases of AAD following ventral midline laparotomy, management and outcomes. Methods: Retrospective case series. Methods: Hospital records of horses that underwent a ventral midline laparotomy at nine hospitals in the UK, Ireland and USA over a 10-year period (2009-2019) were reviewed. Data were collected for pre-, int...
Comparison of Recovery Quality Following Medetomidine versus Xylazine Balanced Isoflurane Anaesthesia in Horses: A Retrospective Analysis. Medetomidine partial intravenous anaesthesia (PIVA) has not been compared to xylazine PIVA regarding quality of recovery. This clinical retrospective study compared recoveries following isoflurane anaesthesia balanced with medetomidine or xylazine. The following standard protocol was used: sedation with 7 µg·kg medetomidine or 1.1 mg·kg xylazine, anaesthesia induction with ketamine/diazepam, maintenance with isoflurane and 3.5 µg·kg·h medetomidine or 0.7 mg·kg·h xylazine, and sedation after anaesthesia with 2 µg·kg medetomidine or 0.3 mg·kg xylazine. Recovery was timed and, using vi...
Diagnostic and Treatment Challenges for Diaphragmatic Hernia in Equids: A Concise Review of Literature. Diaphragmatic hernia (DH) represents an acute abdominal crisis, but respiratory symptoms may be occurring. Different types of diaphragmatic hernias (DHs) like typical DH, Morgagni hernia, hiatal hernia and diaphragmatic diverticulum have been recorded in equids. These DHs have various clinical presentations and prognoses. Early diagnosis and prompt surgical repair are highly recommended in order to diminish the ischemic changes to thoracic and abdominal viscera, thus improving the overall prognosis of equids with DH. Over last decade, the prognosis of DH in equids was better than previously be...
Outcomes following single, caudally based bilateral versus unilateral frontonasal sinusotomy for treatment of equine paranasal sinus disease. Bilateral sinus disease is relatively uncommon in horses, accounting for 3%-4.5% of horses with sinonasal disease, but may require bilateral paranasal surgery for complete resolution. Complications and recurrence following bilateral sinusotomy have not been reported or compared to those following unilateral procedures. To describe clinical features and outcomes in horses undergoing standing single, caudally based bilateral frontonasal sinusotomy compared to unilateral frontonasal surgery. Records of horses (n = 37) undergoing surgical treatment for sinus disease (five bilateral, 32 unilatera...
Neuromuscular blockade with atracurium for ophthalmic surgery in horses-Effects on surgical and anesthetic characteristics and recovery quality. To study the surgical, anesthetic and recovery qualities of horses receiving either a neuromuscular blocking agent (atracurium) or intravenous lidocaine (treatment groups A and L, respectively). Methods: A total of thirty horses presented for ocular surgery were used in this study. Methods: Horses were randomly assigned to receive either atracurium (group A) or a lidocaine constant rate infusion (group L). Surgical quality was graded on a scale from 1 (excellent)-5 (poor). While anesthetized, the heart rate, oxygen saturation and mean arterial blood pressure, and end-expiratory carbon dioxide ...
Use of Polyamide (Nylon) Cable Ties for Vascular Ligation of Healthy Equine Jejunal Mesentery. Jejunal vascular ligation is an essential step in performing jejunojejunostomy. Hand sewn ligation is typically used and can increase operative time with long sections of bowel to be removed. Nylon cable ties (NCT) have been used for vascular ligation in horses but are yet to be investigated for application on the mesenteric vasculature of the gastrointestinal tract. Our objective was to evaluate the efficacy and short-term safety of NCT jejunal mesenteric vessel ligation in healthy horses. Eight healthy adult horses underwent midline celiotomy. A segment of jejunal mesentery was identified (...
A critical evaluation for validation of composite and unidimensional postoperative pain scales in horses. Proper pain therapy requires adequate pain assessment. This study evaluated the reliability and validity of the Unesp-Botucatu horse acute pain scale (UHAPS), the Orthopedic Composite Pain Scale (CPS) and unidimensional scales in horses admitted for orthopedic and soft tissue surgery. Forty-two horses were assessed and videotaped before surgery, up to 4 hours postoperatively, up to 3 hours after analgesic treatment, and 24 hours postoperatively (168 video clips). After six evaluators viewing each edited video clip twice in random order at a 20-day interval, they chose whether analgesia would b...
Fungal osteitis of the axial aspect of the mid body of the medial proximal sesamoid bone in a horse. The satisfactory outcome of fungal osteitis in an 8-year-old American Quarter Horse is described. The horse was admitted with a grade 4 out of 5 lameness and exhibited metacarpophalangeal synovial effusion, indicative of a mild suppurative inflammation. Results of initial radiographic and ultrasonographic examination were unremarkable. Intra-articular anesthesia of the metacarpophalangeal joint allowed localization of the insult. It was not until day 6 of hospitalization when lytic changes on the axial aspect were observed on radiographic examination. Arthroscopic examination permitted identif...
Medial malleolus fragmentation following talocalcaneal arthrodesis by a dorsomedial approach in a horse. A 16-year-old, Quarter Horse mare was presented for a 3/5 right hind lameness associated with osteoarthritis of the talocalcaneal joint (TCLJ). Positron emission tomography (PET) and computed tomography (CT) demonstrated marked increased uptake of 18F-sodium fluoride and bone remodeling at the medial facet of the TCLJ, respectively. Under general anesthesia 2 cortical screws (4.5 and 5.5 mm) were placed in neutral fashion via an arthrotomy from dorsomedial to plantaromedial through the medial facet of the TCLJ followed by copious lavage of the tarsocrural joint. Eight weeks after surgery, obse...
Use of Negative Pressure Wound Therapy in the Treatment of Limb Wounds: A Case Series of 42 Horses. Traumatic limb injuries are common in horses. Negative pressure wound therapy (NPWT) has been proven to promote wound healing in human medicine. It has also been described for the treatment of wounds in horses. In this retrospective study, clinical records of 42 (n = 42) animals were assessed. Categories of wounds, duration of NPWT application, frequency of resetting the NPWT device, technical complications, and tolerance to the procedure were recorded. 42 wounds were classified as bony (n = 15; 36 %), articular (n = 14; 33 %), tenosynovial (n = 9; 21%), muscular (n = 2; 5%) and cuta...
Total Intravenous Anaesthesia with Ketamine, Medetomidine and Midazolam as Part of a Balanced Anaesthesia Technique in Horses Undergoing Castration. To evaluate the use of ketamine-medetomidine-midazolam total intravenous infusion as part of a balanced anaesthetic technique for surgical castration in horses. Five healthy Standardbred cross colts were premedicated with IV acepromazine (0.01-0.02 mg/kg), medetomidine (7 µg/kg) and methadone (0.1 mg/kg) and anaesthesia induced with IV ketamine (2.2 mg/kg) and midazolam (0.06 mg/kg). Horses were anaesthetised for 40 min with an IV infusion of ketamine (3 mg/kg/h), medetomidine (5 µg/kg/h) and midazolam (0.1 mg/kg/h) while routine surgical castration was performed. Cardiorespiratory variables...
Arthroscopic removal of osteochondral fragments of the cervical articular process joints in three horses. To report arthroscopic osteochondral fragment removal from the equine cervical spine articular process joints (APJs) including long-term follow-up. Methods: Case series. Methods: Three Warmblood horses with forelimb lameness and/or reduced range of motion of the cervical spine with osteochondral fragments between the cervical vertebrae C5 /C6 or C6 /C7 . Methods: Arthroscopy of the APJs of C5 /C6 and C6 /C7 was performed under general anesthesia. Following endoscopic evaluation of the joints, osteochondral fragments were removed using a rongeur. Results: All horses recovered from anesthesia wi...
Hybrid natural orifice transluminal endoscopy surgery (NOTES) to perform bilateral ovariectomy in mares. To combine laparoscopic techniques with natural orifice transluminal endoscopic surgery (hybrid NOTES) to minimize number and enlargement of paralumbar laparoscopic portals for bilateral ovariectomy in standing, sedated mares. Methods: Case series. Methods: Six horses. Methods: Six mares with palpably normal ovaries were restrained in stocks, sedated, and had caudal epidural anesthesia performed. A 7.5 MHz ultrasound probe was used transvaginally to select placement of vaginotomy. An attempt was made to remove both ovaries with 70 cm esophageal forceps through the vaginotomy, while visualiz...
Effect of anesthesia duration on the quality of recovery in horses undergoing elective and emergency surgeries using the same anesthetic protocol. The objective of this study was to investigate the effect of anesthesia duration on the quality of recovery in horses. The medical records of horses that were anesthetized and underwent surgery for elective and emergency soft tissue and orthopedic conditions from 2013 to 2019 were reviewed. Horses included in the study (N = 305) fulfilled the following requirements: all had the same premedication/induction protocol and the same balanced anesthesia for maintenance and were anesthetized by the same, experienced Board-certified anesthesiologist. A standardized anesthetic recovery score was comple...
Comparison of one-layer Utrecht pattern with two-layer (simple continuous/Cushing) pattern for jejunojejunostomy in healthy horses in vivo. To compare end-to-end jejunal anastomoses with a one-layer (Utrecht) and two-layer (simple continuous/Cushing) patterns. Methods: Experimental study. Methods: Eight healthy adult horses. Methods: Jejunal end-to-end anastomoses were performed in randomly assigned one-layer or two-layer patterns. Horses were recovered from surgery and monitored for complications. At 14 days, the opposite pattern was performed (cross-over design) prior to euthanasia. Duration of closures was compared between patterns. Serosal width was measured before harvesting anastomotic sites from the first procedure. Lumin...
Causes, Effects and Methods of Monitoring Gas Exchange Disturbances during Equine General Anaesthesia. Horses, due to their unique anatomy and physiology, are particularly prone to intraoperative cardiopulmonary disorders. In dorsally recumbent horses, chest wall movement is restricted and the lungs are compressed by the abdominal organs, leading to the collapse of the alveoli. This results in hypoventilation, leading to hypercapnia and respiratory acidosis as well as impaired tissue oxygen supply (hypoxia). The most common mechanisms disturbing gas exchange are hypoventilation, atelectasis, ventilation-perfusion (V/Q) mismatch and shunt. Gas exchange disturbances are considered to be an import...
Evaluation of the subcapsular technique for primary closure castration in donkeys (Equus asinus). This study described the subcapsular technique for primary closure castration in donkeys with special regard to its efficiency and welfare impacts. The study was conducted on twelve adult male donkeys, allocated randomly into two groups; subcapsular castration (SC) and open castration (OC) groups, whether the donkeys were subjected to surgical castration either by subcapsular or open castration techniques, respectively. Testosterone, cortisol, lactate, glucose, total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), triglyceride (TG), and nitric oxide (NO) were measured before an...
Equine inflammatory response to abdominal surgery in the absence of gastrointestinal disease. To investigate the, equine inflammatory response to ventral midline celiotomy in the absence of gastrointestinal disease in horses of varying body condition scores primarily using serial measurements of serum amyloid A (SAA). Methods: Experimental clinical study. Methods: University teaching hospital. Methods: Ten adult light breed horses free of any clinical disease, 5 with body condition score (BCS) 3-4/9 and 5 with BCS 7-8/9. Methods: Horses had a ventral midline celiotomy performed under general anesthesia, including manual decompression of the small intestine. SAA, semiquantitative fibrin...
Slab fractures of the third carpal bone involving both radial and intermediate facets and outcomes after surgical repair in racing Quarter Horses. Characteristics and outcomes after surgical repair of third carpal bone (C3) slab fractures involving both radial and intermediate facets in racing Quarter Horses are unknown. Objective: To describe the pre- and intraoperative characteristics of C3 slab fractures of both radial and intermediate facets in Quarter Horses and to report on the long-term outcomes after internal fixation. Methods: Retrospective case series. Methods: Case records were collected from racehorses with C3 slab fractures between 2008 and 2020. Inclusion criteria required arthroscopic-guided repair of C3 slab fractures inv...
Evaluation of the sublingual microcirculation with sidestream dark field video microscopy in horses anesthetized for an elective procedure or intestinal surgery. To compare the sublingual microcirculation between healthy horses anesthetized for elective procedures and horses with colic anesthetized for abdominal surgery and to determine the effect of mean arterial blood pressure (MAP) on the microcirculation. Methods: 9 horses in the elective group and 8 horses in the colic group. Methods: Sublingual microcirculation was assessed with sidestream dark field video microscopy. Videos were captured at 3 time points during anesthesia. Recorded microvasculature parameters were De Backer score (DBS), total density of perfused vessels (PVD) and small vessels (...
