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Topic:Surgery
Surgery for horses encompasses a range of procedures performed to diagnose, treat, or manage various medical conditions. These procedures may involve soft tissue or orthopedic interventions and require specialized techniques to accommodate the unique anatomical and physiological characteristics of equines. Common surgical procedures in horses include colic surgery, fracture repair, and arthroscopy. The success of equine surgery depends on numerous factors, including the type of procedure, the horse's overall health, and post-operative care. This page compiles peer-reviewed research studies and scholarly articles that explore surgical techniques, outcomes, and advancements in equine surgical practices.
Sutured end-to-end and stapled side-to-side jejunal anastomoses in the horse. Hand sutured end-to-end (EE) and stapled side-to-side (SS) small intestinal anastomoses were performed in 10 healthy adult horses. In five SS anastomoses, staple lines on the blind ends of the jejunum were inverted (SSI) and in five they were not (SSNI). Five EE anastomoses were sutured with polydioxanone and five were sutured with polyglyconate. All horses were euthanatized on day 30. Intra-abdominal adhesions were graded (0-4), and stomal areas were calculated from contrast radiographs made with the bowel distended. Histopathology scores for the anastomoses were based on the degree of inflam...
Medical and surgical management of small-colon impaction in horses: 28 cases (1984-1989). Medical records of 28 horses with impaction of the small colon were reviewed; 20 horses were admitted during the winter months. Diagnosis of small-colon impaction was made in 21 horses by rectal examination, and in 7 horses at exploratory celiotomy. Ten horses were treated medically, and 18 were treated surgically. Horses that were treated surgically were more likely to have abdominal distention than were those that responded to medical treatment (P less than 0.025). Signs of greater degree of abdominal pain and higher heart rate were seen in horses treated surgically, but these values were no...
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 laparoscopic surgery. Laparoscopic procedures can replace many more invasive procedures. Guided visceral biopsy, cryptorchid castration, ovariectomy, and limited abdominal exploration may be done laparoscopically in the standing horse.
Standing surgical procedures of the foot. Several surgical conditions affecting the foot can be successfully managed with the horse standing. Many factors affect the clinician's choice of whether to perform surgery with the horse standing or anesthetized. Temperament or pregnancy of the horse and economics may influence the decision to perform surgery with the horse standing. This article discusses several foot conditions that can be treated successfully in the ambulatory horse.
Mesenteric tears of the descending (small) colon as a postpartum complication in two mares. Segmental ischemic necrosis of the descending colon associated with discrete tears of the mesocolon were diagnosed in 2 mares following foaling. After foaling, both mares had a slow onset of signs of abdominal pain and gradual deterioration of clinical status. Increases in peritoneal fluid total protein concentration and WBC count and a palpable impaction of the descending colon on examination per rectum were useful diagnostic aids. Surgical intervention was successful in one mare, but not in the other.
The pharmacology of local anesthetics. Understanding of the pharmacology of local anesthesia is important for selection of a local anesthetic for use in equine standing surgery. In general, the action potential is inhibited by local anesthetics by preventing the influx of sodium ions across the axonal membrane. The physicochemical properties of each local anesthetic determine the onset of action, potency, and duration of action. Procaine, chlorprocaine, lidocaine, and mepivacaine are the local anesthetics still used clinically in horses; lidocaine is the most widely used. The future of equine local anesthesia may see the introducti...
Standing musculoskeletal surgery. Indications for performing orthopedic surgery on the standing horse include inability to tolerate general anesthesia, risk of worsening an injury during recovery from anesthesia, and cost. The surgeon should be aware that performing surgery in the standing horse can be more demanding and require more experience than the same procedures when the time and convenience of general anesthesia are available. Improved sedatives and analgesics have allowed more latitude because the horses now are more tolerant than when older agents were used. Common sense should be applied to each situation before the...
Standing rectal and tail surgery. A variety of rectal, perirectal, and coccygeal surgeries can be performed in the standing equine patient if appropriate chemical and physical restraints are available and adequate regional anesthesia can be achieved. Some rectal tears and most rectal prolapses, mass lesions, perirectal abscesses, rectal biopsies, and selected injuries of the tail can be managed without prohibitive difficulty. Severe injuries that compromise the small colon cranial to the peritoneal reflection may require flank laparotomy, midline celiotomy, or humane euthanasia to manage the disease process effectively and app...
Standing endoscopic electrosurgery. Common equine upper respiratory conditions are diagnosed via endoscopy. Endoscopic surgery facilitates correction of many conditions without general anesthesia or laryngotomy, reducing the morbidity and cost of the procedures. Modalities of endoscopic surgery include the Nd-YAG laser or electrosurgery, which may be complementary. The least expensive method is electrosurgery, and instruments are available that can be passed through the biopsy channel of the endoscope. Conditions amenable to such procedures include entrapped epiglottis, rostral displacement of the palatopharyngeal arch, pharynge...
Standing surgery of the neck and thorax. Many surgical procedures of the head and neck can be safely performed in the standing horse, with easy access to all aspects of the surgical field. Some procedures, such as tracheotomy, are easier to perform with the horse standing with the head in a more natural position than with the horse under general anesthesia. Procedures of the neck and thorax that require evacuation of purulent and necrotic material from confined spaces, such as occur in horses with esophageal ruptures and extensive intrathoracic abscesses, can be done as standing procedures to avoid the risks of general anesthesia on ...
Bone biopsy in the horse. 1. Method using the wing of ilium. Two hundred and five bone biopsies from the wing of ilium were taken from 52 growing and 70 older horses. The method was initially evaluated in 4 horses at post mortem and then performed in 26 horses under general anaesthesia. The technique was later developed for biopsying horses in the standing position under local anaesthesia (n = 70 adults; n = 22 foals). The core of the bone biopsy consisted of a central cancellous portion between two cortices. This type of sample allowed a complete histomorphometrical analysis. An integral part of the procedure was intravital bone labelling using fluoroc...
Chemical restraint for surgery in the standing horse. Chemical restraint can be a useful pharmacologic tool to assist the veterinarian performing surgery in the standing horse. The agents discussed impose minimal adverse side effects and are considered relatively safe when administered in the doses described. Acetylpromazine, the most widely used tranquilizer, produces mild sedation but no analgesia. The use of tranquilizers for surgical procedures requires the combined use of either a local anesthetic technique or a sedative-hypnotic or opiate to provide analgesia. Sedative-hypnotics such as xylazine and detomidine or opiates such as morphine an...
Standing surgery and procedures of the head. Although most surgical procedures of the head are technically easier to perform with the horse under general anesthesia, other factors will influence whether a surgical procedure is performed with the horse standing or recumbent under the influence of general anesthesia. The accessibility of the head lends itself to many standing surgical procedures if the proper combination of analgesia and physical and chemical restraint is used. Traumatic injuries of the head (lacerations, facial bone fractures, and oral fractures) may involve vital structures, and a thorough examination is indicated. Failu...
Septic tenosynovitis in horses: 25 cases (1983-1989). The medical records of 25 horses with septic tenosynovitis treated over 7 years (1983 to 1989) were reviewed to determine clinical features of the disease and response to treatment. The median age of horses with septic tenosynovitis was 5 years (range, 1 month to 21 years). Fourteen fore limbs and 11 hind limbs were affected. Sepsis was located in the sheath of the digital flexor tendons of 22 horses. Sepsis was located in the sheath of the extensor carpi radialis tendon (1 horse), sheath of the long digital extensor tendon (1 horse), or sheath of the common digital extensor tendon (1 horse) i...
The decision process. Standing surgery versus general anesthesia and recumbency. The decision to perform a procedure in the standing patient rather than in a completely anesthetized patient depends on many factors, such as patient health, cost, time, facilities, and anesthetic expertise. Although the procedure often is technically easier to perform if the patient is anesthetized, cost and patient risk considerations may result in a decision to do the surgery standing. Surgical experience in performing procedures standing is important for a successful outcome.
Perineural and spinal anesthesia. Local and regional anesthetic techniques are useful tools for the equine practitioner. These techniques allow surgery to be performed without the risk and cost of general anesthesia. There are, however, risks associated with the local and regional techniques. Neurotoxicity, although rare, may occur when 200 mL or more of a local anesthetic are infiltrated in a short period of time to a 450-kg horse. More likely, horses may become ataxic after nerve blockade in the limbs. This ataxia may lead to self trauma because the horse may not know where the limbs are actually being placed. Although local...
Standing laser surgery of the head and neck. The use of carbon dioxide and Nd:YAG lasers has expanded the capabilities of equine surgeons. These lasers are used to incise, vaporize, and coagulate tissue with minimal hemorrhage and reduced morbidity to the patient. In this article, practical fundamentals of laser surgery are briefly reviewed, and selected standing laser procedures of the head and neck are discussed.
Ophthalmic procedures and surgery in the standing horse. Although many ophthalmic procedures can be performed on the standing horse, the decision to perform a procedure under sedation rather than general anesthesia must be made on the basis of the temperament of the horse, severity of the injury, and skill of the veterinarian. For example, veterinarians who are not comfortable with small suture material may find accurate repair of an eyelid laceration easier after general anesthesia rather than attempting to handle this suture in a moving patient. Correct use of nerve blocks and topical anesthesia will greatly facilitate examination, diagnosis, and ...
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...
Standing abdominal surgery. Safe, effective surgery can be performed in the standing, conscious horse using a combination of mechanical and chemical restraint. Clear indications for performing standing abdominal surgery exist, but many procedures are best performed under general anesthesia. The preferred approach involves a modified grid incision of the left paralumbar fossa. Flank celiotomy allows the surgeon to thoroughly explore the abdominal cavity, but few structures can be exteriorized, and visibility of abdominal contents is poor. Indications for standing abdominal surgery include diagnosis of abdominal masses, dr...
Rostral mandibulectomy in five horses. Rostral mandibulectomy with primary gingival closure was performed in 5 horses with rapidly growing or bleeding mandibular tumors. The technique involved preservation of the most caudal portion of the mandibular symphysis to maintain stability. There were no surgical complications or recurrences, and the cosmetic and functional results were good. The histopathologic diagnosis of all the tumors was ossifying fibroma. Rostral mandibulectomy affords a simple and effective technique of treating tumors of the rostral portion of the mandible in horses.
Therapeutic management of ocular squamous cell carcinoma in the horse: 43 cases (1979-1989). The records of 50 horses with ocular squamous cell carcinoma (OSCC) presented to the University of Florida Veterinary Medical Teaching Hospital over an 11 year period were reviewed to determine the influence of therapy on the outcome of the case. Follow-up information was obtained for 43 of the 50 cases. The disease was more prevalent in the light horse breeds; however, the draft breeds also were at risk. There was no sex predisposition and the average age was 11.8 years. Tumour recurrence was significant when surgery alone was performed. The eyelid and nictitating membrane were the primary si...
Multivariable prediction model for the need for surgery in horses with colic. A survey of 1,965 equine colic cases was conducted from August 1985 to July 1986 at 10 equine referral centers located throughout the United States. The purpose of this study was to develop and validate a multivariable model for the need for surgery. Two-thirds of the cases were randomly selected for model development (1,336), whereas the remaining cases (629) were used only for subsequent validation of the model. If a lesion requiring surgical correction was found at either surgery or necropsy, the case for the horse was classified as surgical, otherwise the case was classified as medical. On...
[Adenoma of the pigmented epithelium of the iris with endothelialization and descemetization in the horse]. The authors describe peculiar tumors with brown-white piebald anterior surface, which had grown bilaterally from the corpora nigra (C.N.) of an adult horse and occluded the pupils. The surgical procedure for removing the larger tumor and the postoperative treatment are described. The findings by light and electron microscopy suggest that the tumor represent a so-called adenoma of the iris pigment epithelium. The white patches on its surface consist of newly formed Descemet-like material produced by displaced corneal endothelial cells, which have probably grown on the tumor after contact with t...
Incorporation of fresh and cryopreserved bone in osteochondral autografts in the horse. The structural integrity of subchondral bone in fresh and frozen osteochondral autografts was investigated at month 3 in 10 horses. Two osteochondral autografts were harvested from the lateral aspect of the lateral trochlear ridge of the left talus in each of 10 anesthetized horses. Grafts were frozen in 7.5% DMSO. After 14 days, the thawed grafts were press-fitted into drill holes in the trochlear ridges of the right stifles. A fresh graft from the right hock was implanted in each left stifle. To control for the effects of surgery, a fresh graft was transferred from the right stifle to the le...
Heterotopic transfer of fresh and cryopreserved autogenous articular cartilage in the horse. Two 10 mm thick osteochondral grafts were harvested from the lateral aspect of the lateral trochlear ridge of the left talus in each of 10 anesthetized horses. The grafts were frozen in a 7.5% DMSO solution and stored in liquid nitrogen. The horses were anesthetized again on day 14 and the thawed grafts were press-fitted into drill holes in the trochlear ridges of the right stifle. A fresh graft was transferred from the right hock to the left stifle. To control for the effects of surgery, another fresh graft was transferred from the right stifle to the left stifle. The result was two grafts in...
Evaluation of epiglottic augmentation by use of polytetrafluoroethylene paste in horses. Epiglottic augmentation was evaluated in 7 horses, using 7 ml of polytetrafluoroethylene (polytef) paste injected submucosally on the ventral surface of the epiglottis. In 6 horses, an Arnold-Bruning intracordal injection syringe, specifically designed to inject polytef into paralyzed vocal folds in human beings, was used. At necropsy 60 days after surgery, group mean thickness measurement 20 mm from the epiglottic tip was 40% greater (P less than 0.01) and, at the epiglottic attachment of the aryepiglottic fold, was 29% greater (P less than 0.01) in the 6 polytef-augmented horses than in clin...
Histopathological and ultrastructural changes in simulated large colonic torsion and reperfusion in ponies. This investigation examines the histological and ultrastructural lesions of the colonic mucosa during terminal experimental infarction and subsequent reperfusion. Four ponies were anaesthetised and subjected to surgical torsion of the colon. Biopsies were collected at hourly intervals for 3 h, at which point the torsions were corrected. Circulation was re-established for 2 h and the bowel was re-biopsied at hourly intervals. The ponies were killed while under anaesthesia. During the 3 h experimental infarction, the bowel became macroscopically thickened and dark purple. Histologically, the muc...
