Suspicion of Postanesthetic Femoral Paralysis of the Non-Dependent Limb in a Horse.
Abstract: A 15-year-old Selle Francais gelding was presented to the equine referral hospital for treatment of a left guttural pouch mycosis previously diagnosed. After induction, the horse was shortly hoisted by all four feet, moved on a padded surgical table, and positioned in right lateral recumbency. In order to reduce the risk of bleeding during surgical manipulation of the carotid and maxillary arteries, a mean arterial pressure between 60 and 70 mmHg was targeted. After surgery, the horse was moved in a padded recovery box keeping the same lateral recumbency. Four unsuccessful attempts were performed, with the horse always returning to sternal recumbency keeping the left hind limb up. At the fifth attempt, performed 120 min after the end of the general anesthesia, the horse stood up correctly but moderate ataxia and absence of weight bearing on the left hind limb were shown. Both the stifle and the fetlock joint were held in a flexed position and could not be extended properly in order to set the foot on the ground, resulting in a very short step. The horse was calm, not sweating, and willing to move; the muscles of the affected limb were relaxed, and the limb was neither warm nor painful at palpation. Occasionally, the horse flexed the affected hind limb in an exaggerated motion with marked abduction. No additional laboratory analyses were performed. Due to a strong suspicion of neuropathy, a sling support was initiated and a supportive bandage associated with flunixine administration was performed until resolution of the symptoms. The horse fully recovered after 3 days. This case report does not clarify the pathogenesis of the possible postanesthetic neuropathy accounted on the non-dependent limb, highlighting the need for future research in this field. Non-dependent limb neuropathy should be an expected problem even after having ruled out the most commonly known causes predisposing to postanesthetic lameness.
Publication Date: 2018-02-07 PubMed ID: 29468166PubMed Central: PMC5808350DOI: 10.3389/fvets.2018.00012Google Scholar: Lookup
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Summary
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The research article discusses the case of a Selle Francais gelding horse that depicted signs of neuropathy in its left hind limb after undergoing anesthesia for a surgical procedure. The horse recovered fully after three days, yet the exact cause behind the postanesthetic neuropathy remains unknown, underlining the need for further investigation.
Case Background
- A 15-year old Selle Francais gelding was brought for the treatment of a condition known as left guttural pouch mycosis, which had been previously diagnosed.
- Post-induction of anesthesia, the horse’s all four feet were shortly hoisted and it was moved to a padded surgical table. The horse was laid on its right side (right lateral recumbency) throughout the procedure and the recovery phase.
Surgical Details and Postoperative Complications
- During the surgical procedure, a mean arterial pressure of 60-70 mmHg was maintained to lower the risk of excessive bleeding during surgical intervention.
- After surgery, for a total of four times, attempts were made to get the horse to rise from its right lateral recumbency, in the padded recovery box. However, the horse would return to sternal recumbency while lifting the left hind limb each time.
- On the fifth attempt after 120 minutes of the end of anesthesia, the horse was able to stand, but showed signs of ataxia and disuse of the left hind limb. It was unable to extend the limb sufficiently to place on the ground, causing shorter steps.
Condition Assessment and Intervention
- Observations showed that the horse was calm, not sweating and showed willingness to move. On palpitation, the limb was neither warm nor painful and the musculature felt relaxed. Occasionally, the horse would flex the affected limb in an exaggerated motion with marked abduction, indicating potential neuropathy.
- No additional laboratory analyses were performed and the horse was given a sling support and a supportive bandage with flunixine administered to manage the symptoms. After three days, the horse was reported to have fully recovered.
Conclusions and Future Implications
- While the exact cause behind this postanesthetic neuropathy was not elucidated in this case report, the authors highlight that it’s crucial to anticipate non-dependent limb neuropathy, even with the exclusion of typical causes leading to postanesthetic lameness.
- This case thus underscores an unexplored area of equine medicine and anesthesia, necessitating further research in enhancing our understanding of postanesthetic neuropathy.
Cite This Article
APA
Mirra A, Klopfenstein Bregger MD, Levionnois OL.
(2018).
Suspicion of Postanesthetic Femoral Paralysis of the Non-Dependent Limb in a Horse.
Front Vet Sci, 5, 12.
https://doi.org/10.3389/fvets.2018.00012 Publication
Researcher Affiliations
- Division of Anesthesiology and Pain Therapy, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
- Swiss Institute for Equine Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
- Division of Anesthesiology and Pain Therapy, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
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Citations
This article has been cited 1 times.- Gozalo-Marcilla M, Ringer SK. Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature. Animals (Basel) 2021 Jun 14;11(6).
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