Summary Rupture of the urinary bladder of adult horses is rare with both reports of surgical repair and conservative management in the literature. The case report by Gosling et al . in this issue describes the successful treatment of an iatrogenic bladder tear in an adult gelding. The aim of this commentary is to review the described treatment options.

OBJECTIVE:To determine the prognostic value of (1) colonic venous lactate or peripheral lactate values obtained before and after manual correction of a large colon volvulus and (2) a combination of variables including pelvic flexure biopsy.STUDY DESIGN:Prospective clinical study.ANIMALS:Forty adult horses in which large colon volvulus was diagnosed intraoperatively.METHODS:Colonic venous, peripheral venous, and arterial blood samples were collected to measure lactate values before and after manual correction. Mucosal biopsy samples were obtained in cases that underwent enterotomy or colonic resection and anastomosis. Interstitium to crypt (I:C) ratio and hemorrhage scores were measured. Optimal cutoff values were determined by receiver operator curve analysis, and associations between variables and short-term outcome were determined by univariable regression. Short-term survival was defined as horses being discharged from the hospital. P ≤ .05 was considered significant.RESULTS:No association was found between colonic venous lactate values before (P = .011) or after (P = .201) manual correction of large colon volvulus and determination of short-term outcome. Peripheral venous lactate at admission ≥3.2 mmol/L and after manual correction ≥5 mmol/L, arterial lactate postmanual correction ≥3.53 mmol/L, and histomorphometric measurements of mucosal hemorrhage ≥3 and I:C ratio > 1 were associated with poor short-term outcome.CONCLUSION:Peripheral lactate values, histomorphometric measures of I:C ratio, and hemorrhage score provided prognostic information that could help guide recommendations made to owners.CLINICAL SIGNIFICANCE:Peripheral lactate values after manual correction provide important intraoperative diagnostic information to assist in predicting case outcome in the operative and immediately postoperative period.

SummaryThe objective of the study was to describe a modified Heineke–Mikulicz pyloroplasty for the treatment of pyloric stenosis in foals due to gastric ulceration and assess the short‐ and long‐term outcome of foals receiving the pyloroplasty. Medical records of foals undergoing a modified Heineke–Mikulicz pyloroplasty due to gastric outflow obstruction secondary to a pyloric stenosis were included in this retrospective case series. The pyloroplasty consisted of an oral to aboral full thickness longitudinal incision on the ventral aspect of the pylorus and proximal duodenum, which was sutured closed with 0 polydioxanone in a transverse orientation, thereby, enlarging the pyloric lumen diameter. Long‐term outcome was obtained from medical and race records. The pyloroplasty was successfully performed in three foals with a surgical time of 95–121 min, with immediate return to nursing and hospital stay of 4–14 days. Complications included a small intestinal volvulus and intra‐abdominal adhesions in a foal that did not survive. Another foal had an incisional infection. Two of the three foals went on to race. It was concluded that the pyloroplasty procedure is an acceptable option for the treatment of pyloric stenosis and secondary gastric outflow obstruction due to gastric ulceration. The limited amount of bowel manipulation with no change in intestinal flow, along with the successful outcomes achieved, make this another surgical option available for the correction of pyloric stenosis in foals.

Summary Right recurrent laryngeal neuropathy ( RLN ) is an uncommon, acquired disease for which the aetiology can frequently be diagnosed. Numerous aetiologies have been proposed for right‐sided RLN which comprises 2% of all cases of RLN . In this report we discuss the clinical course, treatment and outcome following right‐sided laryngeal paralysis as a complication of left‐sided prosthetic laryngoplasty in a horse. To the authors' knowledge, this is the first report of such a surgical complication.

Summary Rupture of the urinary bladder is rare in adult horses with various standing or recumbent surgical repair techniques historically reported as the treatments of choice. This case series describes the successful conservative management of cystorrhexis in 4 adult horses. Conservative management is therefore a potentially viable treatment option which forgoes the risks of general anaesthesia and may reduce the post operative complications associated with surgery of the bladder.

This retrospective study provides long-term results of medial patellar ligament (MPL) desmoplasty in horses with intermittent upward fixation of the patella (UFP) that were treated at a single referral hospital over a 7-year period. Follow-up interviews were conducted with owners, trainers, or referring veterinarians using a standardized questionnaire. Overall, 71% of horses returned to their intended use with only 18% at a higher level. Recurrence of UFP was noted in 33% of cases. Satisfaction with the procedure was generally low, with only 50% of owners being completely satisfied. Further investigation is warranted to determine appropriate medical and/or surgical therapy.

OBJECTIVES:To evaluate the effect of periosteal transection and elevation in foals with naturally occurring carpal valgus deviation.STUDY DESIGN:Prospective clinical study.ANIMALS:Foals (n = 9) with bilateral carpal valgus.METHODS:Foals with bilateral carpal valgus had distolateral radial periosteal transection and elevation (PE) including distal ulnar transection on 1 limb. Foals were stall confined until the skin incisions healed, and then allowed free exercise in a small paddock or round pen. Dorsopalmar carpal radiographs were obtained at 14 day intervals to determine the carpal valgus angle (CVA) until it was <5°.RESULTS:All limbs had a reduction in CVA and there was no significant difference in total carpal valgus angular correction or the rate at which the correction occurred between the surgical and control limb.CONCLUSIONS:Unilateral distolateral radial PE had no effect on carpal angulation in 9 foals with naturally occurring bilateral carpal valgus deviation when performed between 19 and 43 days.

This study investigated the influence of perfusate volume on antimicrobial concentration in synovial fluid following intravenous regional limb perfusion (IVRLP) and assessed the efficacy of low volume IVRLP. The front limbs of 9 horses were randomly assigned to 1 of 3 volume groups: 10 mL (Group 1), 30 mL (Group 2), or 60 mL (Group 3). A tourniquet was applied distal to the carpus and the limbs were perfused with 500 mg genta-micin diluted to the assigned volume via a catheter placed in the lateral palmar digital vein at the level of the proximal sesamoid bones. Synovial fluid samples were collected from the metacarpophalangeal joint at 30 minutes, followed by removal of the tourniquet. Gentamicin concentration in synovial fluid was detected using a fluorescence polarization immunoassay. There were no statistically significant differences among gentamicin concentrations in synovial fluid among perfusate volume groups. Mean gentamicin concentration in Group 1 (125.9 μg/mL) was higher than Group 2 (82.7 μg/mL) and Group 3 (56.1 μg/mL).

Objective To describe a tenosynoviotomy technique for treatment of sepsis of the digital flexor tendon sheath (DFTS) in horses and report long-term outcome. Study Design Case series. Animals Horses (n = 9). Methods Horses were positioned in lateral recumbency with the affected limb uppermost. A linear incision was made just lateral to the mesotenon beginning 5 cm proximal to the apices of the proximal sesamoid bones, extending 2 cm distal to the bifurcation of the superficial digital flexor tendon (SDFT). The incision was continued through the skin, subcutaneous tissue, palmar/plantar annular ligament, and DFTS. Tenotomy of the distal lateral branch of the SDFT was also performed. The site was thoroughly debrided, lavaged, and packed with gauze and allowed to heal by second intention. Follow-up was obtained via owner telephone interview. Results Mean surgery time was 32 minutes (range, 1064 minutes). Systemic antibiotics were administered postoperatively (range, 1146 days; mean, 23 days). Mean hospitalization was 11 days (range, 049 days). Follow-up was available for 7 (70%) horses. One year postoperatively, 5 (71%) horses were serviceable for their intended use, and 2 (29%) had been euthanatized. Of 5 survivors, 3 returned to ridden exercise, 1 was retired as a broodmare, and 1 was a broodmare. All owners were satisfied with the cosmetic appearance of the surgery site. Conclusion Open drainage via tenosynoviotomy, performed as a salvage procedure, represents a feasible treatment for DFTS sepsis.

OBJECTIVE:To validate the safety of a suprapatellar pouch (SPP), approach to the femoropatellar joint (FPJ), and describe use of a laparoscopic cannula to remove debris or loose bodies.STUDY DESIGN:Retrospective case seriesANIMALS:Horses (n = 168) with osteochondritis dissecans (OCD) of the FPJ.METHODS:Arthroscopy was performed on 245 FPJ with OCD. Two subpatellar portals were created, 1 axial and 1 abaxial to the lateral patellar ligament. Additionally, a SPP egress portal for lavage, was created 2 cm proximal to the most palpable dorsolateral eminence of the patellar base. A 10-mm laparoscopic cannula and trocar unit was used in all SPP portals. The SPP portal was closed in 2 layers in the first 121 horses and the skin only in the remaining 47 horses. Medical records were reviewed for complications and surgical time and owner satisfaction with cosmesis obtained.RESULTS:No complications were recorded for the SPP portal regardless of closure technique. All owners were satisfied with the cosmetic outcome of the procedure once the hair had grown back and felt the additional incision did not negatively impact horses presented for sale at public auction. Mean surgery time was 27.7 min/joint.CONCLUSION:No complications were recorded using a SPP portal and laparoscopic cannula, and owner satisfaction was high.

ObjectiveTo evaluate the racing and sales performance of Thoroughbred horses with varus angular limb deformities of the carpus treated by unilateral or bilateral single transphyseal screw (STS) placement.Study DesignCase series.AnimalsThoroughbred horses (n=53).MethodsMedical records (January 1, 2005-December 31, 2006) of yearling Thoroughbreds treated for carpal angular limb deformity by transphyseal screw insertion in the distal aspect of the radius were reviewed. Retrieved data were sex, surgery, and screw removal dates, surgical site, appearance, limb(s) affected, type of angular limb deformity, and degree of angular deviation measured by a goniometer. Racing and sales data were collected for analysis from an online racing site for all treated horses and their maternal siblings.ResultsNo significant differences were identified between treated horses and their maternal siblings in yearling sale price, 2-year-olds in training sale price, percent starters, percent winners, and starts, earnings, and earnings/start made during the 2- and 3-year old years.ConclusionsNo deleterious effects on sales or racing performance were identified after use of STS in the distal aspect of the radius of Thoroughbreds for the treatment of varus angular limb deformities of the carpus.

Objective: To evaluate the outcome in horses treated with a rolling technique or surgically for nephrosplenic entrapment of the large colon (NSE) and to examine the benefit of phenylephrine (PE) HCl on the efficacy of nonsurgical (rolling) management of NSE.Study Design: Case series.Animals: Horses (n = 211) diagnosed with NSE by rectal palpation with or without ultrasonography, or at the time of exploratory celiotomy or necropsy.Methods: Medical records (January 1, 2001-September 1, 2008) were collected from horses diagnosed with NSE at 2 referral centers. Records were used to obtain signalment, physical exam findings, laboratory results, ultrasonographic findings, the use of PE HCl, the specific treatment used, and outcome. Rectal findings indicative of NSE were: (1) palpation of large colon within the nephrosplenic space or (2) palpation of colonic bands coursing dorsally toward the nephrosplenic space in association with ultrasonographic findings suggestive of NSE.Results: Rolling was successful in 50 of 87 (58%) horses, 85 horses (98%) survived to discharge. Horses (n = 155) that were treated surgically (42 of which had previously undergone the rolling procedure) had a 94% short-term survival rate. Premedication with PE resulted in no significant difference (P = .91) in resolution of NSE by rolling.Conclusions: Resolution of NSE by rolling was not significantly affected by premedication with PE in the population studied.

To report complications and survival after large colon resection and end-to-end anastomosis in horses with strangulating large colon volvulus.Retrospective case series.Horses (n=73) with strangulating large colon volvulus.Records (January 1995 to December 2005) of horses that had large colon resection and anastomosis for strangulating large colon volvulus were reviewed for complications. Follow-up data were obtained by telephone questionnaire at least 1 year postoperatively. Cox proportional hazards model was used for multivariate association with survival time. Variables included admission date, age, temperature, heart rate, packed cell volume, total plasma protein concentration, white blood cell count, breed, and sex. Significance was set at P <.05.The most common postoperative complication was diarrhea. None of the 9 variables of interest were significant for survival. Short-term survival rate (to discharge) was 74%. Overall survival rates at 1, 2, and 3 years postoperatively were 67.8%, 66.0%, and 63.5%, respectively. Four horses died of colic in the first year after surgery. All horses surviving long-term (> 1 year) returned to their intended use (37 brood mares, 2 racehorses, and 1 show horse) with no chronic problems related to the surgical procedure.None of the variables examined were associated with survival. Outcomes were similar to other large studies of surgical colic in the horse. Self-limiting diarrhea is common after large colon resection and the prognosis for survival after hospital discharge is favorable.Horses that survive the early postoperative period and are discharged after large colon resection and anastomosis have a good chance for long-term survival with minimal negative impact on quality of life and use.

Objective- To report fertility (foals conceived, live foal births) of mares after partial fetotomy to resolve dystocia and complications associated with fetotomy.Study Design- Retrospective study.Animals- Horses (n=20).Methods- Medical records (2001-2006) of mares that had partial fetotomy (1-3 cuts) for dystocia were reviewed. Complications and subsequent fertility were obtained by interview and live foal data were recorded by the Jockey Club. Postfetotomy conception and live foals produced over 21 breeding seasons (defined as years each mare was bred regardless of conception) were recorded.Results- Twenty mares were identified. Bilateral carpal flexion alone (3 mares) or in combination with another deformity (7 mares) was the most common presentation for dystocia. From 2001 to 2006, there were 24 breeding seasons for which 20 mares conceived (83%). Eighteen mares conceived before 2006 and all produced live foals. Three mares were bred in 2006; 2 became pregnant, 1 was electively aborted, and 1 is pregnant. Eight of 19 (42%) mares had retained placenta, which were expelled within 24 hours after medical therapy.Conclusions- Partial fetotomy performed with 1-3 cuts does not impede a successful reproductive future.Clinical Relevance- In selected equine dystocia cases, partial fetotomy should be given primary consideration when the foal is dead and vaginal delivery cannot be readily achieved. Fetotomy should not adversely affect the future fertility of the mare.(c) Copyright 2007 by The American College of Veterinary Surgeons

OBJECTIVETo evaluate the relationship of colonic luminal pressure (CLP) measurements to outcome in horses with large colon volvulus (LCV) after either manual correction or large colon resection and anastomosis (LCRA).STUDY DESIGNRetrospective study.ANIMALSHorses (n=57) that had LCV.METHODSRecords for horses with LCV (March 1997-December 2003) were reviewed. Inclusion criteria were strangulating LCV proximal to the cecocolic ligament (>270 degrees), recorded CLP, and successful recovery from anesthesia. CLP measurements and survival/mortality rates were compared between horses that had manual correction (M) or LCRA (R).RESULTSOf 57 horses, 27 had M and 30 had LCRA. For group M, CLP measurements had a sensitivity of 0.60 and specificity of 0.77 for predicting survival, whereas for group R, sensitivity was 0.50 and specificity was 0.54.CONCLUSIONIn our LCV population, elevated CLP measurements had poor accuracy for predicting outcome in horses after surgical correction, especially after LCRA.CLINICAL RELEVANCECLP measurements based on a single hospital population of horses with LCV should be used with caution for other hospital populations of LCV. CLP may be only one of many variables needed for predicting outcome of horses with strangulating LCV, especially after LCRA.

Veterinary RecordVolume 156, Issue 1 p. 24-26 Short Communication Cystolithiasis secondary to intravesical foreign body in a horse J. A. Textor DVM, DipACVS, J. A. Textor DVM, DipACVSSearch for more papers by this authorD. E. Slone DVM, MS, DipACVS, D. E. Slone DVM, MS, DipACVSSearch for more papers by this authorC. K. Clark DVM, DipACVIM, C. K. Clark DVM, DipACVIM Peterson and Smith Equine Hospital, 4747 SW 60th Avenue, Ocala, FL, 34476 USASearch for more papers by this author J. A. Textor DVM, DipACVS, J. A. Textor DVM, DipACVSSearch for more papers by this authorD. E. Slone DVM, MS, DipACVS, D. E. Slone DVM, MS, DipACVSSearch for more papers by this authorC. K. Clark DVM, DipACVIM, C. K. Clark DVM, DipACVIM Peterson and Smith Equine Hospital, 4747 SW 60th Avenue, Ocala, FL, 34476 USASearch for more papers by this author First published: 01 January 2005 https://doi.org/10.1136/vr.156.1.24Citations: 10 Institute of Veterinary and Biomedical Sciences, Massey University, Private Bag 11222, Palmerston North, New Zealand Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. References ARUNKALAIVANAN, A.S. & SMITH, A.R. (2002) Bladder calculus after laparoscopic colposuspension. 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OBJECTIVE:To examine the effect of partial arytenoidectomy without mucosal closure on postoperative racing performance and long-term complications in Thoroughbred racehorses treated for laryngeal hemiplegia, arytenoid chondropathy, or failed laryngoplasty.STUDY DESIGN:Retrospective study.ANIMALS:Twenty-seven Thoroughbred racehorses.METHODS:Medical records of Thoroughbred racehorses that had partial arytenoidectomy without mucosal closure between 1992 and 2002 were reviewed. Horses were divided into groups: horses that had not raced (Group 1) and those that had raced (Group 2) before surgery. Lifetime race records were compared between groups. A standard starts index (SSI) and performance index (PI) were used for Groups 1 and 2, respectively, to objectively evaluate each horse's postoperative performance. Telephone interviews of owners and trainers were used for subjective performance evaluation and to determine prevalence of long-term complications.RESULTS:Eleven (61%) Group 1 and 7 (78%) Group 2 horses raced and earned money after surgery. All Group 1 horses that raced performed at a level lower than the national average. Only 1 Group 2 horse had an improved PI score postoperatively.CONCLUSIONS:Thoroughbred racehorses have a fair prognosis for racing successfully after partial arytenoidectomy without mucosal closure.CLINICAL RELEVANCE:This technique may be a practical alternative to primary mucosal closure, would decrease surgical time, and avoid some problems reported with primary mucosal closure.

The medical records of 80 horses treated for left laryngeal hemiplegia by prosthetic laryngoplasty, ventriculectomy and vocal cordectomy were examined, first to compare the subjective and objective success rates for groups of horses of different ages and used for different purposes, and secondly, to compare the efficacy of including vocal cordectomy in the surgical protocol with published success rates for laryngoplasty and ventriculectomy alone. Subjectively, 70 per cent of the horses were said to have had a successful surgical outcome. The success rate for thoroughbred racehorses (66 per cent) was lower than for other breeds (90 per cent) on the basis of a subjective assessment by owners and trainers. Thoroughbreds two years old or younger had a success rate of 69 per cent, but older thoroughbreds had a success rate of 61 per cent. Of the 17 horses for which an objective performance index could be calculated, 10 (59 per cent) had an improved performance postoperatively. There was a nearly significant association between the objective and subjective assessments (P=0.078). Six of 69 horses (8.7 per cent) continued to make a respiratory noise after surgery. The subjective assessment of success did not appear to correlate with the objective measure of success used in this study and age had no apparent association with a successful surgical outcome. Inclusion of a vocal cordectomy in the surgical protocol may be more important in the eradication of postoperative respiratory noise than in improving clinical success rates.

The purpose of our study was to determine the types of lesions that cause colic in juvenile Thoroughbreds, factors associated with these lesions and the subsequent survival and athletic performance of the juveniles. The age of juvenile Thoroughbreds requiring surgical exploration for abdominal pain has an influence on the type of lesion causing colic. The short-term survival rate (discharge from the hospital) after colic surgery for foals was 85% and was strongly influenced by the lesion causing colic. Thirteen percent of juveniles recovered from the first surgery experienced another severe colic episode requiring additional surgery or euthanasia. Eight percent of foals recovered from the first celiotomy developed adhesions. Adhesion formation was related to the initial lesion causing colic and the foals' age at the first surgery. Foals being suckled (15 days to 6 months) were at greatest risk for adhesions and more frequently required multiple surgeries. Juvenile Thoroughbreds that had a celiotomy were significantly less able to race (63%) than their unaffected siblings (82%), and age at the initial surgery was associated with the percentage of horses that raced. However, affected foals able to race won as much money, raced as often, and made as many starts as their siblings. Colic and surgical treatment have a negative impact on athletic performance, but the majority of foals discharged from the hospital after colic surgery will perform athletically as adults.