An examination of the occurrence of surgical wound infection following equine orthopaedic surgery (1981-1990).

Post operative surgical wound infection rates were determined 452 cases of equine orthopaedic surgery performed at the Western College of Veterinary Medicine, Saskatoon, Saskatchewan, between January 1, 1981 and December 31, 1990. Only surgical procedures classified as clean or clean-contaminated by the National Research Council were included in this study. The overall post operative infection rate was 10.0% (45 of 452). Clean surgeries (n = 433) had an 8.1% infection rate while clean-contaminated surgeries (n = 19) had a 52.6% infection rate. Information collected from the medical records was used in univariate and multivariate logistic regression models to evaluate significant determinates of post operative infection. Significant determinates of post operative infection were: surgical classification, orthopaedic involvement, duration of surgery, administration of preoperative antibiotics and gender. Clean-contaminated surgeries had an increased risk of infection compared to clean surgeries (odds ratio (OR) = 24.3), procedures involving long bones had an increased risk of infection compared to procedures involving articular surfaces (OR = 5.1), surgeries lasting 90 minutes or longer had an increased risk of infection compared to those less than 90 minutes (OR = 3.6), administration of preoperative antibiotics was associated with an increased risk of infection (OR = 4.6) and female patients were 2.6 times more likely to develop post operative infection than male patients.

Effect of feed rate and drill speed on temperatures in equine cortical bone.

OBJECTIVE: To examine the amount of heat generated in equine cortical bone by a 6.2-mm drill, using low- and high-speed and controlled feed rate drilling. SAMPLE POPULATION: 10 metacarpal bones harvested from five 2-year-old draft-type horses. PROCEDURE: Drilling on metacarpal bones was done using a machine shop mill with which the feed rate and drill speed could be precisely controlled. Bones were drilled, using 6 combinations of feed rate (1, 2, and 3 mm advance/s) and drill speed (317 and 1,242 revolutions/min [rpm], with maximal temperatures recorded by thermocouples placed 1, 1.5, and 2 mm from the drill. Maximal temperatures were evaluated for the effect of feed rate, drill speed, cortical thickness, and distance from the drill, using linear regression analysis. RESULTS: Increasing feed rate from 1 to 2 and from 2 to 3 mm/s significantly decreased mean maximal temperature. Increasing drill speed from 317 to 1242 rpm significantly increased mean maximal temperature. Increasing cortical thickness significantly increased mean maximal temperature, and increasing the distance from the drill hole significantly decreased mean maximal temperatures. CONCLUSIONS: On the basis of our results, we recommend using low drill speeds while applying sufficient axial force to advance the drill as rapidly as possible through the bone. CLINICAL RELEVANCE: Results of using this in vitro model suggest that temperatures at the drill-bone interface may be sufficiently high to result in significant thermal necrosis when drilling equine cortical bone.

Fibroblastic tumor of the premaxilla in two horses.

In 2 horses with rapidly growing, locally destructive tumors of the premaxilla, there was major disruption and displacement of some incisor teeth, with radiographic evidence of disruption of the premaxilla at the base of the tumors. In horse 1, most of the tumor was removed by incising it at its base, and the tumor bed was treated cryosurgically with 3 freeze-thaw cycles, using liquid nitrogen. The area healed by 2nd intention. The tumor was found to be a benign fibroblastic tumor, possibly a fibroma. After 4 years, there has been no recurrence. Horse 2 was euthanatized on the basis of a tentative biopsy diagnosis of osteogenic sarcoma. Postmortem studies supported a diagnosis of fibrosarcoma without metastasis.

Periorbital skull fractures in five horses.

Periorbital skull fractures were diagnosed in 5 horses, and were associated with ophthalmic complications including corneal ulceration, uveitis, and entrapment of the eye by retrobulbar bone fragments. Physical examination was of greater diagnostic use than radiography. Surgical repair was performed on all horses and was associated with a more favorable postoperative appearance in horses treated acutely; however, the cosmetic results were considered acceptable in all horses. Major postoperative complications were not observed.

Balloon-tipped catheter arterial occlusion for prevention of hemorrhage caused by guttural pouch mycosis: 13 cases (1982-1985).

Epistaxis, caused by guttural pouch mycosis, was treated by balloon-tipped catheter and ligature occlusion of the involved arteries in 13 horses. In 7 horses, more than one artery was catheterized. Serious postoperative hemorrhage was prevented in all horses. Long-term endoscopic follow-up examination was possible in 8 horses, and all had complete regression of the fungal lesion as early as 5 weeks after surgery. Six of the 8 horses did not receive medical treatment. Problems related to the use of the balloon-tipped catheter technique were rare. There were incisional infections in 3 horses, catheter breakage during removal occurred twice, and in one horse, a catheter was inappropriately placed.

Esophageal patch grafting as a treatment for esophageal stricture in a horse.

Esophageal patch grafting, using the sternocephalicus muscle, was used for treatment of cervical esophageal stricture in a mare. The mare was maintained during the initial healing phase by total parenteral nutrition.

Management of umbilical hernias in cattle and horses.

The medical records of 60 cattle and 47 horses treated for umbilical hernia at the Western College of Veterinary Medicine over a 3-year period were studied retrospectively. Age, hernia size, physical signs at admission, reducibility, method of repair, prevalence, and types of complications were evaluated. Most patients were less than 6 months old, with hernias less than 10 cm long. Affected cattle had a higher prevalence of organic diseases associated with umbilical hernias and more postsurgical complications than did affected horses.

Management of proximal sesamoid bone fractures in the horse.

The case records of 49 horses with proximal sesamoid bone fracture were studied. The population consisted of 20 Thoroughbreds, 20 Standardbreds, 5 Quarter Horses, 2 Arabians, and 2 grade horses. The fractured bones were classified into 5 categories: apical fractures, basilar fractures, abaxial fractures, middle one-third fractures, and bilateral comminuted-distracted fractures. Apical fractures occurred most frequently in the Standardbred, with the prevalence of medial fracture being equal to that of lateral fracture. Basilar fractures occurred predominantly in the Thoroughbred, with the highest prevalence in the lateral sesamoid bone of the right front fetlock. Bilateral comminuted-distracted fractures also occurred primarily in the right front fetlock. The prognosis following surgical removal of apical fractures appeared to be superior to that for stall rest alone. The prognosis for basilar fractures was poor.

Paralaryngeal abscess with laryngeal hemiplegia and fistulation in a horse.

A three year old Thoroughbred filly was examined because of bilateral nasal discharge and external swelling of the left laryngeal area. Endoscopy revealed an enlarged left arytenoid cartilage, left laryngeal hemiplegia and drainage of purulent material into the lumen of the larynx. Radiographs showed a large fluid and gas filled cavity overlying the caudal larynx and cranial trachea. Surgical drainage and debridement of the abscess led to complete healing by secondary intention. Laryngeal ventriculectomy was performed as a treatment for left laryngeal hemiplegia, but a grave prognosis for respiratory soundness was given due to the extensive laryngeal fibrosis. The etiology of the Staphylococcus aureus abscess is unknown but may have originated from oral trauma to the larynx.

Torsion of the uterus--a cause of colic in the mare.

A case of uterine torsion in a mare with colic is described in which an early diagnosis was made and the torsion successfully reduced through a standing laparotomy with survival of both the mare and the foal. This case is used to stress the importance of thorough examination of all pregnant mares with colic in order to differentiate uterine torsion from other causes of abdominal pain, thereby avoiding delay in surgical correction and reducing the risk of fetal and/or maternal death. The advantages of the standing laparotomy are presented in support of this method of treatment of torsion of the gravid uterus.

An unusual location of foreign body in the horse.

A seven year old Arabian gelding was presented because of a draining tract cranial to the scapula that developed following puncture with a wooden rail four months previously and drained continuously despite antibiotic treatment.The full extent of the tract could not be determined with the horse standing but a polyethylene catheter was passed 25 cm down the tract and passed medial to the scapula. With the horse under a general anaesthetic, further probing revealed the tract was much longer. The direction, length and contents of the tract were determined by fistulograph. The tract continued medial to the scapula and terminated with two radiolucent filling defects adjacent the spinous processes of the 5th-11th thoracic vertebrae. The filling defects were located more accurately in a cranial-caudal direction by the use of radiopaque markers, and in a medial-lateral direction by deep needle probing during surgery. Following surgical removal of the foreign bodies the tract healed and the horse returned to his original use. Foreign bodies and the use of fistulography are discussed.

Guttural pouch hemorrhage associated with lesions of the maxillary artery in two horses.

A two year old Thoroughbred gelding, presented with guttural pouch hemorrhage, had the internal and external carotid arteries ligated. Guttural pouch mycosis was detected on endoscopic examination. After one month of topical antifungal therapy, the horse was returned and euthanized because of recurrent epistaxis. A bacterial infection of the guttural pouch with associated ulceration and hemorrhage from the maxillary artery was found at necropsy.A two year old grade gelding had ulceration and hemorrhage from the external carotid artery. Utilizing balloon-tipped catheters and arterial ligation, hemestasis was achieved in the internal carotid artery and the external carotid artery and its branches. Mycotic ulceration of the internal carotid artery was detected endoscopically and treated with local antifungal therapy for one month. Thirty-three days postoperatively the horse returned, bleeding from a lesion in the maxillary artery. The rationale for surgical intervention to prevent epistaxis associated with guttural pouch mycosis and possible etiologies for postsurgical epistaxis are discussed.

Pyloric stenosis in a foal.

A two month old Thoroughbred filly was presented with signs of depression, grinding of the teeth, frothing of the mouth and abdominal pain. These signs had persisted for two weeks despite treatment with mineral oil, dioctyl sodium sulfosuccinate, meperidine and antibiotics. A variety of diagnostic tests were done, the only abnormal finding was a stress leukon. On exploratory laparotomy the stomach was dilated with fluid and gas and the pyloric canal was constricted. Pyloroplasty resulted in correction of the condition. The etiological possibilities are discussed. This is believed to be the first report of pyloric stenosis in the horse.

Esophageal ectasia in a quarterhorse colt.

A one month old Quarterhorse colt was presented after a week history of bilateral nasal discharge and respiratory difficulty. The cervical esophagus was greatly dilated, tortuous and filled with diluted milk. A nasogastric tube could not be passed beyond the base of the heart. An aspiration pneumonia was found at postmortem examination and the esophageal segment from the pharynx to the base of the heart was dilated, thin-walled, had degenerative muscular changes, and a reduction in size and number of ganglion cells of the myenteric plexus. Muscular hypertrophy of the terminal esophagus had reduced its lumen size. Some similarities and disparities of this condition to achalasia of man and megaesophagus of dogs are discussed.

Disruption of the blood supply to the small colon following rectal prolapse and small colon intussusception in a mare.

A coliky and depressed four year old Arabian mare was examined three days after replacement of a rectal prolapse that had occurred during parturition. Fresh blood was present in the rectum and a septic peritonitis was diagnosed based upon the clinical pathological examination of the peritoneal fluid. At laparotomy the terminal 1.3 meters of small colon was found to be necrotic as a result of rupture of the terminal mesocolon and associated blood vessels. Based upon the poor prognosis the mare was euthanized. Rupture of the mesocolon was thought to be a sequel to the rectal prolapse. The anatomy predisposing the horse to these events is discussed.

Comparison of herniorrhaphy versus clamping of umbilical hernias in horses: a retrospective study of 93 cases (1982-1994).

Many uncomplicated umbilical hernias have been managed successfully in foals by the application of a hernia clamp. Isolated reports of complications following clamp application have led some authors to suggest that it is an unsuitable method of treatment. Little information has been published comparing the complication rates associated with the use of hernia clamps and herniorrhaphy in the treatment of umbilical hernias. The purpose of this retrospective study was to report the characteristics of clinical cases of umbilical hernia and to compare the complication rates following these 2 treatment approaches. Information was collected from records or from owners to identify the occurrence of complications and owner satisfaction following treatment. Of 93 cases, 10 complicated and 18 uncomplicated hernias were treated by herniorrhaphy, 40 uncomplicated hernias were treated by clamping, 1 originally uncomplicated hernia was treated by both techniques, and 24 cases were untreated. Nineteen percent of uncomplicated hernias treated by herniorrhaphy, and 19% of those clamped developed minor complications. This study demonstrates that although minor complications may be associated with either technique, they generally do not result in significant morbidity.

Urethrorectal fistula in a horse.

Anomalies of the urethra are uncommon. Urethrorectal fistula in horses has only been reported in foals and only in conjunction with other congenital anomalies. This report describes the diagnosis, surgical management, and possible etiologies of a unique case of urethrorectal fistula in a mature gelding.

Subluxation of the carpus in thirteen horses.

The records of 13 horses of various breeds with subluxation of the radiocarpal, intercarpal or carpometacarpal joint, or combinations of these were reviewed. Subluxation was most common at the carpometacarpal joint (n = 10) and concomitant fractures of individual carpal bones or metacarpus II and IV were seen (n = 12).Treatment comprised of immobilization in a full leg plaster cast for from four to 18 weeks. Three animals were euthanized, two because of cast complications and one because of a request by the owner. The remaining ten were saved to function as breeding animals.

Osteochondritis dessicans and subchondral cystic lesions in draft horses: a retrospective study.

The clinical features, radiographic findings, treatment, and outcome in 51 draft horses with osteochondritis dessicans (OCD) or subchondral cystic lesions (SC) are reported. Clydesdale and Percheron were the most commonly affected breeds, and affected animals represented only 5% of the hospital population of draft horses. Horses were most frequently affected in the tibiotarsal joints and 73% (24 of 33 cases) of the horses with tibiotarsal effusion were affected bilaterally. Osteochondritis dessicans of the distal intermediate ridge was the most common lesion found in the tibiotarsal joint. The stifle was also frequently affected; 87% (13 of 15 cases) of horses with femoropatellar OCD only were lame, and lesions were most commonly located on the lateral trochlear ridge. Sixteen cases were managed conservatively, 30 received surgery, and 5 were euthanized. Lameness, effusion, or both clinical signs resolved in more than 50% of surgically treated cases, but clinical signs improved in 30% of conservatively-managed cases.