Nonseptic tenosynovitis of the digital flexor tendon sheath caused by longitudinal tears in the digital flexor tendons: a retrospective study of 135 tenoscopic procedures.

REASONS FOR PERFORMING STUDY: Longitudinal tears (LTs) of the digital flexor tendons are an important cause of chronic tenosynovitis of the digital flexor tendon sheath (DFTS). The origin of those marginal tears is not yet fully understood. The long-term outcome after medical and surgical treatment is guarded. OBJECTIVES: To determine the prevalence of LTs of the digital flexor tendons in a large population of horses undergoing diagnostic tenoscopy of the DFTS and to assess the outcome of surgical treatment and the factors influencing the outcome. METHODS: Medical records of 130 horses with chronic tenosynovitis of the DFTS that had tenoscopic surgery between 1999 and 2009 were evaluated. One hundred and thirty-five DFTSs were examined. LTs were diagnosed in 104 DFTSs in 101 horses and long-term follow-up was obtained. RESULTS: Seventy-eight percent of the horses with a nonseptic tenosynovitis of the DFTS had a LT. Preoperative ultrasonographic examination diagnosed tears in 76% of the cases. In showjumpers forelimbs were more frequently affected than hindlimbs (88 vs. 12%), with the right front having a higher incidence of injury than the left front (76 vs. 24%). Seventy-nine percent of the tears involved the deep digital flexor tendon (DDFT) and 87% were located on the lateral tendon border. Thirty-seven horses (38%) returned to an equal or higher level of work. The use of a radiofrequency probe (coblation) was associated with a lower level of performance and decreased the cosmetic end result. Persistence of marked post operative distension of the DFTS carried a poor prognosis for return to previous level of work. CONCLUSIONS AND POTENTIAL RELEVANCE: A guarded prognosis for future soundness should be given to horses presented for treatment of LTs of the digital flexor tendons. The use of coblation wands had a negative effect on the final outcome.

Extraction of cheek teeth using a lateral buccotomy approach in 114 horses (1999-2009).

REASON FOR PERFORMING THE STUDY: There are few published data regarding the success rates of cheek tooth (CT) removal by lateral buccotomy in the horse. OBJECTIVES: A retrospective study of 114 horses admitted to 2 private equine referral hospitals over a 10 year period (1999-2009), which underwent CT removal via a lateral buccotomy. METHODS: Hospital records were analysed and details including case details, presenting complaint and results of all diagnostic tests and surgical reports were documented. Information obtained during post operative reassessment was also available for analysis. Long-term follow-up information (>2 months) was obtained for 112 horses. RESULTS: Short-term complications (<2 months) occurred in 24/77 horses (31%) undergoing exodontia of the maxillary CT and 10/37 horses (27%) involving mandibular CT, with the majority arising from partial wound dehiscence and infection following 16 extractions (47%). All healed well by second intention. Other complications included both temporary (n = 6) and permanent (n = 3) facial nerve paralysis, myositis (n = 4) and the inadvertent establishment of an oroantral fistula (n = 4). One myositis case was subjected to euthanasia 24 h post operatively. Five horses had persistent sinusitis following surgery due to dental remnants (n = 2) and excessive packing material (n = 1) found in the sinuses. No inciting cause could be found in the remaining 2 horses. One further horse suffered a fatal cardiac arrest at induction of anaesthesia. Of all horses, 92% operated on had returned to their previous level of work after >2 months with no complications. CONCLUSION: Horses with CT removal by a lateral buccotomy have a reasonable prognosis for long-term outcome. POTENTIAL RELEVANCE: Performing a lateral buccotomy is a justified treatment alternative for the surgical removal of equine CT following unsuccessful attempts by standing oral extraction, offering advantages over alternatives such as retropulsion, endodontic therapy and periapical curettage.

Dorsoproximal proximal phalanx osteochondral fragmentation in 117 Warmblood horses.

The objective of the present study was to determine clinical and arthroscopic characteristics associated with dorsoproximal proximal phalanx (P1) fragments in Warmblood horses, as well as to examine their histopathological appearance. One hundred sixty-eight fragments were removed from 150 fetlocks of 117 Warmblood horses. Details of signalment and results of clinical examination were collected prior to surgery. After arthroscopic fragment removal and joint evaluation for synovial and/or cartilage abnormalities, the fragments were measured and evaluated histopathologically. The vast majority of the fragments (95.2%) were found medially, without predilection for front or hind limbs. In 10% of the joints, more than one fragment was present. The mean size of the fragments was 6.8 +/- 2.6 mm. Only eight horses presented fetlock-related lameness. Horses of seven years of age and older (OR = 13.32; p = 0.033) and the presence of more than one fragment (OR = 11.12; p = 0.016) were significantly associated with lameness. Arthroscopic evaluation revealed one or more abnormalities in 50.7% of the joints. On histopathology, osteochondral fragments presented as a bony center covered with smooth hyaline cartilage on one side and some fibrous tissue on the other side. No clear histopathological signs were indicating precisely their origin. In Warmblood horses with dorsoproximal P1 fragments, the age (seven years and older) and the presence of more than one fragment in a fetlock significantly increased the risk of lameness. The osteochondral dorsoproximal P1 fragments could be defined as a developmental orthopaedic disease.

Treatment of irreducible caecocolic intussusception in horses by jejuno(ileo)colostomy.

Six of eight horses with caecocolic intussusception were treated successfully by jejuno- or ileocolostomy. The other two horses were euthanased during surgery. Four of the six horses survived long term, but two died within two-and-a-half months, of problems related to the surgery. Compared with other techniques for treating caecocolic intussusception, jejuno- or ileocolostomy reduces surgical time and decreases the risk of abdominal contamination.