Outcome following neurectomy of the deep branch lateral plantar nerve and plantar fasciotomy for hindlimb proximal suspensory desmopathy in western performance horses: 21 cases.

OBJECTIVE: To report the outcome of horses used in western performance disciplines after deep branch lateral plantar neurectomy/fasciotomy surgery for hind limb proximal suspensory desmopathy (PSD). STUDY DESIGN: Retrospective analysis. SAMPLE POPULATION: Twenty-one client-owned horses. METHODS: Medical records were reviewed (2009-2019) for horses involved in western performance disciplines that had been treated with deep branch lateral plantar neurectomy and plantar fasciotomy for lameness due to hind limb PSD. Follow-up was obtained by reexamination and/or verbal interviews with owners >2 years postoperatively. RESULTS: Sixteen quarter horses and five paints were used for western pleasure (14/21), barrel racing (2/21), cutting (1/21), steer wrestling (1/21), working cow horse (1/21), team roping (1/21) and reining (1/21). A median duration of 8 months was required before horses were able to resume training or athletic work. Nine horses were able to return to a similar or higher level of athletic use, nine horses returned to a lower level of athletic performance, and three horses could not return to intended function. Owner satisfaction with outcome after the procedure was high (16/21), average (3/21), and low (2/21). CONCLUSION: Deep branch lateral plantar neurectomy and plantar fasciotomy allowed most horses to resume some athletic function as western performance horses. CLINICAL SIGNIFICANCE: These results provide evidence of potential outcomes when considering surgical treatment of hind limb PSD in western performance horses.

Tenotomy of the semitendinosus muscle under standing sedation versus general anesthesia: Outcomes in 20 horses with fibrotic myopathy.

OBJECTIVE: To compare outcomes after semitendinosus tenotomy performed under standing sedation versus general anesthesia. STUDY DESIGN: Retrospective case series. SAMPLE POPULATION: 20 horses with fibrotic myopathy of the semitendinosus muscle. METHODS: Medical records (2002-2015) of horses undergoing tenotomy of the semitendinosus muscle for the treatment of fibrotic myopathy were reviewed. Signalment, history, affected muscles, restrain method, surgical procedures, and short-term outcome as well as complications were retrieved from records. Long-term outcome (gait and athletic function) was assessed at least 6 months postoperatively by conversation with the owners. Pearson's χ2 statistical analysis was used to compare restrain method and affected muscles with overall outcome. Significance was set at P < .05. RESULTS: Tenotomy of the semitendinosus muscle was performed under standing sedation in 8 horses and under general anesthesia in 12 horses. Follow-up period ranged from 9 months to 10 years. Gait was improved to variable degrees in 8 of 14 horses when the semitendinosus muscle alone was affected and in 4 of 6 horses when both the semitendinosus and semimembranosus muscles were involved (P = .11). Six of 8 horses treated under standing sedation and 6 of 12 horses treated under general anesthesia exhibited some improvement in the characteristic fibrotic gait (P = .4473). Five of 6 athletic horses treated under standing sedation and 6 of 9 athletic horses treated under general anesthesia returned to their preinjury level of athleticism. Horses treated under standing sedation had no incisional complications; 2 of 12 horses treated under general anesthesia exhibited incisional drainage. CONCLUSION: Tenotomy of the semitendinosus muscle in horses with fibrotic myopathy leads to similar improvement in gait, whether performed under standing sedation or general anesthesia.

Efficacy of Teaching the Gambee Suture Pattern Using Simulated Small Intestine versus Cadaveric Small Intestine.

OBJECTIVE: To determine if instruction using simulated small intestine (SSI) is as effective as using cadaveric small intestine to teach the Gambee suture pattern to second year veterinary students. STUDY DESIGN: Prospective, randomized, blinded study. SAMPLE POPULATION: Second year veterinary students (n=59). METHODS: Students were randomly assigned to groups using SSI or equine cadaver small intestine (CSI) to learn the Gambee suture pattern. The same educator, an experienced surgical instructor, instructed all students. Instruction consisted of verbal description of the technique with a schematic diagram followed by a demonstration. Students then practiced the technique with supervision and verbal feedback. One week later, 3 board certified surgeons experienced in surgical instruction evaluated each student suturing equine CSI and scored them using a rubric developed and validated for surgical skills assessment. RESULTS: Fifty-nine students were enrolled (4 students were absent for the lab during which the assessment was performed; 55 students were available for evaluation). Of the 55 students evaluated, 26 were in the SSI group and 29 were in the CSI group. There was no significant difference between CSI and SSI groups in ability to perform the Gambee suture pattern using equine CSI 1 week following training. CONCLUSION: SSI is as effective as equine cadaveric small intestine tissue to teach the Gambee suture pattern to second year veterinary students. If cadaver tissue is unavailable or undesirable, SSI could be used to instruct suture placement techniques.