Laparoscopic cryptorchidectomy using a resorbable self-locking loop device in dorsally recumbent horses.

OBJECTIVE: To report the use and feasibility of a self-locking resorbable loop device for cryptorchidectomy. STUDY DESIGN: Clinical prospective study. POPULATION: Twenty horses. METHODS: Horses suspected to have an abdominal testicle/s after admission work-up were enrolled. Horses were anesthetized in dorsal recumbency and a standard laparoscopic technique was performed. The looped device was inserted into the abdomen, glided around the testis/cord and tightened. Then, the spermatic cord was transected prior testis removal. Surgical procedure details and remarks, perioperative complications and total surgical time were recorded. Short- (>3 weeks) and long-term (>6 months) follow-ups were obtained by telephone questionnaire. RESULTS: Median total surgical time was 67 min (range: 43-189 min) and significantly shortened after the first four horses. The loop device was easily glided around 13/20 abdominal testes and required more time and technical skills around larger testes (≥3 years). Excellent intraoperative hemostasis was achieved in 17 horses. Three horses demonstrated mild intraoperative bleeding that required retightening, device replacement or adding a second device, respectively. Three horses developed mild postoperative hemoabdomen identified ultrasonographically and were successfully managed medically. Follow-up revealed no significant complications related to the procedure. One horse was euthanized for colic 4 months after surgery and one died of hemolytic shock 17 months postoperatively. CONCLUSION: This device represents another method to perform equine cryptorchidectomy that requires minimal training and laparoscopic expertise but demands knowledge of the device and application to prevent complications. CLINICAL SIGNIFICANCE: Laparoscopic cryptorchidectomy using this device is an alternative technique for horses <3 years.

Standing surgery among equine board certified surgeons: Survey regarding current use and trends.

BACKGROUND: Publications about equine standing surgery are flourishing, however, information regarding its use and prevalence among surgeons is still limited. OBJECTIVES: To determine the current use and recent trends for equine standing surgery among board certified surgeons and to identify the main reasons and limitations for performing a procedure standing. STUDY DESIGN: Cross-sectional survey. METHODS: A 139-item questionnaire was sent by email to 733 large animal surgery Diplomates (ACVS and ECVS) from November 2020 to February 2021. The survey collected demographic information and general data regarding standing surgery before being divided into seven identical sections for each body system, involving 36 standing procedures. RESULTS: The survey response rate was 29.7% (218/733). Most respondents (58.9%, 126/214) had performed standing surgery for <10 years regardless of length of time they were board certified (48.2% board certified <10 years and 51.8% >10 years). Most respondents (range: 50.0%-92.9%, mean 69.5%) changed from performing 14/36 surgeries under general anaesthesia (GA) to standing within the previous 10 years and had always performed 8/36 surgeries standing (51.6%-73.9%, mean 61.4%) regardless of board certification time. Surgeons board certified <10 years ago performed more often 3/36 listed procedures standing than those board certified >10 years ago (p < 0.05). Avoiding GA (179/218) and/or reducing procedure cost (111/218) were the two main reasons to perform standing surgeries whereas the horse's behaviour (183/218) and/or the patient size/age (94/218) were the two main limiting factors. MAIN LIMITATIONS: Low response rate. Results biased towards the opinion of a subgroup of surgeons, those performing standing surgery. Some standing procedures were not included in the survey. CONCLUSIONS: The use of standing surgery is well established among board certified surgeons and progressively increasing, especially in the last 10 years and among recent Diplomates. With increased training and awareness, more Diplomates may be encouraged towards performing standing surgeries.

Effects of sand, asphalt and 3-degree hind toe or heel elevation on horse kinematics.

BACKGROUND: Although the effects of both the surfaces and plantar angles on equine locomotion have been widely discussed, limited scientific data are available. METHODS: Our objectives were to determine the effects of two surfaces (asphalt and sand) and of 3-degree hind toe or heel elevation on horse kinematics in an experimental study. Six saddle horses were shod with a reference shoeing (REF), characterized by a fore aluminium (REF F) and hind steel racehorse (REF H) shoeing. Two dimensional kinematic videos compared horse's kinematic parameters when walking and trotting on asphalt and sand. On asphalt, REF was also compared with REF F and a modified REF H with additional 3-degree hind-toe or -heel wedges. RESULTS: On asphalt versus sand, horses had, at the trot, a shorter stride duration and forelimb maximal retraction, and at walk and trot, a greater fetlock, carpus, elbow and tarsus extension, a greater fore and hind limbs maximal protraction and a shorter hind limbs maximal retraction. Increasing the plantar angle decreased the tarsus and hind fetlock extension, in contrast to fore-limb, on asphalt during the stance phase. CONCLUSIONS: These findings could be useful to adapt rehabilitation programs related to fore and hind limb pathologies, at slow gaits.

Hematuria in a 3-month-old filly with an internal umbilical abscess and internal iliac artery aneurysm.

A 3-month-old foal with a history of acute hematuria was evaluated. Hydronephrosis and hydroureter were visualized upon renal ultrasonography of the left kidney. Cystoscopy identified a blood clot occluding the left ureter. Computed tomography (CT) revealed a large retroperitoneal abscess at the level of the aortic bifurcation and a left internal iliac aneurysm. Due to the severity of the lesions and the poor prognosis, the filly was euthanized and the clinical findings were confirmed by post-mortem examination. This report emphasizes the value of obtaining a precise diagnosis via CT in order to avoid unviable treatment approaches when confronted with this unusual secondary complication of omphaloarteritis. Key clinical message: Umbilical complications are routinely diagnosed in equine neonatal medicine, and commonly lead to septicemia, physitis, and septic arthritis; severe internal umbilical abscessation, and subsequent vascular and urinary disorders are uncommon sequelae.

Hématurie chez une pouliche de 3 mois avec abcès ombilical interne et anévrisme de l'artère iliaque interne. Un poulain de 3 mois ayant des antécédents d'hématurie aiguë a été évalué. L'hydronéphrose et l'hydro-uretère ont été visualisés par échographie rénale du rein gauche. La cystoscopie a identifié un caillot sanguin obstruant l'uretère gauche. La tomodensitométrie (TDM) a révélé un gros abcès rétropéritonéal au niveau de la bifurcation aortique et un anévrisme iliaque interne gauche. En raison de la gravité des lésions et du mauvais pronostic, la pouliche a été euthanasiée et les résultats cliniques ont été confirmés par un examen post-mortem. Ce rapport souligne l'intérêt d'obtenir un diagnostic précis par TDM afin d'éviter des approches thérapeutiques non-viables face à cette complication secondaire inhabituelle de l'omphalo-artérite.Message clinique clé :Les complications ombilicales sont couramment diagnostiquées en néonatalogie équine et conduisent généralement à une septicémie, une épiphysite et une arthrite septique; un abcès ombilical interne sévère et des troubles vasculaires et urinaires subséquents sont des séquelles peu fréquentes.(Traduit par Dr Serge Messier).