Survival and racing performance after surgical treatment of rib fractures in foals.

OBJECTIVE: To evaluate the short and long-term outcomes of foals treated surgically for fractured ribs and variables that may affect outcome. STUDY DESIGN: Retrospective. ANIMALS: Seventy-three equine neonates with surgically repaired fractured ribs. METHODS: Medical records were reviewed to include sex, breed, the side of thorax affected, number of ribs fractured, co-morbidities directly associated with rib fracture, and surgical technique used. Short-term outcome was defined as survival to discharge. Long-term outcome was whether or not they started a race. Race records of maternal siblings were obtained for comparison. RESULTS: Seventy-three neonates underwent surgery for fractured ribs. Fifty-seven neonates (78%) survived to discharge from the hospital. Rib fractures were more commonly observed in colts and in the left hemithorax (61% and 57%, respectively). Sex, side affected, number of ribs fractured, co-morbidities, number of ribs repaired, and surgical technique did not affect the short- or long-term outcomes. Thirty-five of 57 (61%) foals treated surgically for rib fractures that survived to discharge started a race compared to 173 of 257 (67%) of maternal siblings that raced. CONCLUSIONS: Short- and long-term outcome were not affected by co-morbidities, surgical technique, or number of fractured ribs. CLINICAL SIGNIFICANCE: Neonates with surgically repaired fractured ribs had a good prognosis for survival and and those that survived had a similar chances of starting a race compared to maternal siblings.

Description of a rare osteochondrosis lesion of the medial aspect of the distal intermediate ridge of the tibia in seven Thoroughbred horses (2008-2018).

Osteochondritis dissecans (OCD) of the distal intermediate ridge of the tibia (DIRT) is commonly identified on either the lateral to medial (LM) or dorso45°medial-plantarolateral oblique (D45M-PLO) projection of the tarsus. This manuscript describes a retrospective case series out of Hagyard Equine Medical Institute, for which medical records and radiographic projections of the tarsus were reviewed, consistent with Keeneland's repository requirements. This original investigation identified seven yearling Thoroughbred horses between 2008 and 2018 with radiographic signs of atypical osteochondrosis lesions within the tarsus. The atypical lesions, originating along the medial margin of the distal intermediate ridge of the tibia, were initially only diagnosed on the dorso10°lateral-plantaromedial (D10L-PMO) projection and were overlooked on the LM and D45M-PLO views. Following the diagnosis of osteochondrosis in these seven cases, the radiographs were reviewed and re-evaluated, but osteochondrosis and/or fragmentation could not be definitively diagnosed on the LM and/or D45M-PLO projections alone. Our findings highlight the importance of a complete radiographic study of the equine tarsus when screening horses for OCD lesions of the distal intermediate ridge of the tibia and that atypical DIRT lesions may go undetected if the D10L-PMO projection is not performed.

Endoscopic, transoral, reduction of epiglottic entrapment via wire snare technique.

OBJECTIVE: To describe the use of a wire snare technique for epiglottic entrapment. STUDY DESIGN: Case series. ANIMALS: Eight adult horses. METHODS: Under general anesthesia, a modified mouth gag was placed in the oropharynx. An endoscope was passed through the gag until there was adequate visualization of the entrapped epiglottis. The entrapping mucosa was grasped with bronchoesophageal forceps and pulled rostrally, releasing the epiglottis. A custom snare was passed down the bronchoesophageal forceps to encircle the redundant subepiglottic mucosa. Tension was applied to the entrapping mucosa via the forceps as the obstetric wire was tightened at the base and the redundant mucosa (aryepiglottic fold) was excised. RESULTS: The procedure was performed on 8 adult thoroughbred horses. Re-evaluation by endoscopy did not show entrapment in any horse and no horse developed complications or has had problems with performance. CONCLUSIONS: This technique is a minimally invasive, competitively priced and straightforward method for resection of entrapping subepiglottic mucosa in adult horses.

Osteomyelitis of the patella in eight foals.

OBJECTIVE: To describe the characteristics of osteomyelitis lesions of the patella and to report short- and long-term outcome after treatment in 8 foals. STUDY DESIGN: Retrospective case series. ANIMALS: Foals (n = 8). METHODS: Medical records (2003-2007) and radiographs of foals that had osteomyelitis of the patella were reviewed. Inclusion criteria included clinical, radiographic, and surgical findings consistent with osteomyelitis of the patella, and a long-term follow-up of >15 months. Information acquired included signalment, hematologic and serum biochemical profile results, clinical and radiographic signs, surgical technique and perioperative treatment. Follow-up radiographs were evaluated and outcome was determined from veterinary examination, race records, and telephone questionnaire. RESULTS: Six foals survived long term (15 months-4 years); all had intralesional and systemic antimicrobial therapy, along with synovial lavage and antimicrobial medication. All were sound and achieved either yearling sales (n=3), show hunter or racing (2). Two foals died in the short term from renal failure and suppurative peritonitis secondary to cecal perforation, 1 remaining lame with suppurative osteonecrosis confirmed at necropsy. This foal was not administered intralesional antimicrobial therapy. CONCLUSIONS: Prompt medical and surgical therapy for osteomyelitis of the patella can result in a good prognosis for soundness and a potential athletic career. Concurrent septicemia or other systemic perinatal disease can result in prolonged therapy and delayed recovery.

Surgical technique to repair grade IV rectal tears in post-parturient mares.

OBJECTIVE: To describe a surgical technique for repair of grade IV rectal tears after parturition in mares and to report outcome. STUDY DESIGN: Clinical report. ANIMALS: Horses (n=6) with grade IV rectal tears. METHODS: Mares were sedated and restrained in standing stocks. After caudal anesthesia and evacuation of feces from the rectum, the perineal region was aseptically prepared. Four stay sutures were placed through the external anal sphincter before vertical transection (12 o'clock). Caudal retraction of the tear was performed using Allis tissue forceps (5 mares) or stay sutures before accurate apposition of the tear margins with steel staples below the tissue forceps. The mucosal edges were then sharply dissected leaving approximately 5 mm edges which were apposed in a single layer (2-0 poliglecaprone 25) before stapler release. In 1 mare, the rectal tear was identified and apposed using a 2-layer hand-sutured closure. Systemic antibiotics and anti-inflammatory agents were administered postoperatively (5 mares) and standing abdominal lavage performed (3 mares). RESULTS: Four mares survived long term and subsequently became pregnant. Immediately after surgical repair, 1 mare was anesthetized for exploratory celiotomy and abdominal lavage but fractured her pelvis during recovery from anesthesia and was euthanatized. A 2nd mare was euthanatized after 72 h because of severe diffuse peritonitis; however, the repair was still intact. CONCLUSION: In standing mares, rectal tears can be exteriorized by prolapse through the anal sphincter after sphincterotomy and repaired in 2 layers with staples oversewn with a continuous suture pattern. CLINICAL RELEVANCE: Rectal tears occurring as a result of parturition can potentially be repaired efficiently using an oversewn stapled primary closure technique.

Racing prognosis of horses following surgically repaired olecranon fractures.

Olecranon fracture is a common orthopedic problem in juvenile horses. Prognosis for complete fracture healing when various methods of internal fixation are used is good; however, the impact of olecranon fracture stabilization on the likelihood that foals will start on a racecourse is unknown. Medical records of foals undergoing internal fixation for an olecranon fracture were reviewed. The dam's foaling records were obtained and lifetime racing records were then retrieved for both the affected foals and 1 of their siblings. Twenty-two of 24 repaired fractures healed completely, subsequently, 16 of the foals started in at least 1 race. Statistical calculations suggest that when compared with their siblings, the occurrence of olecranon factures requiring internal fixation in juvenile racehorses will not significantly reduce the likelihood that they will race; however, the siblings had significantly more lifetime race starts and higher career earnings.