Effects of head position on internal and external carotid pressures in standing sedated horses.

The effects of head position on internal carotid artery (ICA) and external carotid artery (ECA) pressures in standing sedated horses were evaluated in this study. The common carotid artery (CCA) was catheterized in 6 horses using an ultrasound-guided technique to facilitate placement of a pressure transducer within the ICA and ECA at the level of the guttural pouch. Transducer position was confirmed by endoscopic visualization. Mean arterial pressure (MAP) was measured with horses in both a head-up and head-down position. The dorsal metatarsal artery was catheterized as a control. Maintaining a head-up position decreased MAP in both the ICA (median: 75.21 mmHg) and ECA (median: 79.43 mmHg), relative to the head-down position (ICA median: 104.65 mmHg; ECA median: 102.26 mmHg). Mean arterial pressure in the dorsal metatarsal artery was not affected by head position. The head-up position resulted in lower arterial pressures in both the ICA and ECA (P = 0.03) compared with the head-down position in standing sedated horses.

Cette étude a évalué les effets de la position de la tête sur la pression artérielle au niveau de l'artère carotide interne (ICA) et de l'artère carotide externe (ECA) chez des chevaux sous sedation debout. L'artère carotide commune (CCA) a été cathétérisée chez six chevaux en utilisant une technique échoguidée pour faciliter le placement d'un transducteur de pression dans l'ICA et l'ECA au niveau de la poche gutturale. La position du transducteur a été confirmée par endoscopie. La pression artérielle moyenne (MAP) a été mesurée chez les chevaux avec la tête en position haute et en position basse. L'artère métatarsienne dorsale a été cathétérisée et a servi comme témoin. Les MAP enregistrées au niveau de l'ICA (médiane: 75,21 mmHg) et de l'ECA (médiane: 79,43 mmHg) lorsque la tête est en position élevée sont plus faibles que celles enregistrées lorsque la tête est en position basse (médiane ICA: 104,65 mmHg; médiane ECA: 102,26 mmHg). La MAP de l'artère métatarsienne dorsale n'a pas été affectée par la position de la tête. En conclusion, chez les chevaux sédatés et debout, la position élevée de la tête produit des pressions artérielles plus faibles au niveau de ICA et ECA (P = 0,03) que celles obtenues lorsque la tête est en position basse.(Traduit par les auteurs).

Midbody penile urethrocutaneous fistula repaired by fistulectomy and urethral anastomosis in a stallion.

CASE DESCRIPTION: A 12-year-old Friesian stallion was examined because of a 1-year history of preputial injury and urination through a urethrocutaneous fistula located at the midbody of the ventral aspect of the penis. CLINICAL FINDINGS: Physical examination revealed an opening with a clearly apparent mucocutaneous junction 12 cm from the distal opening of the urethra on the ventral left side of the penis. Endoscopic examination of the distal portion of the urethra confirmed a blind pouch with no communication with the fistula or proximal portion of the urethra. TREATMENT AND OUTCOME: A temporary perineal urethrostomy was performed with sedation and local anesthesia, with the stallion standing, to divert urine from the urethral reconstruction site. Fistulectomy and urethral resection and anastomosis were performed under general anesthesia with the stallion in dorsal recumbency. At 15 days after surgery, endoscopic examination of the urethra revealed distortion of the urethral lumen at the fistulectomy site. Under sedation, the urethra was dilated for 5 minutes every 12 hours for 3 days. At 22 days after surgery, endoscopic examination of the urethra revealed a healed anastomosis site and a large urethral luminal diameter. At 36 months after surgery, the owner reported that the stallion had normal micturition and had sired multiple foals by live cover matings. CLINICAL RELEVANCE: Severe preputial or penile trauma in horses is most commonly treated with amputation because of concerns of postoperative urethral stricture and occlusion. To the authors' knowledge, this case represented the first time that a successful end-to-end anastomosis of the distal portion of the urethra has been performed in a stallion.

Morcellation for testes extraction in horses undergoing standing laparoscopic cryptorchidectomy.

The major objective of this study was to describe the use of morcellation for standing laparoscopic cryptorchidectomy in 30 client-owned horses. A second objective was to describe a laparoscopic-assisted standing scrotal technique for removal of a descended testis in unilateral cryptorchids. Morcellation for extraction of abdominal testes is effective, efficient, and well-tolerated. Morcellation enabled safe and straightforward extraction of testes from the abdomen through an approximately 13- to 20-mm incision using a 2-portal technique. No incisional or morcellator-related complications occurred. Our laparoscopic-assisted standing scrotal technique for removal of a descended testis in unilateral cryptorchids entails intra-abdominal sealing and transection of the spermatic cord under laparoscopic viewing and subsequent removal of the testis through a scrotal incision. This technique enabled the surgeon to confirm hemostasis after transection of the spermatic cord and allowed tension-free removal of the descended testis. No intra-operative or incisional complications were encountered.

Morcellement pour l'extraction des testicules chez les chevaux subissant une cryptorchidectomie laparascopique debout. L'objectif majeur de cette étude consistait à décrire l'utilisation du morcellement pour la cryptorchidectomie laparascopique debout chez 30 chevaux appartenant à des clients. Un second objectif était de décrire une technique scrotale debout assistée par laparascopie pour l'enlèvement d'un testicule descendu pour les cryptorchides unilatéraux. Le morcellement pour l'extraction des testicules abdominaux est efficace et bien tolérée. Le morcellement a permis une extraction sûre et simple des testicules par l'abdomen par une incision d'environ 13 à 20 mm à l'aide d'une technique à deux portails. Aucune complication cicatricielle ou liée au morcellateur ne s'est produite. Notre technique scrotale debout assistée par laparoscopie pour l'enlèvement des testicules descendus dans les cryptorchides unilatéraux implique un scellement intra-abdominal et le sectionnement transversal du cordon spermatique sous une vue laparascopique et l'enlèvement subséquent des testicules par une incision scrotale. Cette technique a permis au chirurgien de confirmer l'hémostase après le sectionnement transversal du cordon spermatique et a permis l'enlèvement sans tension des testicules descendus. Aucune complication intra-opératoire ou cicatricielle ne s'est produite.(Traduit par Isabelle Vallières).

Imaging diagnosis--muscular hypertrophy of the small intestine and pseudodiverticula in a horse.

A 14-year-old Thoroughbred gelding was presented for chronic colic and weight loss. Transcutaneous and transrectal abdominal ultrasonography revealed distended, thickened small intestine with primary thickening of the muscularis and a focally more thickened loop with an echoic structure crossing the wall from the mucosa to the serosa. Visualization of diffuse thickening of the muscularis (muscular hypertrophy of the small intestine) and a focal lesion (pseudodiverticulum) helped clinicians make informed decisions. This case illustrates the importance of transabdominal and transrectal ultrasonography in horses with chronic colic and the relevance of considering the abnormalities in layering pattern of the intestinal wall.

Use of a motorized morcellator for elective bilateral laparoscopic ovariectomy in standing equids: 30 cases (2007-2013).

OBJECTIVE: To describe the use of a motorized morcellator for elective bilateral laparoscopic ovariectomy in standing equids and to evaluate long-term outcome. DESIGN: Retrospective case series. ANIMALS: 30 equids (20 horses, 9 mules, and 1 pony). PROCEDURES: Medical records of equids undergoing elective bilateral laparoscopic ovariectomy from 2007 to 2013 were evaluated. Cases were selected on the basis of use of a motorized morcellator for ovary extraction. Data collected included age, breed, reason for surgery, surgery date, surgical approach, intraoperative complications, surgery and morcellation times, postoperative complications, and duration of hospitalization. Long-term follow-up was obtained by telephone interview with owners, and included effectiveness at resolving original reason for surgery, time to return to usual activity, incision site appearance, signs of estrus after surgery, and overall owner satisfaction. RESULTS: 30 equids underwent laparoscopic bilateral ovariectomy with the morcellator technique. Median surgery time was 102 minutes (range, 47 to 150 minutes). Median single ovary morcellation time was 3.5 minutes (range, 2 to 8 minutes). Intraoperative complications occurred in 2 of 30 cases and included iatrogenic organ damage (uterus; 1) and persistent hemorrhage (1). Nineteen of 20 mares for which long-term follow-up was available returned to their previous use at a median of 60 days after surgery (range, 21 to 180 days). CONCLUSIONS AND CLINICAL RELEVANCE: Results of the present study indicated that use of a mechanical morcellator with a 2-portal technique for bilateral laparoscopic ovariectomy in clinically normal equids eliminated the need for a larger laparotomy incision as well as a third portal. Few complications occurred, and clients were satisfied with the procedure. The morcellator technique may offer advantages over other techniques but should only be used by experienced laparoscopic surgeons following adequate training.

Laparoscopic removal of a bladder urolith in a standing horse.

CASE DESCRIPTION: An 11-year-old Arabian gelding was evaluated for hematuria, stranguria, and pollakiuria that had been observed for 1 week. CLINICAL FINDINGS: Transrectal palpation revealed a 5-cm firm round mass in the urinary bladder. Cystoscopy and transrectal ultrasonography confirmed the diagnosis of urinary bladder urolithiasis. TREATMENT AND OUTCOME: A multiportal transparalumbar fossa laparoscopic approach was selected for cystotomy and urolith removal. Cystotomy and urolith removal was performed with sedation and local anesthesia with the horse standing. No perioperative complications were observed. Urination returned to normal 5 days after surgery. The horse returned to its previous level of activity at 3 weeks after surgery. CLINICAL RELEVANCE: Findings suggested that minimally invasive transparalumbar fossa laparoscopic approach can be successfully used for cystotomy and urolith extraction in standing horses; this avoids the disadvantages of conventional laparocystotomy for removal of large uroliths in male equids and the potential complications of general anesthesia and recovery. The technique provided excellent viewing and access to the bladder, permitting extraction of the urolith and secure closure of the cystotomy with minimal tension and tissue trauma to the bladder.