Amélie Vitte

Laryngoplasty in Standing Horses

OBJECTIVE To describe the clinical experience with standing laryngoplasty in a series of horses mostly nonracing. STUDY DESIGN Case series. ANIMALS Seventy-one client-owned horses. METHODS Medical records (April 2008-February 2014) of horses treated by standing laryngoplasty for abnormal respiratory noise and or poor performance were reviewed. Horses were included if they had a diagnosis of idiopathic right or left recurrent laryngeal neuropathy confirmed by videoendoscopy. All horses underwent a unilateral laryngoplasty with a unilateral or bilateral ventriculectomy or ventriculocordectomy. Follow-up endoscopy was performed in all horses within 24 hours postoperative, in 24 horses at 2-weeks, and in 65 horses at 6 weeks. Late follow-up was obtained from the trainer, owner, or referring veterinarian by telephone. RESULTS Laryngoplasty was performed under endoscopic guidance with the horses sedated, and the surgical site was desensitized with local anesthetic solution. Laryngoplasty was completed in all horses and was well tolerated. No hyperabduction was observed. Two horses developed incisional swelling that resolved with drainage only. Late follow-up reported satisfactory improvement in respiration in all but 3 horses. CONCLUSIONS Laryngoplasty performed with the horse standing avoids risks associated with general anesthesia and recovery and yields comparable results in nonracing horses, to laryngoplasty performed with the horse anesthetized. This technique reduces cost and allows accurate intraoperative adjustment of the degree of arytenoid abduction.

Standing laparoscopic inguinal hernioplasty using cyanoacrylate for preventing recurrence of acquired strangulated inguinal herniation in 10 stallions

OBJECTIVE To describe a technique for standing inguinal hernioplasty in horses using cyanoacrylate glue, and to evaluate its effect on prevention of recurrent inguinal herniation in stallions that had previous acquired strangulated inguinal hernia (SIH). STUDY DESIGN Case series. ANIMALS Stallions (n = 10) with a history of SIH. METHODS Hernioplasty was performed in standing horses using 4 laparoscopic portals. The mesorchium was retracted caudomedially using Babcock forceps. A flexible polyethylene extension tube was introduced through the sheath of a laparoscopic needle and n-butyl-2-cyanoacrylate (2 mL) was injected into the inguinal canal including its margins while a 2nd Babcock forceps prevented deep ventral diffusion of the cyanoacrylate. The craniolateral parts of the vaginal ring were compressed until full adhesion between the visceral and parietal walls was achieved. In 2 horses, the lateral part of the vaginal ring was sutured before gluing. A contralateral approach was used to check the caudomedial part of the vaginal ring. RESULTS No recurrence (1-4 years) of inguinal hernia was reported. No major complications occurred and cosmetic outcome was excellent. All horses were used for their intended purpose and 7 horses being used as breeding stallions remained fertile. CONCLUSION Standing inguinal hernioplasty using cyanoacrylate seems to provide efficient and secure closure of the vaginal ring in stallions.Objective To describe a technique for standing inguinal hernioplasty in horses using cyanoacrylate glue, and to evaluate its effect on prevention of recurrent inguinal herniation in stallions that had previous acquired strangulated inguinal hernia (SIH). Study design Case series. Animals Stallions (n = 10) with a history of SIH. Methods Hernioplasty was performed in standing horses using 4 laparoscopic portals. The mesorchium was retracted caudomedially using Babcock forceps. A flexible polyethylene extension tube was introduced through the sheath of a laparoscopic needle and n-butyl-2-cyanoacrylate (2 mL) was injected into the inguinal canal including its margins while a 2nd Babcock forceps prevented deep ventral diffusion of the cyanoacrylate. The craniolateral parts of the vaginal ring were compressed until full adhesion between the visceral and parietal walls was achieved. In 2 horses, the lateral part of the vaginal ring was sutured before gluing. A contralateral approach was used to check the caudomedial part of the vaginal ring. Results No recurrence (1–4 years) of inguinal hernia was reported. No major complications occurred and cosmetic outcome was excellent. All horses were used for their intended purpose and 7 horses being used as breeding stallions remained fertile. Conclusion Standing inguinal hernioplasty using cyanoacrylate seems to provide efficient and secure closure of the vaginal ring in stallions.

Mechanical comparison of 3 anchoring techniques in the muscular process for laryngoplasty in the equine larynx.

Objective To compare mechanical properties of 2 techniques with a conventional technique for anchoring the muscular process in a laryngoplasty procedure. Study design Experimental ex vivo study. Sample Population Equine larynges (n = 60). Methods A single loop (SL), a screw (SC), and a double loop technique (DL) were compared. Constructs were subjected to cyclic loading, oscillating from 5 to 50 N for 3000 cycles, followed by a single cycle to failure test. Mean distraction, load at failure, stiffness, and failure mode were compared between groups. Results Mean ± SD distraction in cyclic loading was greater for DL (2.1 ± 0.7 mm) than for SL (1.9 ± 1.3 mm) and SC (1.539 ± 0.9 mm); however, there was no significant difference between SL and SC or between SL and DL. Mean ultimate failure load was greater for DL (240 ± 44.56 N) than for SC (189.59 ± 46.16 N) and SL (150.93 ± 44.43 N) and greater for SC compared with SL. Failure occurred by cartilage tearing for DL and SL, and by screw pull out (n = 13) or knot slippage (4) for SC. Conclusion In cyclic loading, SC is more stable than DL and at least as stable as SL. In single cycle to failure, DL is the strongest construct and SC is stronger than SL.OBJECTIVE To compare mechanical properties of 2 techniques with a conventional technique for anchoring the muscular process in a laryngoplasty procedure. STUDY DESIGN Experimental ex vivo study. SAMPLE POPULATION Equine larynges (n = 60). METHODS A single loop (SL), a screw (SC), and a double loop technique (DL) were compared. Constructs were subjected to cyclic loading, oscillating from 5 to 50 N for 3000 cycles, followed by a single cycle to failure test. Mean distraction, load at failure, stiffness, and failure mode were compared between groups. RESULTS Mean ± SD distraction in cyclic loading was greater for DL (2.1 ± 0.7 mm) than for SL (1.9 ± 1.3 mm) and SC (1.539 ± 0.9 mm); however, there was no significant difference between SL and SC or between SL and DL. Mean ultimate failure load was greater for DL (240 ± 44.56 N) than for SC (189.59 ± 46.16 N) and SL (150.93 ± 44.43 N) and greater for SC compared with SL. Failure occurred by cartilage tearing for DL and SL, and by screw pull out (n = 13) or knot slippage (4) for SC. CONCLUSION In cyclic loading, SC is more stable than DL and at least as stable as SL. In single cycle to failure, DL is the strongest construct and SC is stronger than SL.

Two-step surgery combining standing laparoscopy with recumbent ventral median celiotomy for removal of enlarged pathologic ovaries in 20 mares.

OBJECTIVES To report a combination of standing laparoscopic technique for intra-abdominal dissection of the mesovarial pedicle followed by a limited ventral median celiotomy under general anesthesia for removal of enlarged ovaries in mares. STUDY DESIGN Case series. ANIMALS Mares (n = 20) aged 3-22 years with unilateral enlarged ovaries. METHODS Enlarged ovaries were confirmed by transrectal palpation and ultrasonography. After sedation, 3 laparoscopic portals were made in the paralumbar fossa. The mesovarium was desensitized and dissected using a vessel sealing device, and the ovary was left free in the abdomen. Then under general anesthesia, the mare was positioned in dorsal recumbency and an 8 cm ventral median celiotomy made for ovary retrieval in a specimen bag. RESULTS This 2-step procedure was successfully used for removal enlarged ovaries (12-50 cm) in 17 mares and for management of behavioral problems in 3 mares. No operative or postoperative complications occurred. Owner satisfaction and cosmesis were considered excellent. CONCLUSIONS Standing laparoscopy combined with a limited median celiotomy is a safe technique for ovariectomy in mares. This technique mitigates most of the disadvantages of standing flank ovariectomy and a conventional open ventral median approach.

Ex vivo biomechanical stability of 5 cricoid-suture constructs for equine laryngoplasty†

Objective: To determine the biomechanical properties of 5 suture constructs in the equine cricoid under cyclic loading and load to failure testing. Study design: Ex vivo study. Samples: Seventy‐five equine cadaver larynges. Methods: Each larynx was implanted with 1 of 5 cricoid‐suture constructs. The standard laryngoplasty, where a suture is passed once through the cricoid, including its caudal edge, was used in 2 constructs: 1 with 5 USP Ethibond (ES) and 1 with 2 mm Fibertape (FS). In the third construct, the 2 mm Fibertape was passed twice through the cricoid including its caudal edge (Double Loop—DL). Constructs 4 and 5 used 2 mm Fibertape in a U‐shaped loop passed through the cricoid but excluding its caudal edge. One construct was supported with a metallic button (MB) on the caudo‐ventral aspect of the cricoid while the other included only the U‐shaped loop (U). Constructs were subjected to cyclic loading and to single cycle to failure. Reduction of the left‐to‐right arytenoid angle quotient (LRQ), suture migration, and load at failure were compared. Results: LRQ reduction after cyclic loading was lower in MB and U than ES constructs. During cyclic loading, suture migration was reduced in MB, U, and DL compared to ES constructs. Mean load at failure was lower in FS and U than in ES constructs. Conclusion: Loss of abduction after equine laryngoplasty may be reduced and pullout forces increased by applying a MB construct in the cricoid cartilage. In vivo testing is required to verify these results.

Use of a modified transfixation pin cast for treatment of comminuted phalangeal fractures in horses

OBJECTIVES To (1) report a modified transfixation pin cast technique, using dorsal recumbency for fracture reduction, distal positioning of the pins in the epiphysis and distal metaphysis, and a hybrid cast, combining plaster of Paris (POP) and fiberglass casting, and (2) report outcome in 11 adult horses. STUDY DESIGN Case series. ANIMALS Adult horses (n = 11) with comminuted phalangeal fractures. METHODS Horses were anesthetized and positioned in dorsal recumbency. The phalangeal fracture was reduced by limb traction using a cable attached to the hoof. Screw fixation in lag fashion of fracture fragments was performed when possible. Transfixation casting was performed using two 6.3 mm positive profile centrally threaded pins with the 1st pin placed in the epiphysis of the metacarpus/tarsus at the center of, or slightly proximal to, the condylar fossa and the 2nd one 3-4 cm proximal. A hybrid cast was applied. RESULTS Forelimbs were involved in 9 horses and the hind limb in 2. Pins were maintained for a minimum of 6 weeks. No pin loosening was observed at the time of removal (6-8 weeks). A pony fractured the distal aspect of the metacarpus at the proximal pin. Nine horses survived (82%); none of the horses developed septic arthritis despite the distal location of the distal pin, close to the fetlock joint. CONCLUSION This modified transfixation pin casting technique was associated with good pin longevity and could reduce the risk of secondary pin hole fractures and pin loosening.

Carpal arthrodesis using a minimally invasive approach: three cases

Introduction: Osteoarthritis (OA) begins many years before structural changes are detectable, since DJD spans over a lifetime in man. In racehorses progression from post-traumatic OA stage to DJD seems much shorter. The purpose of this study was to assess changes in inflammatory and structural biomarkers in serum (S) and synovial fluid (SF) in a cohort of STBRs diagnosed with post-traumatic fetlock OA over the racing career of the animals. We hypothesised that biomarkers assay could demonstrate the progression of degenerative status in the joints after post-traumatic OA, better than clinical and radiographic assessment.

Two-Step Surgery Combining Standing Laparoscopy With Recumbent Ventral Median Celiotomy for Removal of Enlarged Pathologic Ovaries in 20 Mares: Two-Step Procedure for Ovariectomy in Mares

OBJECTIVES To report a combination of standing laparoscopic technique for intra-abdominal dissection of the mesovarial pedicle followed by a limited ventral median celiotomy under general anesthesia for removal of enlarged ovaries in mares. STUDY DESIGN Case series. ANIMALS Mares (n = 20) aged 3-22 years with unilateral enlarged ovaries. METHODS Enlarged ovaries were confirmed by transrectal palpation and ultrasonography. After sedation, 3 laparoscopic portals were made in the paralumbar fossa. The mesovarium was desensitized and dissected using a vessel sealing device, and the ovary was left free in the abdomen. Then under general anesthesia, the mare was positioned in dorsal recumbency and an 8 cm ventral median celiotomy made for ovary retrieval in a specimen bag. RESULTS This 2-step procedure was successfully used for removal enlarged ovaries (12-50 cm) in 17 mares and for management of behavioral problems in 3 mares. No operative or postoperative complications occurred. Owner satisfaction and cosmesis were considered excellent. CONCLUSIONS Standing laparoscopy combined with a limited median celiotomy is a safe technique for ovariectomy in mares. This technique mitigates most of the disadvantages of standing flank ovariectomy and a conventional open ventral median approach.