Dwayne H. Rodgerson

Standing Hand‐Assisted Laparoscopic Ovariectomy in 65 Mares

OBJECTIVE To review the efficacy and safety of unilateral ovariectomy by use of a standing hand-assisted laparoscopic approach and evaluate the effect of ovary size on posttransection hemorrhage after application of a linear stapling device. STUDY DESIGN Case series. ANIMALS Horses (n=65) aged 2-20 years. METHODS Medical records of mares that had ovariectomy performed by use of a standing hand-assisted laparoscopic approach were reviewed. Data retrieved were signalment, ovary removed (left, right), ovarian size, ovarian pathology, intraoperative and postoperative complications, and length of hospitalization. RESULTS Mean ovarian diameter was 17 cm. Histopathology (52 mares) confirmed 41 granulosa cell tumors (79%), 8 ovarian cysts (15%), 1 teratoma (2%), and 2 ovaries (4%) without abnormalities. Hemorrhage was observed laparoscopically in 16 mares after transection of the mesovarium. Complications encountered during surgery included 1 mare collapsing in the stocks and 1 mare that hemorrhaged excessively from the incision. Postoperative complications included 2 cases of mild colic. Overall complication rate was 6%. CONCLUSIONS All attempts to remove the target ovary were successful. The approach is safe for the mare, as complications encountered were similar to those recently reported for other approaches.

Comparison of Surgical and Medical Treatment of 49 Postpartum Mares with Presumptive or Confirmed Uterine Tears

OBJECTIVE To determine outcome after medical or surgical treatment of postpartum mares with confirmed or presumptive uterine tears. STUDY DESIGN Case series. METHODS Postpartum mares were included if foaling had occurred within 7 days and uterine tear was confirmed surgically or, in medically treated mares, by palpation or presumed based on peritonitis. Information (age, breed; physical examination, laboratory and abdominocentesis findings; treatment, survival rates, length of hospital stay, treatments costs, and breeding performance after discharge) was obtained from the medical records (1990-2007). The influence of variables was compared between medical and surgical treatment, and between survivors and nonsurvivors. RESULTS For 49 mares, survival was 75%, with no significant difference between medical (11/15; 73%) or surgical (26/34; 76%) treatment. Admission variables, treatment cost, duration of hospital stay, and likelihood of foaling after discharge were not significantly different between treatment groups. Nonsurvivors were significantly more likely to have gastric reflux, higher heart rate, anion gap, lower total CO(2), and leukocyte count, compared with survivors. Tears were significantly (P=.018) more likely to occur in the right uterine horn than in other parts of the uterus. CONCLUSIONS Uterine tears occur more commonly in the uterine horns, more so the right horn, and survival is similar with surgical or medical treatment of uterine tears in postpartum mares. CLINICAL RELEVANCE Medical treatment may be a reasonable alternative to surgical treatment for uterine tears, although the severity of tear that can resolve with medical treatment is unknown, and medical therapy can be as expensive as surgical treatment.

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.

Ultrasound assisted arthroscopic approach for removal of basilar sesamoid fragments of the proximal sesamoid bones in horses.

Objective To describe an ultrasound assisted arthroscopic approach for removal of non-articular basilar sesamoid fragments in Thoroughbred yearlings. Animals Thoroughbred yearlings (n = 7). Methods Basilar sesamoid fragments identified during pre-sale radiographic examination were removed using a palmar/plantar arthroscopic approach to the fetlock joint and ultrasonographic guidance. Complete fragment removal was confirmed by ultrasonography and radiography. Results Basilar sesamoid fracture fragments were localized and removed successfully using rongeurs and a radiofrequency probe for soft tissue dissection of the fragment. Complete fragment removal was confirmed by ultrasonography and radiography. No intra- or postoperative complications occurred. At 6–8 months follow-up, no fragments or bony proliferation at the base of the sesamoid was observed. Conclusions Ultrasonographic guidance can be used to facilitate localization, dissection, and confirmation of removal of basilar fragments of the proximal sesamoid bone.OBJECTIVE To describe an ultrasound assisted arthroscopic approach for removal of non-articular basilar sesamoid fragments in Thoroughbred yearlings. ANIMALS Thoroughbred yearlings (n = 7). METHODS Basilar sesamoid fragments identified during pre-sale radiographic examination were removed using a palmar/plantar arthroscopic approach to the fetlock joint and ultrasonographic guidance. Complete fragment removal was confirmed by ultrasonography and radiography. RESULTS Basilar sesamoid fracture fragments were localized and removed successfully using rongeurs and a radiofrequency probe for soft tissue dissection of the fragment. Complete fragment removal was confirmed by ultrasonography and radiography. No intra- or postoperative complications occurred. At 6-8 months follow-up, no fragments or bony proliferation at the base of the sesamoid was observed. CONCLUSIONS Ultrasonographic guidance can be used to facilitate localization, dissection, and confirmation of removal of basilar fragments of the proximal sesamoid bone.

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.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.

Ultrasound Assisted Arthroscopic Approach for Removal of Basilar Sesamoid Fragments of the Proximal Sesamoid Bones in Horses: Ultrasound Assisted Sesamoid Fragment Removal

Objective To describe an ultrasound assisted arthroscopic approach for removal of non-articular basilar sesamoid fragments in Thoroughbred yearlings. Animals Thoroughbred yearlings (n = 7). Methods Basilar sesamoid fragments identified during pre-sale radiographic examination were removed using a palmar/plantar arthroscopic approach to the fetlock joint and ultrasonographic guidance. Complete fragment removal was confirmed by ultrasonography and radiography. Results Basilar sesamoid fracture fragments were localized and removed successfully using rongeurs and a radiofrequency probe for soft tissue dissection of the fragment. Complete fragment removal was confirmed by ultrasonography and radiography. No intra- or postoperative complications occurred. At 6–8 months follow-up, no fragments or bony proliferation at the base of the sesamoid was observed. Conclusions Ultrasonographic guidance can be used to facilitate localization, dissection, and confirmation of removal of basilar fragments of the proximal sesamoid bone.OBJECTIVE To describe an ultrasound assisted arthroscopic approach for removal of non-articular basilar sesamoid fragments in Thoroughbred yearlings. ANIMALS Thoroughbred yearlings (n = 7). METHODS Basilar sesamoid fragments identified during pre-sale radiographic examination were removed using a palmar/plantar arthroscopic approach to the fetlock joint and ultrasonographic guidance. Complete fragment removal was confirmed by ultrasonography and radiography. RESULTS Basilar sesamoid fracture fragments were localized and removed successfully using rongeurs and a radiofrequency probe for soft tissue dissection of the fragment. Complete fragment removal was confirmed by ultrasonography and radiography. No intra- or postoperative complications occurred. At 6-8 months follow-up, no fragments or bony proliferation at the base of the sesamoid was observed. CONCLUSIONS Ultrasonographic guidance can be used to facilitate localization, dissection, and confirmation of removal of basilar fragments of the proximal sesamoid bone.

Foaling Rates After Surgical Repair of Ventral Cervical Lacerations Using a Trendelenburg Position in 18 Anesthetized Mares

OBJECTIVE To (1) describe a surgical technique for repair of lacerations of the ventral aspect of the cervix in anesthetized mares in Trendelenburg position; and (2) report conception rates and foaling after repair. STUDY DESIGN Case series. ANIMALS Mares (n = 18). METHODS Cervical lacerations were repaired in 2 layers with anesthetized mares in Trendelenburg position. The cervix was retracted caudally with stay-sutures, and after excision of the healed margin of the laceration, the internal cervical mucosa and fibromuscular tissue were sutured in 1 layer with a continuous Lembert pattern. The external cervical mucosa was sutured using a simple-continuous suture pattern. Number of foals produced by each mare before and after surgical repair was obtained from client/farm communication and from a commercial record keeping service. RESULTS Mean repair time for 1 laceration was 22 minutes and for 2 lacerations was 29 minutes. Nine mares conceived and 7 had at least 1 live healthy foal. CONCLUSION Trendelenburg position allows for efficient repair of a ventrally located cervical laceration in anesthetized mares.Objective To (1) describe a surgical technique for repair of lacerations of the ventral aspect of the cervix in anesthetized mares in Trendelenburg position; and (2) report conception rates and foaling after repair. Study Design Case series. Animals Mares (n = 18). Methods Cervical lacerations were repaired in 2 layers with anesthetized mares in Trendelenburg position. The cervix was retracted caudally with stay-sutures, and after excision of the healed margin of the laceration, the internal cervical mucosa and fibromuscular tissue were sutured in 1 layer with a continuous Lembert pattern. The external cervical mucosa was sutured using a simple-continuous suture pattern. Number of foals produced by each mare before and after surgical repair was obtained from client/farm communication and from a commercial record keeping service. Results Mean repair time for 1 laceration was 22 minutes and for 2 lacerations was 29 minutes. Nine mares conceived and 7 had at least 1 live healthy foal. Conclusion Trendelenburg position allows for efficient repair of a ventrally located cervical laceration in anesthetized mares.