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.
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.
To characterize clinical findings and outcomes for horses with heel bulb lacerations.
Medical records of a teaching hospital were reviewed to identify horses treated for heel bulb lacerations between February 2004 and October 2018. Long-term outcome was assessed by telephone communication with owners. Results were analyzed to determine association with clinical outcome.
31 mares and 31 geldings of various ages, breeds, and uses were evaluated. Thirty-six horses had a wound of 0 to 2 days’ duration, and 17 horses had a wound of > 2 days’ duration. Horses with a wound duration of < 2 days had a significantly greater likelihood of a higher outcome score (P = .025; OR = 7.08; 95% CI = 1.28% to 39.08%). Synovial communication with the wound was confirmed in 21 of 62 (33.9%) horses. One synovial structure was involved in 17 horses, and > 1 synovial structure was involved in 4 horses. Fifty-nine horses survived to discharge, and follow-up information was available for 18 (30.5%) horses. Of the horses available for follow-up, 78% returned to the previous level of work (14/18). Degree of lameness at presentation, degree of wound contamination, treatment prior to presentation, treatment with foot casting, and involvement of synovial structures were not found to be significantly associated with clinical outcome.
Results suggest that horses with heel bulb lacerations have a good prognosis for survival and a favorable prognosis for return to work. Clinical application of additional findings needs further investigation before clinical relevance can be ascertained.