OBJECTIVE To develop and validate a simulation model for laparoscopic ovariectomy in standing horses.
DESIGN Prospective cohort study.
SAMPLE 15 third-year veterinary students and 4 equine surgeons with experience in laparoscopy.
PROCEDURES A simulation model that mimicked laparoscopic ovariectomy in standing horses was developed. Face validity of the model was determined with a questionnaire completed by the equine surgeons. Construct validity was determined by comparing performance scores (based on time to completion and accuracy completing various operative tasks) for simulated laparoscopic ovariectomy performed in the model for the students with scores for the equine surgeons. Concurrent validity was assessed by comparing performance scores with scores obtained with the validated McGill Inanimate System for Training and Evaluation of Laparoscopic Skills (MISTELS).
RESULTS Questionnaire responses indicated that the simulation model replicated the operative experience to a high degree (face validity). Performance scores for simulated laparoscopic ovariectomy performed in the model were significantly different between the students and the equine surgeons (construct validity). Performance scores for the simulation model were significantly correlated with scores for the MISTELS (concurrent validity).
CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that the simulation model had face, construct, and concurrent validity, suggesting that it may be useful when training students to perform laparoscopic ovariectomy in standing horses.
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.
Objective—To compare the analgesic efficacy of administration of butorphanol tartrate, phenylbutazone, or both drugs in combination in colts undergoing routine castration.
Design—Randomized controlled clinical trial.
Animals—36 client-owned colts.
Procedures—Horses received treatment with butorphanol alone (0.05 mg/kg [0.023 mg/lb], IM, prior to surgery and then q 4 h for 24 hours), phenylbutazone alone (4.4 mg/kg [2.0 mg/lb], IV, prior to surgery and then 2.2 mg/kg [1.0 mg/lb], PO, q 12 h for 3 days), or butorphanol and phenylbutazone at the aforementioned dosages (12 horses/group). For single-drug–treated horses, appropriate placebos were administered to balance treatment protocols among groups. All horses were anesthetized, and lidocaine hydrochloride was injected into each testis. Physical and physiological variables, plasma cortisol concentration, body weight, and water consumption were assessed before and at intervals after surgery, and induction of and recovery from anesthesia were subjectively characterized. Observers assessed signs of pain by use of a visual analogue scale and a numerical rating scale.
Results—Significant changes in gastrointestinal sounds, fecal output, and plasma cortisol concentrations were evident in each treatment group over time, compared with preoperative values. At any time point, assessed variables and signs of pain did not differ significantly among groups, although the duration of recumbency after surgery was longest for the butorphanol-phenylbutazone–treated horses.
Conclusions and Clinical Relevance—With intratesticular injections of lidocaine, administration of butorphanol to anesthetized young horses undergoing routine castration had the same apparent analgesic effect as phenylbutazone treatment. Combined butorphanolphenylbutazone treatment was not apparently superior to either drug used alone.
To describe a technique for basihyoid-ceratohyoid disarticulation (BCD) in standing sedated horses affected by temporohyoid osteoarthropathy (THO) and report outcomes for horses that underwent the procedure.
6 client-owned horses.
Electronic medical records of a veterinary teaching hospital were searched to identify horses that underwent BCD for treatment of THO from 2018 to 2019. Signalment, clinical data, use of the horse, and complications were recorded. Follow-up data obtained by telephone interview with owners included the clinical outcome and time to improvement after surgery, any persistent clinical signs, horse's activity level before onset of clinical signs and after BCD, subsequent use of the horse, and whether they would pursue the same treatment again.
All horses tolerated the procedure well, with no complications and improved neurologic function after BCD. Five of 6 horses had a reported activity level equal to or greater than that prior to having signs of THO. Three of 3 horses with acute ataxia prior to BCD reportedly had full resolution of this sign; 3 of 4 horses with facial nerve deficits prior to BCD had mild residual facial nerve deficits at follow-up. All owners indicated they would pursue BCD again.
CONCLUSIONS AND CLINICAL RELEVANCE
The BCD procedure was performed safely in this sample of THO-affected horses that were sedated while standing, avoiding risks associated with general anesthesia and resulting in no adverse effects such as iatrogenic injury to neurovascular structures. (J Am Vet Med Assoc 2021;259:300–305)
Objective—To assess the use of magnetic resonance
(MR) imaging for identifying subchondral bone damage
in the distal limbs of horses.
Procedure—Medical records of horses with lameness
and subsequent evidence of subchondral bone
damage as determined by MR imaging were
reviewed. Severity and duration of lameness, results
of diagnostic local anesthesia and diagnostic testing,
surgical and necropsy findings, and treatment were
recorded. Outcome was determined by follow-up
information obtained from the owner or referring veterinarian.
Results—Lameness was localized by physical examination
and diagnostic local anesthesia. Lameness was
localized to the metacarpophalangeal or metatarsophalangeal
joint in 4 horses, distal interphalangeal joint in 5
horses, and tarsocrural joint in 2 horses. The duration of
lameness ranged from 2 weeks to 20 months. Magnetic
resonance imaging of the affected joints revealed abnormal
fluid accumulation within the subchondral bone.
None of the abnormalities observed by MR imaging
were detected by radiography. Subchondral bone damage
was diagnosed in all horses. Arthroscopy of the
affected joint was performed in 4 horses. Communication
with the articular surface of the affected bone was
suspected on the basis of results of MR imaging in 4
horses and was confirmed by arthroscopy in 1 horse and
by necropsy in 1 horse.
Conclusions and Clinical Relevance—Magnetic resonance
imaging was useful for providing a diagnosis
when other imaging techniques did not definitively
identify the cause of lameness. Subchondral bone
damage was clearly identified by MR imaging and
should be considered as a cause of lameness in horses
in which radiographic findings are unremarkable.
( J Am Vet Med Assoc 2004;224:411–418)