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Select Surgical Problems in Miniature Horses

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Select Surgical Problems in Miniature Horses – PowerPoint PPT presentation

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Title: Select Surgical Problems in Miniature Horses


1
Select Surgical Problems in Miniature Horses
  • Olivia Inoue DVM, MS, DACVS
  • Loomis Basin Equine Medical Center

2
Angular Limb Deformities
  • Viewed from the front/behind
  • front leg gtgtgtgt hind legs
  • Knees (carpi), fetlocks, hocks
  • Decreases performance
  • Increase pain
  • unmanageable lameness
  • passing on poor genetics

3
Causes of ALD
  • Small mare/large foal
  • Genetics
  • Poor decreased/nutrition
  • Trauma to limb
  • Rapid growth phase
  • inflammation of growth plates vs abnormality
  • Developmental
  • growth plate deformities
  • UNKNOWN

4
Types of ALD
  • Valgus - toed out - splayed out
  • knees - primary location
  • fetlock
  • hocks
  • Varus - toed in - pigeon toed
  • fetlocks
  • carpi/hocks less common

5
LTgtgtgtgtRT Valgus
6
Knock kneed Carpal Valgus
7
Left Front Fetlock Varus
8
Tarsal Valgus - cow hocked
9
Sources of ALD
  • Weak supporting structures
  • common
  • Growth plate abnormalities
  • Incompletely formed cuboidal bone
  • immaturity/dysmaturity
  • Complete ulna/fibula

10
Diagnosis of ALD
  • Visual inspection
  • firm ground
  • Palpation
  • straighten?
  • Radiographs
  • bone development
  • growth plate changes

11
Diagnosis of Weakness/Laxity
  • Must be able to manipulate limb to straight
  • Normal radiographs

12
Diagnosis of ALD
13
Incompletely formed cuboidal bones - hock
14
Treatment for ALD
  • Stall rest
  • controlled walks 1-2 x a day
  • FARRIER
  • Splints
  • Casts
  • Surgery

15
Hoof Care - ALL ALD Foals
  • Trim toes so less pointed
  • Trim slow growing side (Outside of valgus joint)
  • 1 - 2 x week rasp
  • 2 - 3 weeks
  • Decrease fast growing side
  • Acrylic - inside of valgus joint - lengthen
  • pre-made shoe
  • If not better consider surgery

16
Management of soft bone and/or weakness
  • Farrier with stall rest
  • Casts
  • Splints
  • Foot not incorporated
  • Twice daily checking
  • Changed/managed carefully

17
Glue on Shoe for ALD
18
Surgical Options for ALD
  • Increase the slow growing side
  • periosteal stripping
  • Decrease the fast growing side
  • staples
  • screws /wires
  • plates

19
Periosteal Stripping
  • Slow growing side
  • Short acting general anesthesia
  • bandage changes
  • suture removal
  • Good cosmetics
  • Can be repeated

20
Periosteal strip and rongeur of intact ulna
21
Slowing Rapid Growth Transphyseal Bridging
  • Staples
  • easiest
  • customized
  • Screw(s) /- wires
  • wires can cause pain and swelling
  • Bone plates

22
Radial Physeal Staples
23
Physeal screws and wires on fast/rapid growth
24
Transphyseal Bridging
  • Periosteal Strip
  • slow growing side at time of placement of
    hardware
  • Stall rest
  • Farrier
  • trimming w/ or w/o acrylic

25
Slowing Rapid Growth - transphyseal bridging
  • Results can be initially slower - slower side to
    catch up
  • Once leg straight steel must be removed
  • second surgical procedure
  • Overcorrection

26
Timing of treatment
  • Fetlocks - urgent due to early closure of growth
    plates
  • begin therapy during first month
  • Carpi and hocks - slower growing
  • 4-6 months most rapid growth
  • growth plates close at 8 months

27
ALD Review
  • Document changes
  • digital pictures
  • Farrier
  • /- acrylic
  • Stall rest
  • Surgery
  • NOT All ALDs Fixable!

28
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29
Dystocia
  • Difficult delivery
  • more common in smaller breeds
  • Ponies
  • Miniatures

30
Dystocia
  • Abnormal fetal posture
  • most common
  • Long extremities/neck
  • Malpositioning
  • breech etc
  • Deformities of foal
  • legs/back/head

31
Dystocias
  • Small mare
  • internally/externally
  • Caslicks not opened
  • Foal- active participant
  • weak or dead foal does not participate
  • Septic/twins

32
3 Stages of Foaling
  • 1 - restlessness
  • 3 - 4 hours
  • nesting/colic
  • 2 - water breaks
  • delivery of foal
  • less than 20 minutes
  • 3 - passage of placenta

33
Stage 1 or ...
34
Management of Dystocia
  • Resolved at the farm by experienced personnel
  • if not
  • Referral hospital
  • equipment
  • personnel
  • CVD, fetotomy, C-section
  • neonatal resuscitation care

35
Management of Dystocia
  • Assess problem
  • foal dead
  • Emphasis on mare
  • Health
  • reproductive future

36
Management of Dystocia
  • Foal alive
  • emphasis on mare and foal
  • no single management scheme
  • Individual plan for each situation
  • Assisted delivery
  • Controlled delivery
  • C-section

37
Management of Dystocia
  • Manually correct position
  • care repositioning foal
  • Tear/rupture uterus
  • Assisted vaginal delivery (AVD)
  • awake standing mare
  • Vaginal delivery
  • intact foal

38
Management of Dystocia
  • Controlled vaginal delivery (CVD)
  • mare anesthetized
  • Hind quarters elevated
  • veterinarian delivers foal
  • Dead foal
  • fetotomy
  • Dead foal removed in pieces

39
Management Dystocia
  • CVD
  • preparing mare for C-section
  • 20-30 minutes of CVD attempts
  • longer decreases mares chances for post-operative
    C-section survival

40
Management of Dystocia
  • Cesarean section
  • general anesthesia
  • fetus is removed through an incision in the
    uterus
  • Bleeding
  • placenta still needs to be passed

41
Management of Dystocia
  • Changing strategies
  • best method for given situation
  • There is no one procedure that is right for every
    situation

42
Management of Dystocia
  • Owners
  • breeding dates
  • foaling history
  • vaccine status
  • horse insurance info
  • your plan
  • clip mare before due date

43
Controlled Vaginal Delivery
44
Cesarian
45
Life After A C-section
  • Mares can be re-bred 60 days post C-section
  • A.I. vs live cover
  • Monitor for recurrence of dystocia

46
(No Transcript)
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