Epiglottic Entrapment A Transnasal Surgical Approach to Divide the Aryepiglottic Fold Axially in the Standing Horse

Transnasal, axial division of the aryepiglottic fold was performed to correct entrapment of the epiglottis in 20 sedated, standing horses, using a hooked bistoury and topical anesthesia. Presenting complaints included decreased exercise tolerance or loss of racing performance, abnormal respiratory noise, and coughing. The surgical procedure was technically easy to perform with a minimum of instrumentation. The horses were rested an average of 18 days before race training or riding was resumed. Evaluation of racing records or contact with owners indicated that most affected horses competed successfully after transnasal surgical correction of the entrapment.     

Epiglottic entrapment by arytenoepiglottic folds in the horse

An abnormality of the epiglottis and arytenoepiglottic folds that caused epiglottic entrapment was diagnosed in 21 horses. Until recently, this entrapment was poorly understood. Definitive diagnosis of epiglottic entrapment can be made only by endoscopic examination of the epiglottis, arytenoepiglottic folds, and soft palate to differentiate the abnormality from dorsal displacement of the soft palate. Dorsal displacement of the soft palate is often associated with entrapped epiglottis. Epiglottic deformity, especially hypoplasia, is often associated with the entrapment. The abnormality was detected in horses 1 to 16 years old. Because of the relatively large number of young animals (11 being less than or equal to 2 years old), a congenital predisposition was suggested. This suggestion was strengthened by the fact that many of the horses had deformities of the epiglottis that were considered congenital. Because some of the horses had trained and raced satisfactorily before signs of upper airway obstruction developed, it was assumed that the abnormality may be a sequel to epiglottic injury.     

Dorsal Laminectomy in the Horse II. Evaluation in the Normal Horse

Subtotal dorsal cervical laminectomy was performed on nine normal horses to evaluate positioning, refine the surgical technique, and assess the immediate and long-term effects of this procedure in the horse. Funkquist type B laminectomies were performed at various levels from C3-C4 to C6-C7. Absorbable gelatin sponge or autogenous nuchal fat was placed over the exposed dura mater. Surgery times varied from 2 to 3 hours, and all horses recovered without complication. Rapid primary intention wound healing occurred, with two horses showing neck pain. All remained neurologically normal. The horses were euthanized 6 weeks, 3 months, or 6 months postoperatively. Myelograms performed just prior to euthanasia demonstrated normal or expanded dye column widths. Necropsy revealed that all surgical sites had healed well. The laminectomy membrane was soft and pliable and could be easily separated from the underlying dura mater when fat was used as interpositional material. When gelatin sponge was used, the laminectomy membrane was firmly bonded to the dura. Spinal cords at the level of laminectomy appeared normal and moved freely within the vertebral canal. Histological evaluation of the laminectomy sites and associated spinal cord revealed no abnormalities attributable to the surgery. It was concluded that dorsal cervical laminectomy can be performed in horses without untoward sequelae. The procedure may be useful for the treatment of equine cervical compressive myelopathies.     

Arthroscopy in the Horse

Veterinary Research Communications -     

Partial Arytenoidectomy in the Horse

Four horses were examined because of inspiratory dyspnea and noise resulting from an inability to abduct one or both arytenoid cartilages. Two unilateral arytenoidectomies were done following failure of laryngoplasty, and two bilateral arytenoidectomies were done to correct permanent arytenoid adduction caused by laryngeal ossification. The surgical procedure included submucosal dissection of the arytenoid cartilage and removal of the vocal fold, lateral ventricle (when present), and the arytenoid cartilage, excluding the muscular process. Excessive mucous membrane was pulled caudally from the opening of the larynx and carefully sutured to close the mucous membrane and smooth the rima glottis. Postoperative swelling was greatest between the 3rd and 7th days. Long-term results included one horse returned to normal function with no noise, one horse returned to normal function but with respiratory noise, one horse returned to light riding with reduced noise, and one horse salvaged for pasture use.     

Plasma Cell Myeloma in the Horse

Plasma cell myelomas in horses have been reported infrequently. Data from 10 cases, 9 from the literature and 1 new case, are used to characterize the disease in the horse. Hot-blooded horses (7/10), specifically Quarter Horses (4/10), were most often affected. Median age at diagnosis was 11 years (range, 3 mo-22 yr) and both male (5) and female horses (5) were represented equally. Clinical findings included weight loss (6/8), anorexia (4/8), fever (4/8), limb edema (4/8), pneumonia (3/8), rear leg paresis/ataxia (3/8), epistaxis (3/8), palpable lymphadenopathy (2/8), and bone pain (2/8). Anemia (8/8) was present routinely, and in three horses, RBCs were macrocytic. Leukopenia (2/8), thrombocy-topenia (2/8), and circulating plasma cells (3/8) were variable findings. Except for abnormal protein concentrations and hyponatremia (3), abnormal results from serum biochemical analysis including hypo-cholesterolemia (1), hypercalcemia (1), and azotemia (1) were reported infrequently. Hyperproteinemia (8/9), hypoalbuminemia (7/9), and hyperglobulinemia (8/9) were characteristic but not invariable findings. Monoclonal proteins (7/7) were detected in the α₂, β, or γ region by serum electrophoresis. The paraprotein's heavy chain, determined in four horses, was a subclass of IgG. Three horses had decreased concentrations of normal immunoglobulins. Variable proteinuria (trace to 4+) was detected by routine urinalysis in four of six horses. Bence Jones proteinuria was detected in one of five horses (heat precipitation) and monoclonal proteins were detected in two of three electrophoresed urine samples. Three of the horses had lytic bone lesions detected radiographically. Bone marrow aspirates were diagnostic in two of five horses. Atypical plasma cells or increased numbers of plasma cells or both were present in histologic sections of bone marrow in six of eight horses. Common extraosseous sites of plasma cell infiltration included lymph nodes (8/8), kidney (5/8), spleen (5/8), liver (3/8), lung (3/8), brain (2/8), and orbit (2/8). Two horses had intracellular and extracellular crystalline deposits.     

Cortical Bone Allografting in the Horse

Half and full cylindrical frozen cortical bone allografts were transplanted into groups of horses. All horses accepted, resorbed, and began replacement of their grafts to varying degrees, according to frequent radiographic and monthly histologic evaluation. Clinically, all the recipients appeared to return to varying degrees of function. This method of bone allografting is suggested as an adjunct to current methods of fracture fixation in the horse.     

Nasal Septum Resection in the Horse

The nasal septum was surgically removed from 22 horses with upper airway obstruction caused by thickening and/or deviation of the septum. The most common presenting complaints were a low-pitched, snoring, respiratory noise and respiratory difficulty during exercise, which usually occurs in young horses. Abnormalities of the septum were most commonly congenital defects or caused by trauma or inflammation secondary to severe respiratory infection.
Diagnosis was made based on history, clinical signs, and results of physical examination. Radiography and endoscopy were useful adjuncts in some horses.
Under general anesthesia, the septum was removed by scalpel and osteotome (19 horses) or by obstetrical wire and osteotome (1 horse). In two horses, the rostral one third of the septum was removed by scalpel alone.
In three horses, the alar folds and floor of the nasal diverticula were removed in an attempt to relieve airway obstruction caused by flattening of the bridge of the nose following removal of the nasal septum.
Follow-up was obtained on 18 horses: persistent noise during exercise continued in 90%; however, 50% returned to usefulness.