Successful closed reduction and conservative management with traumatic elbow luxation and medial collateral ligament rupture in an equid

A 9-year-old donkey jenny (212 kg) presented with an acute, nonweight-bearing left forelimb lameness of 24- to 36-h duration. The limb was held in flexion and abduction, with the toe above the ground, and was unable to be manually straightened. There was significant palpable swelling along the medial aspect of the elbow joint. Radiographic evaluation revealed a medial luxation of the elbow joint with rupture of the medial collateral ligament. Closed reduction was accomplished under injectable anaesthesia without complication. The patient was weight-bearing and comfortable on the limb immediately upon recovery from anaesthesia. The jenny was tied and kept standing for 60 days. Full limb bandages, splints (extending proximal to the scapula), hobbles, NSAIDs and cold laser therapy were utilised, decreased and discontinued. At 74 days, a rehab programme was initiated. At 8 months post-injury, the patient was not lame and was back to her previous level of exercise. Although elbow luxation has been described as having a guarded prognosis, there has now been success in 4/5 (80%) reported cases when treatment has been attempted. Closed reduction without surgical intervention in adult animals with elbow luxation can be successful, likely dependent on the level of associated injury.     

Closed reduction of scapulohumeral joint luxation in an Icelandic horse after general anaesthesia

This report describes the clinical, ultrasonographic and radiographic findings in an 8‐year‐old Icelandic mare with unilateral shoulder luxation after general anaesthesia. Reduction of the luxated humerus was performed in a closed fashion using a calving jack under general anaesthesia. The horse recovered well and ultimately returned to its previous level of performance.     

Successful treatment of a severely contaminated open metatarsophalangeal joint luxation by arthrodesis

A horse with an open medial luxation of the left metatarsophalangeal joint with extensive cartilage and soft tissue damage and severe contamination of the wound was treated with a two-stage approach. In the first stage, the lesion was cleaned, the luxation was reduced, the wound was sutured and the limb was kept in a cast for a total time of 56 days. In the second stage, an arthrodesis of the affected joint was carried out, using a 13-hole broad 4.5 LCP plate. The limb was then kept in a cast for an additional total time of 56 days. At 70 days after the arthrodesis, the horse was brought in for a final check-up, and only a mechanical lameness remained at that time. No significant complications occurred. Previous case reports on the treatment of metatarso-/metacarpophalangeal luxations include neither cases as severe as the one presented here nor treatment by fetlock arthrodesis. This case illustrates that horses with a complicated, open luxation of the fetlock can be salvaged for breeding purposes.     

Distal luxation of the patella in a horse

A 19-year-old Thoroughbred gelding presented with sudden onset, non-weight bearing lameness in the right hindlimb. Radiography confirmed distal luxation of the patella, which was replaced into its normal anatomical location under general anaesthesia. There were no pathological sequelae noted on follow-up examination 9 months after the initial injury. To our knowledge, this is a rare manifestation of patellar luxation, only reported once previously in the equine literature.     

Closed reduction and surgical fixation of elbow joint luxation in an adult mare and in a 3-month-old foal using knotless bone anchors and FiberTape

This report describes the successful surgical stabilisation of elbow joint luxation using knotless bone anchors and FiberTape to repair the medial collateral ligament in an 11-year-old mare (Case 1) and both medial and lateral collateral ligaments in a 3-month-old foal (Case 2). Radiography (both cases) and computed tomography (Case 2) were used to diagnose subluxation (Case 1) and complete luxation (Case 2) with suspected rupture of both collateral ligaments. Case 1 was supported in a rescue sling for 7 weeks postoperatively to prevent recumbency. Recovery was good, and the mare was sound at the walk at the time of discharge 8 weeks after surgery and 1 year later at the follow-up visit. Case 2 was discharged 3 weeks after surgery and was sound at the trot when re-evaluated 2 and 6 months postoperatively. Although elbow luxation accompanied by torn collateral ligaments is rare in horses, successful outcomes have been described. In the present case report, joint stabilisation and a successful outcome were achieved, for the first time, with closed reduction and an open approach for placement of knotless bone anchors and FiberTape. Limitations of our study included inability to directly assess the integrity of the implants during healing and relying mainly on clinical signs to assess healing.     

Femoral head excision after coxofemoral luxation in an Arab filly: Four years follow‐up

A foal with a cranio‐dorsal coxofemoral luxation was treated with a prosthetic capsulorraphy technique after open reduction. After reluxation a femoral head ostectomy was performed for salvage purposes. The filly was discharged with minimal lameness and was using the limb properly after 51 days of hospitalisation. Four years later the filly is still doing well as a breeding mare, with an acceptable quality of life despite angular deformities in the contralateral limb.     

Treatment of coxofemoral luxation in a mature Welsh pony by femoral head ostectomy: Long‐term outcome

A 233 kg, 4‐year‐old Welsh pony stallion presented with a unilateral coxofemoral luxation and a history of previous upward fixation of the patella. This condition was surgically managed by femoral head ostectomy using a craniodorsal approach to the luxated coxofemoral joint, without greater trochanteric osteotomy. Immediate improvement in weightbearing was observed after surgery and primary intention healing was recorded. Long‐term outcome, 4 years after surgery, was assessed by radiographic, ultrasonographic and lameness examination. The pony was in good body condition and the initial weight of this patient was restored. Despite fetlock hyperlaxity of the contralateral hindlimb, amyotrophy and mechanical lameness of the affected hindlimb, the pony showed evident comfort without apparent signs of pain and was able to trot and gallop. Bone callus was observed at imaging examination.     

Traumatic coccygeal luxation and distal amputation of the tail of an Appaloosa mare

A 17‐year‐old Appaloosa mare presented to the emergency service for acute, traumatic, partial amputation of the tail at the level of the ninth coccygeal vertebra. The patient did not have tail or anal tone and did not respond to sharp stimulation of skin in the perineal region. Two grade 1 rectal tears were found during rectal palpation. Radiographs revealed dislocation of the second (Cd2) and third (Cd3) caudal vertebrae. The patient was treated with antibiotics, an anti‐inflammatory drug and stall confinement. The ninth caudal vertebra was surgically removed to facilitate closure of skin over the wound. When the mare was discharged after 7 days of hospitalisation, she had regained partial sensation of the perineum and partial function of the internal and external anal sphincters. At re‐evaluation one year following injury, the mare was able to move her tail laterally and had regained sensation of her perineum and tail; however, she still was unable to lift her tail.     

Posterior lens luxation with associated glaucoma in a pony

Secondary lens luxation is an infrequent consequence of equine recurrent uveitis (ERU). This Case Report describes a pony with posterior lens luxation with associated glaucoma, thought to be secondary to ERU.     

Surgical treatment of tarsometatarsal joint luxation in a miniature horse foal

A 2-week-old Miniature Horse foal was referred for evaluation and treatment of a luxated right tarsometatarsal joint. Treatment consisted of closed reduction and internal fixation using two partially threaded Steinmann pins placed in normograde fashion through the tuber calcis into the proximal third metatarsus. Traumatic luxation has been reported to occur in the tarsocrural, proximal intertarsal and tarsometatarsal joints within the equine tarsus. Treatment for luxation of the distal intertarsal joint has not been documented. The treatment method most commonly suggested for tarsal luxation is closed reduction and cast immobilisation. Internal fixation using lag screws and plating has also been described. A combination of internal fixation and external coaptation is thought to achieve maximal stability and allow faster convalescence in cases of tarsal luxation. This case report describes for the first time a technique using two Steinmann pins to achieve successful internal fixation of a traumatic tarsometatarsal joint luxation in a 2-week-old Miniature Horse foal.     

Successful removal of a guidewire from the jugular vein of a mature horse

This case report describes the removal of a metal guidewire that was lost accidentally in the jugular vein during the placement of an indwelling catheter. The proximal end of the guidewire was identified in the distal third of the cervical region by radiography and ultrasonography. The retained wire was removed successfully by percutaneous fluoroscopically assisted endovascular retrieval with a 4 pronged retrieval catheter.     

Radiographic diagnosis of craniodorsal coxofemoral luxation in standing equids

Radiographic evaluation of the pelvis in standing horses has been used to diagnose fractures of the pelvis, head and greater trochanter of the femur, and luxations of the coxofemoral joint. Coxofemoral luxation injuries are more common in smaller horse breeds and donkeys, but, due to their size, the standing ventrodorsal projection is not possible, as there is insufficient space to place the radiography equipment under the animal's abdomen. The objective of the study was to report the advantages and limitations of the use of an oblique radiographic projection to diagnose unilateral craniodorsal coxofemoral luxation in 3 ponies and a donkey performed with the animals standing under light sedation. All cases had severe unilateral hindlimb lameness and asymmetry of the gluteal region; 2 also had concurrent intermittent upward fixation of the patella. A standing dorsolateral 20–30° ventral oblique radiograph of the affected coxofemoral joint was performed in all cases to obtain a definitive diagnosis. Radiography of the coxofemoral joint in standing ponies and donkeys can be carried out to identify craniodorsal coxofemoral luxation avoiding the need for general anaesthesia.     

Open reduction and stabilisation of coxofemoral joint luxation in dogs and cats, using a stainless steel rope inserted via a ventral approach to the hip joint

Open reduction and stabilisation of coxofemoral joint luxation was made via a ventral approach to the hip joint in dogs and cats, using a transarticular stainless steel rope. A feature of the procedure is transarticular penetration of the rope from the pelvic cavity to the femoral neck by guidance with a guide wire which was previously inserted from the femoral neck into the pelvic cavity and by detection of the guide wire in the pelvic cavity by use of forceps connected to an alarm-ohmmeter. Forty-seven animals (37 dogs and 10 cats) with acute and simple coxofemoral luxation were treated and postoperatively maintained in cage rest without external fixation. Most of the animals regained an almost normal gait within several days.     

Lumbar fractures in a 5-year-old Warmblood cross gelding

This case report describes multiple lumbar vertebral fractures in a 5-year-old Warmblood cross gelding used for low-level exercise, with no known history of trauma. Clinical signs included intermittent severe pain, distress and unwillingness to move. When the horse was in less severe pain, he tilted the pelvis to one side when walking and also when trotting. Fracture of the 6th lumbar vertebral body was diagnosed by transrectal ultrasonography and confirmed by post-mortem computed tomography. Post-mortem examination also revealed a complete fracture of the 3rd lumbar vertebral body. Previously, lumbar fractures have only been reported in racing breeds and ante mortem diagnosis has been limited to scintigraphy.     

Surgical management of a pony with a traumatic medial luxation of the patella

This report describes a successful surgical repair of medial patellar luxation in a Miniature Shetland pony where manual reduction of the patella was not possible. The surgical procedure involves transection of the medial femoropatellar ligament to facilitate patellar release, the placement of a prosthetic suture to replace the lateral femoropatellar ligament and reinforcement of the lateral retinaculum by the use of a mesh implant. This is a newly described surgical technique for the rare but recognised condition of a medial luxation of the patella.     

Intracranial botryomycosis in a mature horse

This case report describes an unusual diagnosis of central nervous system botryomycosis in a horse. A 16‐year‐old Welsh Section D gelding was evaluated for acute onset of hypermetric ataxia, leaning to the left and head tilt to the right. Based on the neurological signs, a cerebellar lesion with accompanying vestibular disease was suspected and supportive therapy consisting of antimicrobial and glucocorticosteroid drugs and hypertonic saline was instituted. This resulted in marked clinical improvement over a 48 h period. Computed tomography performed in the standing, sedated horse following initial stabilisation identified extensive sclerosis and lysis of the right temporal and occipital bones, consistent with an infectious or neoplastic process. Based on the grave prognosis for survival despite the clinical improvement, euthanasia was undertaken. Post mortem magnetic resonance imaging identified a mass lesion impinging on the right cerebellar hemisphere, sclerosis of the temporal and occipital bones lateral and ventral to the mass, as well as destruction of the temporal bone between the inner ear and the cerebellum. These changes corresponded to the presence of a mass within the right dorsal temporal bone, extending into the right lateral temporal bone. The mass extended to compress and adhere to the right lateral hemisphere of the cerebellum. A histopathological diagnosis of botryomycosis was made, affecting the temporal and occipital bones and compressing the cerebellum.