Noncitrated blood transfusions used as adjunctive treatment in a 7‐year‐old Shetland Pony with haemoperitoneum due to a ruptured corpus haemorrhagicum

Chronic bleeding due to extensive haemorrhage from a ruptured corpus haemorrhagicum developed 2–4 weeks after parturition and was identified as the cause for a haemoperitoneum in a 7‐year‐old Shetland Pony mare, leading to anaemia. Diagnosis was made upon exploratory coeliotomy and a unilateral ovariectomy was performed. Intra‐ and post operatively, the mare received autologous blood transfusions of noncitrated blood. To our knowledge, this is the first report of an autologous blood transfusion accomplished using noncitrated blood collected from the abdominal cavity.     

Malignant melanoma of the third eyelid in a horse

An 8‐year‐old grey Quarter Horse gelding was referred for evaluation of a rapidly growing mass associated with the third eyelid of the left eye. A pigmented mass of approximately 2 cm in diameter was palpated and visualised associated with the conjunctival lining of the nictitans. It was not possible to palpate normal nictitans deep to the base of the mass. A full dermatological examination revealed no other melanomas in common sites. Based on the size and rapid growth of the mass, surgical excision and one application of local chemotherapy was performed under general anaesthesia. Histopathology confirmed the diagnosis of malignant melanoma and the presence of clean surgical margins. There was no recurrence at 5 weeks post surgery. To our knowledge, this is the first report of a primary malignant melanoma of the third eyelid in a horse.     

Incarceration of the caecum through a rent in the gastrosplenic ligament

A 3-year-old Thoroughbred gelding presented with acute signs of colic and tachycardia. Transabdominal ultrasonography revealed a viscus visible on the left and right sides of the cranioventral abdomen with a mural thickness of up to 1.6 cm. Exploratory laparotomy was performed under general anaesthesia. This revealed that the caecum was incarcerated through a rent in the gastrosplenic ligament, and the caecal apex was in the left caudal abdomen. The ventral aspect of the gastrosplenic ligament was ligated and transected. The caecum was freed, and normal orientation confirmed. The horse recovered uneventfully from surgery. Caecal mural thickness was monitored using daily ultrasonography, until normal. The horse was discharged from the hospital 11 days post-operatively. Five months later, the horse returned to race training.     

Endodontic treatment of a mandibular premolar abscess in a horse: A case study

A pulpar abscess of cheek tooth 307 (according to the Triadan numerical system) was diagnosed in a 7‐year‐old female Quarter Horse. History included a painful response to palpation in the mandibular region for approximately 4 weeks. Symptoms included swelling of the mandibular bone with subsequent fistulisation. A complete intraoral examination was performed and no lesions or abnormalities were found. Digital radiographs of the mandibular arcade demonstrated a periapical lesion of cheek tooth 307. Various therapeutic options were considered, including standing oral extraction, retrograde repulsion and endodontic therapy. Together with the client, a decision was made to perform endodontic therapy, with the double aim of preserving the tooth and maintaining normal molar occlusion. This was done under general anaesthesia without apicectomy, and using materials commonly used in the field of human endodontics. Following surgery, radiographs were taken and confirmed the complete sealing of the pulp canals. Recovery was uneventful and no post operative complications were observed. A complete intraoral follow‐up examination was performed one year after surgery, and revealed normal eruption and occlusion of the tooth involved. Radiographic examination confirmed the correct position and integrity of the sealant material, as well as normal perialveolar bone structure. This case report indicates that endodontic therapy, following the above protocol, involving pulpectomy and sealing of the pulp cavity, represents a valid alternative to the more commonly used technique of tooth extraction.     

Successful small intestinal resection and anastomosis in a late term broodmare with colic via a standing left flank laparotomy

A late term broodmare presented with low‐grade intestinal colic. Clinical findings were consistent with a small intestinal lesion requiring surgical intervention. The risks of general anaesthesia to the fetus, combined with clinical findings in an otherwise quiet natured horse influenced the decision to choose an alternative standing left flank approach first. A small intestinal resection and anastomosis was performed successfully and the mare delivered a healthy foal without complications a month later. Standing colic surgery might be a preferred alternative to general anaesthesia in certain circumstances as discussed in this case report.     

Two occurrences of presumptive venous air embolism in a gelding during cystoscopy and perineal urethrotomy

A 14‐year‐old Arabian gelding presented for evaluation of macroscopic haematuria. Routine cystoscopy was performed under standing sedation during which the horse collapsed with apparent seizure activity. General anaesthesia was induced and the horse recovered neurologically normal. Four days later, during a perineal urethrotomy procedure, the horse experienced a similar collapse with seizure‐like activity. General anaesthesia was again induced and cystoscopy performed through the urethrotomy incision. A ventral bladder mass was visualised and sampled. Cytology confirmed a neoplastic process and the horse was subjected to euthanasia. Histopathology confirmed transitional cell carcinoma. Air embolism was the suspected cause of loss of consciousness and seizure activity in both instances.     

Splenectomy in a foal to control intra‐abdominal haemorrhage caused by splenic rupture

Intra‐abdominal haemorrhage in horses can be due to rupture of the spleen and may result in severe blood loss. The assessment and resuscitation of a foal that collapsed due to intra‐abdominal haemorrhage is presented. Diagnosis of the source of the blood loss required exploratory laparotomy and confirmed splenic capsular rupture and haemorrhage. Splenectomy using a 17th rib resection approach was used to control the haemorrhage. Complications included acute cardiac muscle damage, which was monitored using echocardiography and troponin I levels. The successful surgical management of the ongoing blood loss in this foal suggests that splenectomy should be considered an option to control severe blood loss due to splenic rupture.     

Anastomosis of the medial digital artery in a mare following traumatic laceration

A 7‐year‐old Warmblood mare presented with blood loss from a laceration of the medial digital artery sustained in the field. The mare was initially managed conservatively by pressure bandaging but the bleeding did not stop. After a blood transfusion the mare underwent arterial repair under general anaesthesia and was initially managed in a cast post operatively. Doppler ultrasonography 4 days post operatively confirmed effective blood flow distal to the arterial anastomosis and the mare was discharged from the hospital. At 6 months follow‐up the owner reported that the mare was sound at the trot with an excellent cosmetic outcome of the surgical site.     

Outcome of treatment in 23 horses with progressive ethmoidal haematoma.

This paper describes the outcome of treatment in 23 horses with an ethmoidal haematoma. In 22 cases a diagnosis could be made by endoscopic means alone but in 1 horse the lesion was confined to the maxillary sinus and a diagnosis was made only at surgery. One horse was destroyed at the owner's request but the other 22 underwent radical excision of the lesion via a facial flap approach under general anaesthesia. Post-operative haemorrhage was controlled by nasal packing with a gauze bandage and this was removed between the 2nd and 4th post-operative day. One horse died from encephalitis the day after surgery. Other complications included facial wound dehiscence, sequestration and suture periostitis. Of 21 horses followed up post-operatively there was definite recurrence of lesion in 2 cases and possibly a third. However, in 18 horses there was no evidence of recurrence (follow up times were 2 to 85 months). It is suggested that radical excision of the lesion provides an effective means of treatment.     

An atypical case of recurrent cellulitis/lymphangitis in a Dutch Warmblood horse treated by surgical intervention

The case reported here describes an atypical presentation of cellulitis/lymphangitis in an 8‐year‐old Dutch Warmblood mare. The horse was presented with a history of recurrent episodes of cellulitis/lymphangitis and the presence of fluctuating cyst‐like lesions on the left hindlimb. These lesions appeared to be interconnected lymphangiectasias. Surgical debridement followed by primary wound closure and local drainage was performed under general anaesthesia. Twelve months post surgery, no recurrence of cellulitis/lymphangitis had occurred and the mare had returned to her former use as a dressage horse.     

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.     

Severe polyuria and polydipsia as major clinical signs in a horse with unilateral renal adenocarcinoma

A 14‐year‐old Swiss Warmblood gelding was presented with chronic severe polyuria, polydipsia and weight loss. At the time of admission, water intake was 240 l/day. On rectal examination, a large mass was identified in the left dorsal abdominal quadrant, which was shown to originate from the left kidney by transabdominal ultrasonographic examination. Unilateral nephrectomy via flank incision was performed under general anaesthesia. Histopathological examination of the tumour revealed a papillary renal adenocarcinoma. Successful outcome and survival was documented 13 months after surgery. Severe polyuria and polydipsia should be considered as major clinical signs for renal carcinoma in horses, which can be successfully treated with unilateral nephrectomy if no signs of metastatic spread are evident.     

The use of porcine urinary bladder matrix (UBM) to repair a perforated corneal ulcer with iris prolapse in a horse

This report describes the use of porcine urinary bladder matrix (UBM) to repair a full thickness defect in the cornea of a Thoroughbred racehorse. The horse presented with acute keratomalacia of the right eye of 12 h duration that had rapidly progressed to perforation of the cornea with partial iris prolapse. The cornea was surgically debrided with the horse under general anaesthesia and the defect repaired with ACell multilayer wound matrix. A temporary tarsorrhaphy was performed. The defect in the cornea was successfully repaired and the horse regained vision in the eye. Four months after surgery the defect was still undergoing remodelling and the area of opacity in the cornea was progressively reducing.     

Subscapular lymph node abscessation as a result of metastatic Streptococcus equi subspecies equi infection: An atypical presentation of bastard strangles in a mare

The case reported here represents an atypical presentation of bastard strangles in an 18‐year‐old Arab mare. The horse initially presented for progressive neck pain characterised by reluctance to lateral and ventroflexion of the neck. Subsequent diagnostics revealed a subscapular abscess and aspirates of the mass cultured positive for Streptococcus equi ssp. equi. Surgical drainage and debridement of the abscess was performed under general anaesthesia. Six months post surgery, the mare had made a complete recovery.     

Concurrent atypical myoglobinuria and colon displacement in a filly

An 18‐month‐old pony filly was examined for acute colic and abdominal distension. The signs of colic failed to resolve following analgesic treatment. At exploratory laparotomy, a right dorsal displacement of the large colon was identified and corrected. On recovery from anaesthesia, the pony developed signs of widespread myopathy, confirmed by serum biochemistry evaluations. Myopathy consistent with atypical myoglobinuria was confirmed post mortem.     

Primary malignant melanoma in the oesophagus of a foal

A 2‐month‐old filly was evaluated for severe colic. Ultrasound, abdominocentesis and physical examination findings prompted an abdominal exploratory surgery. Perforation of the stomach was discovered during the surgery. The filly was humanely subjected to euthanasia under anaesthesia and post mortem examination was performed. In addition to gastric and duodenal ulceration, a thickened, black area of the proximal oesophagus was discovered. Histopathology of the lesion revealed primary malignant melanoma. Although rare, primary melanoma can occur in noncutaneous locations.     

Standing surgical repair of propagating metacarpal and metatarsal condylar fractures in racehorses

REASONS FOR PERFORMING STUDY: Repair of spiral and long diaphyseal metacarpal and metatarsal fractures under anaesthesia can be problematic and associated with a high incidence of complications, including fracture propagation necessitating euthanasia. OBJECTIVE: To report on a practical repair technique for which general anaesthesia is not required. METHODS: Thirteen racehorses with a spiral/propagating condylar fracture had the fracture repaired using local anaesthesia and sedation, without the need for general anaesthetic. RESULTS: Ten of the horses returned to training and 8 raced again. Two horses were retired directly to stud. One horse had propagation of the fracture 3 days post surgery, and was subjected to euthanasia. CONCLUSIONS AND POTENTIAL RELEVANCE: Results achieved were comparable to those gained using standard repair techniques under general anaesthesia. The described technique removes the need for general anaesthesia for repair of selected condylar fractures.     

A study of cardiovascular function under controlled and spontaneous ventilation in isoflurane–medetomidine anaesthetized horses

Objective To determine, in mildly hypercapnic horses under isoflurane–medetomidine balanced anaesthesia, whether there is a difference in cardiovascular function between spontaneous ventilation (SV) and intermittent positive pressure ventilation (IPPV). Study design Prospective randomized clinical study. Animals Sixty horses, undergoing elective surgical procedures under general anaesthesia: ASA classification I or II. Methods Horses were sedated with medetomidine and anaesthesia was induced with ketamine and diazepam. Anaesthesia was maintained with isoflurane and a constant rate infusion of medetomidine. Horses were assigned to either SV or IPPV for the duration of anaesthesia. Horses in group IPPV were maintained mildly hypercapnic (arterial partial pressure of carbon dioxide (PaCO₂) 50–60 mmHg, 6.7–8 kPa). Mean arterial blood pressure (MAP) was maintained above 70 mmHg by an infusion of dobutamine administered to effect. Heart rate (HR), respiratory rate (f_R), arterial blood pressure and inspiratory and expiratory gases were monitored continuously. A bolus of ketamine was administered when horses showed nystagmus. Cardiac output was measured using lithium dilution. Arterial blood‐gas analysis was performed regularly. Recovery time was noted and recovery quality scored. Results There were no differences between groups concerning age, weight, body position during anaesthesia and anaesthetic duration. Respiratory rate was significantly higher in group IPPV. Significantly more horses in group IPPV received supplemental ketamine. There were no other significant differences between groups. All horses recovered from anaesthesia without complications. Conclusions There was no difference in cardiovascular function in horses undergoing elective surgery during isoflurane–medetomidine anaesthesia with SV in comparison with IPPV, provided the horses are maintained slightly hypercapnic. Clinical relevance In horses with health status ASA I and II, cardiovascular function under general anaesthesia is equal with or without IPPV if the PaCO₂ is maintained at 50–60 mmHg.