Epiglottic Augmentation in the Horse

Epiglottic augmentation with injectable bovine collagen or an autogenous or allogenous auricular cartilage graft was performed in 12 horses with endoscopically and radiographically normal epiglottises. The grafting procedures were easy to perform and did not cause apparent discomfort. Cartilage graft extrusion or resorption may have occurred, but was not seen by endoscopy and lateral laryngeal radiography. Only collagen implants remained evident endoscopically, as smooth round submucosal bulges ventral to the epiglottic cartilage. Two horses with collagen implants, and all horses with cartilage autografts and allografts, were euthanatized at week 16. One horse with a collagen implant was euthanatized at week 4 and one at week 6. The epiglottis appeared thickened in three horses with collagen implants, two horses with autogenous grafts, and three horses with allogenous grafts. Pharyngeal lymphoid tissue was hyperplastic in two horses with autografts and three horses with allografts, but not in horses with collagen implants. Collagen grafts persisted as one or two smooth bulges 8 mm in diameter. Collagen incited a brisk foreign body reaction that was surrounded by a fibrous connective tissue capsule. Epiglottises of the horses with collagen implants were significantly thicker 20 mm from the tip than those of normal horses and horses with allografts. Cartilage graft incorporation was not evident grossly and was seen on microscopic examination in only one autograft. Thickening was caused by submucosal fibrosis.     

Regeneration of wool follicles in autografts of sheep skin.

Three experiments involving six sheep were carried out at three different times in the annual wool growth cycle. Forty-eight full-thickness fitted autografts were sampled 2 h, 6 h, 24 h, 48 h, 3, 4, 5, 7, 9, 11, 14, 21 and 28 days after grafting. The histopathology of the grafts is described. Individual variation in 'take' was probably related to the speed with which vascular integrity was reestablished between graft and bed. Delayed acceptance caused the death of pilosebaceous units. In a successful graft, wool follicle regeneration appears to occur in three main ways: (1) an inactive follicle regenerates from the dormant bulb at about seven days, (2) follicles that were active at the time of grafting have first to form a papilla stalk, and such follicles did not become active until 11 days, (3) sometimes one or more outgrowths appeared at higher levels suggesting follicle regeneration by branching. In addition there were a few instances of de novo downgrowth of follicle plugs from the epidermis. Wool growth on the graft therefore arises almost entirely from the reorganisation of preexisting follicles.     

Treatment of equine leg wounds using skin grafts: Thirty-five cases, 1975-1988

A retrospective study was conducted on 35 equine patients with lower leg wounds that were managed utilizing skin graft procedures. Two pinch graft, five punch graft, seven tunnel graft, eight split-thickness mesh graft and thirteen full-thickness mesh expansion graft procedures were performed in the initial treatment. The average wound size was 188 cm². Twentyfour cases had pregrafting complications: 10 wounds developed sequestra; three wounds were grossly contaminated and infected; and 11 cases developed granulation tissue complications prior to grafting. Graft failure following the initial procedure was seen in 12 cases and occurred with all techniques except pinch grafting. Graft failure was often attributable to poor quality of granulation tissue as well as anatomic site, especially the dorsal surface of the tarsus. An average of two additional grafting procedures was required to successfully treat initial failures. Pinch grafts took the longest time to epithelialize (70 days), followed by punch grafts (47 days). Both were similar in terms of being the least durable and least cosmetically acceptable of all techniques used. Split-thickness and full-thickness mesh expansion grafts were technically the most difficult, but showed the most rapid epithelialization (28 days), greatest durability, and the best cosmetic appearance. Tunnel grafts provided a practical technique for grafting cases which were either not suited for, or which had failed with, mesh expansion grafts.     

Indirect measurement of blood pressure as a guide to the efficacy of fluid therapy in equine shock: A case report

A case of acute circulatory failure in a horse is described. The response to intravenous fluid therapy was monitored by measurement of heart and respiratory rates, and arterial and central venous pressures. Heart rate was an unreliable guide to improved circulatory status. Central venous pressure and indirect arterial blood pressure were valuable guides to the efficacy of fluid therapy.     

Incorporation of Fresh and Cryopreserved Bone in Osteochondral Autografts in the Horse

The structural integrity of subchondral bone in fresh and frozen osteochondral autografts was investigated at month 3 in 10 horses. Two osteochondral autografts were harvested from the lateral aspect of the lateral trochlear ridge of the left talus in each of 10 anesthetized horses. Grafts were frozen in 7.5% DMSO. After 14 days, the thawed grafts were press-fitted into drill holes in the trochlear ridges of the right stifles. A fresh graft from the right hock was implanted in each left stifle. To control for the effects of surgery, a fresh graft was transferred from the right stifle to the left stifle. The end result was two grafts in each femoropatellar joint. Fresh and frozen bone grafts maintained a structurally intact support for the cartilage surface. Graft stability and surface congruency were determining factors in the outcome of the grafts. Incorporation of both types of graft was complete at month 3, but remodeling of the fresh grafts was more active.     

Full‐Thickness Skin Grafting to Cover Equine Wounds Caused by Laceration or Tumor Resection

Objective: To describe and evaluate full‐thickness skin grafting of equine wounds. Study Design: Case series. Animals: Adult horses (n=6). Methods: A full‐thickness graft was harvested from the pectoral region with the horse anesthetized or standing and sedated after local anesthetic infiltration. Grafts were attached to the cutaneous margin of the wound with staples and/or sutures if the horse was anesthetized or if the recipient site was desensitized. Cyanoacrylate glue was used to attach the grafts to the cutaneous margin of the wound of 3 horses. Medical records were reviewed for history, physical examination findings, grafting technique, postoperative complications, and outcome. Results: Three horses had full‐thickness skin grafting to cover a fresh defect created by excision of a cutaneous neoplasm, and 3 horses had full‐thickness skin grafting to cover a fresh or granulating laceration. Grafts were completely accepted in 5 horses. The superficial layers of all grafts sloughed, but the final cosmetic appearance of accepted grafts was good. Conclusions: Full‐thickness skin grafting can be performed in standing sedated horses with good cosmesis, especially when the meshed graft is expanded minimally. Clinical Relevance: Good acceptance of a full‐thickness graft can be expected, regardless of whether the graft is applied to a fresh or granulating wound.     

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.     

Pulmonary vascular pressures of thoroughbred horses exercised 1, 2, 3 and 4 h after furosemide administration

Furosemide premedication of horses 4 h prior to exercise significantly attenuates exercise-induced pulmonary capillary hypertension which may help diminish the severity of exercise-induced pulmonary haemorrhage. As pulmonary hemodynamic effects of furosemide may be mediated via a reduction in plasma volume (which is most pronounced 15-30 min postfurosemide administration, with plasma volume recovering thereafter), we hypothesized that administration of furosemide at intervals shorter than 4 h before exertion may be more effective in attenuating the exercise-induced rise in pulmonary capillary blood pressure. Thus, our objective was to determine whether furosemide-induced attenuation of exercise-induced pulmonary arterial, capillary and venous hypertension would be enhanced when the drug is administered at intervals shorter than 4 h before exercise. Using established techniques, right atrial, and pulmonary arterial, capillary and wedge (venous) pressures were ascertained in seven healthy, sound, exercise-trained Thoroughbred horses in a randomized split-plot experimental design. Measurements were made at rest and during exercise performed at maximal heart rate (217 +/- 3 beats/min) in the control (no medications) experiments and following furosemide administration (250 mg intravenously (i.v.)) at 1, 2, 3 and 4 h before exercise. Sequence of treatments was randomized and 7 days were allowed between experiments on each horse. Although furosemide administration in the four treatment groups caused only insignificant changes in the pulmonary arterial, capillary and wedge pressures of standing horses, furosemide-induced reduction in mean right atrial pressure achieved statistical significance in the 2 h postfurosemide experiments. In the control studies, exercise was attended by statistically significant increments in mean right atrial, as well as pulmonary arterial, capillary and wedge pressures. Although exercise in each of the four furosemide experiments was also attended by significant increments in right atrial as well as pulmonary vascular pressures, in the 1, 2 and 3 h postfurosemide experiments, mean right atrial pressure increased to a significantly lower value than in the control study. Exercise-induced changes in pulmonary vascular pressures in the 1 h postfurosemide experiments were not different from the pressures in the control study. There was a significant attenuation of exercise-induced pulmonary capillary and venous hypertension in the 2, 3 and 4 h postfurosemide experiments, but significant differences among these treatments were not found. Thus, these data did not support the contention that administration of furosemide at intervals shorter than 4 h before exercise is more effective in attenuating exercise-induced pulmonary capillary or venous hypertension in Thoroughbred horses.     

Gross and histomorphological observations following homologous deep frozen tendon grafting in equines

Experimental tenectomies were performed in the mid metacarpal region of the superficial digital flexor (SDF) tendon while the deep digital flexor (DDF) tendon was traumatized in 10 donkeys. In group I (n=8) the deep frozen tendons were used for grafting where as in group II (n=2) no grafting was done. Amniotic membrane casing was performed around grafted SDF and traumatized DDF tendons in group I only. Gross and histomorphological observations were recorded on the last day of the experiment, i.e., on the 15th (n=1), 30th (n=2), 60th (n=2), 90th (n=2) and 120th (n=1), post-operative days (POD) in group I and on the 60th (n=1) and 120th (n=1) POD in group II. Gross intraoperative observations suggested the presence of only thin filamentous adhesions in all but three animals at 30 (two animals) and 60 (one animal) days which were present only in the limited area of grafted tendon as compared to tenectomized SDF tendon that showed thick fibrous adhesion and thickening at both the cut ends. However, DDF tendon showed no adhesions in all except one animal of group I as compared to group II where adhesions were noticed in both the animals. Histological examination suggested an increase in fibroblastic activity at 2 weeks after grafting. Extrinsic and intrinsic healing response was observed in grafted tendons. Inflammatory reaction was reabsorbed by one month. The bundle formation was observed from two to three months. The histological structure appeared near normal by 4 months. Observation suggested that homologous tendon grafts remain viable by all histological criteria and healing was at a comparatively more advanced stage than tenectomized tendon. However, the traumatized DDF tendon healed completely by two months. It is concluded that the tendon healing was more rapid in animals where deep frozen grafts had been used.     

Comparison of full- and partial-thickness autogenous skin transplantation in dogs: a pilot study.

Thin partial-thickness (0.063 cm), medium (0.127 cm) partial-thickness, and full-thickness skin autografts were transplanted to surgically created granulating foreleg wounds of dogs. Thin partial-thickness grafts had an 89% survival, medium partial-thickness grafts had 47% survival, and full-thickness grafts had a 58% survival. Of the successful grafts, only the thin partial-thickness grafts did not grow adequate hair after transplantation.     

Septic Arthritis of the Distal Interphalangeal Joint in 12 Horses

The medical records of 12 horses with septic arthritis of a distal interphalangeal joint were reviewed to determine clinical features and response to treatment. Sepsis was caused by trauma or an injection that resulted in an open or contaminated distal interphalangeal joint. All horses were severely lame. Treatment included broad-spectrum parenterally administered antimicrobial drugs (ten horses), percutaneous through-and-through joint lavage (eight horses), indwelling drains (three horses), immobilization of the limb in a cast (three horses), intraarticular injection of sodium hyaluronate (one horse), intraarticular injection of antimicrobial drugs (five horses), curettage of the distal phalanx (one horse), and cancellous bone grafting to promote fusion (one horse). Five horses were euthanatized. Ankylosis of the affected joint developed in five horses, four of which are pasture sound. Two horses treated medically are sound although one underwent subsequent palmar digital neurectomy for treatment of navicular syndrome.     

Effect of preservation methods on the performance of bovine pericardium graft in a rat model

This study investigates the effect of preservation methods on the performance of bovine parietal pericardium grafts in a rat model. Mid-ventral full thickness abdominal wall defects of 3 x 2.5 cm in size were created in 90 male Sprague-Dawley rats (300-400 g), which were divided into three groups of 30 rats each. The abdominal defects of group one and two were repaired with lyophilized and glycerolized bovine pericardium grafts, while the defects of group three were repaired with expanded polytetrafluoroethylene (ePTFE) Mycro Mesh as a positive control. Another group of 30 rats underwent sham operation and was used for comparison as negative control. Each group of rats (n = 30) was divided into five subgroups (n = 6) and killed at 1, 3, 6, 9 and 18 weeks post-surgery for gross and morphological evaluations. The rats tolerated the surgical procedure well with a total mortality of 0.05%. No serious post-operative clinical complications or signs of rejection were encountered. Adhesions between the grafts and the underlying visceral organs observed in the study were mostly results of post-surgical complications. Glycerol preservation delayed degradation and replacement of the grafts, whereas lyophilization caused early resorption and replacement of the grafts. The glycerolized grafts were replaced with thick dense fibrous tissue, and the lyophilized grafts were replaced with thin loose fibrous tissue. The healing characteristic of the bovine pericardium grafts was similar to those of the sham-operated group, and quite different from those of the ePTFE Mycro Mesh. The outcome of the present study confirmed the superiority of glycerolized bovine pericardium grafts over its lyophilized counter part.     

Esophageal Replacement in the Dog by Microvascular Colon Transfer

An orthotopic colon graft based on the middle colic artery and vein was implanted with microvascular technique and a stapling instrument in five dogs. The grafts were successful in four dogs. A similar colon autograft was used to replace the entire thoracic esophagus in five dogs. The recipient vessels were the left carotid artery and left external jugular vein. Four of the grafts failed because of kinking and thrombosis of the arterial supply (2 dogs) or the venous outflow (2 dogs). One graft, which had a viable vascular supply, developed a severe leak at the colon-to-stomach anastomosis, and the dog was euthanatized on day 3. The recipient vascular pedicle was modified and used successfully to replace a portion of the cervical esophagus in three dogs. The grafts survived, the dogs could swallow liquids and semisolid food well, and, at necropsy after 4 weeks, the anastomotic sites were well healed. The graft sites contained essentially normal colon mucosa.     

Esophageal replacement in the dog by microvascular colon transfer

An orthotopic colon graft based on the middle colic artery and vein was implanted with microvascular technique and a stapling instrument in five dogs. The grafts were successful in four dogs. A similar colon autograft was used to replace the entire thoracic esophagus in five dogs. The recipient vessels were the left carotid artery and left external jugular vein. Four of the grafts failed because of kinking and thrombosis of the arterial supply (2 dogs) or the venous outflow (2 dogs). One graft, which had a viable vascular supply, developed a severe leak at the colon-to-stomach anastomosis, and the dog was euthanatized on day 3. The recipient vascular pedicle was modified and used successfully to replace a portion of the cervical esophagus in three dogs. The grafts survived, the dogs could swallow liquids and semisolid food well, and, at necropsy after 4 weeks, the anastomotic sites were well healed. The graft sites contained essentially normal colon mucosa.     

A Modified Parainguinal Approach for Cryptorchidectomy in Horses An Evaluation in 107 Horses

A modified parainguinal approach was used to castrate 119 abdominal cryptorchid horses. The operative time ranged from 10 to 30 minutes. Follow-up information was obtained for 107 horses. Swelling, more severe than that expected in routine castrations, was reported in six horses. An incisional abscess had to be drained in one horse and one horse died of unexplained causes 3 days after the surgery.     

Heterotopic Transfer of Fresh and Cryopreserved Autogenous Articular Cartilage in the Horse

Two 10 mm thick osteochondral grafts were harvested from the lateral aspect of the lateral trochlear ridge of the left talus in each of 10 anesthetized horses. The grafts were frozen in a 7.5% DMSO solution and stored in liquid nitrogen. The horses were anesthetized again on day 14 and the thawed grafts were press-fitted into drill holes in the trochlear ridges of the right stifle. A fresh graft was transferred from the right hock to the left stifle. To control for the effects of surgery, another fresh graft was transferred from the right stifle to the left stifle. The result was two grafts in each femoropatellar joint. Fresh and frozen osteoarticular autografts appeared to maintain a durable weight-bearing surface for 3 months; however, the fresh grafts were clearly superior. Frozen grafts had fewer living chondrocytes, decreased safranin-O staining, and decreased SO435 uptake. Graft stability and articular surface congruency were determining factors in the outcome of all grafts. Since the availability of osteochondral autografts is limited, further work on the use of preserved allogeneic osteochondral tissue is warranted.     

Effects of hyperbaric oxygen on full-thickness meshed sheet skin grafts applied to fresh and granulating wounds in horses

OBJECTIVE: To determine the effects of hyperbaric oxygen therapy (HBOT) on full-thickness skin grafts applied to fresh and granulating wounds of horses. ANIMALS: 6 horses. PROCEDURES: On day 0, two 4-cm-diameter circular sections of full-thickness skin were removed from each of 2 randomly selected limbs of each horse, and two 4-cm-diameter circular skin grafts were harvested from the pectoral region. A skin graft was applied to 1 randomly selected wound on each limb, leaving the 2 nongrafted wounds to heal by second intention. On day 7, 2 grafts were harvested from the pectoral region and applied to the granulating wounds, and wounds grafted on day 0 were biopsied. On day 14, 1 wound was created on each of the 2 unwounded limbs, and the wounds that were grafted on day 7 were biopsied. All 4 ungrafted wounds (ie, 2 fresh wounds and 2 wounds with 1-week-old granulation beds) were grafted. The horses then received HBOT for 1 hour daily at 23 PSI for 7 days. On day 21, the grafts applied on day 14 were biopsied. RESULTS: Histologic examination of biopsy specimens revealed that grafts treated with HBOT developed less granulation tissue, edema, and neovascularization, but more inflammation. The superficial portion of the graft was also less viable than the superficial portion of those not treated with HBOT. CONCLUSIONS AND CLINICAL RELEVANCE: The use of HBOT after full-thickness skin grafting of uncompromised fresh and granulating wounds of horses is not indicated.     

Use of continuous-flow peritoneal dialysis for the treatment of acute renal failure in an adult horse

A 15-year-old Paso Fino gelding was evaluated because of acute renal failure following an episode of exertional rhabdomyolysis. The horse was azotemic and treated conservatively at another referral practice with no improvement in the azotemia. With conservative treatment and intermittent peritoneal dialysis, the horse had minimal improvement. Continuous-flow peritoneal dialysis (CFPD) was instituted on day 7 and continued for 3 consecutive days. Dramatic changes in the horse's attitude and serum creatinine concentration were detected within the first 24 hours of CFPD treatment. The horse remained hospitalized for 23 days; within 3 months of discharge, serum BUN and creatinine concentrations had returned to within the reference ranges and the horse had resumed normal activity. In adult horses, it appears that CFPD can be used to successfully treat acute renal failure that is refractory to conventional treatments.     

A study of seven different types of grafts for jugular vein transplantation in the horse

The aim of this study was to investigate the biological behaviour of vascular grafts replacing a section of the jugular vein in order to improve the results of the surgical treatment of complete thrombosis of the jugular vein in the horse. Seven graft types: fresh allograft, home frozen allograft, glutaraldehyde-fixed allograft, cryo-preserved allograft, PTFE-graft (Gore), small intestinal submucosa preparation (Cook) and fresh autograft, were randomly implanted in ponies. The grafts were removed after one month and examined histologically for: preservation of the graft structures, acceptance by the host, intima proliferation, presence of endothelium and patency. The glutaraldehyde- and cryopreserved grafts show reasonable results and the PTFE and autograft had the best results especially with respect to host acceptance, endothelium presence and patency. Further research is necessary to improve graft behaviour, especially to the aspect of endothelisation. Obstruction of the jugular vein in horses can be treated surgically.     

Occlusion of the External Carotid and Maxillary Arteries in the Horse to Prevent Hemorrhage from Guttural Pouch Mycosis

Balloon-tipped catheters were used to occlude the external carotid artery and its branches in nine horses with hemorrhage caused by guttural pouch mycosis. The internal carotid artery on the affected side was occluded simultaneously in four horses and had been occluded previously in two others. In three horses, a single balloon-tipped catheter was inserted in the external carotid artery beneath the floor of the guttural pouch and its tip was advanced blindly into distal branches. In one horse, the superficial temporal artery was occluded briefly during surgery by a balloon-tipped catheter so a catheter inserted into the external carotid artery could be diverted into the maxillary artery. In the other five horses, the external carotid artery was occluded proximally and the maxillary artery was occluded immediately caudal to the alar canal by a balloon-tipped catheter inserted into the major palatine artery. Serious postoperative hemorrhage did not occur in eight horses, but one horse that had a single balloon-tipped catheter inserted into the external carotid artery had profuse hemorrhage 11 days after surgery and was euthanatized. One horse was euthanatized because of persistent dysphagia. The only complication related to use of balloon catheters was a mild incisional infection in one horse. It was concluded that the external carotid and maxillary arteries must be occluded on both sides of the eroded segment to prevent hemorrhage from normograde and retrograde flow.