The Modern Equine Vet - March 2023

SALES: ModernEquineVet@gmail.com

EDITOR: Marie Rosenthal

ART DIRECTOR: Jennifer Barlow

CONTRIBUTING WRITERS: Paul Basilio

• Tom Rosenthal COPY EDITOR: Patty

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THE

Should You Refer a Foal

MAYBE for Colic Surgery?

By Marie Rosenthal, MS

Foals treated surgically for strangulating small intestinal lesions appear to have postoperative outcomes similar to those in adults, according to a retrospective study by Sara J. Erwin, DVM, a PhD candidate at North Carolina State University.

“We think that this means there should be more optimism toward surgical treatment of foals with suspected small intestinal strangulating lesions,” she said at the 68th AAEP Annual Convention in San Antonio.

The team performed a retrospective study evaluating the clinical outcomes of foals with surgical strangulating lesions of the small intestine and compared them to those of adult horses.

“Strangulating small intestinal lesions cause ischemic injury, and the length of ischemia increases the damage to the intestinal lining that eventually kills the epithelial

cells of the intestinal lining. Epithelial cell death starts to occur with as little as 15 minutes of ischemia, so a strangulating lesion is a medical emergency, Dr. Erwin explained. By about 4 hours of ischemia, one can see total loss of small intestinal architecture, which can lead to sepsis, systemic inflammatory response syndrome and death of the patient.

“Surgery is often required to restore perfusion to these areas and to prevent this sequela,” she said, adding that colic accounts for more than 30% of deaths in horses between the ages of 1 and 20 years. Strangulating lesions are the most likely to cause morbidity in adult horses.

Small intestinal volvulus is the leading cause of strangulation in foals. “There's a commonly held thought that foals tend to do worse than adults with

these lesions,” Dr. Erwin said.

So, she and her colleagues set out to see if that was true.

“Adult survival of small intestinal strangulation ranges from 50% to 80%, and foal survival ranges from 27% to 50%. And while age-dependent outcomes have been examined in adults, these have not been compared directly between foals and adult horses,” she explained.

In many of the studies, the primary veterinarian plays a key role in referring the horse for surgery.

“The referral process is complicated in the foal due to varying degrees of visible or recognizable pain in these younger patients,” she explained. Veterinarians cannot perform physical rectal palpation in foals, and while abdominal radiographs and ultrasonography can be useful in determining possible lesions, they are not commonly used in the field with colic workups, especially in these younger patients.

Other factors also determine whether a young horse is referred. Finances often are key—foals tend not to be insured and not many people want to send an animal for an extensive work up and surgery if they don’t think it is going to survival anyway.

Because of how quickly ischemia can impair a foal’s chances of survive, distance from a referral hospital also plays a role. Every minute counts in these situations.

“The distance to the nearest referral hospital and the prognosis and cost estimate that's usually provided by the referring veterinarian” all play a role in whether the foal is referred, Dr. Erwin said.

Dr. Erwin and her colleagues thought that updated survival statistics could help guide these conversations among referring veterinarians and owners, as well as among the surgeons.

“Our objective in designing this study was to directly examine differences in clinical outcomes between foals and case-matched adult patients undergoing surgical correction of strangulating small intestinal lesions,” she said.

They collected small intestinal strangulating surgery cases from 2000 to 2020 from five veterinary university from around the country: North Carolina State University, the University of Pennsylvania, UC Davis, The Ohio State University, and Colorado State University.

“We collected signal lesion and resection information, short-term survival information—which we defined as the time from recovery from surgery to hospital discharge—and long-term survival information when it was available. We defined foals as being 6 months of age or younger, and adult cases were between 2 and 20 years of age,” she said. They did not look at horses 2 months to 2 years in case there were physiologic changes due to weaning that could influence outcome. They also excluded horses that were

older than 20 because they were more likely to have comorbidities that could also play a larger role in outcomes.

In total, they reviewed the records from 41 foals and 105 adults. “Each foal case that was recovered from surgery was case-matched by year, by lesion and resection type to 3 adults that were also recovered from surgery cases,” she said.

In a separate analysis that was not case matched, they looked at horses that were euthanized during surgery.

Most of the horses were Thoroughbreds (28 adults; 13 foals) from California or the tristate area around Pennsylvania, which they thought was due to the number of Thoroughfare breeding farms in those areas. There were also fewer horses from Colorado State because of the delay in time to recognition of colic and the average trailer ride to the university.

Other horses represented in the foal group were Standardbreds (9), Warmbloods (7), Quarter Horses (3), Andalusian (3), Arabian (2) and other or unspecified (4). In the adults, after Thoroughbreds, they saw Quarter Horses (15), Arabians (13), Warmbloods (11), Standardbreds (7), Morgans (5), American Saddlebreds (4), Paints (3), Ponies (3) and other or unspecified (16).

They saw trends in the ages of presenting horses, with many more foals presenting younger than 2 months of age. There was another, smaller increase in foals around 120 to 150 days of age. Among the adults, they saw a peak between 6 and 9 years and then again between 17 and 20 years.

More than half of the lesions (22) in the foals were volvulus, and the most common lesion in adults was strangulating lipoma (38), followed by volvulus (31).

“Volvulus was pretty common,” Dr. Erwin said. “It was the most common foal lesion and the secondmost common adult lesion followed closely to strangulating lipomas,”

Recovery trends were similar among all the hors-

es and did not differ by age, sex, breed or type of lesion, according to Dr. Erwin.

“We saw no trend toward any certain breed being more or less likely to be recovered from surgery. We also saw no trend toward any certain sex being recovered or not from surgery as well.

“Interestingly, once all the adult horses recovered, volvulus was the most common lesion. But there was still no trend toward any certain lesion type being more or less likely to recover from surgery,” she explained.

Of the 41 foals that went to surgery, 25 (60%) of them recovered from surgery. Of the 105 adults, 75 (71%) recovered.

Few horses needed a resection in the foal group, but all seven of the foals that received a resection survived short-term and 17 of the 18 that did not need a resection survived short-term,” she said.

“We saw 28 of 33 adults that needed a resection survive short-term and 38 of the 42 that did not need a resection survived short-term. So similar proportions here as well.”

Of the 25 foals that recovered from surgery, only 1 of them was euthanized while still in the hospital. And 66 of the 75 adults that recovered from surgery survived to hospital discharge.

The investigators only had long-term information for 13 adults and 5 foals. Two in each group were euthanized 2 months after discharge because of the formation of adhesions, but the numbers were too small to draw any conclusions.

The retrospective nature of the study, as well as the often-incomplete medical records were limitations of the study, she admitted.

“Overall, we saw similar incidents of intraoperative euthanasia and resections between age groups, and we saw no significant difference in short-term outcomes of foals compared with adults undergoing surgical correction of small intestinal strangulating lesions,” Dr. Erwin explained. MeV

They saw no trend toward any certain breed being more or less likely to be recovered from surgery.

Erwin SJ, Blikslager AT, Ziegler AL. Age-dependent intestinal repair: implications for foals with severe colic. Animals (Basel) 2021;11(12)3337.

nothing else like it.

For more than 30 years, Adequan® i.m. (polysulfated glycosaminoglycan) has been administered millions of times1 to treat degenerative joint disease, and with good reason. From day one, it’s been the only FDA-Approved equine PSGAG joint treatment available, and the only one proven to.2, 3

Reduce inflammation

Restore synovial joint lubrication

Repair joint cartilage

Reverse the disease cycle

When you start with it early and stay with it as needed, horses may enjoy greater mobility over a lifetime.2, 4, 5 Discover if Adequan is the right choice. Visit adequan.com/Ordering-Information to find a distributor and place an order today.

BRIEF SUMMARY: Prior to use please consult the product insert, a summary of which follows: CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian. INDICATIONS: Adequan® i.m. is recommended for the intramuscular treatment of non-infectious degenerative and/or traumatic joint dysfunction and associated lameness of the carpal and hock joints in horses. CONTRAINDICATIONS: There are no known contraindications to the use of intramuscular Polysulfated Glycosaminoglycan. WARNINGS: Do not use in horses intended for human consumption. Not for use in humans. Keep this and all medications out of the reach of children. PRECAUTIONS: The safe use of Adequan® i.m. in horses used for breeding purposes, during pregnancy, or in lactating mares has not been evaluated. For customer care, or to obtain product information, visit www.adequan.com. To report an adverse event please contact American Regent, Inc. at 1-888-354-4857 or email pv@americanregent.com. Please see Full Prescribing Information at www.adequan.com.

1 Data on file.

2 Adequan® i.m. Package Insert, Rev 1/19.

3 Burba DJ, Collier MA, DeBault LE, Hanson-Painton O, Thompson HC, Holder CL: In vivo kinetic study on uptake and distribution of intramuscular tritium-labeled polysulfated glycosaminoglycan in equine body fluid compartments and articular cartilage in an osteochondral defect model. J Equine Vet Sci 1993; 13: 696-703.

4 Kim DY, Taylor HW, Moore RM, Paulsen DB, Cho DY. Articular chondrocyte apoptosis in equine osteoarthritis. The Veterinary Journal 2003; 166: 52-57.

5 McIlwraith CW, Frisbie DD, Kawcak CE, van Weeren PR. Joint Disease in the Horse.St. Louis, MO: Elsevier, 2016; 33-48.

All trademarks are the property of American Regent, Inc.

© 2021, American Regent, Inc.

PP-AI-US-0629 05/2021

From the

BATTLEFIELD BARN to

the

BFR breaks into equine rehab

Although it was first developed in the 1960s, blood flow restriction (BFR) training has recently experienced a type of renaissance.

Conceived and developed by Yoshiaki Sato in the 1960s, it was virtually unknown outside of Japan until the 2000s. Now, thanks to innovations by the military to help wounded veterans, as well as free publicity from professional sports trainers, this orthopedic rehab modality is making its way to the equine world.

What is it?

BFR employs a pressurized cuff to safely and temporarily reduce blood flow to an exercising limb. By applying patient-specific amounts of occlusion pressure to the limb, arterial inflow is greatly reduced while venous outflow is occluded distal to the site. Through low-intensity exercise, the body can reap high-intensity benefits.

By Paul Basilio

images courtesy of Dr. Sherry Johnson.

“Basically, it’s been successfully utilized as a ‘biohack’ to improve muscle size and strength without the use of damaging loads,” said Sherry Johnson, DVM, MS, PhD, DACVSMR, of Equine Sports Medicine and Rehabilitation in Whitesboro, TX. “In humans, rapid, irreversible muscle loss occurs quickly within 1 week of bedrest, so it's become an ‘in vogue’ modality for human orthopedic rehab.”

Patients undergoing BFR training typically perform high-repetition, low-intensity exercise with weight that is around 20% to 30% of their one-repetition maximum. The exact mechanism by which it works is not fully known, but there are some hypotheses.

“Throughout the literature, consistent supraphysiologic levels of growth hormones—up to 290 times baseline—have been documented, along with lactate accumulation,” Dr. Johnson said during a presentation at the 68th Annual AAEP Convention in San Antonio. “Downstream signaling as a result of these two physiologic accumulations seem to be the most consistently reported driving forces behind these muscle-strength gains.

The equine frontier

While the BFR craze has set up shop in the world of human medicine, the number of animal studies—let alone studies of horses in particular—was severely lacking.

In the mid-2000s, a few studies from a Japanese team did find BFR to be safe in horses, and effective in increasing muscle thickness of the ulnaris lateralis. However, those studies were extremely small, and the investigators were primarily human-focused.

To set the equine stage, Dr. Johnson and her team worked closely with leading BFR experts of Delfi Medical Innovations, Inc., Owens Recovery Science and Brian Noehren , PT, PhD, FACSM, of Univeristy of Kentucky to develop a BFR cuff and protocol for use in the horse. They then evaluated short-term effects of BFR on equine superficial digital flexor (SDF) muscle oxidative capacity. Over the course of the 10-day study, they found that acute metabolic adaptions of both increased mitochondrial density and an improved ability to oxidize fuels was possible.

“The specific BFR walk protocol that we utilized

Patients undergoing BFR training typically perform high-repetition, low-intensity exercise with weight that is around 20% to 30% of their one-repetition maximum.

THE HISTORY OF BFR

According to Dr. Sherry Johnson , one of BFR’s first high-profile utilizations was when the US Department of Defense employed the modality to combat debilitating levels of muscle loss in wounded veterans, particularly those with traumatic blast-related wounds that required limb salvage procedures or even amputation.

Even after the damaged portions of the limb were removed, the soldiers still lacked the muscle strength and the function to successfully use prosthetic devices.

“It was actually through the use of BFR that the military started to circumvent these muscle losses in extreme injury,” she explained, “and they were able to tremendously improve prosthetic suitability.”

After whispers of its success in the military population, the modality eventually broke into the high-profile world of professional sports. NFL player Jadeveon Clowney’s use of BFR following a meniscal injury brought widespread attention, and it wasn’t long until strength conditioning coaches were using the technique on their healthy patients to maintain peak physical fitness without the use of damaging loads.

“With the advent of lower, more comfortable pressures, even the geriatric population uses BFR to combat sarcopenia,” Dr. Johnson noted. “One of the latest, greatest uses is in human patients with neurologic dysfunction.”

consisted of a 10-minute interval walk protocol under 80% vascular occlusion,” she said. This protocol was extrapolated from human exercise protocols following numerous think-tanks amongst the translational BFR ‘dream-team’ of Colorado State University, Delfi Medical Innovations, Owens Recovery Science and Dr. Noehren.

This study

Using that same protocol, Dr. Johnson and her team set their attention on the safety of BFR in a longterm clinical setting.

One barrier is that established levels of limb occlusion pressure (LOP) have not been determined in horses. LOP is the pressure required to achieve full vascular occlusion, and it varies among patients.

Significant physiologic benefit can be obtained in a more comfortable manner using about 40% to 80% of a patient’s measured LOP, so fine-tuning is needed for each patient.

“Basically, a patient comes in for BFR training, the LOP gets measured, the occlusion percentage is automatically back-calculated, and then the session begins with the patient-specific pressure levels,” she explained.

But before BFR can be introduced on a widespread level in equine medicine, steps needed to be

taken to ensure that the modality does not result in harmful gait dysfunction. “We also need to know just how variable LOPs are between horses and between an individual horse’s limbs,” Dr. Johnson explained.

To get those results, Dr. Johnson and her team enrolled 4 healthy horses to perform 40 unilateral forelimb BFR exercise sessions over a 56-day study period. Clinical examinations and objective gait analysis were performed by a blinded, board-certified equine sports medicine clinician.

LOP values were determined daily by Doppler ultrasonography immediately prior to the BFR walk sessions, and those daily values were back-calculated to deliver 80% vascular occlusion while at a walk.

“All of the study horses seemed to tolerate the BFR sessions pretty well,” Dr. Johnson explained. “A couple horses would intermittently paw at the treadmill belt during the stop periods, but there were no ‘worker strikes.’”

To evaluate whether BFR was contributing to clinical or biomechanical lameness, a total of 20 kinematic/kinetic parameters were evaluated, such as stride length, peak vertical force, and stance duration. Subjective lameness evaluation and limb palpation were also included.

Results showed that no gait dysfunction was introduced, and lameness scores did not change over the course of the study period.

“No evidence of venous or arterial thrombosis was noted in any horse at any evaluation time point based on our clinical examination,” she said. “There was no evidence of dermatitis, swelling, thickening, or sensitivity [at the area of the BFR cuff.]”

The team recorded a total of 160 LOP readings over the course of the study. Mean limb occlusion pressure was about 189 mm Hg, with a standard deviation of about 22 mm Hg.

Interestingly, there was a significant difference in mean LOP between the measures of left and right forelimbs—mean LOP in the right forelimbs was about 174 mm Hg, and mean LOP in the left forelimbs was about 205 mm Hg.

“Pressures of 75 to 150 mm Hg would likely simulate the 50% to 80% vascular occlusion levels in our standing, non-sedated horses,” Dr. Johnson explained. “Our results suggest that differences between horses and measured limbs will necessitate patient-specific pressure readings.” MeV

Disclosure statement: Members of the investigative team are partners of Equine Core an entity that is involved in the development of equine-specific blood flow restriction devices.

Vetscan Imagyst Adds AI Fecal Egg Count Analysis

Zoetis expanded of its multipurpose, diagnostics platform, Vetscan Imagyst, to include a new artificial intelligence application for equine fecal egg count (FEC) analysis, which will be available in Spring 2023.

This diagnostic addition broadens Vetscan Imagyst testing capabilities beyond existing AI canine and feline fecal analysis, AI blood smear analysis and digital cytology applications to include new inclinic tests that are fully integrated into the company’s cloud-based AI capabilities. With the launch of these applications, Zoetis is continuing to redefine what is possible for in-clinic veterinary diagnosis and animal care across species.

Launched in 2020, Vetscan Imagyst is a first-ofits-kind technology, offering multiple applications in a single diagnostics platform leveraging a combination of image recognition technology, algorithms and cloud-based AI. Using a compact scanner along with AI technology and backed by a global network of expert clinical pathologists, Vetscan Imagyst efficiently delivers a variety of consistent diagnostic tests and results. New applications, like AI dermatology and AI equine FEC analysis, will be easily integrated with existing Vetscan Imagyst testing capabilities, maximizing clinic investment.

“At Zoetis, we are committed to equipping veterinary healthcare teams with cutting-edge diagnostic tools that provide convenient and efficient solutions to facilitate the best possible care for animals in their practice,” said Lisa Lee, senior vice president, head of Product and Customer Experience, Global Diagnostics at Zoetis. “Adding AI dermatology and AI equine FEC analysis expands the capacity of care that clinicians can provide.”

Available now, Equine Digital Cytology Image Transfer includes digital review of sample images by board-certified clinical pathologists within the Zoetis network. Cytopathology results are received in less than two hours, 24 hours a day, seven days a week, compared to the traditional 24- to 48-hour wait with off-site lab results, saving veterinary healthcare teams time and shipping expenses. This allows for faster, more informed results to guide treatment decisions.

“Clinicians know that an accurate diagnosis can make all the difference—ensuring optimal treatment, better outcomes and happier owners and patients—but the reality is that time and capacity in busy clinics get in the way,” said Richard Goldstein, DVM, DACVIM, DECVIM-CA, Vice Presi-

dent, Global Diagnostics Medical Affairs at Zoetis. “Vetscan Imagyst allows veterinary healthcare teams in busy environments to meet the diagnostic and therapeutic needs of their patients quickly and consistently.”

With the upcoming addition of AI equine FEC analysis this Spring, Vetscan Imagyst will soon deliver fast, reliable and shareable results to equine clinicians within 10 minutes, allowing for rapid detection of Parascaris and strongyles.

It is powered by AI, and, in a study, demonstrated up to 99% agreement with board-certified parasitologist results. This allows for rapid identification of high shedders versus low shedders to enable strategic targeted deworming protocols to be implemented.

In addition, Zoetis also added an AI application for dermatology. MeV

Visit www.VETSCANIMAGYST.com to learn more about Vetscan Imagyst.

Not A Rhino; a Wry Nose

Surgically correcting a yearling's campylorrhinus lateralis

By Arie Wolff, LVT, LVMT

A Rocky Mountain Horse yearling suffering from wry nose presented to the Equine Surgery, Lameness, and Rehabilitation Service at the University of Tennessee, College of Veterinary Medicine in March 2022. The airflow of the yearling was restricted through the nasal cavity, with the right nasal passage especially affected. The premaxillary incisors failed to contact the mandibular incisors because the premaxillae, maxillae, nasal and vomer bones, and the nasal septum deviated to the left of the sagittal plane of the head. The deviation was determined radiographically to be about 30 degrees.

While standing, the horse received a temporary tracheostomy at the juncture of the proximal- and

middle-thirds of the cervical portion of the trachea. After the horse was sedated with xylazine HCl, it was anesthetized with IV ketamine HCl and midazolam. With the horse in dorsal recumbency and still in the anesthetic induction room, a laryngotomy was performed at the cricothyroid space, and an endotracheal tube was inserted into the trachea through the temporary tracheostomy.

The yearling was then placed on the surgery table in right lateral recumbency with its head elevated by a sandbag. Anesthesia was maintained with isoflurane.

A 10-cm incision was made over the center of the 15th rib. The incision extended through the periosteum, which was reflected from underlying bone using a periosteal elevator. A 5-cm section of rib was harvested using obstetrical wire and placed in gauze swabs soaked in blood. The musculature and subcutaneous tissue were juxtaposed in one layer with

The patient prior to surgery.

All images are courtesy of Arie Wolff

Preoperative imaging.

2-0 polydioxanone suture (PDS) placed in a simple-continuous pattern. The skin incision was closed with staples, and a stent bandage was sutured to the incision.

At the same time a section of rib was being harvested, a 5-cm incision was made on the dorsal midline slightly rostral to the rostral border of the dorsal conchal sinuses, the site of which was determined radiographically using staples placed on the dorsal midline of the nose as markers. This incision extended to the ligament connecting the right and left nasal bones. A circular section of the nasal bones and underlying parietal cartilage was excised, on midline, using a 3/8-inch (1-cm) Galt trephine. Three, 1-m strands of obstetrical wire, the ends of which were ensheathed with a polypropylene catheter to

protect the respiratory mucosa, were placed through the nasal cavity, using the trephine hole and the laryngotomy, so that they encircled the dorsal, ventral, and caudal aspects of the nasal septum. After the three loops of wire had been placed, the caudal, ventral, and dorsal borders of the septum were incised simultaneously, and the rostral border of the septum was transected using a scalpel, leaving about 1-cm of septum rostrally. The resected septum was extracted from the nasal cavity, and the nasal cavity was packed with rolled gauze. The skin incision was closed with staples, and the laryngotomy was left unsutured to heal by second intention.

To straighten the nasal bones, an 8-cm incision was made on the dorsal midline centered at the site at which the nasal bones deviated from the sagit-

The airflow of the yearling was restricted through the nasal cavity, with the right nasal passage especially affected.

Teaching Points

Equine campylorrhinus lateralis, or wry nose, is a congenital deformity of the premaxillae, maxillae, nasal and vomer bones, and nasal septum. This facial deviation results in partial occlusion of the nasal cavity, which, if severe, can affect a foal’s ability to nurse. Most foals with wry nose, however, do nurse effectively.

Surgical correction of this deformity was first reported in the late 1970s and was performed in two stages. Stage 1 of the correction entailed osteotomy and repositioning of the maxillae to correct the malocclusion of the incisors. The repositioned upper jaw and a rib graft, inserted into the osteomy on the concave side of the deformity, were stabilized with internal fixation. The nasal septum was removed, and the nasal bones repositioned and stabilized with wire during a second surgery performed a few weeks later.

Similar techniques were used to correct the deviation of the horse described in this report, but correction was performed during one anesthetic period.

tal plane. Using an oscillating saw, a wedge of nasal bone, the point of which was at the concave border of the deviation, was excised from the right and left nasal bones, and the transected nasal bones were rotated to the sagittal plane. The repositioned left nasal bone was fixed to parent bone with an 8-hole, 2.7-mm, dynamic compression plate, and the repositioned right nasal bone was fixed to parent bone with a 12-hole, 2.7-mm, dynamic compression plate. The plates were attached using 6, 8, and 10-mm cortical screws. Subcutaneous tissue was closed with 2-0 PDS suture placed in a simple-continuous pattern, and the skin incision was closed with staples.

The horse was placed into dorsal recumbency with its mouth held open with a wooden wedge placed between the right cheek teeth. A 5-cm, mucoperiosteal incision, centered at the site of maximum of the deviation of the maxillae, was made on the ventral border of the premaxilla at each interdental space. Through these incisions, the premaxillae and palatine processes of the premaxillae were transected with an oscillating saw after elevating the

overlying periosteum and gingiva. The transected segment of the upper jaw was rotated until the premaxillary and mandibular incisors were aligned. A 2-cm rib graft was inserted into the gap created at the left premaxilla using a mallet and dental punch. The transected segment of the upper jaw was stabilized to parent bone with 4 appropriately sized Steinmann pins (3 on the left side and 1 on the right side) inserted through the premaxillae into the medullary cavity of the ipsilateral maxillae. Dental acrylic was placed over the protruding ends of the pins to prevent the exposed end of the pins from abrading the mucosa of the upper lip. The incisions in the interdental space were closed with 2-0 barbed PDS suture placed in a simple-continuous pattern. The occlusal surface of the incisors was reduced with a power-driven float. The horse was administered potassium penicillin gentamicin sulfate and phenylbutazone before surgery and for 5 days after surgery. The horse was administered omeprazole for 12 days after surgery. Hydromorphone was administered as needed for 2 days. Antimicrobial therapy was changed at 5 days

Shutterstock/nelelena

The patient prior to anesthesia induction.

post-surgery to trimethoprim-sulfamethoxazole, which was administered for 14 days. Intravenous administration of phenylbutazone was changed at 5 days to oral administration of a paste for 12 days.

Conclusion

Surgery time was 4 hours; anesthesia time was 4.5 hours. Recovery from anesthesia, which was assisted, was 1 hour. The gauze pack in the nasal cavity and the tracheostomy tube inserted into the trachea after surgery were removed 3 days post-surgery. The yearling was discharged 11 days after surgery.

Movement of air through the nasal cavity was good

For more information:

Implants

when the horse was presented 70 days after discharge for evaluation. One of the screws from the 12-hole, dynamic compression plate had backed out and was removed through a stab incision. Radiographs showed that the horse’s nose was still deviated but to a lesser degree. The owner believed that surgery had improved the horse’s appearance and quality of life. MeV

About the Author

Being in love with horses her whole life, Arie joined the University of Tennessee College of Veterinary Medicine as the Equine Surgery Technician in 2018. Working with horses and competing from a young age in Hunter/Jumper disciplines, her passion and focus have contributed to her knowledge and skills in the welfare and care of horses. When Arie is not working or competing, she spends her time advancing her yoga practice and hiking with her partner, Jarret, and their dogs, Stryker and Riley. Arie holds a bachelor's degree in animal science and an associate's degree in Veterinary Technology Medicine. She is a licensed technician in the states of Tennessee and New York.

Schumacher J, Brink P, Easley J et al. Surgical correction of wry nose in four horses. Vet Surg. 2008;37:142-148.

Cousty M, Haudiquet P, Geffroy O. Use of an external fixator to correct a wry nose in a yearling. Equine Vet Educ. 2010;22:458-461

Robertson JT. Surgical correction of wry nose in newborn foals. Equine Vet Educ. 2010;22:462-466

Valdez H, McMullan WC, Hobson HP, et al. (1978) Surgical correction of deviated nasal septum and premaxilla in a colt. J Am Vet Med Assoc. 1978;173:1001-1004.

Nasal septum