A guarded prognosis for future soundness should be given to horses presented for treatment of LTs of the digital flexor tendons. The use of coblation wands had a negative effect on the final outcome.
Summary
Reasons for performing study: Inflammation of the digital flexor tendon sheaths is a chronic and nebulous condition often unresponsive to medical and surgical treatment.
Objectives: To evaluate the incidence of longitudinal tears (LT) as the underlying cause of chronic tenosynovitis and annular ligament constriction syndrome (ALCS) in warmblood horses.
Methods: The records of 25 horses with chronic tenosynovitis and ALCS in which tenoscopical inspection of the digital flexor tendon sheath (DFTS) was performed between 1999–2000 were reviewed. Of 25 horses, 17 were diagnosed with an LT in the deep digital flexor tendon (DDFT). All horses had a history of distension of the DFTS and/or signs of an ALCS. All cases presented typical signs of a chronic inflamed DFTS on ultrasonography and 11 horses showed ultrasonographic changes (echogenic material or an irregular outlining) at the lateral or medial border of the DDFT. The diagnosis of LTs of the DDFT was established in all cases by tenoscopy. Surgical treatment consisted of removal of the torn collagen fibrils using a mechanical resector and decompressing the fetlock canal by a transection of the palmar annular ligament (PAL) using a hook knife under tenoscopic control.
Results: Ten horses became sound and resumed their previous level of work, 3 horses remained lame, 4 horses returned to previous level of work but needed intrasynovial treatment of the DFTS and reduced competition frequency to remain sound.
Conclusions: Horses presented with chronic inflamed DFTS and/or ALCS might sufferfrom LTs in the DDFT; however, the diagnosis cannot be established with absolute certainty using only ultrasonography. Longitudinal tears should be suspected if ultrasonographic changes are present lateral or medial to the border of the DDFT but tenoscopical examination of the tendon sheath is essential to establish an accurate diagnosis and an effective treatment.
Potential relevance: The presence of these LTs might explain why some cases of chronic tenosynovitis of the digital flexor tendon sheath and/or ALCS do not respond on surgical transection of the PAL alone without tenoscopy.
Performing a lateral buccotomy is a justified treatment alternative for the surgical removal of equine CT following unsuccessful attempts by standing oral extraction, offering advantages over alternatives such as retropulsion, endodontic therapy and periapical curettage.
The efficient and fast isolation of microorganisms from infected SF by the BACTEC system allows for rapid susceptibility testing and a more appropriate antibiotic treatment.
Six of eight horses with caecocolic intussusception were treated successfully by jejuno- or ileocolostomy. The other two horses were euthanased during surgery. Four of the six horses survived long term, but two died within two-and-a-half months, of problems related to the surgery. Compared with other techniques for treating caecocolic intussusception, jejuno- or ileocolostomy reduces surgical time and decreases the risk of abdominal contamination.
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