Objective: To report the outcome of horses used in western performance disciplines after deep branch lateral plantar neurectomy/fasciotomy surgery for hind limb proximal suspensory desmopathy (PSD). Study design: Retrospective analysis. Sample population: Twenty-one client-owned horses. Methods: Medical records were reviewed (2009-2019) for horses involved in western performance disciplines that had been treated with deep branch lateral plantar neurectomy and plantar fasciotomy for lameness due to hind limb PSD. Follow-up was obtained by reexamination and/or verbal interviews with owners >2 years postoperatively. Results: Sixteen quarter horses and five paints were used for western pleasure (14/21), barrel racing (2/21), cutting (1/21), steer wrestling (1/21), working cow horse (1/21), team roping (1/21) and reining (1/21). A median duration of 8 months was required before horses were able to resume training or athletic work. Nine horses were able to return to a similar or higher level of athletic use, nine horses returned to a lower level of athletic performance, and three horses could not return to intended function. Owner satisfaction with outcome after the procedure was high (16/21), average (3/21), and low (2/21). Conclusion: Deep branch lateral plantar neurectomy and plantar fasciotomy allowed most horses to resume some athletic function as western performance horses. Clinical significance: These results provide evidence of potential outcomes when considering surgical treatment of hind limb PSD in western performance horses.
A 45-day-old foal presented for weight bearing lameness. Radiography revealed an abnormal radiolucent line associated with the proximal ulnar carpal bone and a separate curvilinear mineral opacity palmaromedial to the distal radial epiphysis. Computed tomography illustrated a sagittal, biarticular, non-displaced fracture of the ulnar carpal bone with small separate fragments associated with the accessory-ulnar and accessory-radial carpal ligaments. The foal was treated conservatively with rest and adjunct intra-articular hyaluronic acid. The lameness resolved within 90 days. Full range of motion of the carpus returned within 120 days following an active rehabilitation protocol. This report details avulsion of the accessory-carpal ligaments and sagittal fracture of the ulnar carpal bone secondary to presumed hyperextension injury.
BackgroundLocal anaesthetics are being combined clinically with amikacin in intravenous regional limb perfusion (IVRLP), with limited knowledge on the analgesia provided and its onset and duration of action after tourniquet application and release.ObjectiveTo evaluate the systemic clinical effect, limb withdrawal to nociceptive stimulation, and plasma and synovial fluid concentrations after IVRLP with lidocaine or mepivacaine in standing sedated horses.Study designProspective, controlled, randomised, cross‐over study.MethodsSix healthy adult horses were sedated and received IVRLP with lidocaine, mepivacaine or saline (negative control), or perineural anaesthesia of the medial and lateral palmar and palmar metacarpal nerves (positive control) in one forelimb with a 3‐week washout period between trials. Electrical and mechanical stimuli were used to test nociceptive threshold of the limb before and after IVRLP/perineural anaesthesia. For lidocaine and mepivacaine trials, blood was collected from the jugular vein and synovial fluid from the radiocarpal joint before, during and out to 24 hours after IVRLP. Drug concentrations were measured using high‐performance liquid chromatography.ResultsNociceptive thresholds for lidocaine, mepivacaine and perineural anaesthesia trials were significantly increased compared with saline and baseline values at 10, 20 and 30 minutes, with no differences between anaesthetic trials. During this time, horses had lower heart rates than IVRLP with saline. After tourniquet release at 30 minutes, nociceptive thresholds for lidocaine and mepivacaine trials gradually returned to baselines, whereas perineural anaesthesia trial remained unchanged out to an hour. Plasma lidocaine and mepivacaine concentrations were ≤50 ng/mL while the tourniquet was in place, significantly increasing 10 minutes after tourniquet release. Maximal lidocaine and mepivacaine concentrations in synovial fluid were reached 25 minutes after IVRLP injection.Main limitationsAmikacin was not included in the perfusate.ConclusionSimilar to perineural anaesthesia, IVRLP with lidocaine or mepivacaine provides anti‐nociception to the distal limb in standing sedated horses while a tourniquet is applied with concentrations remaining below toxic levels in plasma and synovial fluid.
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