A case study of surgical wiring of an lower jaw fracture

Rehabilitation and return to performance after colic surgery, written by Dr. Crystal Lee for the Canadian Horse Journal.

Colic is a general term referring to any sort of problem with the horse’s gastrointestinal tract. In the majority of cases, horses with signs of colic will resolve with just medical treatment. However, in some cases, emergency surgery is required to correct the twist or entrapment of the intestines.

An enucleation is the surgical removal of a horse's eye. There are many indications for which this surgery would be performed, including trauma, neoplasia (cancer), extensive infection, or any condition causing pain in a blind eye. In Misty's case, the procedure was recommended due to an acute worsening of uveitis and ulceration along with equine recurrent uveitis flare-ups that had been occurring over the last four years.

Sarcoids are the most common tumour that occurs in horses. They are locally invasive, and difficult to deal with because recurrence is common even with aggressive therapy. One study showed that 14% of sarcoids occur exclusively in the periocular region (near the eye), and these tumours can be particularly tricky to deal with as it is difficult to get good margins to remove all tumour cells during surgical excision.

Sugar sustained a major laceration to the front of her carpus during the big snowstorm we had in September 2014. Even though her owner found it the day it happened, there was already a large amount of swelling present as well as a large amount of dirt and contamination in the wound. Initial treatment included intravenous regional limb perfusions with antibiotics, intravenous antibiotics, and bandaging. Because of the large amount of motion present on the front of the carpus, we ultimately decided to use pinch grafts in this wound. Pinch grafts are small 3mm discs of skin, harvested by removing an elevated cone of skin, that are implanted into small slits in the granulation tissue.

In horses, the third eyelid is prone to developing squamous cell carcinoma. Squamous cell carcinoma is the second most common tumour in horses, and it is the most common tumour in the equine eye. It develops most commonly on areas lacking pigmentation, poorly haired regions, and skin near mucocutaneous junctions. It can be quite an aggressive tumour, spreading to nearby tissues and local lymph nodes. In the third eyelid, it often initially appears as a reddened area, then becoming raised and in some cases developing a wart-like appearance. In most other areas, recurrence is extremely common unless surgical excision is combined with another treatment such as chemotherapy or cryotherapy. Fortunately, the third eyelid can be removed in its entirety, and a success rate of 90% has been reported with removal alone.