Select Surgical Problems in Miniature Horses

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Select Surgical Problems in Miniature Horses

• Olivia Inoue DVM, MS, DACVS
• Loomis Basin Equine Medical Center

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Angular Limb Deformities

• Viewed from the front/behind
• front leg gtgtgtgt hind legs
• Knees (carpi), fetlocks, hocks
• Decreases performance
• Increase pain
• unmanageable lameness
• passing on poor genetics

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Causes of ALD

• Small mare/large foal
• Genetics
• Poor decreased/nutrition
• Trauma to limb
• Rapid growth phase
• inflammation of growth plates vs abnormality
• Developmental
• growth plate deformities
• UNKNOWN

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Types of ALD

• Valgus - toed out - splayed out
• knees - primary location
• fetlock
• hocks
• Varus - toed in - pigeon toed
• fetlocks
• carpi/hocks less common

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LTgtgtgtgtRT Valgus
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Knock kneed Carpal Valgus
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Left Front Fetlock Varus
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Tarsal Valgus - cow hocked
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Sources of ALD

• Weak supporting structures
• common
• Growth plate abnormalities
• Incompletely formed cuboidal bone
• immaturity/dysmaturity
• Complete ulna/fibula

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Diagnosis of ALD

• Visual inspection
• firm ground
• Palpation
• straighten?
• Radiographs
• bone development
• growth plate changes

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Diagnosis of Weakness/Laxity

• Must be able to manipulate limb to straight
• Normal radiographs

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Diagnosis of ALD
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Incompletely formed cuboidal bones - hock
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Treatment for ALD

• Stall rest
• controlled walks 1-2 x a day
• FARRIER
• Splints
• Casts
• Surgery

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Hoof Care - ALL ALD Foals

• Trim toes so less pointed
• Trim slow growing side (Outside of valgus joint)
• 1 - 2 x week rasp
• 2 - 3 weeks
• Decrease fast growing side
• Acrylic - inside of valgus joint - lengthen
• pre-made shoe
• If not better consider surgery

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Management of soft bone and/or weakness

• Farrier with stall rest
• Casts
• Splints
• Foot not incorporated
• Twice daily checking
• Changed/managed carefully

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Glue on Shoe for ALD
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Surgical Options for ALD

• Increase the slow growing side
• periosteal stripping
• Decrease the fast growing side
• staples
• screws /wires
• plates

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Periosteal Stripping

• Slow growing side
• Short acting general anesthesia
• bandage changes
• suture removal
• Good cosmetics
• Can be repeated

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Periosteal strip and rongeur of intact ulna
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Slowing Rapid Growth Transphyseal Bridging

• Staples
• easiest
• customized
• Screw(s) /- wires
• wires can cause pain and swelling
• Bone plates

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Radial Physeal Staples
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Physeal screws and wires on fast/rapid growth
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Transphyseal Bridging

• Periosteal Strip
• slow growing side at time of placement of
  hardware
• Stall rest
• Farrier
• trimming w/ or w/o acrylic

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Slowing Rapid Growth -transphyseal bridging

• Results can be initially slower - slower side to
  catch up
• Once leg straight steel must be removed
• second surgical procedure
• Overcorrection

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Timing of treatment

• Fetlocks - urgent due to early closure of growth
  plates
• begin therapy during first month
• Carpi and hocks - slower growing
• 4-6 months most rapid growth
• growth plates close at 8 months

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ALD Review

• Document changes
• digital pictures
• Farrier
• /- acrylic
• Stall rest
• Surgery
• NOT All ALDs Fixable!

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Dystocia

• Difficult delivery
• more common in smaller breeds
• Ponies
• Miniatures

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Dystocia

• Abnormal fetal posture
• most common
• Long extremities/neck
• Malpositioning
• breech etc
• Deformities of foal
• legs/back/head

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Dystocias

• Small mare
• internally/externally
• Caslicks not opened
• Foal- active participant
• weak or dead foal does not participate
• Septic/twins

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3 Stages of Foaling

• 1 - restlessness
• 3 - 4 hours
• nesting/colic
• 2 - water breaks
• delivery of foal
• less than 20 minutes
• 3 - passage of placenta

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Stage 1 or ...
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Management of Dystocia

• Resolved at the farm by experienced personnel
• if not
• Referral hospital
• equipment
• personnel
• CVD, fetotomy, C-section
• neonatal resuscitation care

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Management of Dystocia

• Assess problem
• foal dead
• Emphasis on mare
• Health
• reproductive future

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Management of Dystocia

• Foal alive
• emphasis on mare and foal
• no single management scheme
• Individual plan for each situation
• Assisted delivery
• Controlled delivery
• C-section

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Management of Dystocia

• Manually correct position
• care repositioning foal
• Tear/rupture uterus
• Assisted vaginal delivery (AVD)
• awake standing mare
• Vaginal delivery
• intact foal

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Management of Dystocia

• Controlled vaginal delivery (CVD)
• mare anesthetized
• Hind quarters elevated
• veterinarian delivers foal
• Dead foal
• fetotomy
• Dead foal removed in pieces

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Management Dystocia

• CVD
• preparing mare for C-section
• 20-30 minutes of CVD attempts
• longer decreases mares chances for post-operative
  C-section survival

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Management of Dystocia

• Cesarean section
• general anesthesia
• fetus is removed through an incision in the
  uterus
• Bleeding
• placenta still needs to be passed

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Management of Dystocia

• Changing strategies
• best method for given situation
• There is no one procedure that is right for every
  situation

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Management of Dystocia

• Owners
• breeding dates
• foaling history
• vaccine status
• horse insurance info
• your plan
• clip mare before due date

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Controlled Vaginal Delivery
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Cesarian
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Life After A C-section

• Mares can be re-bred 60 days post C-section
• A.I. vs live cover
• Monitor for recurrence of dystocia

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