Arthroscopic treatment of meniscal cysts in the horse

REASONS FOR PERFORMING STUDY

To describe the clinical symptoms, treatment, and outcome of meniscal cysts in horses. These structures have not been previously described in the literature as a potential cause of lameness in the horse.

HYPOTHESIS

Meniscal cysts are an uncommon condition of the femorotibial joint but can be a significant cause of lameness. Symptoms can be resolved by arthroscopic excision.

METHODS

Records of horses diagnosed with meniscal cysts and treated by cyst excision and meniscal debridement at 2 surgical practices were reviewed. Clinical outcome was determined by repeat veterinary examination and contact with owner.

RESULTS

Seven cases of meniscal cyst were treated with arthroscopic cyst excision and meniscal debridement. Five of 7 horses had lameness attributable to femorotibial joint pathology, while the remaining 2 horses had meniscal cysts found incidentally during diagnostic arthroscopy for the treatment of osteochondritis dissecans of the lateral trochlear ridge of the femur. Five of 6 horses with long-term follow-up were sound and a 7th horse was improved 11 months after surgery.

CONCLUSIONS AND POTENTIAL RELEVANCE

Meniscal cysts, while uncommon, can be associated with progressive lameness in the horse. Surgical excision of the cysts results in resolution or improvement of symptoms, without evidence of recurrence on follow-up examination.

Laparoscopic Hernioplasty in Recumbent Horses Using Transposition of a Peritoneal Flap

OBJECTIVE

To evaluate the efficacy of a laparoscopic peritoneal flap hernioplasty (PFH) to close anatomically the vaginal ring and to evaluate its protective effect in horses with a history of strangulated inguinal hernia (SIH) against future herniation.

STUDY DESIGN

Prospective study.

ANIMALS

A first group of 5 ponies, 3 horses and 1 donkey with no history of SIH and a second group of 4 horses 'clinical cases' with a history of SIH.

METHODS

A laparoscopic PFH was effected on all horses under general anaesthesia. Peritoneum ventro-lateral to the vaginal ring was elevated and cut on 3 sides, separated from the underlying muscle, then inverted and attached dorso-medially and laterally to the parietal wall using intra-corporeal stitches (6 cases) or laparoscopic staples (7 cases). Animals of the first group (n=9) underwent a standing laparoscopy 7 days post-operatively to visualize the vaginal rings. Horses of the second group were followed to confirm the absence of re-herniation.

RESULTS

The laparoscopic check-up showed that the vaginal ring had been effectively and completely covered in all cases except the first one. No adhesions was observed. In the four clinical cases, none of the horses have had a reccurence of SIH at the time of writing (6 months to 4 years).

CONCLUSION

Laparoscopic hernioplasty on a recumbent horse is feasible by closing the vaginal ring with a peritoneal flap. This technique was efficient in our cases to prevent recurrence of SIH but more cases are needed. This technique may reduce inflammation and irritation of the spermatic cord, which could otherwise jeopardise the animal's breeding career.

CLINICAL RELEVANCE

Laparoscopic PFH coud be used in horses with a history of SIH.

Review of 115 cases of colic in the pregnant mare

The medical records of pregnant mares over a 3-year period were reviewed. In all cases persistent pain or progressive abdominal distension were the main reason for referral. The overall survival rate for the 115 mares treated for colic was 73.9% (85 cases). The abortion rate was 20.5% in surgical patients (34 cases), 40% (5 cases) for mares with uterine torsions and 10.8% (46 cases) after medical treatment. The total abortion rate was 16.4%. Clinical evidence of endotoxaemia was, except for 1 mare, present in all the aborting mares after colic treatment. Anaesthesia did not appear to be a problem because abortion occurred in 5/46 medically treated cases as well as in 9/39 mares treated surgically. Abortion occurred in 3 mares that suffered intraoperative hypoxia, but fasting for > 30 h did not seem to cause prolonged hypoglycaemia and subsequent abortion. Clenbuterol hydrochloride was used as a tocolytic agent in 9 mares with uterine displacement, abortus imminens and post-operative uterine torsion and 3 mares aborted during treatment.