IBKV 2 UAS

EQUINE DENTISTRY
Sings & Symptoms

• Dental disease (broken teeth, irregular dental arcades) = common underlying cause of thriftiness, loss of
condition / poor breeding / nursing performance
• Classic signs = difficulty / slowness in feeding & reluctance to drink cold water
• Stop for few moment & start again during chewing process
• Head held one side if in pain
• Horse may quid e.g.: pick up its food, form it into a bolus but drop the bolus from the mouth after partially
chewed.
• Semi-chewed mass of feed packed between the teeth and the cheek.
• Bolt its food and subsequently suffer indigestion, choke, or coli → avoid using painful tooth / sore mouth
• Lack of desire to eat hard grain & uncrushed grain in the feces
• Excessive salivation & blood-tinged mucus in the mouth + the fetid breath of dental decay
• Extensive dental decay + periostitis & root abscessation → empyema of the paranasal sinuses &
intermittent unilateral nasal discharge
• Facial / mandibular swelling & development of mandibular fistulas from apical infections of the lower cheek
teeth

TRIADAN CLASSIFICATION OF EQUINE TEETH

1 – 3: Incisors
4: Canine (only male)
5: Wolf (premolar)
6 – 8: Premolars
9 – 11: Molars

ANATOMY OF EQUINE PERMANENT INCISOR (AGE)

BY ANNA
IBKV 2 UAS
HEAD & NECK SURGERY

Surgery of Eyes
Nasolacrimal obs

Def: partial / complete obs of nasolacrimal duct occur after inflammatory, neoplastic trauma process

Cause

Internal External
• Dacryocystitis • Trauma
• Foreign bodies • Neoplasia
• Neoplasia (SCC, sarcoid) • Disease of maxillary dental arcade
• Parasitic granuloma (habronemiasis) • Sinusitis

Clinical sign: Epiphora & Mucopurulent discharge Postoperative care: bac culture & AB after catheter
removal
Diagnosis: careful examination
Complication
▪ Dysgenesis tech: fluorescein stain, normagrade
cannulation of duct, dacryocystorhinography ▪ Congenital ostium malformation / scarring of
nasolacrimal duct / puncta
Treatment & Prognosis: Catheterization & Antibiotic ▪ Corneal ulceration
(AB) & Anti-inflammatory (AI)

Ectero / Entropion
Def: inward rolling of eyelid margin Clinical sign
Ectropion: Eyelash
Cause: ▪ Involve lower eyelid outward → dry up of
▪ Excessive tearing tears
Congenital Acquired ▪ Blepharospasm
• Breed • Dehydration ▪ Conjunctivitis & keratitis Entropion: eyelash
predisposition• Septicemia inward, poke eyeball,
• Malnutrition Postoperative care: eye cup irritate eyes, tears
Treatment: Surgery – temporary eyelid tacking / hotz
celsus blepharoplasty | shave excess eyelash Complication: Corneal irritation & Ectropion

Enucleation
Def: removal of eyeball from eye orbit 1. Simple suture or continuous suture on the eyelid
2. Transpalpebral incision 1 cm from the edge of
Cause: the eyelid, around the orbit.
▪ Ruptured globes ▪ Panophthalmitis 3. 360 ° dissection around the orbit
▪ Intraocular neoplasia ▪ Chronic uveitis / 4. All muscles, adipose tissue, lacrimal glands, and
/ eyelid neoplasia: glaucoma the fascia is removed, along with the eyelid and
squamous cell eyeball.
carcinoma (SCC) of 5. If neoplasia, ensure all neoplastic tissue is
3rd eyelid removed.
6. If non-neoplastic condition, some tissue of the
Postop care: retrobulbar can be left out ⇒ reduce the amount
▪ Eye cup for 1 week preventing self-trauma of dead space and bleeding intraoperative.
7. The optic artery can be tied; / control bleeding by
▪ Medications: nonsteroidal AI drugs from 3 – 7
tight skin closure & pressure => impossible to
days ⇒ min associated discomfort & edema
obliterated when filled with blood in dead space.
▪ Suture removal: approx. 14 D
8. The cavity that is filled with blood clots will
Complications: Periorbital swelling & Orbital cysts / disappear during the healing process
mucoceles 9. Closing: interlocking pattern / simple suture
using nonabsorbent
Procedure: 10. Stitches are removed 2–3 weeks postoperatively.

BY ANNA
IBKV 2 UAS
Upper Alimentary System Surgery
Mandibular Fractures
Cause: DDx Other

▪ Trauma / Collision ▪ Esophageal obs | Botulism ▪ Diet

▪ Falls / Biting injuries ▪ Retropharyngeal masses ▪ Mouth rinsing
▪ Kicks by other horse ▪ Severe dental disease ▪ X grazing for 2 – 4 weeks
▪ Stick-&-ball trauma in polo ▪ Neurologic conditions ▪ Checked of wire everyday
▪ Self-induce trauma when ▪ Soft-tis trauma of oral cav
free from trapping in muzzle ▪ Dental disease common Complication
Clinical signs cause of focal vent ▪ Purulent drainage
mandibular swelling ▪ Bone sequestration
▪ External wound
Treatment ▪ Septic osteitis
▪ Sudden facial & mandibular
▪ Difficult mastication
swelling
▪ Remove loose bone ▪ Unusual incisor eruption
▪ Inability to close mouth
fragments & debridement of ▪ Wire loosening
▪ Failure of effective
gross contamination ▪ Fixation failure
prehension of ingesta
▪ Broad-spectrum AB
▪ Small fractures often no sign Management
▪ Intraoral wire
▪ Saliva drooling
Wiring of incision ▪ Minor injuries heal
▪ Caudally cause ptyalism,
Tension-band wiring to spontaneously
dysphagia
cheek teeth ▪ Cerclage wires
▪ Chronic: halitosis as food
Acrylic reinforcement of ▪ U-shaped
impacted
intraoral wiring ▪ Frames held by wires around
▪ Cavitation of dorsal skull
▪ U-Bar braces teeth
▪ SQ emphysema as air in
▪ Intramedullary Pins ▪ X grazing until complete
nasal cavities / sinuses
▪ Screw & plates healing
▪ Displaced incisors /
▪ External fixators ▪ Removal of implant on
laceration of rostral gingiva
Postop care: Broad-spectrum AB (3 standing patient after healing
Diagnosis: Radiographic
– 5 D) | Xsteroidal AI drugs (1 – 3 D) (6 – 8 weeks)
investigation

Teeth Repulsion
Indication
▪ Rlt deciduous teeth
▪ Interventional orthodontics
▪ Severe periodontal disease
▪ Loose teeth supernumerary teeth
▪ Dental impactions | Malocclusions & neoplasia
▪ Odontic disease w 2’ osteomyelitis
▪ Severe disease / injury to the dental crown / root
▪ Occlusal trauma & biting discomfort
▪ Sinus disease 2’ to dental disease
Clinical sign
▪ Presence of head tilt while eating
▪ Nasal discharge, sinusitis
▪ Headshaking, facial pain, ptyalism
▪ Anorexia / pica
▪ Facial swelling / distortion
▪ Weight loss, diarrhea, colic, reluctance to eat,
slow / intermittent eating, diff in prehension,
choke & epistaxis
Diagnosis: PE & dental radiography
Treatment: dental extract → gen anes | affected top
position tooth | oral speculum ⇒ widen mouth
Postop care
▪ Exercise restriction: stall rest 2 weeks w
controlled hand walking only
▪ Medication: broad-spectrum AB (3 – 5 D).
Infection: AB + Xsteroidal AI drug (1 – 2 D)
▪ Lavage mouth & clean surgery site daily. Acrylic
plug / dental wax ⇒ self-expelled / removed w/in
30 D | Clean wound until granulation
Complication
▪ Hemorrhage | Wrong tooth removed
▪ Damaged to adjacent structure of tooth being
removed | Infected tooth root socket
▪ Wound dehiscence / persistent drainage
resulting formation of fistula
▪ Incomplete removal | Foreign body in wound
▪ Bone sequestrum | Packing breakdown
▪ Mucous membrane healing prior to wound
granulation

BY ANNA
IBKV 2 UAS
Sinusitis
Def: inflammation of sinus Cause: stagnation of mucus on sinus cavities thru
inhabited dynamic clearance
Acute: sinusitis serosa acute 1’ 2’
Chronica: sinusitis chronica purulenta Upper resp infection Periapical abscess
Inflammation due to cold, Dehorning → not heal,
Symptoms strangle， malleus cause encephalitis
Metastase
▪ Lethargy, no appetite Trauma
▪ Head tilt to pain site Clinical sign: nasal discharge & facial swelling & obs
▪ Discharge from nostril (unilat / bilat) dyspnea
▪ Sinus area: sensitive & swollen Common: 5 paired sinuses:
▪ Advance into fistula / alveolitis (rlt to molar) ▪ Sinus maxillaris ▪ Frontal / concho
▪ Acute: high temp & long lasting major et minor frontal
▪ Sinusitis sphenoidalis: around base of brain → otitis ▪ Sinus frontalis ▪ Caudal maxillary
sphenoidalis ▪ Sinus chonco- ▪ Rostral maxillary
▪ Suffer from encephalitis (critical) frontalis ▪ Ethmoidal
▪ Sinus sphenoidalis ▪ Sphenopalatine
Prognosis: dubius
Diagnosis
PE  Facial area inspects for deformity of supporting bones thru swelling / trauma
 SQ emphysema detected after trauma in cases where sinus walls been disrupted
 Paranasal sinuses wall percussion = unreliable
 ↑ resonance: wall thin / dullness = filled w fluid / soft tis
 Airflow at each nostril should be checked to assess obs of nasal meati
 Clinical crowns checking for fracture, displacement/impaction of degenerated ingesta
 Patency of nasolacrimal duct by catheterization & infusion of saline sol from either end
Radiograph  Free fluid interfaces in the sinuses
 Loss of normal air contrast thru substitution by fluid or soft tissue
 Depression / elevation of supporting bones of the face
 Distortion of normal structure e.g.: tooth roots, sinus wall, midline septum & infra-orbital canals
Treatment

▪ Medical: non-surgical treatment i.e.: AB, mucolytics, steam inhalation, volatile inhalation & continued
controlled exercise
▪ Systemic AB
▪ Surgical treatment: sinus trephination & fascial flap surgery

Trephination sinus maxillaris major et minor Facial flap surgery

 Trephination portal (TP) for frontal sinus: 3
– 4 cm caudal to most rostral aspect of
frontal sinus & 3 – 4 cm lat to midline
 TP for caudal maxillary sinus: 1 – 2 cm
dorsal to facial crest & 7 – 8 cm caudal to
most rostral aspect of facial crest
 TP for cranial maxillary sinus: 1 – 2 cm
dorsal to facial crest & 3 – 4 cm caudal to
facial tubercle
Sinus trephination = trephination to access
for dental repulsion
 Skin incision & periosteum in same plane b4
periosteum peeled away from underlying bone
 Bone flap w 5 cm diameter trephine (oscillating
saw), osteotomy at least 1 cm inside the
skin/periosteum incision ⇒ repair support by
bone
 Contents exposed, focus = identified &
removed
 Closure of incision achieved w single layer
mattress sutures, but accurate alignment for
cosmetic result in horse w natural facial
markings

Postop care Complication

▪ Sinus irrigation: portals remain open for 10 – ▪ Hemorrhage

12 D ⇒ allow repeated irrigation / entrance ▪ Addition: oronasal fistula formation, bone
▪ Cleaning site at least daily w moistened gauze sequestration, hemorrhage, & death
sponges depending on structured penetrated
BY ANNA
IBKV 2 UAS
Laryngeal Hemiplegia [hemipleghia laryngitis]
▪ Commonly: left-sided laryngeal hemiplegia /
hemiparesis
▪ Recurrent laryngeal neuropathy: progressive
loss of large, myelinated nerve
Cause: unknown, idiopathic
▪ Specific:
o Accidental perivascular inj of irritant
chemicals around jugular vein
o Mediastinal mass
o Guttural pouch / lead poisoning but
commonly as idiopathic form
Occurrence
▪ Large male horse, sometimes in female &
small horse / ponies
▪ Occur @ right side in small proportions →
accompanied brachial arch anomaly
▪ Bilateral paralysis ⇒ extremely rare
▪ Highest in young horses & common in
Thoroughbred yearling @ sale time, b4 started
training / 2- & 3- y/o for racing / in racing
training
▪ Complete idiopathic laryngeal hemiplegia =
2.75%
Tracheotomy
Indication: emergency airway → upper airway obs /
relieve nasal / laryngeal inflammation
Clinical sign: dyspnea – apnea & inspiratory &
expiratory stridor
Diagnosis
▪ PE <cough / resentment during tracheal
palpation & irregularity of 1 / more rings>
▪ Lat radiograph
▪ Endoscopic ex ⇒ ascertain size & shape of
lesion & determine airway diameter
▪ Computed tomography ⇒ evaluate trachea for
extraluminal & intraluminal obs
Postop care
Tracheotomy tube management
 Continuous mon & management
 Tubes & surrounding skin cleaned at least
daily
 Avoid scrubbing of tracheotomy site
 Exudate & blood clots remove w dry, sterile
sponge, & clean the skin surrounding the
site
 Extra tubes must be immediately available
Clinical sign
▪ Inspiratory musical ‘whistle’ / ‘roar’ in severe
cases
▪ Exercise = dyspnea | gentle palpation of larynx
= fremitus
▪ Obvious atrophy of left dorsal cricoarytenoid
muscle & on careful palpation ⇒ left arytenoid
Treatment
▪ Surgical: enlarge reduced laryngeal lumen
▪ Traditional: left ventriculectomy w / w/o
cordectomy by cricothyroid laryngotomy
▪ Ventriculectomy + laryngoplasty (tieback
procedure) ⇒ collapsed left larynx fixed in
abduction by insertion of retrolaryngeal sutures
Surgical
▪ Laryngoplasty: placement of prothesis (suture)
btw cricoid & arytenoid cartilages
▪ Ventriculectomy (sacculectomy) unilat / bilat:
removal of crescent-shaped wedge of tis from
leading edge of vocal fold
Medication: broad-spectrum AB & non-steroidal
AI agents x necessary unless for underlying
problem
Other:
 Allow wound to heal by 2nd intention w daily
cleaning after removal
 Cleaning of wound during closure at least
once daily / as needed w moistened gauze
sponges
 Petroleum ⇒ scalding from anticipated
drainage
 Healing gen 2 – 3 weeks
Procedure
▪ 6 – 8 cm ventral midline incision on upper &
middle 3rd of neck ⇒ trachea easily palpable
▪ SQ tis incised & paired sternothyrohyoideus
muscle separated on midline
▪ 2 tracheal rings incision center & transverse
stab bet 2 rings
▪ Stab incision must completely penetrate the
tracheal mucosa. Shallow stab incision →
separation of mucosa from tracheal ring & ↑
bleeding & granuloma formation
▪ Annular lig incised from midline 1 – 2 cm in
both direction then place tracheotomy tube
BY ANNA
IBKV 2 UAS
Head Region
Dehorning
▪ Cornuectomy
▪ Disbudding: claves, lamb: 1st week
▪ Dehorning: adult cow w embryotomy wire,
saw/guillotine shears. | Lamb: major surgery, not
for cosmetic
Purpose: prevent dangers, avoid stabbing head
Methods
▪ Guillotine shears: horn cutting
▪ Rubber bonding
▪ Burning / disbudding: burning the horns
▪ Horn saw:
Postop care
▪ Oxytetracycline spray
▪ Parenteral AB
▪ NSAID
▪ Bandaging every 2 D
Poll Evil [Bursitis Atlantis = Fistulous Withers – Bursitis Supraspinosus]
Def: Inflammation of bursa atlantis / bursa
supraspinosus → injuries causing necrosis in deep tis
Characteristics: Acute / chronic, in the form of:
Aseptic, infected / proliferated
Cause
▪ Wound & infection in neck region ⇒ abscess
formed
▪ Transmission of brucellosis (B. abortus &
B.suis)
▪ Actinomycosis bovis
Prognosis
▪ Early stage → good
▪ Hard to remove necrotize area
▪ Avoid infection: aseptic & acute
Paralysis Nervus Facialis
▪ N, facialis: auricular, palpebral, buccal
▪ Common in horse, none in cattle
▪ Norm: bilat / unilat
▪ Peripebral, intratemporal / medullary / cerebral
Cause
▪ Traumatic: contusion / wound + nerve damage
▪ Toxic: infectious disease, mis. influenza equii,
strangles
▪ Physical / rheumatoid: cold whether
▪ Tumor: parotis gl → pressured nervus facialis
▪ Inflammation: perbarahan from parotid ducts &
pressured by bridle
Complication
▪ Hemorrhage: intra & post-surgery
▪ Infections: sinusitis, encephalitis
▪ Fight trauma: head butting
▪ Myasis
▪ Regeneration of horn: avoid amputation <1 cm>
of skin around the base of the horn
Controlling hemorrhagic
▪ Hot irons: reduce pain ⇒ destroy nerve end
▪ Tourniquet of string around crown of head & tied
bet horns, fairly effective but has disadvantage
that certain amount oh horn needs to be left to
tie the tourniquet & this must be removed in 24H
▪ Ligature corneal artery – runs ventral to horn,
carried out if horn has been removed w wide
margin of skin
▪ Blocking arteries as emerge from corneal bone
w matchsticks
Symptoms
▪ Swelling & pain @ neck (os vert C1 & 2)
▪ Lig nuchae strain → outstretch of head
▪ Fluid / pus discharge
▪ Osteomyelitis if sero+ brucella
Treatment
▪ Irrigation & curation, H2O2
▪ Cold / warm compress
▪ Streptomycin inj, sulphate prep, rifampicin /
oxytetracycline
▪ Radical ops (mild), usually satisfactory exp
neurological manifestation
Symptoms
▪ Drooping of ears & lips on lesion side
▪ Areflexia of muscle of facial expression
▪ Expose keratitis & cornel ulcer (Lagophthalmos)
▪ Bila facial paralysis & severe dysphagia
▪ Chronic paralysis, facial muscle atrophy & hemi-
spasm (grimacing)
▪ Unilat → lips pulled towards healthy side | Bilat
→ hanging of lower lips
▪ Hard to drink, mouth fold towards commissure
(alae nasi)
▪ Nostril (nares) constriction | Resp: rest (calm),
exercise (rapid/nervous)
BY ANNA
IBKV 2 UAS
Papillomatosis [Warts]
DNA papovavirus: equine papillomaviruses Prognosis: Fausta – dubius

2 distinct clinical form: viral papillomatosis & aural ▪ Sometimes spontaneous immunity
papilloma (aural plaques) ▪ Become carrier depending on disease duration

Symptoms Treatment

▪ Shape: cauliflower, papillae, large/small ▪ Spontaneous cure | Cosmetic surgery

▪ Occurrence @ head, neck, shoulder body &
mammary
▪ Predominantly restricted to young horse 9 – 36
Mo, occasional affect >25 y/o horse
▪ Aural plaques on internal surface of ear
▪ Local: papilloma binding, excision part
▪ Smeared: tinct. Yodii 10%
▪ R/ Procaine adrenalin 2 %: constrict bv
▪ Vaccination: autovaccine

Carries Dentum [Tatar]

Decalcification of tooth tis → carb breakdown by bac Symptoms
characterized by semineralization if inorganic tis &
destruction of dental organic tis ▪ Open mouth → careful observation
▪ Pain, swells, heat
Damage starts from enamel, thendental cement to dental ▪ Red gingiva & swelling | Hypersalivation
pulp (pain → presence of nerve) ▪ Teeth pulp → damage

Cause Prognosis: depending on affected indi

▪ Acidification of bac: low pH → damage enamel Treatment

▪ Malnutrition → lack of minerals
▪ Bone disease (Rachitis)
▪ Alveolitis
▪ Small animals: soft feed, no bones
▪ Teeth extraction: pain (must)
▪ Anesthetic local @ extraction site
▪ ATS inj | Trephination
▪ Blocked anesthesia: Lidocaine

Sharp Teeth
▪ Common in young horse & pigs Symptoms: mastication, digestion disorder, diarrhea
▪ Birth defects, affect 1 – 4% → common cause of
stillborn neonates ▪ Foals  loud resp noise & exercise intolerance
▪ Unilat expiration
Molar (horse): ▪ Nasopharynx observe through 1 nostril
▪ Mastication disorder:
▪ Top molar: downwards, outwards  Imperfect rumination
▪ Base molar: inwards, upwards  Imperfect mastication, part of feed drops
Cause: on ground
 Outer & inner edges w sharp edges
▪ Bad chewing / bad food grinding  Lower molar inner tip: scratch / cut
▪ Failure of perforation of bucconasal memb @ tongue
choanae / posterior nares  Upper molar outer edge: scratch / cut
check
Treatment
 Injury of both checks, & tongue
▪ Floating → smooth out teeth ▪ Decrease of body condition
▪ Feed correction ▪ Sometime diarrhea
▪ Bilat neonatal: ops cito, tracheotomy
DDx: malleus → smelly
▪ Unilat: ~ 1 y/o ops, frontonasal bone flap
Prognosis: dubis
Diagnose: endoscope, contract radiograph

BY ANNA
IBKV 2 UAS
Glossitis [Tongue Inflammation]
▪ Acute / chronic | Superficial / profundal

Acute Chronic (Elacrophelgia)

cause ▪ Wound ▪ Advance from acute
▪ FMD, Horse-pox, Black quarter ▪ Foreign body
▪ Spread from surrounding ‘perbarahan’ ▪ Actinomycosis
▪ Tuberculosis
Symptoms ▪ Swollen tongue 2 – 4x than norm ▪ Tongue swollen over time & cause
▪ Protruded from mouth → salivation hardening
▪ Palatum mole (soft) pushed upwards & ▪ Pain, difficulty in eating & breathing
backwards
▪ Enzootis
▪ Gangrene → on tongue
Treatment ▪ Sacrifice tongue from midline ▪ Hard to heal / cure
▪ Irrigation with antiseptic (mouth rinse) ▪ Treat infectious disease first
▪ Prevent: tongue protrusion
▪ Treat the specific disease first

Tongue Paralysis [Glosoplegia]

▪ Periphery / central Symptoms
▪ Central: meningitis / Hydrocephalus / Brain
lesion ▪ Unilat tongue paralysis (monoplegia) → pulled
▪ First occurrence: Glossopharyngeal paralysis towards healthy side of tongue
▪ Monoplegia: tongue atrophy over time
Cause: ▪ Bilat tongue paralysis (diplegia) → hanging
outside
▪ Infectious disease: influenza equi , contagious
pleuro-pneumonia, meningitis, botulism, Prognosis
encephalomyelitis, leucoencephalomalacia,
equine protozoal encephalomyelitis & cerebral ▪ Infectious disease treated accordingly
abscessation ▪ Traumatic: depends on damaged nerve
▪ Rabies, distemper dog ▪ Monoplegia: tongue still functioning
▪ Traumatic: wound, excessive traction ▪ Diplegia: not functioning tongue
▪ Any condition that damages the hypoglossal Treatment
nerve (cranial nerve XII)
▪ Treat according to paralysis
▪ Given antiseptic: potassium iodine,
chlorhexidine
▪ Not cure/heal → cut off

Fractures Os Hyoid
Cause: kicked / horned, rough handling Prognosis

Symptoms ▪ Dubius – Infausta

▪ Swollen surrounding tis
▪ Excessive salivation
▪ Difficulty in eating, especially swallowing
▪ Accumulation of food in mouth
▪ Swollen throat
▪ Bleeding from laceration of a. hypoglossal
▪ Crepitation of tongue when moving
▪ Hard to cure → cut off
Treatment
▪ Incomplete fracture → semi fluid feed
▪ Complete fracture → removal of fracture bone
▪ Feeding by stomach tube

BY ANNA
IBKV 2 UAS
ABDOMEN REGION

Perineal Reproduction Abdomen

Anus prolapse Male: penis, scrotum Hernia umbilicalis Hernia scrotalis
Vagina prolapse Female: vulva, vagina, Hernia inguinalis Hernia diaphragm
ovarium, uterus Hernia perianalis Fistula
Omphalitis
Tractus Digestive tract Reproductive organ
Urinary tract Rectal prolapse Crypthochid Vaginal prolapse
Atresia ani Phimosis / paraphimosis C-section
Fistula

Umbilical
1. Infection (SQ abscess / disease w/in umbilical remnants)
2. Herniation (non-strangulating / strangulating) {Strangulation = emergency due to loss of blood supply}
3. Combination of infection & herniation = primary problem associated w umbilicus in calves
*Usually cause enlargement of umbilicus*

Herniation in farm animals

Horse Cattle

▪ Umbilical hernia, 0.5 – 2.0% ▪ Umbilical hernia = most common bovine

▪ Congenital & heredity congenital defect & can occur in any breed,
▪ Fail to close the umbilical ring > 4D (normally although appear to be most common in
w/in 4D) Holstein-Friesian cattle

Herniorrhaphy = closure of hernia ring / umbilical hernia

Omphalitis
Def: umbilical infection Treatment:

Cause: unlege artis / unsterile handling of wound ▪ Irrigation, curette, sterilization

▪ Maintain the hygiene in umbilical area after birth
Symptoms: swells, redness, necrotize

Umbilical hernia
Def: abnormal protrusion of part of the organ in a location ➢ Seeded with bac from generalized septicemia /
that is not where it belongs with the formation of a ring bacteremia
around it ➢ Most common bovine congenital defect & can occur
in any breed, most common in HF
Cause: imperfect closure of umbilicus, infection ➢ Often classified as uncomplicated vs complicated,
Normally regress after birth & developed into: depending on existence of 2’ infection

1. Urachus → vestigial part of bladder apex Category in cattle

2. Umbilical vein → round lig of liver
3. Paired umbilical arteries → lat lig of bladder
➢ Umbilical mass ≠ umbilical hernia
➢ Infection of umbilicus / umbilical cord remnant
occurs in neonatal period as result of environmental
contamination
Umbilical: abscess / mass / hernia
1. Uncomplicated umbilical hernia
2. Umbilical hernia w SQ infection / abscesses
3. Umbilical hernias w umbilical remnant infection
4. Umbilical abscesses / chronic omphalitis
5. Urachal cysts / ruptures

▪ Similar to calves w hernia as enlargement of umbilicus

▪ Viusual inspection: evaluate size, shape, color & presence of drainage
▪ Palpation: consistency, temp & presence pain shud be performed => consistency w intestine = soft,
infected / inflammation = hard
▪ Complete / incomplete hernial ring & reducibility of the content w/in the mass
▪ Calf in lat / dorsal recumbency facilitate deep palpation of mass | USG
BY ANNA
IBKV 2 UAS
Uncomplicated umbilical hernia (UUH)
▪ Risk in FH breed >> beef cattle
▪ Completely reducible w palpanle
circumferential hernial ring
▪ Hernial sac contain intestines (enterocele),
abomasum (most common) omentum / both
▪ < 6 Mo = Hernia < 10 cm
▪ Conservative treatment: < 5 cm
 Hernial clamps
 Elastrator band
 Abdominal support bandages
 Local injection of irrtants around
hernial ring
 Daily digital palpation to irritate ring
▪ > 5 cm = surgery
Umbilical hernia w infection of umbilical cord
remnants
▪ Omphalophlebitis, omphaloarteritis & infection /
abscessation of the urachus
▪ Calves history:
 Intermittent purulent drainage from
umbilical beginning 1 – 2 weeks of age
 Rapid enlarging mass several weeks ltr
 Unthrifty & small w comorbid infectious
disease
 Umbilical mass usually large, broadbased,
painful to palpate, & only partly reducible,
hernia ring incompletely palpable
Umbilical abscess / chronic omphalitis

Umbilical hernia w localized abscess / SQ ▪ Common sequele to circumscribed omphalitis

infection
▪ Calves > foals
▪ 45% calves repaired had concurrent infection
▪ Treatment: open herniorraphy
 Removal of abscess / area of cellulitis
/ fibrosis, tgt w repai of hernia
 Excision of hernial sac / invert
umbilical remnants
▪ Umbilical mass usually warm, painful to palpte,
nonreducible, & firm / fluctuant
▪ No hernial ring is palpable, drainage uncommon
▪ Open herniorrhaphy w complete removal of the
abscess is recommended
Urachal cysts / ruptures: included as DDx in
claves with nonreducible umbilical mas

Herniorrhaphy surgery

▪ Small, uncomplicated umbilical hernias & many umbilical abscesses may not rqd surgery
▪ Calf in dorsal recumbency using sedation (Xylazine HCl) & local anesthetic
▪ Large abscess: drained / aspirated & treated medically w antimicrobials for few days b4 surgery to ↓ size
& min # bac
▪ Infected umbilical remnant & abscess shud be resected en bloc if possible, to prevent contamination of
abdomen & incision
▪ Small, umcomplicated hernias in claves repaired w closed herniorrhaphy like those performed in foals
▪ Compared to closed herniorrhaphy, open herniorrhaphy take less time, less traumatic, allows inspection
of abdominal viscera, & permits removal of umbilical remnant

Atresia
Atresia ani
▪ Common in pigs, sheep, horse & (less extend)
cattle
▪ Female: rectal fistula into vagina
▪ SQ bilges when straining: A. ani / et recti
▪ A. coli: poor prognosis
▪ X-ray & USG: distance between rectal pouch &
perineal skin
Atresia
▪  hole form organs w end tube
▪ Abnormality in anus & rectum
▪ Congenital atresia, prolapse / hernia, fistula
▪ Abnormal congenital @ rectum & anus:
 Atresia ani:  anus,  hole | common in
cattle, pigs, dog, sheep & goat
 Atresia recti:  anus,  rectum
 Atresia ani et recti:  anus,  rectum
➢ In Europe, congenital abnormalities animals not
used for farming
➢ Normally include fistula recto-vaginalis on
female
➢ Rectum  run towards anus, but end in VU in
male
➢ Other abnormalities: fistula recto-urethralis

BY ANNA
IBKV 2 UAS
Atresia ani
Clinical ▪ Known 2 – 3 D post partus →
symptoms digestive tract disorder i.e.:
cholic, pops up anal skin,
fluctuation when pressed on
the pop-ups
▪  defecation, enlarged
abdomen
▪ Apart from straining, feces 
coming out → intoxication →
death, appetite decrease
▪ Male  last long, female live
longer → fistula
rectovaginalis, feces come
out thru vagina
Treatment ▪ Anesthesia / sedation /
epidural anesthesia
▪ Local anesthesia, clean area
below the tail, incise skin
dorso-ventral around anus
▪ Fluid feces come out if incise
@ correct location
▪ Oval incision, suture snua
mucosa to the skin w simple
suture
▪ Apply laxament soapy water,
boorwater / laxantia i.e.: olium
ricini, paraffin
▪ Complication: fecal
incontinence
Atresia recti Atresia ani et recti
▪ Anus seems like dead ▪ No pop-up @ anus,
end pouch hard when pressed
▪ Symptoms like atresia ani ▪ Suppose  anus, but
▪ If fistula recto-vaginalis → only fine line, & 
feces out from vagina fluctuations &  feel
(sometimes, feces accumulation of feces
accumulate in vestibulum ▪ No appetite, full
vaginae) abdomen, straining,
▪ if fistula recto-urethralis, long term →
accumulation of feces in intoxication → death
VU
▪ prognosis: dubius –
infausta
▪ Shave skin & disinfect ▪ No treatment →
▪ Local anesthesia euthanized
▪ Incise slightly lower at ▪ Flank fistulation
bottom of tail until SQ ▪ Flank assisted surgery
▪ Prepare bluntly to pelvic
space
▪ Blunt end of rectum, pull
out using tang artery
▪ Rectum end suture to
skin
▪ The blund end of rectum
if cut & suture mucosa to
the skin
▪ Give laxament & change
diet
▪ Remove suture when
heal

Prolapse {Colo-rectal / Utero-vaginal}

Def: Cause:

▪ Protruded part of organ thru hole ▪ Straining / loose sphincter  withstand pressure
▪ Digestive tract: anus, rectum, colon ▪ Prolapses during pregnant → strong push from
▪ Reproduction: female (vagina, uterus) abnormal birth canal / abnormal fetus (dystocia /
giant fetus)

Rectal Prolapse
Cause: straining from diarrhea, dystocia, intestinal parasitism, cholic, proctitis, rectal tumor & rectal foreign body

Common in female than males and affect any age group

Classification

Classification Treatment
Type I Only rectal mucosa & submucosa project ▪ Mucosal edema & irritation reduced by topical
thru anus, sometimes more on one side than application of glycerin, sugar, magnesium
on other side ▪ Purse-string suture
Type II Complete prolapse of the full thickness of all
lesion / part of the rectal ampulla
Type III Variable amount of small colon Submucosal incision
prolapse intussuscepts into the rectum in addition to a ▪ 2 incisions around circumference of prolapse,
type II prolapse peel & remove the mucosal layer
Type IV Peritoneal rectum & a variable length of the Resection & anastomosis
prolapse small colon form an intussusception thru ▪ Full thickness circumferential incisions thru inner
anus & outer walls of the intussuscepted healthy tis
BY ANNA
IBKV 2 UAS
Vaginal & Cervical Prolapse
▪ Common in cattle & sheep Operation
▪ Usually in mature female in last trimester of
pregnancy Buhner suture placement

Predisposing factor ▪ Buried purse-string sutures

▪ Buhner perivaginal suture tape, / umbilical tape,
▪ Elevation in intraabdominal pressure commonly used for the purse-string suture
associated w increased size of the pregnant
uterus, intraabdominal fat Cervicopexy & vaginopexy
▪ Rumen distention superimposed upon ▪ Pexy of cranial vaginal to prevent
relaxation and softening of pelvic gridle & cervicovaginal
associated soft tissue structures in the pelvic ▪ Suturing cranial vaginal to iliopsoas muscle
canal & perineum

Treatment

▪ Irrigation w light antiseptic to protruded organ

▪ Soak with ice to ↓ inflammation, lub b4 replace
▪ Push slowly until the end of the organ into the
lumen until all entered

Male Abdomen Region

Cryptorchidism
➢ Rare in calve, rams, & bucks ▪ Testis too big due to cysts / tumor
➢ Inheritance in swine, sheep, horse, & cattle ▪ Aggressive animals behavior when sees female
➢ Left testis more often retained in cattle
➢ Predilection for right cryptorchids in goat Diagnose
➢ Physiological implication of undescended testis ▪ Control scrotum: sign of abdomen near to raphe
is a slight reduction in testosterone production scorti
and a decrease in spermatogenesis ▪ Exploration per rectal: tuber coxae & below
Def: ▪ USG / CT scan

▪ Abnormalities in form of retention of 1 / 2 testis Surgical treatment (Laparoscopy)

in abdomen /inguinal canal ▪ Direct spproach over testis
▪ Happened to all animals ▪ Abdominal testis best removes via flank
▪ Crypt abdominal: heterotropia testis abdominal celiotomy
▪ Crypt inguinal: heterotropia testis inguinal ▪ Closure of vaginal ting in needed to prevent
▪ Crypt abdomen incomplete: testis in abdomen, formation of an inguinal hernia
epididymis in inguinal canal ▪ Op: flank for pigs
▪ Can be bilat or monolat ▪ OP: ventral rare in pig & horse bcos easily
▪ Common in horse & pigs infected by peritonitis
▪ Horse: Sanglir
▪ Pig: Binner beer Complication
▪ Horse: common crypt absominalis sinistra
▪ Mislocated surgery
Cause ▪ Not found testis during ops due to small size
▪ Large testis
▪ Hereditary ▪ Perforated wound
▪ Weak m. gubernaculum testis ▪ Cysts in testis
▪ Abdominal / internal inguinal ring / tight folding ▪ Prolapse intestine
ring too narrow ▪ Peritonitis
▪ Funiculus spermaticus (hanging apparatus) too
short

BY ANNA
IBKV 2 UAS
Castration [Orchidectomy]
Aim

▪ Improve meat quality

▪ More manageable males
▪ Unilat hydrocele, hematocele, testicular tumor, epididymitis, abscess, varicocele

Bleed castration / surgical method Non-bleed castration

▪ Open: newberry knife To create ischemia of the testis w subsequent atrophy
▪ Closed: emusculator / necrosis
▪ Vasectomy & epididymectomy Burdizzo emasculatome
Older animals ▪ Crush spermatic cord w/in scrotum
▪ Restrain in chutes / tilt table ▪ Testes atrophy but usually not slaugh
▪ Local anesth in scrotal skin & spermatic cord ▪ Crush spermatic cord twice while manipulating the
▪ Distal scrotum removed / vertical incisions on cord w/in scrotum
either side of median raphe ▪ Crushes shud staggered w/o crossing midline
▪ Testis freed from fascia w blunt dissection
▪ Spermatic cord ligated & transected /
emasculated
▪ Closed: vaginal tunica  incised & remove en bloc
w testis
▪ Open: if tunica vaginal is incised, ligate testis &
spermatic cord / emasculated
▪ Scrotum: 1’ closure w scrotal trimming / 2’ closure
Young < 5 Mo
▪ Gen anesth / sedation / local anesth w restrain
▪ Spermatic cord ligated & transected, emasculated
/ stretch until vasculature rupture Elastrator
▪ Lamb: prevent inguinal injury – closes ▪ Small rumin < 1 Mo
(emasculator) spermatic cord ▪ Elastic band & applicator pliers soaked in
▪ Wound usually left open to heal by 2nd intention disinfectant b4 use
▪ Scrotum & testes usually slough w/in 3 weeks of
band application

Callicrate bander

Post op care

▪ Clean n dry environment & fly control preventing post op infection

▪ Obs for abnormalities: excessive swelling, hemorrhage & sign of infection: depression, ↓ appetite, &
abnormal drainage
▪ Older animals / unclean environ: periop AB 5 – 7 D

Complications

▪ Tetanus: several weeks b4 procedure

▪ Min complication – include seroma formation, swelling & inflammation at surgical site – self-limiting

BY ANNA
IBKV 2 UAS
Scrotal Problem
Hydrocele / Varicocele
▪ Hydrocele: abnormal collection of serous fluid bet the visceral & parietal layers of t. vaginalis
▪ Varicocele: abnormally distended & tortuous pampiniform plexus

Cause ▪ USG: anechoic to semi-echoic fluid surrounding

involved testis & epididymis
▪ Discrepancy bet production rate & flid resorption ▪ Aspiration: yellowish, clear fluid is obtained
rate ▪ Chronic (horse) → abnormal small testis
▪ Accompany testicular neoplasia / orchitis
▪ Parasites migrate thru vaginal cavity, 180° Treatment
torsion of s.c, trauma, & hot + lack of exercise
▪ Reduce temporarily w exercise
Clinical sign ▪ Spontaneous resolve when moved to cooler
environment
▪ Fluid undulation in smaller testis ▪ Unilat orchidectomy

Orchitis
Def: testis inflammation Symptoms: pain from scrotum, swelling

Cause: excessive trauma on testis causes inflammation Treatment: alternating cold & warm compression

Tumor of testis
▪ Sertoli cell tumor (SCT), interstitial cell tumor ▪ Teratomas & ICT rare in boars
(ICT) & teratoma in bulls & horse ▪ Most stallion castrated while young, avoid dev
▪ Seminoma, rete testis tumors & leiomyoma of ▪ Majority benign → remove affected testis
testis in rams
Penile Problem
Paraphimosis: glans penis extended from preputium & Balanitis: penis inflammation
x return Balanophatitis: inflammation on preputium
Phimosis: glans penis x come out from preputium

Bovine Penile Tumor [Penile Fibropapilloma]

▪ Usually in young bulls, regress spontaneously
▪ Pedunculated tumor: sharp dissection / electrocautery
▪ Histological analysis: aggressive, malignant fibrosarcomata → culling

Equine Penile Tumor

▪ SCC: most common penile & preputial neoplasm
▪ Melanomas occasional found on prepuce of old gray horses
▪ Squamous papilloma, benign counterparts of SCC, often on ex genital of young horses / ad to penile /
preputial carcinomas of old horses

Equine Penile Habronemiasis [Cutaneous habronemiasis / summer sore / granular dermatitis]

▪ Granulomatous, mildly pruritic disease → ▪ Squeezing lesion → granules to extrude
encystment of the larvae of equine stomach ▪ Occasional – microscopically found larvae
worm
Treatment
Clinical sign
Surgical Non-surgical
▪ Penis & prepuce = common site of infestation ▪ Resection of chronic ▪ Ivermectin,
by larvae → moisture attract flies fibrotic areas administeres orally
▪ Ulcerated, red areas demarcated by edges of ▪ Penile amputation fo @ 200 μg/kg
depigmentation affected urethra ▪ Daily topical cream:
▪ Lesions may be granulomatous & extensive organophosphate –
trichlorfon &
Diagnosis corticosteroid –
dexamethasone
▪ X healing, granulating wound w circulating
eosinophilia

BY ANNA
IBKV 2 UAS
Female Abdomen Region
Mare Caesarian Section [C-sec]
Elective indication Emergency indication
▪ Pelvic fracture / soft tis injury w/in rep tract ▪ Dystocia
▪ Previous dystocia ▪ Near-term undergoing colic surgery
▪ Severe uterine artery hemorrhage ▪ Correction for uterine torsion
▪ Produce gnotobiotic foals for research purposes

Anesth & surgical prep ▪ Euthanasia is planned: sterility if not a high

▪ Short acting inj agents
▪ Inhalation agents i.e.: isofluorine / sevofluorine,
mechanical ventilation, & blood pressure
support improve outcome for both mare & foal Post-op
▪ Time for decision < 20 mins
Technique
▪ Mare: vent midline / low flank
▪ Position: dorsal lat recumbency, the ventral
midline tilted towards the surgeon
▪ 35- to 45- cm incision made into abdomen
beginning 10 cm caudal to umbilicus and
extending cranial
▪ Incise uterine wall & chorioallantois from level of
fetal hocks to the feet, creating a straight incision
bet stay sutures
▪ Umbilical cord is clamped & transected
▪ Neonate is quickly transferred for resuscitation &
evaluation
▪ Chorioallantois is separated from endometrium
3 – 4 cm along incise edge of uterine wall
▪ Placenta separates easily from uterus → remove
entirely
▪ Placenta is usually still well attached
▪ Closure of uterus in 2 layers
 1st: continuous connell – continuous
inverting suture, horizontal mattress
suture, Cushing modified
seromuscular
 2nd: continuous lambert
▪ After uterine closure, lavage uterus & 40 IU of
oxytocin IV
▪ Abdominal lavage w 10 – 15: of warm saline →
removed by suction
▪ Abdominal drain for subsequent lavage may
necessary
▪ Crystalline penicillin sol into abdomen
▪ Closed in routine fashion for ventral midline
celiotomy
Terminal c-sec
▪ Recumbent mare for neurologic abnormalities,
severe laminitis, potentially fatal / debilitating
condition
priority but speed of delivery
▪ Quick surgeries: low flank approach after
induction of anesthesia
▪ If placenta not passed, oxytocin administered
again 2 – 3 hrs portpartum
▪ Initial dose of 40 IU in 1L of lactated Ringer’s sol
given IV over 30 – 60 mins
▪ Placenta passes w/in 8 hr postpartum
▪ Oxytocin → abdominal pain, administration rate
dictated by response of mare
▪ Refractory case: 80 IU every 4 – 6 hr
▪ Systemic AB & flunixin meglumine administered
for 3 – 5 D
▪ IV fluids administered as needed
▪ Abdominal surgery can result in transient postop
ileus
▪ Swollen & painful pelvic tis lead to retention of
feces
▪ Postpartum diet reflect concern for potential
problem
▪ Water offered freely
▪ Allow walking & graze on green grass the 1st
postop day
▪ Bran mash w mineral oil might beneficial
▪ Discharge instruction include hand walking 2 – 3
time each day, with / w/o small-paddock turn-out
to for 3 – 4 weeks
Complications & prognosis
▪ Anemia & bleeding from hysterotomy site =
common but serious
▪ 22% prevalence rate
▪ Survival to discharge rate 84% for mares & 35%
for foals
▪ Retained palcenta
▪ Metritis
▪ Uterine traes
▪ Vaginal / cervical tears
▪ Colitis
▪ Peritonitis
▪ Decreased fertility
▪ Incisional dehiscence

BY ANNA
IBKV 2 UAS
C-sec in Cattle
Elective indication Emergency indication
▪ Prolonged gestation ▪ Dystocia
▪ Potentially valuable calf, ehrn a dystocia ▪ Deformities of maternal pelvis
anticipated, e.g.: in Belgian blue ▪ Induration of cervix
▪ Hydrops aminii & allantois, uterine torsion
▪ Emphysematous fetuses

Surgical prep Postop

▪ L paralumbar / flank approach: standard incision ▪ Oxytocin to encourage uterine involution, 20 IU

for viable / recently expired, uncontaminated
fetus & cow capable for standing surgery
▪ R-flank laparotomy: marked distention of the
rumen or when clinical examination dictates
removal from the right side more convenient
▪ Oversized fetus situated in right side of
abdominal cavity
▪ Routine case, however, left flank incision more
convenient → fewer problem w encroaching Complication & prognosis
bowel are encounter
Ventral approach
▪ Dead & emphysematous fetus
▪ Animal recumbent & considered incapable of
standing surgery
▪ Unmanageable & dangerous to operator
Anesthesia
▪ Local analgesia
▪ Flank approach: paravertebral blocl, inverted L
block / line block
▪ Paramedian approach, high epidural, inverted L
bloack, or line block
▪ Line block: ventral midline approach
▪ Casting w rope, w / w/o sedation, supplementary
restraint for cows in which ventral approach is
used
QID until memb passed for 24 hrs
▪ Monitored & make sure placenta passed intact &
shud receive gen medical support, including
analgesic, if necessary, exercise, & udder care,
w fresh water & electrolytes available at all time
▪ AB continued for 3 – 7 days / until placenta
passed
▪ Temporary reductions in milk production postop
▪ Adhesions bet uterus & surrounding tis occur in
roughly half of all cases, regardless of whether
catgut / Vicryl suture used for closure of uterus
▪ 15% decline in fertility pop of cattle that c-sec
compared w similar group that had normal
vaginal deliveries
▪ Rebred after c-sec 60% - 80% pregnancy rate w
5% - 9% loss → abortion
▪ C-sec increase # of services to conception &
days open

Surgical technique

▪ Uterine torsion: over a limb, but in certain

malposition, area of head may be incised
▪ Uterus incision not in body of uterus, but as close
to the tip of the horn
▪ Incision parallel to the long axis of uterus and on
its greater curvature → fewest large vessels
▪ Avoid incising caruncles
▪ Fetal memb shud only be removed if can
separate from uterus w/o undue traction of if they
are lying free w/in uterus
▪ Uterus is closed w continuous inverting pattern
& absorbable suture material
▪ Surrounding adhesions developed along the
suture line when suture patterns were exposed

BY ANNA
IBKV 2 UAS
Teat Laceration
▪ Common in cow → severe deficits in milk production
▪ Laceration do not penetrate mucosa → 2nd intention healing
▪ Laceration penetrate mucosa → suturing:
 Maintain normal teat function for milking
 Prevent dev of teat fistulae / acute mastitis & loss of quarter

Anesthesia & surgical prep

▪ Restraint & anesth → meticulous repair

▪ Teat surgery may be attemo w cow in standing position using local anesth, but result more predictable if
tabled / cast & neither uneasy nor kicking
▪ Local anesth inj around base of teat (circle / ring block)
▪ Epinephrine not used with local anesth
▪ Topical anesthetic directly into teat canal to supplement ring block anesth
▪ For topical anesth, 2% lidocaine
▪ Epidural anesth effective alternative for teat surgery
▪ Rubber torniquet to base of teat → control hemorrhage & milk flow
▪ Doyen forceps clamped across the base to teat
▪ Wound edge → freshened to remove anu devitalized tis & foreign material
▪ Debridement = important procedures in repairing lacerated teats
▪ Closure in 3 layers
 1st layer closed mucosa: simple continuous, 3-0 or 4-0 synthetic, monofilamenr, absorbable suture
material
 When mucosa is close, teat cannula inserted thru teat sphincter, & suture line is gently probe to
check integrity
 2nd layer close submucosa: simple continuous, 3-0 / 4-0 synthetic, monofilament, absorbable
suture material
 3rd layer skin: near-far-far-near / simple interrupted, non-absorbable, 0 / 2-0

Post op management

▪ Larson’s teat tube for 1 week

▪ Advantages milk let down / left off permanently
▪ Teat shud not be hand milk
▪ Intramammary AB infused into affected teat & systemic AB as indicated
▪ If long period laceration, mastitis present
▪ Verified with California Mastitis Test, bac cultures & sensitivity testing
▪ Sutures remove aseptic 8 – 10 D postop to avoid inflammation & suture tract infection

Complication & prognosis

▪ Excessive teat swelling & fibrous reaction that impede milking

▪ Vertical laceration: better prognosis than horizontal teat wounds → circulation to wound edge better
▪ Laceration at base of teat less favorable prognosis → susceptible to extensive hemorrhage as proximity
to the pudendal venous ring

BY ANNA
IBKV 2 UAS
LIMB FRACTURE TREATMENT IN LARGE ANIMAL
▪ Emergency stabilization of fractures: extremely
important
▪ External stabilization → definitive treatment
▪ Appropriate field stabilization enables safe
transportation to facility for surgical procedure
to achieve anatomic reduction & compression
of fracture / ensure survival of patient
▪ Improper emergency care may limit treatment
options & endanger patient life
Fracture in cattle
▪ Metacarpus / metatarsus – 50%
▪ Tibia – 12%
▪ Radius / Ulna – 7%
▪ Humerus – 5%
▪ Other – 26%: femur, pelvis, phalanges,
mandible, vertebrae, ribs
Cattle = good orthopedic patient
▪ Mostly recumbent
▪ High potential of bone healing
▪ More resistance compared to others against
damage of contralateral leg & stress laminitis
▪ Not resists orthopedic tools installation on legs
Horse = challenging: Mostly standing, feeding &
moving
Limb fracture & stabilization technique
Principles
▪ Axial skeletal fracture – stall rest, external / internal fixation not rqd
▪ Appendicular skeleton fracture:
 Is treatment rqd?
 Can fracture acceptably reduce closed / internal reduction rqd
 Can the fracture adequately immobilize using external coaptation alone / is internal fixation w /
w/o external coaptation rqd?
 What is the cost-benefit analysis?
Limb fracture level
Evaluation of fracture patient
▪ Successful management of unstable fracture in
the field involves a combination of
 Clinical assessment
 Appropriate medical treatment
 Stabilization of fracture
 Careful & prompt transportation to a
facility equipped for fracture repair
Prognosis for unstable fracture
▪ Closed fracture >> open (compound) fracture
▪ Simple fractures >> comminuted fractures
▪ Nondisplaced fractures >> displaced fractures
Medical emergency treatment
▪ Achieve relaxation & pain relief w/o ataxia:
sedation (+ tranquilizer)
▪ Shock is a rare consideration w most acute
fractures, excessive blood loss / fatigue,
particularly in extreme exertion / high temp →
compromised perfusion rqd appropriate fluid
therapy
▪ Sig soft tis trauma associated w fracture:
broad-spectrum systemic antimicrobial + non-
steroidal AI therapy
BY ANNA
IBKV 2 UAS
Level 1: Robert Jones bandage w
caudal splint (hind limb) & dorsal
splint (front limb)
Level 2 (mid diaphyseal
fractures): Robert Jones bandages
w plantar & lat splint (hind limb) &
caudal & lats splints (fore limb)
Level 3: Robert Jones bandage
support hind limb + extended
bandage | forelimb: caudal splint +
extended lateral splint
▪ Prognosis: simple fracture of pastern >> severe comminuted
▪ Proximal sesamoid bone fracture & condylar fracture of Mc 3/ Mt 3
▪ Traumatic disruptions of fetlock arthrodesis & prognosis for
successful repair = variable → degree of soft tis injury present
Walking block
▪ Cow stand on 1 digit during convalescence of paired digit
▪ Wooden, rubber / plastic bloc (2.5 – 3.5 cm) formed to the size &
shape of hoof
▪ Most suitable for management of P1, P2, P3 fractures of a 1 digit
▪ Confined to a pen for 6 – 10 weeks while the fracture heals
▪ Remove after 6 weeks
▪ 3rd Mc & 3rd Mt: mon soft tis coverage → open due to external trauma
or penetration of skin by edges of the fractured bone: poor prognosis
▪ Unstable fracture of carpus & tarsus: poor prognosis for athletic
soundness but salvaged in some breeding case
Metacarpus & metatarsus III / IV
▪ Fractures involving Mc / Mt III / IV: most common in food animal
▪ Due to forced extraction during dystocia
▪ Closed fracture of distal physis of metacarpus (Mc) / Metatarsus
(Mt): half-limb cast
▪ Closed fracture of middle portion of Mc / Mt: full limb cast
▪ Open fractures in mature cattle treated thoroughly debriding,
cleaning, & flushing wound, applying full limb cast, & AB for 10 –
14D
▪ Valuable cattle & young calves, open fractures best treated by use
of external skeletal fixator & daily wound care until healing
Casting – half limb cast
▪ Half-limb cast (low-limb cast / short cast) used for immobilization of
phalangeal fractures & for distal metacarpal / metatarsal physis
▪ Fractures cast if placed from a point immediately distal to the carpus
/ hock extending to the ground & encasing the foot
Casting – full limb cast
▪ Full-limb cast (high-limb cast / long cast): for fractures at proximal to
mid-Mc / Mt, but distal to the midradius / midtibia
▪ Full limb cast place similar to half-limb cast, but bony prominences
of the accessory carpal bone, styloid process of the ulna, calcaneus,
& medial & lat malleolus of tibia must be padded
▪ Prognosis: poor
▪ Fracture of ulna often repaired w good prognosis
▪ Radial fracture in foals / calf → repair w internal fixation
▪ Complete diaphyseal fractures of the tibia: poor
Radius-Ulna Fracture
▪ Closed fractures of distal physis of the radius: full limb cast → good
prognosis
▪ Fracture of the midradius & ulna: Thomas splint cast, TPC, bone
plate
▪ Most open radial fractures involve distal diaphysis / physis
Tibia fracture
▪ Result of forces extraction during dystocia & trauma
▪ Fracture of distal physis of tibia: full-limb cast, uncommon
▪ Fracture of middle portion of tibia: Thomas splint-cast, TPC, bone
plate
▪ Thomas splint cast have good prognosis for bone healing, but have
a high rate of injury to the contralateral limb
BY ANNA
IBKV 2 UAS
Level 4: padded bandage with
caudal splint that extends form the
elbow to the ground is used to fix the
carpus & support forelimbs
▪ TPC & bone plate have good – excellent prognosis for healing &
pose min problem w contralateral limb injury
Thomas Splint + Cast
▪ Distal to elbow / stifle fracture
▪ Length of splint shud be measured while standing & using normal
limb for measure
▪ Must assisted to stand for 3 – 5 days until they learn how to rise
under their own power
Transfixation-pin + Cast & ESF
▪ ESF = stabilization of debilitating musculoskeletal injury (typically
fractures but + joint luxation / tendon rupture) using transfixation pin
& any external frame connecting the pins & spanning the region of
instability
▪ TPC aim to provide a sustainable, comfortable means to return the
patient to weight bearing asap postop, to maintain normal joint
mobility, if possible, & to provide an optional environment for
osteosynthesis & wound healing
▪ Disruption of diaphysis of the humerus in adult horse: poor
prognosis
▪ In foals & yearling, some humeral fractures heal w/o surgery
▪ Humeral fractures in yearlings & foals undergo surgery >> adults,
unless radial nerve damage
▪ Simple fractures of the neck of the scapula that are repaired w
internal fixation: good prognosis for athletic function
▪ Comminuted fractures of the glenoid / neck of the scapula: poor
prognosis
▪ Fracture of scapula spine: good prognosis
▪ Diaphyseal fractures adult femur: grave prognosis
▪ Diaphyseal femoral fractures in foals younger than 3 Mo: guarded
to fair prognosis
▪ Distal femoral fractures in foals: guarded prognosis
▪ Pelvic fractures: uncommon in horse, overall survival rate 50 – 70%
▪ Fractures of tuber coxae: good prognosis for athletic activity
▪ Pelvic fractures involving the articular surface of the coxofemoral
joint: 20% chance for athletic soundness

Transportation of fracture patient Complication of casting & splinting

▪ Adult placed in partitioned / confines space in
trailer, restrained w chest / rump bars, & head
shud be tied loosely to allow the horse use of
the head & neck for balance
▪ Thoracic limb fracture: position horse facing
rearward to allow for use of pelvic limbs to
brace when stop
▪ Pelvic limb fracture: placed facing forward for
use of thoracic limbs as brace when stopping
▪ Foals shud shipped with mare, attendant help
to stabilize foals during shipping
▪ Bales of hay to provide a reduce stall space for
an injured foal of an attendant is not available
▪ Foals usually travel in recumbent position
▪ Most common complication = sepsis, nerve
injury, & vascular injury
▪ Cast / splint sores, breakdown injury in
contralateral limb, & malunion
▪ Septic nonunion from a combine of factors
involved w fracture & fracture treatment
▪ Nerve & vascular injury minimized by
appropriate fracture immobilization b4
transporting for definitive treatment
▪ Min sepsis by close attention to detail,
thorough cleaning of fracture site, & selection
of appropriate antimicrobial drugs
▪ Prevent malunion by optimal closed reduction
/ opn reduction & internal fixation when closed
reduction
▪ Prevent contralateral limb injury by strict
confinement during convalescence, frequent
monitoring, removal of external coaptation @
earliest appropriate time, & client education for
on-farm fracture-patient management

BY ANNA
IBKV 2 UAS
Close VS Open fracture
▪ Prognosis: close >> open
▪ Success recovery rate depends:
 Severity of soft tis damage
 Bone affected
 Age
 Duration & degree of contamination
 Economic limitations placed on
fracture management
▪ Mature cow w open Mc fracture able to heal &
return to productivity after thorough cleaning of
the wound, administration of AB, & full limb
cast
▪ By contrast, young calf w similar injury prone to
septic nonunion / delay union
Infection management for open fractures
▪ Induction of anesth → clean & debride the
wound, & copiously lavage the wound
▪ Ab for therapeutic concentration in bone:
penicillin, cephalosporins, fluoroquinolones &
trimethoprim-sulfa combine (age dependent)
▪ Chronic infection (osteomyelitis) of fracture
difficult to resolves
▪ Chronic osseous infection: IV infusion of AB
distal to tourniquet achieves high levels of AB
in synovial fluid
Ossues sequestrum
▪ Caused by calving chain injuries & extensive
soft tis damage associated
▪ Healing is slow by presence of sequestrum &
sequestrectomy usually allow fracture healing
to proceed
▪ Def not apparent until 4 – 6 weeks after initial
injury
▪ Remove sequestrum at earliest time possible
based on radiographs / clinical findings,
cleanse the wound until a healthy granulation
bed is present, then perform cancellous bone
grafting from sternum
▪ Sternum provides largest volume of cancellous
bone for grafting
▪ Alternatively, proximal tibia, proximal humerus,
or ileum may be used for cancellous grafts
Septic non-union
▪ Infected fractures that progress to septic non-
union shud be treated similarly to cortical
sequestrum cases
▪ Aerobic & anerobic cultures & microbial
susceptibility test aid in AB selection & fracture
site if extensively debrided of fibrous tis
▪ Debridement is continued until healthy bone is
exposed
▪ A fresh, autologous cancellous bone graft is
harvested & implanted into the fracture site
BY ANNA
IBKV 2 UAS
TUMOR IN HORSE
Sarcoid
▪ Cutaneous, fibroblastic neoplasia w ▪
proliferative epithelial component
▪ Classified histopathological as benign tumors
→ morphologic characteristics of the
fibroblasts & slow growing causing little of any
physical problems
▪ Misleading classification & ignores the large #
of tumors whose clinical behavior can only be
described as malignant
▪ On basis of clinical appearance
 Occult
 Verrucous
 Nodular fibroblastic
 Ulcerative fibroblastic
 Mixed tumors
 Malevolent
▪ Most aggressive subtype  malevolent sarcoid
that infiltrate locally along fascial planes &
vessels, grow rapidly & high recurrence rate
after excision
Occult sarcoid
▪ Appear as roughly circular hairless areas of
skin
▪ Early development: subtle & difficult to
recognize
▪ Mistaken for ‘ring-worm’ or even rub marks
from tack
▪ Common on nose & side of face, armpit & groin
▪ Accidentally traumatized, develop rapidly into
more serious type of sarcoid
Verrucous sarcoid
▪ ‘wart-like’ appearance & often greyish in color
▪ Skin crack easily & flakes of scale often be
rubbed off from the surface
▪ Appear singularly / in groups that merge into
larger lesions
▪ Manipulation of verrucous sarcoid usually not
painful
▪ Interference w verrucous sarcoid lead to rapid
transformation into more serious & aggressive
forms
Nodular fibroblastic sarcoid
▪ Firm, round nodules appear anywhere on the
horse’s body
▪ Often seen in the armpit, inside edge of the
thigh & groin & under the skin of the eyelids
▪ Singular or multiple & variable in size
▪ Usually covered by a layer of normal skin but
can also be ulcerative
Usually firmly attached to the skin overlying
them but sometimes freely moveable under the
surface
Ulcerative fibroblastic sarcoid
▪ Fleshy masses that grow quickly, bleed easily
& have ulcerated surfaces
▪ Like exuberant granulation tissue (‘proud flesh’)
▪ Develop at the site of a wound
▪ Found anywhere on the horse body
Mixed tumors sarcoid
▪ Sub-classification describing a lesion that
shows qualities of two or more different sarcoid
groups
▪ Commonly described as ‘mixed’ as a lot of
sarcoid lesions will demonstrate
characteristics of more than one type.
Malevolent sarcoid
▪ Most aggressive
▪ Rapidly spread over a wide area of the horse’s
body & grows just as quickly
▪ Most likely appearance of ulcerative nodular-
like lesions group in large bundles
▪ Aggressive in nature that often there are no
treatment options
Sites of predilection
▪ Vary with geographic location:
 Face (muzzle, ears, and periocular
region)
 Distal limbs
 Neck / ventral abdomen
 Areas of previous injury & scarring
▪ Location affect prognosis
▪ Distal limb & periorbital region having a worse
prognosis for resolution than in other locations
Cause
▪ Older horse: common in spontaneous
malignancies
▪ Younger horse: genetic predisposition /
exogenous factor
▪ Standardbred – ½ x → Thoroughbreds –→
Quarter horse (2x of Tb)
Surgical excision
▪ Transform to a more aggressive phenotype
after incomplete / unsuccessful treatment →
harder to resolve
▪ Surgical excision w/o adjunctive therapy =
least successful treatment options, recurrence
rate of 15.8% to 82%.
BY ANNA
IBKV 2 UAS
Squamous Cell Carcinoma (SCC)
▪ Malignant, locally invasive neoplasia of Cause:
squamous epithelial cells
▪ Location: ▪ Develop in areas of chronic, poorly healing
 Integument, sites of predilection wounds and at sites of previous burn injury
include areas lacking pigmentation, ▪ Breeds with poorly pigmented, pink-skinned
poorly haired regions, & skin near areas including Appaloosas and paint-colored
mucocutaneous junctions horses are more prone to develop SCC→ 69%
 Most common neoplasm of the equine of all ocular SCC cases occur in individuals
eye, conjunctiva, ocular adnexal lacking periocular pigmentation
structures, & external genitalia ▪ Draft breeds have an increased incidence of
 Nasal cavity, paranasal sinuses, SCC.
pharynx, larynx
 Hoof capsule & it should be
considered in horses with chronic,
refractory foot abscesses.

Type: ulcerative & proliferative

Ulcerative
▪ Develop over time, early lesions appearing as
small nodules underlying normal-haired skin
▪ Mistaken for nonhealing wounds and chronic
granulation tissue → delayed treatment
▪ Ocular lesions begin as small ulcerative lesions on
lid margins / as keratitic plaques on the cornea
▪ Thus, be suspicious whenever raised red lesions
appear on the lid margins, sclera, or conjunctiva,
particularly in unpigmented skin
Treatment
Proliferative
▪ In the ocular structures can invade the orbit,
calvarium, tear duct, and sinuses if left untreated.
▪ Pedunculated lesions on the penis often have a
cauliflower-like appearance
▪ Typically spreads to surrounding tis & local lymph
nodes, but distant metastasis is rare
▪ Local / distant metastases or large, invasive
tumors have a poor prognosis for cure.

▪ Surgical excision ▪ Cryotherapy: most useful in ▪ Hyperthermia

▪ Radiation therapy small periocular lesions & ▪ Immunotherapy
▪ Topical application of lesions arising from external ▪ Laser excision
antimitotic genitalia ▪ Intralesional chemotherapy
▪ Larger lesions may benefit from surgical debulking prior to cryotherapy
▪ Frequent reexamination to monitor regrowth & important determined success
▪ Failure to retreat small recurrences quickly allow tumor regrowth & failure of treatment protocol
▪ Combination therapy  greater success rate than single modality treatment
▪ Factors influenced survival included tumor location & size
▪ Prior treatment modalities, the presence of multiple tumors & treatment modality used at time of
examination x influence survival

Melanoma [Curse of Grey]

▪ Histopathologic surveys report that ▪ Progression from melanocyte accumulation to
melanomas comprise 4% to 15% of all skin melanoma formation has been documented in
tumors melanoma-prone locations
▪ Most melanomas occur in gray horses; breed ▪ Interestingly, sites of predilection are the 1st
predispositions → incidence of the color gray areas to show depigmentation changes (vitiligo)
within a breed with aging
▪ Virtually all gray horses will develop melanoma ▪ 4 types of melanomas:
over time. 1. Melanocytic nevi
▪ In a population study of Lipizzan horses, < 6% 2. Dermal melanomas
of horses 16 y/o / older were melanoma free 3. Dermal melanomatosis
▪ Arise → disturbance in melanin transfer from 4. Malignant melanomas
dermal melanocytes to follicular cells

BY ANNA
IBKV 2 UAS
Melanocytic nevi Malignant melanomas
▪ Usually benign ▪ True MM rare & classified on basis of presence
▪ Small, single discrete masses (< 2 – 5 cm) of both histopathologic & clinical
▪ Seen in young horse of any color characteristics of malignancy
▪ Appear anywhere on body ▪ Occurred > 20 y/o, recurred w/in 10 Mo after
surgical excision
Dermal melanomas ▪ Frequently in various size & associated w a
▪ Usually benign
poor prognosis for complete resolution
▪ Large / dev in atypical location can bcome
malignant Location
▪ Vary in size, discrete masses & appears in
clusters ▪ The vast majority:
▪ Mostly in more mature grey horses  Around the perineum and base of the
▪ Common under tail, in perineum & external tail
genitalia, but can also invade parotid salivary  Lesions around the head (lips, eyes,
glands, lips, eyelids, & neck parotid region) and other sites less
frequent
Dermal melanomastosis ▪ Foot, meninges, thorax, ocular structures, and
▪ More likely malignant & metastatic abdominal cavity
▪ Usually in horse > 15 y/o ▪ These unusual locations appear to be
▪ Multiple, large poorly circumscribed masses of associated with a poor prognosis.
various size

Treatment

Surgical remove Oral medication

▪ Dermal melanomas & melanocytic nevi have
similar clinical characteristics, => surgical
excision is curative in majority
▪ Smaller lesions can be sharply excised;
alternatively, the use of the CO2 laser is
recommended
▪ Cauterize the wound bed & control hemorrhage
makes laser excision particularly useful in sites
where primary closure cannot be achieved (e.g.,
the base of the tail)
▪ Complete excision is difficult with larger lesions
i.e.: dermal melanomatosis, but surgical
debulking can be palliative
Epidemiology (Cause)
▪ Cimetidine has antitumor activity & histamine
receptor antagonist.
▪ Immunomodulation of lymphocyte activity via
histamine receptor interaction is postulated to be a
mechanism of antitumor activity
▪ Response is reported to be the highest in tumors
exhibiting a rapid growth phase; successful
response was achieved using a dose of 2.5 mg/kg
every 8 hrs
▪ Treatment is recommended for 3 Mo, / for 3 weeks
after cessation of tumor growth.

▪ Gray horses exhibited normal quality of life regardless of tumor number and type
▪ Treated with benign neglect, as rarely the cause of significant disease in affected horses
▪ However, with age, the risk of progression to dermal melanomatosis and metastases increases
▪ Small nodules are easily removed and rarely recur, but owners need to be informed that new tumors will
quite likely develop over time
▪ Although conservative management is reasonable in the majority of cases, more aggressive treatment,
including early removal of smaller tumors, may decrease the risk of melanomatosis or metastases as the
animal ages
▪ Malignant melanomas have a higher recurrence rate with simple excision
▪ Combination therapy, including surgical debulking and intralesional chemotherapeutic injections, may
offer palliation, but the prognosis for cure is poor

BY ANNA