History and owner complains: The young dog had this problem for several weeks. A corticosteroids with anti biotic were injected to the edema area but it didn’t help much. The dog was kept on hard surface with no padding for most of the time.

Clinical signs: The caudal aspect of the left elbow of the dog was enlarged, the consistency was of a liquid, it was circumscribed and mobile, the place was with a normal temperature and didn’t cause any pain when palpated.

Diagnosis: Hygroma, due to large breed of the dog, his young age and the fact of the serous content of the lesion.

Treatment: The dog was operated in order to remove the Hygroma. The incision was made sagital to the olecranon and dilacerations of the fibrous tissue that covered the hygroma from the surrounding soft tissue was made. The incision was closed and a draining was placed. It was covered with Robert Jones bandage that will change frequently until sutures are removed. Anti biotic (Synulox) and NSAID (melxicam) where giving.

Supportive care: The dog should lie only on soft bedding.

Owner complaint and history: a 4 years old Labrador male, didn’t eat for 3 days, he is apatic most of the time.

Clinical signs: the dog was dehydrated and appears very apathetic.

Diagnosis: an x ray imaging was made and revealed a white round mass in the abdominal cavity inside the intestinal mass apparently it’s a stone: mechanic obstruction.

Treatment and therapy: a surgery ( laperotomy) was made in order to find the obstruction and remove it. The abdomen cavity was opened via the lina alba. the intestinal were taken out until the place of the obstruction was found and then incision in the intestinal wall and removal of 6 cm round stone and 2 cm smaller stone as well. The intestinal were suture in 2 layers (Lambert suture).

Supportive care: anti biotic (Mynolox) and Melxicam (NSAID) to relief the pain.

Clinical Signs: Sialorrhea, a swallow hard mass in the salivary (parotid) gland.

Diagnosis: By palpation and also diagnosed a rocking teeth.

Treatment: By surgical operation the stone was remove and also one tooth.

Supportive Care: wash the horse mouth accusingly.

Owner complains: after horseback riding the horse started to limp.

Clinical signs: limping when running and lowering the head when running.
      

Diagnosis: it was detected by looking at the horse running that the horse is limping on the left front leg. Hoof taster examination, palpation, regional Anastasia reveal that the problem is in the hoof. The hoof was treated by friar searching for an abases. An x ray imaging revel there was a fracture in the 3rd phalanx.
      

Treatment: a bandage on the distal part of leg. a bareshoe was placed. and treatment against pain.

Supportive care: the horse needs a long rest with no back riding for a least 3 months.

Pedal Bone fracture (PIII fracture)

A 17 yo Gelding became abruptly lame while trotting on a rocky terrain. He is Bright alert and responsive. Lameness 5\5. Responsive to hoof tester, on the solar surface, especially on the medial side and the toe area. After a mild trim job, in hope of finding an abscess some hemorrhage and bruising was found on the medial side and the toe area of the sole.

We grade lameness from 1-5/5. 1/5 would be a very mild lameness, very hard to recognize. 5/5 is a horse that in not bearing any weight on the leg.

We apply hoof testers on the foot to get an inflicted painful response. A horse that is doing well will not respond at all to the hoof testers if used correctly. when there is a response, we know where to look.

It was decided to take x rays.

On the x rays a fracture was noted on the medial side going toward the toe area. It is a oblique fracture that does not involve the Coffin joint. 

In these fractures we are worried about the involvement of the joint and the age of the horse. There was no involvement of the joint so the chances of recovery are good although the horse is 17-yo and this means that the bones heal slower and weaker than a younger horse.

A bar shoe was placed on the hoof and a cast was applied. Usually ether would do but I thought that the bar shoe was not sufficient, that the clips on the side did not hold the hoof tight enough. The idea is to make sure that there is a minimal amount of movement inside the hoof capsula.

After a two weeks the horse did not show a lot of improvement. After a month the horse improved dramatically and today he is turned out after only two and a half months from the injury.

A 5 yo QH mare flipped on her back after after it was decided to try to take her off the trailer forcefully.

A fluid filled pocked was felt on the dorsal part of the lumbar region. The fluid filled pocket kept getting bigger throughout the next two weeks, according to the owner.

On palpation there was movement of fluid inside. aspiration of bloody fluid was obtained, what seamed to be whole blood.

The hematoma was surgically opened and drained, a penrose drain was left in. The pocket was flushed with antibiotics and saline. After a 3 days the drain was taken out.

The opening closed nicely. DMSO and Cortisone were applied daily to reduce the thickness of the capsula that formed from the hematoma.

I highly doubt that the swelling gradually got bigger, in my personal opinion the swelling was big through day one, they just decided to play it through and see what happens if they don’t call the vet right away, bad choice.

Sometime I will not open these hematomas, they can bleed the horse to death. The main problem is that they can gradually lose all their coagulation elements and then the bleeding persists. In this case they need a blood transfusion. I told the owner to keep an eye on the bleeding, if it persists we would need to do coagulation tests to ensure that the coagulation time is still within normal limits. I decided to open it because it is in such a problematic place, where the saddle fits, and that is like this for two weeks already. The likelihood of her bleeding from there after 2 weeks are slim.

A 7 yo QH mare, 4 month pregnant.

Bladder eversion is mostly associated with parturition and third degree perineal lacerations. This just goes to show that horses don’t always read the books we do. The Bladder was in this position for about a year and a half. She was bread this way. 4 months pregnant.

The Bladder is reverting through the urethral sphincter so that exposed mucosa extends beyond the ventral commissure of the vulva.

An attempt to reverse the bladder back in its place was made at first, successful, it did not last long. After 2-3 hours the bladder was out again. DMSO and Cortisone were used to diminish the inflammation of the bladder, What seamed to be making the mare strain again and again an by this reverting the bladder was the palpation of the neck of the bladder. Local lidicaine was used as well.

On the third days a foley catheter (could not find one so I used a small tracheal tube intended for small animals) was placed inside the bladder (after replacing the everted bladder, which took a good hour). The cuff was inflated. A pursestring suture was placed around the the catheter. This suture helped keep the catheter in place and the urine dripping only from the catheter. The mare stopped straining and urine was coming out of the catheter. DMSO, lidocaine and Cortisone were used in the first 24 hours after surgery, to reduce the inflammation and the straining from the stimulus of the neck of the bladder.

Three weeks have passed and the mare is doing well.

This Method of castration is very easy to use. Although I was very skeptic in the beginning about it’s safety today I am very pleased with the safety, time and cleanness that it provides. My three “T”eees for surgery are Trauma, Trash and Time, It goes by all three.

I still have the emasculator always out, just in case there in a need for it, for instance a Cryptorchid castration that did not seam to be one at first, so I always have it ready.

At first I tried to move the two edges closer with some towel clamps. I had them on while I sutures the lip that also had a fair cut, right through the side of it. That done with I dedicated all my attention and skill as a surgeon ti the facial cut. I quickly found out that there is not enough skin to suture.

A tension suture was elected and revaluation in 18 hours was what seemed to be the only option. At the base of the tention sutures (U shaped, Single interrupted sutures) an small piece of  an IV set line was placed, not to put too much stress on the skin edges so there Will be no necrosis due to ischemia of the blood supply. Towel claps go a long way when trying to suture a place that has a lot of tention.

After 18 hours there was already laying down of fibrin. horizontal tention relieving incisions were made, below and above the suture line. At this time the tention sutures were removed and again using the force of the towel claps the skin edges came together nicely. A staple gun was used to get a very precise suture line and U shaped Single interrupted sutures were put in with the added IV set pieces to minimize the tention on the edges of the suture line.

The result was very satisfying. This all was possible for the use of a lot of Carbocaine, a small amount can go a long way.

Barak Amram DVM