Surgery

The clinic is equipped with the most advanced technologies to provide a high quality service and to minimize the risks of surgery and general anesthesia.

The surgical procedure is started with the administration of intravenous and preoperative treatments. Thereafter the horse is led into one of the padded induction boxes where sedation is administered to reduce anxiety and the natural nervousness of horses. Once our patient is calm and safe in the induction box, products that will anesthetise the horse are administered thereby allowing the horse to calmly lie down. The horse is transferred usinga winch to the operating room and placed on the operating table. It is then connected to the gas anesthesia machine. The table is designed to maximize the comfort of our patientsthroughout the surgical procedure.

With the exception of emergency cases, general anesthesia is always performed on an empty stomach. It takes place in three stages:

Full, pre-anaesthetic examination (analysis of blood, heart and respiratory auscultation and ECG’s).

The horse is sedated and then anesthetized in the induction box. Tracheal tubing is performed, then the gas relay (02 + Isoflurane) is provided by the anesthesia apparatus (respirator).

Monitoring of the horse is done continuously by an ECG, a capnograph and pulse oximetry and invasive blood pressure. Periodic blood gas analyses are performed.

The bringing round of a horse may be carried out under supervision, in a recovery box.

This infection is usually caused by a fungus from the Aspergillus family. The guttural pouch is located between the pharynx and the inner ear. Several blood and nerve vessels pass through the guttural pouches. The main symptom of fungoid diseases of the guttural pouches is epistaxis(nosebleed). It results from a lesion on one or more blood vessels, caused by the infection. Dysphagia (difficulty swallowing) may also be present if the infection and inflammation spread to the branches of the nerves that pass through the pouches.

The preferred surgical technique is the intra-arterial embolization with coils. This technique is performed in our clinic and, in some cases, is performed on standing horses to avoid general anesthesia; often the animal may be low, due to loss of blood. Significant blood loss may sometimes require a transfusion.It is possible to proceed in the local treatment of fungal infections with anti-fungal drugs.

COLIC SURGERY

A large number of horses with colic are referred and treated at the clinic each year. Once admitted to the clinic, the horses are quickly assessed and if necessary, a decision on whether to operate is taken in agreement with the owners and the referring vets.

Our team is aware that this can be a stressful situation for the owners. For this reason, one of our priorities is to reassure and communicate with those responsible for the animal.

Arthroscopy:

Arthroscopy is a “minimum invasive” surgery, a small incision is made and thearthroscope is inserted into the joint. In this way, the interior of the joint can be seen andthe fragments of osteochondrosis (OC) removed.

If the horse is cooperative, it is possible to remove OC fragments located on the front of the phalanx, whilst under sedation; thus avoiding general anesthesia. Arthroscopy is the technique of choice for the treatment ofbacterial infections in the joint where its use improves the prognosis.

The clinic is also capable of treating cystic arthroscopic corticosteroid injection.

Laparoscopic (or laparoscopy) “minimum invasive” surgery, allows us to reduce the standard surgery and recovery times.

It allows for a much faster return to work as compared to conventional techniques.

It is mainly used for producing ovariectomies, castration, cryptorchidism (testis in the abdomen), closing the nephrosplenic space (reduces nephrosplenic entrapment occurrences of the large colon) and hernia repair (to prevent inguinal hernias in stallions and umbillical hernias in foals).

It also allows us to explore the abdomen in cases of chronic colic, chokes, peritonitis or presence of masses in the abdomen.

Les chirurgies respiratoires peuvent être réalisées sur cheval debout ou anesthésié, selon l’intervention. La clinique dispose d’un Nd-Yag laser de grande puissance (60 W) qui nous permet de réaliser différents types d’interventions sur les voies respiratoires supérieures. Le plus souvent, ces chirurgies sont réalisées à l’aide d’un endoscope, évitant ainsi une approche invasive.

  • Cornage (Tie-back): La chirurgie la plus couramment réalisée est la chirurgie de cornage. Lors du cornage, dû à une dégénérescence du nerf laryngé récurrent, le côté gauche (le plus fréquemment) du larynx est paralysé. Cette paralyse provoque un rétrécissement des vois aériennes avec intolérance à l’effort et bruit respiratoire. La chirurgie se déroule en deux temps, dans la première phase, sous anesthésie générale, une prothèse est placée pour corriger le côté paralysé du larynx et ouvrir les voies aériennes (laryngoplastie). Avec cette intervention l’intolérance à l’effort est corrigée. Le lendemain se déroule la deuxième phase avec la ventriculo-cordectomie qui a pour objectif principal de réduire le bruit inspiratoire. Celle-ci est réalisée debout sous tranquillisation avec une technique au laser. La technique au laser évite l’incision au niveau de la gorge et par conséquent, il n’y a pas de soins locaux suite à cette intervention.

 

  • Déplacement dorsal du voile du palais: Cette pathologie touche principalement les chevaux de courses. Le voile du palais se disloque de sa position normale et va obstruer partiellement les voies aériennes. Classiquement le problème se déclenche à la fin de la course et s’accompagne de l’apparition d’un bruit respiratoire avec ralentissement de la vitesse en course. En fonction du cas, une technique chirurgicale de déplacement rostrale du larynx (Tie-forward) avec une prothèse et/ou une technique au laser pour stabiliser le voile du palais seront réalisées.

Kystes et hématomes progressifs de l’ethmoïde, kystes sous-épiglottiques et replis ary-épiglottiques:


Avec le Nd-Yag, les kystes de grande taille et les hématomes de l’ethmoïde peuvent être traités avec succès sur cheval debout tranquillisé.

Dystocia is a difficult or abnormal foaling.

Most often, it is due to abnormal foetal lie or presentation of the foal that blocks the smooth running of the expulsion phase.

A timely and coordinated response between medical and surgical team is essential to improve the prognosis of the mare and foal.

If the standing extraction of the foal is notpossible, the mare is anesthetized and hind limbs raised in the winch, to repositionthe foal. Caesarean section may be required.

  • Dystocia is a difficult or abnormal foaling. Most often, it is due to abnormal foetal lie or presentation of the foal that blocks the smooth running of the expulsion phase. A timely and coordinated response between medical and surgical team is essential to improve the prognosis of the mare and foal. If the standing extraction of the foal is notpossible, the mare is anesthetized and hind limbs raised in the winch, to repositionthe foal. Caesarean section may be required.
  • Perineal lacerations and recto-vaginal fistula are problems with foaling. In most cases, without surgery reproductive prognosis is compromised.
  • In males, urinary stones, and amputation of the penis are problems where surgical intervention is required.

Extraction of a foal by caesarian sectionIntensive care of a foal