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Biomedical subjects

C A Ragle

Publications and source records attributed to C A Ragle.

18 recordsLinked to original sources

Injury to abdominal wall vessels during laparoscopy in three horses.

Epigastric vessels were inadvertently injured during placement of instrument portals in 3 horses undergoing laparoscopy for bilateral cryptorchidectomy, bilateral ovariectomy, and removal of electrode wires surgically implanted in the large colon. The resulting hemorrhage increased surgery time, caused hematoma formation or hemoperitoneum, and obscured the surgical field. Hemostasis was achieved by direct pressure or vessel ligation. This complication can be attributed to the high degree of vascularity of the ventral aspect of the abdominal wall.

Abdominal Muscles

Use of tenoscopy for management of septic tenosynovitis caused by a penetrating porcupine quill in the synovial sheath surrounding the digital flexor tendons of a horse.

A 6-year-old Quarter Horse gelding with acute onset of a grade-4/5 lameness of the left forelimb 21 days after an encounter with a porcupine was examined. Quills had been removed by the referring veterinarian, and the horse had been treated with antibiotics and hydrotherapy for 14 days. The horse was pyretic and had effusion in the digital synovial sheath. Signs of pain were elicited on palpation of the area. A tentative diagnosis of septic tenosynovitis caused by a porcupine quill was made. Exploratory tenoscopy revealed large amounts of fibrin in the sheath and a 1.2-cm quill. Bacteriologic culture of synovial fluid yielded a pure growth of Staphylococcus aureus. The horse improved dramatically after tenoscopic removal of the quill, debridement of fibrin, and lavage to dilute inflammatory mediators and bacteria, debridement of fibrin, discovery and removal of a quill, and complete evaluation of the sheath for prognostic purposes. Tenoscopy can provide a means for direct observation and enhance the ability of clinicians to debride a septic synovial sheath in a minimally invasive manner.

Animals

Laparoscopic diagnosis of ischemic necrosis of the descending colon after rectal prolapse and rupture of the mesocolon in two postpartum mares.

Two mares were referred for evaluation after dystocia and rectal prolapse. Diagnostic laparoscopy, performed while the horses were standing, was used to evaluate the condition of the distal portion of the colon, rectum, uterus, and mesocolon. In both horses, laparoscopic observation revealed tears in the mesocolon of the descending colon. Exploration from the left or right flank was adequate. Because of the poor prognosis associated with the findings, euthanasia was elected at completion of laparoscopy. Tears in the mesocolon are not easily detected by use of traditional tests. Laparoscopy proved to be a more thorough means of evaluating the caudal portion of the abdomen including the digestive and urogenital tracts in these horses. As a less invasive diagnostic tool, laparoscopy can be performed earlier in the course of disease than alternative approaches for direct viewing. Furthermore, laparoscopy can be used to access the viability of tissues as well as the location and severity of lesions for prognostic purposes. The distal portion of the descending colon can also be evaluated to determine whether celiotomy with anastomosis or colostomy may be the surgical procedure of choice.

Animals

Anorectal lymphadenopathy causing colic, perirectal abscesses, or both in five young horses.

Enlarged anorectal lymph nodes can cause colic in young horses by obstructing the caudal aspect of the rectum. Dyschezia and clinical signs consistent with abdominal pain were the predominant reasons for evaluation of the 5 young (3 to 15 month old) horses of this report. Digital transrectal palpation revealed a firm mass obstructing the caudal aspect of the rectum in each horse. Results of cytologic evaluation of the masses revealed a lymphoid population of cells in 4 of 5 horses. These nodes regressed over time or became abscesses and drained into the rectum. In 1 horse, detection of a mature abscess and concomitant dysuria necessitated immediate surgical drainage of the mass; however, the other 4 horses were successfully managed medically, thereby avoiding risks associated with surgery of the perirectal area. Anorectal lymphadenopathy should be considered as a differential diagnosis in young horses with colic.

Abscess

Laparoscopic ovariectomy in two horses with granulosa cell tumors.

Two mares were admitted for ovariectomy of unilateral granulosa cell tumors. Both mares were ovariectomized (1 unilateral and 1 bilateral) by use of a ventral abdominal laparoscopic technique. This approach required tilting the operative table 30 degrees to elevate the pelvis and to allow observation of the ovaries. Using a single laparoscopic portal and 3 to 4 instrument portals, a triangulation technique was used. The ovarian pedicles were isolated and secured via loop ligation. The ovaries then were divided from the ligated pedicle and placed within specimen bags for extraction. The specimen bags then were removed through a ventral midline celiotomy. Using this technique, it was determined that granulosa cell tumors or ovaries of up to 20 cm in diameter can be removed. Laparoscopic ovariectomy provided a means to provide tension-free dissection and ligation of the ovarian pedicle. In comparison to conventional techniques, this may improve suture security and reduce complications related to excessive pedicle tension. Improved observation during surgery, less pedicle tension, and minimal invasiveness made laparoscopic ovariectomy of these 2 mares advantageous.

Animals

Arthroscopic removal of osteochondral fragments from the proximal interphalangeal joint of the pelvic limbs in three horses.

Osteochondral fragments detected in the proximal interphalangeal joint in the pelvic limbs of 3 horses (2 Standardbreds and 1 Thoroughbred) caused joint enlargement and lameness. Fragments were removed by use of arthroscopy. Accurate placement of the arthroscope into the dorsal joint space was necessary to obtain an adequate view of the fragments. After surgery, 2 of the horses resumed racing without joint problems, and the third was in training to race. High-detail radiographs are necessary to detect osteochondral fragments in horses with joint enlargement or lameness localized to the proximal interphalangeal joint.

Animals

Head trauma.

The equine head is especially prone to trauma from kicks, collisions, entrapments, and falls. The specialized structures of the equine head are important in both function and appearance. When injury causes either loss of function or cosmesis, timely treatment is paramount. This article discusses the occurrence and therapy of trauma to the equine head, including fractures of the mandible and premaxilla, facial bone, hyoid apparatus, and skull base.

Animals

Surgical treatment of colic in American miniature horses: 15 cases (1980-1987).

A study of 15 American miniature horses (AMH) that underwent surgical treatment for colic was performed. Information obtained from the medical records included signalment, clinical signs, type and location of gastrointestinal lesion, and postoperative complications. All 15 AMH had intraluminal obstructions, attributable to feed impactions (11 horses), enteroliths (2), and sand (2). The most common location of obstruction was the small colon, which was involved in 9 of the 15 cases. All 15 AMH survived and were discharged from the hospital. Six of the 15 AMH underwent subsequent surgical treatment for abdominal disorders. Elapsed time between the first and second operations ranged from 1 month to 5 years. Intestinal adhesions were observed in all AMH that were surgically treated twice. Thus, despite the fact that most of the AMH had a simple intraluminal obstruction, 40% (n = 6) developed adhesions that required or complicated a second surgery. Of the 15 AMH, 87% (n = 13) survived at least 12 months after the initial exploratory celiotomy. These findings suggest that most surgical abdominal conditions in AMH can be corrected; however, precautions should be taken to avoid or minimize adhesion formation.

Animals

Traumatic disruption of the suspensory apparatus in foals.

Traumatic disruption of the suspensory apparatus is a catastrophic injury in the horse. Although this injury has been described in the adult, little information is available in the foal. This paper describes 3 foals with metacarpophalangeal joint instability caused by traumatic disruption of the suspensory apparatus. Two foals had biaxial proximal sesamoid fractures in a single forelimb, and 1 foal had avulsion of the distal sesamoidean ligaments in 1 forelimb plus biaxial proximal sesamoid fractures in the other forelimb. The foals with single forelimb involvement were managed with splints, and the foal with bilateral disruption of the suspensory apparatus was euthanatized. Both treated foals resumed natural exercise at pasture. Both continue to be pasture sound 2 and 3 years after injury and are to be used for breeding. Management of disruption of the suspensory apparatus causing metacarpophalangeal joint instability using external support was effective for salvage of these 2 valuable foals for breeding.

Animals

Necrosis of the collateral cartilage of the distal phalanx in horses: 16 cases (1970-1985).

The medical records of 16 horses with necrosis of the collateral cartilage of the distal phalanx were reviewed. Typical history included a laceration or puncture wound over the affected cartilage, resulting in persistent drainage proximal to the coronary band. All horses had signs of lameness. The duration of drainage prior to admission to the hospital ranged from 5 days to 5 months. The involved cartilages were left front lateral (n = 4), right front lateral (n = 5), left rear lateral (n = 1), right rear lateral (n = 4), left front medial (n = 1), and left rear medial (n = 1). The affected cartilage was curetted or resected in 13 horses, and conservative treatment was used in 3 horses. Follow-up information on 15 horses (2 to 72 months after discharge) revealed that 66% were sound and able to perform at their previous level. One horse was euthanatized 2 months after discharge from the hospital because it had septic arthritis of the distal interphalangeal joint. The outcome of treatment for each horse was evaluated with respect to the duration of drainage and the method of treatment. Horses with drainage of less than 1 month's duration had a better prognosis for eventual soundness, compared with horses with drainage of greater than or equal to 1 month's duration prior to initiation of treatment. Nine of the 13 horses managed surgically and 1 of the 3 horses managed conservatively were sound at follow-up evaluation.

Animals

Surgical treatment of sand colic. Results in 40 horses.

A retrospective study of 40 horses that underwent surgical treatment for sand colic was performed. Three horses were euthanatized and one died during surgery. Of the 36 horses that recovered from anesthesia, five died before discharge from the hospital and seven died after discharge. Twenty-four horses survived at least 12 months. Sand impaction of the right dorsal colon was present in 26 horses. In addition to sand impaction, 10 horses also had colonic displacement or volvulus.

Animals

Ventral abdominal approach for laparoscopic ovariectomy in horses.

Eleven mares and four mules were ovariectomized by a ventral abdominal laparoscopic technique. This approach required tilting the operative table about 30 degrees elevating the pelvis to allow observation of the ovaries. A triangulation technique with a single laparoscopic portal and four instrument portals was used. The ovarian pedicles were ligated and the ovaries were removed through a single enlarged instrument portal. Females ranged in age from 5 months to 18 years. Mean operative time was 44 minutes (range 20 to 90 minutes); mean operative time of the last seven animals was 26 minutes. Signs of abdominal pain occurred in three mules and one mare in the immediate postoperative period. Peritoneal fluid collected from six animals 48 hours after surgery had a mean leukocyte count of 34,463/microL: (range, 21,000 to 62,800/microL), mean protein concentration of 3.1 g/dL (range, 2.2 to 4.6 g/dL), and mean differential leukocyte count of 74% neutrophils and 26% mononuclear cells. The animals were confined for 2 weeks after surgery. Signs of estrus were observed in two mares within 6 months after ovariectomy. All owners reported satisfaction with the results of laparoscopic ovariectomy. The ventral abdominal laparoscopic approach permitted efficient and safe ovariectomy of foals and adults.

Animals

Ventral abdominal approach for laparoscopic cryptorchidectomy in horses.

OBJECTIVE: To report a ventral abdominal approach and a ligating loop technique for laparoscopic cryptorchidectomy in horses. STUDY DESIGN: Prospective. SAMPLE POPULATION: Six horses, aged 1 to 5 years, with retained testes. METHODS: One laparoscopic portal and three to four instrument portals were used for ventral abdominal laparoscopic cryptorchidectomy. Laparoscopic instruments were used to maneuver and secure the testis through a ligating loop (modified Roeder knot) that was secured from outside the abdominal cavity. Only minimal enlargement of one instrument portal was used to remove the testicle. RESULTS: Three horses were bilateral cryptorchids, and three were unilateral (left side, two; right side, one) cryptorchids. Operative time, defined as the time from laparoscope insertion to removal, ranged from 20 to 25 minutes for unilateral cryptorchids and from 40 to 50 minutes for bilateral cryptorchids. CONCLUSIONS: The reported technique allowed decreased tension on the tissues during ligation and removal of the testis from the peritoneal cavity. Improved observation of the abdominal cavity, ligation security, shortened patient confinement time, and minimally invasive technique are all considered to be benefits of laparoscopic cryptorchidectomy. CLINICAL RELEVANCE: Direct observation of retained testes and intraabdominal castration are distinct advantages of the use of laparoscopy in horses that have had previous unsuccessful surgical attempts, horses with unknown histories that have retained testicular tissue, or bilateral abdominal cryptorchids.

Animals

Abdominal auscultation in the detection of experimentally induced gastrointestinal sand accumulation.

A blind study was designed to determine if abdominal auscultation is an effective method for detecting the presence of intestinal sand. Fifteen horses divided into two groups were used in the study. There were seven horses in Group 1 and eight horses in Group 2. All horses were auscultated and determined to be free of sand sounds before initiation of Trial 1. Group 1 horses were given 4.2 g/kg body weight of sand via nasogastric tube using carboxymethylcellulose (CMC) as a suspending agent at 9.0 ml/kg body weight. Group 2 horses were given CMC only. Horses remained in the same group through all trials. A total of five trails, each lasting 24 hours, was performed. Dosing with sand and CMC or CMC alone was repeated at the beginning of each trial. Abdominal auscultation was performed on each of the 15 horses beginning on Trial 2 by an investigator with no knowledge of the grouping of the horses. The ventral abdomen was auscultated for 5 minutes at 7 hours and 17 hours after trial initiation. When a horse was considered positive for intestinal sand by auscultation, the horse was eliminated from future trials. On Trial 2, no horses were positive; on Trial 3, one horse; on Trial 4, two horses, and on Trial 5, four horses. Sounds considered characteristic for sand in the intestinal tract were eventually identified in all Group 1 horses. No horses in Group 2 were ever identified as having sounds characteristic for intestinal sand at any point during this investigation.

Animals