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Biomedical subjects

E P Tulleners

Publications and source records attributed to E P Tulleners.

At least 19 recordsLinked to original sources

Neodymium:yttrium-aluminum-garnet laser-assisted excision of progressive ethmoid hematomas in horses: 20 cases (1986-1996).

OBJECTIVE: To describe a technique of contact neodymium:yttrium-aluminum-garnet (Nd:YAG) laser-assisted excision of progressive ethmoid hematoma (PEH) in horses, to determine the recurrence rate of clinical signs of PEH in horses with follow-up time of a minimum of 12 months, and to compare this result with reported results achieved by using conventional techniques. DESIGN: Retrospective study. ANIMALS: 21 horses with 26 PEH. PROCEDURE: Medical records of all horses with PEH treated by Nd:YAG laser excision from December 1986 through August 1996 were analyzed. Twenty-one horses underwent unilateral (18 surgeries) or bilateral (14) frontonasal bone flap with excision of the mass, using an Nd:YAG laser. One horse with bilateral PEH underwent a unilateral bone flap twice, 1 year apart. RESULTS: 1 horse died. Four of 20 horses with followup times of 12 months or longer had recurrence of PEH. The PEH recurrence rate was 20% (5/25 PEH). Three of 6 horses with bilateral lesions had recurrence of PEH. Recurrence rate for horses that had bilateral PEH (3/6 horses) was greater than for horses with unilateral PEH (1/14 horses). CLINICAL IMPLICATIONS: Treatment of PEH by Nd:YAG laser excision through a frontonasal bone flap results in a recurrence rate comparable with that reported for conventional techniques. Horses with bilateral lesions are more likely to have a recurrence of PEH.

Animals↗

Videoendoscopic assessment of dynamic laryngeal function during exercise in horses with grade-III left laryngeal hemiparesis at rest: 26 cases (1992-1995).

OBJECTIVE: To evaluate laryngeal function by means of videoendoscopy during high-speed treadmill exercise in racehorses with grade-III left laryngeal hemiparesis at rest and to determine outcome of treatment. DESIGN: Retrospective study. ANIMALS: 26 racehorses. PROCEDURE: Videoendoscopy of the larynx was performed while horses were at rest and exercising on a treadmill. Horses were classified as having grade-IIIA, -IIIB, or -IIIC laryngeal hemiparesis on the basis of the degree of arytenoid cartilage abduction maintained during exercise. Postoperative racing performance was determined by evaluating race records and conducting telephone surveys. RESULTS: 20 (77%) horses had grade-IIIC laryngeal hemiparesis (i.e., severe dynamic laryngeal collapse during exercise). Eighteen underwent surgery, and racing performance was improved in 9. Five (19%) horses had grade-IIIB laryngeal hemiparesis (i.e., left arytenoid cartilage and vocal fold were maintained in an incompletely abducted position during exercise). Four underwent surgery, and racing performance was improved in 1. One (4%) horse had grade-IIIA laryngeal hemiparesis (i.e., full abduction of arytenoid cartilage during exercise); surgery was not performed. CLINICAL IMPLICATIONS: Videoendoscopy is useful in determining dynamic laryngeal function in racehorses with grade-III laryngeal hemiparesis at rest.

Animals↗

Metacarpal and metatarsal fractures in cattle.

Metacarpal and metatarsal fractures are usually amenable to external coaptation using a short or full limb polyurethane resinimpregnated knitted fiberglass fabric cast. The prognosis for long-term pain-free survival is excellent for closed fractures and fair to good for open fractures managed in the manner. Surviving animals generally are not lame and do not demonstrate significant limb deformity or limb shortening and generally become completely productive. Even considering the narrow profit margin involved when treating cattle with serious injuries, this method of fracture management is usually economically and technically feasible.

Animals↗

Sternothyrohyoideus myectomy or staphylectomy for treatment of intermittent dorsal displacement of the soft palate in racehorses: 209 cases (1986-1991).

The efficacy of sternothyrohyoideus myectomy (SM) and staphylectomy as treatments for intermittent dorsal displacement of the soft palate was evaluated in 209 racehorses (126 Thoroughbreds, 83 Standardbreds). The 2 most common complaints were respiratory tract noise (75% of horses) and exercise intolerance (51% of horses). Stopping, defined as the inability to finish the race at racing speed, was reported in 40% of the horses. Endoscopy at rest revealed evidence of abnormal epiglottic anatomy (hypoplasia or flaccidity) in 51% of the horses and abnormal soft palate function in 36% of the horses. Race records were available for 149 (77 Thoroughbreds, 72 Standardbreds) horses. The sex distribution consisted of 38% sexually intact males, 20% geldings, and 42% females, with a mean age of 3.4 years. Sixty-nine horses underwent staphylectomy, with a mean of 16 weeks to first stage after surgery. Eighty horses underwent SM, with a mean of 10 weeks to first start. Sternothyrohyoideus myectomy was performed on significantly more (P < 0.05). Thoroughbreds than Standardbreds, and staphylectomy was performed on significantly (P < 0.0001; chi 2 = 39.56) more Standardbreds than Thoroughbreds. After surgery, most horses (74%) had no change in class; however, more moved up in class (17%) than down (9%). On the basis of comparison of earnings for 3 starts before surgery with that for 3 starts after surgery, successful outcome was obtained in 60% of the horses (35 Thoroughbreds, 13 Standardbreds) that received SM and in 59% of the horses (11 Thoroughbreds, 30 Standardbreds) that received a staphylectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Alar fold resection in horses: 24 cases (1979-1992).

Between 1979 and 1992, the alar folds were resected bilaterally in 22 horses and unilaterally in 2 horses. Abnormal respiratory tract noise and exercise intolerance were the primary complaints prior to surgery. Significantly (P = 0.01) more Standardbreds underwent resection of the alar folds, compared with the number of Standardbreds in the hospital population during the same period. The alar folds palpated abnormally thick in 13 horses and normal in 11 horses. Temporary dilatation of the nares with mattress sutures or clips lessened the respiratory tract noise and improved exercise tolerance in all 8 horses in which the diagnostic test was performed. Manual elevation of the alar folds reduced respiratory noise in the 11 horses evaluated. Long-term follow-up evaluation by telephone was available for 14 horses. All surgical incisions had healed cosmetically. Respiratory tract noise was decreased, and exercise tolerance improved in 10 of 14 (71%) horses. Complete charted racing information was obtained for 16 horses. Fourteen horses started their first race a mean of 118 days (range, 13 to 321 days) after surgery. The mean number of starts after surgery was 51, with 14 of 16 (88%) horses starting more than 6 times after surgery. Of the 16 horses, 8 horses raced at least 3 times before and after surgery; 4 had improved racing performance, 2 had similar performance, and 2 had decreased performance. Five Standardbreds never raced, and 1 Standardbred raced once before surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Concordance of ultrasonographic and physical findings in cattle with an umbilical mass or suspected to have infection of the umbilical cord remnants: 32 cases (1987-1989).

Medical records of 32 cattle treated for umbilical abnormalities that had undergone ultrasonographic examination of the umbilicus followed by umbilical resection or postmortem examination were reviewed. Thirty of the cattle were between 6 and 240 days old (mean, 73 days); the remaining 2 cattle were a 3-year-old bull and a 5-year-old cow. Thirty (94%) animals had external evidence of infection associated with the umbilicus. Two calves did not have external signs of infection; 1 had an abscess of the urachus and the other was found to be normal. Two-dimensional real-time ultrasonography was used to identify abnormal umbilical cord remnants. Ultrasonographic results were most reliable for the urachus, and the urachus was the most commonly affected internal umbilical cord remnant. Statistical agreement between ultrasonographic and physical (surgical or postmortem) findings was good to excellent for all umbilical structures. Intra-abdominal adhesions were found at surgery in 47% of animals with umbilical abnormalities; however, adhesions were not detected ultrasonographically.

Abdominal Muscles↗

Epiglottitis in horses: 20 cases (1988-1993).

Epiglottitis was diagnosed and treated in 20 horses (13 Thoroughbreds and 7 Standardbreds) over a 5-year period. Eighteen horses were used for racing, and 2 Standardbreds were broodmares. Primary clinical signs were exercise intolerance, respiratory noise, and coughing. The most common endoscopic diagnosis made by referring veterinarians was epiglottic entrapment (11 horses). In 19 horses, endoscopic evaluation at admission revealed mucosal ulceration and thickening of the lingual surface of the epiglottis. Other endoscopic findings included dorsal displacement of the soft palate (14 horses), and dorsal deviation of the epiglottic axis (11 horses). Only 1 horse had epiglottic entrapment. Treatment consisting of stall confinement for 7 to 14 days, topical administration of a solution of furacin, dimethyl sulfoxide, glycerin, and prednisolone, and systemic administration of nonsteroidal anti-inflammatory drugs and corticosteroids was effective in controlling epiglottic edema and inflammation. Antimicrobials were administered to 6 horses. Racing performance of the 18 racehorses was evaluated by examination of racing records. One horse was still convalescing at the time of the study, and 1 horse had been euthanatized 1 week after treatment for epiglottitis because of colic. The remaining 16 horses all started at least 1 race (mean time between initial examination and start of first race, 74 days; range, 8 to 265 days). Thirteen horses started at least 4 races following treatment for epiglottitis; racing performance after treatment was the same in 8 and decreased in 5. Long-term sequelae of epiglottitis included epiglottic deformity (5 horses), intermittent or persistent dorsal displacement of the soft palate (4 horses), and epiglottic entrapment (1 horse).

Animals↗

Transendoscopic contact neodymium:yttrium aluminum garnet laser treatment of tympany of the auditory tube diverticulum in two foals.

Tympany of the auditory tube diverticulum was treated in 2 Standardbred foals by fenestrating the median septum, using an endoscopically placed Nd:YAG laser. Recurrence in 1 foal was treated by enlarging the fenestration, using a modified Whitehouse approach, and the pharyngeal opening of the auditory tube. Use of the Nd:YAG laser eliminates the risk of inadvertent cranial nerve damage associated with incisions into the auditory tube diverticulum. The procedure can be performed with the horse sedated or anesthetized. Clinical signs can recur in the fenestration heals closed or if the condition is bilateral rather than unilateral.

Animals↗

Loop colostomy for management of rectal tears and small-colon injuries in horses: 10 cases (1976-1989).

Loop colostomy was performed in 10 horses as treatment for grade-III rectal tears (n = 6 horses), small-colon infarction (n = 2 horses), perirectal abscess and stenosis (n = 1 horse), and small-colon stricture (n = 1 horse). In 7 horses, the colostomy was constructed through a single incision low in the left flank, with closure of the incision around the stoma (single-incision technique). In 3 horses, 2 of which had colostomy performed as a standing procedure, the selected segment of small colon was placed from a flank incision into a separate, small incision low in the left flank (double-incision technique). Five horses underwent colostomy reversal (at 18 to 63 days) and 2 of these horses, both with grade-III rectal tears, recovered completely. Of 8 horses that did not survive, 6 died from the primary disease or associated complications. Technical problems associated with colostomy accounted for death of 2 horses. One horse had gastric rupture attributable to suture occlusion of the small intestine after colostomy reversal, and another horse had complications of incisional infection after repair of a peristomal hernia. Small-colon prolapse through the stoma necessitated premature reversal of the colostomy in a horse that was euthanatized because of worsening laminitis. Minor complications of the colostomy procedure were partial stomal dehiscence (n = 4 horses), partial dehiscence of the flank wound after colostomy reversal (n = 2 horses), and small ventral midline hernia after colostomy reversal (n = 1 horse). Loop colostomy may be of benefit to horses with rectal tears, provided it is done soon after the tear occurs.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Rostral mandibulectomy in five horses.

Rostral mandibulectomy with primary gingival closure was performed in 5 horses with rapidly growing or bleeding mandibular tumors. The technique involved preservation of the most caudal portion of the mandibular symphysis to maintain stability. There were no surgical complications or recurrences, and the cosmetic and functional results were good. The histopathologic diagnosis of all the tumors was ossifying fibroma. Rostral mandibulectomy affords a simple and effective technique of treating tumors of the rostral portion of the mandible in horses.

Animals↗

Use of transendoscopic contact neodymium:yttrium aluminum garnet laser to drain dorsal epiglottic abscesses in two horses.

A submucosal abscess, located on the dorsal surface of the epiglottis, was diagnosed in 2 Thoroughbred racehorses by use of endoscopy. Both horses had exercise intolerance. One horse had intermittent dorsal displacement of the soft palate, coughed while eating and galloping, and made an abnormal respiratory noise. Both abscesses were drained transendoscopically by use of a contact neodymium:yttrium aluminum garnet laser. Eleven days after surgery, the surgical sites appeared to have healed. Clinical signs resolved permanently, and both horses returned to successful racing careers.

Abscess↗

Evaluation of peroral transendoscopic contact neodymium:yttrium aluminum garnet laser and snare excision of subepiglottic cysts in horses.

Three basic techniques (and one modified technique) were developed, allowing successful excision of subepiglottic cysts in 10 horses (5 Standardbreds, 4 Thoroughbreds, and 1 Quarter Horse; mean age, 3.5 years) via peroral approach. This approach eliminated the need for laryngotomy or pharyngotomy and reduced postoperative care. None of the cysts redeveloped. Clinical signs of disease before surgery included respiratory noise, exercise intolerance, coughing, and dysphagia and were eliminated in all horses except one that raced successfully, but in which some respiratory noise was detected. Peroral subepiglottic cyst excision was performed on anesthetized horses that were positioned in lateral recumbency and intubated via the nares and trachea. General anesthesia allowed careful intraoral palpation and endoscopic visualization of the oropharynx on a television monitor. Custom-designed instruments, including a guide tube, cyst snare, and long grasping forceps, facilitated either laser or snare, or laser and snare cyst excision. Hemorrhage was negligible in all horses. Initial attempts to develop a technique to submucosally excise subepiglottic cysts through a transnasal transendoscopic approach in conscious horses, using a contact neodymium:yttrium aluminum garnet laser, were unsuccessful. In each of 3 horses, the cyst was inadvertently penetrated before it could be excised, causing it to collapse and disappear beneath the soft palate. Postoperative complications were excessive subepiglottic swelling after laser excision (n = 1 horse), which resolved completely in response to anti-inflammatory treatment, and subepiglottic cicatrix formation after snare excision (n = 1 horse), which required surgical excision of the cicatrix.

Animals↗

Correlation of performance with endoscopic and radiographic assessment of epiglottic hypoplasia in racehorses with epiglottic entrapment corrected by use of contact neodymium:yttrium aluminum garnet laser.

Epiglottic entrapment in 35 Thoroughbred and 44 Standardbred horses was corrected transendoscopically by use of a neodymium:yttrium aluminum garnet laser. Before surgery, the entrapped epiglottis was classified as hypoplastic or normal in each horse on the basis of endoscopic appearance alone. Using a digitizer, thyroepiglottic length was determined from lateral-view laryngeal radiographs. For 78 racehorses, earnings (less than $5,000 or greater than $5,000) were compared before and after surgery. Earnings category and racing performance after surgery were tested for association with endoscopically determined epiglottic hypoplasia and radiographically determined thyroepiglottic length. Endoscopy and radiography were useful methods of evaluating the epiglottis in horses with epiglottic entrapment. Mean (+/- SD) thyroepiglottic length for both breeds of horses with epiglottic entrapment was significantly (P = 0.0001) smaller (Thoroughbreds, 7.28 +/- 0.67 cm; Standardbreds, 7.21 +/- 0.62 cm), compared with thyroepiglottic length measured from control groups composed of clinically normal Thoroughbred (8.56 +/- 0.29 cm) and Standardbred (8.74 +/- 0.38 cm) racehorses. Both breeds of horses with epiglottic entrapment that had endoscopically apparent hypoplastic epiglottis had significantly (P less than 0.0001) smaller thyroepiglottic length (Thoroughbreds, 6.64 +/- 0.60 cm; Standardbred, 6.93 +/- 0.72 cm) than did horses with epiglottic entrapment that had endoscopically normal epiglottis (Throughbreds, 7.57 +/- 0.47 cm, Standardbreds, 7.36 +/- 0.50 cm). Significant difference was not detected in endoscopic appearance of the epiglottis among age, gender, or breed distributions.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Transendoscopic contact neodymium:yttrium aluminum garnet laser correction of epiglottic entrapment in standing horses.

Fifty-seven Standardbred and 44 Thoroughbred racehorses and 1 Thoroughbred polo mare with primary clinical signs of exercise intolerance or respiratory tract noise or combined exercise intolerance and respiratory tract noise were referred for laser correction of epiglottic entrapment. Significantly (P less than 0.001) more Standardbred than Thoroughbred racehorses were affected, compared with the observed hospital population during the same period. At referral, 14 horses did not have evident epiglottic entrapment and were returned to exercise without development of entrapment after treatment, which consisted of 1 week of rest and administration of anti-inflammatory medication. In 88 standing horses under sedation and topical anesthesia, epiglottic entrapment was corrected transendoscopically by use of a contact neodymium:yttrium aluminum garnet laser. In these 88 horses, 98% of entrapments were persistent, 92% were thick, 97% were wide, and 45% were ulcerated. Thirty-one percent of the horses had endoscopic evidence of epiglottic hypoplasia, and 8% had deviated epiglottic axis. Complete correction was achieved in 97% of the horses, Persistent dorsal displacement of the soft palate in 1 horse and severe epiglottic hypoplasia with thick, chronic entrapping membranes in 2 horses precluded successful transendoscopic correction with the horses in standing position. Most horses were treated on an outpatient basis, and all were able to be returned to exercise after 7 to 14 days of rest and treatment with anti-inflammatory medication. Entrapment recurred in 4 horses (5%), 3 of which had hypoplastic epiglottis. Dorsal displacement of the soft palate developed after surgery in 9 horses (10%) and continued in 4 horses (5%) that had displaced soft palate before surgery. All these horses had epiglottic hypoplasia. Laser correction of epiglottic entrapment in standing horses was safe, well tolerated, and effective. Laser surgery was an alternative to conventional surgery, and eliminated the need for general anesthesia and laryngotomy. It also reduced convalescence and postoperative complications.

Airway Obstruction↗

Third-degree perineal lacerations and rectovestibular fistulae in cattle: 20 cases (1981-1988).

The case records of 20 cows with either a third-degree perineal laceration or rectovestibular fistula were reviewed to ascertain the signalment, history, treatment, and long-term result of treatment. Fifteen cows, including 10 first-calf cows, had third-degree perineal lacerations that occurred at calving. Surgery was done in 14 of 15 cows; 10 of the 14 (71%) remained fertile. The cow that was not treated surgically was culled after 24 months because of infertility. Five cows had a rectovestibular fistula; 4 of these were treated surgically. The cow that did not have surgery healed by second intention and remained fertile, and 3 of the 4 cows in which surgery was performed were fertile. None of the cows that produced calves after the initial injury suffered a perineal laceration at subsequent calvings. Single-stage surgical repair of third-degree perineal laceration or rectovestibular fistula appeared to have a good prognosis for subsequent fertility in cows.

Animals↗

Prevention and treatment of complications of bovine gastrointestinal surgery.

Abdominal surgery is the most common major surgical procedure performed by bovine practitioners. Most cattle, particularly dairy cattle, are sufficiently placid that major abdominal procedures are routinely completed with the animal standing, using local anesthesia and minimal physical and chemical restraint. An experienced bovine surgeon who exercises good judgment will infrequently encounter complications associated with this surgery. The purpose of this article is to describe the potential complications related to bovine abdominal surgery, how to avoid them, and how to treat them when they arise.

Anesthesia↗

Intestinal atresia in calves: 22 cases (1978-1988).

A retrospective study of 22 calves afflicted with intestinal atresia was performed to determine typical signs of disease, treatment, and survival rate. All 22 calves, except 2 heifers with atresia ani and rectovaginal fistula, were examined when they were between 1 and 10 days old because of depression, anorexia, abdominal distention, and lack of feces. All calves had been observed to stand and suckle shortly after birth. Survival rate was influenced by the atretic segment affected: 0% (0/2 surgically treated) for atresia jejunal; 42% (5/12 examined) or 71% (5/7 recovering from general anesthesia) for atresia coli; and 63% (5/8 examined) or 71% (5/7 surgically treated) for atresia ani. Survival appeared to depend principally on early recognition, anatomic site affected, and successful surgical establishment of a patent intestinal tract.

Anastomosis, Surgical↗