This week was packed with interesting cases! I was able to
learn a lot and gain great hands on opportunities!
This week started off with two ventral cordectomies or VCs. Ventral
cordectomy is a procedure that is done for horses that are “roarers.” Roaring
is when a horse makes loud roaring noises during inhalation. This is because
the horse suffers from laryngeal paralysis. There are nerves that innervate the
muscles that help to open the arytenoid cartilage and when the horse inhales,
they stimulate the muscles to constrict, which opens up the horses air way and
allows them to breathe. With horses that have damage to this nerve it can cause
the arytenoid cartilage to not open correctly, therefore, causing the roaring
sound and making it difficult for them to breathe. This can sometimes be
apparent during strenuous exercise and reduce performance with horses. In order
to fix this problem the horses were first scoped and we observed their
arytenoid cartilage in order to confirm that the horses had nerve damage. Once
this was done the doctor made a ventral incision and cut through to the larynx.
Once they were inside they removed the vocal cords and the vestibular fold in
order to increase the ventral diameter and reduce the noise associated with
laryngeal paralysis. This procedure is done standing and with the endoscope
still near the opening of the horses larynx. This allows the surgeon to get a
better view and it allows the horse to still be standing for the procedure. I
unfortunately did not get any pictures for this week, hopefully I will have
some next week!
A yearling showed up to the clinic for a bilateral
cryptorchid surgery. When a horse is cryptorchid it means that the testicles
have not descended, they are still in the abdominal cavity. Before the surgery
started we had to safely drop the horse for surgery. During this process, the anesthesiologist
administers the drugs and guides the head of the horse, while 1-2 assistants, depending
on the size of the horse, will push the hips and shoulders of the horse against
the wall so they fall safely. We essentially guide the horse to the ground.
Once this was done, the anesthesiologist let me place the endotracheal tube! It
was so exciting! For horses you have to grab the tongue first and then place a
tube in its mouth so that the endotracheal tube can pass through the horse’s
mouth safely. Once the tube is in, you
should have no resistance when passing it into the trachea. If you have
resistance you want to pull the tube back slightly and rotate it slightly. Once
you are in the trachea you should be able to feel the horses breath. Once I did
the rotation I could feel the horses breath! Then we hoisted the horse onto the
surgical table and prepped the patient for surgery. The surgeon found the
testicles and removed them. The patient recovered well and went home.
Another colic emergency showed up to the clinic yesterday.
We ultrasounded the abdomen and took a sample of the fluid and it was blood.
The horse had a hemoabdomen. The veterinarian ran some blood work and the horse
was found to have little to no platelets. The surgeon said that the horse was
not a surgical candidate due to this issue. The plan was to give the horse
fluids and give it a transfusion in order to increase its platelets and help
stop the bleeding. We went to a neighboring horse farm and found a blood donor
and began the transfusion. I was able to monitor the transfusion. I took the
horses temperature, respiration rate and heart rate every fifteen minutes in
order to monitor the horses condition. The horse did well throughout the
transfusion and is in stable condition. We are still monitoring her status and
I will keep you posted on her outcome!
Another horse presented to the clinic for a mass on her
uterus. The owners wanted to see if this would impede her breeding abilities.
The horse was put in the stalks, rectally palpated and ultrasounded. It was
found that she had a mass on the bifurcation of her uterus and she was
vaginally scoped to further investigate the mass. The mass was not seen with
the scope and the veterinarian said that it could not be safely sampled. The
mass was on the outside of the lumen of the uterus and would not likely
interfere with future breeding if it did not increase in size. The veterinarian
suggested to follow up with the mass to see if it will enlarge further. If the
owner wanted to, surgical removal could be an option for the mare.
I was also able to rectally palpate a mare for the first
time, which was a wonderful experience. I got to palpate one of the
veterinarians horses after they ultrasounded the ovaries for follicle
development. They were trying to see if they should breed the mare and used
ultrasound to measure the diameter of her follicles on her ovary in order to
determine when to order semen to breed the mare. I was able to rectally palpate
and feel the horses aorta, uterine body, bifurcation and right and left
ovaries! It was amazing to have such an experience like that!
Other than that, I have become more comfortable with placing
IV catheters, helping to drop horses for surgery, recovery after surgery, TPR,
administering medications and scrubbing for joint injections, surgery and
sterile scrub. Dropping horses for surgery is very interesting. It takes a
couple of people, depending on the size of the horse; the anesthesiologist to
hold the horses head and guide them when they fall, one person to guide the
point of the shoulder, another to guide the hips and maybe a third to help the
horse fall safely. Recovery can be challenging, but I am glad I get opportunities
to help! Once we get them off the table we lay them down and tie ropes to the
halter and the tail. Once the horse is ready to get up on their own we will use
the ropes to help guide them up safely. This helps to limit falling and injury
to the horse. After the horse has been up for a period of time we will test
their balance. If they pass this test, we will untie the ropes from the halter
and tail and allow them to walk around the recovery suite for a bit and then
lead them down to their stalls.
So far this has been a great experience. I have learned so
much about equine medicine and I have gained so many valuable skills. Can’t
wait to see what this next week brings me!
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