Results 2007

1874 sets of x-rays were filed (1983, -5%). 987 (1181, -16%) of which were taken in the clinic and 887 (802, +11%) were acquired in the van. 112 horses underwent shockwave therapy (98, +14%), and 226 bone scanswere acquired (150, +51%), 6 of which horses had two scans during the year. There were 116 standing MRI scans performed (52, +123%). 649 ultrasound examinations were performed, 489 of which were tendon scans and 83 were repeat tendon scans. 3571 endoscopic examinations were performed, 2874 of which also had tracheal washes performed. A further 50 horses had a gastroscopic examination performed

538 surgeries (478, +14%) were performed. The standard anaesthetic protocol at Donnington Grove was changed at the end of April 2007 to incorporate cri with alpha 2 agonists, the Zurich protocol, and on 22/10/07 the Linatex recovery room floors entered service. 330 operations were performed using the Zurich protocol and 101 horses recovered on the new flooring. 

Of the 538 surgeries, a similar number of total surgeries to 2006 were orthopaedic - 254 (250, +1%). Two horses had second surgery for a septic tendon sheath 48 hours after the first. A mare had a 6 hour operation to repair a diaphragmatic hernia only to die during recovery. 2 horses that had arthroscopy of the femoro-patellar joint required a second surgery 24 hours later. One foal had three arthroscopies of a septic stifle joint, each 72 hours apart. The foal was later euthanised and at post mortem, the presence of an abscess was confirmed in the proximal aspect of the lateral trochlear ridge and distal femoral growth plate.

Standing surgeries49, were increased on numbers from 2006 (40, +23%). The breakdown of surgical cases was as follows: horses required standing sinus trephination and endoscopy (3, +100%). 4 laparoscopic castrations (5, -20%), 2 laparoscopic ovariectomies (2, 0%), 1 dorsal spinous process resections (4, -75%), 5screw removals (4, +25%) and 3 septic joints were flushed standing. In addition, a semitendinosus myotomy, a medial patellar ligament desmotomy and a fetlock arthroscopy were performed standing. An attempt was made to repair a rectal tear in a mare, but was given a general anaesthetic later on in the day. Of the 8 jaws that were wired at Donnington Grove Veterinary Surgery, 3 were done under standing sedation and a further 5 were performed under general anaesthetic.

197 arthroscopies were performed (153, +29%), an increase on 2006 and 2005 figures. This figure compensates slightly for the reduced number of colic surgeries that were performed over the year, and helped maintain the total number of surgeries. The arthroscopies can be divided up as follows:  8 calcaneal bursae (7, +14%), 32 carpal arthroscopies (39, -18%), 40 septic tendon sheaths/joints, 4 coffin joints, 8 femoro-patellar joints, 16 femoro-tibial joints, 29 fetlocks, 5 high check ligament desmotomies (18, -72%), 5 hocks (5, 0%), 1 pastern joint, and 3 physeal spikes (5, -40%).

38 fractures were repaired (33, +15%). 8 of these comprised of a non-displaced, sagittal fractures of the first phalanx (7, +14%). Fractures were equally distributed between the fore and hind limbs.  A similar number of non displaced condylar fractures of the 3rd metacarpal and metatarsal bones occurred (8, 0%). 7 of these involved the lateral condyle and 1 involved the medial condyle. 6 of the fractures involved hind limbs, and another 2involved the forelimbs. They were mostly repaired with two 4.5mm AO screws and a further one 5.5 mm AO screw or a combination of the same. A foal that had a fracture of the lateral trochlear ridge of its hock was repaired using two 3.5 mm AO screws. There were 2 olecranon fractures (2, 0%) repaired, both of which had been sustained in mares following kick injuries. One was repaired using a ten hole, DCP plate contoured to fit the ulna. The second was repaired using a nine hole, hook-shaped LCP. A repair of a tibial tuberosity fracture was carried out using a pre-bent, six hole narrow dynamic compression plate.

In addition, there was one horse that had a pastern arthrodesis and one foal that had an angular limb deformity corrected with a transphyseal screw and periosteal elevation. A further 5 jaws were wired under general anaesthetic.

ENT surgeries were well up from 2006 figures at 140 (112, +25%). Fire of the soft palate was again the most common with 40 (26, +54%) closely followed by hobday 34 (23, +48%). Tie forward in combination with firing the soft palate made up another 32 surgeries (23, +39%). Only 2 horses had a tie forward performed alone (7, -71%). Tie back and hobday procedure in combination made up a further 11 surgeries (7), hobday and firing the soft palate made up a further 6 cases (3, +100%). There was only 1 case of a tie back procedure performed alone (10, -90%). 4 epiglottic entrapments were released via a transoral approach (3, +33%). 5 lateral buccotomies (9, -44%) were performed and a further 4 teeth were removed orally with grasping forceps.

83 colics were admitted to Donnington Grove Veterinary Surgery for colic assessment. Of these, 30 horses (38, -21%) were taken to surgery, reflecting a slight drop in numbers from previous years. 2 horses had a second colic operation within a 24-hour period of the first operation.  These can be categorised as follows: strangulating lipomas 5 (4, +25%), one of which was euthanised during the operation due to the severity of length of small intestine requiring resection; large colon torsions 4 (2, +100%); small intestinal impactions 5 (3, +66%); small intestinal volvulus 2 (3, -33%). 3 cases of colic presented with grass sickness like symptoms and were biopsied at surgery, later to be confirmed positive by histology.

A foal presented with colic symptoms was later found to have dark red urine on catheterisation at the start of the operation. No abnormalities were found during surgery. Atypical myoglobinuria was later confirmed on post mortem. Another horse was also found to have a ruptured stomach with no other reason for obstruction. A biopsy of the liver was later to confirm that chronic ragwort poisoning had lead to liver cirrhosis and subsequent gastric outflow obstruction.

Other frequently performed operations included 18 (9, +100%) plantar fasciotomies and neurectomies, plus bilateral medial patellar ligament esmotomies  and 3 neurectomies.

There were 12 perioperative deaths (11, +9%), of which 4 (7, -43%) were euthanased on the table. Four of the colic surgeries were euthanased during the operation for a variety of reasons. Two of the cases were euthanased at their owners request on the discovery of an extensive length of necrotic gut, warranting a guarded prognosis. One the horses had a pedunculated lipoma; the other had a small intestinal strangulation through a mesenteric rent. As mentioned earlier, another colic was found to have a ruptured stomach as a result of ragwort poisoning, and the fourth was euthanased and found to have atypical myoglobinuria at post mortem. One horse that had a diaphragmatic hernia died in recovery. Two routine carpal arthroscopies also sustained a fractured olecranon and humerus in recovery and were later euthanised. Two horses also died of upper respiratory tract obstruction whilst recovering from routine general anaesthetics.

A horse that had a split pastern repaired later went on to fracture a femur in recovery and subsequently euthanased (both these occurred before the Linatex flooring was installed). Another horse that had an arthroscopy for a septic fetlock managed to dislocate the offending joint in recovery, rupturing the collateral ligaments in the process and warranting euthanasia (on the Linatex flooring). Only 1 anaesthetic death was incurred (3, -66%), that of a pony undergoing the removal of a neuroma which died during the operation for no obvious reason (before the adoption of the Zurich anaesthetic protocol). The total of unanticipated and unexpected deaths in horses undergoing anaesthesia was therefore 5 of 489, 1.02%.