COW: Pancake Batter (aka abscess)

This horse presented with a large swelling in his right inguinal area. The sheath was a little swollen too. He was a little sore as well. Here is a picture of what it looked like. What do you think?

The swelling was quite soft and felt like it was filled with fluid. The primary rule outs here are a hematoma (filled with blood), seroma (filled with serum) or an abscess (filled with pus). Here is an ultrasound image of the swelling. You can see that this huge swelling was filled with echogenic material. This image is characteristic of an abscess. An ultrasound allows us to get a good feel for how deep it goes and what structures are involved.

The best treatment for these is to establish drainage, so all the pus can get out. That is what we did. This is a picture of pus gushing out of this abscess.

Here it has slowed to a weak stream.

This was quite a large abscess that left a fairly good sized puddle.

Looks like a huge pancake on the griddle.

Abscess are not a rare occurence in veterinary medicine. It is just not very often that we encounter one of this size. This horse should go on and make a full recovery.

COW: Too Pregnant

Breeding season is now well upon us. Here is an interesting ultrasound of a mare with 14 day twin pregnancies. Being the parent of twin boys, I have often heard the expression, ‘Congratulations, two for the price of one.’ While that is a false statement in people, it is exponentially more false in horses. The unfortunate reality is that horses do not do well with twin pregnancies. Often, both pregnancies are lost somewhere along the way so that neither one survives. Of those that survive to term, the foals are often either born pre-mature and/or extremely weak. Typically, of those that survive to term, one of the foals is either born dead or dies shortly after birth. Often the mare experiences complication with foaling as well. It is quite rare to have twin foals survive to weaning.

All that to say that twin pregnancies in horses are not good. As a result, when we encounter twin pregnancies early on, we attempt to reduce them to a single pregnancy. Early pregnancy diagnosis with ultrasound is key to successfully managing twin pregnancies. This is one of the primary reasons to pregnancy check mares 14 days after ovulation. When the vesicles are small (less than 1.5 cm), like they are in this image, one of the pregnancies can be ‘pinched’ off with pretty good success. With one of the vesicles pinched off, the other one can go on and develop into a normal healthy foal, just as if it had started as a single pregnancy.

One of the questions we are often faced with when pinching twins is, which one do you pinch? The rule of thumb is to pinch the smaller one. Inevitably, halter horse people want the one that is a colt pinched, performance horse people want the filly pinched and paint horse people want the one without color pinched. Unfortunately, we don’t yet have the technology to easily distinguish those factors so we usually just try to do the smaller one.

Early diagnosis of twin pregnancies is key to success. If not identified and pinched early, there are other options for reducing them to a single pregnancy, but those options are much more complicated with much lower success rates.

Taking a "Barb" at Veterinary Medicine

Over 80% of new grads from veterinary school are female. Apparently Mattel has taken note. I don't know many vets that would dress like this to go to work. At least she is wearing boots!

http://www.target.com/webapp/wcs/stores/servlet/p/Barbie-I-Can-Be-Pony-Doctor/-/A-13422959

New Web Page

We here at West Michigan Veterinary Service just launched a newly redesigned web page at www.wmvs.com . If you have not already done so, click here and take a minute to check it out.

While you are visiting our site, take a minute to fill out the client survey. There is a link posted on the home page.

One added feature on our new site is the option to go to a slimmed down version of the site to run on your mobile device. It would be worthwhile bookmarking it (www.wmvs.com/m) on your cell phone for one click dialing to the office. I would love to hear your comments on our new page, so after you have looked at it click 'comments' at the bottom of this posting.

COW: Routine Castration(s)

Gelding horses is the most routine surgery done in equine practice. I thought you might enjoy seeing how this surgery is done in the field. What follows are pictures from a couple of castrations that I performed recently. The first victim was a Minature Donkey. The second is a 2yr. Fresian. Anesthesia, is of course an essential component, since most horses (or donkeys) are not necessarily fond of having their testicles cut off.

A word of caution: The pictures below are of the real word and involve real tissues. If you have a weak stomach and/or are in the midst of eating something, you may not want to scroll down.

We will start with the Donkey.

We use injectable anesthetic agents to anesthetize the patient.

Once the patient is out cold, the hind legs are restrained by tying them up with ropes.

After the area of interest is thoroughly scrubbed an incision is made over each testicle. The testicle is then identified and lifted from the incision.

Donkeys tend not to clot as well as horses do, so it is important when gelding donkeys to be sure the blood supply to the testicle is tied off well. We do this by ligating (tying an absorbable suture) tightly around the vasculature.

The testicle and epididymis are now ready to be transected from the patient. I like to place a clamp across the cord before cutting the cord.

It is essential to closely inspect the removed tissue to ensure that the testicle and epididymis have been removed in their entirety.

This is what it looks like once both testicle has been removed, but the cords are still being held in clamps.

Done. The incisions are not closed up, but rather are left open to heal by second intention. Significantly more complications are encountered if the incisions are sutured closed.

Now all that is left is to wait for the little guy to recover from anesthesia.

That is how it is done on a little one. Most of the time our patients are a bit larger. Here are some pictures of the same surgery, but on a much bigger horse.

General anesthesia is induced with an intravenous injection. This protocol usually gives us about 20 minutes of anesthesia.

Timber!

Once the horse is down, we tie the hind leg forward, providing a nice space in which to work.

With the surgical site thoroughly scrubbed, an incision is made over each testicle. Often in these large, more ‘well developed’ horses, we will remove a portion of the scrotum. The testicle is then identified and easily extracted.

After the testicle has been exposed we ‘strip’ the cord by removing any overlying connective tissue, so that we are left with the testicle fully dissected from the adjoining tissues.

I like to ligate the blood supply to the testicle in these big horses, like we do with the donkeys.

With the cord tied and clamped, the testicle is cut off with a surgical tool known as an emasculator. This instrument is specifically designed for this procedure. It not only cuts off the testicle and epididymis while simultaneously crushing the blood supply.

The second testicle is removed in like fashion. Here are the fruits of our harvest.

That is pretty much how it is done.

USEF Drugs and Medication Rule Changes

The recent changes demolition Google made to their Google Reader has made it much more difficult for me to post links in the 'Current News' section of this blog. So, for now, I am stuck posting links that I find of particular interest in its own blog posting, such as this.

This week the USEF made known some impending drug and medication rule changes. If you exhibit your horse in an event that uses USEF drug rules, it is well worth your time to review this information. Click here to get the details. This article also has links to some USEF literature that is worth reviewing.

Did You Know?

Did you know that WMVS has a clinic facebook page? Join in the fun by clicking here.

Also, did you know that we have an online pharmacy? Both prescription and non-prescription products are available through our online pharmacy. Prescriptions are processed automatically through our office for approval, so you do not need to do anything to send or fax any prescriptions in. Orders over $39 receive free shipping. So save your gas and order your Bute, Banamine, Adequan and all your other meds and supplies online.

We are also very close to completing a major update to our clinic website. Our new site will include a page with links to our clients web page. If you would like to have your website listed on the 'Our Clients' page, please call our office at 616-837-8151, ext. 5 to find out how to have your website included.