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AAEP Convention: Standing Arthroscopy Can Be Used On More Than Stifles

When traditional diagnostic tools such as X-ray and ultrasound provide no definitive diagnosis for an equine lameness, a vet may perform an arthroscopy. While this procedure typically requires putting the horse under general anesthesia, a needle arthroscopy can be done while the horse is under standing sedation, Dr. Alvaro Bonilla said at the virtual 2020 American Association of Equine Practitioners Convention and Trade Show.

A safe, reliable procedure, needle arthroscopy is less risky and less costly to the owner; putting a horse under general anesthesia for surgery has its own risks, including recovery. While typically used for diagnostics, a standing arthroscopy can also be used therapeutically for septic joints and small osteochondral fragments, specifically for dorsal fragments of the first phalanx in the fetlock, Alvaro says. However, the procedure does still have limitations.

Previously, needle arthroscopy was used only in the stifle joint; Alvaro reports that now it can be used successfully to evaluate multiple synovial structures, including shoulders, fetlocks, hocks, radiocarpal and middle carpal joints, and carpal sheaths.

When using this diagnostic tool, it's important that the horse is sedated, but not overly so, which could make him unsteady and make the procedure not only difficult, but dangerous. Additionally, the surgical site must be sterile, which can be difficult as debris can fall onto the joint or the horse can urinate. Potential for both complications can be decreased by using blankets and inserting a urinary catheter.

An adjustable, lightweight splint made from stainless steel and aluminum is used during the procedure; to ensure as successful an outcome as possible, horses should be acclimated to wearing the brace before being sedated for the surgery.

The surgical area should be bandaged for four to five days following the procedure; horses that had the procedure for diagnostic reasons can go back to work as soon as the bandages are removed.

Treatment Options For Horses With Atrial Fibrillation

Atrial fibrillation is the most common heart arrhythmia found in horses, but it's also the one that most impacts a horse's athletic performance. The University of Illinois Veterinary Teaching Hospital in Urbana offers a unique way to treat the condition: transvenous electrical cardioversion (TVEC).

Atrial fibrillation, commonly known as “AFib,” is an electrical disorder that affects the heart's rhythm; the top two chambers of the heart (the atria) don't contract properly, preventing blood from moving to the rest of the body efficiently. This affects how hard a horse can work before he tires. It isn't known why horses get AFib, but their large hearts and slow heart rate could predispose them to loss of electrical coordination.

The most common sign of AFib is a sudden, dramatic decrease in performance. Occasionally a nosebleed can also be seen. A veterinarian should be contacted when this occurs. As part of the exam, the vet will listen to the horse's heart, which is how most AFib in horses is detected. The vet can confirm that the horse is experiencing AFib by performing an electrocardiogram (ECG).

Horses with AFib can be given oral quinidine to restore proper heart rhythm, but this medication does have side effects, including laminitis, swelling of the nose and even death. Horses given this medication that don't have heart disease typically return to the correct heart rhythm.

The TVEC procedure can also return a horse's heart to a normal rhythm. This treatment only takes place at specialty equine hospitals, including the University of Illinois College of Veterinary Medicine. Once the horse has had a full work-up and been deemed clear for surgery, a catheter is placed in the horse's jugular vein, though which two small electrodes are fed. The electrodes then administer a shock to the heart to convert it back to its normal rhythm.

This is the same shock given to humans with AFib via paddles—horses have too much muscle to let the paddles work from the outside. Delivering the shock directly to a horse's heart muscle is effective; TVEC has a 95 percent success rate in converting the heart back to its normal rhythm.

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Decoding Hoof Cracks

Horse owners can attest that the old adage “No hoof, no horse” is one truest about equine care. Any defect in a hoof wall can be worrisome as the health and integrity of the hoof wall is imperative for overall horse health. Some issues can look concerning, but be non-issues, while others may require intense care to rectify.

Here are some types of cracks and what the level of concern they should elicit:

Though hoof cracks can look scary, small, vertical cracks that start at the ground and extend only an inch or so up the hoof wall are of minor concern. The farrier will most likely take care of these when he or she is out next.
Horizontal cracks less than an inch wide that start at the coronet band and grow down are typically the result of a minor injury to the coronary band that briefly inhibited hoof production. It's rare that intervention is needed for these cracks; they will grow out on their own. \
Vertical cracks at the bottom of the hoof that wrap around to the underside of the hoof and involve the sole could be more than just a superficial defect. If it looks like any other structures than just the hoof wall are involved, this could become a significant issue.
Long, vertical cracks that don't ever seem to grow out are a sign that a hoof is chronically unbalanced. Even if the crack is thin, it is worth having a conversation with the farrier to see if a new manner of trimming or shoeing may be necessary.
Cracks that flex and open each time the horse takes a step, cracks that bleed or cracks that make a horse lame requires an immediate call to the veterinarian and farrier. Both professionals will need to work together to resolve the issue, but time is of the essence and these cracks need to be addressed immediately.

Old Friends: Whitney, Travers Winner Will’s Way Passes At Age 27

Will's Way, winner of the 1997 Whitney Handicap and 1996 Travers Stakes, died Dec. 24 at Old Friends at Cabin Creek in Greenfield Center, NY.

Euthanized due to declining health, the son of Easy Goer out of the Tentam mare Willamae was 27.

Will's Way was among the flagship stallions retired to Old Friends, the non-profit Thoroughbred Retirement farm in Georgetown, Ky. After a few seasons in Kentucky, Will was transferred to Cabin Creek, the organization's satellite facility just outside Saratoga where he was often greeted by his many adoring New York fans.

Campaigned by trainer James H. Bond for owners Rudlein Stables, Will had a relatively short but spectacular career on the race track. After breaking his maiden at Gulfstream Park first time out in 1996, he went on to capture the G1 Travers Stakes at Saratoga, prevailing over Preakness winner Louis Quatorze and the great Skip Away.

In 1997 Will took the G1 Whitney Handicap, again at Saratoga, over Formal Gold, with Skip Away finishing third. The top two finishers each earned extraordinary 126 Beyer Speed Figures.

In his career, Will's Way won or placed in 11 of 13 races and retired with earnings of $954,400. His greatest son, Lion Tamer, won the G1 Cigar Mile Handicap in 2004.

“We all loved him so much,” said Joann Pepper, owner and manager of Cabin Creek. “He would take our breath away when he decided to run. I will miss brushing his tail and kissing his star—I'll even miss letting him chew on me,” Pepper added, referring to Will's sometimes cantankerous personality. “It was such an honor to care for him.”

“He was such an exciting racehorse, and we were so thrilled to have him with us first in Kentucky and then in New York,” said Old Friends founder and president Michael Blowen. “Our heart goes out to our friends at Cabin Creek. Joann and Will had a very special bond, and we know he will be sorely missed by everyone there.”

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