Additional Information
Book Details
Abstract
Equip yourself for success with the only book on the market that covers all aspects of equine surgery! Equine Surgery, 5th Edition prepares you to manage each surgical condition by understanding its pathophysiology and evaluating alternative surgical approaches. Explanations in the book describe how to avoid surgical infections, select and use instruments, and perfect fundamental surgical techniques including incisions, cautery, retractions, irrigation, surgical suction, wound closure, dressings, bandages, and casts. In addition to diagnostic imaging and orthopedic coverage, it includes in-depth information on anesthesia, the integumentary system (including wound management, reconstructive surgery, and skin grafting), the alimentary system, respiratory, and urogenital systems.
- Complete coverage of all the information needed to study for the American and European College of Veterinary Surgeons Board Examinations makes this edition an excellent study tool.
- Section on anesthesiology and pain management prepares you to manage these critical aspects of any surgery.
- Extensive, up-to-date orthopedic coverage includes joint disorders and joint trauma.
- Section on integumentary system contains information on wound management, reconstructive surgery, and skin grafting.
- Section on the alimentary system covers postoperative care, complications and reoperation guidelines.
- New techniques in vascular surgery keep you up-to-date with best practices.
- NEW! Expert Consult site offering 40+ videos of surgeons performing techniques so that you can quickly access drug and equipment information.
- NEW! Expansion of minimally invasive surgical techniques includes laser ablation procedures, implantation of plates against bones in orthopedic procedures, and laparoscopic procedures for soft tissue injuries.
- NEW! World-renowned contributors, featuring two new associate editors include over 70 of the most experienced and expert equine specialist surgeons, each providing current and accurate information.
- NEW! Current advances in imaging detect musculoskeletal conditions in the sports horse.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Endsheet 2 | IFC1 | ||
| Equine Surgery | i | ||
| Copyright Page | ii | ||
| Dedication | iii | ||
| Contributors | iv | ||
| Preface | viii | ||
| Organization | viii | ||
| Key Features of the Fifth Edition | viii | ||
| New Features | viii | ||
| Book Cover | viii | ||
| Acknowledgments | ix | ||
| Table Of Contents | xi | ||
| Video Contents | xiv | ||
| I Surgical Biology | 1 | ||
| 1 Shock | 1 | ||
| Definition of Shock | 1 | ||
| Classification of Shock | 1 | ||
| Pathophysiology of Shock | 2 | ||
| Clinical Signs of Shock | 3 | ||
| Treatment | 5 | ||
| Fluid Administration | 5 | ||
| Types of Fluids | 6 | ||
| Isotonic Crystalloids | 6 | ||
| Hypertonic Crystalloids | 6 | ||
| Colloids | 6 | ||
| Whole Blood | 7 | ||
| Current Recommendations | 7 | ||
| Vasopressors | 7 | ||
| Monitoring | 8 | ||
| Capillary Refill Time | 8 | ||
| Central Venous Pressure | 8 | ||
| Urine Output | 8 | ||
| Arterial Blood Pressure | 9 | ||
| Lactate | 9 | ||
| Oxygen Extraction | 9 | ||
| Mixed Venous Partial Pressure of Oxygen | 9 | ||
| Cardiac Output | 9 | ||
| Regional Perfusion | 10 | ||
| Hypotensive Resuscitation and Delayed Resuscitation | 10 | ||
| Predicting Outcome | 10 | ||
| On the Horizon | 11 | ||
| Treatment | 11 | ||
| Monitoring | 11 | ||
| Physiologic Response to Trauma | 11 | ||
| Mediators of the Stress Response: Ebb Phase | 11 | ||
| Response to Trauma: Catabolic Period | 11 | ||
| Response to Trauma: Anabolic Period | 12 | ||
| References | 12 | ||
| 2 Systemic Inflammatory Response | 14 | ||
| Systemic Inflammatory Response Syndrome | 14 | ||
| Pathophysiology of SIRS | 15 | ||
| Cytokines | 15 | ||
| Lipid-Derived Mediators | 15 | ||
| Platelet-Activating Factor | 15 | ||
| Acute Phase Proteins | 15 | ||
| Reactive Oxygen Species | 16 | ||
| Vasoactive Mediators | 16 | ||
| Diagnosis of SIRS | 16 | ||
| Treatment of SIRS and Prognosis | 16 | ||
| Multiple Organ Dysfunction Syndrome (MODS) | 17 | ||
| Pathophysiology of MODS | 17 | ||
| Diagnostic Criteria for MODS | 19 | ||
| Respiratory Criteria | 20 | ||
| Hemostasis Criteria | 21 | ||
| Gastrointestinal Criteria | 21 | ||
| Renal Criteria | 21 | ||
| Hepatic Criteria | 21 | ||
| Cardiovascular Criteria | 21 | ||
| Musculoskeletal Criteria | 21 | ||
| Neurologic Criteria | 22 | ||
| Treatment of MODS and Prognosis | 22 | ||
| Common Causes of SIRS and MODS in Horses | 22 | ||
| Sepsis | 22 | ||
| Diagnosis of Sepsis | 22 | ||
| Treatment of Sepsis | 22 | ||
| Endotoxemia | 22 | ||
| Pathophysiology of Endotoxemia | 23 | ||
| Clinical Findings and Diagnostic Approach | 24 | ||
| Clinical Management | 24 | ||
| References | 25 | ||
| 3 Fluids, Electrolytes, and Acid-Base Therapy | 28 | ||
| Fluid and Electrolyte Balance | 28 | ||
| Distribution of Fluids | 28 | ||
| Acid-Base and Electrolyte Balance | 30 | ||
| Acid-Base Terminology | 30 | ||
| Assessing the Acid-Base and Electrolyte Status | 30 | ||
| Henderson-Hasselbalch (Traditional Approach) | 30 | ||
| Primary Acid-Base Abnormalities | 31 | ||
| Metabolic Alkalosis and Acidosis | 31 | ||
| Respiratory Acidosis and Alkalosis | 31 | ||
| Mixed Acid-Base Disorders | 31 | ||
| Quantitative Strong Ion Approach | 31 | ||
| Strong Ions | 32 | ||
| Total Mass of Nonvolatile Weak Acids (Atot) | 32 | ||
| Measurement and Interpretation of Blood Gases | 32 | ||
| Interpretation—Traditional Approach | 33 | ||
| Interpretation—Quantitative Strong Ion Approach (Table 3-5) | 33 | ||
| Unmeasured Anions | 33 | ||
| Anion Gap | 33 | ||
| Strong Ion Gap | 34 | ||
| Lactate | 34 | ||
| Designing a Fluid Therapy Regimen | 34 | ||
| Volumes of Fluid to Administer | 34 | ||
| Maintenance | 34 | ||
| Dehydration | 35 | ||
| Ongoing Losses | 35 | ||
| Fluid Overload | 35 | ||
| Type of Fluid | 35 | ||
| Isotonic Crystalloids | 35 | ||
| Sodium Bicarbonate Solutions (NaHCO3) | 36 | ||
| Dextrose-Containing Solutions | 37 | ||
| Hypertonic Crystalloids (7.2% NaCl) | 37 | ||
| Colloids | 37 | ||
| Rate and Route of Administration | 37 | ||
| Intravenous Fluids | 37 | ||
| Oral Fluids | 38 | ||
| Materials for Fluid Therapy | 38 | ||
| Intravenous Catheters | 38 | ||
| Sites for Intravenous Catheterization in Horses | 39 | ||
| Catheter Maintenance | 39 | ||
| Coil Sets and Administration Sets | 39 | ||
| Pump Delivery | 39 | ||
| Oral Feeding Tubes | 39 | ||
| References | 39 | ||
| 4 Hemostasis, Surgical Bleeding, and Transfusion | 41 | ||
| Physiology of Hemostasis | 41 | ||
| Blood Vessels and the Role of the Vascular Endothelium | 41 | ||
| Platelets and Primary Hemostasis | 41 | ||
| Secondary Hemostasis and Models of Coagulation | 42 | ||
| Coagulation Cascade | 42 | ||
| Cell-Based Model | 42 | ||
| Initiation | 42 | ||
| Amplification | 42 | ||
| Propagation | 42 | ||
| Fibrinolysis | 43 | ||
| Inhibitors of Coagulation and Fibrinolysis | 43 | ||
| Inhibitors of Coagulation | 43 | ||
| Inhibitors of Fibrinolysis | 44 | ||
| Coagulation Testing | 44 | ||
| Tests of Primary Hemostasis | 44 | ||
| Prothrombin Time (Quick Test) | 44 | ||
| Activated Partial Thromboplastin Time | 44 | ||
| Activated Clotting Time | 45 | ||
| Anticoagulant Testing | 45 | ||
| Fibrin(ogen) Degradation Products | 45 | ||
| Fibrinogen | 45 | ||
| D-Dimer | 45 | ||
| Viscoelastic Monitoring | 45 | ||
| Hemostatic Dysfunction | 45 | ||
| Inherited Conditions | 45 | ||
| Acquired Conditions | 46 | ||
| Inflammation and Coagulation | 46 | ||
| Disseminated Intravascular Coagulation (DIC) | 46 | ||
| Treatment of DIC | 47 | ||
| Surgical Bleeding | 47 | ||
| Indications for Whole Blood Transfusion | 47 | ||
| Packed Red Blood Cells | 47 | ||
| Plasma | 48 | ||
| Blood Donation and Transfusion | 48 | ||
| Donor Selection and Management | 48 | ||
| Blood Typing and Crossmatching | 48 | ||
| Blood Collection and Administration | 48 | ||
| Collection Technique | 48 | ||
| Alternatives to Allogeneic Blood Transfusion | 49 | ||
| Systemic Adjunctive Treatments | 49 | ||
| Topical Hemostatic Agents | 50 | ||
| Mechanical Hemostatic Agents | 50 | ||
| Purified Gelatin Sponge | 50 | ||
| Oxidized Regenerated Cellulose | 50 | ||
| Microfibrillar Collagen Hemostatic Agents | 50 | ||
| Polysaccharide Hemostatic Agents | 50 | ||
| Bone Wax | 50 | ||
| Adhesives and Sealants | 50 | ||
| Thrombin Products | 50 | ||
| Fibrin-Based Sealants | 51 | ||
| Tissue Adhesives | 51 | ||
| References | 51 | ||
| 5 Wound Healing | 53 | ||
| Classification of Wounds | 53 | ||
| Phases of Wound Healing | 54 | ||
| Inflammatory Phase | 54 | ||
| Tissue Formation Phase | 57 | ||
| Angiogenesis and Vasculogenesis | 57 | ||
| Fibroplasia and Granulation Tissue Formation | 57 | ||
| Epithelialization | 58 | ||
| Contraction | 58 | ||
| Remodeling and Maturation Phase | 59 | ||
| Wound-Healing Differences in the Horse | 59 | ||
| Ponies Heal Faster | 59 | ||
| Distal Limb Wounds | 60 | ||
| Wound Expansion | 60 | ||
| Effect of Motion | 60 | ||
| Exposed Bone | 60 | ||
| Infection | 60 | ||
| Development of Exuberant Granulation Tissue | 60 | ||
| Prolonged Inflammatory Phase | 60 | ||
| Tissue Hypoxia | 61 | ||
| Bandaging | 61 | ||
| Management of Granulation Tissue | 61 | ||
| General Factors That Influence Wound Healing | 62 | ||
| Age | 62 | ||
| Nutritional Status | 62 | ||
| Type of Injury | 62 | ||
| Tissue Perfusion | 62 | ||
| Hemostasis and Hematoma Formation | 63 | ||
| Débridement | 63 | ||
| Wound Closure Technique | 63 | ||
| Topical Therapy | 63 | ||
| Stem Cells | 65 | ||
| Pharmaceuticals | 65 | ||
| Local Anesthetics | 65 | ||
| Antiinflammatory Drugs | 65 | ||
| Malignancy | 65 | ||
| Summary | 65 | ||
| References | 65 | ||
| 6 Metabolism and Nutritional Support of the Surgical Patient | 70 | ||
| Indications for Nutritional Support | 70 | ||
| Pure Protein/Calorie Malnutrition | 71 | ||
| Metabolic Response to Injury | 71 | ||
| Metabolic Requirements | 72 | ||
| Adults | 72 | ||
| Increased Energy Demand | 72 | ||
| Foals and Weanlings | 72 | ||
| Protein Requirements | 73 | ||
| Vitamin Requirements | 73 | ||
| Assessment of Nutritional Support | 73 | ||
| Enteral Nutrition | 73 | ||
| Parenteral Nutrition | 74 | ||
| References | 76 | ||
| 7 Surgical Site Infection and the Use of Antimicrobials | 77 | ||
| Introduction | 77 | ||
| Surgical Site Infection Classification | 77 | ||
| Risk Factors for Surgical Site Infection | 77 | ||
| Infection and Sources of Microorganisms | 79 | ||
| Endogenous Sources | 79 | ||
| Exogenous Sources | 80 | ||
| Microbe-Related Risk Factors | 80 | ||
| Host-Related Risk Factors | 81 | ||
| Systemic Risk Factors | 81 | ||
| Age | 81 | ||
| Concomitant Infection | 81 | ||
| Gender | 81 | ||
| Obesity | 81 | ||
| Nutritional Status | 81 | ||
| Immune Function | 81 | ||
| Hypothermia | 82 | ||
| Local Risk Factors | 82 | ||
| Surgical Trauma | 82 | ||
| Hypoxia | 82 | ||
| Skin Conditions/Skin Penetration | 82 | ||
| Foreign Material and Prosthetic Implants | 82 | ||
| Surgical Risk Factors | 82 | ||
| Surgical Procedure | 82 | ||
| Patient and Surgeon Preparation | 83 | ||
| Surgical Attire | 83 | ||
| Surgical Technique and Duration of Surgery | 84 | ||
| Suture Materials and Surgical Implants | 84 | ||
| Topical Antimicrobial Therapy | 84 | ||
| Bandages and Drains | 84 | ||
| Nosocomial Infection | 85 | ||
| Prevention and Management of Surgical Site Infection | 85 | ||
| Diagnosis | 85 | ||
| Clinical Signs | 85 | ||
| Clinical Pathology | 86 | ||
| Microbiology | 86 | ||
| Imaging Techniques | 87 | ||
| Pathogenic Bacteria Associated With Equine Surgical Site Infection | 87 | ||
| Treatment of Surgical Site Infection | 88 | ||
| Antimicrobial Prophylaxis Against Surgical Site Infection | 88 | ||
| Antibiotic Classification | 88 | ||
| Prophylactic Antibiotic Use | 88 | ||
| Selection of Prophylactic Antimicrobials | 89 | ||
| Timing and Duration of Antibiotic Administration | 89 | ||
| Postantibiotic Effect | 89 | ||
| Prophylactic Antibiotics Used in Horses | 90 | ||
| β-Lactam antibiotics | 90 | ||
| Aminoglycoside antibiotics | 90 | ||
| Trimethoprim sulphonamides | 91 | ||
| Special Routes of Administration and Dosages | 91 | ||
| Antibiotic-Impregnated Polymethyl Methacrylate (AIPMMA) or Plaster of Paris (AIPOP) | 91 | ||
| Other | 92 | ||
| Regional Limb Perfusion | 92 | ||
| Toxic Side Effects of Antibiotics | 93 | ||
| Emergence of Bacterial Resistance to Antibiotics | 93 | ||
| Summary of Antibiotic Prophylaxis | 94 | ||
| References | 94 | ||
| 8 Regenerative Medicine | 104 | ||
| Introduction | 104 | ||
| Platelet-Rich Plasma | 104 | ||
| Biology of Platelet-Rich Plasma | 104 | ||
| Generation of Platelet-Rich Plasma and the Platelet-Rich Plasma Classification System | 105 | ||
| Composition of the Optimal Platelet-Rich Plasma Product | 106 | ||
| Platelet-Rich Plasma in Horses for the Treatment of Tendon and Ligament Injuries | 106 | ||
| Platelet-Rich Plasma in Horses for the Treatment of Osteoarthritis | 107 | ||
| Autologous Conditioned Serum | 107 | ||
| Autologous Protein Solution | 109 | ||
| Stem Cells | 109 | ||
| Stem Cell Biology | 110 | ||
| Immunomodulation Versus Immunogenicity | 110 | ||
| MSC Isolation From Horses | 111 | ||
| MSCs in Horses for the Treatment of Tendon and Ligament Injuries | 112 | ||
| MSCs in Horses for the Treatment of Cartilage Damage and Osteoarthritis | 113 | ||
| Further Considerations and Future Directions | 115 | ||
| References | 115 | ||
| II Surgical Methods | 123 | ||
| 9 Instrument Preparation, Antisepsis, and Disinfection | 123 | ||
| Processing of Textiles | 123 | ||
| Processing of Instruments and Devices | 123 | ||
| Definitions of and Approaches to Disinfection and Sterilization | 123 | ||
| The Cleaning and Sterilization Facility | 124 | ||
| Cleaning Process | 124 | ||
| Automated Processes | 125 | ||
| Maintenance and Identification of Instruments | 126 | ||
| Packaging | 126 | ||
| Storage and Shelf Life | 126 | ||
| Process Monitoring | 129 | ||
| Cleaning Process Indicators | 129 | ||
| Sterilization Indicator Systems | 129 | ||
| Physical Sterilization | 130 | ||
| Thermal Energy | 130 | ||
| Filtration | 131 | ||
| Radiation | 132 | ||
| Chemical Sterilization | 132 | ||
| Gas Sterilization | 132 | ||
| Ethylene Oxide | 132 | ||
| Hydrogen Peroxide Gas Plasma | 132 | ||
| Liquid Chemical Sterilization | 132 | ||
| Disinfectants | 133 | ||
| Aldehydes | 134 | ||
| Glutaraldehyde (GH) | 134 | ||
| Ortho-phthalaldehyde | 134 | ||
| Succindialdehyde | 135 | ||
| Formaldehyde | 135 | ||
| Peracetic Acid | 135 | ||
| Hydrogen Peroxide (H2O2) | 135 | ||
| Vaporized Hydrogen Peroxide (VHP) | 136 | ||
| Electrolyzed Acid Water (EAW) | 136 | ||
| Chlorine and Chlorine Compounds | 136 | ||
| Miscellaneous | 136 | ||
| Antiseptics | 137 | ||
| Alcohols | 137 | ||
| Chlorhexidine (CHX) | 137 | ||
| Iodine Compounds | 138 | ||
| Octenidine | 138 | ||
| Phenols | 138 | ||
| Quaternary Ammonium Compounds | 138 | ||
| Polyhexamethylene Biguanide (PHMB) | 138 | ||
| Choosing and Using Antiseptics | 139 | ||
| Microbial Resistance to Disinfectants and Antiseptics | 139 | ||
| References | 140 | ||
| 10 Preparation for Surgery | 143 | ||
| Decision Making/Operative Risk | 143 | ||
| Primary Disease | 144 | ||
| General Health Assessment | 144 | ||
| Prediction Systems | 144 | ||
| Reducing the Operative Risk | 144 | ||
| Training | 144 | ||
| Checklist | 146 | ||
| Duration of the Procedure | 146 | ||
| Personal Relationships | 147 | ||
| Informed Consent | 147 | ||
| Professional Relationship | 148 | ||
| Preoperative Evaluation of the Patient | 148 | ||
| History | 148 | ||
| Physical Examination | 148 | ||
| Supplemental Testing | 148 | ||
| Physiologic Preparation | 149 | ||
| Preparation for the Surgical Procedure | 149 | ||
| Measures and Compliance | 149 | ||
| Surgical Facility | 149 | ||
| General | 149 | ||
| Drains | 151 | ||
| Induction and Recovery Rooms | 152 | ||
| Patient Preparation Room | 152 | ||
| Scrub Room | 152 | ||
| Standing Surgery | 152 | ||
| Instrument and Equipment Storage and Cleaning | 152 | ||
| Temperature and Airflow | 153 | ||
| Lighting | 153 | ||
| Human Traffic | 153 | ||
| Biosecurity | 153 | ||
| Maintenance of the Facility | 153 | ||
| Operating Team | 154 | ||
| Scrub Attire | 154 | ||
| Masks and Caps | 154 | ||
| Head Cover | 154 | ||
| Face Masks | 154 | ||
| Gowns | 155 | ||
| Gown-Donning Procedure | 155 | ||
| Gown Removal | 155 | ||
| Gloves | 156 | ||
| Punctures | 159 | ||
| Glove-Contamination Risk | 159 | ||
| Gloving Techniques | 160 | ||
| Foot Covers | 161 | ||
| Jewelry and Nails | 161 | ||
| Mobile Devices | 164 | ||
| Surgeon’s Skin | 164 | ||
| Current Recommendations and Procedures | 165 | ||
| Staffing the Surgery Area | 169 | ||
| Surgical Patient | 170 | ||
| General Patient Preparation | 170 | ||
| Positioning | 170 | ||
| Standing Surgery | 171 | ||
| Surgical Site Preparation | 171 | ||
| Hair Removal | 171 | ||
| Skin Preparation | 173 | ||
| General Considerations | 173 | ||
| Time and Method | 173 | ||
| Choice of Antiseptic | 173 | ||
| Attention Points | 173 | ||
| Draping the Surgical Field | 174 | ||
| Rationale for Draping | 174 | ||
| Types of Draping | 175 | ||
| Disposable Versus Nondisposable Drapes | 175 | ||
| Plastic Drapes and Incise Films | 175 | ||
| Drape Application | 175 | ||
| Standing Surgery | 176 | ||
| Finalizing the Surgical Procedure | 177 | ||
| Debriefing | 177 | ||
| Surgical Report Writing | 177 | ||
| References | 179 | ||
| 11 Surgical Instruments | 184 | ||
| Materials | 184 | ||
| Instruments for General Surgery | 184 | ||
| Scalpels | 184 | ||
| Steel Scalpels | 184 | ||
| Disposable Scalpels | 185 | ||
| Scissors | 185 | ||
| Needle Holders | 186 | ||
| Forceps and Clamps | 186 | ||
| Thumb Forceps | 186 | ||
| Hemostatic Forceps | 187 | ||
| Tissue Forceps | 187 | ||
| Clamps | 187 | ||
| Towel Clamps | 188 | ||
| Retractors | 188 | ||
| Finger-Held Retractors | 188 | ||
| Hand-Held Retractors | 189 | ||
| Self-Retaining Retractors | 189 | ||
| Suction Tubes | 189 | ||
| Orthopedic Instruments | 190 | ||
| Rongeurs | 190 | ||
| Curettes | 191 | ||
| Periosteal Elevators | 191 | ||
| Bone-Cutting Instruments | 192 | ||
| Bone Clamps | 193 | ||
| Cerclage Wire Instruments | 193 | ||
| Pin Insertion and Pin-Cutting Instruments | 194 | ||
| Trephines | 194 | ||
| Specific Equine Surgical Instruments | 194 | ||
| Energy-Based Surgical Tools | 194 | ||
| Identification | 197 | ||
| References | 198 | ||
| 12 Surgical Techniques | 198 | ||
| Introduction | 198 | ||
| Technique Training and Outcome | 198 | ||
| Surgical Etiquette and Communication | 199 | ||
| Improving Aseptic Technique | 200 | ||
| Basic Manipulations of Surgical Instruments | 200 | ||
| Scalpels | 200 | ||
| Steel Scalpel | 200 | ||
| Electro Scalpel | 202 | ||
| Scissors | 202 | ||
| Needle Holders | 203 | ||
| Forceps | 204 | ||
| Thumb Forceps | 204 | ||
| Hemostat Forceps | 204 | ||
| Tissue Forceps | 204 | ||
| Tissue Incision and Excision | 205 | ||
| Slide Cutting | 205 | ||
| Stab or Press-Cutting Incision | 205 | ||
| Scissor Incision | 205 | ||
| Electro-Incision | 205 | ||
| Tissue Excision | 206 | ||
| Blunt Dissection | 206 | ||
| Surgical Hemostasis | 207 | ||
| Mechanical Hemostasis | 207 | ||
| Pressure | 207 | ||
| Ligatures | 207 | ||
| Staples | 208 | ||
| Surgical Repair | 208 | ||
| Esmarch System | 209 | ||
| Thermal Hemostasis | 209 | ||
| Chemical Hemostasis | 210 | ||
| Physical Hemostasis | 210 | ||
| Tissue Retraction and Handling | 210 | ||
| Tissue Handling | 211 | ||
| Retraction | 211 | ||
| Surgical Irrigation and Suction | 211 | ||
| Surgical Irrigation | 211 | ||
| Suction | 211 | ||
| Curettage | 212 | ||
| References | 212 | ||
| 13 Minimally Invasive Surgical Techniques | 214 | ||
| Introduction | 214 | ||
| Procedures With Rigid Endoscopes | 214 | ||
| Basic Equipment | 214 | ||
| The Endoscopy Tower | 214 | ||
| Light Source | 214 | ||
| Video Camera | 215 | ||
| Fluid Irrigation System | 215 | ||
| Gas Insufflation System | 215 | ||
| Basic Techniques | 216 | ||
| The Principle of Triangulation | 216 | ||
| Arthroscopy, Tenoscopy, and Bursoscopy | 216 | ||
| Instrumentation | 216 | ||
| Arthroscope and Arthroscopic Sleeve | 216 | ||
| Hand Instruments | 217 | ||
| Motorized Equipment | 218 | ||
| Electrosurgery | 218 | ||
| Basic Techniques for Arthroscopy, Tenoscopy, and Bursoscopy | 219 | ||
| Arthroscopy | 220 | ||
| Tenoscopy | 220 | ||
| Laparoscopy and Thoracoscopy | 220 | ||
| Instrumentation for Laparoscopic and Thoracoscopic Surgery | 220 | ||
| Laparoscope | 220 | ||
| Access Instruments | 221 | ||
| Laparoscopic and Thoracoscopic Instruments | 221 | ||
| Coagulation and Dissection | 222 | ||
| Intracorporeal and Extracorporeal Knot Tying and Suturing | 222 | ||
| Stapling Devices | 223 | ||
| Tissue-Retrieval Devices | 223 | ||
| Basic Technique for Laparoscopy and Thoracoscopy | 224 | ||
| Standing Versus Recumbent Laparoscopic and Thoracoscopic Surgery | 224 | ||
| Access Techniques in Laparoscopic and Thoracoscopic Surgery | 224 | ||
| Procedures With Flexible Endoscopes | 225 | ||
| Anatomical Structure of the Flexible Endoscope | 225 | ||
| Basic Technique for Transvaginal NOTES in Mares | 226 | ||
| Vertebral Canal Endoscopy | 226 | ||
| Cardiovascular Minimally Invasive Procedures | 227 | ||
| Embolization | 227 | ||
| III Recent Advances in Anesthesia | 301 | ||
| 18 Balanced Inhalation Anesthesia | 301 | ||
| Introduction | 301 | ||
| Anesthetic Risk | 301 | ||
| Modern Inhalation Anesthetic Drugs and Techniques Used for Balanced Anesthesia | 301 | ||
| Modern Inhalation Anesthetics | 301 | ||
| Lidocaine | 302 | ||
| Alpha2-Adrenoreceptor Agonists | 303 | ||
| Ketamine | 304 | ||
| Opioids | 305 | ||
| Centrally Acting Muscle Relaxants | 305 | ||
| Guaifenesin | 305 | ||
| Benzodiazepines | 305 | ||
| Regional Anesthesia Techniques | 306 | ||
| References | 306 | ||
| 19 Modern Injectable Anesthesia for Adult Horses | 308 | ||
| Short-Duration Injectable Anesthesia | 308 | ||
| Ketamine and Ketamine Drug Combinations | 308 | ||
| S(+)-Ketamine | 309 | ||
| Tiletamine | 309 | ||
| Propofol | 310 | ||
| Alfaxalone | 310 | ||
| Long-Duration Total Intravenous Anesthesia (TIVA) | 310 | ||
| Ketamine–Guaifenesin–α2-Adrenoceptor Agonist (Triple-Drip) | 311 | ||
| Ketamine–Midazolam–α2-Adrenoceptor Agonist | 311 | ||
| Propofol | 311 | ||
| Alfaxalone | 311 | ||
| References | 311 | ||
| 20 Anesthesia and Analgesia for Foals | 313 | ||
| Introduction | 313 | ||
| Physiological and Pharmacological Considerations as They Relate to Anesthesia in the Neonatal and Maturing Foal | 313 | ||
| Cardiovascular System | 313 | ||
| Transition From Fetal to Neonatal Circulation | 313 | ||
| Hemodynamic Function | 314 | ||
| Respiratory System | 315 | ||
| Nervous System Development | 315 | ||
| Early Postnatal Behaviors | 316 | ||
| Body Metabolism, Biotransformation, and Excretion | 316 | ||
| Body Water Content and Body Tissue Composition | 316 | ||
| Thermoregulation | 317 | ||
| Hepatic Function and Development | 317 | ||
| Renal Function and Development | 317 | ||
| Hematology and Biochemistry | 317 | ||
| Anesthetic Management of the Systemically Healthy Neonate and Maturing Foal | 318 | ||
| Preanesthetic Examination and Preparation | 318 | ||
| Sedation of the Mare | 318 | ||
| Anesthetic Management of the Neonate (≤1 Month Old) | 319 | ||
| Sedation | 319 | ||
| Induction and Maintenance of Anesthesia | 320 | ||
| Anesthetic Management of the Pediatric/Juvenile Foal (1 to 4 Months Old) | 321 | ||
| Sedation | 321 | ||
| Induction and Maintenance of Anesthesia | 321 | ||
| Monitoring During Anesthesia | 322 | ||
| Anesthetic Depth and Drug Concentration | 322 | ||
| Cardiovascular System | 323 | ||
| Respiratory System | 323 | ||
| Blood Glucose | 323 | ||
| Body Temperature | 324 | ||
| Fluid Management in the Perianesthetic Period | 324 | ||
| Oxygen Supplementation and Mechanical Ventilation | 324 | ||
| Recovery | 324 | ||
| Perioperative Pain Management | 325 | ||
| Perianesthetic Complications Requiring Intervention | 326 | ||
| Impaired Cardiovascular Function | 326 | ||
| Impaired Respiratory Function | 326 | ||
| Hypothermia | 327 | ||
| Return to Fetal Circulation | 327 | ||
| Cardiac Arrest and Cardiopulmonary Resuscitation | 327 | ||
| Anesthetic Considerations for the Critically Ill Neonate and Maturing Foal | 328 | ||
| Foal With Uroperitoneum | 328 | ||
| Foals Affected by Acute Intestinal Disease | 329 | ||
| Foal With Thoracic Trauma | 329 | ||
| References | 330 | ||
| 21 Recovery From Anesthesia | 332 | ||
| Management of Horses During Recovery | 332 | ||
| Introduction | 332 | ||
| General Considerations | 332 | ||
| Maintenance of Breathing During Recovery | 333 | ||
| Cardiovascular Considerations During Recovery | 333 | ||
| Factors Influencing Recovery | 333 | ||
| Inhalation Anesthetics | 334 | ||
| Sedation, Analgesia | 334 | ||
| Recovery Systems and Aids | 335 | ||
| Recovery Stall Design and Construction | 335 | ||
| Thick Mattresses | 336 | ||
| Rope-Assisted Recovery | 336 | ||
| Pool Recovery | 336 | ||
| Sling Recovery | 337 | ||
| Problems Encountered During Recovery | 338 | ||
| Reluctance or Inability to Stand | 338 | ||
| Myopathies | 338 | ||
| Neuropathies | 338 | ||
| Miscellaneous Problems | 338 | ||
| References | 338 | ||
| 22 Complications of Inhalation Anesthesia and Their Management | 340 | ||
| Physiological Considerations | 340 | ||
| Body Temperature | 340 | ||
| Hypothermia | 340 | ||
| Hyperthermia | 340 | ||
| Cardiovascular System | 340 | ||
| Heart Rate | 340 | ||
| Blood Pressure | 341 | ||
| Respiratory System | 341 | ||
| Oxygenation | 341 | ||
| Ventilation | 342 | ||
| Electrolyte Imbalances | 342 | ||
| Additional Considerations | 342 | ||
| Behavioral Complications | 342 | ||
| Upper Airway Management | 342 | ||
| Myopathy and Neuropathy | 343 | ||
| Gastrointestinal Considerations | 343 | ||
| Alterations in Blood Glucose | 343 | ||
| Urine Output | 343 | ||
| Summary | 343 | ||
| References | 343 | ||
| 23 Chemical Restraint for Standing Procedures | 345 | ||
| General Principles of Drug Administration | 345 | ||
| Drug Selection | 345 | ||
| Drugs Available for Chemical Restraint | 346 | ||
| α2-Adrenoreceptor Agonists | 346 | ||
| Mechanism of Action Leading to Sedation and Analgesia | 346 | ||
| Uses | 346 | ||
| Administration, Doses, Routes | 346 | ||
| Other Effects and Side Effects | 348 | ||
| Special Considerations and Contraindications | 348 | ||
| Foals | 348 | ||
| Combinations With Other Drugs | 348 | ||
| Uses as a Constant-Rate Infusion | 349 | ||
| Antagonists | 349 | ||
| Phenothiazines | 351 | ||
| Mechanism of Action | 351 | ||
| Uses | 351 | ||
| Administration, Dosages, Routes | 351 | ||
| Other Effects and Side Effects | 351 | ||
| Special Considerations and Contraindications | 352 | ||
| Foals | 352 | ||
| Combinations With Other Drugs | 352 | ||
| Antagonists | 352 | ||
| Butyrophenones | 352 | ||
| Benzodiazepines | 352 | ||
| Mechanism of Action | 352 | ||
| Uses | 352 | ||
| Administration and Routes | 353 | ||
| IV Integumentary System | 367 | ||
| 25 Principles of Plastic and Reconstructive Surgery | 367 | ||
| Introduction | 367 | ||
| Cutaneous Blood Supply | 367 | ||
| Physical and Biomechanical Properties of Skin | 368 | ||
| Lines of Skin Tension | 368 | ||
| Skin Extensibility | 368 | ||
| Creep and Stress Relaxation | 369 | ||
| Principles of Wound Closure | 369 | ||
| Incision Orientation | 369 | ||
| Sutures and Patterns | 369 | ||
| Basic Patterns | 370 | ||
| Subcuticular and Intradermal Sutures | 370 | ||
| Simple Interrupted Sutures | 370 | ||
| Simple Continuous Sutures | 370 | ||
| Corner Suture | 370 | ||
| Tension-Relieving Patterns | 370 | ||
| Mattress Sutures | 371 | ||
| Far-Near-Near-Far Suture | 371 | ||
| Walking Suture | 371 | ||
| Support for Suture Lines | 371 | ||
| Tension-Relieving and Skin-Mobilization Procedures | 372 | ||
| Undermining Skin | 372 | ||
| Tissue Debulking | 373 | ||
| Tension-Release Incisions | 373 | ||
| Mesh Expansion | 373 | ||
| V-to-Y-Plasty and Y-to-V-Plasty | 373 | ||
| Z-Plasty | 373 | ||
| W-Plasty | 374 | ||
| Skin-Stretching and Expansion Techniques | 375 | ||
| Presuturing | 375 | ||
| Intraoperative Tissue Expansion | 375 | ||
| External Skin-Stretching Devices | 375 | ||
| Tissue Expanders | 375 | ||
| Cosmetic Closure of Skin Defects of Various Shapes | 376 | ||
| Fusiform Defects | 376 | ||
| Triangular, Square, and Rectangular Defects | 376 | ||
| V-Shaped Defects | 376 | ||
| Circular Defects | 376 | ||
| Management of Skin Puckers (Dog-Ears) | 376 | ||
| Skin Flaps | 377 | ||
| Advancement Flaps | 378 | ||
| Rotating Flaps | 378 | ||
| Vascularized Free Tissue Transfers | 379 | ||
| References | 379 | ||
| 26 Skin Grafting | 381 | ||
| Indications for Grafting | 381 | ||
| Graft Classification | 381 | ||
| Physiology of Graft Acceptance | 382 | ||
| Recipient Bed Characteristics | 382 | ||
| Adherence | 382 | ||
| Serum Imbibition (Plasmatic Imbibition or Plasmatic Circulation) | 382 | ||
| Revascularization | 382 | ||
| Organization (Organic Union) | 383 | ||
| Graft Contraction | 383 | ||
| Graft Failure | 384 | ||
| Fluid Accumulation | 384 | ||
| Infection | 384 | ||
| Inflammation | 384 | ||
| Motion | 384 | ||
| Grafting Techniques | 385 | ||
| Preparation of the Recipient Site | 385 | ||
| Preparation of the Donor Site | 385 | ||
| Full-Thickness Sheet Grafting | 386 | ||
| Split-Thickness Sheet Grafting | 387 | ||
| Hand Instruments | 387 | ||
| Drum Dermatomes | 388 | ||
| Power-Driven Dermatomes | 388 | ||
| Technique of Harvesting a Split-Thickness Sheet Graft | 388 | ||
| Meshing Split-Thickness Sheet Grafts | 389 | ||
| Applying Split-Thickness Sheet Grafts | 390 | ||
| Acceptance and Cosmesis | 391 | ||
| Island Grafts | 392 | ||
| Punch Grafts | 392 | ||
| Pinch Grafts | 393 | ||
| Tunnel Grafts | 394 | ||
| Modified Meek Grafting Technique | 396 | ||
| Aftercare of the Donor Site | 397 | ||
| Aftercare of the Recipient Site | 399 | ||
| Allografts and Xenografts | 400 | ||
| Storage of Grafts | 400 | ||
| References | 401 | ||
| 27 Management of Superficial Wounds, Deep and Chronic Wounds, Sinus Tracts, and Fistulas | 403 | ||
| Anatomy | 403 | ||
| First Aid | 404 | ||
| Assessment | 404 | ||
| Initial Management | 404 | ||
| Restraint and Analgesia | 404 | ||
| Initial Preparation | 404 | ||
| Débridement | 405 | ||
| Sharp Débridement | 405 | ||
| Mechanical Débridement | 405 | ||
| Chemical and Enzymatic Débridement | 407 | ||
| Biological Débridement | 407 | ||
| Autolytic Débridement | 407 | ||
| Options for Wound Closure | 407 | ||
| Stages of Wound Healing | 407 | ||
| Wound Classification | 408 | ||
| Bacteria in Wounds | 408 | ||
| Bacteriologic Assessment | 408 | ||
| Technical Considerations in Contaminated Wound Closure | 408 | ||
| Wound-Closure Techniques | 409 | ||
| Primary Closure | 409 | ||
| Delayed Primary Closure | 410 | ||
| Second-Intention Healing | 410 | ||
| Dressings, Growth Factors, and Drugs | 410 | ||
| Hypertonic Saline Dressing | 410 | ||
| Honey | 411 | ||
| Antimicrobial Dressings | 411 | ||
| Hydrogels | 411 | ||
| Calcium Alginate Dressings | 412 | ||
| Topical Dressings | 412 | ||
| Biological Dressings | 412 | ||
| Stem Cells | 412 | ||
| Growth Factors | 412 | ||
| Semiocclusive Foam Dressings | 413 | ||
| Silicone Dressings | 413 | ||
| Negative-Pressure Wound Therapy | 413 | ||
| Extracorporeal Shock Wave Therapy | 413 | ||
| Corticosteroids | 414 | ||
| Nonsteroidal Antiinflammatory Agents | 414 | ||
| Tetanus Prophylaxis | 414 | ||
| Specific Wound Considerations | 414 | ||
| Deep Wounds | 414 | ||
| Head and Neck | 414 | ||
| Thorax | 415 | ||
| Abdomen | 416 | ||
| Extremities | 416 | ||
| Axillary Lacerations | 416 | ||
| Lacerations Involving Synovial Structures | 416 | ||
| Heel Bulb Lacerations | 417 | ||
| Chronic Wounds | 417 | ||
| Management of Sinus Tracts and Fistulas | 419 | ||
| Etiology | 420 | ||
| Diagnosis | 420 | ||
| Exploration | 420 | ||
| Special Considerations | 421 | ||
| Complications | 422 | ||
| References | 422 | ||
| 28 Skin Conditions Amenable to Surgery | 425 | ||
| Sarcoids | 426 | ||
| Epidemiology | 427 | ||
| Treatment | 427 | ||
| Surgical Excision | 427 | ||
| Laser Ablation | 428 | ||
| Ultrasonic Coagulation | 428 | ||
| Cryotherapy | 428 | ||
| Hyperthermia | 428 | ||
| Radiotherapy | 428 | ||
| Immunotherapy | 428 | ||
| Intralesional Cisplatin | 429 | ||
| Topical Application of Chemotherapeutics | 429 | ||
| Imiquimod | 429 | ||
| Aciclovir | 429 | ||
| Other Agents | 429 | ||
| Electrochemotherapy | 429 | ||
| Squamous Cell Carcinoma | 430 | ||
| Epidemiology | 430 | ||
| Treatment | 430 | ||
| Surgical Excision | 430 | ||
| Irradiation | 430 | ||
| Intralesional Chemotherapy | 431 | ||
| Topical Chemotherapy | 431 | ||
| Other Treatments | 431 | ||
| Photodynamic Therapy | 431 | ||
| Summary | 431 | ||
| Melanoma | 431 | ||
| Epidemiology | 431 | ||
| V Alimentary System | 440 | ||
| 29 Oral Cavity and Salivary Glands | 440 | ||
| Dentistry | 440 | ||
| Dental Anatomy | 440 | ||
| Examination of the Oral Cavity and Teeth | 440 | ||
| Disorders of the Incisors | 443 | ||
| Overjet and Overbite (“Parrot Mouth”) | 443 | ||
| Clinical Signs | 443 | ||
| Treatment | 443 | ||
| Underbite (“Sow Mouth”) | 445 | ||
| Retained Deciduous Incisors | 445 | ||
| Supernumerary Incisors | 446 | ||
| Fractures of the Incisors | 446 | ||
| Abnormalities of Incisor Wear | 446 | ||
| Equine Odontoclastic Tooth Resorption and Hypercementosis | 447 | ||
| Disorders of the Canine Teeth (Triadan 04s) | 447 | ||
| Disorders of “Wolf Teeth” (Triadan 05s) | 448 | ||
| Disorders of the Cheek Teeth | 448 | ||
| Developmental Disorders of the Cheek Teeth | 448 | ||
| Retained Deciduous Cheek Teeth | 448 | ||
| Diastemata | 449 | ||
| Clinical signs and diagnosis | 449 | ||
| Treatment | 450 | ||
| Rostral Positioning of the Maxillary Cheek Teeth Rows | 450 | ||
| Displacements of the Cheek Teeth | 450 | ||
| Supernumerary Cheek Teeth | 451 | ||
| Acquired Disorders of the Cheek Teeth | 451 | ||
| Acquired Overgrowths of Cheek Teeth | 451 | ||
| Traumatic Disorders of the Cheek Teeth and Bars of the Mouth | 451 | ||
| Idiopathic Fractures of the Cheek Teeth | 452 | ||
| Restoration of Carious Infundibula | 453 | ||
| Dental (Odontogenic) Tumors | 453 | ||
| Cheek Teeth Periapical Infection | 454 | ||
| Treatment of Disorders of the Cheek Teeth | 456 | ||
| Extraction of Cheek Teeth | 456 | ||
| Oral Extraction of Cheek Teeth | 456 | ||
| Repulsion | 458 | ||
| Removal of the Lateral Alveolar Plate (Lateral Buccotomy Technique) | 460 | ||
| Minimally Invasive Transbuccal Technique | 460 | ||
| Endodontic Therapy | 461 | ||
| Retrograde Endodontic Therapy | 461 | ||
| Orthograde endodontics | 462 | ||
| Oral Cavity Soft Tissue Trauma | 462 | ||
| Tongue | 462 | ||
| Anatomy | 462 | ||
| Trauma | 462 | ||
| Lips | 463 | ||
| Cheek and Gums | 464 | ||
| Oral Cavity Foreign Bodies | 464 | ||
| Persistent Lingual Frenulum | 465 | ||
| Oral Cavity Soft Tissue Neoplasia | 465 | ||
| Salivary Glands | 466 | ||
| Anatomy | 466 | ||
| Disorders | 467 | ||
| Trauma | 467 | ||
| Sialoliths | 468 | ||
| Atresia of the Parotid Salivary Duct | 469 | ||
| Salivary Mucocele and Ranula | 470 | ||
| Heterotopic Salivary Tissue | 470 | ||
| Idiopathic Parotiditis (“Grass Glands”) | 470 | ||
| Neoplasia | 470 | ||
| References | 471 | ||
| 30 Esophagus | 474 | ||
| Surgical Anatomy | 474 | ||
| Clinical Manifestations and Evaluation of Esophageal Disease | 475 | ||
| Clinical Signs | 475 | ||
| Physical Examination | 475 | ||
| Diagnostic Imaging | 475 | ||
| Endoscopic Evaluation | 477 | ||
| Manometric Evaluation | 478 | ||
| Surgical Approaches | 479 | ||
| Ventral Approach | 479 | ||
| Ventrolateral Approach | 479 | ||
| Approach to the Thoracic Esophagus | 480 | ||
| Management of Esophageal Disorders | 480 | ||
| Impaction | 480 | ||
| Foreign Body | 481 | ||
| Esophagotomy | 481 | ||
| Ulceration and Esophagitis | 482 | ||
| Rupture, Perforations, and Lacerations | 483 | ||
| Esophagostomy | 484 | ||
| Stricture | 485 | ||
| Esophagomyotomy | 487 | ||
| Partial Resection | 487 | ||
| Resection and Anastomosis | 488 | ||
| Patch Grafting | 488 | ||
| Fistula | 489 | ||
| Diverticulum | 490 | ||
| Intramural Cyst | 492 | ||
| Megaesophagus | 492 | ||
| Reduplication | 494 | ||
| Neoplasia | 494 | ||
| Complications of Esophageal Surgery | 494 | ||
| Dehiscence and Stricture | 494 | ||
| Acid-Base and Electrolyte Alterations | 494 | ||
| Laryngeal Hemiplegia | 494 | ||
| Carotid Artery Rupture | 495 | ||
| References | 495 | ||
| 31 Stomach and Duodenum | 496 | ||
| Anatomy | 496 | ||
| Physiology | 497 | ||
| Gastric Barrier Function | 497 | ||
| Pathophysiology | 498 | ||
| Mechanisms of Gastric Ulceration | 498 | ||
| Gastroduodenal Reparative Mechanisms | 498 | ||
| Diagnostic Techniques | 499 | ||
| Endoscopy | 499 | ||
| Ultrasonography | 499 | ||
| Radiography | 499 | ||
| Measurement of Gastric Emptying | 499 | ||
| Disorders of the Stomach and Duodenum | 499 | ||
| Gastroduodenal Ulcers | 499 | ||
| Gastric Impaction | 500 | ||
| Chronic Gastric Impaction and Dilation | 500 | ||
| Gastric Rupture | 500 | ||
| Gastric Neoplasia | 501 | ||
| Gastric Outflow Obstruction | 501 | ||
| Duodenitis-Proximal Jejunitis | 502 | ||
| Duodenal Obstruction | 503 | ||
| References | 503 | ||
| 32 Spleen and Liver | 505 | ||
| Spleen | 505 | ||
| Anatomy | 505 | ||
| Physiology | 507 | ||
| Diagnostic Procedures | 507 | ||
| Indications for Surgery | 508 | ||
| Splenomegaly | 508 | ||
| Neoplasia | 508 | ||
| Splenic Infarction and Splenic Abscesses | 508 | ||
| Splenic Rupture | 508 | ||
| Preoperative Considerations | 509 | ||
| Surgical Techniques | 509 | ||
| Splenectomy | 509 | ||
| Approaches | 509 | ||
| 17th rib resection technique | 509 | ||
| Surgical Procedure | 510 | ||
| Laparoscopy-assisted open technique | 511 | ||
| Laparoscopic hand-assisted splenectomy | 511 | ||
| Splenorrhaphy and Partial Splenectomy | 511 | ||
| Aftercare | 511 | ||
| Complications | 512 | ||
| Closure of the Nephrosplenic Space | 512 | ||
| Liver | 512 | ||
| Anatomy | 512 | ||
| Physiology | 513 | ||
| Diagnostic Procedures | 514 | ||
| Indications for Surgery | 514 | ||
| Biopsy | 514 | ||
| Surgical Technique | 514 | ||
| Aftercare | 515 | ||
| Complications | 515 | ||
| Bile Duct Obstruction | 515 | ||
| Indications for Surgery | 516 | ||
| Surgical Technique | 516 | ||
| Aftercare | 516 | ||
| Complications | 516 | ||
| Closure of the Epiploic Foramen | 516 | ||
| References | 517 | ||
| 33 Colic | 521 | ||
| Diagnosis | 521 | ||
| History and Signalment | 521 | ||
| Physical Examination | 521 | ||
| Palpation of the Abdomen per rectum | 522 | ||
| Nasogastric Intubation | 522 | ||
| Clinical Pathology | 522 | ||
| Abdominocentesis | 523 | ||
| Ultrasonography | 523 | ||
| Radiography | 525 | ||
| Ancillary Diagnostic Aids | 525 | ||
| Endoscopy | 525 | ||
| Laparoscopy | 525 | ||
| Decision for Surgery | 525 | ||
| Preoperative Management | 525 | ||
| Surgical Approaches to the Abdomen | 526 | ||
| References | 527 | ||
| 34 Principles of Intestinal Injury and Determination of Intestinal Viability | 529 | ||
| Introduction | 529 | ||
| Types of Obstruction | 529 | ||
| Simple Obstruction | 529 | ||
| Strangulating Obstruction | 529 | ||
| Nonstrangulating Infarction | 529 | ||
| Mechanisms of Injury | 530 | ||
| Luminal Distention | 530 | ||
| Mucosal Ischemic Injury | 530 | ||
| Reperfusion Injury | 530 | ||
| Determination of Intestinal Viability | 532 | ||
| Clinical Assessment of Bowel Viability | 532 | ||
| Ancillary Methods of Determining Intestinal Viability | 533 | ||
| Fluorescein Dye | 533 | ||
| Surface Oximetry | 533 | ||
| Doppler Ultrasonography | 533 | ||
| Intraluminal Pressure | 533 | ||
| Histopathology | 534 | ||
| Dark-Field Microscopy | 534 | ||
| References | 534 | ||
| 35 Jejunum and Ileum | 536 | ||
| Anatomy | 536 | ||
| Digestive Anatomy | 536 | ||
| Physiology | 536 | ||
| Intraluminal Digestion | 536 | ||
| Absorption of Ions and Water | 537 | ||
| Carbohydrate Absorption | 538 | ||
| Protein Absorption | 538 | ||
| Fat Absorption | 538 | ||
| Absorption of Iron, Calcium, and Magnesium | 539 | ||
| Intestinal Secretion | 539 | ||
| Motility | 539 | ||
| Control of Motility | 540 | ||
| Motility of the Ileum | 540 | ||
| Altered Motility | 540 | ||
| Surgical Diseases of the Jejunum and Ileum | 540 | ||
| Nonstrangulating Obstruction | 541 | ||
| Ileal Impaction | 541 | ||
| Muscular Hypertrophy of the Ileum | 542 | ||
| Ascarid Impactions | 543 | ||
| Duodenitis–Proximal Jejunitis | 544 | ||
| Neoplasia | 545 | ||
| Intestinal Inflammation and Fibrosis | 545 | ||
| Eosinophilic Gastrointestinal Diseases | 545 | ||
| Grass Sickness | 546 | ||
| Miscellaneous Nonstrangulating Lesions | 546 | ||
| Strangulating Obstruction | 547 | ||
| Pedunculated Lipoma | 547 | ||
| Entrapment in the Epiploic Foramen | 548 | ||
| Volvulus | 550 | ||
| Inguinal Hernia | 550 | ||
| Surgery: Congenital Hernias | 551 | ||
| Surgery: Acquired Hernias | 552 | ||
| Intussusception | 552 | ||
| Surgery: Ileocecal and Ileoileal Intussusceptions | 553 | ||
| Surgery: Jejunojejunal Intussusception | 554 | ||
| Mesenteric Rents | 554 | ||
| Entrapment of Small Intestine by the Gastrosplenic Ligament | 555 | ||
| Vitelline Anomalies | 556 | ||
| Strangulated Umbilical Hernia | 557 | ||
| Diaphragmatic Hernias | 557 | ||
| Surgery | 557 | ||
| Miscellaneous Strangulating or Ischemic Diseases | 558 | ||
| Surgical Techniques | 558 | ||
| Resection | 558 | ||
| Preparation for End-to-End Jejunojejunostomy | 559 | ||
| Anastomosis Patterns | 560 | ||
| Stapled Jejunojejunostomy | 560 | ||
| Side-to-Side Stapled Jejunojejunostomy | 561 | ||
| Functional End-to-End Stapled Jejunojejunostomy | 561 | ||
| Skin Staples for Small Intestinal Anastomosis | 561 | ||
| Jejunoileal Anastomosis | 561 | ||
| Jejunocecal and Ileocecal Anastomoses | 562 | ||
| End-to-Side Jejunocecal Anastomosis | 562 | ||
| Side-to-Side Jejunocecal Anastomosis | 562 | ||
| Outcome for Jejunocecostomy | 563 | ||
| Small Intestinal Enterotomy | 563 | ||
| Small Intestinal Biopsy | 563 | ||
| Adjunctive Procedures for Small Intestinal Surgery | 564 | ||
| Aftercare for Small Intestinal Surgery | 564 | ||
| Prognosis | 565 | ||
| References | 566 | ||
| 36 Cecum | 575 | ||
| Cecal Anatomy | 575 | ||
| Cecal Physiology | 575 | ||
| Cecal Motility | 577 | ||
| Medications Affecting Cecal Motility | 577 | ||
| Medications That Decrease Cecal Motility | 577 | ||
| Medications That Increase Cecal Motility | 577 | ||
| Diseases of the Cecum | 578 | ||
| Cecal Tympany | 578 | ||
| Cecal Impaction | 578 | ||
| Categorization of Cecal Impactions | 578 | ||
| Clinical Signs and Diagnosis of Cecal Impaction | 579 | ||
| Treatment of Cecal Impaction | 579 | ||
| Medical Treatment for Cecal Impaction | 580 | ||
| Analgesia | 580 | ||
| Promotility agents | 580 | ||
| Prognosis following medical management | 580 | ||
| Surgical Treatment for Cecal Impaction | 580 | ||
| Typhlotomy | 581 | ||
| Cecocolic anastomosis | 581 | ||
| Cecal bypass procedures | 582 | ||
| Enlargement of the cecocolic orifice | 583 | ||
| Postoperative Care After Surgical Intervention for Cecal Impaction | 583 | ||
| Complications After Surgery for Cecal Impactions | 583 | ||
| Cecocecal or Cecocolic Intussusception | 583 | ||
| Prevalence and Etiology | 583 | ||
| Clinical Signs | 583 | ||
| Diagnosis | 583 | ||
| Treatment | 584 | ||
| Manual Cecal Intussusception Reduction With or Without Partial Typhlectomy | 584 | ||
| Right Ventral Colotomy to Aid Intussusception Reduction (Cecocolic Intussusception) | 584 | ||
| Cecal Bypass Procedure | 586 | ||
| Right Flank Approach for Treatment of Cecal Intussusception | 586 | ||
| Postoperative Care | 586 | ||
| Cecal Perforation or Rupture | 586 | ||
| Clinical Signs | 586 | ||
| VI Respiratory System | 678 | ||
| 42 Overview of Upper Airway Function | 678 | ||
| Overview | 678 | ||
| Mechanics of Airflow | 678 | ||
| Head Position | 679 | ||
| Stabilizing the Upper Airway | 679 | ||
| Support of the External Nares | 679 | ||
| Nasal Turbinate Region | 680 | ||
| Nasopharynx | 680 | ||
| References | 681 | ||
| 43 Diagnostic Techniques in Equine Upper Respiratory Tract Disease | 683 | ||
| Physical Examination | 683 | ||
| Endoscopic Evaluation | 683 | ||
| Videoendoscopic Examination at Rest | 683 | ||
| Elizabeth J. Davidson | 683 | ||
| Videoendoscopic Examination During Treadmill Exercise | 685 | ||
| Elizabeth J. Davidson | 685 | ||
| Videoendoscopic Examination During Overground Exercise | 687 | ||
| Samantha H. Franklin | 687 | ||
| Factors to Consider When Choosing Equipment | 688 | ||
| Ease of Use and Safety | 688 | ||
| Quality of the Image | 688 | ||
| Ability to Flush the Endoscope During Exercise | 688 | ||
| Ability to View the Image in Real Time: Telemetry Distance | 688 | ||
| Ability to View the Image in Slow Motion After the Exercise Test | 688 | ||
| Setting Up the Equipment and Positioning the Endoscope | 688 | ||
| Choice of Exercise Test | 688 | ||
| Exercise Testing | 689 | ||
| VII Nervous System | 822 | ||
| 50 Anatomy and Physiology of the Nervous System | 822 | ||
| Anatomy of the Nervous System | 822 | ||
| Development and Organization of the Nervous System | 822 | ||
| The Cranium | 823 | ||
| The Vertebral Column | 825 | ||
| Cerebrospinal Fluid | 825 | ||
| Physiology of Neurotransmission | 826 | ||
| Clinical Neuroanatomy | 826 | ||
| Whole Brain | 826 | ||
| Level of Consciousness | 826 | ||
| Upper Motor Neuron System: Voluntary Movement | 826 | ||
| Forebrain | 827 | ||
| Behavior (Limbic System, Temporal Lobes) | 827 | ||
| Seizures | 827 | ||
| Perception of Pain (Parietal Cortex, Cranial Nerve V) | 827 | ||
| Smell (Olfactory Bulbs, Cranial Nerve I) | 828 | ||
| Vision (Occipital Cortex, Thalamus, Cranial Nerve II) | 828 | ||
| Midbrain | 828 | ||
| Pupillary Light Reflex, Pupil Size (Midbrain, Cranial Nerves II, III) | 828 | ||
| Midbrain/Hindbrain | 829 | ||
| Eye Position (Midbrain; Pons; Cranial Nerves III, IV, VI, Input From VIII [Vestibular]) | 829 | ||
| Hindbrain | 829 | ||
| Mastication (Pons, Cranial Nerve V) | 829 | ||
| Facial Expression and Movement (Medulla, Cranial Nerve VII) | 829 | ||
| Balance and Equilibrium, Hearing (Medulla, Cranial Nerve VIII [Auditory]) | 829 | ||
| Taste (Cranial Nerves VII, IX, X) | 830 | ||
| Movement of Pharynx and Larynx (Cranial Nerves IX, X, XI) | 831 | ||
| Tongue Movement (Cranial Nerve XII) | 831 | ||
| Cerebellum | 831 | ||
| Spinal Cord | 831 | ||
| Upper Motor Neuron: Muscle Tone and Voluntary Movement | 831 | ||
| Lower Motor Neuron and Spinal Cord Reflexes | 832 | ||
| Proprioception | 832 | ||
| Urination | 832 | ||
| Defecation | 833 | ||
| Sensation | 833 | ||
| References | 834 | ||
| 51 Diagnostic Procedures | 834 | ||
| Neurologic Examination | 834 | ||
| Mentation | 835 | ||
| Alertness | 835 | ||
| Behavior | 835 | ||
| Lesion Location | 835 | ||
| Associated Clinical Signs | 835 | ||
| Orientation and Coordination of the Head | 835 | ||
| Examination | 835 | ||
| Lesion Location | 836 | ||
| Associated Clinical Signs | 836 | ||
| Muscles of Mastication | 836 | ||
| Examination | 836 | ||
| Lesion Location | 837 | ||
| Associated Clinical Signs | 837 | ||
| Facial Tone | 837 | ||
| Examination | 837 | ||
| VIII Eye and Adnexa | 910 | ||
| 56 Surgery of the Globe and Orbit | 910 | ||
| Anatomy and Physiology | 910 | ||
| Relevant Ocular Examination Techniques and Findings | 911 | ||
| Sedation | 913 | ||
| Regional Anesthesia | 913 | ||
| Diagnostic Imaging | 913 | ||
| Radiography | 914 | ||
| Ultrasonography | 914 | ||
| Computed Tomography | 914 | ||
| Magnetic Resonance Imaging | 915 | ||
| Anesthetic Considerations | 916 | ||
| Treatment of the Globe and Orbit | 917 | ||
| Required Surgical Equipment | 917 | ||
| Surgical Techniques | 917 | ||
| Evisceration and Intrascleral Prosthesis | 917 | ||
| Surgical Procedure | 917 | ||
| Aftercare | 919 | ||
| Complications | 919 | ||
| Enucleation | 920 | ||
| Transpalpebral Enucleation With Intraorbital Prosthesis | 920 | ||
| Subconjunctival Enucleation | 920 | ||
| Aftercare | 921 | ||
| Complications | 921 | ||
| Scleral Shell Prosthesis | 922 | ||
| Exenteration | 922 | ||
| Orbitotomy | 923 | ||
| Orbital Fractures | 923 | ||
| References | 925 | ||
| 57 Adnexal Surgery | 927 | ||
| Eyelids | 927 | ||
| Anatomy and Physiology | 927 | ||
| Protection of the Globe | 927 | ||
| Optimization of Light Transmission and Refraction Through the Cornea | 927 | ||
| Maintenance of Globe Position Within the Orbit | 927 | ||
| Musculature and Motor Control | 927 | ||
| Sensory Innervation | 928 | ||
| Vasculature and Lymphatics | 929 | ||
| Ophthalmic Examination Techniques and Findings | 930 | ||
| Motor Blockade | 930 | ||
| Sensory Blockade | 930 | ||
| Diagnostic Procedures | 930 | ||
| Neoplasia | 931 | ||
| Squamous Cell Carcinoma | 931 | ||
| Sarcoids | 931 | ||
| Anesthetic Considerations | 935 | ||
| Required Surgical Equipment | 938 | ||
| Relevant Pharmacology | 938 | ||
| Surgical Techniques | 938 | ||
| Temporary and Permanent Tarsorrhaphy | 939 | ||
| Entropion | 939 | ||
| Everting Sutures | 940 | ||
| Modified Hotz-Celsus Procedure | 940 | ||
| Ectropion | 940 | ||
| Distichia | 942 | ||
| Ectopic Cilia | 942 | ||
| Repair of Eyelid Lacerations | 942 | ||
| Aftercare | 942 | ||
| Reconstructive Blepharoplastic Techniques | 942 | ||
| Sliding Skin Flap | 942 | ||
| Conjunctival Advancement Flap | 943 | ||
| Full-Thickness Eyelid Graft | 944 | ||
| Rhomboid Graft Flap | 944 | ||
| Sliding Z Flap | 946 | ||
| Other Reconstructive Procedures | 946 | ||
| Nictitating Membrane | 947 | ||
| Anatomy and Physiology | 947 | ||
| Ophthalmic Examination Techniques and Diagnostic Procedures | 947 | ||
| Anesthetic Considerations | 947 | ||
| Required Surgical Equipment | 947 | ||
| Surgical Techniques | 947 | ||
| Third Eyelid Flap | 947 | ||
| Complications | 948 | ||
| Excision of the Third Eyelid | 948 | ||
| Aftercare | 949 | ||
| Complications | 949 | ||
| Lacerations | 949 | ||
| Nasolacrimal System | 949 | ||
| Anatomy and Physiology | 949 | ||
| The Preocular Tear Film | 949 | ||
| Nasolacrimal Drainage System | 950 | ||
| Examination Techniques | 950 | ||
| Diagnostic Procedures | 951 | ||
| Dacryocystorhinography | 951 | ||
| Endoscopy | 952 | ||
| Anesthetic Considerations | 952 | ||
| Required Surgical Equipment | 952 | ||
| Surgical Techniques | 952 | ||
| Imperforate Puncta | 952 | ||
| Lacerations | 952 | ||
| References | 953 | ||
| 58 Surgery of the Ocular Surface | 956 | ||
| Anatomy and Physiology | 956 | ||
| Conjunctiva | 956 | ||
| Structure and Function | 956 | ||
| Lymphatics, Vasculature, and Innervation | 957 | ||
| Response to Injury | 957 | ||
| Sclera | 957 | ||
| Limbus | 958 | ||
| Cornea | 958 | ||
| Structure and Function | 958 | ||
| Vasculature and Innervation | 959 | ||
| Response to Injury | 959 | ||
| Wound Healing | 959 | ||
| Ocular Surface Microflora | 960 | ||
| Ophthalmic Examination Techniques and Diagnostic Procedures | 961 | ||
| Examination of the Ocular Surface | 961 | ||
| Diagnostic Procedures | 961 | ||
| Ophthalmic Stains | 961 | ||
| Culture and Sensitivity | 962 | ||
| Cytology | 962 | ||
| Relevant Pharmacology | 963 | ||
| Application of Medication | 963 | ||
| Subpalpebral Lavage Placement | 963 | ||
| Topical Antibiotics | 964 | ||
| Topical Antifungal Medications | 964 | ||
| Antiinflammatory Drugs | 965 | ||
| Anesthetic Considerations | 965 | ||
| Topical Anesthesia | 965 | ||
| Sedation | 965 | ||
| General Anesthesia | 965 | ||
| Surgical Equipment and Surgical Principles | 966 | ||
| Instrumentation | 966 | ||
| Suture Materials, Needles, and Suture Patterns | 967 | ||
| Preparation for Surgery of the Ocular Surface | 968 | ||
| Additional Exposure of the Globe | 968 | ||
| Intraoperative Hemostasis | 968 | ||
| Entering the Anterior Chamber | 968 | ||
| Postoperative Care | 968 | ||
| Routine Surgical Techniques | 969 | ||
| Conjunctivectomy and Conjunctival Biopsy | 969 | ||
| Repair of Conjunctival and Scleral Lacerations | 969 | ||
| Superficial Keratectomy | 969 | ||
| Adjunctive Therapies for Ocular Surface Tumors | 970 | ||
| Repair of Corneal Lacerations | 971 | ||
| Advanced Surgical Techniques | 972 | ||
| General Principles for Conjunctival Grafting | 972 | ||
| Conjunctival Grafting Techniques | 973 | ||
| Rotational Pedicle Graft | 973 | ||
| Advancement Pedicle Graft | 974 | ||
| Hood Grafts | 974 | ||
| Bipedicle and Bridge Grafts | 974 | ||
| Amniotic Membrane Transplantation | 975 | ||
| Sliding Lamellar Keratoplasty (Corneoconjunctival Transposition) | 976 | ||
| General Principles for Corneal Transplantation | 976 | ||
| Corneal Transplantation Techniques | 977 | ||
| Penetrating Keratoplasty | 977 | ||
| Posterior Lamellar Keratoplasty | 977 | ||
| Deep Lamellar Endothelial Keratoplasty | 977 | ||
| References | 978 | ||
| 59 Intraocular Surgery | 981 | ||
| Equine Recurrent Uveitis | 981 | ||
| Anatomy and Physiology | 981 | ||
| Relevant Ocular Examination Techniques and Findings | 982 | ||
| Diagnostic Procedures | 982 | ||
| Anesthetic Considerations | 982 | ||
| Required Surgical Equipment | 983 | ||
| Relevant Pharmacology | 983 | ||
| Surgical Techniques | 984 | ||
| Intravitreal Injections | 984 | ||
| Suprachoroidal Cyclosporine Implantation | 984 | ||
| Pars Plana Vitrectomy | 985 | ||
| Cataracts | 987 | ||
| Anatomy and Physiology | 987 | ||
| Relevant Ocular Examination Techniques and Findings | 987 | ||
| Diagnostic Procedures | 987 | ||
| Anesthetic Considerations | 988 | ||
| Required Surgical Equipment | 988 | ||
| Relevant Pharmacology | 988 | ||
| Surgical Techniques | 989 | ||
| Phacoemulsification | 989 | ||
| Intraocular Lens Placement | 989 | ||
| Intracapsular Lens Extraction | 989 | ||
| Glaucoma | 990 | ||
| Anatomy and Physiology | 990 | ||
| Relevant Ocular Examination Techniques and Findings | 990 | ||
| Diagnostic Procedures | 990 | ||
| Required Surgical Equipment | 990 | ||
| Relevant Pharmacology | 990 | ||
| Surgical Techniques | 991 | ||
| Transscleral Cyclophotocoagulation | 991 | ||
| Gonioimplants (Anterior Chamber Shunts) | 991 | ||
| Pharmacologic Ablation of the Ciliary Body | 991 | ||
| References | 991 | ||
| IX Reproductive System | 994 | ||
| 60 Testis | 994 | ||
| Anatomy and Physiology | 994 | ||
| Scrotum | 994 | ||
| Epididymis and Testis | 994 | ||
| Inguinal Canal | 995 | ||
| Tunics | 995 | ||
| Gubernaculum | 996 | ||
| Descent of the Testis | 996 | ||
| Spermatic Cord | 996 | ||
| Pathophysiology | 997 | ||
| Congenital Monorchidism | 997 | ||
| Cryptorchidism | 997 | ||
| Etiology | 998 | ||
| Incidence | 999 | ||
| Inguinal Herniation and Rupture | 999 | ||
| Etiology | 1000 | ||
| Torsion of the Spermatic Cord | 1000 | ||
| Hydrocele (Vaginocele) and Hematocele | 1001 | ||
| Varicocele | 1002 | ||
| Retraction of a Testis Into the Inguinal Canal | 1002 | ||
| Testicular Neoplasia | 1002 | ||
| Seminoma | 1002 | ||
| Sertoli Cell Tumor | 1003 | ||
| Leydig Cell Tumor | 1003 | ||
| Teratoma | 1003 | ||
| Teratocarcinoma and Embryonal Carcinoma | 1003 | ||
| Intersex | 1003 | ||
| Diagnostic Procedures | 1004 | ||
| History and Physical Examination | 1004 | ||
| Examination per Rectum | 1005 | ||
| Testicular Biopsy | 1005 | ||
| Aspiration Biopsy | 1005 | ||
| Needle Biopsy | 1006 | ||
| Hormonal Assays | 1006 | ||
| Other Diagnostic Tests | 1007 | ||
| Surgical Procedures | 1008 | ||
| Castration | 1008 | ||
| Indications | 1008 | ||
| Preoperative Considerations | 1008 | ||
| Standing Castration | 1008 | ||
| Case Selection | 1008 | ||
| Preparation of the Horse | 1008 | ||
| Restraint | 1008 | ||
| Recumbent Castration | 1008 | ||
| Anesthesia | 1008 | ||
| Positioning | 1009 | ||
| Approach | 1009 | ||
| Scrotal Incision | 1009 | ||
| Inguinal Incision | 1010 | ||
| Emasculators | 1010 | ||
| Surgical Techniques | 1010 | ||
| Open Technique | 1011 | ||
| Closed Technique Through a Scrotal Approach | 1011 | ||
| Half-Closed Technique | 1011 | ||
| Considerations Concerning All Techniques | 1011 | ||
| Selection of Technique | 1012 | ||
| Primary Closure of the Incision | 1012 | ||
| Aftercare | 1013 | ||
| In Situ Castration | 1013 | ||
| Vasectomy | 1014 | ||
| Immunologic Castration | 1014 | ||
| Cryptorchid Castration | 1014 | ||
| Approaches | 1014 | ||
| Inguinal Approach | 1014 | ||
| Preventing Evisceration | 1017 | ||
| Parainguinal Approach | 1017 | ||
| Suprapubic Paramedian Approach | 1018 | ||
| Flank Approach | 1018 | ||
| Selection of Approach | 1018 | ||
| Laparoscopic Technique of Cryptorchidectomy | 1019 | ||
| Standing Technique | 1019 | ||
| Recumbent Technique | 1019 | ||
| Repair of Inguinal Hernias and Ruptures | 1020 | ||
| Nonsurgical Management | 1020 | ||
| Surgical Management | 1021 | ||
| Special Considerations | 1022 | ||
| Unilateral Orchidectomy (“Hemicastration”) | 1022 | ||
| Hormonally Induced Testicular Descent | 1022 | ||
| Postoperative Complications of Castration | 1023 | ||
| Hemorrhage | 1023 | ||
| Evisceration | 1024 | ||
| Edema | 1025 | ||
| Signs of Colic | 1025 | ||
| Lameness | 1026 | ||
| Pyrexia | 1026 | ||
| Septic Funiculitis | 1026 | ||
| Clostridial Infection | 1027 | ||
| Septic Peritonitis | 1027 | ||
| Penile Damage | 1027 | ||
| Hydrocele (Vaginocele) | 1027 | ||
| Continued Masculine Behavior | 1028 | ||
| Incomplete Cryptorchid Castration | 1028 | ||
| Polyorchidism | 1028 | ||
| References | 1029 | ||
| 61 Penis and Prepuce | 1034 | ||
| Anatomy and Physiology | 1034 | ||
| Penis | 1034 | ||
| Erectile Bodies | 1034 | ||
| Mechanism of Erection | 1035 | ||
| Muscles | 1037 | ||
| Blood Vessels, Nerves, and Lymphatics | 1037 | ||
| Accessory Genital Glands | 1037 | ||
| Prepuce | 1038 | ||
| Diagnostic Procedures | 1038 | ||
| History | 1038 | ||
| Clinical Examination | 1038 | ||
| Urination | 1038 | ||
| Erection and Ejaculation | 1038 | ||
| Palpation | 1038 | ||
| Visual Inspection | 1039 | ||
| Endoscopy | 1039 | ||
| Ultrasonography | 1040 | ||
| Cavernosography | 1040 | ||
| Miscellaneous Diagnostic Procedures | 1040 | ||
| Penile and Preputial Disorders | 1040 | ||
| Penile and Preputial Injuries | 1040 | ||
| Etiology | 1040 | ||
| Pathophysiology | 1040 | ||
| Treatment | 1040 | ||
| Open Wounds | 1040 | ||
| Hematomas | 1041 | ||
| Aftercare | 1041 | ||
| Paraphimosis | 1041 | ||
| Etiology | 1041 | ||
| Pathophysiology | 1041 | ||
| Treatment | 1042 | ||
| Phimosis | 1043 | ||
| Etiology | 1043 | ||
| Treatment | 1043 | ||
| Priapism | 1043 | ||
| Etiologic Factors | 1043 | ||
| Pathophysiology | 1043 | ||
| Clinical Signs | 1044 | ||
| Treatment | 1044 | ||
| Medical | 1044 | ||
| Irrigation of the Corpus Cavernosum Penis | 1044 | ||
| Surgical | 1044 | ||
| Creation of a shunt | 1044 | ||
| Partial Phallectomy | 1046 | ||
| Hypospadias | 1046 | ||
| Intersex | 1047 | ||
| Clinical Features | 1047 | ||
| Treatment | 1047 | ||
| Neoplasia | 1047 | ||
| Incidence and Etiology | 1047 | ||
| Diagnosis | 1048 | ||
| Treatment | 1048 | ||
| Surgical Excision | 1048 | ||
| Cryotherapy | 1048 | ||
| Chemotherapy | 1048 | ||
| Hyperthermia | 1049 | ||
| Prognosis | 1049 | ||
| Habronemiasis | 1049 | ||
| Etiology | 1049 | ||
| Pathophysiology | 1050 | ||
| Clinical Signs | 1050 | ||
| X Urinary System | 1095 | ||
| 64 Diagnostic Techniques and Principles of Urinary Tract Surgery | 1095 | ||
| Patient Evaluation | 1095 | ||
| History | 1095 | ||
| Physical Examination | 1096 | ||
| Rectal Examination | 1097 | ||
| Clinical Pathology | 1098 | ||
| Hematology and Serum Chemistry Analysis | 1098 | ||
| Acid-Base Balance | 1100 | ||
| Urinalysis | 1100 | ||
| Sample Collection | 1100 | ||
| Gross Appearance | 1101 | ||
| Assessment of Urine Tonicity | 1101 | ||
| Reagent Strip Analysis | 1102 | ||
| Sediment Examination | 1102 | ||
| Urine Electrolyte Concentrations and Clearances | 1103 | ||
| Urinary Diagnostic Indices | 1103 | ||
| Peritoneal Fluid Analysis | 1104 | ||
| Imaging Techniques | 1104 | ||
| Radiography | 1104 | ||
| Ultrasonography | 1104 | ||
| Endoscopy | 1106 | ||
| Nuclear Scintigraphy | 1107 | ||
| Computed Tomography and Magnetic Resonance Imaging | 1108 | ||
| Surgery | 1108 | ||
| Instruments | 1108 | ||
| Suture Material | 1108 | ||
| Laparoscopy | 1109 | ||
| Pharmacologic Considerations | 1109 | ||
| Anesthesia | 1109 | ||
| J. Brett Woodie | 1109 | ||
| Antimicrobial Agents | 1110 | ||
| Harold C. Schott II | 1110 | ||
| Specific Antimicrobial Agents | 1111 | ||
| Penicillins | 1111 | ||
| Aminoglycosides | 1111 | ||
| Potentiated Sulfonamides | 1111 | ||
| Cephalosporins | 1111 | ||
| Tetracyclines | 1111 | ||
| Fluoroquinolones | 1111 | ||
| Other Antimicrobial Agents | 1111 | ||
| Antiinflammatory Drugs | 1112 | ||
| Harold C. Schott II | 1112 | ||
| References | 1112 | ||
| 65 Kidneys and Ureters | 1115 | ||
| Anatomy | 1115 | ||
| Kidney | 1115 | ||
| Ureters | 1115 | ||
| Histology | 1116 | ||
| Innervation | 1117 | ||
| Disorders Requiring Surgery | 1117 | ||
| Congenital Anomalies | 1117 | ||
| Ectopic Ureter | 1117 | ||
| Ureteral Defects or Tears (Ureterorrhexis) | 1119 | ||
| Vascular Anomalies | 1119 | ||
| Acquired Renal and Ureteral Disorders | 1120 | ||
| Renal and Ureteral Calculi | 1120 | ||
| Pyelonephritis | 1121 | ||
| Ureterorrhexis | 1121 | ||
| Renal Neoplasia | 1122 | ||
| Surgical Procedures | 1122 | ||
| Renal Biopsy | 1122 | ||
| Harold C. Schott II | 1122 | ||
| Nephrectomy | 1123 | ||
| J. Brett Woodie | 1123 | ||
| Laparoscopic Nephrectomy by Hand-Assisted Techniques | 1124 | ||
| Nephrotomy | 1125 | ||
| Ureterotomy | 1125 | ||
| Neoureterostomy | 1126 | ||
| Aftercare | 1126 | ||
| Complications | 1127 | ||
| References | 1127 | ||
| 66 Bladder | 1129 | ||
| Anatomy and Physiology | 1129 | ||
| Disorders Requiring Surgery | 1130 | ||
| Uroperitoneum | 1130 | ||
| Foals | 1130 | ||
| Adult Horses | 1132 | ||
| Presurgical Considerations | 1132 | ||
| Correction of Hyperkalemia | 1132 | ||
| Draining of the Abdomen | 1132 | ||
| Patent Urachus | 1132 | ||
| Urolithiasis | 1133 | ||
| Sabulous Urolithiasis | 1135 | ||
| Bladder Displacement | 1135 | ||
| Neoplasia | 1136 | ||
| Surgical Procedures | 1136 | ||
| Cystorrhaphy | 1136 | ||
| Cystoplasty | 1138 | ||
| Cystotomy | 1139 | ||
| Parainguinal Approach | 1140 | ||
| Laparoscopic Techniques | 1141 | ||
| Lithotripsy | 1142 | ||
| Aftercare | 1142 | ||
| Complications | 1143 | ||
| References | 1143 | ||
| 67 Urethra | 1145 | ||
| Anatomy and Physiology | 1145 | ||
| Male | 1145 | ||
| Female | 1146 | ||
| Disorders Requiring Surgery | 1147 | ||
| Rectourethral and Rectovaginal Fistulas | 1147 | ||
| Urolithiasis | 1147 | ||
| Soft Tissue Lesions | 1148 | ||
| Neoplasia | 1149 | ||
| Hematoma | 1150 | ||
| Urethral Stricture | 1150 | ||
| Urethrorrhexis | 1150 | ||
| Hematuria and Hemospermia | 1150 | ||
| Surgical Procedures | 1151 | ||
| Perineal Urethrotomy and Urethrostomy | 1151 | ||
| Distal Urethrotomy | 1153 | ||
| Urethroplasty | 1153 | ||
| Aftercare | 1154 | ||
| Complications | 1154 | ||
| References | 1154 | ||
| XI Diagnostic Imaging | 1156 | ||
| 68 Radiography | 1156 | ||
| Indications | 1156 | ||
| X-Ray Production and Equipment | 1156 | ||
| Image Formation Devices | 1158 | ||
| Screen-Film Radiography | 1158 | ||
| Digital Radiography | 1158 | ||
| Computed Radiography | 1158 | ||
| Flat-Panel Detectors | 1158 | ||
| Digital Image Storage and Display | 1160 | ||
| Screen-Film Versus Digital Radiography in Equine Practice | 1160 | ||
| Fluoroscopy | 1161 | ||
| Performing the Examination | 1161 | ||
| Study-Specific Positioning | 1162 | ||
| Contrast Studies | 1162 | ||
| Radiation Safety | 1166 | ||
| Interpretation Principles | 1167 | ||
| Image Quality | 1168 | ||
| Artifacts | 1169 | ||
| Artifacts Occurring With Both Screen-Film and Digital Systems | 1169 | ||
| Overexposure | 1169 | ||
| Underexposure | 1169 | ||
| Motion Artifact | 1170 | ||
| Grid Artifacts | 1170 | ||
| Artifacts Specific to Screen-Film Systems | 1170 | ||
| Scratches | 1170 | ||
| Dirt Artifacts | 1171 | ||
| Processing Errors | 1171 | ||
| Artifacts Specific to Digital Systems | 1171 | ||
| Processing Artifacts | 1171 | ||
| Dirty Light Guide Artifact | 1172 | ||
| References | 1172 | ||
| 69 Ultrasonography | 1174 | ||
| Physics of Ultrasound | 1174 | ||
| Ultrasound Applications | 1176 | ||
| Cervical Region | 1177 | ||
| Shoulder Region | 1177 | ||
| Carpus | 1177 | ||
| Metacarpal and Metatarsal Regions | 1178 | ||
| Digits | 1179 | ||
| Pelvis and Coxofemoral Region | 1179 | ||
| Femorotibial Region | 1180 | ||
| Tarsus | 1180 | ||
| Abdomen | 1180 | ||
| Thorax | 1180 | ||
| Conclusion | 1181 | ||
| References | 1181 | ||
| 70 Nuclear Scintigraphy | 1182 | ||
| Principles | 1182 | ||
| The Gamma Camera | 1183 | ||
| Examination Procedure | 1184 | ||
| Vascular Phase | 1185 | ||
| Soft Tissue Phase | 1185 | ||
| Bone Phase | 1185 | ||
| Indications for Nuclear Scintigraphy | 1186 | ||
| Interpretation Principles | 1186 | ||
| Artifacts and Image Quality | 1190 | ||
| Poor Image Resolution | 1190 | ||
| Gamma Ray Count Density | 1191 | ||
| Time-Based Acquisition | 1191 | ||
| Impurities in the Radiopharmaceutical | 1191 | ||
| Gamma Camera | 1191 | ||
| Radiation Safety and Personnel Exposure | 1191 | ||
| Time, Distance, and Shielding | 1191 | ||
| Excretion | 1192 | ||
| Dosimeters | 1192 | ||
| Patient Isolation | 1192 | ||
| References | 1192 | ||
| 71 Computed Tomography | 1193 | ||
| Introduction | 1193 | ||
| Indications | 1194 | ||
| Basic Physical Principles and Equipment | 1194 | ||
| Hardware | 1194 | ||
| Axial and Helical Scanning | 1194 | ||
| Single- and Multiple-Detector Array Scanning | 1196 | ||
| Choice of Slice Thickness | 1196 | ||
| Image Formation | 1196 | ||
| Artifacts | 1196 | ||
| Beam Hardening | 1196 | ||
| Motion Artifacts | 1197 | ||
| Partial Volume | 1197 | ||
| Metallic Artifacts | 1198 | ||
| Use of Contrast Media | 1198 | ||
| CT Angiography | 1198 | ||
| CT Fistulography | 1198 | ||
| Dacryocystography | 1198 | ||
| Interpretation Principles | 1198 | ||
| Image Viewing | 1198 | ||
| Reconstruction in Multiple Dimensions | 1200 | ||
| Three-Dimensional Volume Rendering | 1200 | ||
| Curvilinear Reconstruction | 1200 | ||
| References | 1200 | ||
| 72 Magnetic Resonance Imaging | 1201 | ||
| Physics Overview and Pulse Sequences | 1201 | ||
| Sequence Selection | 1204 | ||
| Equipment and Logistics | 1205 | ||
| MRI Contrast Media | 1206 | ||
| Safety | 1207 | ||
| Interpretation of Magnetic Resonance Imaging Studies | 1207 | ||
| The Foot | 1207 | ||
| Distal Sesamoid Bone and Podotrochlear Bursa | 1207 | ||
| Deep Digital Flexor Tendon | 1209 | ||
| Distal Sesamoidean Impar Ligament | 1210 | ||
| Collateral Sesamoidean Ligament | 1210 | ||
| Collateral Ligaments of the Distal Interphalangeal Joint | 1211 | ||
| Distal Digital Annular Ligament | 1212 | ||
| Other Structures of the Limb | 1212 | ||
| Distal Sesamoidean Ligaments | 1212 | ||
| Suspensory Ligament | 1212 | ||
| Accessory Ligament of the Deep Digital Flexor Tendon | 1212 | ||
| Cartilage Evaluation | 1212 | ||
| Bone Evaluation | 1213 | ||
| The Head and Neck | 1213 | ||
| MRI Artifacts | 1214 | ||
| Magnetic Susceptibility Artifact | 1214 | ||
| Magic Angle Effect | 1215 | ||
| Zipper Artifact | 1216 | ||
| Motion Artifact | 1216 | ||
| Volume Averaging Artifact | 1217 | ||
| References | 1217 | ||
| XII Musculoskeletal System | 1220 | ||
| 73 Diagnostic and Regional Surgical Anesthesia of the Limbs and Axial Skeleton | 1220 | ||
| General Considerations | 1220 | ||
| Mechanism of Action | 1220 | ||
| Choice of Local Anesthetic Solution | 1220 | ||
| Dosage of Local Anesthetic Solution | 1221 | ||
| Sequence of Application of Diagnostic Anesthesia Techniques | 1221 | ||
| Preparation of the Injection Site | 1222 | ||
| Choice of Needle | 1222 | ||
| Restraint of the Horse | 1222 | ||
| Onset and Efficacy of Local Anesthesia | 1222 | ||
| Testing the Perineural Nerve Block | 1222 | ||
| Interpretation of Gait in Response to Diagnostic Anesthesia | 1223 | ||
| Prevention of Complications | 1223 | ||
| Contraindications for Diagnostic Anesthesia | 1223 | ||
| Care of the Horse After Performing Diagnostic Anesthesia | 1224 | ||
| Abolishing Cutaneous Sensation for the Purpose of Limb Surgery on a Standing Horse | 1224 | ||
| Diagnostic Anesthesia of the Forelimb | 1224 | ||
| Perineural Regional Anesthesia | 1224 | ||
| Palmar Digital Nerve Block (PDNB) | 1224 | ||
| Abaxial Sesamoid Nerve Block | 1225 | ||
| Low 4-Point Nerve Block | 1225 | ||
| High 4-Point Nerve Block | 1225 | ||
| Lateral Palmar Nerve Block | 1225 | ||
| Median and Ulnar Nerve Blocks | 1226 | ||
| Regional Surgical Anesthesia of the Forelimb | 1226 | ||
| Intrasynovial Anesthesia of the Forelimb | 1227 | ||
| Distal Interphalangeal (DIP) Joint | 1227 | ||
| Podotrochlear (Navicular) Bursa | 1227 | ||
| Proximal Interphalangeal (PIP) Joint | 1228 | ||
| Digital Flexor Tendon Sheath (DFTS) | 1228 | ||
| Metacarpo-/Metatarsophalangeal (Fetlock) Joint | 1229 | ||
| The Antebrachiocarpal and Middle Carpal Joints | 1229 | ||
| Carpal Sheath of the Superficial and Deep Digital Flexor Tendons | 1230 | ||
| The Cubital (Elbow) Joint | 1230 | ||
| Scapulohumeral (Shoulder) Joint | 1231 | ||
| Bicipital Bursa | 1231 | ||
| Diagnostic Anesthesia of the Pelvic Limb | 1231 | ||
| Perineural Regional Anesthesia | 1231 | ||
| High 4-Point Nerve Block | 1232 | ||
| Deep Branch of the Lateral Plantar Nerve (DBLPN) Block | 1232 | ||
| Tibial and Peroneal Nerve Blocks | 1232 | ||
| Tibial Nerve | 1233 | ||
| Peroneal Nerve | 1233 | ||
| Intrasynovial Anesthesia of the Pelvic Limb | 1233 | ||
| Tarsal Joints | 1233 | ||
| Tarsocrural Joint | 1234 | ||
| Tarsometatarsal Joint | 1234 | ||
| Distal Intertarsal (Centrodistal) Joint | 1234 | ||
| Cunean Bursa | 1235 | ||
| Tarsal Sheath (Sheath of the Lateral Digital Flexor Tendon) | 1235 | ||
| Calcaneal Bursae | 1235 | ||
| Stifle Joints | 1235 | ||
| Femoropatellar Joint | 1236 | ||
| Medial compartment of the femorotibial joint | 1236 | ||
| Lateral compartment of the femorotibial joint | 1236 | ||
| Centesis of all three compartments of the stifle through a single site | 1236 | ||
| Trochanteric Bursa | 1237 | ||
| Coxofemoral (Hip) Joint | 1237 | ||
| Sacroiliac (SI) Joint | 1237 | ||
| Blind Craniomedial Approach to the SI Joint | 1238 | ||
| Ultrasonographically Aided Injection of the SI Joint | 1238 | ||
| Diagnostic Anesthesia of the Axial Skeleton | 1239 | ||
| Thoracolumbar Interspinous Spaces | 1239 | ||
| Cervical Intervertebral Facet (Articular Process) Joints | 1239 | ||
| Thoracolumbar Intervertebral Facet (Articular Process) Joints | 1239 | ||
| References | 1240 | ||
| 74 Emergency Treatment and Transportation of Equine Fracture Patients | 1243 | ||
| Examination of the Patient | 1244 | ||
| Treatment or Euthanasia | 1244 | ||
| Optimal Emergency Treatment | 1244 | ||
| Sedation | 1244 | ||
| Anesthesia | 1245 | ||
| Wound Management | 1245 | ||
| Fracture Stabilization | 1245 | ||
| Goals | 1245 | ||
| Reduction of pain and anxiety and facilitation of partial weight bearing | 1245 | ||
| Prevention of further compromise of the patient | 1245 | ||
| Immobilization of the adjacent joints | 1246 | ||
| Types of Stabilization | 1246 | ||
| Robert Jones bandage | 1246 | ||
| Splints | 1246 | ||
| Bandage cast | 1246 | ||
| Cast | 1246 | ||
| Principles of Stabilization | 1246 | ||
| Prevention of soft tissue damage | 1246 | ||
| Regional immobilization | 1247 | ||
| Region I: fractures of the proximal, middle, and distal phalanges, proximal sesamoid bones, and the distal sesamoid bone | 1247 | ||
| Region II: fractures of MCIII, MTIII, carpal, and tarsal bones | 1248 | ||
| Region IIIA: fractures of the radius and tibia | 1249 | ||
| Region IIIB: fractures of the ulna | 1249 | ||
| Region IV: fractures of the humerus, femur, scapula, and pelvis | 1249 | ||
| Fractures of the spinal column | 1251 | ||
| Fractures of the head | 1252 | ||
| Analgesia and Antiinflammatory Medications | 1252 | ||
| Antimicrobial Therapy | 1252 | ||
| Intravenous Fluid Therapy | 1252 | ||
| Transportation of the Horse | 1252 | ||
| Equipment | 1252 | ||
| Loading Injured Horses | 1253 | ||
| Transport in a Supporting Harness | 1253 | ||
| Transport of Recumbent Horses | 1253 | ||
| Unloading Fracture Patients | 1254 | ||
| References | 1254 | ||
| 75 Bone Biology and Fracture Healing | 1255 | ||
| Anatomy | 1255 | ||
| Biomechanical Definitions | 1258 | ||
| Biological Reaction and Healing of Bone | 1262 | ||
| Indirect Bone Healing | 1263 | ||
| Direct Bone Healing | 1264 | ||
| Evaluation of Healing | 1264 | ||
| Complications | 1265 | ||
| Distraction Osteogenesis | 1266 | ||
| Stimulation of Bone Healing | 1266 | ||
| References | 1267 | ||
| 76 Metallic Instruments and Implants | 1270 | ||
| Metallic Instrument Materials | 1270 | ||
| Stainless Steel | 1270 | ||
| Aluminum | 1270 | ||
| Aluminum Alloys | 1270 | ||
| Other Materials | 1271 | ||
| Metallic Implant Materials | 1271 | ||
| Stainless Steel | 1271 | ||
| Titanium | 1273 | ||
| Titanium Alloys | 1273 | ||
| Cobalt-Base Alloys | 1274 | ||
| Metallic Implant Failure | 1274 | ||
| Fatigue | 1274 | ||
| Failure Analysis | 1275 | ||
| References | 1276 | ||
| 77 Principles of Fracture Treatment | 1277 | ||
| Nonsurgical Management | 1277 | ||
| Stall Rest | 1277 | ||
| External Coaptation | 1277 | ||
| Splints | 1277 | ||
| Casts | 1278 | ||
| Complications | 1279 | ||
| Surgical Management | 1279 | ||
| External Fixation | 1279 | ||
| Transfixation Pin Casting | 1279 | ||
| External Skeletal Fixator | 1281 | ||
| External Skeletal Fixation Device | 1281 | ||
| Complications | 1281 | ||
| Internal Fixation | 1283 | ||
| Principles | 1283 | ||
| Anatomic Fracture Reduction | 1283 | ||
| Stable Internal Fixation of the Fracture | 1283 | ||
| Preservation of Blood Supply | 1283 | ||
| Early, Active Mobilization | 1283 | ||
| Approach to and Manipulation of Bone | 1283 | ||
| Instruments | 1284 | ||
| Plate-Bending Press | 1285 | ||
| Implants | 1285 | ||
| Screws | 1285 | ||
| Screw types | 1285 | ||
| Screw sizes | 1288 | ||
| Screw functions | 1289 | ||
| Screw removal | 1291 | ||
| Plates | 1292 | ||
| Dynamic compression plate | 1293 | ||
| Limited-contact dynamic compression plate | 1293 | ||
| Dynamic condylar screw plate | 1293 | ||
| Locking compression plate | 1296 | ||
| Technique of plate application with cortex screws | 1298 | ||
| Principles of plate fixation | 1302 | ||
| Plate functions | 1302 | ||
| Double plating | 1303 | ||
| Special LCPs | 1305 | ||
| One-third tubular plate | 1307 | ||
| T-plates | 1307 | ||
| Compact 2.4 UniLOCK system | 1307 | ||
| Minimally Invasive Plate Osteosynthesis | 1307 | ||
| Addendum | 1308 | ||
| Cerclage Wire | 1308 | ||
| Cables | 1309 | ||
| Pins | 1309 | ||
| Steinmann pins | 1309 | ||
| Rush pins | 1309 | ||
| Nails | 1310 | ||
| Aftercare | 1311 | ||
| Implant Removal | 1311 | ||
| References | 1311 | ||
| 78 Bone Grafts and Bone Replacements | 1314 | ||
| Bone Grafts | 1314 | ||
| Definitions | 1314 | ||
| Source | 1314 | ||
| Function | 1315 | ||
| Incorporation | 1315 | ||
| Augmentation | 1316 | ||
| Surgical Techniques | 1316 | ||
| General Guidelines | 1316 | ||
| Location | 1316 | ||
| Proximal Tibia | 1316 | ||
| Sternum | 1317 | ||
| Tuber Coxae | 1317 | ||
| Complications | 1317 | ||
| Natural and Synthetic Bone Graft Substitutes | 1318 | ||
| Demineralized Bone Matrix | 1318 | ||
| Bone Fillers and Cements | 1319 | ||
| Polymers | 1319 | ||
| Ceramics | 1320 | ||
| Bioglass | 1320 | ||
| Metals | 1320 | ||
| Biodegradation | 1320 | ||
| Multipotent Stromal Cells | 1321 | ||
| Bioreactors | 1321 | ||
| References | 1322 | ||
| 79 Synovial Joint Biology and Pathobiology | 1326 | ||
| Anatomy of Synovial Joints | 1327 | ||
| Synovial Membrane and Synovial Fluid | 1327 | ||
| Periarticular Ligaments and Joint Capsule | 1328 | ||
| Subchondral Bone | 1328 | ||
| Articular Cartilage | 1329 | ||
| Microscopic Appearance | 1329 | ||
| Cartilage Collagens | 1330 | ||
| Type II Collagen | 1331 | ||
| Minor Collagens | 1331 | ||
| Proteoglycans | 1332 | ||
| Aggrecan | 1332 | ||
| Aggrecan (Proteoglycan) Aggregates | 1332 | ||
| Small Proteoglycans | 1332 | ||
| Noncollagenous Proteins | 1333 | ||
| Chondrocytes | 1334 | ||
| Physiology of Synovial Joints | 1334 | ||
| Intraarticular Volume and Pressure | 1334 | ||
| Joint Mechanics | 1334 | ||
| Kinematics | 1334 | ||
| Kinetics | 1335 | ||
| Lubrication | 1335 | ||
| Pathophysiology of Osteoarthropathy | 1337 | ||
| Metabolism of Arthritic Cartilage | 1337 | ||
| Mechanisms of Articular Cartilage Matrix Depletion | 1338 | ||
| Synovial Membrane and Ligamentous Joint Capsule | 1338 | ||
| Chondrocytes | 1338 | ||
| Matrix Metalloproteinases (MMPs) | 1338 | ||
| Cytokines | 1339 | ||
| Natural Inhibitors of MMPs and Cytokines | 1340 | ||
| Clinical Manifestations of Osteoarthritis | 1341 | ||
| Sources of Pain | 1341 | ||
| Clinical Parameters | 1341 | ||
| Cartilage Repair | 1343 | ||
| References | 1344 | ||
| 80 Medical Treatment of Joint Disease | 1348 | ||
| Nonsteroidal Antiinflammatory Drugs | 1348 | ||
| Corticosteroids | 1350 | ||
| Hyaluronan | 1352 | ||
| Polysulfated Polysaccharides | 1354 | ||
| Hyaluronan, Sodium Chondroitin Sulfate, and N-Acetyl-d-Glucosamine Combination Products | 1355 | ||
| Oral Joint Supplements | 1355 | ||
| Extracorporeal Shock Wave Therapy | 1356 | ||
| Bisphosphonates | 1357 | ||
| Biological Therapies | 1357 | ||
| Challenges of Medical Management in Equine Joint Disease | 1359 | ||
| References | 1359 | ||
| 81 Surgical Treatment of Joint Disease | 1363 | ||
| Surgical Treatment | 1363 | ||
| Diagnostic and Surgical Arthroscopy | 1363 | ||
| Removal of Osteochondral Fragments | 1364 | ||
| Reconstruction of Intraarticular Fractures | 1364 | ||
| Synovectomy | 1366 | ||
| Joint Resurfacing | 1368 | ||
| Stimulated Endogenous Cartilage Repair | 1368 | ||
| Articular Cartilage Grafting | 1369 | ||
| Arthrodesis | 1370 | ||
| Joint Replacement | 1370 | ||
| Aftercare | 1371 | ||
| References | 1371 | ||
| 82 Arthrodesis Techniques | 1374 | ||
| Introduction | 1374 | ||
| General Guidelines | 1374 | ||
| Distal Interphalangeal Joint | 1375 | ||
| Indications | 1375 | ||
| Surgical Techniques | 1375 | ||
| Dorsal Hoof Wall Approach | 1375 | ||
| Palmar/Plantar Approach | 1376 | ||
| Dorsal Approach Using Plate and Screws | 1376 | ||
| Proximal Interphalangeal Joint | 1377 | ||
| Indications | 1377 | ||
| Facilitated Chemically Induced Ankylosis | 1377 | ||
| Internal Fixation | 1377 | ||
| Lag Technique | 1377 | ||
| Combination of a Plate and Lag Technique | 1378 | ||
| Collateral Ligament Transection | 1379 | ||
| State of the Art | 1379 | ||
| Surgical Techniques | 1379 | ||
| Approach | 1379 | ||
| Arthrodesis Technique | 1380 | ||
| Closure and Aftercare | 1380 | ||
| Proximal Interphalangeal Joint Arthrodesis for Fracture Repair | 1382 | ||
| Minimally Invasive Application of LCPs | 1382 | ||
| Arthrodesis for Septic PIP Joints | 1383 | ||
| Prognosis | 1383 | ||
| Metacarpophalangeal or Metatarsophalangeal Joint | 1383 | ||
| Indications | 1383 | ||
| Surgical Techniques | 1383 | ||
| Surgical Approach | 1384 | ||
| Plate Application | 1384 | ||
| Application of the Tension Band | 1384 | ||
| Lag Technique Through the Proximal Sesamoid Bones | 1384 | ||
| Cerclage Wire | 1384 | ||
| Completion of Plate Application | 1385 | ||
| Minimally Invasive Technique | 1385 | ||
| Prognosis | 1385 | ||
| Carpus | 1386 | ||
| Indications | 1386 | ||
| Surgical Techniques | 1386 | ||
| Facilitated Ankylosis for Osteoarthritis of the Carpometacarpal Joint | 1386 | ||
| Partial Carpal Arthrodesis | 1386 | ||
| Surgical Technique | 1387 | ||
| Pancarpal Arthrodesis | 1388 | ||
| Surgical Technique | 1388 | ||
| Minimally Invasive Approach | 1388 | ||
| Postoperative Management | 1388 | ||
| Scapulohumeral Joint | 1388 | ||
| Indications | 1388 | ||
| Surgical Technique | 1389 | ||
| Tarsus | 1389 | ||
| Indications | 1389 | ||
| Facilitated Ankylosis Techniques | 1390 | ||
| Chemically Induced Ankylosis | 1390 | ||
| Laser-Facilitated Ankylosis | 1390 | ||
| Transarticular Drilling Technique | 1391 | ||
| Fixation Techniques | 1391 | ||
| T-Plate Application for Arthrodesis | 1391 | ||
| Stainless Steel Cylinders for Arthrodesis | 1394 | ||
| Plate Fixation for Arthrodesis After Luxation | 1394 | ||
| Talocalcaneal Arthrodesis | 1395 | ||
| Complications | 1396 | ||
| References | 1396 | ||
| 83 Management of Bursitis | 1399 | ||
| Structure and Function of Bursae | 1399 | ||
| Diagnosis of Bursitis | 1399 | ||
| Management of Clinically Significant Bursitis | 1399 | ||
| Management Principles | 1399 | ||
| Acquired Bursae | 1399 | ||
| Carpal Hygroma | 1399 | ||
| Olecranon Bursitis or Elbow Hygroma | 1400 | ||
| Capped Hock | 1401 | ||
| False Thoroughpin | 1402 | ||
| Acquired Bursae in the Region of the Fetlock | 1402 | ||
| Congenital Bursae That Protect Ligaments | 1402 | ||
| Nonseptic Atlantal (Nuchal) and Supraspinous Bursitis | 1403 | ||
| Septic Atlantal (Nuchal) and Supraspinous Bursitis | 1403 | ||
| Congenital Bursae That Protect Tendons | 1403 | ||
| Bicipital Bursitis (Intertubercular Bursitis) | 1403 | ||
| Infraspinatus Bursitis | 1405 | ||
| Congenital Bursa in the Region of the Fetlock | 1406 | ||
| Navicular Bursitis | 1406 | ||
| Trochanteric Bursitis (Whirlbone Lameness) | 1407 | ||
| Bursa of the Long Digital Extensor Tendon | 1408 | ||
| Calcaneal Bursitis | 1408 | ||
| Cunean Bursitis | 1409 | ||
| References | 1409 | ||
| 84 Diagnosis and Management of Tendon and Ligament Disorders | 1411 | ||
| Tendon Biology | 1411 | ||
| Structure of Tendons and Ligaments: From Molecule to Organ | 1411 | ||
| Blood Supply | 1413 | ||
| Functional Characteristics of Tendons and Ligaments | 1413 | ||
| Etiopathogenesis of Tendon Injury | 1415 | ||
| Response of Tendons to Aging and Exercise | 1416 | ||
| Mechanisms for Tendon Degeneration | 1416 | ||
| Mechanisms of Clinical Injury | 1417 | ||
| Strain-Induced Injury | 1417 | ||
| Tendon Tears | 1418 | ||
| Percutaneous Tendon Injury | 1418 | ||
| Pathophysiology of Tendon Repair | 1418 | ||
| Diagnosis | 1420 | ||
| Clinical Evaluation | 1420 | ||
| Ultrasonography | 1421 | ||
| Advanced Imaging Modalities | 1421 | ||
| Molecular Markers | 1422 | ||
| Clinical Characteristics of Specific Strain-Induced Injuries | 1422 | ||
| Clinical Characteristics of Specific Tendon Lacerations | 1423 | ||
| Treatment of Tendon and Ligament Injuries | 1424 | ||
| Nonsurgical Therapies | 1425 | ||
| Physical Therapies | 1425 | ||
| Cold Therapy | 1425 | ||
| Compression and Coaptation | 1425 | ||
| Shoeing | 1426 | ||
| Controlled exercise | 1426 | ||
| Extracorporeal Shock Wave Therapy | 1426 | ||
| Therapeutic Ultrasound, Laser, and Magnetic Fields | 1427 | ||
| Counter-Irritation | 1427 | ||
| Pharmacologic Management | 1427 | ||
| Systemic Medication | 1427 | ||
| Intralesional Medication | 1427 | ||
| New Advances: Tissue Engineering Approaches | 1428 | ||
| Surgical Therapies of Tendinopathy and Tendon Lacerations | 1430 | ||
| Tendon Splitting | 1430 | ||
| Desmotomy of the Accessory Ligament of the Superficial Digital Flexor Tendon | 1430 | ||
| Desmotomy or Desmectomy of the Accessory Ligament of the Deep Digital Flexor Tendon | 1431 | ||
| Palmar/Plantar Annular Ligament Desmotomy | 1431 | ||
| Tenoscopy and Bursoscopy | 1432 | ||
| Tenoscopy | 1432 | ||
| Digital flexor tendon sheath | 1432 | ||
| Carpal sheath | 1434 | ||
| Tarsal sheath | 1434 | ||
| Bursoscopy | 1434 | ||
| Podotrochlear bursa | 1434 | ||
| Bicipital bursa | 1435 | ||
| Calcaneal bursa | 1435 | ||
| Surgical Treatment of Proximal Suspensory Desmopathy in the Forelimb | 1435 | ||
| Surgical Treatment of Proximal Suspensory Desmopathy in the Hind Limb | 1436 | ||
| Surgical Treatment of Lesions of the Suspensory Ligament Branches | 1437 | ||
| Tendon Lacerations | 1437 | ||
| Emergency Treatment of Tendon Lacerations | 1437 | ||
| Surgical Repair | 1437 | ||
| Flexor tendons | 1437 | ||
| Extensor tendons | 1438 | ||
| References | 1439 | ||
| 85 Biology and Management of Muscle Disorders and Diseases | 1445 | ||
| Structure and Function of Muscles | 1445 | ||
| Anatomy | 1445 | ||
| Physiology of Contraction | 1446 | ||
| Muscle Fiber Types | 1446 | ||
| Muscle Repair | 1447 | ||
| Specific Muscle Disorders | 1447 | ||
| Fibrotic Myopathy | 1447 | ||
| Pathophysiology | 1447 | ||
| Diagnosis | 1447 | ||
| Treatment | 1447 | ||
| Complete Resection of the Fibrotic Tissue | 1447 | ||
| Transection of the Fibrotic Tissue | 1448 | ||
| Semitendinosus Tenotomy | 1448 | ||
| Prognosis | 1448 | ||
| Stringhalt (Equine Reflex Hypertonia) | 1448 | ||
| Pathophysiology | 1449 | ||
| Classical Stringhalt | 1449 | ||
| Australian Stringhalt | 1449 | ||
| Diagnosis | 1449 | ||
| Treatment | 1449 | ||
| Prognosis | 1450 | ||
| Peroneus Tertius Disorders | 1450 | ||
| Pathophysiology | 1450 | ||
| Diagnosis | 1451 | ||
| Treatment | 1451 | ||
| Prognosis | 1452 | ||
| Rupture of the Gastrocnemius Muscle | 1452 | ||
| Diagnosis | 1452 | ||
| Treatment | 1452 | ||
| Rupture of the Extensor Carpi Radialis Tendon | 1453 | ||
| Diagnosis | 1453 | ||
| Treatment | 1453 | ||
| Prognosis | 1453 | ||
| Cribbing/Wind-Sucking | 1453 | ||
| Etiology | 1454 | ||
| Therapy | 1454 | ||
| Nonsurgical Management | 1454 | ||
| Surgical Management | 1455 | ||
| Modified Forssell procedure | 1455 | ||
| Prognosis | 1455 | ||
| Calcinosis Circumscripta | 1456 | ||
| Pathophysiology | 1456 | ||
| Diagnosis | 1456 | ||
| Treatment | 1456 | ||
| Prognosis | 1456 | ||
| References | 1456 | ||
| 86 Synovial and Osseous Infection | 1458 | ||
| Introduction | 1458 | ||
| Septic Arthritis/Osteomyelitis in Foals and Adults | 1458 | ||
| Foals | 1458 | ||
| Types of Infections | 1459 | ||
| S-Type | 1459 | ||
| E-Type | 1459 | ||
| P-Type | 1459 | ||
| Clinical Signs | 1459 | ||
| Adults | 1459 | ||
| Diagnosis | 1460 | ||
| Microbiology | 1460 | ||
| Diagnostic Imaging | 1460 | ||
| Treatment | 1461 | ||
| Initial Therapy | 1461 | ||
| Synovial Lavage | 1461 | ||
| Débridement and Drainage | 1462 | ||
| Antimicrobials | 1462 | ||
| Regional Limb Perfusion | 1463 | ||
| Intraosseous and Intraarticular Administration | 1464 | ||
| Antibiotic Impregnated Biomaterials | 1464 | ||
| Analgesia | 1464 | ||
| Other Intrasynovial Treatments | 1464 | ||
| Osseous Infections | 1465 | ||
| Sequestrum | 1465 | ||
| Postoperative Infection | 1465 | ||
| Etiology | 1465 | ||
| Prevention | 1465 | ||
| Diagnosis | 1466 | ||
| Treatment | 1466 | ||
| Prognosis | 1468 | ||
| References | 1468 | ||
| 87 Angular Limb Deformities | 1471 | ||
| Definition | 1471 | ||
| Diagnosis | 1471 | ||
| Perinatal Deformities | 1472 | ||
| Cuboidal Bone Ossification | 1472 | ||
| Treatment | 1474 | ||
| Stall Rest | 1474 | ||
| Splints and Casts | 1474 | ||
| Laxity of the Periarticular Structures | 1475 | ||
| Treatment | 1475 | ||
| Aberrant Intrauterine Ossification | 1476 | ||
| Acquired Deformities | 1476 | ||
| Treatment | 1477 | ||
| Nonsurgical Techniques | 1477 | ||
| Stall Rest and Controlled Exercise | 1477 | ||
| Foot Manipulation | 1477 | ||
| Surgical Techniques | 1478 | ||
| Growth Acceleration | 1478 | ||
| Distal radius | 1478 | ||
| Distal MCIII/MTIII and proximal P1 | 1478 | ||
| Bench knees | 1480 | ||
| Distal tibia | 1481 | ||
| Growth Retardation | 1481 | ||
| Screws and wires | 1481 | ||
| Single transphyseal screw | 1481 | ||
| Bone plates | 1483 | ||
| Combination of growth acceleration and retardation | 1483 | ||
| Miniature horses | 1483 | ||
| Implant removal | 1485 | ||
| Outcome | 1485 | ||
| Complications | 1486 | ||
| Corrective Osteotomy/Ostectomy | 1486 | ||
| Step ostectomy in the sagittal plane | 1486 | ||
| Step osteotomy in the frontal plane | 1487 | ||
| Wedge ostectomy | 1487 | ||
| References | 1489 | ||
| 88 Flexural Limb Deformities | 1490 | ||
| Introduction | 1490 | ||
| Congenital Flexural Deformities | 1491 | ||
| Pathogenesis | 1491 | ||
| Diagnosis | 1492 | ||
| Digital Hyperextension Deformities | 1492 | ||
| Flexural Deformities | 1492 | ||
| Distal Interphalangeal Region | 1492 | ||
| Metacarpophalangeal/ Metatarsophalangeal Region | 1492 | ||
| Carpal Region | 1493 | ||
| Proximal Interphalangeal Region | 1493 | ||
| Tarsal Region | 1493 | ||
| Ruptured Common Digital Extensor Tendon | 1493 | ||
| Radiography for the Diagnosis | 1495 | ||
| Treatment | 1495 | ||
| Digital Hyperextension Deformities | 1495 | ||
| Farriery | 1495 | ||
| Bandaging | 1495 | ||
| Surgical Management | 1496 | ||
| Flexural Deformities | 1496 | ||
| Nonsurgical Management | 1496 | ||
| Exercise | 1496 | ||
| Intravenous oxytetracycline | 1496 | ||
| Analgesics | 1497 | ||
| Farriery | 1497 | ||
| Toe extensions | 1497 | ||
| Splints and Casts | 1498 | ||
| Index | 1836 | ||
| A | 1836 | ||
| B | 1839 | ||
| C | 1841 | ||
| D | 1845 | ||
| E | 1847 | ||
| F | 1849 | ||
| G | 1852 | ||
| H | 1853 | ||
| I | 1854 | ||
| J | 1856 | ||
| K | 1857 | ||
| L | 1857 | ||
| M | 1859 | ||
| N | 1862 | ||
| O | 1863 | ||
| P | 1865 | ||
| Q | 1869 | ||
| R | 1869 | ||
| S | 1871 | ||
| T | 1876 | ||
| U | 1879 | ||
| V | 1880 | ||
| W | 1881 | ||
| X | 1882 | ||
| Y | 1882 | ||
| Z | 1882 |