We ask that your horse is dropped off the day before surgery so the horse can settle in and we can prepare your horse. The hair has to be clipped above and below the joint which is being operated on to reduce the risk of infection so your horse will get a special hair cut! The night before, the area is cleaned and placed into a bandage so it is clean for surgery the following day. Your horse’s shoes will be removed to reduce the risk of injury in recovery and the feet will be trimmed and cleaned. A small area will be clipped and a catheter placed in the jugular vein in your horse’s neck to allow the easy administration of drugs to your horse during the procedure.
The term "arthro" applies to a joint and "scopy" to a camera. Thus, "arthroscopy" is the procedure of placing a camera into a joint. This allows the surfaces of the joint to be assessed and also allows instruments to be inserted into the joint for assessment and treatment of conditions identified.
Tenoscopy involves placing a small camera into a tendon sheath via a small opening, similar to that of an arthroscopy. Tendon sheathes are thin membranes which surround tendons, coating them in a thin layer of synovial fluid. This protects and lubricates the tendons. The horses’ limb has several tendon sheathes but the most common site for tenoscopy is the sheath which covers the flexor tendons at the back of the cannon, termed the digital flexor tendon sheath. Tenoscopy allows close examination of the tendon sheath and the tendons within it. Depending on the extent of the damage some areas may need to be debrided or transected with surgical instruments.
Palmer/Plantar Annular Ligament Desmotomy
The annular ligament is located at the back of the fetlock within the tendon sheath of the horse. If this ligament is swollen or the tendon sheath is inflamed then the annular ligament may constrict the tendon sheath which will put pressure on the surrounding tendons and may cause lameness. A palmar/plantar annular ligament desmotomy is performed through two small skin incisions and a camera is placed into the tendon sheath to allow visualisation of a hook knife which is advanced into the tendon sheath and then used to cut the ligament. The benefit of performing this procedure with a tenoscopy (camera in the tendon sheath) is that it allows the tendons and other structure within the tendon sheath to be assessed concurrently and any lesions can also be treated during the same surgery.
This procedure involves cutting a small segment out of a nerve to stop the horse feeling pain to a certain area of the leg. There are two sites this can be performed at. The "suspensory neurectomy" cuts the deep branch of lateral palmar/plantar nerve which supplies sensation to the suspensory ligament. For this procedure the incision will be made below the hock on the back of the leg. The "digital neurectomy" cuts the palmer/plantar digital nerve, which provides sensation to the foot. This provides pain relief in conditions such as navicular syndrome or chronic foot pain. The incision for this surgery is at either side of the back of the pastern. For horses which have undergone a digital neurectomy, it must be considered that they can no longer feel the sole of their foot. Extra care must be made to check the foot regularly for foot abscesses or injuries and your farrier needs to be made aware as your horse will no longer feel pain associated with any trauma to the foot.
Horses will usually be hospitalised for 3 days following a routine orthopaedic procedures, however more complicated surgeries such as infected joints or fracture fixation may require hospitalisation for a longer period of time. When you collect your horse, you will be given a set of discharge instructions that have been specifically written for your horse. These instructions will explain how and when to give any medication, when re-examinations are required and will outline in detail your horse’s exercise rehabilitation programme. It is routine for horses to remain on box rest until the bandage(s) and sutures are removed, usually at 14 days post-surgery. In some situations, strict box rest is necessary but in most cases hand grazing for 5-10 minutes twice daily is acceptable. Box rest is a risk factor for the development of colic, particularly impactions, so it is vital to monitor your horse’s appetite and the number and consistency of your horse’s droppings. If you have any concerns feel free to call the clinic for some over the phone advice where we can advise you further. Some horses will become stressed or bored when kept apart from their companions who are in the field. Boredom can be reduced with toys such as feed balls, salt-licks and hanging vegetables. In extreme cases your horse may need a mild sedative to calm them at particularly stressful times such as when other horses are being led to the field. We can tailor rehabilitation programmes to each horses’ needs and appreciate your horse may not have read the text book! So, contact us if you have any questions about the management of your horse after surgery.
Your horse will have a bandage covering the site(s) which have been operated on to protect it from trauma and dirt. A vet will change the bandage every 2 to 4 days at your yard as necessary but it is import you monitor for any spilling, creasing or rubbing of the bandages and check for any strike-through or discharge, again if you are concerned about a bandage contact us for further advice. Monitor for any increase in lameness or general discomfort as this may indicate the horse needs assessing. If the foot is included there will be a layer of black tape covering the bandage to reduce wear. Some horses’ will wear through the black tape at the toe. If this happens more tape can be applied.