Typical Protocol

Equine Surgery requires a great deal of pre-surgical planning and preparation. The goal is to do everything possible to reduce the amount of time your horse will spend under general anesthesia. The preparation usually takes more time than the actual surgery!

In this case, Woody, a thoroughbred gelding was diagnosed with bone fragmentation in the hock which required arthroscopic surgery to remove. Before Woody arrived, his shoes were pulled to avoid self-injury during induction and recovery. He was admitted the afternoon before his elective surgery to allow time for acclimatization and a pre-surgical health check.

On surgery day, sterilized surgical equipment is laid out in advance to minimize total anaesthetic time. The surgical table is adjusted for his procedure to ensure proper positioning. Woody is groomed and sedated prior to walking into the preparation area. Preliminary clipping, a thorough hoof cleaning and the first of several surgical scrubs is done in the treatment area to limit contamination of the OR.  His hock is then shaved and the area receives a sterile scrub. In the distal limb a sterile bandage is applied to protect the scrubbed surgical site during induction and positioning. Catheters are placed in each of the jugular veins in order to readily administer medications and fluids intravenously. Administration of pre-operative antibiotics and pain medication is followed by a tetanus vaccine, rinsing of the mouth and a final check by the anesthetist.

 

If required additional sedative is administered and Woody is then led to the induction area, where he is settled against a completely padded squeeze gate. Here a muscle relaxant and the induction anaesthetic drugs are administered causing him to slump quietly onto a padded mat as he reaches a state of unconsciousness. An endotracheal tube is placed through his mouth into his trachea to ensure a patent airway for administration of oxygen and anaesthetic gas.

 

Special hobbles, placed above the knees and hocks, are then attached to a hoist, and he is quickly and easily lifted onto the operating table. Once positioned correctly on the thickly padded table, both sides are raised to cradle him comfortably in place. The sterile bandage is removed, the area rinsed with alcohol and Woody is ready for surgical draping.

Anaesthetic monitoring begins seconds after he is positioned.  The most important parameter to monitor is blood pressure so the anesthetist places an arterial catheter to allow for direct blood pressure monitoring. ECG leads are attached to monitor the heart. Carbon dioxide levels and anaesthetic gas concentration are continuously sampled and measured. A pulse oximeter attached to the tongue monitors oxygenation. Most horses will receive a minimum of 5 litres of fluids throughout the duration of the procedure. The anaesthetic team constantly monitors all readings and vital signs during surgery.

When the surgery is complete, the hoist is used to move Woody into the padded recovery room. Our new state-of-the-art recovery room was built with your horse’s safety in mind. Padded octahedral walls and a memory foam floor cushion promote quieter and safer recoveries. The anesthetic team stays with Woody until he is breathing on his own and his swallowing reflex has returned. Then a final dose of sedative is administered to allow for a quieter recovery; the endotracheal tube is removed and Woody is left to have a nap and recover. Recovery usually takes about half an hour. A video surveillance camera monitors his recovery every step of the way.

 

Once he is steady on his feet Woody is transferred to the adjacent recovery stall and given a warm bran mash.  A 20-30 minute period allows for full recovery and exhalation of residual anaesthesia.  Before transferring back to his hospital stall Woody receives his post-op medications, a physical exam is carried out, a cooler is applied and both catheters are removed.