Large Animal Surgery

1. Large Animal Surgery Angular limb deformities

2. What subset of the population most commonly gets flexor tendon laxity • Premature foals

3. What is the pathogenesis of flexor tendon laxity • Uterine malposition • Premature parturition • Flaccidity of flexor muscles • Misc mare factors (infections, nutrition etc)

4. What is the treatment for flexor tendon laxity • Controlled exercise is usually sufficient • Also swimming or a glue on shoe with palmar extension in severe cases

5. What is the prognosis for flexor tendon laxity • Good

6. How long does it usually take for full recovery • Full recovery in about 2 weeks

7. Why do you not cast or splint foals with flexor tendon laxity • Weakening of the soft tissue supporting structures which causes articular laxity upon cast removal

8. Following cast removal how long should return to exercise take • As long as the limb was immobilized

9. What does an injury to the DDF look like • Toe is pointing up

10. What is the treatment for DDF laceration or laxity • Suture the tendon together • Orthopedic shoe with raised and extended heal

11. What is club foot • Flexural deformity of the coffin joint

12. Where and in what age group is club foot most common • Young animals • In the thoracic limb

13. What is the medical treatment for flexural deformity • Controlled exercise • Lower nutrition plane • Physical therapy • Bandage splints or casts • Oxytet 3 grams • Phenylbutazone • Corrective shoeing • Hoof trimming

14. How does oxytet help • Binds the calcium relaxing the muscle

15. Do cows have a check ligament • No

16. What is the treatment for a calf with a contracted tendon • Physical therapy and stretching • Can glue a shoe on with an extended toe

17. What is the surgical therapy for a contracted tendon in cattle • Cut SDF, DDF and maybe the joint capsule

18. If you cut the SDF or DDF what else must you do • Cast or splint

19. What happens after the cast is removed • Tendon laxity

20. What is the prognosis for return to function • Guarded to poor

21. What is your diagnosis • Chronic club foot

22. How do you differentiate this from laminitis • P3 is parallel to the hoof wall which would not be the case if this horse had laminitis

23. How do you trim the hoof to overcome club foot • Trim the heal • Leave the toe long

24. What else can be done besides the extended toe • Use padding between the shoe and the hoof • To raise the toe and stretch the flexor tendon

25. What is the surgical treatment for club foot • Inferior check ligament desmotomy

26. When would you do surgery for club foot • Cases that are refractory to medical treatment

27. What may need to be the treatment in very severe cases of club foot • Incise the entire DDF

28. How does fetlock flexural deformity develop • Usually acquired • Over nutrition or decreased use of the leg due to pain

29. Which limb is fetlock flexural deformity most common in • More common in the forelimb

30. What age is fetlock and pastern flexural deformity most commonly seen in • Yearlings • 8-18 months

31. What are the parameters to designate a severe case of fetlock flexural deformity • >180 degree rotation

32. What may have to be done in these severe cases • May have to cut both check ligaments and SDF

33. What is the treatment for a mild case of fetlock flexural deformity • Toe extensions, decrease feeding

34. What is the treatment for a moderate case of fetlock flexural deformity • Proximal check ligament desmotomy (maybe also distal check desmotomy)

35. What is the prognosis for club foot • Good

36. What is the prognosis for flexural deformity • Guarded

37. What prenatal factors may cause angular limb deformities • Periarticular laxity, hypoplasia of cuboidal bones, teratogenic insult, placentitis, hormonal nutritional imbalances

38. What postnatal factors may cause angular limb deformities • Unfavorable limb conformation • Excessive growth rate • Physeal injuries • Continuous overloading of the physis

39. If you find an angular limb deformity what else should you look for • Another congenital anomaly

40. What is ill thrift syndrome in llamas • Poor growth rates with ALD

41. What other things were found in the lab work on these llamas • Hypothyroidism • Anemia • Erythrocyte dyscrasia

42. What is the conservative treatment of ALD • Stall rest • Physical therapy • Splinting/ casts

43. Describe the cast that would be used for ALD • They do not include the foot so that the tendons can accept weight properly

44. If the ALD is manually reducible what are the probable causes • Periarticular laxity • Hypoplasia of the cuboidal bones (early stage)

45. If the ALD is not manually reducible what are the probable causes • Asynchronous physeal or epiphyseal growth • Untreated cases of cuboidal bone hypoplasia • Diaphyseal deformities

46. When do the carpal bones ossify • Should be ossified at birth

47. What can happen if carpal/tarsal bone hypoplasia is not corrected • Can result in crushed carpal bones leading to permanent lameness

48. Which animals tend to have hypoplasia of the carpal/tarsal bones • Premature, dysmature and twins

49. How do you treat hypoplasia of the carpal/tarsal bones • Tube cast (not including the foot or the fetlock)

50. How long does it take for ossification to be completed • 2-4 weeks