DCLAH Case Archive 2022

Tongue Laceration Repair

Tongue lacerations are traumatic in nature and they require immediate surgical repair.  Clinical signs vary from bleeding, salivation, protruding tongue, fever, smelly mouth, poor or no appetite, and some horses have difficulty chewing or swallowing.This case shows two lacerations: one on the top and one on the bottom of the tongue. 

It was surgically repaired using non-absorbable sutures.At the time of recheck the lacerations had healed and the horse made a complete recovery! 


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Left Hind Laceration Repair

This case shows a left hind pastern laceration on the lateral aspect just above the coronary band. On presentation the horse was 4/5 lame. Contrast radiology of the coffin joint did not show communication with the wound. The laceration was surgically repaired by our surgeon, Dr. Castro, using non-absorbable suture that was removed 2 weeks later.
At the time of recheck, the laceration had healed and the horse made a complete recovery with no signs of lameness or swelling!


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Healing Process of a Laceration 

The laceration was located at the disto-dorsal aspect of the right hind cannon bone. At a walk, her foot will flip up. Exploration of the wound revealed transection of the long digital extensor tendon while radiographs ruled out a fracture. The wound was allowed to heal by second intention over a long period of time. This mare went healed and she is sound!


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Laceration of the Hard Palate

This mare was brought to Davie County Large Animal Hospital due to profuse bleeding (jet fashion) from her mouth. Using standing sedation and local anesthesia, the cut artery was doubly-ligated to stop the hemorrhage and the laceration on her hard palate was surgically repaired. The mare went home and she made a full recovery.

Hard Palate Laceration

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Hind Limb Laceration 

This mare was brought to DCLAH to have a laceration to her right hind leg examined. As the mare stepped off of the trailer it quickly became evident that her laceration was much more serious that originally thought-within a couple of steps blood was pulsating in an arc from her leg. She had damaged the main arterial supply to the distal limb-The Greater Metatarsal Artery. Dr. LoPresti and the staff quickly sedated the mare and clamped off the bleeding blood vessels to prevent anymore blood loss. The owners were able to provide crucial information that they had also found a large puddle of blood at home. The artery and vein were sutured to prevent any further bleeding and the wound was left open because it was considered a "dirty wound". Some basic in house blood work and the mare's physical exam and clinical signs had Dr. LoPresti bring in a technician's horse to donate blood for a necessary blood transfusion. By evening the mare had successfully received her transfusion. 

Hind Limb Laceration with blood transfusion

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Large Nose Laceration Repair

Dr. Castro treated a patient that was presented with a large laceration that also involved a partial fracture of the rostral aspect of the nasal septum. Time is of the essence when seeking medical care following traumatic injuries. 

Laceration assessment and repair is recommended in order to restore cosmetic and anatomic function, control infection, maintain blood supply, determine the extent of the injury and treat potential sequelae to the inciting trauma.


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Chest & Shoulder Laceration

This patient suffered an accident that resulted in shock and multiple large body lacerations that were managed by drain placement and suturing. Shock was managed with large volumes of IV fluids. Analgesics and antibiotics were used for pain and infection.

Chest and Shoulder Laceration in Horse

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Chest Laceration Repair

This patient presented with a right-sided chest laceration due to a trailer accident. The patient was sedated and Dr. Escudero applied local anesthesia. Dr. Castro placed a two way drain and did a partial closure of the wound based on the depth of the wound. The wound healed without any complications

Chest Laceration Repair

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Ear Laceration Repair

Today we want to show you an ear laceration. This horse came to DCLAH because he suffered a cut on his left ear. Dr. Castro first blocked the affected area to reduce sensitivity and surgically reconstructed the deep laceration. Antibiotics and anti inflammatories were continued at home. 


                                                                                                                                                                                           Click the image to view the post on Instagram.

Hoof Abscesses and Septic Coffin Bone (P3)

Jack Reacher was referred to Dr. Castro by veterinarian Dr. Kate Workman for surgical treatment of a septic coffin bone. The surgery was performed under sedation and regional anesthesia. Using radiographic guidance, a portion of the sole was removed, and a thick, fibrous capsule was encountered and removed. White, thick pus was drained, necrotic tissue was removed, and infected bone was curetted. A hospital plate was applied to treat the wound and to keep the hoof dry. 

After months of daily treatments and a long rehabilitation process, the infection resolved, and Jack Reacher and John went back to the show ring. They ended their first season of dressage competition in the Rolex Stadium at U.S. Dressage Finals!


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Street Nail - Puncture Wound

A puncture wound caused by a “street nail”. This horse came to DCLAH because he was suddenly lame. At presentation he had a 3/5 lameness meaning that the lameness is consistently observable under all circumstances. Upon careful inspection of the limb, a nail was found creating a penetrating wound in the frog. Next, a complete radiographic study was performed to determine the depth and direction of penetration, in order to determine what structures might be involved. The nail did not appear to affect any synovial or deep structures. The nail was removed and the horse was started on anti-inflammatories, along with topical and oral antibiotics. Tetanus prophylaxis was also administered. The wound was treated similarly to a hoof abscess creating an opening to allow drainage. This was followed by a bandage to prevent further contamination. The bandage included a waterproof covering (diaper, as shown in the video), followed by Vetrap and Elastikon. Remember it is important to release the pressure of a bandage above the coronary band to avoid blood supply disruption. This horse stayed with us for a few days for close monitoring and bandage changes.

Street Nail puncture wound in horse

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Oral Mass Removal

Over the course of 2 weeks, this horse had a mass growing rapidly in her mouth. The mass was removed surgically using our laser machine. Samples of the mass were sent to the lab for biopsy and culture/sensitivity to determine its cause and the next stage of care. 


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Squamous Cell Carcinoma of the Eyelid, Removed with Laser and Followed with Intralesional Chemotherapy

A large sub palpebral mass located in the lower eyelid was surgically removed using our laser. Samples of the mass were sent for histopathology and culture/sensitivity testing. The results came back as Squamous Cell Carcinoma (SCC). It is very important to perform these lab cell tests to determine definitive diagnosis and to establish proper treatment. 

SCC is one of the 3 most common skin cancer in the horse. The other two are Sarcoids and Melanomas!


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The owners of this horse noticed a tick adjacent to their mare’s udder and came to DCLAH for a veterinary consult. Dr. Castro found a golf ball sized furuncle (boil) which was first heated to encourage it to rupture. Then Dr. Castro performed local anesthesia and opened the lesion. Purulent material was drained and a gauze with iodine was placed inside as a drain to be removed by the owner at home. An antibiotic ointment was prescribed to be applied at home and a recheck to evaluation was scheduled to confirm furuncle resolution.

Furuncle found in horse

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Successful Treatment of a Melting Corneal Ulcer

This horse was presented to DCLAH Emergency Services for diagnosis and treatment of a large melting corneal ulcer of his right eye. An ophthalmologic exam, that included collecting samples for cytology, and culture and sensitivity testing confirmed that the ulcer was infected. Treatment of these cases requires medication around the clock. To facilitate the administration of eye medications Dr. Castro applied a Subpalpebral Lavage System (SPL). A SPL is an ophthalmic catheter that delivers topical liquid medication onto the surface of the equine cornea and was instrumental in the successful treatment of this case. A SPL is an ophthalmic catheter that delivers topical liquid medication onto the surface of the equine cornea and was instrumental in the successful treatment of this case.


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Esophageal Obstruction, aka Choke

Choke is a condition in horses in which the esophagus is blocked, usually by food material. Although the horse is still able to breathe, it is unable to swallow, and may become severely dehydrated. 

A secondary condition, aspiration pneumonia, may also develop if food material and saliva accumulate in the pharynx, spilling into the trachea and lungs.


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Gastric and Pyloric Ulcers 

This horse was referred to DCLAH to perform a gastroscopy because gastric ulcers were suspected. He was diagnosed with grade 2-Gastric Ulcers in the non glandular area and severe hemorrhagic and fibrinosuppurative ulceration at the antrum and pylorus. Gasterophilus (Botfly) infestation was also present. After 13 days of treatment he came back to DCLAH for a recheck. Dr. Castro found grade 1-Gastric Ulcers in the non glandular area and the hemorrhagic and fibrinosuppurative ulceration at the antrum and pylorus had improved by 90%. Only 2 bots Gasterophilus were seen.


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Gastric Ulcers - Grade 4 

This pony was unable to gain or keep weight on, going off feed, and wasn’t shedding out. After initial workup, Dr. LoPresti recommended that a gastroscopy be performed at the hospital because gastric ulcers were suspected. When ulcers are suspected a gastroscopy is recommended to evaluate the esophagus, cardia, stomach, pylorus, proximal duodenum and overall gastric motility. The findings were: severe grade 4 bleeding gastric ulcers in the non-glandular area of the stomach and a moderate botfly (*Gasterophilus*) infestation. Treatment with deworming and “gastric acid pump inhibitor“ was prescribed. After 28 days of treatment, the patient came back for a rescope. The gastroscopy showed a major improvement. The gastric ulcers were healed and the infestation gone. The improvement was not only in the inside but also in the outside. She was looking much better, began eating well again, and gaining weight. We are thrilled to show you the huge difference proper diagnosis and treatment of Equine Gastric Ulcers can make! And… deworming 🐛


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Wooden Stick Trapped in Mouth

This mare was presented to DCLAH because her owner had noticed an abnormal chewing behavior when eating. It was described as the mare twisting the pole of the head to one side, dropping her food, and chewing with signs of discomfort. Dr. Castro performed a dental examination and found something surprising. A 10-cm wooden stick wedged between the upper molars!. Under heavy sedation it was carefully removed. Dr. Castro then noticed a 2-cm ulcer in the hard palate caused by the other end of the wooden stick. She was sent home on a couple medications and mouthwashes until recheck. 


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Surgical Repair of a Grade 3 Recto Vaginal/Vestibular Tear (RVT)

This mare came to DCLAH for surgical repair of a grade 3 Recto Vaginal/Vestibular Tear (RVT). Dr. Castro examined the perineum, perineal body, vagina, and rectum to assess the damaged structures. Feces were found in the vaginal/vestibule.

The RVT was approximately 20cm long. First the mare was given oil by nasogastric tube to soften stool. Then surgery started with an epidural for regional anesthesia and she was given systemic antibiotics and anti-inflammatories. A Goetze technique was performed to repair the tear. The recto vestibular shelf and perineal body were reconstructed first followed by a Caslick procedure. The surgical repair of the RVT was a success! There are no more feces in the vagina.


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DCLAH Case Archive 2023 ❯

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❮ DCLAH Archive 2021