FELLOWSHIP EXAMINATION
JUNE/JULY 2006
EQUINE SURGERY
PRINCIPLES
PAPER 1
Perusal time: 20 minutes
Time allowed: THREE (3) Hours after perusal
Answer only SIX (6) of the seven questions.
All questions are of equal value.
Subsections of Questions are of equal value unless stated otherwise
EQUINE SURGERY 2006 – FELLOWSHIP – PAPER 1
Answer only SIX (6) of the seven questions.
1.
Discuss EACH of the following techniques in relation to their application,
limitations, complications, special precautions and advantages and/or
disadvantages over conventional techniques in equine diagnostics and surgery:
a.
b.
c.
Diode laser
Abdominal laparoscopy
Computed tomography
2.
Describe in detail the reported arthrodesis techniques used to achieve
ankylosis of a hind limb proximal interphalangeal joint with degenerative joint
disease. Include in your answer the biomechanical advantages and
disadvantages of each technique, and indicate your preferred method and
reasons supporting your preference.
3.
Discuss in detail current concepts of the aetiopathogenesis of injury and repair
of superficial digital flexor tendonitis in racing thoroughbreds. Include in your
answer current knowledge of tendon physiology, biomechanics, treatment
methods, rehabilitation programs, and factors influencing prognosis for return
to racing.
4.
For EACH of the following, discuss the reported methods of action, efficacy,
routes of administration, indications and contra-indications and clinical
applications in managing degenerative joint disease in horses.
5.
a.
b.
c.
d.
e.
Sodium hyaluronate
Pentosan polysulphate
Methylprednisolone acetate
Non-steroidal anti-inflammatory drugs
Full thickness cartilage grafting
a.
b.
c.
Describe the mechanisms of gastrointestinal motility.
List factors that may decrease or inhibit intestinal motility.
Discuss the use of prokinetic drugs that may be used to treat postoperative ileus in horses. Include in your answer the mechanism of
action and advantages and disadvantages of each drug.
Continued over/Equine Surgery 2006/Paper 1
Continued/Equine Surgery 2006/Paper 1
6.
7.
a.
Give a detailed description of bone healing.
b.
Define and discuss non-union of fractures, including significant factors
that may lead to non-union formation.
c.
Discuss techniques that can be used to promote fracture healing,
stating advantages and disadvantages of each. Include in your answer a
review of the current literature.
Orthopaedic infection in horses is commonly encountered, and at times is
difficult to diagnose and treat. Discuss in detail EACH of the following:
a.
The pathophysiology of orthopaedic infections in horses with specific
reference to septic arthritis and fractures. Your answer should include
risk factors associated with establishment of an orthopaedic infection.
b.
Methods available to facilitate a diagnosis of orthopaedic infection in
horses.
c.
Recommended treatment strategies, both medical and surgical, for
treating orthopaedic infections in horses.
END OF PAPER
FELLOWSHIP EXAMINATION
JUNE/JULY 2006
EQUINE SURGERY
APPLICATION
PAPER 2
Perusal time: 20 minutes
Time allowed: THREE (3) Hours after perusal
Answer only SIX (6) of the seven questions.
All questions are of equal value.
Subsections of Questions are of equal value unless stated otherwise
EQUINE SURGERY 2006 – FELLOWSHIP – PAPER 2
Answer only SIX (6) of the seven questions.
1.
You are presented with a 10-year-old, multiparous Thoroughbred mare three
(3) months post foaling with acute onset of severe abdominal pain. Assuming
a diagnosis of 720 degree strangulating volvulus of the ascending colon is
made at exploratory laparotomy:
a.
b.
Discuss available methods to determine intestinal viability and their
application to this case.
Describe in detail your surgical technique for each of the following.
Include in your answer the complications, post-operative management,
indications and contraindications for each procedure.
i.
ii.
2.
A 4-year old Quarter horse gelding used for reining is presented to you for
evaluation of grade 3 (out of 5) hind limb lameness of 3-months duration.
Your examination reveals moderate effusion of the femoropatella and medial
femorotibial joint pouches.
a.
b.
c.
Assuming the lameness is localized to the stifle, list your differential
diagnoses.
Describe in detail your approach to arthroscopic evaluation of the
stifle.
Assuming a diagnosis of medial meniscal injury:
i.
ii.
3.
Resection and anastomosis of the ascending colon.
Colopexy of the ascending colon.
Discuss your approach to managing this case.
Discuss the specific factors that are likely to influence the
prognosis for return to athletic activity.
Poor performance secondary to laryngeal and/or pharyngeal dysfunction is
common in racing horses. For EACH of the following, discuss your preferred
surgical treatment, including complications and prognosis for return to racing.
Where appropriate include in your discussion a critique of the current
veterinary literature.
a.
b.
c.
d.
Unilateral left-sided chronic arytenoid chondropathy in a 2-year-old
Thoroughbred gelding.
Axial deviation of the aryepiglottic folds in a 4-year-old Standardbred
mare.
Intermittent dorsal displacement of the soft palate in a 3-year-old
Thoroughbred colt.
Intermittent epiglottic entrapment in a 2-year old Standardbred filly.
Continued over/Equine Surgery 2006/Paper 2
Continued/Equine Surgery 2006/Paper 2
4.
A four-year-old Warmblood gelding is referred to your hospital for evaluation
of oesophageal obstruction of four (4) days duration. The horse had been
perfectly normal until the owner turned him out into an apple orchard to graze
and he was found ‘choked’ later the same day. The referring veterinarian had
been trying to clear the choke over the last few days but had been
unsuccessful. On examination, the horse was febrile, severely depressed with
bilateral, watery nasal discharge, an elevated respiratory rate and heart rate
and an occasional deep cough.
a.
b.
c.
5.
You are presented with a twelve(12) year-old Standardbred brood mare with a
large, ventral abdominal hernia to the right of midline adjacent to the right
flank fold. The mare had been kicked by another horse two weeks previously
and the stud manager reported that the swelling slowly enlarged to the size of
a ‘soccer ball’ during the first week after the kick, and that the mare had been
very painful in the injured area. She had been treated with rest and
phenylbutazone and local hydrotherapy after which time the swelling did not
get any larger.
a.
b.
c.
6.
Describe your approach to this case. Include in your answer expected
metabolic derangements that typically occur in such cases and how you
would treat them as well as common complications.
Describe what diagnostics you would perform to further evaluate the
case.
After performing the diagnostic test(s) just described, you locate a
complete oesophageal obstruction within the thoracic oesophagus
approximately 20 cm orad to the cardiac sphincter. Describe your
surgical management of this case, including potential complications.
Describe how you would evaluate this case.
What surgical options are available to you to repair the hernia?
Describe in detail how you would manage this case surgically. Your
answer should include a discussion of prostheses available for
herniorrhaphy and the principles that govern hernia repair in horses.
Discuss in detail your surgical treatment of each of the following conditions.
Include in your answer the specific biomechanical problems, complications
and prognosis associated with surgical repair of each condition.
a.
b.
c.
A craniodorsal coxofemoral luxation in a 165 kg pony.
(8 marks)
A displaced type 1b olecranon fracture (Donecker et al 1984) in a 245
kg thoroughbred foal.
(9 marks)
A displaced, articular tibial tuberosity fracture in a Thoroughbred
eventer.
(8 marks)
Continued over/Equine Surgery 2006/Paper 2
Continued/Equine Surgery 2006/Paper 2
7.
You are referred a 12-year-old Thoroughbred broodmare with a history of
progressive weight loss and anaemia. Transrectal examination reveals splenic
enlargement.
a.
List any additional diagnostic steps and/or procedures you may
employ.
b.
Assuming a diagnosis of splenic lymphosarcoma is made, described in
detail your pre-operative management, anaesthetic protocol, surgical
technique and post-operative management for performing a
splenectomy.
END OF PAPER