Indy’s OCD Surgery

Surprisingly, I was not the nervous wreck I thought I would be the morning of the surgery.  Well, for the most part.  I admit I nearly lost it and there were some tears in my eyes when he went into the padded room for his anesthesia.  However, I knew that Indy was in the best hands possible and was going to be just fine.  I also knew that I was making the right decision for him and he will be so happy once he heals and can run around pain free.

I’ve got lots of pictures and videos to follow as I walk you through the surgery.  I initially didn’t think I could watch, but science won out and I did.  It was pretty amazing!

We began the morning by having an IV catheter sewn into his neck and having some pre-surgery antibiotics.  He got a little sedation for this part, as they were huge, uncomfortable needles being used.  When the sedation wore off, he was in a very playful mood, despite not having eaten breakfast.  I stayed with him in his stall, grooming and patting him.  His adorable face and wonderful personality helped keep my mind occupied as well.

His next step was to head into the exam room where his mouth was rinsed out to prepare for the intubation tube.  He was really good for this.  He also was super while his hocks were wrapped up.  He then headed into the padded stall where he would be placed under general anesthesia.  While awkward for a horse to step onto, he was very good.  This is the room where he will lie down.  From here, he will be hoisted into the operating room and onto the table.  I did not watch this part.

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The padded room where he was given sedation and gently laid down.

I’ve seen a lot of horses upside down and under anesthesia. To me it’s never a pleasant site to see.  Indy was made as comfortable as possible and had a wonderful team keeping a close eye on him.

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There is a big hoist mounted in the ceiling that lifts Indy up by all four of his legs.  His head was gently carried in and he was delicately laid down on the padded table.

Prepping him for surgery took a long time.  He was first hooked up to a machine that monitored his blood pressure, heart rate, and gas exchange while ventilating him.  He was given IV fluids throughout, as the anesthesia process can cause dehydration.  His front feet were wrapped, padded, and secured down, folded across his chest.  His hind feet were wrapped and lifted in the air, placing them in a secure position for the surgery.

His hocks were then scrubbed, scrubbed and scrubbed some more.  It is always imperative that any surgical area be completely disinfected and as sterile as possible, but particularly so if you are going to enter a joint.  An infection in the joint can be life threatening.

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Preparing the tools

The surgery began.  Arthroscopic surgery is a minimally invasive procedure.  A small incision, about the size of a pencil, is made and a fiber optic camera is inserted.  Another small incision is then made for tools.  The camera is connected to a monitor where the surgeon can then see inside the joint and guide his tools.  A side note on this; the image on the monitor is displayed is a mirror image.  Add this to the fact that Indy’s legs were in the air and thus the joint upside down – the surgeon had to move opposite to what was portrayed on the monitor and opposite the typical picture of the joint that we have in mind.  By watching his skillful hands move without a bobble, I would never guessed until I was told!

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The surgery setup.  The camera and saline line are in his right hand.

They started with the left hock, which needed the most work.  The videos below show part of the process.  This was the video that was aimed at the window where I and the Indy Fan Club were watching.  The surgical team had a much bigger and clearer screen!

Throughout the process, the joint was kept well lubricated and flushed using saline.  A spoonlike tool was used to loosen the OCD pieces that were still attached to the bone.  This tool could also be used to help smooth any rough edges and debride any improperly formed bone and tissue.  Next, you’ll see the Rongeurs, (a scooping tool that reminded me of the game “Hungry Hungry Hippos”) come in and remove the bone fragment.

On the next video, you’ll see the Rongeurs working on a lesion where part of it was already removed.  On some of the bigger pieces, a section would come break off when attempting removal.  It’s a good demonstration of just how weak and improperly formed these lesions were.  Over time, these pieces would break off on their own (as one did) and be free floating around the joint, causing damage and pain.

The assistant then held the piece in her hand so I could film how big that piece actually was.

This last video shows more impressive Rongeur action.  Sometimes the pieces were a little more connected to the joint and would require a slight tug.   In case you were wondering, the floating, waving thin pieces of tissue in the videos is the synovial membrane in the joint.  Indy’s membranes were working overtime, trying to keep the joint lubricated to compensate for the lesions.

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Camera picture of a lesion being scooped up.
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A larger lesion where the top half popped off during removal.
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You can see how uneven the lesions are, and how weak they are.

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Reaching under the synovial membrane to grab a piece.

The right hock didn’t take nearly as long.  All told, the surgery lasted two hours.  They took a radiograph of the left hock before stitching up the small incisions, then carefully wrapped him up.  He was hoisted back to the padded recovery stall to wake up.

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The left image is the left hock directly after surgery.  The right image is two weeks prior.

You can see on the x-ray where the surgery occurred.  The one from two weeks ago shows the free floating OCD lesion superimposed on the front of the joint, seeming to point at the letter L on the film.  Below that is the area where the smaller flaps and lesions were.  Thanks to Indy’s young age, he will remodel this area quickly and properly, laying down nice, strong, correctly formed bone.

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Free floating piece that was removed from the left hock.
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Total pieces that were removed from the left hock.  They were very vascular!
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Pieces removed from the right hock.

Suddenly, lots of whinnying erupted from the recovery room.  Indy was awake and announcing it to the world.  Due to his age and size, he metabolized the medications very quickly and woke up fast.  Typically after anesthesia horses are shaky and sweaty.  Indy was both, but he did make it to his feet and soon was walking around well enough on his own.  He actually tried to trot down the aisle to his stall!

(Please note that the wonderful woman holding his tail is doing so to support Indy and help keep him balanced.  Should he stumble or lean too far, she can help to right him.  He was still slightly sedated, though he didn’t think so!)

He could start eating hay immediately, much to his enjoyment.  He hadn’t eaten in a while so he was very very happy to have that.  We toweled him off and he got to wear his first cooler.

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Still a little confused as to what the heck happened to him, but happy and kind as always.

I stayed with him for a while, then let him be on his own to relax and process.  The sedation and anesthesia drugs make horses very sensitive to sound, so even something that he is used to, such as me coughing or the noise of my clothing, would make him jump a little.

When I came back that night, he was his normal self.  He enjoyed a thorough grooming and seemed completely unfazed by his wraps.

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Relaxed and back to normal!

He was thrilled when dinner came and cleaned his bucket like always.

This morning, day 1 of recovery, he was very social and clearly feeling well.  He had rolled in his fresh shavings and eaten everything he was given.  He had left his wraps alone overnight, though they were starting to itch.  Thankfully, he’s got a friend next to him on stall rest as well.  He will be staying at the clinic for the duration of his stall rest, where he will have company all day and lots of activity to keep him entertained.

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“Chillin'”

I can’t wait for him to be able to go outside and try his new hocks.  I know he is going to be much more comfortable!  One day of stall rest down, 20 more to go.  Then a month in a smaller turnout.

I’ll be working on creative ways to keep him happy and busy while stuck in his stall!

Thank you to everyone for your support and positive thoughts.  I appreciate everyone helping me through this!

 

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9 thoughts on “Indy’s OCD Surgery”

  1. Yay Indy! Congratulations on getting through the big surgery!

    I have to say, those bone pieces are incredibly fascinating. I had no idea they would be so vascularized. And looking at the arthroscopic camera pictures was awesome! This was really cool, thanks for sharing!

    Liked by 1 person

      1. So happy it’s behind you both!!! After he has re-cooped, you may want to have him seen by chiropractor, from hanging by his legs. Shunka was totally out of alignment after both his surgeries. Just a thought

        Liked by 1 person

  2. Thank you for sharing, this is fascinating to see the operation in such detail. I’m sure that the time Indy spends on box rest will allow you two to develop an even deeper bond. When my horses are in and getting bored I sometimes hang sprout sticks up for them to pick at; with some horses it keeps them amused for hours but others, typically the mares, can devour them in no time at all! I look forward to hearing how he’s getting on.

    Liked by 1 person

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