The Horse:Your Guide To Equine Health Care provides monthly equine health care information to horse owners, breeders, veterinarians, barn/farm managers, trainer/riding instructors, and others involved in the hands-on care of the horse.
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28 TheHorse.com THE HORSE July 2015 ■ Pleasure horses with well-rounded chip fractures (a sign that the chip has been present for some time) and no evidence of active degenerative joint disease often do not require surgery; and ■ Chip fractures at the proximal and dorsal (front) aspect of the first pha- lanx can be found in sound horses and do not necessarily cause lame- ness. That said, surgeons might need to remove those same chip fractures in some performance horses that are not living up to their owner's expectations. Basically, there is no rule of thumb for chip removal. Just remember that the higher the horse's athletic level, the less tolerant the joint will be of any insult, no matter how small the chip. Conservative options include either ignoring the problem if the chip does not cause overt lameness, or using nutritional joint supplements or other chondropro- tective medications, such as polysulfated glycosaminoglycan, to help support and maximize joint health. Surgical Options: Present and Future If you do elect to take your horse to surgery to remove his chip(s), he will most likely be anesthetized and undergo arthroscopic surgery recumbent and on a table. Compared to arthrotomy, where the surgeon cuts the joint open with a scalpel to find and remove the chips, arthroscop- ic surgery involves making only two tiny incisions into a joint: one for the camera and one for the surgical instruments. The surgeon can easily locate and remove the chips using an endoscopic camera with far less trauma to the joint than with arthrotomy. "Arthroscopic surgery is currently considered the 'standard of care' for the surgical removal of chip fractures in horses," says Alicia Bertone, DVM, PhD, Dipl. ACVS, the Trueman Family En- dowed Chair and a professor at The Ohio State University. Rarely, horses can develop complica- tions following recovery from general anesthesia, so surgeons have been look- ing for ways to perform some orthope- dic surgeries in the sedated, standing horse (e.g., chip fractures in the front of the fetlock joint). Benefits to standing surgery, in general, are that it permits the horse to be treated as an outpatient with lower care and anesthesia costs and shorter procedure length because there is no need for general anesthesia induction/ recovery. At this point, though, widespread use of standing surgery for routine arthros- copies does not appear to be particularly popular, primarily because most surgeons can find and remove bone chips rapidly in the anesthetized recumbent horse without any concerns about the horse moving during the procedure. Besides, as Bertone points out, most arthroscopic surgeries can be performed relatively quickly using short-acting general anesthetic. Bone Chips in Horses Tired of guessing what supplement your horse needs? Ask your vet. Available only through your veterinarian. Developed by: No more guesswork. No more worries. KPPvet.com, 859-873-2974 FootWise TM Maintains strong hooves, healthy skin, and a gleaming hair coat. TH 2015-03b Chips can range in size from fakes to pebbles to even slabs of bone. DUSTY PERIN