Hoof wall masses removal in 30 standing sedated horses: Surgical technique, postoperative complications and long-term outcome.
Authors: Ross Catherine, White Jonathan M, Hibner-Szaltys Maria, Stephenson Richard S, Withers Jonathan M, Marcatili Marco
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Hoof Wall Mass Removal Under Standing Sedation Keratomas and other hoof wall masses present a significant diagnostic and therapeutic challenge in equine practice, often causing prolonged lameness before definitive treatment. Between 2016 and 2023, a single equine hospital performed standing sedation with local anaesthesia for keratoma removal in 30 client-owned horses, documenting surgical technique, complications and long-term outcomes via telephone follow-up of 28 cases. Lameness duration prior to surgery ranged from 1 to 289 days (mean 90 days), with grade 3/5 lameness typical on presentation; all horses underwent radiography with 14 receiving MRI, followed by partial hoof wall resection. Post-operative complications were notably modest—only 3 horses experienced marked early lameness and 2 developed exuberant granulation tissue—with 26 of the 28 horses followed up returning to their previous exercise level and just one case of suspected recurrence documented. The complication rate observed in this series was substantially lower than previously reported for general anaesthesia approaches, suggesting that standing sedation with local anaesthesia offers a viable and potentially safer alternative to general anaesthesia for surgical management of hoof wall masses, whilst eliminating risks associated with recumbency and general anaesthetic recovery in a large animal.
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Practical Takeaways
- •Standing sedation with local anesthesia is a viable, safer alternative to general anesthesia for keratoma removal with excellent long-term outcomes (93% return to work)
- •Expect early postoperative lameness in only 10% of cases and plan farriery support accordingly for rapid recovery
- •This technique reduces surgical risk and recovery time compared to general anesthesia, making it practical for client-owned working horses
Key Findings
- •Standing sedation with local anesthesia successfully removed hoof wall masses in all 30 horses with a 5-10% complication rate (3 postoperative lameness, 2 granulation tissue cases)
- •26 of 28 horses (93%) with long-term follow-up (>6 months) returned to previous exercise levels
- •Postoperative complication rate was lower than previously reported for general anesthesia procedures
- •Lameness duration averaged 90 days (range 1-289 days) preoperatively with mean grade 3/5 severity