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Laparoscopic ovariectomies performed at equine medical center offer medical solutions for some mares


   

Dr. Norrie Adams, left, performs a laparoscopic ovariectomy with the assistance of Dr. James Brown. Dr. Norrie Adams, left, performs a laparoscopic ovariectomy with the assistance of Dr. James Brown.


LEESBURG, Va., Feb. 19, 2010 – Combining their surgical expertise with state-of-the-art laparoscopic equipment, veterinary specialists at Virginia Tech's Marion duPont Scott Equine Medical Center have been able to remove certain mares' ovaries in a surgical procedure that’s less invasive, requires less anesthesia, less hospitalization, and less recovery time.

This procedure is known as a laparoscopic ovariectomy, and it is performed at the center with Ligasure, a medical device that allows the surgeons to remove an ovary efficiently, and with almost no risk of bleeding.

“About half the time, we perform this type of procedure because it’s medically necessary,” noted Dr. James Brown, a third year resident at the center who specializes in equine reproductive issues. “These are the cases that involve a medical problem, such as an ovarian tumor. For the remainder of the cases we see, the procedure is considered elective. For those patients, the owners are looking to resolve a behavioral problem the mare has – or permanently disallow her from being able to breed.”

Within just a few months recently, very different circumstances brought two patients needing ovariectomies to the center for treatment by Dr. Norris Adams, a board certified surgeon and equine medical center faculty member, who worked on these patients with Brown’s assistance.

One horse, Eveleen, a 14-year-old Hanovarian/Thoroughbred cross, was brought to the medical center because she was showing signs of colic.

“Actually,” Eveleen’s owner, Renee Shertzer, noted, “for the last two years or so, I’d seen that there were differences in her performance: she was taking shorter strides and becoming less forward. And then, more recently, over the course of several months, I began to see that she exhibited on-again, off-again symptoms of abdominal distress. We brought her to the equine medical center this last time because the condition appeared more serious than the other episodes.”

After his examination of Eveleen, which included an ultrasound, Brown was able to diagnose the horse’s condition, and as it turned out, the cause of the colic was a basketball-sized ovarian tumor. Laparoscopic assisted ovary removal (ovariectomy) was performed with Eveleen standing sedated with local anesthesia. A large amount of fluid was drained from the large ovary prior to removing it through a small incision in the horse’s flank.

According to Brown, a clear indicator that the mare’s distress was due to an issue with her reproductive organs was that Shertzer had mentioned that the on-again, off-again periods of discomfort for Eveleen were taking place more frequently; he also had noted that the affected ovary was abnormally large when palpated.

“I feel very fortunate that Dr. Brown was on hand to work on Eveleen, since he’s very knowledgeable about equine reproduction issues,” Shertzer said. “I think he had her diagnosed within 20 minutes – even before the ultrasound was performed.”

“Everything went very smoothly at the medical center,” she remarked. “And now, I find it very noteworthy that Eveleen is a much sweeter mare; she’s definitely more comfortable. She used to pin her ears back and was often quite uncooperative. Now, she’s more willing to move and she’s happy to see people,” Shertzer said.

Another horse, Fiona, also recently underwent a laparoscopic ovariectomy at the equine medical center, but for reasons that were quite different from Eveleen’s.

Fiona had recently been rescued, and her caretakers at the horse sanctuary wanted to remove any breeding potential before offering her out for adoption; therefore, they elected to have Adams and Brown perform a laparoscopic ovariectomy.

“We got Fiona in May of 2008,” recalled Rosie Crofutt, Fiona’s caretaker. “She came in with a couple of other rescue horses and, while the other two were in deplorable condition, Fiona didn’t look too bad because she was pregnant at the time.

“The baby was born five days later,” Crofutt said, “and Fiona was fine until after the baby was weaned, about eight months later. At that point, she became something of a bully. She started behaving very badly — she wouldn’t allow anyone to groom her or pick her feet. She was difficult at times.”

For Crofutt, “a flag went up,” with regard to this sequence of events. She did some research and checked with her veterinarian, and when an ovariectomy was suggested, Crofutt decided that, by removing Fiona’s ovaries, the horse would not only be more appealing to a potential adoptive owner, but would also “help offset a larger problem, which is an overpopulation of horses.”

Because Crofutt thinks that there are too many unwanted horses, she feels that – by taking away Fiona’s ability to breed, she “can put a dent in the overpopulation of horses.” Crofutt indicated that she would definitely consider bringing other horses back to the equine medical center to undergo the same procedure for the same reason.

According to Brown, the use of the laparoscopic equipment offers significant advantages over other forms of surgery for this type of procedure. “The main benefit of using this state-of-the-art equipment is that it allows us to see what we’re doing the whole time,” Brown explained. “Surgically, there are other ways to accomplish the same goal, but this way, it’s really a much more efficient and satisfying way of operating.”

Because cost is almost always an important factor in how medical treatments are administered, a laparoscopic ovariectomy brings several considerations to bear. “For the most part, when owners desire to limit reproduction, castrating stallions is a much more cost-effective route to take,” Brown noted.

And, for owners of mares that have hormonally-related behavior issues, drug therapy might also be a good – and possibly less costly – option. But the long-term use of drugs, such as oral progesterone (Regumate®) to stabilize a mare’s behavior could possibly run into some costly amounts. “It may even be that the long-term need for drug therapy could equal the cost of something like an ovariectomy,” Brown said.

“And, for horses like Eveleen, who arrive with urgent medical issues that can be resolved this way, this really offers a better treatment option,” he added.

For Shertzer, Eveleen’s owner, the laparoscopic ovariectomy might have offered the best overall option. “Eveleen still has one ovary, so if we ever do decide to breed her, we can do that,” Shertzer said. “But, with the ovarian tumor gone, she’s not only a much happier horse, but we have all our future options available to us. If we do breed her, we’ll definitely keep the baby forever.”

Shertzer and Crofutt say they remain completely satisfied with the choices they made for their mares. “We’ve never looked back,” Crofutt concluded.

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