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Paralyzed lower lip after surgery

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  • Paralyzed lower lip after surgery

    A horse I take care of has glaucoma. He has recently undergone surgery on his eye, and was totally knocked out for it. He awoke, had the usual issues coming out of an aneasthia. His lower lip and tongue seemed to be the last things coming back to life.

    Fast forward, a week, (5 days) later, the lip is still drooping, and the horse seems like he has some trouble eating. He can eat, he's not missing out on his meals, but it seems like he just has to work that much harder.

    Has anyone had this sort of experience after their horse had aneasthesia?

    I'd love to know if you resolve the matter.

  • #2
    Sounds like he may have some facial nerve paralysis. This can occasionally happen if the halter is left on during surgery and the hardware presses on the horses face in just the right place. This will usually dissipate with time, but there are cases where the damage is permanent. You should speak to the treating surgeon for their opinions on treatment.
    Entropy Farm
    www.entropyfarm.com
    Home of Roc USA
    I used to have a handle on life, but it broke.

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    • #3
      When my mare had tie-back surgery, she damaged some nerves when they were turning her. One side of her face was paralyzed -- droopy lip and slack on that one side. Vet/surgeon predicted that she would be back to normal before I got back on her (a few months, I think it was). He was a little wrong on the timing -- I think it was about 6 months in total before things looked pretty normal. Nerves can regenerate amazingly well. I'm not sure there is much you can do other than give it time.

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      • #4
        A friend's horse had that happen after some sort of surgery. Took awhile, but he looked just fine.
        The Evil Chem Prof

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        • #5
          Originally posted by ajimom View Post
          Sounds like he may have some facial nerve paralysis. This can occasionally happen if the halter is left on during surgery and the hardware presses on the horses face in just the right place. This will usually dissipate with time, but there are cases where the damage is permanent. You should speak to the treating surgeon for their opinions on treatment.
          ^^^^^^^^^^^^This. I have seen it but thankfully it resolved.
          Come to the dark side, we have cookies

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          • #6
            Should always take the halter off a horse when it is under anesthesia, even breifly, for this very reason. Also pull down front leg forward to take pressure off of brachial plexus/nerves to front leg.

            Just the humble opinions of a veterinary anesthesiologist.

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            • #7
              Proper positioning and relief of pressure points is essential in ALL surgery!!!

              Pressure points cause nerve injuries as such.

              Limbs streched beyond normal ranges of motion cause nerve injuries.


              Nerve injuries can resolve, or they can be permanent disabilities.

              One of the greatest preventable accidents are pressure sores and nerve injuries. Great care should always be taken while positioning a patient for surgery.

              Hope this horse makes a full recovery. Speak with vet involved with care.

              Good Luck!
              Life is too short to argue with a mare! Just don't engage! It is much easier that way!

              Have fun, be safe, and let the mare think it is her idea!

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              • Original Poster

                #8
                Thanks for the responses! I have told the owner to talk to the vet about it, as it bothers me to see him having to put forth such effort to eat. He is eating, cleaning his plate, so I don't worry about that. I do worry about him choking. Otherwise, he seems to be coming along well after the surgery.

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                • #9
                  Originally posted by mustangtrailrider View Post
                  Proper positioning and relief of pressure points is essential in ALL surgery!!!

                  Pressure points cause nerve injuries as such.

                  Limbs streched beyond normal ranges of motion cause nerve injuries.


                  Nerve injuries can resolve, or they can be permanent disabilities.

                  One of the greatest preventable accidents are pressure sores and nerve injuries. Great care should always be taken while positioning a patient for surgery.

                  Hope this horse makes a full recovery. Speak with vet involved with care.

                  Good Luck!
                  1) very true. 'Twas the subject of my research during my residency. While positioning is definitely important (all horses in the study were "properly" positioned by anesthesiologists) maintaince of blood pressure was THE most important thing.

                  2) Yup

                  3) Limbs are not stretched beyond normal ROM for surgerical positioning. Just pulled out from underneath the wt of the thorax to prevent compression of the brachial plexus. And there is no tension on the leg holding it there, which would be necessary to maintain a limb beyond its ROM.

                  4) True

                  5) I certainly hope the horses is not down long enough to result in pressure sores!! That takes days. And for procedures done in an OR, the table is (or should be!) heavily padded to reduce pressure points.

                  6) Ditto.

                  Again, just the perspectivce and opinion of a board certified veterinary anesthesiologist.

                  Comment


                  • #10
                    Oh, in case anybody really wants to read the boring article, here is the reference.

                    Veterinary Surgery, 1990, Sept-Oct: 19(5): 392-7
                    Equine post-anesthetic lameness: A retrospective study.
                    Richey, Holland, McGrath, Dodman, Marshall, Court, Norman, Seeler

                    We looked at 655 horses undergoing 733 procedures over the course of 3 yrs. We looked at something like a couple dozen factors. The statistics were an absolute nightmare!

                    Warning: It is really dry reading. Trust me.

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                    • #11
                      Hope the horse improves! Good Luck!
                      Life is too short to argue with a mare! Just don't engage! It is much easier that way!

                      Have fun, be safe, and let the mare think it is her idea!

                      Comment


                      • #12
                        Try acupuncture

                        Our mare suffered nerve damage and partial face paralysis after the surgical removal of a tumor, causing her nose to look slightly "wry" and her lower lip to droop on the one side. It did improve as her face healed, but our vet practiced acupuncture on her (about 5 or 6 treatments), and she is noticeably improved. Indeed, if you didn't know about the problem, you wouldn't immediately note it. Nerve damage apparently takes a long time to heal, and so the horse should improve just with time, but I believe for the acupuncture to be fully effective, it should be done within a year after the damaging incident (if I recall correctly what the vet told me). Good luck--hope it turns out well.

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                        • #13
                          I'd encourage her to have the vet back out for a post-op check up.

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                          • #14
                            [QUOTE=MeghanDACVA;5439129] We looked at something like a couple dozen factors. The statistics were an absolute nightmare!
                            QUOTE]

                            My brain hurts just thinking of what the math on that would look like.
                            HAS provides hospital care to 340,000 people in Haiti's Artibonite Valley 24/7/365/earthquake/cholera/whatever.
                            www.hashaiti.org blog:http://hashaiti.org/blog

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