Tie-back Surgery, Part I

This post will be the first in a series covering Johnny’s tie-back (Laryngoplasty) surgery and his recovery.

Johnny underwent Laryngoplasty and a ventriculectomy to repair a completely paralyzed laryngeal fold on 06 November, 2013. When I initially purchased him, he had a grade 3 roar that affected him, but it wasn’t significant enough to impair his ability to complete a Novice level XC gallop, so I opted to delay surgery. However, as 2013 progressed, I noticed Johnny seemed to struggle more. By the fall, he could barely trot two laps around a dressage arena without becoming fatigued. So, I finally convinced my husband it was time to make the investment, and I crossed my fingers nothing would go wrong.

When Dr. Malark of Edisto Equine scoped him, we saw he had definitely progressed to a grade 4–total paralyzation of the laryngeal fold. Doing the surgery after the fold is completely paralyzed has better prognosis, as the fold won’t tug on the sutures as it tries to move with respiration.

The surgery went smoothly, and as an added bonus, I got to watch from start to finish thanks to Edisto’s observation deck. The surgery itself took approximately 1 1/2 hours, but total time from induction to wake-up was more like 3-4 hours. The hardest part was watching Johnny struggle to shake off his anesthesia-induced haze. He had the saddest whinny and was pacing around the padded recovery room, obviously looking for someone to comfort him. They let me climb the ladder and lean over into the room to talk to him, and it nearly broke my heart when he came over for reassurance upon hearing my voice. I wished I could get down there and cradle his big head in my arms and soothe him, but since he was still wobbly and drunk, that just wasn’t an option. Thankfully, recovery was fairly quick, and he settled down nicely once they moved him out to his stall. I was able to pick him up the next day, as the swelling was minimal, and he seemed to be doing quite well.

They sent him home with a week-long course of injectable antibiotics (penicillin and gentocin) and a tube of bute for pain management. Unfortunately, since his ventriculectomy incision was left open to heal and he needed to remain quiet, he was remanded to stall rest over the next 30 days. His laryngoplasty incision was closed with subcutaneous dissolvable sutures with external staples (to be removed in 30 days), and the ventriculectomy incision would close over the next few weeks. In the meantime, I was to clean it twice daily. I loaded him up with hay, treats, and a stall with a view and hoped he wouldn’t go stir-crazy over the next 30 days.

I snapped a few photos before, during, and after surgery.

My next post will cover the 30 days of stall rest.


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