In spring 2022, Jack Easley, DVM, MS, DABVP, DAVDC, and his team at Kentucky Equine Veterinary Dental Specialists (KEVDS) received a call from Fighting Chance Rescue in Ohio. The rescue had just received Vada, a 4-day-old Quarter Horse filly with wry nose (a class IV malocclusion), and wanted to know what could be done about it. The filly could breathe and nurse normally, so they advised waiting to see how she developed before pursuing surgical correction.
As these foals grow dramatically in the first six to eight months of life, the twist or deviation can worsen significantly, impairing airflow through the nasal passages, explained Bo Rainbow, DVM, of KEVDS. And that’s precisely what happened to Vada. At 6 months of age she began having trouble breathing, and CT scan showed her maxilla, premaxilla, and essentially everything from the incisive bone back to her first premolar was deviated hard and to the left and tucked down.
“Part of the reason this develops is there’s a growth plate on the side of the face, and those growth plates aren’t expanding as usual,” said Rainbow. “With the growth plate locked, that curve is going to become substantially more dramatic as that head expands, but it’s locked on one side. The next consequence you have is that a nares, one of the nostrils, on either side is going to get occluded. So what they noticed up in Ohio is this filly beginning to have more difficulty breathing. At that point, it’s definitely time to consider surgical intervention.”
Easley, Jim Schumacher, DVM, MS, DACVS, MRCVS, and the surgical team at Hagyard Equine Medical Institute devised a creative plan to correct Vada’s malocclusion. They resected the filly’s nasal septum using Shumacher’s three-wire technique, corrected the nasal bones using screws and plates, and cut through the bent maxilla to straighten it out. Meanwhile, another surgical team harvested a section of Vada’s rib to use as a bone graft to fill in the 2-3-centimeter gap now present in the concave side of the maxilla.
Listen to this episode of Daily Vet Life to hear Rainbow recount the entire procedure and share tips and considerations for practitioners faced with similar cases.
About Dr. Bo Rainbow
Bo Rainbow, DVM, of Kentucky Equine Veterinary Dental Specialists, is from Ocala, Florida, where he grew up on a commercial Thoroughbred farm. Following graduation from Davidson College, he was accepted into the prestigious Darley Flying Start Program to study the Thoroughbred industry around the world for two years. During this time, he knew that veterinary medicine would be his calling, and he was accepted into the University of Florida College of Veterinary Medicine. After graduation in 2012, he worked for the Hagyard Equine Medicine Institute and then did stints in Western Australia and Texas before returning to the Bluegrass. He and his wife, Dr. Jackie Snyder, have two sons and a farm in Versailles.
Related Reading
- Neonatal Foal Care: When to Start and When to Stop
- Daily Vet Life: A Foal with Pyloric Outflow Obstruction
- A Novel Approach to Managing Angular Limb Deformities in Foals
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