The Modern Equine Vet
December 2023
Vol 13 Issue 12 2023
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Surgery

‘Nose Job’ Gives Young Filly New Lease on Life

By Natalie Pompilio

Often, when horses, especially those meant for sport, are borne with a severe deformity, they are euthanized, but the spark and determination of a Standardbred born in May with wry nose tugged at the heart strings of the owner and his daughter.

It was clear the filly would require a major medical intervention, and even if that went well, it was extremely unlikely she would live up to her potential as an equine athlete.

Shortly after her arrival into the world, the veterinarian who assisted in Coco Chanel 23’s foaling contacted Matt Morrison of Morrison Racing, to alert him about the filly’s extreme deformity.

Most owners would have put the foal down because her future was so dim, but Mr. Morrison didn’t want to euthanize the filly. His teenage daughter agreed, saying they had to at least give the foal a chance.

“There was a fight in her,” Mr. Morrison said. “She didn’t know she was abnormal. She just knew she needed to feed and was persistent. Without that fighting spirit, she probably wouldn’t have survived that first weekend.”

Her condition and attitude sparked a nick name: Wry Not.

Armed with her steely tenacity, Wry Not was sent to New Bolton Center at the University of Pennsylvania’s School of Veterinary Medicine, where a multidisciplinary team were ready to give her that long-shot she needed to live a healthy life.

Wry nose, especially cases as severe as Wry Not’s, are uncommon. The filly’s surgical team, Kyla Ortved, DVM, PhD, DACVS, DACVSMR, and Jose Garcia-Lopez, VMD, DACVS, DACVSMR, said they’ve each seen about 3 cases, but none as severe as hers.

“It was a severe deviation, the most extreme that I’d ever seen,” Dr. Garcia-Lopez said. “Where it was bent also made [surgery] more complicated.”

Before undergoing the complex and technically demanding reconstructive procedure, the filly was first stabilized by an internal medicine team led by Michelle Abraham, BSc, BVMS, DACVIM.

To be considered a good surgical candidate, they had to ensure Wry Not was in good overall health, according to Dr. Abraham.

Because the filly struggled to nurse, one of the biggest concerns was the transfer of passive immunity: Foals must consume colostrum from their mare, beginning within 2 hours after birth. Another problem: An ultrasound of Wry Not’s lungs showed mild changes consistent with aspiration pneumonia.

Dr. Abraham’s team installed a feeding tube that provided Wry Not supplemental colostrum and hyperimmunized plasma. They also started the filly on antibiotics.

“Any local infection could have disastrous effects on the outcome,” Dr. Abraham said. “Antibiotic therapy and continued nutritional support were important for [Wry Not] to overcome her initial challenges.”

Before the surgeons could plot the best ways forward, the doctors took a scan of the filly’s muzzle using New Bolton Center’s OmniTom, a mobile CT scanner that delivers high-quality, point-of-care imaging. They also collected blood from the dam, Coco, for a transfusion that Wry Not would eventually need to make it through the procedure successfully.

Three hours would pass before the filly’s life-changing and life-saving operation was finished. Post-surgery, Wry Not’s care team was delighted to find the filly “bright,” and able to nurse normally from Coco as well as nibble hay.

“A case like [Wry Not’s] is very much a team effort,” Dr. Ortved noted. “There’s everyone from the NICU that admitted her and kept her alive, the anesthesiologist who handled this difficult case, the radiologist, the equine dentist and many other specialists. When there’s an intense case like this, there’s a huge care team, including nurses, staff, residents, interns and vet students.”

Although the filly’s nose will never be completely strait, she will be able to live a happy and healthy life. MeV

This story originally ran on the PennVet website. It has been edited for space and style. https://www.vet.upenn.edu/about/news-room/news-stories/news-story-detail/wry-nots-triumph-over-a-twisted-fate

 

Imaging of the Wry nose. The filly after surgical correction.
Images courtesy of New Bolton Center