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Comparison of phenylephrine administration and exercise versus phenylephrine administration and a rolling procedure for the correction of nephrosplenic entrapment of the large colon in horses: 88 cases (2004–2010)

Lisa E. Fultz DVM1, John G. Peloso DVM, MS, DACVS2, Steeve Giguère DVM, PhD, DACVIM3, and Aric R. Adams DVM, DACVS4
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  • 1 Equine Medical Center of Ocala, 7107 W Hwy 326, Ocala, FL 34482.
  • | 2 Equine Medical Center of Ocala, 7107 W Hwy 326, Ocala, FL 34482.
  • | 3 Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.
  • | 4 Equine Medical Center of Ocala, 7107 W Hwy 326, Ocala, FL 34482.

Abstract

Objective—To compare the outcome of horses with nephrosplenic entrapment of the large colon (NSELC) that were treated nonsurgically by IV administration of phenylephrine and exercise with that of horses treated by IV administration of phenylephrine and a rolling procedure under general anesthesia.

Design—Retrospective case series.

Animals—88 horses with NSELC.

Procedures—Horses examined between 2004 and 2010 because of acute abdominal pain that had NSELC on the basis of findings on abdominal palpation per rectum, abdominal ultrasonography, or both were included. Medical records were reviewed to obtain information on treatment (IV administration of phenylephrine and exercise vs IV administration of phenylephrine and a rolling procedure) and outcome.

Results—Overall, 85% (75/88) of horses with NSELC responded to exercise or rolling under general anesthesia. The success rate of rolling under general anesthesia (42/50 [84%]) was significantly higher than the success rate of exercise after IV administration of phenylephrine (24/38 [63.2%]). Resolution of NSELC was achieved by rolling under general anesthesia in 8 of 14 horses that initially failed to resolve with exercise.

Conclusions and Clinical Relevance—A rolling procedure performed under general anesthesia had a higher success rate than exercise after IV phenylephrine administration for resolution of NSELC in horses, suggesting that rolling could be considered as the initial medical treatment. The rolling procedure may be labor intensive and should only be attempted in a surgical facility in the event that exploratory laparotomy is required

Abstract

Objective—To compare the outcome of horses with nephrosplenic entrapment of the large colon (NSELC) that were treated nonsurgically by IV administration of phenylephrine and exercise with that of horses treated by IV administration of phenylephrine and a rolling procedure under general anesthesia.

Design—Retrospective case series.

Animals—88 horses with NSELC.

Procedures—Horses examined between 2004 and 2010 because of acute abdominal pain that had NSELC on the basis of findings on abdominal palpation per rectum, abdominal ultrasonography, or both were included. Medical records were reviewed to obtain information on treatment (IV administration of phenylephrine and exercise vs IV administration of phenylephrine and a rolling procedure) and outcome.

Results—Overall, 85% (75/88) of horses with NSELC responded to exercise or rolling under general anesthesia. The success rate of rolling under general anesthesia (42/50 [84%]) was significantly higher than the success rate of exercise after IV administration of phenylephrine (24/38 [63.2%]). Resolution of NSELC was achieved by rolling under general anesthesia in 8 of 14 horses that initially failed to resolve with exercise.

Conclusions and Clinical Relevance—A rolling procedure performed under general anesthesia had a higher success rate than exercise after IV phenylephrine administration for resolution of NSELC in horses, suggesting that rolling could be considered as the initial medical treatment. The rolling procedure may be labor intensive and should only be attempted in a surgical facility in the event that exploratory laparotomy is required

Contributor Notes

Dr. Fultz's present address is Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602

The authors thank Shanna Tipton, Nina Ubide, and Lynn Hilt for technical assistance.

Address correspondence to Dr. Peloso (jpeloso@emcocala.com).