• 1. Lugo J, Carr E. Thoracic disorders. In: Auer JA, Stick JA, eds. Equine surgery. 4th ed. Philadelphia: Saunders Co, 2011; 650663.

  • 2. Arnold CE, Chaffin MK. Abdominal abscesses in adult horses: 61 cases (1993–2008). J Am Vet Med Assoc 2012; 241: 16591665.

  • 3. Rumbaugh GE, Smith BP, Carlson GP. Internal abdominal abscesses in the horse: a study of 25 cases. J Am Vet Med Assoc 1978; 172: 304309.

    • Search Google Scholar
    • Export Citation
  • 4. Zicker SC, Wilson WD, Medearis I. Differentiation between intra-abdominal neoplasms and abscesses in horses, using clinical and laboratory data: 40 cases (1973–1988). J Am Vet Med Assoc 1990; 196: 11301134.

    • Search Google Scholar
    • Export Citation
  • 5. Reed SM, Bayly WM, Sellon DC. Disorders of the liver. In: Equine internal medicine. 3rd ed. St Louis: Saunders, 2009; 897.

  • 6. Sellon DC, Spauling K, Breuhaus BA, et al. Hepatic abscesses in three horses. J Am Vet Med Assoc 2000; 216: 882887.

  • 7. Pusterla N, Whitcomb MB, Wilson WD. Internal abdominal abscesses caused by Streptococcus equi subspecies equi in 10 horses in California between 1989 and 2004. Vet Rec 2007; 160: 589592.

    • Search Google Scholar
    • Export Citation
  • 8. Farrar ET, Washabau RJ, Saunders HM. Hepatic abscess in dogs: 14 cases (1982–1994). J Am Vet Med Assoc 1996; 208: 243247.

  • 9. Sergeeff JS, Armstrong PJ, Bunch SE. Heptaic abscesses in cats: 14 cases (1985–2002). J Vet Intern Med 2004; 18: 295300.

  • 10. Sonnenfield JM, Armbrust LJ, Radlinsky MA, et al. Radiographic and ultrasonographic findings of liver lobe torsion in a dog. Vet Radiol Ultrasound 2001; 42: 344346.

    • Search Google Scholar
    • Export Citation
  • 11. Sato AF, Solano M. Radiographic diagnosis: liver lobe entrapment and associated emphysematous hepatitis. Vet Radiol Ultrasound 1998; 39: 123124.

    • Search Google Scholar
    • Export Citation
  • 12. Blot S, De Waele JJ. Critical issues in the clinical management of complicated intra-abdominal infections. Drugs 2005; 65: 16111620.

    • Search Google Scholar
    • Export Citation
  • 13. Reef VB, Whittier M, Allam LG. Sonographic evaluation of the adult abdomen. Clin Tech Equine Pract 2004; 3: 294307.

  • 14. Reuss SM, Chaffin MK, Schmitz DG, et al. Sonographic characteristics of intraabdominal abscessation and lymphadenopathy attributable to Rhodococcus equi in foals. Vet Radiol Ultrasound 2011; 52: 462465.

    • Search Google Scholar
    • Export Citation
  • 15. Tennent-Brown BS, Mudge MC, Hardy J, et al. Liver lobe torsion in six horses. J Am Vet Med Assoc 2012; 241: 615620.

  • 16. Bentz KJ, Burgess BA, Lohmann KL, et al. Hepatic lobe torsion in a horse. Can Vet J 2009; 50: 283286.

  • 17. Downs MO, Miller MA, Cross AR, et al. Liver lobe torsion and hepatic abscess in a dog. J Am Vet Med Assoc 1998; 212: 678680.

  • 18. Schwartz SG, Mitchell SL, Keating JH, et al. Liver lobe torsion in dogs: 13 cases (1995–2004). J Am Vet Med Assoc 2006; 228: 242247.

    • Search Google Scholar
    • Export Citation
  • 19. Swann HM, Brown DC. Hepatic lobe torsion in 3 dogs and a cat. Vet Surg 2001; 30: 482486.

  • 20. Weinstein MP, Towns ML, Quartey SM, et al. The clinical significance of positive blood cultures in the 1900s: a prospective comprehensive evaluation of the microbiology, epidemiology and outcome of bacteremia and fungemia in adults. Clin Infect Dis 1997; 24: 584602.

    • Search Google Scholar
    • Export Citation
  • 21. Benjamin B, Kan M, Schwartz D, et al. The possible significance of Clostridium spp. in blood cultures. Clin Microbiol Infect 2006; 12: 10061012.

    • Search Google Scholar
    • Export Citation
  • 22. Berlin D, Kelmer G, Steinman G, et al. Successful medical management of intra-abdominal abscesses in 4 adult horses. Can Vet J 2013; 54: 157161.

    • Search Google Scholar
    • Export Citation
  • 23. Mair TS, Sherlock CE. Surgical drainage and postoperative lavage of large abdominal abscesses in six mature horses. Equine Vet J Suppl 2011;(39):123127.

    • Search Google Scholar
    • Export Citation
  • 24. Prades M, Peyton L, Pattio N, et al. Surgical treatment of an abdominal abscess by marsupialisation in the horse: a report of two cases. Equine Vet J 1989; 21: 459461.

    • Search Google Scholar
    • Export Citation
  • 25. Rigg DL, Gatlin SJ, Reinertson EL. Marsupialization of an abdominal abscess caused by Serratia marcescens in a mare. J Am Vet Med Assoc 1987; 191: 222224.

    • Search Google Scholar
    • Export Citation
  • 26. Montiero S, Segard E, Lepage OM. Abdominal abscess involving a metallic foreign body removed via thoracotomy in a horse. Equine Vet Educ 2011; 23: 289293.

    • Search Google Scholar
    • Export Citation
  • 27. Hilton H, Aleman M, Madigan J, et al. Standing lateral thoracotomy in horses: indications complications, and outcomes. Vet Surg 2010; 39: 847855.

    • Search Google Scholar
    • Export Citation
  • 28. Hudson NPH, McClintock SA, Hodgson DR. Case of pleuropneumonia with complications in a Thoroughbred stallion. Equine Vet Educ 1999; 11: 285289.

    • Search Google Scholar
    • Export Citation
  • 29. Dechan J. Combination of medical and surgical therapy for pleuropneumonia in a horse. Can Vet J 1997; 38: 499501.

  • 30. Colahan PT, Knight HD. Drainage of an intrathoracic abscess in a horse via thoracotomy. J Am Vet Med Assoc 1979; 174: 12311233.

  • 31. Chaffin MK, Arnold CE, Carter GK, et al. Lateral thoracotomy for management of recurrent or refractory thoracic abscesses associated with equine pleuropneumonia, in Proceedings. 6th Cong Eur Coll Equine Intern Med 2013; 701.

    • Search Google Scholar
    • Export Citation
  • 32. Haggett EF, Wilson WD. Overview of the use of antimicrobials for the treatment of bacterial infections in horses. Equine Vet Educ 2008; 20: 433448.

    • Search Google Scholar
    • Export Citation
  • 33. Sweeney RW, Sweeney CR, Weiher J. Clinical use of metronidazole in horses: 200 cases (1984–1989). J Am Vet Med Assoc 1991; 198: 10451048.

    • Search Google Scholar
    • Export Citation
  • 34. Steiner A, Lischer CJ, Oertle C. Marsupialization of umbilical vein abscesses with involment of the liver in 13 calves. Vet Surg 1993; 22: 184189.

    • Search Google Scholar
    • Export Citation
  • 35. Quinn PJ, Markey FC, Leonard P, et al. Pseudomonas aeruginosa and Burkholderia species. In: Veterinary microbiology and microbial disease. 2nd ed. Ames, Iowa: Blackwell Publishing Ltd, 2011; 287292

    • Search Google Scholar
    • Export Citation
  • 36. Paradis M. Cutaneous and musculoskeletal manifestations of Rhodococcus equi infections in foals. Equine Vet Educ 1997; 9: 266270.

    • Search Google Scholar
    • Export Citation
  • 37. Madison JB, Scaratt WK. Immune-mediated polysynovitis in four foals. J Am Vet Med Assoc 1988; 192: 15811584.

  • 38. Pusterla N, Pratt SM, Magdesian KG, et al. Idiopathic immune-mediated polysynovitis in three horses. Vet Rec 2006; 159: 1315.

  • 39. Lumsden JM. Suspected immune-mediated polysynovitis and serositis in a horse. Aust Vet J 1990; 67: 470471.

  • 40. Byars TD, Tyler DE, Whitlock RH, et al. Non-erosive polysynovitis in a horse. Equine Vet J 1984; 16: 141143.

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Medical and surgical management of an intra-abdominal abscess of hepatic origin in a horse

Elizabeth E. Cypher DVM1, Anna T. Kendall DVM2, Luca Panizzi DVM, MS3, Allison J. Stewart BVSc, MS4, Sarah L. Taylor BSc, PhD, BVetMed5, Christa J. Bodaan DVM6, Chris B. Riley BVSc, PhD7, Stuart J. G. Gordon BVSc, M Phil8, and Lisa K. Whitfield BVSc9
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  • 1 Institute of Veterinary, Animal and Biomedical Sciences, Massey University Manawatu, Palmerston North 4442, New Zealand
  • | 2 Institute of Veterinary, Animal and Biomedical Sciences, Massey University Manawatu, Palmerston North 4442, New Zealand
  • | 3 Institute of Veterinary, Animal and Biomedical Sciences, Massey University Manawatu, Palmerston North 4442, New Zealand
  • | 4 College of Veterinary Medicine, Auburn University, Auburn, AL 36849.
  • | 5 Institute of Veterinary, Animal and Biomedical Sciences, Massey University Manawatu, Palmerston North 4442, New Zealand
  • | 6 Institute of Veterinary, Animal and Biomedical Sciences, Massey University Manawatu, Palmerston North 4442, New Zealand
  • | 7 Institute of Veterinary, Animal and Biomedical Sciences, Massey University Manawatu, Palmerston North 4442, New Zealand
  • | 8 Institute of Veterinary, Animal and Biomedical Sciences, Massey University Manawatu, Palmerston North 4442, New Zealand
  • | 9 Institute of Veterinary, Animal and Biomedical Sciences, Massey University Manawatu, Palmerston North 4442, New Zealand

Abstract

Case Description—A 4-year-old Arabian-cross mare was examined because of a 48-hour history of pyrexia, lethargy, and signs of abdominal discomfort.

Clinical Findings—On initial evaluation, the horse was in good body condition, but febrile, tachycardic, tachypneic, and icteric and had signs of colic. Findings on CBC and serum biochemical analysis indicated marked systemic inflammation and hepatocellular damage. Serial abdominal ultrasonographic examinations revealed progressive, localized hepatic parenchymal abnormalities in the left ventral aspect of the abdomen in proximity to the left liver lobes, and eventual identification of an irregularly marginated, hyperechoic walled region of heterogenous echogenicity consistent with an encapsulated hepatic abscess.

Treatment and Outcome—Medical treatment was initiated with administration of doxycycline and flunixin meglumine. After 7 days, the horse's clinical signs and hematologic values improved. After 14 days, the horse was discharged from the hospital and prescribed continuation of doxycycline treatment for 14 days. One week following hospital discharge, the horse was reevaluated for recurrent signs of colic and pyrexia. The horse was sedated, and the region overlying the caudal aspect of the seventh rib was desensitized with an inverted L nerve block by local infiltration with 2% lidocaine. While the horse was standing and sedated, drainage of an encapsulated intra-abdominal abscess was followed by rib resection and removal of a portion of necrotic left lateral liver lobe. The development of a pneumothorax following rib resection represented the only major surgical complication. Twelve months later, the horse was clinically normal and had returned to its previous level of performance.

Clinical Relevance—Rib resection in standing sedated horses, together with appropriate medical management, should be considered an option for removal of well-encapsulated cranially located intra-abdominal abscesses that are adherent to the ventrolateral aspect of the body wall in horses.

Abstract

Case Description—A 4-year-old Arabian-cross mare was examined because of a 48-hour history of pyrexia, lethargy, and signs of abdominal discomfort.

Clinical Findings—On initial evaluation, the horse was in good body condition, but febrile, tachycardic, tachypneic, and icteric and had signs of colic. Findings on CBC and serum biochemical analysis indicated marked systemic inflammation and hepatocellular damage. Serial abdominal ultrasonographic examinations revealed progressive, localized hepatic parenchymal abnormalities in the left ventral aspect of the abdomen in proximity to the left liver lobes, and eventual identification of an irregularly marginated, hyperechoic walled region of heterogenous echogenicity consistent with an encapsulated hepatic abscess.

Treatment and Outcome—Medical treatment was initiated with administration of doxycycline and flunixin meglumine. After 7 days, the horse's clinical signs and hematologic values improved. After 14 days, the horse was discharged from the hospital and prescribed continuation of doxycycline treatment for 14 days. One week following hospital discharge, the horse was reevaluated for recurrent signs of colic and pyrexia. The horse was sedated, and the region overlying the caudal aspect of the seventh rib was desensitized with an inverted L nerve block by local infiltration with 2% lidocaine. While the horse was standing and sedated, drainage of an encapsulated intra-abdominal abscess was followed by rib resection and removal of a portion of necrotic left lateral liver lobe. The development of a pneumothorax following rib resection represented the only major surgical complication. Twelve months later, the horse was clinically normal and had returned to its previous level of performance.

Clinical Relevance—Rib resection in standing sedated horses, together with appropriate medical management, should be considered an option for removal of well-encapsulated cranially located intra-abdominal abscesses that are adherent to the ventrolateral aspect of the body wall in horses.

Contributor Notes

Dr. Cypher's present address is Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996.

Dr. Taylor's present address is Athletic Equine and Acupuncture Ltd, Palmerston North 4472, New Zealand.

Address correspondence to Dr. Cypher (ecypher@utk.edu).