• 1. Voigt A, Saulez MN, Donnellan CM, et al. Causes of gastrointestinal colic at an equine referral hospital in South Africa (1998-2007). J S Afr Vet Assoc 2009;80:192198.

    • Search Google Scholar
    • Export Citation
  • 2. Dart AJ, Hodgson DR, Snyder JR. Caecal disease in equids. Aust Vet J 1997;75:552557.

  • 3. Edwards R. Cecal diseases that result in colic. In: Mair T, Divers T, Ducharme N, eds Manual of equine gastroenterology. 2nd ed. London: WB Saunders, 2002;267269.

    • Search Google Scholar
    • Export Citation
  • 4. Dabareiner RM, White NA, Donaldson LL. Effects of intraluminal distention and decompression on microvascular permeability and hemodynamics of the equine jejunum. Am J Vet Res 2001;62:225236.

    • Search Google Scholar
    • Export Citation
  • 5. Faleiros RR, Macoris DG, Alves GE, et al. Local and remote lesions in horses subjected to small colon distension and decompression. Can Vet J Res 2008;72:6876.

    • Search Google Scholar
    • Export Citation
  • 6. Hardy J. Specific diseases of the ascending colon. In: Blikslager AT, White NA, Moore JN, eds. The equine acute abdomen. 3rd ed. Kent, England: WB Saunders, 2017;748775.

    • Search Google Scholar
    • Export Citation
  • 7. Adams SB. Diseases of the alimentary system. In: Colahan PTM, Merritt AM, Moore JN, eds. Equine medicine and surgery. 4th ed. Santa Barbara, Calif: American Veterinary Publications Inc, 1991;632.

    • Search Google Scholar
    • Export Citation
  • 8. Gerber H. Krankheiten von Verdauungstrakt, Bauchfell, Leber und Bauchspeicheldruese. In: Gerber H, ed. Pferdekrankheiten. Stuttgart, Germany: Ulmer Verlag, 1994;179180.

    • Search Google Scholar
    • Export Citation
  • 9. Zimmel D. Management of pain and dehydration in horses with colic. In: Robinson NES, Sprayberry KA, eds. Current therapy in equine medicine. 5th ed. St Louis: Saunders Elsevier, 2003;115.

    • Search Google Scholar
    • Export Citation
  • 10. Hackett R. Primary colonic tympany. In: Mair TD, Divers T, Durcharme N, eds. Manual of equine gastroenterology. London: WB Saunders, 2002;292293.

    • Search Google Scholar
    • Export Citation
  • 11. Scotti GB, Lazzaretti SS, Zani DD, et al. Transrectal decompression as a new approach for treatment of large intestinal tympany in horses with colic: preliminary results. Equine Vet Educ 2012;25:184188.

    • Search Google Scholar
    • Export Citation
  • 12. Dallap Schaer BOJA. Gastrointestinal system: diagnostic and therapeutic procedures. In: Orsini JAD, Mair TJ, eds. Equine emergencies: treatment and procedures. 4th ed. St Louis: Saunders Co, 2014;157.

    • Search Google Scholar
    • Export Citation
  • 13. Mair T. Medical management of gastrointestinal disease. In: White NM, Moore JN, Mair TS, eds. The equine acute abdomen. Jackson, Wyo: Teton NewMedia, 2008;291307.

    • Search Google Scholar
    • Export Citation
  • 14. Cook V. Medical management of the large (ascending) colon colic. In: Sprayberry KA, Robinson NES, eds. Current therapy in equine medicine. 7th ed. St Louis: Elsevier Saunders, 2015;323327.

    • Search Google Scholar
    • Export Citation
  • 15. Bassage LH. Stabilizing the horse with surgical colic for referral. In: Robinson NES, Sprayberry KA, eds. Current therapy in equine medicine. 6th ed. St Louis: Saunders Elsevier, 2009;380381.

    • Search Google Scholar
    • Export Citation
  • 16. Unger L, Fouche N, Schnider D, et al. Peritonitis, abscessation and haemorrhage: complications of transcutaneous caecal decompression. Equine Vet Educ 2014;26:430435.

    • Search Google Scholar
    • Export Citation
  • 17. Schumacher J, Spano JS, Moll HD. Effects of enterocentesis on peritoneal-fluid constituents in the horse. J Am Vet Med Assoc 1985;186:13011303.

    • Search Google Scholar
    • Export Citation
  • 18. Matthews S, Dart AJ, Dowling BA, et al. Peritonitis associated with Actinobacillus equuli in horses: 51 cases. Aust Vet J 2001;79:536539.

    • Search Google Scholar
    • Export Citation
  • 19. Nógrádi N, Toth B, Macgillivray KC. Peritonitis in horses: 55 cases (2004-2007). Acta Vet Hung 2011;59:181193.

  • 20. Hawkins JF, Bowman KF, Roberts MC, et al. Peritonitis in horses: 67 cases (1985-1990). J Am Vet Med Assoc 1993;203:284288.

  • 21. Henderson IS, Mair TS, Keen JA, et al. Study of the short- and long-term outcomes of 65 horses with peritonitis. Vet Rec 2008;163:293297.

    • Search Google Scholar
    • Export Citation
  • 22. Moore JN. Diseases of the cecum. In: White NA, Moore JN, Mair TS, eds. Equine acute abdomen. Jackson, Wyo: Teton NewMedia, 2008;618619.

    • Search Google Scholar
    • Export Citation
  • 23. White NAE, Edwards GB. Handbook of equine colic. Oxford, England: Butterworth-Heinemann, 1999.

  • 24. Akaike H. 2nd International Symposium on Information Theory. In: Petrov BC, Csaki F, eds. Information theory and an extension of the maximum likelihood principle. Budapest: Akadémiai Kiadó, 1973;267281.

    • Search Google Scholar
    • Export Citation
  • 25. Roy MF, Kwong GP, Lambert J, et al. Prognostic value and development of a scoring system in horses with systemic inflammatory response syndrome. J Vet Intern Med 2017;31:582592.

    • Search Google Scholar
    • Export Citation
  • 26. Wintzer HJK. Krankheiten des Verdauungstraktes. In: Wintzer HJ, ed. Krankheiten des Pferdes. 3rd ed. Berlin: Parey Buchverlag, 1999;203205.

    • Search Google Scholar
    • Export Citation
  • 27. Fehr J. Trocharization. In: Southwood LL, ed. Practical guide to equine colic. Chichester, England: John Wiley & Sons, 2012;160163.

    • Search Google Scholar
    • Export Citation
  • 28. Hanson RR, Nixon AJ, Gronwall R, et al. Evaluation of peritoneal fluid following intestinal resection and anastomosis in horses. Am J Vet Res 1992;53:216221.

    • Search Google Scholar
    • Export Citation
  • 29. Santschi EM, Grindem CB, Tate LP Jr, et al. Peritoneal fluid analysis in ponies after abdominal surgery. Vet Surg 1988;17:69.

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Outcome and complications following transrectal and transabdominal large intestinal trocarization in equids with colic: 228 cases (2004-2015)

Angelika Schoster PD, Dr Med Vet, PhD, DVSc1, Nicole Altermatt Med Vet4, Paul R. Torgerson PhD, VetMB2, and Andrea S. Bischofberger Dr Med Vet, PhD3
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  • 1 1Clinic for Equine Internal Medicine, Vetsuisse Faculty, University of Zurich, CH-8057 Zurich, Switzerland.
  • | 2 2Section of Epidemiology, Vetsuisse Faculty, University of Zurich, CH-8057 Zurich, Switzerland.
  • | 3 3Clinic for Equine Surgery, Vetsuisse Faculty, University of Zurich, CH-8057 Zurich, Switzerland.
  • | 4 4Swiss Institute of Equine Medicine, Department of Veterinary Clinical Science and Veterinary Physiology, Vetsuisse Faculty, University of Bern and Agroscope, Bern CH-3012, Switzerland.

Abstract

OBJECTIVE

To describe outcome and complications after large intestinal trocarization in equids with colic and identify factors associated with nonsurvival and clinically relevant peritonitis (CRP).

ANIMALS

228 (198 horses, 24 ponies, and 6 donkeys and mules) equids with colic that underwent large intestinal trocarization.

PROCEDURES

Medical records from 2004 through 2015 were reviewed for equids with colic that underwent large intestinal trocarization. Factors associated with nonsurvival in all (ie, surgically and medically treated) equids and with CRP in medically only treated equids were identified. Medically only treated equids with a high peritoneal fluid cell count (ie, > 10,000 cells/μL) after large intestinal trocarization were classified as having CRP if they met ≥ 2 of the following clinical criteria: anorexia, fever, lethargy, abnormal oral mucous membrane color, abnormal WBC count, or high blood fibrinogen concentration (> 5 g/L).

RESULTS

Transabdominal large intestinal trocarization was performed in 190 (83%) equids, transrectal trocarization in 17 (7%), and both procedures in 21 (9%). Of 228 equids, 167 (73%) survived to hospital discharge. None died or were euthanized because of complications from large intestinal trocarization. Nonsurvival was associated with an increasing number of trocarization procedures and diagnosis of a large intestinal strangulating lesion. A diagnosis of nephrosplenic ligament entrapment of the large colon decreased the odds of nonsurvival. Twelve of 60 (20%) equids that received medical treatment only had CRP following large intestinal trocarization.

CONCLUSIONS AND CLINICAL RELEVANCE

Large intestinal trocarization could be considered for equids with colic and large intestinal gas distension. More than one trocarization procedure was associated with an increase in nonsurvival, which should be considered for equids for which consent for surgery has been obtained.

Abstract

OBJECTIVE

To describe outcome and complications after large intestinal trocarization in equids with colic and identify factors associated with nonsurvival and clinically relevant peritonitis (CRP).

ANIMALS

228 (198 horses, 24 ponies, and 6 donkeys and mules) equids with colic that underwent large intestinal trocarization.

PROCEDURES

Medical records from 2004 through 2015 were reviewed for equids with colic that underwent large intestinal trocarization. Factors associated with nonsurvival in all (ie, surgically and medically treated) equids and with CRP in medically only treated equids were identified. Medically only treated equids with a high peritoneal fluid cell count (ie, > 10,000 cells/μL) after large intestinal trocarization were classified as having CRP if they met ≥ 2 of the following clinical criteria: anorexia, fever, lethargy, abnormal oral mucous membrane color, abnormal WBC count, or high blood fibrinogen concentration (> 5 g/L).

RESULTS

Transabdominal large intestinal trocarization was performed in 190 (83%) equids, transrectal trocarization in 17 (7%), and both procedures in 21 (9%). Of 228 equids, 167 (73%) survived to hospital discharge. None died or were euthanized because of complications from large intestinal trocarization. Nonsurvival was associated with an increasing number of trocarization procedures and diagnosis of a large intestinal strangulating lesion. A diagnosis of nephrosplenic ligament entrapment of the large colon decreased the odds of nonsurvival. Twelve of 60 (20%) equids that received medical treatment only had CRP following large intestinal trocarization.

CONCLUSIONS AND CLINICAL RELEVANCE

Large intestinal trocarization could be considered for equids with colic and large intestinal gas distension. More than one trocarization procedure was associated with an increase in nonsurvival, which should be considered for equids for which consent for surgery has been obtained.

Supplementary Materials

    • Supplementary Table S1 (PDF 113 kb)

Contributor Notes

Address correspondence to Dr. Schoster (aschoster@vetclinics.uzh.ch).