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Summary

The microvascular anatomic features of the small intestine was described by correlating results of microangiography, light microscopy, gross studies, and scanning electron microscopy of vascular replicas in 14 horses. After heparinization, the horses were euthanatized, a length of jejunum was transected, and blood was flushed free of the circulation, using isotonic NaCl solution. In six horses, the circulatory system was perfused with a modified radiopaque medium and evaluated radiographically. These sections were then evaluated by standard histologic methods. Sections from 8 horses were perfused with 1 of 2 types of plastics and studied grossly or by scanning electron microscopy.

The margined arterial arcade gives rise to vessels that enter the jejunum at the mesenteric angle. These vessels penetrated either directly, by branching and entering on both sides of the mesenteric angle, or supplying only 1 side of the mesenteric angle. All these vessels continued in the submucosa branching extensively, forming a submucosal plexus. This submucosal plexus supplied the tunica muscularis, tunica serosa, and the mucosa. Vessels within the 2 muscle layers ran parallel to the muscle fibers and, consequently, perpendicular to each other. The arterial supply to the mucosa penetrated the muscularis mucosae and branched to supply 2 mucosal capillary networks. An eccentrically placed arteriole penetrated the base of the villus and spiralled to the tip where it "fountained" into a mesh-like capillary network, which descended peripherally in the villus to drain via 1 to 3, but most commonly 2 venules. Venules from adjacent villi united and drained via the submucosal veins. The second capillary network supplied the glands of the intestinal crypts. The capillary network around adjacent glands anastomosed just below the luminal surface. There were connections between this network and the base of the villus capillary network. Drainage of the glandular capillary network was through these connections and through the villus venules. There was no evidence of arterovenous anastomoses.

Free access
in American Journal of Veterinary Research

Abstract

Objectives

To evaluate the role of nitric oxide (NO), vasoactive intestinal peptide (VIP), and a transmitter acting through an apamin-sensitive mechanism in mediating inhibitory transmission in the equine jejunal circular muscle, and to determine the distribution of VIP-and NO-producing nerve fibers in the myenteric plexus and circular muscle.

Procedure

Circular muscle strips were suspended in tissue baths containing an oxygenated modified Krebs solution and attached to isometric force transducers. Responses to electrical field stimulation (EFS), tetrodotoxin, the NO antagonists l-N-nitro-arginine-methyl-ester (L-NAME) and N-nitro-l-arginine, apamin, VIP, authentic NO, and the NO donar sodium nitroprusside were tested. Immunostaining for VIP-like and NADPH diaphorase histochemical staining were performed on paraformaldehyde-fixed tissue.

Results

Subpopulations of myenteric neurons and nerve fibers in the circular muscle were positive for NADPH diaphorase and VIP-like staining. EFS caused a frequency-dependent inhibition of contractile activity. Tetrodotoxin prevented the EFS-induced inhibition of contractions. L-NAME (200 μM) and apamin 0.3 μM) significantly (P < 0.01) reduced EFS-stimulated inhibition of contractile activity at most frequencies tested. The effects of L-NAME and apamin were additive. In their combined presence, EFS induced excitation instead of inhibition (196.7% increase at 5 Hz, n = 28, P < 0.01). Inhibition of contractile activity by EFS was mimicked by sodium nitroprusside. Authentic NO (3-6 μM) abolished contractile activity. VIP induced a dose-dependent inhibition of contractile activity (89.1 ± 6.3% reduction at approximately 0.3 μM, n = 16). Antagonism of NO synthesis did not alter the response to VIP.

Conclusion

NO, VIP, and a substance acting through an apamin-sensitive mechanism appear to comediate inhibitory transmission in the equine jejunal circular muscle.

Clinical Relevance

These findings may suggest new therapeutic targets for motility disorders, such as agents that inhibit the synthesis or actions of NO. (Am J Vet Res 1996;57:1206-1213)

Free access
in American Journal of Veterinary Research

Abstract

Objectives

To provide an accurate and detailed description of the laparoscopic anatomy of the abdomen of horses positioned in dorsal recumbency and to compare those observations with laparoscopic anatomy of standing horses. The effects of laparoscopy and positional changes on arterial blood pressure and blood gas values also were investigated.

Design

Descriptive anatomic study.

Sample Population

Laparoscopy was performed on 6 horses (2 mares, 2 geldings, and 2 stallions) to record the normal laparoscopic anatomy of the abdomen in dorsal recumbency.

Procedure

Feed was withheld from all horses for 36 hours. Horses, under general anesthesia, were examined in horizontal and inclined positions (head-up and head-down). Intermittent positive-pressure ventilation was used, arterial blood pressure was continuously monitored, and samples for arterial blood gas measurements were taken at intervals.

Results

The main structures of diagnostic relevance observed in the caudal region of the abdomen were the urinary bladder, mesorchium and ductus deferens (left and right), left and right vaginal rings, insertion of the pre-pubic tendon, random segments of jejunum and descending colon, pelvic flexure of the ascending colon, body of the cecum, and cecocolic fold. The main structures observed in the cranial region of the abdomen were ventral surface of the diaphragm, falciform ligament and round ligaments of the liver, ventral portion of the left lateral, left medial, quadrate, and right lateral lobes of the liver, spleen, right and left ventral colons, sternal flexure of the ascending colon, apex of the cecum, and stomach.

Conclusions

Alterations in cardiovascular and respiratory function in response to pneumoperitoneum and various positional changes indicated the need for continuous and throrough anesthetic monitoring and support. Comparison of anatomic observations made in dorsally recumbent, inclined horses with those reported for standing horses should enable practitioners to make patient positioning decisions that best suit access to specific visceral structures. Development of special instrumentation for manipulation of the viscera in horses, particularly the intestinal tract, would increase the diagnostic and therapeutic capabilities of laparoscopy during dorsal recumbency. (Am J Vet Res 1996;57:923–931)

Free access
in American Journal of Veterinary Research

Summary

A review of medical records was used to identify 10 horses in which stringhalt developed subsequent to trauma to the dorsal metatarsus. Six horses developed stringhalt within 3 months after injury, 3 horses developed stringhalt > 3 months after injury, and time from injury to stringhalt was unknown for 1 horse. Horses were treated with exercise, including daily hand-walking with pasture turnout, followed by lunging; or surgically, using lateral digital extensor myotenectomy. Of the horses treated with exercise, 1 had resolution of stringhalt, 2 improved but had residual stringhalt, and 1 had no change. Two of the horses having lateral digital extensor myotenectomy had resolution of stringhalt. Two of the remaining 3 horses treated surgically had varying degrees of improvement, and in 1 horse there was no change. Stringhalt is a potential complication following trauma to the dorsal metatarsal region. Potential causes include tendon adhesions enhancing tarsocrural joint flexion or abnormalities in the myotatic reflex caused by tendon injury that result in abnormal flexion of the tarsocrural joint.

Free access
in Journal of the American Veterinary Medical Association

Summary

Medical records of 245 horses that had been evaluated by use of abdominal radiography between January 1990 and December 1992 were reviewed. One hundred forty-one horses subsequently had a postmortem examination or surgical exploration performed for definitive lesion diagnosis. The signalment, diagnosis, site, and number of enteroliths were obtained from the medical records. Radiographs were evaluated individually by 3 reviewers for the presence of enteroliths, preferred diagnostic view, evidence of large colon tympany, and film quality. Of the 141 cases reviewed, 66.7% (94/141) had confirmed enterolithiasis. Enteroliths were identified in the right dorsal colon of 59 horses, in the transverse colon of 28, in the small colon of 24, and in the ventral colon of 1 (enteroliths were detected in multiple sites in 12 horses). For the 3 reviewers, mean sensitivity was 76.9% and specificity was 94.4%. Mean positive-predictive value was 96.4%, and negative-predictive value was 67.5%. Cases involving only large colon enteroliths were correctly diagnosed 83.2% of the time, compared with 41.6% of the time for cases involving small colon enteroliths. Enteroliths were evident in 54.8% of the horses with radiographic signs of large colon distention. Fifteen horses had enteroliths in the small colon, 4 in the transverse colon, and 4 in the dorsal colon.

Radiographic quality was evaluated and scored as adequate (0), underexposed (−1), overexposed (1), or incomplete. Mean score was −0.5, and there were 21 (14.9%) incomplete studies. For the 75 cases correctly diagnosed via abdominal radiography, there were 14 (18.7%) incomplete studies and a mean score of −0.43. Of the 19 false-negative evaluations, there were 3 (15.8%) incomplete studies and a mean score of −0.69. The most common error leading to the missed diagnoses seemed to be inadequate penetration of the abdomen.

Free access
in Journal of the American Veterinary Medical Association

Summary

The signalment, clinical and laboratory findings of surgical conditions, treatment, and outcome of 102 cases of descending colon disease in horses were reviewed. Abnormal conditions were categorized as enteroliths, impactions, strangulating lipomas, fecaliths, foreign body obstruction, volvulus, nephrosplenic entrapment, and other conditions. Eleven breed categories of horses were seen during this period. Arabians, ponies, and American miniature horses were more predisposed to descending colon disease than other breeds (P < 0.05). Female horses and animals >15 years old were more likely to be affected with descending colon disease, whereas horses <5 years old were less likely to be affected (P < 0.05). More specifically, Arabians, Quarter Horses, and Thoroughbreds >10 years old were breeds that were overrepresented when compared with the hospital population (P < 0.05). Enteroliths were most commonly seen in horses between 5 and 10 years old (P < 0.05) and were not seen in horses <2 years old. Enteroliths had a tendency to develop more commonly in Arabians and in female horses. Impactions affected horses >15 years old (P < 0.05) and had a greater tendency to affect ponies and American miniature horses. Female horses were more commonly affected by impaction than were males. Strangulating lipomas were commonly seen in horses >15 years old (P < 0.05) and more specifically female Quarter Horses (P < 0.05). Fecaliths tended to be a disease of horses <1 year old or >15years old and affected males more commonly than females. Ponies, American miniature horses, mixed-breed horses, and mustangs were the breeds most commonly affected. Surgical conditions were categorized as vascular (16%) or nonvascular (84%) conditions. Vascular conditions included strangulating lipomas (6%) and other conditions (10%). Nonvascular conditions included enteroliths (40%), impactions (25%), fecaliths (13%), and other conditions (6%). Horses with vascular lesions were older than horses with nonvascular conditions (P < 0.05). Peritoneal fluid values were high for all surgical conditions of the descending colon. Nucleated cell count and total protein concentration in peritoneal fluid retrieved from horses with vascular lesions were higher than in horses with nonvascular lesions (P < 0.01). Palpation per rectum revealed abnormal findings more commonly in horses with vascular compromise (P < 0.05). Of those horses taken to surgery, 91% were recovered from anesthesia and discharged; 90% of horses, for which the condition was monitored to at least 6 months after surgery, were alive. All horses that were medically treated were alive at least 6 months after discharge.

Free access
in Journal of the American Veterinary Medical Association

Summary

To quantify some components of prepurchase evaluations in horses, records from 134 evaluations performed during a 2-year period were reviewed and the outcome was determined via telephone follow-up interview. Sixty-two percent of the prepurchase evaluations had been performed at the clinic and 38% had been performed in the field by the ambulatory service. All evaluations included physical and lameness examinations, whereas radiography (49%), endoscopy (15%), nerve blocking (5%), transrectal palpation (3%), hematologic analysis (2%), electrocardiography (2%), drug testing for analgesic agents (2%), and ultrasonography of the flexor tendons (1%) were not always performed. Fifty-nine percent of horses evaluated at the clinic were radiographed, compared with 33% of horses evaluated in the field (P < 0.05).

Thirty-seven percent of horses evaluated were judged serviceable for their intended use. Thirty-five percent of horses evaluated at the clinic were assessed to be serviceable, compared with 41% of those evaluated in the field (P < 0.05). Horses used for pleasure riding (48%) tended to be considered serviceable more often than horses used for more athletic endeavors (3-day eventing, 33%; hunter/jumper, 24%; show, 31%; dressage, 30%). The most common basis for finding a horse unserviceable was lameness (88%).

On the basis of a telephone interview, horses were divided into 5 groups: horses determined unserviceable on evaluation and not purchased (n = 40); horses determined unserviceable on evaluation, purchased, and then found serviceable on follow-up interview (n = 35); horses determined unserviceable on evaluation, purchased, and then found unserviceable on follow-up interview (n = 9); horses determined serviceable on evaluation, purchased, and found serviceable on follow-up interview (n = 42); and horses determined serviceable on evaluation, purchased, and found unserviceable on follow-up interview (n = 8).

The buyer and seller were present at the evaluation in 34% of cases. The buyer alone was present in 57% of cases, the seller alone in 4% of cases, whereas neither was present in 6% of cases. The potential buyer had used the horse for its intended purpose prior to the prepurchase evaluation in 39% of cases for a mean time of 20.5 days, but this did not appear to affect the serviceability of the horse on follow-up evaluation. Five horses that were leased for > 6 months prior to purchase were all serviceable on follow-up interview, irrespective of the findings at the time of the prepurchase evaluation.

There was a tendency for the value of horses examined at the clinic to be higher than those evaluated by the ambulatory service. The price paid by the buyer was reduced through negotiations on the basis of the prepurchase evaluation in 6% of cases.

Lameness was seen only in horses within the unserviceable group. Lameness tended to be seen more often in horses valued > $2,500 (61%, 46/75) than in horses valued ≤ $2,500 (48%, 28/59). Lameness was associated with 92% (22/24) of horses valued at > $2,500 within the group judged to be unserviceable and not purchased.

Radiography was performed to investigate a specific lameness in 24% (32/134) of evaluations and for survey purposes in 25% (34/134) of evaluations. Of horses radiographed within the unserviceable group, radiography commonly was performed for specific lameness (84%, 32/38) and rarely for survey purposes (24%, 9/38), whereas only survey radiographs were obtained from the serviceable group because no horses exhibited a specific lameness. Radiography was significantly (P < 0.05) more likely to have been performed in horses valued > $2,500 (65%, 49/75) than in those valued < $2,500 (29%, 17/59), and this trend was reflected in all categories. For survey radiographs, the combination of tarsi and bilateral distal forelimbs was the most commonly radiographed area (44%). Bilateral distal forelimbs alone were the second most commonly radiographed area (41%).

A written report summarizing the findings of the evaluation was furnished in 24% of cases. At the time of follow-up interview, 75% of buyers indicated that they would have liked a written report.

Free access
in Journal of the American Veterinary Medical Association

SUMMARY

The ultrastructural injury that develops sequentially in the ascending colon during experimentally induced ischemia was examined in 6 halothane-anesthetized horses. Colonic ischemia was created by 2 types of vascular occlusion 24 cm proximal and distal to the pelvic flexure.

In all horses, transmural vascular compression was created. The colonic venous circulation was obstructed in 3 horses, whereas in the other 3 horses, arterial and venous circulation was obstructed. Two additional horses were anesthetized as controls for determination of any morphologic alterations associated with the experimental protocol.

Full-thickness colonic biopsy specimens were obtained from the antimesenteric border of the pelvic flexure at 0, 0.25, 0.5, 1, 1.5, 1.75, 2, 2.25, 2.5, 3, 3.5, 4, 4.5, and 5 hours during occlusion, and were studied by light and transmission electron microscopy. Morphologic alterations did not develop in the colon of control horses. Mucosal congestion was observed by light microscopy in the colon of horses with experimentally induced ischemia, but congestion developed early in those with obstructed colonic venous circulation, compared with those having arterial and venous obstruction. Inter- and intracellular vacuolation and loss of staining initially resulted in groups of 3 to 5 superficial luminal epithelial cells. Alterations in the glandular epithelium lagged behind those in the superficial epithelium, but were observed in both groups by 2 hours of obstruction. These changes progressed to 100% sloughing of all epithelium by 4.5 to 5 hours.

The initial cellular alterations, which were observed by transmission electron microscopy, developed at 0.25 hour in horses with colonic venous obstruction and was characterized by inter- and intracellular edema. By 1 hour in horses with colonic venous obstruction, vacuoles were observed within the basal lamina and some vacuoles contained intracellular organelles. These cellular changes were followed by increases in the intercellular gap and breaks between degenerating and more normal-appearing superficial epithelium, which led to sloughing of the epithelium. Endocrine cells by 1 hour also had evidence of ischemic injury.

Injury to the vascular circulation, including congestion and platelet accumulations within the mucosal capillaries was apparent by 0.25 hour in horses with venous obstruction. By 1 to 1.5 hours in both groups of horses with experimentally induced ischemia, loss of vascular integrity and leukocyte migration frequently were observed. Platelets, proteinaceous material, and cellular debris continued to accumulate, and by 2.25 hour capillary plugging frequently was observed. These results indicated that the initial ultrastructural injury in the ischemic colon consisted of degenerative changes in epithelial cells, which led to sloughing of degenerating and necrotic cells. Although injury between the 2 types of vascular obstruction differed, end results were similar. Ischemic vascular injury may lead to further vascular thrombosis and necrosis, resulting in an irreversible injury or contribute to difficulty in medically managing horses with natural ischemia during the perioperative period.

Free access
in American Journal of Veterinary Research

SUMMARY

Conventional fluid resuscitation is unsatisfactory in a small percentage of equine emergency surgical cases because the large volumes of fluids required cannot be given rapidly enough to adequately stabilize the horse. In anesthetized horses, the volume expansion and cardiopulmonary effects of a small volume of highly concentrated hypertonic saline-dextran solution were evaluated as an alternative initial fluid choice. Seven halothane-anesthetized, laterally recumbent, spontaneously ventilating, normovolemic horses were treated with a 25% NaCl-24% dextran 70 solution (hsd) at a dosage of 1.0 ml/kg of body weight, iv, infused over 10 minutes, and the effects were measured for 120 minutes after infusion. Plasma volume expansion was rapid and significant (from 36.6 ± 4.6 ml/kg to 44.9 ± 4.8 ml/kg), and remained significantly expanded for the duration of the experiment. Packed cell volume, total blood hemoglobin, and plasma protein concentrations significantly decreased, confirming rapid and sustained volume expansion with hemodilution. Cardiac index and stroke index immediately increased and remained high for the entire study (from 69.6 ± 15.3 ml/min/kg to 106.6 ± 28.4 ml/min/kg, and from 1.88 ± 0.49 ml/beat/kg to 2.50 ± 0.72 ml/beat/kg, respectively). Systemic vascular resistance significantly decreased immediately after hsd infusion and remained decreased for the duration of the study (from 1.41 ± 0.45 mm of Hg/ml/min/kg to 0.88 ± 0.22 mm of Hg/ml/min/kg). Arterial and venous blood oxygen content decreased significantly because of hemodilution, but actual oxygen transport transiently increased at the 10-minute measurement before returning toward baseline. Plasma osmolality and sodium significantly increased and remained high for the entire 120 minutes (from 293 ± 2 osm/L to 326 ± 9 mosm/L, and from 142.8 ± 3.3 mM/L to 159.0 ± 6.2 mM/L, respectively). Urine output increased in 5 of 7 horses within minutes of hsd infusion, but the mean increase was not statistically significant.

Three horses developed transiently severe, clinically apparent intravascular hemolysis and hemoglobinuria. One horse developed multiple single premature ventricular contractions during the infusion with no persistent ecg changes after infusion. The potential benefit of using hsd as a rapid volume expander in anesthetized horses was documented because infusion of 1 ml of hsd/kg rapidly increased plasma volume by approximately 8 ml/kg. Substantial side effects developed in these normovolemic horses, however, and this solution requires further investigation before it can be recommended in hemodynamically unstable horses.

Free access
in American Journal of Veterinary Research

Abstract

Objective—To use an extracorporeal circuit to evaluate effects of intraluminal distention on the jejunum of healthy horses.

Sample Population—2 jejunal segments from each of 5 horses.

Procedure—Jejunal segments were harvested and maintained in an extracorporeal circuit. One segment was subjected to distention (intraluminal pressure, 25 cm H2O) followed by decompression, and 1 segment was maintained without distention. The influence of distention-decompression on vascular resistance was calculated. Mucosal permeability was evaluated by measuring the clearance of albumin from blood to lumen. After distention and decompression, tissue specimens were collected for histomorphologic evaluation. In addition, the contractile response of the circular smooth muscle layer was determined following incubation with 3 prokinetic agents.

Results—Intestinal vascular resistance increased during intraluminal distention and returned to baseline values after decompression. Albumin clearance rate increased after distention, compared with baseline and control values. Histologic examination of the distended segments revealed grade-1 and -2 lesions of the mucosal villus. Edema and hemorrhage were evident in the submucosa and muscular layers. Mesothelial cell loss, edema, and hemorrhage were also evident in the serosa. Mucosal surface area and villus tip height decreased and submucosal volume increased in the distended tissue. Compared with responses in control specimens, distention decreased the contractile response induced by cisapride, erythromycin, and metoclopramide.

Conclusions and Clinical Relevance—Intraluminal distention of the jejunum followed by decompression increased mucosal permeability and injury and decreased responses to prokinetic agents. Horses with intraluminal intestinal distention may have a decreased response to prokinetic agents. (Am J Vet Res 2002;63:267–275)

Full access
in American Journal of Veterinary Research