Procedures—Information was retrieved from medical records and through telephone calls on horses that had a hand-sewn or stapled side-to-side jejunocecostomy for treatment of colic, which was performed by or under the supervision of the same surgeon. KaplanMeier life table analysis was used to compare survival times and rates between horses that underwent a hand-sewn or stapled side-to-side anastomosis.
Results—32 horses met inclusion criteria; 22 underwent a hand-sewn anastomosis, and 10 underwent a stapled anastomosis. Horses in the stapled group had a significantly greater prevalence of postoperative colic and combined postoperative colic and reflux than horses in the hand-sewn group. In the hand-sewn group, repeated celiotomy was performed within the same hospitalization period for 3 of 22 horses; in the stapled group, 4 of 10 horses had repeated celiotomies. Hospital discharge rates (ie, short-term survival rates) were similar between horses in the hand-sewn group (20/22 horses) and those in the stapled group (9/10 horses). Long-term survival rates were similar for both groups, ranging from 5 to 126 months. Conclusions and Clinical Relevance—Short- and long-term results justify use of jejunocecostomy in horses. Despite similar survival rates between groups, horses that underwent a stapled anastomosis had significantly greater prevalences of postoperative complications than horses that underwent a hand-sewn anastomosis, suggesting that horses were sensitive to minor differences in anastomosis techniques.
Objective—To test the hypothesis that strangulation
of the small intestine by a lipoma or in the epiploic
foramen is more common in older horses.
Procedure—Ages of horses with strangulation of the
small intestine by a lipoma (n = 29) or in the epiploic
foramen (17) were compared with ages of 79 horses
with miscellaneous small intestinal lesions. Effects of
increasing age on risk of the diseases of interest were
examined by use of logistic regression and a 1-sided
trend test for binomial proportions.
Results—Mean age of the horses with strangulation
in the epiploic foramen (9.6 years) was the same as
that for the horses with miscellaneous small intestinal
lesions (7.7), but mean age of the horses with strangulation
by a lipoma (19.2) was significantly greater
than that for the other groups. The proportion of horses
with lipoma increased significantly with increasing
age, but the proportion with strangulation in the epiploic
foramen did not.
Conclusions and Clinical Relevance—Results
refute the current suggestion that increasing age predisposes
horses for strangulation of the small intestine
in the epiploic foramen but support the suggestion
that the risk of strangulation of the small intestine
by a lipoma increases with age. (J Am Vet Med Assoc
Objective—To determine the rate of development of septic arthritis after elective arthroscopy and evaluate associations between various factors and development of this complication in horses.
Design—Retrospective case series.
Animals—682 horses that underwent arthroscopic procedures at the University of Illinois Veterinary Teaching Hospital from 1994 to 2003.
Procedures—Information pertaining to signalment, joints treated, whether antimicrobials were administered, and development of postoperative septic arthritis was collected from medical records. Horses with a primary problem of septic arthritis or wounds involving joints were excluded. The following factors were evaluated to determine their roles in joint sepsis: breed, sex, joint, and preoperative and intra-articular administration of antimicrobials. Telephone interviews with clients were used to determine whether unreported septic arthritis had developed.
Results—8 of 932 (0.9%) joints in 7 of 682 (1.0%) horses that underwent arthroscopy developed postoperative septic arthritis. Follow-up information after discharge from the hospital was available for 461 of the 682 horses, and of those, 8 of 627 (1.3%) joints in 7 of 461 (1.5%) horses developed septic arthritis. Breed and joint treated were significant risk factors for development of postoperative septic arthritis, with draft breeds and tibiotarsal joints more likely than others to be affected. Sex, preoperatively administered antimicrobials, and intra-articularly administered antimicrobials were not associated with development of postoperative septic arthritis.
Conclusions and Clinical Relevance—Results can be used for comparison with data from other institutions and surgical facilities. Additional precautions should be undertaken when arthroscopic surgery involves draft breeds and tibiotarsal joints.
To examine bicarbonate (HCO3−) secretion ex vivo in the equine large colon to determine any differences between the right dorsal colon (RDC) and right ventral colon (RVC). The effect of phenylbutazone (PBZ) on HCO3− secretion was examined in the RDC.
14 healthy horses.
In anesthetized horses (n = 10), segments of mucosa from RDC and RVC were harvested to measure HCO3− secretion ex vivo with the pH Stat method. The effect of PBZ on HCO3− secretion in the RDC was studied in 4 additional horses.
Three distinct mechanisms of HCO3− secretion previously described in a murine model were confirmed in the equine colon. The RDC had a greater capacity for electrogenic, Cl−-independent HCO3− secretion than the RVC (P = 0.04). In the RDC, all HCO3− secretion was decreased by PBZ (P < 0.02) but was not studied in the RVC because of low baseline secretion.
Secretion of HCO3− by the RDC could play a pivotal role in equine colon physiology, because intense microbial fermentation in this site could require HCO3− secretion to buffer short-chain fatty acids. Inhibition of this secretion by PBZ could interfere with mucosal buffering and predispose to changes associated with right dorsal colitis.
Objective—To determine effects of reactive oxygen metabolites (ROMs), with and without flunixin meglumine, on equine right ventral colon (RVC) in vitro.
Animals—18 healthy horses and ponies.
Procedures—In 3 groups of 6 animals each, short-circuit current and conductance were measured in RVC mucosa in Ussing chambers. The 3 groups received physiologic saline (0.9% NaCl) solution, IV, 10 minutes before euthanasia and tissue incubation in Krebs-Ringer-bicarbonate (KRB) solution; flunixin meglumine (1.1 mg/kg, IV) 10 minutes before euthanasia and tissue incubation in KRB solution; or physiologic saline solution, IV, 10 minutes before euthanasia and incubation in KRB solution with 2.7 × 10−5M flunixin meglumine. Incubation conditions included control (no addition) and ROM systems, including addition of 1mM xanthine and 80 mU of xanthine oxidase (to produce the superoxide radical), 1mM H2O2, and 1mM H2O2 and 0.5mM ferrous sulfate (to produce the hydroxyl radical).
Results—All ROMs that were added or generated significantly increased the short-circuit current except in tissues coincubated with flunixin meglumine, and they induced mild epithelial vacuolation and apoptosis, but did not disrupt the epithelium nor change conductance, lactate dehydrogenase release, or [3H]mannitol flux.
Conclusions and Clinical Relevance—Responses to ROMs could be attributed to increased chloride secretion and inhibited neutral NaCl absorption in equine RVC, possibly by stimulating prostaglandin production. The ROMs examined under conditions of this study could play a role in prostaglandin-mediated colonic secretion in horses with enterocolitis without causing direct mucosal injury.
Case Description—A 6-year-old Appaloosa mare was examined because of inappetance, difficulty eating, and swelling and mucopurulent discharge in the right eye.
Clinical Findings—Results of a CBC and serum bio-chemical analysis revealed no important findings. Ophthalmologic examination revealed scarring and ulcer-ation of the superficial layers of the cornea. Endoscopic examination of the upper portion of the respiratory tract and auditory tube diverticula (guttural pouches) revealed abnormal thickness of the right stylohyoid bone and a plaque suggestive of mycotic growth on the left internal carotid artery. Radiographic examination revealed right-sided otitis media. Temporohyoid osteoarthropathy in the right guttural pouch and mycosis in the left guttural pouch were diagnosed.
Treatment and Outcome—Ceratohyoidectomy of the right stylohyoid bone was performed, and the left internal carotid artery was occluded via placement of stainless steel spring embolization coils. The mare regained the ability to eat without difficulty and improved clinically for approximately 4 weeks. However, the mare returned to the medical center 53 days after surgery with left-sided Horner syndrome, atrophy of the right side of the tongue, and a 3-week history of dysphagia and weight loss. Endoscopic evaluation revealed progression of mycotic growth in the left guttural pouch. The mare was euthanatized.
Clinical Relevance—Although the mycotic lesion in the left guttural pouch was an incidental finding at the time of initial examination, the lesion progressed to cause dysphagia and Horner syndrome after occlusion of the left internal carotid artery, a treatment that is typically associated with resolution of guttural pouch mycosis. Arterial occlusion is not necessarily a reliable method of resolving guttural pouch mycosis.
Objective—To induce ischemia and reperfusion injury in the large colon mucosa of horses in vivo and evaluate the recovery and effects of components of an organ transplant solution on mucosal recovery in vitro.
Animals—6 healthy horses.
Procedures—Horses were anesthetized, and ischemia was induced for 60 minutes in the pelvic flexure, which was followed by reperfusion for 240 minutes. Ischemic (n = 4 horses), reperfused (6), and adjacent control (6) colonic mucosae were isolated for in vitro testing and histologic examinations. Tissues were mounted in Ussing chambers with plain Krebs Ringer bicarbonate (KRB), KRB with N-acetylcysteine (NAC), or KRB with a modified organ transplant solution (MOTS). Transepithelial electrical resistance (TER) and mannitol flux were used to assess mucosal integrity. Data were analyzed by use of ANOVA and Kruskal-Wallis tests.
Results—The TER in reperfused tissues was similar to the TER in control tissues and greater than the TER in ischemic tissues, which was consistent with morphological evidence of recovery in reperfused tissues. Mannitol flux was greater in ischemic tissues than in reperfused tissues. The TER and mannitol flux were not significantly affected by incubation of mucosa with NAC or MOTS.
Conclusions and Clinical Relevance—Ischemia induced during the brief period allowed rapid mucosal repair and complete recovery of tissue barrier properties during reperfusion. Therefore, reperfusion injury was not observed for this method of ischemic damage in equine colonic mucosa.
Objective—To determine characteristics of the inflammatory reaction in the jejunum of horses in response to various mechanical manipulations.
Animals—12 adult warmblood horses without gastrointestinal tract disorders.
Procedures—The proximal aspect of the jejunum in each horse was divided into 5 segments, and the following manipulations were performed: manual emptying, placement of Doyen forceps, enterotomy alone, enterotomy with mucosal abrasion, and serosal abrasion. Jejunum samples were collected before (control), immediately after, and 30 minutes after the end of manipulations and histologically evaluated to determine distribution of neutrophils and eosinophils.
Results—Macroscopically, all manipulations resulted in jejunal hemorrhage and edema. Compared with control samples, neutrophil numbers were significantly higher after manipulations in the serosa (after all manipulation types), circular muscle layer (after manual emptying), submucosa (after placement of Doyen forceps), and mucosa (after all manipulations except enterotomy alone). Eosinophil numbers were significantly higher in the submucosa after mechanical abrasion of the serosa and manual emptying versus control samples.
Conclusions and Clinical Relevance—Results indicated mechanical manipulation of the jejunum resulted in local inflammatory reactions characterized predominantly by infiltration of neutrophils. This could contribute to the development of postoperative ileus or adhesions in horses without macroscopically detectable injury of the jejunum during surgery.
OBJECTIVE To evaluate the eosinophilic response in intestinal mucosa of horses with intestinal ischemia and reperfusion or with strangulation of the jejunum or colon.
SAMPLE Mucosal samples from horses with naturally occurring strangulation (n = 24 horses) or distention (n = 6) of the jejunum or colon (11), with experimentally induced ischemia and reperfusion of the jejunum (6) or colon (15), or that were euthanized for reasons other than gastrointestinal tract disease (13).
PROCEDURES Mucosal samples were collected and grouped by type of intestinal injury. Slides were stained with Luna eosinophil stain and histologically examined to determine eosinophil accumulation and distribution. Number of eosinophils per mm2 of mucosa was calculated as a measure of eosinophil accumulation. Additionally, mucosa was categorized into 5 regions; the percentage of eosinophils in each of the 5 regions, relative to the total eosinophil count in all regions, was determined.
RESULTS Eosinophil migration toward and onto the luminal surface was evident in tissues after ischemia and reperfusion and after naturally occurring strangulating disease of the jejunum and colon, as indicated by a decrease in the number of eosinophils near the muscularis mucosa and an increase in the number of eosinophils on or near the luminal surface. Ischemia alone did not change eosinophil distribution in the jejunum or colon.
CONCLUSIONS AND CLINICAL RELEVANCE Eosinophils responded to mucosal damage evoked by ischemia and reperfusion by migration toward and onto the luminal surface. This migration could represent an important component of the inflammatory response to injury in equine gastrointestinal mucosa.
OBJECTIVE To examine effects of continuous rate infusion of lidocaine on transmural neutrophil infiltration in equine intestine subjected to manipulation only and remote to ischemic intestine.
ANIMALS 14 healthy horses.
PROCEDURES Ventral midline celiotomy was performed (time 0). Mild ischemia was induced in segments of jejunum and large colon. A 1-m segment of jejunum was manipulated by massaging the jejunal wall 10 times. Horses received lidocaine (n = 7) or saline (0.9% NaCl) solution (7) throughout anesthesia. Biopsy specimens were collected and used to assess tissue injury, neutrophil influx, cyclooxygenase expression, and hypoxia-inducible factor 1α (HIF-1α) expression at 0, 1, and 4 hours after manipulation and ischemia. Transepithelial resistance (TER) and mannitol flux were measured by use of Ussing chambers.
RESULTS Lidocaine did not consistently decrease neutrophil infiltration in ischemic, manipulated, or control tissues at 4 hours. Lidocaine significantly reduced circular muscle and overall scores for cyclooxygenase-2 expression in manipulated tissues. Manipulated tissues had significantly less HIF-1α expression at 4 hours than did control tissues. Mucosa from manipulated and control segments obtained at 4 hours had lower TER and greater mannitol flux than did control tissues at 0 hours. Lidocaine did not significantly decrease calprotectin expression. Severity of neutrophil infiltration was similar in control, ischemic, and manipulated tissues at 4 hours.
CONCLUSIONS AND CLINICAL RELEVANCE Manipulated jejunum did not have a significantly greater increase in neutrophil infiltration, compared with 4-hour control (nonmanipulated) jejunum remote to sites of manipulation, ischemia, and reperfusion. Lidocaine did not consistently reduce neutrophil infiltration in jejunum.