Objective—To determine risk factors associated with
development of postoperative ileus in horses undergoing
surgery for colic.
Animals—69 horses that developed ileus after
surgery for colic and 307 horses that did not develop
Procedure—Signalment, history, clinicopathologic
data, treatment, lesions, and outcome were obtained
from medical records.
Results—Variables associated with increased risk of
postoperative ileus included age > 10 years, Arabian
breed, PCV ≥ 45%, high serum concentrations of protein
and albumin, anesthesia > 2.5 hours' duration,
surgery > 2 hours' duration, resection and anastomosis,
and lesions in the small intestine. Enterotomy
reduced the risk of postoperative ileus. After multivariate
logistic regression, the final model included
the variables Arabian breed, PCV ≥ 45%, lesion type,
duration of surgery (> 2 hours vs ≤ 2 hours), and
pelvic flexure enterotomy.
Conclusions and Clinical Relevance—Results suggest
that by evaluating certain factors, horses at
increased risk of postoperative ileus may be recognized
before the condition develops. Preventative
treatment and early intervention may be instituted in
these horses. Shortening surgery time and performing
an enterotomy may decrease the probability of
horses developing postoperative ileus. (J Am Vet Med
Objective—To determine results of ultrasound-guided cystocentesis and percutaneous infusion of Walpole's solution for treatment of male goats with urolithiasis.
Design—Retrospective case series.
Animals—25 male goats with urolithiasis treated with Walpole's solution.
Procedures—Information obtained from the medical records included signalment, degree of urethral obstruction (partial vs complete), pertinent examination findings, concurrent illnesses, diet, other treatments administered, duration of hospitalization, whether the obstruction resolved, and outcome (ie, discharged vs euthanized).
Results—14 (58%) animals had complete urethral obstruction, and 10 (42%) had partial obstruction (degree of urethral patency was not recorded in 1 animal). Walpole's solution was infused once in 18 (72%) animals, twice in 6 (24%) animals, and 3 times in 1 (4%) animal. The amount of Walpole's solution required to achieve the target urine pH of 4 to 5 ranged from 50 to 250 mL. In 20 (80%) goats, the urethral obstruction resolved, and the goat was discharged. The remaining 5 (20%) goats were euthanized because of unresolved urethral obstruction. Six of the 20 (30%) goats that were discharged were reexamined because of recurrence of urethral obstruction.
Conclusions and Clinical Relevance—Results suggested that ultrasound-guided cystocentesis in combination with percutaneous infusion of Walpole's solution may be a useful treatment in male goats with obstructive urolithiasis.
Objective—To determine factors associated with
development of postoperative ileus (POI) in horses
undergoing surgery for colic.
Design—Prospective case-control study.
Animals—251 horses undergoing colic surgery, of
which 47 developed POI.
Procedure—Signalment, history, clinicopathologic
data, pre- and postoperative treatments, lesions,
complications, costs, and outcome were recorded for
all horses during hospitalization.
Results—Variables associated with increased odds of
POI included small intestinal lesion, high PCV, and
increased duration of anesthesia. There was modest
evidence that pelvic flexure enterotomy and intraoperative
administration of lidocaine may have reduced
the odds of developing POI.
Conclusions and Clinical Relevance—Findings during
the preoperative and intraoperative periods can be used
to identify horses at increased risk of POI. Reducing surgical
and anesthetic duration should decrease the incidence
of POI. ( J Am Vet Med Assoc 2004;225:
Objective—To examine the effect of various clinical tracks within the veterinary medical clinical curriculum at Texas A&M University on clinical diagnostic proficiency as determined by pre- and post-training assessment. We expected that the clinical track chosen by the student would impact their measured outcome with bias toward higher scores in their chosen field.
Design—Prospective cohort study.
Study Population—32 students from the College of Veterinary Medicine and Biomedical Sciences at Texas A&M University.
Procedures—By use of standardized, written case scenarios, clinical reasoning was assessed twice: once prior to the clinical (fourth) year of the curriculum and again at completion of the clinical year. Students demonstrated their abilities to collect and organize appropriate clinical data (history, physical examination, and laboratory findings), determine clinical diagnoses, and formulate and implement acceptable treatment modalities. Data from clinical assessments were compared for a given cohort and correlated with other measures (eg, grades, standardized test scores, and species-specific curricular track).
Results—Differences were detected in clinical diagnostic proficiency among students in different clinical tracks and for different species groups in the case scenarios. Tracking by species group in the clinical veterinary curriculum appeared to affect development of clinical reasoning and resulted in differential proficiency among cases for differing species groups.
Conclusions and Clinical Relevance—Differences in clinical experiences between small animal tracks and all other track opportunities (large animal, mixed animal, and alternative) influenced the development of clinical proficiency in fourth-year veterinary students during their clinical training period.