Objective—To compare a double-layer inverting anastomosis
with a single-layer appositional anastomosis,
coated with either 1% sodium carboxymethylcellulose
(SCMC) or 0.4% sodium hyaluronate (HA) solutions,
in the small intestine of horses with respect to
anastomotic healing and adhesion formation.
Animals—18 adult horses.
Procedure—Midline celiotomy and end-to-end jejunal
anastomoses were performed. In control group horses
(n = 6), a double-layer inverting anastomosis coated
with sterile lactated Ringer's solution was performed.
In treatment group horses, a single-layer
appositional anastomosis was performed that was
coated with 1% carboxymethylcellulose solution
(SAA + SCMC group horses, 6) or 0.4% hyaluronate
solution (SAA + HA group horses, 6). An additional
500 mL of the respective treatment solution was
applied to the jejunal serosal surface, and 2 jejunal
serosal abrasion sites were created. Horses were
euthanatized 10 days after surgery. Anastomoses and
abdominal adhesions were evaluated grossly.
Anastomotic healing was evaluated on the basis of
bursting wall tension.
Results—Bursting wall tension was significantly
greater in SAA + SCMC group horses, compared with
control group horses. All intestinal segments failed at
a point distant to the anastomosis. Significantly fewer
adhesions were found at the abrasion sites of SAA +
HA group horses, compared with control group horses.
No differences were found in adhesion formation
at the anastomotic sites among groups.
Conclusions and Clinical Relevance—Coating a single-
layer appositional jejunal anastomosis with SCMC
or HA solutions does not adversely affect anastomotic
healing. Application of 0.4% HA solution to the
serosal surface of the jejunum significantly decreases
the incidence of experimentally induced intra-abdominal
adhesion formation in horses. ( Am J Vet Res 2004;65:637–643)
Objective—To identify factors associated with renal insufficiency in colic- or colitis-affected horses with high serum creatinine (SCr) concentrations evaluated at a referral hospital.
Design—Retrospective case series.
Animals—167 colic- or colitis-affected horses (88 represented a random sample [hospital population], and 79 had high SCr concentration at initial evaluation [study population]).
Procedure—Medical records were reviewed. Data collected included signalment; physical examination, clinicopathologic, and diagnostic findings; and outcome. The study population was categorized on the basis of whether SCr concentration did (AR group; n = 53) or did not (PA group; 26) normalize within 72 hours of fluid therapy. Characteristics of the study and hospital populations were compared.
Results—Males and Quarter Horses were significantly overrepresented in the study population. Compared with the hospital population, study-population horses were significantly more likely to have colitis, gastric reflux, and diarrhea at initial evaluation. Initial mean SCr concentration in the PA group was significantly higher than the AR group; identification of gastric reflux, abnormal rectal examination findings, and hypochloremia were significantly associated with persistent azotemia after 72 hours of fluid therapy. Compared with the AR group, PA group horses were 3 times as likely to die or be euthanized.
Conclusions and Clinical Relevance—In colic- or colitis-affected horses, factors associated with renal insufficiency included gastric reflux, abnormal rectal examination findings, or hypochloremia initially; prognosis for horses in which azotemia resolves within 72 hours of treatment appears to be better than for horses with persistent azotemia.
To compare the pharmacokinetics between repeated doses and to characterize changes in the fecal microbiome after oral and rectal multidose misoprostol administration.
6 healthy university-owned geldings.
In a randomized, crossover study, misoprostol (5 μg/kg) was administered orally or rectally every 8 hours for 10 doses, or not administered (control), with a 21-day washout between treatments. Concentration-versus-time data for dose 1 and dose 10 were subject to noncompartmental analysis. For microbiota analysis using 16S rRNA amplicon sequencing, manure was collected 7 days before study onset, immediately before dose 1, and 6 hours, 7 days, and 14 days after dose 10, with time-matched points in controls.
Repeated dosing-related differences in pharmacokinetic parameters were not detected for either administration route. The area under the concentration-versus-time curve was greater (P < .04) after oral versus rectal administration. The relative bioavailability of rectal administration was 4 to 86% of that of oral administration. Microbial composition, richness, and β-diversity differed among subjects (P < .001 all) while only composition differed between treatments (P ≤ .01). Richness was decreased 6 hours after dose 10 and at the control-matched time point (P = .0109) in all subjects. No other differences for time points, treatments, or their interactions were observed.
Differences in systemic exposure were associated with the route of administration but were not detected after repeated administration of misoprostol. Differences in microbiota parameters were primarily associated with interindividual variation and management rather than misoprostol administration.
Case Description—13 equids (10 horses, 2 donkeys, and 1 pony) were examined for signs of colic (n = 7), weight loss (6), anorexia (3), and diarrhea (2). Ten equids were evaluated in the fall (September to November). Seven equids had a history of persimmon ingestion.
Clinical Findings—A diagnosis of phytobezoar caused by persimmon ingestion was made for all equids. Eight equids had gastric persimmon phytobezoars; 5 had enteric persimmon phytobezoars. Gastroscopy or gastroduodenoscopy revealed evidence of persimmon ingestion in 8 of 10 equids in which these procedures were performed.
Treatment and Outcome—2 of 13 equids were euthanatized prior to treatment. Supportive care was instituted in 11 of 13 equids, including IV administration of fluids (n = 8) and treatment with antimicrobials (5), NSAIDs (5), and gastric acid suppressants (4). Persimmon phytobezoar–specific treatments included dietary modification to a pelleted feed (n = 8); oral or nasogastric administration of cola or diet cola (4), cellulase (2), or mineral oil (2); surgery (4); and intrapersimmon phytobezoar injections with acetylcysteine (1). Medical treatment in 5 of 7 equids resulted in resolution of gastric persimmon phytobezoars. Seven of 8 equids with gastric persimmon phytobezoars and 1 of 5 equids with enteric persimmon phytobezoars survived > 1 year after hospital discharge.
Clinical Relevance—Historical knowledge of persimmon ingestion in equids with gastrointestinal disease warrants gastroduodenoscopy for evaluation of the presence of persimmon phytobezoars. In equids with gastric persimmon phytobezoars, medical management (including administration of cola or diet cola and dietary modification to a pelleted feed) may allow for persimmon phytobezoar dissolution.