A 7-year-old 523-kg (1,151-lb) Morgan gelding was referred for evaluation of signs of depression, fever (40.9°C [105.6°F]), tachypnea, and tachycardia. Flunixin meglumine (1.1 mg/kg [0.5 mg/lb], IV, once) was administered prior to admission. On examination, the horse was lethargic and profusely sweating. Mucous membranes were pale and dry with a capillary refill time of 2.5 seconds. Heart rate was 84 beats/min, respiratory rate was 50 breaths/min, and rectal temperature was 36.7°C (98.1°F). The horse was assessed to be 7% dehydrated. No arrhythmias or murmurs were noted, and peripheral pulses were normal and synchronous. Respiratory effort and results of pulmonary auscultation
A 17-year-old 513-kg (1,129-lb) gray Holsteiner gelding was presented for evaluation of lethargy of indeterminate duration. On examination, the horse was markedly lethargic with dull attitude and exercise intolerance when walking. It was thin (body condition score, 3/9). Mucous membranes were pink and moist with a capillary refill time < 2 seconds. Heart rate was 28 beats/min, respiratory rate was 20 breaths/min, and rectal temperature was 37.6°C (99.8°F). Cardiac auscultation revealed a grade 3/6 left-sided, apical, systolic murmur as well as an irregularly irregular arrhythmia. Frequent pauses with presumptive S4 heart sounds were auscultated. Gastrointestinal sounds and digital pulses were
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)
A 1-year-old 195-kg (429-lb) Quarter Horse colt, procured for resale purposes, was evaluated at the Auburn University Large Animal Teaching Hospital because of continuous bilateral, mucopurulent nasal discharge accompanied by respiratory noise of 6 months' duration. The respiratory noise had worsened during the week prior to the evaluation. The colt had been treated intermittently with systemic broad-spectrum antimicrobials without a positive response.
Clinical and Gross Findings
At the evaluation, the colt was bright, alert, and responsive; heart rate, respiratory rate, and rectal temperature were within reference limits. Bilateral, mucopurulent, malodorous nasal discharge was present with dyspnea and respiratory noise.
A 14-year-old Missouri Fox Trotter gelding was evaluated because of chronic weight loss of 1 year's duration and acute epistaxis from the left nostril that occurred 2 days prior.
Clinical and Clinicopathologic Findings
On physical examination, the horse was quiet but responsive. It weighed 515 kg (1,133 lb) and had an estimated body condition score of 4/9 with loss of muscle over the dorsum. Rectal temperature was 38.3°C (100.9°F), heart rate was 48 beats/min, and respiratory rate was 12 breaths/min. The horse's oral mucous membranes were pale pink; spontaneous mucosal bleeding occurred while assessing capillary refill time, which was
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.
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.