To describe the repair utilizing integral-anchor barbed suture in equine rectal tears.
3 horses aged 3 to 10 years old with grade 3 to 4 rectal tears.
Grade 3 and 4 rectal tears were referred for surgical repair immediately after iatrogenic tearing or tearing during parturition. Integral-anchor barbed suture (Stratafix Symmetric PDS Plus, size 1, 18” CT-1) was placed using long-handled instruments or hand closure depending on the accessibility and visibility of the tear. Closure of grade 3 tears was performed using a continuous appositional pattern. A horizontal mattress pattern was performed in the grade 4 tear. No other surgical procedures were performed.
Two grade 3 tears were successfully repaired with no complications and discharged from the hospital. One grade 4 tear was successfully repaired; however, 4 days post-surgery partial dehiscence of the suture site occurred, and the horse was euthanized.
Grade 3 rectal tears were repaired successfully by using an integral-anchor barbed suture. No post-operative complications were reported. Blind hand suturing could be performed in cranial locations when the laceration could not be made visible. For grade 4 rectal tears, additional surgical procedures beyond barbed suture closure are needed.
Case Description—A 7-year-old mixed-breed stallion was admitted because of colic.
Clinical Findings—Entrapment of the left colon in the renosplenic space was diagnosed via rectal palpation and ultrasonographic examination, despite a renosplenic space ablation 6.5 years earlier.
Treatment and Outcome—The renosplenic entrapment was corrected with a combination of phenylephrine administration, rolling, and ballottement of the horse's abdomen during general anesthesia. The following week, left flank laparoscopic renosplenic space ablation was performed with the horse standing. On examination of the previous surgical site, only 4 bands of fibrous adhesion remained of the original space ablation. The renosplenic space was again closed by suturing the perirenal fascia and renosplenic ligament to the splenic capsule. The horse was discharged from the hospital and recovered at home. No complications or recurrence of entrapment was reported following the procedure.
Clinical Relevance—There have been no previous reports of recurrence of renosplenic entrapment following procedures to permanently ablate the renosplenic space. Recurrence in this patient may be attributed to the horse's young age at the time of initial surgery or inadequate size or spacing of the sutures through the perirenal fascia and splenic capsule.
Objective—To use microarray analysis to identify genes that are differentially expressed in horses with experimentally induced osteoarthritis.
Procedures—During arthroscopic surgery, a fragment was created in the distal aspect of the radiocarpal bone in 1 forelimb of each horse to induce osteoarthritis. At day 14 after osteoarthritis induction, horses began exercise on a treadmill. Blood and synovial fluid samples were collected before and after surgery. At day 70, horses were euthanized and tissues were harvested for RNA analysis. An equine-specific microarray was used to measure RNA expression in peripheral WBCs. These data were compared with mRNA expression (determined via PCR assay) in WBCs, cartilage, and synovium as well as 2 protein biomarkers of cartilage matrix turnover in serum and synovial fluid.
Results—A metalloproteinase domain-like protein decysin-1 (ADAMDEC1), glucose-regulated protein (GRP) 94, hematopoietic cell signal transducer (HCST), Unc-93 homolog A (hUNC-93A), and ribonucleotide reductase M2 polypeptide (RRM2) were significantly differentially regulated in WBCs of horses with osteoarthritis, compared with values prior to induction of osteoarthritis. There was correlation between the gene expression profile in WBCs, cartilage, and synovium and the cartilage turnover proteins. Gene expression of ADAMDEC1, hUNC-93A, and RRM2 in WBCs were correlated when measured via microarray analysis and PCR assay.
Conclusions and Clinical Relevance—Expression of ADAMDEC1, GRP94, HCST, hUNC-93A, and RRM2 was differentially regulated in peripheral WBCs obtained from horses with experimentally induced osteoarthritis. Gene expression of ADAMDEC1, hUNC-93A, and RRM2 in peripheral WBCs has the potential for use as a diagnostic aid for osteoarthritis in horses.