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Objective
To characterize horses with acute diarrhea and determine risk factors for failure to survive.
Design
Retrospective study.
Animals
122 adult horses admitted for acute diarrhea at the teaching hospital between Jan 1, 1990 and Dec 31, 1996.
Procedure
Medical records of horses with acute diarrhea were reviewed to abstract information regarding signalment, history, physical examination, clinicopathologic testing, treatment, and outcome.
Results
91 of 122 (74.6%) horses lived and were discharged from the hospital. Horses with history of administration of antimicrobials for a problem preceding diarrhea were approximately 4.5 times less likely to survive. The following variables that had been determined at the time of admission were significantly associated with failure to survive: administration of antimicrobial drugs for another illness, serum creatinine concentration > 2.0 mg/dl, PCV > 45%, tachycardia (heart rate > 60 beats/min), and low serum total protein concentration. Prevalence of laminitis was 11.5%.
Clinical Implications
Diarrheic horses that are azotemic and have clinicopathologic findings consistent with hemoconcentration and hypoproteinemia have a poor prognosis for survival. Antimicrobial administration may induce diarrhea, and antimicrobial-associated diarrhea may have a worse prognosis than other types of acute diarrhea. (J Am Vet Med Assoc 1999;214:382–390)
Objective
To determine the prevalence of wound infection following celiotomy in horses and to determine risk factors associated with the development of such infections.
Design
Prospective study.
Animals
210 horses that had 235 celiotomies.
Procedure
All horses that had celiotomies between March 1990 and March 1992 were considered for this study. Only horses that survived ≥ 10 days after surgery were included in analysis of risk factors for postoperative wound infection.
Results
Of the 210 horses, 161 (76.7%) were discharged; of the horses discharged, 147 horses had a single celiotomy and 14 had multiple celiotomies. Twenty-six (12.4%) horses were euthanatized during surgery and were, therefore, excluded from further analysis. Twenty-three horses died during the postoperative period. Of these 23 horses, 15 that died within 10 days of surgery also were excluded from further analysis. Thus, 169 horses were included in the analysis of risk factors for developing incisional infection.
Evidence of incisional infection was observed in 43 of 169 (25.4%) horses. Increased concentration of fibrinogen in peritoneal fluid obtained prior to surgery, performing an enterotomy, and use of polyglactin 910 to close the linea alba were all significantly (P ≤ 0.05) associated with increased risk of postoperative wound infection.
Whether incisional herniation developed was recorded for 76 horses. The proportion of horses with hernias among those with postoperative wound infection was 19.1 %, compared with 3.6 % of horses without evidence of postoperative wound infection, indicating a significant association between postoperative wound infection and development of incisional hernias.
Clinical Implications
Increased concentration of fibrinogen in peritoneal fluid prior to surgery, performing an enterotomy, and use of polyglactin 910 to close the linea alba is significantly associated with increased risk for wound infection following celiotomy in horses. (J Am Vet Med Assoc 1997;210:78–81)
Objective
To determine the incidence of and risk factors for developing diarrhea in horses after celiotomy for colic.
Design
Retrospective cohort study.
Animals
357 adult horses that had celiotomy for colic at the teaching hospital between Jan 1, 1990 and Sep 1, 1994.
Procedure
Medical records of horses that had celiotomy for colic were reviewed to abstract information regarding development of diarrhea, signalment, history, and treatment.
Results
In horses that had celiotomy for colic, the incidence of diarrhea was 53.2% (190/357). Using multiple logistic regression, horses with a disorder of the large intestine were approximately twice as likely to develop diarrhea after celiotomy as horses that had surgery for other types of intestinal lesions (P < 0.001). Even after accounting for the effects of large intestinal surgery, horses that also had an enterotomy were approximately 1,5 times as likely to develop diarrhea (P = 0.042). Diarrhea in horses associated with duration > 2 days, isolation of Salmonella spp from feces, or leukopenia was categorized as being severe. Incidence of severe diarrhea was 27.5% (98/357). Using multiple logistic regression, horses that had surgery of the large intestine were approximately 2.5 times as likely to develop severe diarrhea after celiotomy as horses that had surgery for other types of intestinal lesions (P = 0.006). In horses that had celiotomy for colic, those that were fed grass hay were approximately half as likely to develop severe diarrhea as were horses that were not fed grass hay (P = 0.018).
Clinical Implications
Although the risk factors identified for the development of diarrhea are not alterable, knowledge of them will enable clinicians to better advise clients and to better prepare for medical management of horses after surgery. (J Am Vet Med Assoc 1996;209:810–813)
Abstract
OBJECTIVE
To evaluate the prophylactic efficacy of triclosan-coated (TC) suture in preventing surgical site infections (SSIs) in dogs and cats undergoing surgical procedures.
ANIMALS
862 animals (794 dogs and 68 cats).
PROCEDURES
Incidences of SSI of surgical wounds closed with TC suture and surgical wounds closed with non-TC suture occurring between the time of surgery and 1 month postoperatively were compared. Animals were randomly assigned to TC or non-TC suture groups. When TC suture was assigned, all suture available as TC material was used rather than non-TC suture. Presence of an SSI was determined by an owner questionnaire or direct examination.
RESULTS
Overall, 50 of 862 (5.8%) animals developed SSIs. Incidence of SSI was 6% (24/428) in the non-TC suture group and 6% (26/434) in the TC suture group. No significant difference was found in the incidence of SSI between groups. No significant difference was detected in the incidence of incisional problems (eg, redness, dehiscence, and seroma formation) between animals in which TC suture was used and those in which non-TC suture was used. On multivariable analysis, other factors were associated with increased SSI rates, including an incision length > 10 cm, surgery performed by the soft tissue surgery department, and anesthesia duration of > 240 minutes.
CONCLUSIONS AND CLINICAL RELEVANCE
No significant difference in incidence of SSI was detected between animals undergoing surgical procedures performed with non-TC versus TC suture.
Abstract
OBJECTIVE To evaluate the effect of volume of IV regional limb perfusion (IVRLP) on amikacin concentrations in synovial and interstitial fluid of horses.
ANIMALS 8 healthy adult horses.
PROCEDURES Each forelimb was randomly assigned to receive IVRLP with 4 mL of amikacin sulfate solution (250 mg/mL) plus 56 mL (total volume, 60 mL) or 6 mL (total volume, 10 mL) of lactated Ringer solution. Horses were anesthetized, and baseline synovial and interstitial fluid samples were collected. A tourniquet was placed, and the assigned treatment was administered via the lateral palmar digital vein. Venous blood pressure in the distal portion of the limb was recorded. Additional synovial fluid samples were collected 30 minutes (just before tourniquet removal) and 24 hours after IVRLP began; additional interstitial fluid samples were collected 6 and 24 hours after IVRLP began.
RESULTS 30 minutes after IVRLP began, mean amikacin concentration in synovial fluid was significantly greater for the large-volume (459 μg/mL) versus small-volume (70 μg/mL) treatment. Six hours after IVRLP, mean concentration in interstitial fluid was greater for the large-volume (723 μg/mL) versus small-volume (21 μg/mL) treatment. Peak venous blood pressure after large-volume IVRLP was significantly higher than after small-volume IVRLP, with no difference between treatments in time required for pressure to return to baseline.
CONCLUSIONS AND CLINICAL RELEVANCE Study findings suggested that large-volume IVRLP would deliver more amikacin to metacarpophalangeal joints of horses than would small-volume IVRLP, without a clinically relevant effect on local venous blood pressure, potentially increasing treatment efficacy.
Abstract
Objective—To determine the value of serial measurements of peritoneal fluid lactate concentration (PFL) for detecting strangulating intestinal lesions (SLs) in referred horses with signs of colic.
Design—Retrospective cohort study.
Animals—94 horses with signs of colic.
Procedures—Medical records of horses evaluated between September 2006 and February 2010 because of signs of colic were reviewed. All included horses had ≥ 2 peritoneal fluid samples collected, including one at admission and another within 1 to 6 hours after admission. Of the 94 horses, 26 were assigned to the SL group on the basis of findings at surgery or necropsy and 68 were assigned to the nonstrangulating intestinal lesion group because their signs of colic resolved with medical management. Peritoneal fluid lactate concentration was measured by use of a handheld lactate monitor. Data were analyzed by use of univariable and multivariable logistic regression analysis.
Results—PFL at admission > 4 mmol/L, an increase in PFL over time, and especially an increase in PFL over time in horses with a PFL < 4 mmol/L at admission (OR, 62; sensitivity, 95%; specificity, 77%) were significant predictors of horses with an SL.
Conclusions and Clinical Relevance—Serially determined PFL was a strong predictor for differentiating horses with SLs from horses with nonstrangulating intestinal lesions. Given the high OR, sensitivity, and specificity of these tests, serially determined PFL may have potential as a screening test for identifying horses with SLs. Further evaluation of the clinical value of PFL for predicting SLs in a prospective, multicenter study is warranted.
Objective
To determine whether administration of commercially available Escherichia coli antiserum to neonatal foals would affect serum IgG concentration or morbidity and mortality rates during the first 60 days of life.
Design
Randomized controlled trial.
Animals
271 neonatal foals on 4 well-managed farms.
Procedure
Foals were randomly assigned to a treatment or control group. All foals were allowed to suckle colostrum normally. In addition, treatment-group foals were given E coli antiserum (10 ml) orally between 0 and 8 hours after birth. Serum samples were obtained between 18 and 36 hours after birth, and serum IgG concentration was determined. Foals were monitored for the first 60 days after birth, and causes of disease or death were recorded.
Results
Groups did not differ significantly in regard to breed, sex, month of birth, season of birth, age of dams, parity of dams, duration of gestation, or specific gravity of colostrum before suckling. In addition, groups did not differ significantly in regard to mean serum IgG concentration, prevalence of complete or partial failure of passive transfer of immunity, frequency or causes of disease, or frequency of death from infectious causes.
Clinical Implications
In this group of foals on well-managed farms, administration of E coli antiserum did not alter serum IgG concentrations or morbidity and mortality rates during the first 60 days of life. (J Am Vet Med Assoc 1998;212: 1746–1750)
Objective
To identify risk factors for recurrent colic and chronic, intermittent colic in horses.
Design
Case control study.
Animals
The population included 768 horses examined by veterinarians in Texas for colic and 446 horses examined by these veterinarians for emergencies other than colic (control group).
Procedure
Horses with colic that had history of colic (n = 232) were compared with those without such history (n = 536), using logistic regression analysis to identify risk factors for history of previous colic and to determine odds ratios (OR) for these associations. Among the 232 horses in the history of colic group, 58 horses that had chronic, intermittent colic were compared with the no history of colic group and the control group to identify factors associated with chronic, intermittent colic, using multiple logistic regression analysis.
Results
Among horses with colic, factors significantly associated with history of colic by multiple logistic regression analysis included history of abdominal surgery (OR = 3.1; P < 0.0001), age > 8 years (OR = 1.5; P < 0.0001), feeding of coastal grass hay (OR = 1.34; P = 0.012), Arabian breed (OR = 1.28; P = 0.044), and recent change in stabling (OR = 0.76, P = 0.024). Among horses with colic, factors significantly associated with chronic, intermittent colic were history of previous abdominal surgery (OR = 2.2; P = 0.021), age > 8 years (OR = 2.0; P < 0.0001), being a gelding (OR = 1.7 with female as the reference population; P = 0.002), feeding of coastal grass hay (OR = 1.6; P = 0.045), and farm density < 0.5 horses/acre (OR = 1.6; P = 0.003). When the CIC group was compared with the control group, significant risk factors included history of abdominal surgery (OR = 270.7; P < 0.0001), age > 8 years (OR = 2.4; P < 0.0001), recent change in diet (OR = 2.1; P = 0.005), farm density < 0.5 horses/acre (OR = 2.0; P = 0.0001); being a gelding (OR = 1.8, with female as the reference population; P = 0.002), and Arabian breed (OR = 1.6; P = 0.050).
Clinical Implications
Certain findings of signalment and management factors may identify horses at increased risk of recurrent forms of colic. (J Am Vet Med Assoc 1996;208:697–703)
