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 evaluate the effect of sodium carboxymethylcellulose
(SCMC) or a hyaluronate-carboxymethylcellulose
membrane (HA membrane) on
healing of the small intestine in horses.
Animals—18 healthy adult horses.
Procedure—Midline celiotomy and 2 jejunal resection-
and-anastomosis surgeries were performed. In
treated horses, SCMC (n = 6) or a HA membrane (6)
was applied to the jejunum to cover the anastomosis.
There were 6 untreated control horses. Horses were
euthanatized 10 days after surgery. For each horse, 1
anastomosis was used for histologic examination,
and the second was used to determine intestinal
bursting strength. Intestinal bursting tension, serosal
granulation tissue, serosal fibrin deposition, and width
of the fibrous seal at the anastomosis were compared
Results—3 control horses had adhesions associated
with the anastomosis, but none of the treated
horses had adhesions associated with the anastomosis.
Mean thickness of fibrin deposited on the
serosal surfaces for the SCMC and HA-membrane
groups was significantly less than that for control
horses. Mean thickness of serosal granulation tissue,
width of fibrous seal between inverted musculature,
inflammatory cell infiltrate scores, and bursting
tension did not differ significantly among
Conclusions and Clinical Relevance—Use of SCMC
or application of a HA membrane to small intestinal
anastomoses in horses resulted in fewer adhesions
and decreased fibrin deposition, and it did not
adversely affect anastomotic healing. In horses at
increased risk for intra-abdominal adhesions, SCMC
or application of HA membranes may decrease the
frequency of adhesions without adversely affecting
healing of small intestinal anastomoses. (Am J Vet Res 2000;61:369–374)
Objective—To determine whether 1% diclofenac
liposomal suspension (DLS) ointment would be
absorbed transdermally and attenuate experimentally
induced subcutaneous inflammation in horses.
Animals—7 healthy adult horses
Procedure—Inflammation was produced by injecting
1% sterile carrageenan into subcutaneously implanted
tissue cages 8 hours before (time –8) and at the
time of application of test ointment. A crossover
design was used. Horses received 1 of 2 treatments
(topically administered control or DLS ointments) during
48 hours of carrageenan-induced subcutaneous
inflammation. A single application of test ointment
(7.2 g) was applied over each tissue cage (time 0).
Samples of transudate and blood were collected at
–8, 0, 6, 12, 18, 24, 30, 36, and 48 hours. Plasma and
transudate diclofenac concentrations were determined
by use of high-performance liquid chromatography.
Transudate concentrations of prostaglandin E2
(PGE2) were determined with a competitive enzyme
Results—DLS was absorbed transdermally. The highest
concentration (mean ± SEM, 76.2 ± 29 ng/mL)
was detectable in tissue-cage fluid within 18 hours
after application. Minimal concentrations of diclofenac
were detectable in plasma. Application of DLS significantly
decreased transudate concentrations of PGE2
at 6 and 30 hours. Decreases in PGE2 concentration
were observed in the DLS group at all collection
Conclusions and Clinical Relevance—A single topical
application of DLS resulted in concentrations of
diclofenac in transudate within 6 hours and significantly
attenuated carrageenan-induced local production
of PGE2. Results of this study suggest that DLS
is readily absorbed transdermally and may be efficacious
for reducing subcutaneous inflammation in
horses. ( Am J Vet Res 2004;65:271–276)
Objective—To compare the outcomes of doublelayer
inverting anastomosis (DIA), single-layer anastomosis
(SLA), and single-layer anastomosis combined
with a hyaluronate membrane (SLA+HA-membrane)
with respect to stomal diameter, adhesion formation,
surgery time, and anastomotic healing in horses.
Animals—18 adult horses.
Procedure—Midline celiotomy and end-to-end anastomoses
were performed. In control horses (n = 6),
DIA was performed; in treated horses, SLA was performed
(6) or SLA+HA-membrane was performed (6).
Horses were euthanatized 21 days after surgery.
Abdominal adhesions were evaluated grossly and histologically.
Stomal diameters were measured ultrasonographically
and compared with adjacent luminal
diameters. Anastomotic healing was evaluated histologically
for fibrosis and inflammation, tissue alignment,
and inversion. Surgery times were recorded for
the anastomotic procedure and compared among
Results—There were significantly more adhesions in
the SLA group, compared with the DIA and SLA+HAmembrane
groups. Reduction in stomal diameters in
the DIA group was significantly greater than the SLA
and SLA+HA-membrane groups. Surgery times for
the DIA group were significantly greater than the SLA
and SLA+HA-membrane groups. Histologic findings
of fibrosis, inflammation, and mucosal healing were
similar among groups. There was significant tissue
inversion in the DIA group, compared with the 2 treatment
groups. Tissue alignment was not different
Conclusions and Clinical Relevance—Use of a
SLA+HA-membrane was an effective small intestinal
anastomotic technique. This technique was faster to
perform and resulted in a larger stomal diameter,
compared with the DIA technique and significantly
fewer perianastomotic adhesions, compared with the
SLA technique. (Am J Vet Res 2001;62:1314–1319)
Objective—To determine risk factors for development
of sequestra in cattle and identify factors associated
with a successful outcome.
Procedure—Medical records of cattle treated at veterinary
teaching hospitals in North America were
reviewed. To determine risk factors for osseous
sequestration, breed, age, and sex of cattle with
osseous sequestration were compared with breed,
age, and sex of all other cattle admitted during the
Results—110 cattle were included in the study. Three
had 2 sequestra; thus, 113 lesions were identified.
Most sequestra were associated with the bones of
the extremities, most commonly the third metacarpal
or third metatarsal bone. Ninety-two animals were
treated surgically (ie, sequestrectomy), 7 were treated
medically, 3 were initially treated medically and
were then treated surgically, and 8 were not treated.
Follow-up information was available for 65 animals
treated surgically and 6 animals treated medically.
Fifty-one (78%) animals treated surgically and 5 animals
treated medically had a successful outcome.
Cattle that were 6 months to 2 years old had a significantly
increased risk of developing a sequestrum,
compared with cattle < 6 months old. Cattle in which
sequestrectomy was performed with the aid of local
anesthesia were significantly more likely to undergo 2
or more surgical procedures than were cattle in which
sequestrectomy was performed with the aid of general
Conclusions and Clinical Relevance—Results suggest
that sequestrectomy will result in a successful
outcome for most cattle with osseous sequestration.
(J Am Vet Med Assoc 2000;217:376–383)