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Summary

Medical records from all horses with large colon impaction admitted between 1985 and 1991 were examined. Large colon impaction was diagnosed in 147 of 1,100 (13.4%) horses with colic. One hundred thirty horses were admitted for further evaluation of acute onset of abdominal pain after having been examined and treated by referring veterinarians, and 17 horses that were hospitalized for unrelated medical problems developed large colon impaction. Female horses (92/ 147; 62.6%) were more commonly affected than males. The age ranged from 1 to 29 years (median, 7.1 years). Mean duration of clinical signs of abdominal pain prior to referral was 32 hours. At admittance, signs of abdominal pain were not detectable in 70/147 (48%) horses, and were mild in 50 34%), moderate in 16 (11%), and severe in 11 (7%). Heart rate ranged from 30 to 86 beats/min (median, 44 beats/min), and most horses had a decrease in gastrointestinal sounds. Transrectal palpation was used to identify the impaction location as being the pelvic flexure in 103 (70.1%) horses, colon on the left side in 30 (20.4%) horses, and colon on the right side in 14 (9.5%) horses. All 147 horses received fluids iv and nonsteroidal anti-inflammatory medications or sedatives, including flunixin meglumine (124 horses, 84.3%) xylazine hydrochloride (81, 55%), butorphanol (6, 0.04%), and detomidine hydrochloride (9, 0.04%). Duration of medical treatment required to resolve the impaction ranged from 1 to 6 days (mean, 2 days). In addition to medical treatment, 24 (16.3%) horses also required surgery.

Analysis of results of examinations performed at the time of admission revealed significant (P < 0.05) differences for heart rate, respiratory rate, number of wbc, blood lactate concentration, and total protein concentration in peritoneal fluid between horses that lived vs horses that died or were euthanatized. Horses that had surgery had a significantly (P < 0.05) higher fatality rate. Long-term survival rate was higher (P $ 0.05) for horses treated medically.

Most horses with large colon impaction can be treated medically, and those horses have a good prognosis. Surgery usually is not necessary and may pose additional risks because of the possibility of bowel rupture during the operation.

Free access
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine history; clinical, radiographic, ultrasonographic, and scintigraphic abnormalities; treatment; and outcome in horses with tuber coxae fractures and to describe a useful technique for obtaining a dorsomedial-ventrolateral 50° oblique radiographic view of the tuber coxa of the ilium in standing horses.

Design—Retrospective case series.

Animals—29 horses with fractures of tuber coxa.

Procedures—Data collected from medical records included signalment; history; horse use; severity and duration of lameness; radiographic, ultrasonographic, and scintigraphic findings; treatment; and outcome.

Results—All horses had a traumatic event leading to acute, unilateral hind limb lameness. Eighteen horses had a more severe lameness at the walk than at the trot; 22 of 29 horses had an abnormal gait with the hind limbs tracking to 1 side of the forelimbs. Twenty-four of 29 horses had palpable and visual asymmetry between the affected and unaffected tuber coxae. Twenty horses had radiography performed while sedated but standing, and fractures were reliably identified on the dorsomedial-ventrolateral 50° oblique radiographic views. Twenty-seven (27/29 [93%]) horses returned to athletic use. Horses sustaining partial fractures of the caudal aspect of tuber coxae returned to previous use significantly earlier (mean, 3 months), compared with horses with complete tuber coxae fractures (6.5 months).

Conclusions and Clinical Relevance—Horses with tuber coxae fractures returned to athletic soundness following extended periods of rest. Findings emphasized the need for obtaining a dorsomedial-ventrolateral 50° oblique radiographic view of the tuber coxa of the ilium in horses suspected of sustaining injury to this region.

Full access
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine clinical history, structures involved, treatment, and outcome of lacerations of the heel bulb and proximal phalangeal region (pastern) in horses.

Design—Retrospective study.

Animals—101 horses.

Procedures—Medical records of horses with lacerations of the heel bulb and pastern were reviewed, and follow-up information was obtained.

Results—75 horses were Quarter Horses. Most horses were not treated with antimicrobial drugs prior to referral. Mean ± SD time from injury to referral was 24 ± 45 hours (range, 1 to 168 hours). Lacerations were most frequently caused by contact with wire or metal objects. In 17 horses, lacerations involved synovial structures; the distal interphalangeal joint was most commonly affected. One horse was euthanatized after initial examination. Wound treatment consisted of cleansing, lavage, debridement, lavage of affected synovial structures, suturing of fresh wounds, and application of a foot bandage or cast. Fifty-six horses were treated with systemically administered antimicrobial drugs. Follow-up information was collected for 61 horses. Fifty-one horses returned to their intended use and had no further complications; 10 horses had complications associated with the wound, and of those horses, 5 were euthanatized and 1 horse died from an unrelated cause. Horses with lacerations that involved synovial structures had worse outcomes than horses with lacerations that did not involve synovial structures.

Conclusions and Clinical Relevance—Horses that sustain heel bulb lacerations can successfully return to their intended use. Involvement of the distal interphalangeal joint is associated with poor prognosis. (J Am Vet Med Assoc 2005;226:418–423)

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine history, clinical and radiographic abnormalities, and outcome in horses with signs of navicular area pain unresponsive to corrective shoeing and systemic nonsteroidal anti-inflammatory drug administration that were treated with an injection of corticosteroids, sodium hyaluronate, and amikacin into the navicular bursa.

Design—Retrospective study.

Animals—25 horses.

Procedure—Data collected from the medical records included signalment, history, horse use, severity and duration of lameness, shoeing regimen, results of diagnostic anesthesia, radiographic abnormalities, and outcome.

Results—17 horses had bilateral forelimb lameness, 7 had unilateral forelimb lameness, and 1 had unilateral hind limb lameness. Mean duration of lameness was 9.2 months. All horses had been treated with corrective shoeing and nonsteroidal anti-inflammatory drugs for at least 6 months; 18 had previously been treated by injection of corticosteroids and sodium hyaluronate into the distal interphalangeal joint. Fourteen horses had mismatched front feet, and 21 horses had signs of pain in response to application of pressure over the central aspect of the frog. Palmar digital nerve anesthesia resulted in substantial improvement in or resolution of the lameness in all horses. Twenty horses (80%) were sound and returned to intended activities 2 weeks after navicular bursa treatment; mean duration of soundness was 4.6 months. Two horses that received numerous navicular bursa injections had a rupture of the deep digital flexor tendon at the level of the pastern region.

Conclusions and Clinical Relevance—Results suggest that navicular bursa treatment may provide temporary improvement in horses with signs of chronic navicular area pain that fail to respond to other treatments. (J Am Vet Med Assoc 2003;223:1469–1474)

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in Journal of the American Veterinary Medical Association

Abstract

Case Description—4 horses with enthesopathy and desmitis of the medial collateral ligament of the cubital joint were examined.

Clinical Findings—All 4 horses had a history of acute, severe, unilateral forelimb lameness and had signs of pain during manipulation of the affected upper forelimb; 2 also had swelling in the axillary region. There was no improvement in lameness after diagnostic local analgesia below the carpal region, and 1 of 4 horses had mild improvement after cubital joint analgesia. Radiography revealed enthesophyte formation on the radial tuberosity and linear mineralization of the medial collateral ligament in 2 horses and periosteal reaction on the humeral condyle in all 4 horses. One horse had mild osteoarthritis of the cubital joint, and 3 had osteophytosis of the cranial aspect of the radius. Although all horses were initially examined because of an acute onset of lameness, all had chronic abnormalities visible on imaging. Ultrasonography revealed an irregular boney contour and enthesopathy at the insertion of the short medial collateral ligament to the radial tuberosity and desmitis of the short medial collateral ligament. Two horses had radiographic evidence of similar but less severe lesions of the contralateral cubital joint.

Treatment and Outcome—All horses received phenylbutazone and rest. All horses were free of lameness after a median of 3 months (range, 2 to 4 months) and returned to previous use after a median of 6 months (range, 3 to 8 months).

Conclusions and Clinical Relevance—The results of the present report suggested that performance horses with enthesopathy and desmitis of the medial collateral ligament of the cubital joint may have a good prognosis for return to previous use following appropriate treatment.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine whether intraluminal distention and subsequent decompression of the equine jejunum affects intestinal blood flow, hemodynamics, and microvascular permeability.

Animals—5 healthy adult horses.

Procedure—Horses were anesthestized and underwent exploratory laparotomy. Two jejunal segments were identified as sham-operated or instrumented segments. After baseline values were obtained, intraluminal distention was created in the experimental segment to induce an intraluminal pressure of 18 cm H2O. After 120 minutes of distention, the intestine was decompressed for 120 minutes. Mesenteric blood flow, oxygen delivery, oxygen consumption, microvascular permeability, wet weight-to-dry weight ratio, neutrophil infiltration, and vascular resistance were determined and comparisons made among control, sham-operated, and experimental segments.

Results—Mean jejunal blood flow was 21.4 ml/min per kg. There was a significant decrease in mesenteric blood flow to the distended intestine (13.4 ml/min per kg). Blood flow increased significantly during the decompression period (340% of baseline blood flow). Intraluminal distention and subsequent decompression resulted in a significant increase in microvascular permeability, as determined by the osmotic reflection coefficient. Oxygen delivery and oxygen content decreased significantly during the distention period and increased during decompression. Morphologic evaluation revealed a significant increase in edema and neutrophil infiltration after distention and decompression, compared with results for the sham-operated or control segments.

Conclusions and Clinical Relevance—Intraluminal distention and decompression of the equine jejunum results in low-flow ischemia and edema, which may contribute to adhesions and ileus in the postoperative period after surgery for obstructions of the small intestines. (Am J Vet Res 2001;62:225–236)

Full access
in American Journal of Veterinary Research
in Journal of the American Veterinary Medical Association