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  • Author or Editor: Samuel D. Hurcombe x
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Abstract

Objective—To determine clinical and clinicopathologic abnormalities in horses administered a blood transfusion and evaluate effects of blood transfusion on these variables.

Design—Retrospective case series.

Animals—31 adult horses that received ≥ 1 blood transfusion.

Procedures—Medical records of horses receiving a blood transfusion were reviewed to obtain clinical findings, laboratory test results before and after transfusion, adjunctive treatments, transfusion type and volume, response to transfusion, results of donor-recipient compatibility testing, adverse reactions, and outcome.

Results—31 horses received 44 transfusions for hemorrhagic anemia (HG; n = 18 horses), hemolytic anemia (HL; 8), or anemia attributable to erythropoietic failure (EF; 5). Tachycardia and tachypnea were detected in 31 of 31 (100%) and 22 of 31 (71%) horses, respectively, before transfusion. The PCV and hemoglobin concentration were less than the reference range in 11 of 18 horses with HG, 8 of 8 horses with HL, and 5 of 5 horses with EF. Hyperlactatemia was detected in 16 of 17 recorded values before transfusion. Heart rate, respiratory rate, and PCV improved after transfusion, with differences among the types of anemia. Seventeen (54%) horses were discharged, 9 (29%) were euthanized, and 5 (16%) died of natural causes. Adverse reactions were evident during 7 of 44 (16%) transfusions, varying from urticarial reactions to anaphylactic shock.

Conclusions and Clinical Relevance—Abnormalities in clinical and clinicopathologic variables differed depending on the type of anemia. Colic, cold extremities, signs of depression, lethargy, tachycardia, tachypnea, low PCV, low hemoglobin concentration, and hyperlactatemia were commonly detected before transfusion and resolved after transfusion.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To compare the accuracy and precision of cardiac output (CO) measurements derived from 4 thermodilution protocols that used different injectate temperatures and volumes in healthy adult horses.

ANIMALS

8 healthy adult horses.

PROCEDURES

Horses were anesthetized and instrumented with Swan-Ganz catheters. The CO was derived from each of 4 thermodilution protocols (IV injection of physiologic saline [0.9% NaCl] solution chilled to < 5 °C at volumes of 1 mL/15 kg of body weight [protocol A; control], 1 mL/25 kg [protocol B], and 1 mL/35 kg [protocol C] or maintained at 17 °C at a volume of 1 mL/15 kg [protocol D]) 3 times during each of 5 measurement cycles, with a 30-minute interval between cycles. During each measurement cycle, protocol A was performed first, and protocols B, C, and D were performed in a randomized order. Mean CO and within-subject variance in CO were compared among the 4 protocols.

RESULTS

Mean CO did not differ significantly among the 4 protocols. The within-subject variance for CO measurements derived from protocols C and D, but not protocol B, was significantly greater than that for protocol A (control).

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that, in healthy adult horses, decreasing the thermodilution injectate volume to 1 mL/25 kg from the recommended volume of 1 mL/15 kg did not adversely affect the accuracy or precision of CO measurements. However, use of smaller injectate volumes or use of injectate at approximately room temperature is not recommended owing to a clinically unacceptable increase in CO measurement variability.

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in American Journal of Veterinary Research

Abstract

Objective—To assess effects of body position on direct measurements of intra-abdominal pressure (IAP) and abdominal perfusion pressure (APP) in horses anesthetized with total intravenous anesthesia (TIVA).

Animals—9 healthy adult horses.

Procedures—Instrumentation in unsedated standing horses involved insertion of an arterial catheter for blood pressure measurements and 3 intraperitoneal cannulas (left flank, right flank, and ventral abdomen) for IAP measurements. Baseline values were measured for heart rate, respiratory rate, systolic arterial blood pressure, mean arterial blood pressure (MAP), diastolic arterial blood pressure, and IAP. Horses were medicated with xylazine, and pressures were measured again. Anesthesia was induced with ketamine-diazepam and maintained with a ketamine-guaifenesin infusion. Horses were positioned twice into left lateral recumbency, right lateral recumbency, or dorsal recumbency. Hemodynamic pressures and accessible abdominal pressures were measured for each recumbency position. The APP was calculated as MAP – IAP. Differences in IAP, MAP, APP and sedation (standing horses) or body position (anesthetized horses) were compared by means of repeated-measures ANOVA or paired t tests.

Results—Baseline hemodynamic and IAPs were not different after xylazine administration. Ventral abdomen IAP and MAP were lower for horses in dorsal recumbency than in right or left lateral recumbency. Ventral abdomen APP remained unchanged. For lateral recumbencies, flank IAP was lower and APP was higher than pressure measurements at the same sites during dorsal recumbency.

Conclusions and Clinical Relevance—Body position affected IAP and APP in healthy anesthetized horses. These effects should be considered when developing IAP acquisition methods for use in horses with abdominal disease.

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in American Journal of Veterinary Research

Abstract

Case Description—2 horses were examined for chronic nasal discharge secondary to unilateral guttural pouch mycosis.

Clinical Findings—Initial endoscopic examination of both horses confirmed the presence of a fungal plaque on the dorsomedial aspect of the medial compartment of the guttural pouch (auditory tube diverticulum) involving the internal carotid artery (ICA). No signs of hemorrhage or neurologic deficits were present at admission.

Treatment and Outcome—Transarterial stainless steel coil embolization of the affected ICA was performed under general anesthesia, with fluoroscopic guidance. During treatment, an aberrant branch of the ICA, or a proposed bifid ICA, that anastomosed with the caudal cerebellar artery was identified. Occlusion of the distal (noncardiac) side of the aberrant branch was performed in both horses because of potential mycotic involvement at that level. Following treatment, resolution of the mycotic infection was observed in both horses; however, 1 horse developed neurologic signs compatible with unilateral caudal cerebellar artery ischemia on recovery from anesthesia; these signs resolved over the following 2 months.

Clinical Relevance—Findings highlighted variability of the anatomy of the ICA in 2 horses that was identified during treatment for guttural pouch mycosis and identified caudal cerebellar artery infarction as a potential complication of treatment. Because of the size and pathway of both arterial branches, we suggest that the term bifurcation of the ICA is more appropriate than aberrant branching, as has been previously described in the literature. The information in this report may be of value to clinicians performing procedures involving the vasculature of the head and neck in horses.

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in Journal of the American Veterinary Medical Association

Abstract

Case Description—A 2-year-old Thoroughbred filly was evaluated because of hemorrhage from the vulva and suspected hematuria of 5 days' duration.

Clinical Findings—A primary coagulopathy was ruled out on the basis of results of hematologic testing. Vaginoscopy and cystoscopy revealed a large bleeding mass in the bladder that extended into the vagina, causing marked obliteration of normal urogenital structures and difficulty in urination. Histologic examination of endoscopic and surgical biopsy speci-mens revealed a poorly differentiated neoplasia likely of mesenchymal origin. Chronic suppurative cystitis caused by Streptococcus zooepidemicus was also diagnosed.

Treatment and Outcome—The tumor continued to grow despite treatment with doxorubicin and, within 45 days, was causing substantial discomfort and stranguria. Given the grave prognosis, the horse was euthanized. At necropsy, the tumor was found to have caused widespread destruction of the urinary bladder and to have invaded the broad ligament of the uterus. The mass was identified as a poorly differentiated leiomyosarcoma on the basis of results of histologic examination and immunohistochemical staining for α-actin.

Clinical Relevance—Findings suggested that leiomyosarcoma should be considered in the differential diagnosis when examining horses with urogenital bleeding.

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in Journal of the American Veterinary Medical Association