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  • Author or Editor: Sarah S. Le Jeune x
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Abstract

Objective—To evaluate the sensitivity and specificity of abdominal computed radiography (CR) for the diagnosis of enterolithiasis in horses and to examine how these parameters are affected by the number and anatomic location of enteroliths and by gas distension of the gastrointestinal tract.

Design—Retrospective case series.

Animals—Horses ≥ 1 year old that underwent abdominal CR and subsequent exploratory laparotomy or postmortem examination.

Procedures—3 reviewers blinded to signalment, history, clinical signs, and diagnoses separately evaluated abdominal computed radiographs of horses included in the study. Each set of radiographs was evaluated for the presence or absence of enteroliths, the amount of gas distention, and the image quality. Signalment, definitive diagnosis on the basis of findings on exploratory laparotomy or postmortem examination, and the number and location of enteroliths were obtained from medical records.

Results—Of the 142 cases reviewed, 58.4% (83/142) had confirmed enterolithiasis. For the 3 reviewers, overall sensitivity was 85% and specificity was 93%. Sensitivity was lower for small colon enteroliths than for large colon enteroliths (50% and 94.5%, respectively) and was significantly affected by gas distention. Sensitivity was not significantly affected by the number of enteroliths.

Conclusions and Clinical Relevance—Computed radiography provided high sensitivity and high specificity for the diagnosis of enterolithiasis in horses. Caution should be exercised when the radiographic results are negative, as the sensitivity for small colon enterolithiasis was relatively low and gas distension negatively affected detection of enteroliths. Abdominal CR is indicated as a diagnostic test in horses examined for colic in geographic regions in which enterolithiasis is endemic.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate the sensitivity and specificity of direct digital abdominal radiography for the diagnosis of enterolithiasis in equids and to assess the effect of the number and anatomic location of enteroliths and gas distention of the gastrointestinal tract on diagnostic sensitivity of the technique.

Design—Retrospective case series.

Sample Population—238 horses and ponies ≥ 1 year old that underwent digital abdominal radiography with subsequent exploratory celiotomy or postmortem examination.

Procedures—For each case, 3 reviewers independently evaluated radiographic views. Radiographic images were evaluated for presence or absence and location of enteroliths and the degree of gas distention. Signalment, definitive diagnosis based on exploratory celiotomy or postmortem examination findings, and number and anatomic location of enteroliths were obtained from the medical records.

Results—70 of the 238 (29.4%) equids had confirmed enterolithiasis. With regard to diagnosis of enterolithiasis via digital radiography, overall sensitivity and specificity for the 3 reviewers were 84% and 96%, respectively. Sensitivity was lower for small colon enteroliths (61.5%) than for large colon enteroliths (88.9%) and was negatively affected by gas distention of the gastrointestinal tract. Sensitivity was not affected by the number of enteroliths.

Conclusions and Clinical Relevance—Sensitivity and specificity of digital radiography for the diagnosis of large colon enterolithiasis in equids was high. Sensitivity of digital radiography for detection of small colon enteroliths was lower than that for large colon enteroliths, but was higher than that typically associated with computed radiography. In geographic regions in which enterolithiasis in equids is endemic, digital abdominal radiography could be used as a diagnostic test for equids with colic.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate clinical findings, underlying causes, and short-term outcome associated with hemoperitoneum in horses.

Design—Retrospective case series.

Animals—67 horses with hemoperitoneum.

Procedures—Medical records of horses with hemo-peritoneum (excluding postoperative abdominal hemorrhage) from 1989 through 2004 were analyzed. Information obtained included history, signalment, physical examination findings, diagnostic test results, and short-term outcome.

Results—Breed distribution was 28 Thoroughbreds, 13 Arabians, 10 Quarter Horses, 5 Warmbloods, 3 Appaloosas, and 1 each of 8 other breeds. There were 40 mares, 23 geldings, and 4 stallions. Median age was 12 years (range, 1 month to 40 years). Signs of abdominal discomfort were the primary complaint in 79% of horses. Clinical findings included shock (60%) and pale mucous membranes (60%). Median heart rate was 76 beats/min (range, 30 to 216 beats/min), median respiratory rate was 30 breaths/min (range, 8 to 92 breaths/min), median Hct was 31% (range, 10.5% to 73.0%), and total protein concentration was 5.8 g/dL (range, 3.3 to 8.7 g/dL). Cause of hemoperitoneum was attributed to trauma (25.4%), neoplasia (17.9%), uterine artery rupture (13.4%), mesenteric injury (11.9%), disseminated intravascular coagulopathy (6.0%), other causes (3.0%), and idiopathic causes (22.4%). Fifty-one percent of horses survived to hospital discharge, 37% were euthanized, and 12% died. Poor short-term outcome was significantly associated with high respiratory rate and certain underlying causes.

Conclusions and Clinical Relevance—Hemoperitoneum is an infrequent but important cause of abdominal discomfort in horses. Predominant underlying causes were trauma, neoplasia, and idiopathic causes. Identification of underlying cause is important because of its association with outcome.

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in Journal of the American Veterinary Medical Association

Abstract

Case Description—3 horses with penetrating wounds to the shoulder area were examined because of forelimb lameness.

Clinical Findings—All horses had physical examination findings (decreased cranial phase of the stride, swelling in the shoulder region, and signs of pain on manipulation of the shoulder) that were suggestive of problems in the upper portion of the forelimb. Injury to the biceps tendon or bursa was the primary differential diagnosis in each instance, but no abnormalities involving those structures were found. Radiographic and ultrasonographic imaging revealed injuries to the caudal eminence of the greater tubercle of the humerus, the infraspinatus tendon, and the infraspinatus bursa. Examination with ultrasound was more sensitive than radiography at detecting both osseous and soft tissue changes.

Treatment and Outcome—All 3 horses responded favorably to treatment with antimicrobials and non-steroidal anti-inflammatory drugs. Although initial response to standing lavage was favorable in 1 horse, endoscopic lavage was later required. Standing removal of fracture fragments was performed in 2 horses. Ultrasonographic imaging was helpful in monitoring the response to treatment and changes in the affected structures. All 3 horses eventually became sound after treatment.

Clinical Relevance—Infraspinatus bursitis and tendonitis should be included in the differential diagnoses of horses with shoulder lameness. Diagnosis and monitoring should include ultrasonographic monitoring. The prognosis for return to soundness after appropriate treatment appears to be good.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Case Description—A 10-year-old Lipizzaner stallion was evaluated over the course of 1.5 years because of intermittent, recurrent colic.

Clinical Findings—The horse was initially treated medically for gastric ulcers; dietary changes were made, and a deworming protocol was instituted, without resolution of colic episodes. Subsequently, the horse underwent exploratory celiotomy and a large colon volvulus was identified with diffuse colonic wall thickening. A pelvic flexure biopsy sample was submitted for histologic examination, which revealed lymphocytic (CD3-positive T cells) myenteric ganglionitis (MG). The horse developed a cecal impaction after surgery, which did not resolve, despite aggressive medical management; subsequently a complete cecal bypass was performed. Cecal and colonic wall biopsy samples were evaluated histologically and confirmed the diagnosis of MG. After surgery, the horse developed a large colon impaction, which initially responded to aggressive medical treatment, and the horse was discharged.

Treatment and Outcome—Despite rigorous feed restrictions and prokinetic and corticosteroid treatment, the horse continued to have signs of colic and was euthanized 3 weeks after discharge from the hospital because of a recurrent large colon impaction. Intestinal biopsy samples obtained at the time of death revealed chronic changes in intramural ganglia consistent with generalized MG.

Clinical Relevance—MG is a rare disease in horses, causing gastrointestinal motility dysfunction and signs of colic, which is challenging to diagnose and treat successfully. Further studies are needed to identify the etiology of this disease and to explore treatment options.

Full access
in Journal of the American Veterinary Medical Association