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) for the assessment of injury in the segment orad to a small intestinal strangulation in naturally occurring disease. The first objective was to describe the microperfusion as well as the mucosal injury, inflammation, and hypoxia inducible factor 1

Open access
in American Journal of Veterinary Research

intestinal obstruction and possible strangulation ( Figure 1 ). Additionally, within the right perineal region, there was a large amount of multiloculated gas and non–contrast-enhanced fluid, consistent with small intestinal perforation. Mild non

Full access
in Journal of the American Veterinary Medical Association

strangulation obstruction was created as previously described 33,34 by applying rubber-shod hemostats across major mesenteric vessels associated with the experimental segment of jejunum. Mural collateral vessels were occluded by application of rubber-shod Doyen

Full access
in American Journal of Veterinary Research

Abstract

Objective—To describe the clinical findings in horses with small intestinal strangulation through mesenteric rents, and to determine the recurrence and survival rates after surgery.

Design—Retrospective study.

Animals—15 horses with small intestinal obstruction via a mesenteric rent.

Procedure—Medical records of horses with obstruction of the small intestine via a mesenteric rent between January 1990 and December 1997 were reviewed. The signalment, history, initial physical examination findings, results of abdominocentesis, and clinical laboratory values were recorded. Surgical findings, including location of the mesenteric rent and surgical procedure performed, were recorded. Shortand long-term survival rates were calculated.

Results—Most mesenteric rents were located in the mesentery of the small intestine (13 horses). Two horses had multiple mesenteric defects. Seven horses were euthanatized at surgery because of an inability to reduce the entrapped intestine (3 horses), uncontrollable hemorrhage (2), inability to close the rent (1), and the amount of compromised intestine involved (1). Seven horses required intestinal resection and anastomosis. The median length of intestine resected was 2.6 m (range, 0.6 to 4.5 m). The mesenteric rents created during resection were not closed in 2 horses. One of these 2 horses subsequently developed a strangulating obstruction through the open rent.

Seven of 15 horses in our study were discharged from the hospital (ie, short-term survival rate of 47% [7/15]). Long-term follow-up information was available for 5 of the 7 horses (follow-up duration of 5 months to 9 years), of which 2 died as a result of colic, and 1 horse was euthanatized because of severe arthritis (ie, long-term survival rate of 40% [2/5]).

Conclusion and Clinical Relevance—Inability to reduce the intestinal obstruction, severe hemorrhage from the mesentery, and the length of intestine involved are the main factors that decrease survival rates in horses with small intestinal strangulation caused by mesenteric rents. (J Am Vet Med Assoc 2000;216:1446–1449).

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To test the hypothesis that strangulation of the small intestine by a lipoma or in the epiploic foramen is more common in older horses.

Design—Retrospective study.

Animals—46 horses.

Procedure—Ages of horses with strangulation of the small intestine by a lipoma (n = 29) or in the epiploic foramen (17) were compared with ages of 79 horses with miscellaneous small intestinal lesions. Effects of increasing age on risk of the diseases of interest were examined by use of logistic regression and a 1-sided trend test for binomial proportions.

Results—Mean age of the horses with strangulation in the epiploic foramen (9.6 years) was the same as that for the horses with miscellaneous small intestinal lesions (7.7), but mean age of the horses with strangulation by a lipoma (19.2) was significantly greater than that for the other groups. The proportion of horses with lipoma increased significantly with increasing age, but the proportion with strangulation in the epiploic foramen did not.

Conclusions and Clinical Relevance—Results refute the current suggestion that increasing age predisposes horses for strangulation of the small intestine in the epiploic foramen but support the suggestion that the risk of strangulation of the small intestine by a lipoma increases with age. (J Am Vet Med Assoc 2001;219:87–89)

Full access
in Journal of the American Veterinary Medical Association

SUMMARY

In 6 anesthetized ponies, 3 segments of jejunum and 3 segments of small colon were isolated from the peritoneal cavity in plastic bags filled with Hanks' balanced salt solution. One jejunal and 1 small colon segment were subjected to venous strangulation obstruction for 3 hours (vso-3), venous strangulation obstruction for 6 hours (vso-6), or a 6-hour sham procedure to control for changes induced by isolation in a plastic bag. Additional segments of jejunum and colon that were not placed in bags served as controls for histologic examination and collagenase measurements. Samples of fluid surrounding the intestine were obtained for chemical analyses, nucleated cell count, aerobic and anaerobic bacteriologic culture, and measurement of collagenase activity. Full-thickness tissue samples were obtained for histologic examination and measurement of collagenase content.

Bacteria did not cross the intestinal wall after 3 and 6 hours of vso, despite severe mucosal lesions in these segments. At 6 hours, Po2 was significantly less and Pco2 was significantly (P<0.05) greater in the fluid surrounding the vso-6 jejunal segments, compared with the sham jejunal segments. The pH was significantly (P<0.05) less in fluid surrounding vso-6 small colon segments, compared with the sham colon segments at 6 hours. For jejunum and small colon, phosphate and lactate concentrations were significantly (P<0.05) greater in vso-6 fluid than in the corresponding sham fluids at 6 hours. Fibrin formed around all vso segments, although fibrinogen was not detected in the surrounding fluid, indicating possible rapid conversion of fibrinogen to fibrin. Fluid collagenase activity increased significantly (P<0.05) in all segments over 6 hours. The preparation used in this study was successful in measuring local changes on the serosal surface of intestine subjected to vso and in isolating segments under study in a sterile environment.

Free access
in American Journal of Veterinary Research

Summary

Diamine oxidase (dao), an enzyme of small intestinal origin, is released from mucosal storage sites by IV administration of heparin, to yield the plasma postheparin dao (phd) curve. The phd curve is diminished when mucosal surface area is lost, and baseline (without heparin) plasma dao activity increases when mucosal storage sites are damaged. Plasma dao activity was measured after 2 doses of heparin were administered iv in healthy, conscious horses. In anesthetized horses, the phd curve was studied: during sham small intestinal surgery, and during venous strangulation obstruction (vso) of the distal 50% of the small intestine. In a third group of anesthetized horses, baseline plasma dao activity (without heparin) was measured during vso of the distal 50% of the small intestine for 90 minutes, followed by reperfusion for 90 minutes.

Postheparin plasma dao curves in conscious horses were similar to those reported in other species. Horses with vso had a similar phd curve as did sham-operated controls at all times, except at 15 minutes, when plasma dao activity was significantly (P < 0.05) greater in the vso group. Horses with vso and reperfusion had no change in baseline plasma dao activity throughout the study. Peritoneal fluid dao activity remained low throughout the study, but increased slightly in horses with vso that received heparin, possibly because of dao from extravasated blood in the peritoneal fluid.

Results indicated that the plasma dao response to iv administered heparin in horses is similar to that in other mammals, but, unlike other species, baseline and postheparin dao activities did not change as expected after small intestinal vascular obstruction and mucosal injury. There may be additional sources of dao in horses, the type of injury induced was not of sufficient magnitude to affect storage sites of dao, or the circulatory changes induced by vso might have altered tissue delivery of heparin.

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

Abstract

Objective

To measure arterial and venous blood gas, coagulation, and fibrinolysis variables in blood from isolated segments of control and ischemic large colons for the purpose of identifying variables for rapid, indirect assessment of colonic mucosal injury.

Design

Variables were determined at specific intervals during the 4-hour study (3 hours of ischemia and 1 hour of reperfusion).

Animals

Seven clinically normal horses between 2 and 15 years old.

Procedure

Horses underwent laparotomy and occlusion of the lumen and vasculature of the mid-portion of the pelvic flexure of the large colon. During ischemia of 1 randomly-chosen colonic segment, variables were measured to determine colonic mucosal damage and were compared with histologic scores of colonic biopsy specimens.

Results

Significant (P < 0.05) differences from control values were observed over time for venous pH, Pco2, Po2, oxygen saturation, oxygen content, arteriovenous oxygen difference, and lactate and glucose concentrations. Mean histologic scores of biopsy specimens obtained from ischemic colons were significantly (P < 0.05) greater (indicating greater damage) than those from control colons, and increased significantly (P < 0.05) with duration of ischemia.

Conclusions

Venous lactate, oxygen saturation, and Po2 values were the most significant predictors of the severity of histologic damage within the ischemic colons (R 2 = 0.661).

Clinical Relevance

Venous blood gas and lactate values in the large colon are good predictors of the amount of intestinal damage incurred during 3 hours of ischemia, and may be clinically useful for the rapid determination of colonic viability.

Free access
in American Journal of Veterinary Research