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Pilati N, Pressanto MC, Beccati F, Pepe M, Venditti R, Gialletti R. Ultrasonographic findings of fluid accumulation and hyperechogenic spots suggestive of surgical site infection following laparotomy for colic in horses. Vet Rec 2024; 194:e4045. [PMID: 38578431 DOI: 10.1002/vetr.4045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/06/2024] [Accepted: 03/01/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND The aim of this study was to compare ultrasonographic findings of the ventral midline incision after exploratory laparotomy for colic in horses with and without surgical site infection (SSI). METHODS Ultrasonographic examination of the surgical wound was performed on postoperative day 5 (D5) and day 10 (D10) to assess the presence of fluid accumulation, suture sinus formation, hyperechogenic spots and fistulous path. Clinical evaluation of the wound was used to classify horses with and without SSI. The accuracy, sensitivity, specificity and positive and negative predictive values of the ultrasonographic findings were then calculated. Multivariable logistic regression analyses were performed with SSI as a dependent variable and age, sex, breed and ultrasonographic findings as independent variables after univariate and collinearity analyses. RESULTS Twenty-nine of the 84 horses examined had an SSI. Detection of fluid accumulation and hyperechogenic spots increased the odds for SSI at D5 (odds ratio [OR]: 4.99, 95% confidence interval [CI]: 1.53-16.33, p = 0.008; OR: 10.78, 95% CI: 1.75-26.59, p = 0.01, respectively) and D10 (OR: 11.51, 95% CI: 2.39-55.47, p = 0.002; OR: 12.34, 95% CI: 3.45-44.15, p < 0.001, respectively). LIMITATION Ultrasonographic images were taken only on the longitudinal section. CONCLUSION Ultrasonographic examination is helpful in evaluating the surgical incision after laparotomy, with the detection of fluid accumulation and hyperechogenic spots surrounding the sutures being strongly related to SSI.
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Affiliation(s)
- Nicola Pilati
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
- School of Biosciences and Veterinary Medicine, University of Camerino, Matelica, Italy
| | - Maria Chiara Pressanto
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
- Cotts Equine Hospital, Narberth, UK
| | - Francesca Beccati
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
- Department of Veterinary Medicine, Sport Horse Research Centre, University of Perugia, Perugia, Italy
| | - Marco Pepe
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
- Department of Veterinary Medicine, Sport Horse Research Centre, University of Perugia, Perugia, Italy
| | - Rossella Venditti
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
| | - Rodolfo Gialletti
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
- Department of Veterinary Medicine, Sport Horse Research Centre, University of Perugia, Perugia, Italy
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Matthews LB, Sanz M, Sellon DC. Long-term outcome after colic surgery: retrospective study of 106 horses in the USA (2014-2021). Front Vet Sci 2023; 10:1235198. [PMID: 37859945 PMCID: PMC10582563 DOI: 10.3389/fvets.2023.1235198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/18/2023] [Indexed: 10/21/2023] Open
Abstract
Objective To determine long-term survival rate, defined as survival to 1 year after discharge from the hospital, and rate of return to prior athletic, breeding, or other function in horses undergoing colic surgery at the first presentation at one referral hospital in the Pacific northwest region of the United States. Procedures Records were reviewed for all horses that underwent colic surgery between October 2014 and October 2021. Owners of horses that survived to discharge were contacted to obtain follow-up information via internet-based questionnaire or telephone interview. The percentage of horses that survived to 1 year after discharge, rates of return to function, and complications occurring after hospital discharge were determined. The possible association of patient signalment, lesion type, and surgical procedures with long-term survival was examined with Chi-square and Fisher's exact tests. Overall satisfaction was indicated on a scale of 1 (unsatisfied) to 5 (very satisfied). Results Of 185 horses that underwent surgical intervention for colic and met the inclusion criteria, 134 horses recovered from anesthesia, with 106 of these recovered horses (79.1%) surviving to discharge. Of the 71 horses for which follow-up information was obtained, 61 horses survived to 1 year after discharge (long-term survival rate of 85.9%). There were no demographic, lesion type, or surgical procedure variables significantly associated with long-term survival. Prior to surgery, 59/71 horses (83.1%) were engaged in some type of athletic activity. After surgery, 44/61 horses (72.1%) were reported to be athletically active. Only one horse was reported to be retired from athletic activity as a direct result of a complication from surgery. Overall satisfaction with the decision to proceed with colic surgery was rated by all respondents as 4 or 5. Conclusions and clinical relevance The long-term survival for this sample of horses was similar to previously published reports of long-term survival after colic surgery. Horses that survived to hospital discharge were highly likely to remain alive and be athletically active 1 year later. There were no factors related to the signalment of the horse, the specific cause of colic, or the surgical procedures performed that were significantly associated with likelihood of survival.
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Affiliation(s)
| | | | - Debra C. Sellon
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, United States
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Patton ME, Andrews FM, Bogers SH, Wong D, McKenzie HC, Werre SR, Byron CR. Effects of Bit Chewing on Gastric Emptying, Small Intestinal Transit, and Orocecal Transit Times in Clinically Normal Horses. Animals (Basel) 2023; 13:2518. [PMID: 37570326 PMCID: PMC10416828 DOI: 10.3390/ani13152518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/26/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
Ileus is a common life-threatening problem in horses, and currently available treatments may be ineffective. The purpose of this study was to determine whether bit chewing, a form of sham feeding, decreases the gastric emptying time (GET), small intestinal transit time (SITT), and total orocecal transit time (OCTT) in clinically normal horses in a prospective crossover study. Nine healthy horses were acclimated and fed a standardized diet. Following 24 h of fasting, self-contained video endoscopy capsules and acetaminophen were administered into the stomach via a nasogastric tube. Each horse underwent experimental (bit chewing for 20 min every 6 h) or control (no bit chewing) conditions, with a 3-week minimum washout period between conditions. The horses were enrolled in either part of the study until all video capsules were retrieved and/or 30 days lapsed. The video capsules were recovered from manure, and GET, SITT, and OCTT were determined from a video analysis. Bit chewing significantly decreased OCTT (p = 0.015) compared to the control conditions. Bit chewing decreased GET and SITT, but the differences were not significant. The mean (median) times determined via the video capsule analysis for the bit-chewing conditions were as follows: GET, 2.34 h (2.86 h); SITT, 3.22 h (3.65 h); and OCTT, 5.13 h (6.15 h), and for the control conditions, they were as follows: GET, 3.93 h (5 h); SITT, 3.79 h (4.4 h); and OCTT, 8.02 h (9.92 h). Bit chewing decreased OCTT in healthy horses. Because this segment of the gastrointestinal tract is frequently affected by ileus, bit chewing may be a safe and inexpensive intervention for that condition in horses. Further investigation in clinical patients with ileus is warranted.
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Affiliation(s)
- Molly E. Patton
- Department of Large Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, 205 Duck Pond Drive, Blacksburg, VA 24061, USA; (M.E.P.); (S.H.B.); (H.C.M.III)
| | - Frank M. Andrews
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA;
| | - Sophie H. Bogers
- Department of Large Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, 205 Duck Pond Drive, Blacksburg, VA 24061, USA; (M.E.P.); (S.H.B.); (H.C.M.III)
| | - David Wong
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, 1800 Christensen Drive, Ames, IW 50011, USA;
| | - Harold C. McKenzie
- Department of Large Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, 205 Duck Pond Drive, Blacksburg, VA 24061, USA; (M.E.P.); (S.H.B.); (H.C.M.III)
| | - Stephen R. Werre
- Laboratory for Study Design and Statistical Analysis, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, 205 Duck Pond Drive, Blacksburg, VA 24061, USA;
| | - Christopher R. Byron
- Department of Large Animal Clinical Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, 205 Duck Pond Drive, Blacksburg, VA 24061, USA; (M.E.P.); (S.H.B.); (H.C.M.III)
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Gandini M, Giusto G. Development of a classification system for equine postoperative complications and its application in a cohort of 190 horses undergoing emergency laparotomy. Vet Rec 2023; 192:e2782. [PMID: 36906909 DOI: 10.1002/vetr.2782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 02/09/2023] [Accepted: 02/14/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND Accurate reporting of postoperative complications is paramount to understanding procedural outcomes, comparing procedures and assuring quality improvement. Standardising definitions of complications in equine surgeries will improve the evidence of their outcomes. To this end, we proposed a classification for postoperative complications and applied it to a cohort of 190 horses undergoing emergency laparotomy. METHODS A classification system for postoperative complications in equine surgery was developed. Medical records of horses that underwent equine emergency laparotomy and recovered from anaesthesia were analysed. Reported complications pre-discharge were classified as per the new classification system, and the cost and days of hospitalisation were correlated with the equine postoperative complication score (EPOCS). RESULTS Of the 190 horses that underwent emergency laparotomy, 14 (7.4%) did not survive to discharge (class 6 complications), and 47 (24.7%) did not develop complications. The remaining horses were classified as follows: 43 (22.6%) had class 1 complications, 30 (15.8%) had class 2, 42 (22%) had class 3, 11 (5.8%) had class 4; and three (1.5%) had class 5. The proposed classification system and EPOCS correlated with the cost and length of hospitalisation. LIMITATIONS This was a single-centre study and the definition of scores was arbitrary. CONCLUSIONS Reporting and grading all complications will help surgeons better understand the patients' postoperative course, thereby reducing subjective interpretation.
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Affiliation(s)
- Marco Gandini
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
| | - Gessica Giusto
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
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Gillen A, Catherine Archer D. Epidemiology of Colic: Current Knowledge and Future Directions. Vet Clin North Am Equine Pract 2023:S0749-0739(23)00017-2. [PMID: 37268523 DOI: 10.1016/j.cveq.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
Epidemiologic studies are essential for the generation of evidence-based, preventive health care strategies. This includes ways to minimize colic risk and assist informed decision making concerning diagnosis, treatment, and likely outcomes. It is important to consider that colic is not a simple "disease" but is a syndrome of abdominal pain that encompasses multiple different disease processes, and which is multifactorial in nature. This review focuses on prevention and diagnosis of colic, including specific forms of colic, communications with owners/carers concerning colic risk and management, and areas of future research.
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Affiliation(s)
- Alexandra Gillen
- Department of Equine Clinical Science, School of Veterinary Sciences, Leahurst Campus, University of Liverpool, Leahurst, Neston, Wirral CH64 7TE, United Kingdom
| | - Debra Catherine Archer
- Department of Equine Clinical Science, School of Veterinary Sciences, Leahurst Campus, University of Liverpool, Leahurst, Neston, Wirral CH64 7TE, United Kingdom.
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Bauck AG. Basic Postoperative Care of the Equine Colic Patient. Vet Clin North Am Equine Pract 2023:S0749-0739(23)00022-6. [PMID: 37120332 DOI: 10.1016/j.cveq.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
The 3 time periods around colic surgery (preoperative, operative, and postoperative) are all critical to successful outcomes. Although much focus is often paid to the first 2 time periods, the importance of sound clinical judgment and rational decision-making in the postoperative period cannot be overstated. This article will outline the basic principles of monitoring, fluid therapy, antimicrobial therapy, analgesia, nutrition, and other therapeutics routinely used in patients following colic surgery. Discussions of the economics of colic surgery and expectations for normal return to function will also be included.
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Affiliation(s)
- Anje G Bauck
- Large Animal Surgery, Department of Large Animal Clinical Sciences, University of Florida College of Veterinary Medicine, University of Florida, 2015 Southwest 16th Avenue, Gainesville, FL 32608, USA.
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Kilcoyne I. When Things Do Not Go As Planned: Update on Complications and Impact on Outcome. Vet Clin North Am Equine Pract 2023:S0749-0739(23)00014-7. [PMID: 37105780 DOI: 10.1016/j.cveq.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Affiliation(s)
- Isabelle Kilcoyne
- Department of Surgical and Radiological Sciences, UC Davis School of Veterinary Medicine, One Shields Avenue, Davis, CA 95616, USA.
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Kelmer G. What do we currently know about incisional complications of colic surgery? EQUINE VET EDUC 2023. [DOI: 10.1111/eve.13763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Gal Kelmer
- Department of Large Animal Medicine and Surgery, Veterinary Teaching Hospital, Koret School of Veterinary Medicine The Hebrew University of Jerusalem Jerusalem Israel
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Iglesias-García M, Rodríguez Hurtado I, Ortiz-Díez G, De la Calle del Barrio J, Fernández Pérez C, Gómez Lucas R. Predictive Models for Equine Emergency Exploratory Laparotomy in Spain: Pre-, Intra-, and Post-Operative-Mortality-Associated Factors. Animals (Basel) 2022; 12:1375. [PMID: 35681838 PMCID: PMC9179522 DOI: 10.3390/ani12111375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 11/16/2022] Open
Abstract
The extrinsic and intrinsic characteristics of an equine population may influence the onset of gastrointestinal lesions and affect the survival rate of patients. The equine population in Spain has been the focus of a small number of studies, none of which have involved more than one surgical center. In this retrospective cohort study, we aimed to analyze the survival rate, identify the variables that influenced death, and generate multivariate models using clinical variables. Data were collected from the clinical records of two surgical referral centers in the same region, and a total of 566 horses met the inclusion criteria. The statistical analysis was divided into three parts: The first and second included logistic analysis, in order to identify the variables most closely associated with survival. The third part assessed all previous variables in terms of survival and hospitalization time, using a COX survival analysis. The main risk factors associated with intra-operative mortality were related to seasonality (winter and summer), patient age (older than 9 years), distance from the hospital, the presence of a strangulating lesion, and the bowel segment affected (small intestine). Furthermore, the main factors associated with mortality during hospitalization were the characteristics of the lesions (strangulating) and the differences between surgical centers. The models generated in this study have good predictive value and use only reliable and easily obtainable variables. The most reliable characteristics are those related to the type of colic and the location of the lesion.
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Affiliation(s)
| | - Isabel Rodríguez Hurtado
- Large Animal Department, Alfonso X el Sabio University, 28691 Madrid, Spain; (I.R.H.); (J.D.l.C.d.B.); (R.G.L.)
| | - Gustavo Ortiz-Díez
- Department of Animal Medicine and Surgery, Complutense University of Madrid, 28040 Madrid, Spain;
| | | | - Cristina Fernández Pérez
- Servicio de Medicina Preventiva, Área de Santiago y Barbanza, Instituto de Investigaciones Sanitarias de Santiago (IDIS), 15706 Santiago de Compostela, Spain;
| | - Raquel Gómez Lucas
- Large Animal Department, Alfonso X el Sabio University, 28691 Madrid, Spain; (I.R.H.); (J.D.l.C.d.B.); (R.G.L.)
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10
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Monteiro FDDO, Borges LPB, Cardoso TDS, Teixeira PPM, Filho DZ, Sartori VC, Pereira RN, Flores FN, Coelho CMM, Silva MAM, Valadão CAA. Animal Model of Video-Assisted Cecum and Ileum Instrumentation for Equine Visceral Pain Study. J Equine Vet Sci 2021; 108:103799. [PMID: 34856499 DOI: 10.1016/j.jevs.2021.103799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 10/20/2022]
Abstract
This study aimed to describe an animal model for studying equine visceral pain using minimally invasive and video-assisted cecum and ileum instrumentation. The access to the cecum and ileum was affected because of a previous typhlostomy. For video-assisted distention of the cecum and ileum, a distention device, which we developed using an endotracheal Rusch probe, was used, adapted, and coupled to a cuffometer to inflate and measure the pressure of the cuff attached to its distal portion. In a video-assisted manner, the distal portion of the device was introduced into the cecum and ileum, which contained the cuff in its distal portion, properly positioning it in the lumen. The cuff of the distension device was insufflated after the measurement of baseline physiological parameters of the animals and video-assisted confirmation of its right placement in the cecum and ileum lumen (M0). Was performed in one moment through two simultaneous cuff compressions and 1 minute of animal observation to evaluate the degree of abdominal discomfort manifestations (M1). To cease these stimuli, the cuff was deflated by disconnecting the extensor of the distension device attached to its proximal portion (M2). The procedure was easily performed in most cases. Slow and progressive insufflation allowed subjective adjustment of the intensity of the pain stimulus based on behavioral manifestations. Even with a low rate of complications, the model is feasible and reproducible for studies on visceral pain and the evaluation of analgesic effects.
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Affiliation(s)
| | - Luisa Pucci Bueno Borges
- Instituto of Veterinary Medicine, Federal University of Pará (UFPA), Campus Castanhal, Castanhal, Pará, Brazil
| | - Thiago da Silva Cardoso
- Instituto of Veterinary Medicine, Federal University of Pará (UFPA), Campus Castanhal, Castanhal, Pará, Brazil
| | - Pedro Paulo Maia Teixeira
- Instituto of Veterinary Medicine, Federal University of Pará (UFPA), Campus Castanhal, Castanhal, Pará, Brazil
| | | | - Vitor Cibiac Sartori
- School of Agricultural and Veterinarian Scienses, Jaboticabal, São Paulo, Brazil
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Patton ME, Leise BS, Baker RE, Andrews FM. The effects of bit chewing on borborygmi, duodenal motility, and gastrointestinal transit time in clinically normal horses. Vet Surg 2021; 51:88-96. [PMID: 34775623 DOI: 10.1111/vsu.13745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 08/12/2021] [Accepted: 10/21/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To determine the influence of bit chewing on gastrointestinal transit in clinically normal horses. STUDY DESIGN Prospective crossover designed study. ANIMALS Six healthy adult horses. METHODS Horses were assigned randomly to treatment (apple flavored bit) and control (no-bit) groups and studied for 2 × 1-week trial periods with a 2-week washout period between trials. Horses were fasted for 24 h and slowly refed over 3 days. The bit was placed for 20 min every 6 h. Duodenal contractions and borborygmi auscultations were evaluated every 12 h, approximately 5 min following bit placement. Gastrointestinal total transit time (GI TTT) was measured by administering 200 colored beads via stomach tube and then collected in the manure until 50% and 80% were recovered. Measured variables were compared using an ANOVA or Wilcoxon signed-rank test and the P value was noted. RESULTS The GI TTT was shortened in the bit chewing group (median: 106.37 h, range: 70-171 h) compared to the no-bit group (median: 170.1 h, range: 149-186 h) (P = .0156) at 80% bead passage (only 4/6 horses passed 80%). Borborygmi (P = .8193), duodenal contractions (P = .2605), and 50% bead passage (P = .0781) showed no differences. CONCLUSION Bit chewing was safe, inexpensive, and well tolerated. Bit chewing shortened GI TTT and might be an adjunct therapy to augment GI TTT. Further clinical studies are warranted. CLINICAL SIGNIFICANCE Ileus is a common complication following equine abdominal surgery with no current consistently successful treatment. Bit chewing may be a simple and inexpensive way to augment progressive GI motility.
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Affiliation(s)
- Molly E Patton
- Equine Health Studies Program, Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Britta S Leise
- Equine Health Studies Program, Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Rose E Baker
- Equine Health Studies Program, Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, USA
| | - Frank M Andrews
- Equine Health Studies Program, Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, Louisiana, USA
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Hann MJ, Mair TS, Gardner A, Mudge M, Southwood LL, Dechant JE, Barton MH, Garcia-Macias J, Parker RA, Hassel D, Archer DC. Acute abdominal dehiscence following laparotomy: A multicentre, international retrospective study. Equine Vet J 2021; 54:719-725. [PMID: 34418125 DOI: 10.1111/evj.13498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/09/2021] [Accepted: 08/19/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Incisional complications are a common cause of morbidity following laparotomy. Although uncommon, acute abdominal dehiscence (AAD) is a potentially fatal post-operative complication. However, few AAD cases are described in the literature. OBJECTIVES To describe common features of cases of AAD following ventral midline laparotomy, management and outcomes. STUDY DESIGN Retrospective case series. METHODS Hospital records of horses that underwent a ventral midline laparotomy at nine hospitals in the UK, Ireland and USA over a 10-year period (2009-2019) were reviewed. Data were collected for pre-, intra- and post-operative factors that were considered relevant. Descriptive statistical analysis was performed. RESULTS A total of 63 cases of AAD were identified. AAD occurred due to tearing of sutures through the linea alba or rupture of the body wall adjacent to the suture line in 46 horses (73%). AAD occurred at a median of 5 days (0.5-70 days) post-operatively and broodmares accounted for 25% of the cases (n = 16). Surgical site infection developed prior to AAD in 28 horses (44%); leakage of peritoneal fluid occurred in 5% of horses prior to AAD being identified. Surgical repair was performed in 27 horses (43%), 10 (16%) were treated conservatively and 26 (41%) were euthanised immediately. Repair was most frequently performed using suture (n = 14), wire (n = 5) or a combination (n = 5). Overall survival to hospital discharge was 39% (24/63). Where surgical repair was performed, 15 horses (56%) survived to hospital discharge; 9 horses (90%) managed conservatively survived to hospital discharge. MAIN LIMITATIONS Follow-up was not performed for all cases following hospital discharge and some data were incompletely recorded in hospital files. CONCLUSIONS Previously stated causative factors for AAD were not consistent features in the present study. Surgical site infection following laparotomy and pregnant or early post-partum mares may be important risk factors for AAD and warrant further investigation.
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Affiliation(s)
- Michelle J Hann
- Department of Equine Clinical Science, Institute of Veterinary Science, University of Liverpool, Leahurst Campus, Neston, UK
| | - Tim S Mair
- Bell Equine Veterinary Clinic, Maidstone, UK
| | - Alison Gardner
- Department of Veterinary Clinical Sciences, Ohio State University, Columbus, Ohio, USA
| | - Margaret Mudge
- Department of Veterinary Clinical Sciences, Ohio State University, Columbus, Ohio, USA
| | - Louise L Southwood
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania, USA
| | - Julie E Dechant
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, California, USA
| | - Michelle H Barton
- University of Georgia College of Veterinary Medicine, Athens, Georgia, USA
| | | | | | - Diana Hassel
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Debbie C Archer
- Department of Equine Clinical Science, Institute of Veterinary Science, University of Liverpool, Leahurst Campus, Neston, UK
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13
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Weatherall KM, Boone LH, Munsterman A, Hanson RR. Ex vivo comparison of the bursting strength of an equine ventral midline celiotomy covered by two standard abdominal bandages. Vet Surg 2021; 50:615-621. [PMID: 33528048 DOI: 10.1111/vsu.13572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 11/09/2020] [Accepted: 12/11/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To determine the compressive effect of abdominal bandages after ventral midline celiotomy closure in horses. STUDY DESIGN Ex vivo, experimental study. ANIMALS Equine cadavers (n = 18), six per group. METHODS A 20-cm ventral midline celiotomy was created in each of 18 equine cadavers. A 200-L inflatable bladder was placed in the abdomen, and the linea alba was apposed. Horses were randomly assigned to no bandage (C), elastic (E), or Velcro inelastic (I) bandage groups for testing. Circumferential bandages were placed with a subbandage pressure monitoring system over the incision. The bladder was insufflated until construct failure, which was determined by a decrease in pressure reading. Bursting pressure, location of body wall or bandage failure, and subbandage pressures were recorded. RESULTS Maximum bursting pressure was different between groups E and C (P = .004), with no difference between groups E and I (P = .146) or I and C (P = .085). Group I achieved higher subbandage pressure compared with group E (P = .036). Abdominal compliance was not different between groups (P = .099). Location of failure differed between groups (P = .011), with failure at the diaphragm more common in group I (6/6, 100%) compared with groups E (3/6 [50%]) and C (1/6 [16.7%]). CONCLUSION Elastic abdominal bandages had higher abdominal bursting pressures compared with unbandaged incisions.
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Affiliation(s)
- Kathleen M Weatherall
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
| | - Lindsey H Boone
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
| | - Amelia Munsterman
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - R Reid Hanson
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
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14
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Aitken MR. Clinical insights: Update on colic. Equine Vet J 2021; 53:6-8. [PMID: 33345359 DOI: 10.1111/evj.13347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 08/27/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Maia R Aitken
- University of Pennsylvania New Bolton Center - Clinical Studies, Pennsylvania, USA
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15
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Lightfoot KL, Burford JH, England GCW, Bowen IM, Freeman SL. Mixed methods investigation of the use of telephone triage within UK veterinary practices for horses with abdominal pain: A Participatory action research study. PLoS One 2020; 15:e0238874. [PMID: 32966300 PMCID: PMC7510986 DOI: 10.1371/journal.pone.0238874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 08/25/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Telephone triage is an integral part of modern patient care systems in human medicine, and a key component of veterinary practice care systems. There is currently no published research on telephone triage within the veterinary profession. OBJECTIVE To investigate current approaches to telephone triage of horses with abdominal pain (colic) in veterinary practice and develop new resources to support decision-making. STUDY DESIGN Participatory action research using mixed-methods approach. METHODS An online survey assessed current approaches to telephone triage of horses with colic in UK veterinary practices. Structured group and individual interviews were conducted with four equine client care (reception) teams on their experiences around telephone triage of colic. Evidence-based resources, including an information pack, decision flow chart and recording form, were developed and implemented within the practices. Participant feedback was obtained through interviews six months after implementation of the resources. RESULTS There were 116 participants in the online survey. Management and client care staff (53/116) felt less confident giving owner advice (p<0.01) and recognising critical indicators (p = 0.03) compared to veterinary surgeons and nurses (63/116). Thirteen themes were identified in the survey relating to owner advice; exercise and owner safety were most frequently mentioned, but conflicting guidance was often given. Fourteen client care staff were interviewed. They were confident recognising colic during a telephone conversation with an owner and identified the most common signs of critical cases as sweating and recumbency. The new resources received positive feedback; the decision flow chart and information on critical indicators were identified as most useful. After resource implementation, there was an increase in confidence in recognising critical cases and giving owners advice. MAIN LIMITATIONS Limited sample population. CONCLUSIONS This study described existing approaches to telephone triage, identified variations in advice given, and worked with client care teams to develop new resources to aid decision-making.
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Affiliation(s)
- Katie L. Lightfoot
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, Leicestershire, United Kingdom
| | - John H. Burford
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, Leicestershire, United Kingdom
| | - Gary C. W. England
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, Leicestershire, United Kingdom
| | - I. Mark Bowen
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, Leicestershire, United Kingdom
| | - Sarah L. Freeman
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, Leicestershire, United Kingdom
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16
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Salciccia A, de la Rebière de Pouyade G, Gougnard A, Detilleux J, Caudron I, Verwilghen D, Serteyn D, Grulke S. Complications associated with closure of the linea alba using a combination of interrupted vertical mattress and simple interrupted sutures in equine laparotomies. Vet Rec 2020; 187:e94. [PMID: 32862134 DOI: 10.1136/vr.105855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 06/05/2020] [Accepted: 07/07/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES (1) Evaluate the occurrence and variables associated with incisional morbidities (IMs) after ventral median laparotomy when using interrupted vertical mattress sutures (IVMS) and (2) determine the occurrence of abdominal bandage-associated complications in horses. METHODS Occurrence of IM and bandage-associated complications were determined after single laparotomies (SL group; n=546 horses) and repeat laparotomies (RL group: multiple laparotomies within four weeks; n=30 horses) in horses that survived ≥7 days postoperatively. Univariate analysis and multivariate logistic regression were performed to evaluate variables associated with IM. RESULTS The IM rate was 9.52 per cent in the SL group and 33.33 per cent in the RL group. The actual infection rate was 5.31 per cent in the SL group and 26.67 per cent in the RL group. Overall, long-term clinically relevant wound complications was 1.68 per cent. After multivariate analysis, increased anaesthesia duration was associated with IM and performing an enterotomy and postoperative intravenous lidocaine administration were associated with incisional infection in the SL group; no parameter remained significant in the RL group. Bandage-related complications were recorded in 2.95 per cent of the cases. CONCLUSIONS These results suggest that the use of IVMS for closure of the linea alba is another viable option for closure and that an abdominal bandage does not appear to cause significant complications.
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Affiliation(s)
- Alexandra Salciccia
- Department of Companion Animals and Equids, University of Liege, Faculty of Veterinary Medicine, Liege, Belgium
| | | | - Alexandra Gougnard
- Department of Companion Animals and Equids, University of Liege, Faculty of Veterinary Medicine, Liege, Belgium
| | - Johann Detilleux
- Quantitative Genetics Group, University of Liege, Faculty of Veterinary Medicine, Liege, Belgium
| | - Isabelle Caudron
- Department of Companion Animals and Equids, University of Liege, Faculty of Veterinary Medicine, Liege, Belgium
| | - Denis Verwilghen
- Department of Companion Animals and Equids, University of Liege, Faculty of Veterinary Medicine, Liege, Belgium
| | - Didier Serteyn
- Department of Companion Animals and Equids, University of Liege, Faculty of Veterinary Medicine, Liege, Belgium
| | - Sigrid Grulke
- Department of Companion Animals and Equids, University of Liege, Faculty of Veterinary Medicine, Liege, Belgium
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17
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Weatherall KM, Boone LH, Caldwell FJ, Cole RC, Cattley RC, Lascola KM, Clark-Price SC, Farag R, Perkins E, Hanson RR. Tensile strength and early healing of self-locking and surgeon's knots. Vet Surg 2020; 49:1580-1589. [PMID: 32780444 DOI: 10.1111/vsu.13497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 06/07/2020] [Accepted: 07/11/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the biomechanical properties and healing of ventral midline celiotomies (VMC) closed with a self-locking knot combination and forwarder start and Aberdeen end (F-A) vs a traditional knot combination and surgeon's start and end (S-S). STUDY DESIGN In vivo, experimental. ANIMALS Twenty-one horses. METHODS Fourteen horses underwent VMC, which was closed with either an F-A (n = 7) or an S-S (n = 7) knot combination. Incisions were subjectively graded by masked evaluators for dehiscence, edema, and drainage. Biomechanical testing was performed on three abdominal segments, and histology was performed on one segment from each animal after humane euthanasia 10 days post-VMC. The abdominal wall of control horses (n = 7, no celiotomy) was collected for biomechanical testing. RESULTS Forwarder start and Aberdeen end and S-S horses had less tensile strength compared with control horses (P ≤ .001). No differences were detected between treatment groups for any variable evaluated, including tensile strength (P = .975), location of failure (P = .240), and histologic healing at the knot (P = .600). CONCLUSION Closure of VMC with self-locking knots resulted in biomechanical and healing features similar to those with a traditional closure technique, with neither restoring the tensile strength of the linea alba. CLINICAL SIGNIFICANCE Results of this study provide evidence to support a clinical trial to evaluate long-term performance of the F-A self-locking knot closure in horses.
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Affiliation(s)
- Kathleen M Weatherall
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
| | - Lindsey H Boone
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
| | - Fred J Caldwell
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
| | - Robert C Cole
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
| | - Russell C Cattley
- Department of Pathobiology, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
| | - Kara M Lascola
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
| | - Stuart C Clark-Price
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
| | - Ramsis Farag
- Center for Polymer and Advanced Composites, Auburn University Samuel Ginn College of Engineering, Auburn, Alabama, USA.,Department of Textile Engineering, Mansoura University, Mansoura, Egypt
| | - Edmon Perkins
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina, USA
| | - R Reid Hanson
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, USA
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18
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Salem SE, Maddox TW, Antczak P, Ketley JM, Williams NJ, Archer DC. Acute changes in the colonic microbiota are associated with large intestinal forms of surgical colic. BMC Vet Res 2019; 15:468. [PMID: 31864369 PMCID: PMC6925886 DOI: 10.1186/s12917-019-2205-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/03/2019] [Indexed: 02/06/2023] Open
Abstract
Background Horses that undergo surgery for treatment of primary large colon disease have been reported to be at increased risk of developing recurrent colic episodes postoperatively. The reasons for this are currently unknown. The aim of the current study was to characterise the faecal microbiota of horses with colic signs associated with primary large colon lesions treated surgically and to compare the composition of their faecal microbiota to that of a control group of horses undergoing emergency orthopaedic treatment. Faecal samples were collected from horses in both groups on admission to hospital, during hospitalisation and following discharge from hospital for a total duration of 12 weeks. Additionally, colonic content samples were collected from surgical colic patients if pelvic flexure enterotomy was performed during laparotomy. A total of 12 samples were collected per horse. DNA was extracted from samples using a commercial kit. Amplicon mixtures were created by PCR amplification of the V1 – V2 regions of the bacterial 16S rRNA genes and submitted for sequencing using the Ion Torrent PGM next-generation sequencing system. Multivariate data analysis was used to characterise the faecal microbiota and to investigate differences between groups. Results Reduced species richness was evident in the colonic samples of the colic group compared to concurrent sampling of the faeces. Alpha and beta diversity differed significantly between the faecal and colonic microbiota with 304 significantly differentially abundant OTUs identified. Only 46 OTUs varied significantly between the colic and control group. There were no significant differences in alpha and beta diversity of faecal microbiota between colic and control horses at admission. However, this lack of significant differences between groups should be interpreted with caution due to a small sample size. Conclusions The results of the current study suggest that faecal samples collected at hospital admission in colic cases may not accurately represent changes in upper gut microbiota in horses with colic due to large colon disease.
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Affiliation(s)
- Shebl E Salem
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Leahurst Campus, Wirral, CH64 7TE, UK.,Department of Surgery, Faculty of Veterinary Medicine, Zagazig University, Zagazig, 44519, Egypt
| | - Thomas W Maddox
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Leahurst Campus, Wirral, CH64 7TE, UK
| | - Philipp Antczak
- Computational Biology Facility, Institute of Integrative Biology, University of Liverpool, Liverpool, L69 7ZB, UK
| | - Julian M Ketley
- Department of Genetics and Genome Biology, College of Life Sciences, University of Leicester, Leicester, LE1 7RH, UK
| | - Nicola J Williams
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Leahurst Campus, Wirral, CH64 7TE, UK
| | - Debra C Archer
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Leahurst Campus, Wirral, CH64 7TE, UK.
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19
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Lawson AL, Sherlock CE, Mair TS. Equine duodenal motility, assessed by ultrasonography, as a predictor of reflux and survival following colic surgery. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - T. S. Mair
- Bell Equine Veterinary Clinic Maidstone Kent UK
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20
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Affiliation(s)
- Debra C Archer
- Philip Leverhulme Equine Hospital, University of Liverpool, Neston, UK
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21
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Cappelli K, Gialletti R, Tesei B, Bassotti G, Fettucciari K, Capomaccio S, Bonfili L, Cuccioloni M, Eleuteri AM, Spaterna A, Laus F. Guanylin, Uroguanylin and Guanylate Cyclase-C Are Expressed in the Gastrointestinal Tract of Horses. Front Physiol 2019; 10:1237. [PMID: 31611814 PMCID: PMC6776823 DOI: 10.3389/fphys.2019.01237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 09/09/2019] [Indexed: 12/12/2022] Open
Abstract
Guanylate cyclase-C (GC-C) is a multifunctional receptor encoded by the GUCY2C gene, representing an attractive target for therapy in several gastrointestinal diseases in humans. Little is known about this system in horses. We investigated for the first time the gene expression of guanylin, uroguanylin and GC-C receptors in different horse’s gastrointestinal tracts. Tissue samples from stomach, duodenum, jejunum, ileum, head and body of cecum, left and right dorsal colon, left and right ventral colon, pelvic flexure, transverse colon, descending colon and rectum were collected from adult horses within 1 h post mortem. For each sample, total RNA was extracted from 100 mg of ground tissue, and qRT-PCR performed on GUCA2a, GUCA2b and GUCY2 transcripts on a CFX96 Touch instrument. Data analysis was carried out with Bio-Rad CFX Manager software, and genes of interest normalized relative to the abundance of the two reference genes (SDHA, HPRT). Additionally, the protein expression levels of GC-C receptor were analyzed through western blotting. A common pattern of expression throughout the gastrointestinal lumen for all three investigated transcripts was found. The expression of GUCA2a, GUCA2b and GUCY2 genes was higher in jejunum, ileum, descending colon and rectum. The levels of expression of GC-C protein confirmed these data. The findings of this study might open new scenarios for the therapeutic approach to enteric diseases of horse using selective agonists of GC-C.
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Affiliation(s)
- Katia Cappelli
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - Rodolfo Gialletti
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - Beniamino Tesei
- School of Biosciences and Veterinary Medicine, University of Camerino, Camerino, Italy
| | - Gabrio Bassotti
- Department of Medicine, School of Medicine, University of Perugia, Perugia, Italy
| | - Katia Fettucciari
- Department of Experimental Medicine, School of Medicine, University of Perugia, Perugia, Italy
| | - Stefano Capomaccio
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - Laura Bonfili
- School of Biosciences and Veterinary Medicine, University of Camerino, Camerino, Italy
| | | | - Anna Maria Eleuteri
- School of Biosciences and Veterinary Medicine, University of Camerino, Camerino, Italy
| | - Andrea Spaterna
- School of Biosciences and Veterinary Medicine, University of Camerino, Camerino, Italy
| | - Fulvio Laus
- School of Biosciences and Veterinary Medicine, University of Camerino, Camerino, Italy
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22
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Cullen MD, Archer DC, Mair TS. Clinical audit in equine practice, and the International Colic Surgery Audit. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M. D. Cullen
- School of Veterinary Science Philip Leverhulme Equine Hospital Neston Cheshire UK
| | - D. C. Archer
- School of Veterinary Science Philip Leverhulme Equine Hospital Neston Cheshire UK
| | - T. S. Mair
- Bell Equine Veterinary Clinic Mereworth, Maidstone Kent UK
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23
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Gardner A, Dockery A, Quam V. Exploratory Celiotomy in the Horse Secondary to Acute Colic: A Review of Indications and Success Rates. Top Companion Anim Med 2019; 34:1-9. [PMID: 30808489 DOI: 10.1053/j.tcam.2018.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 11/06/2018] [Accepted: 11/07/2018] [Indexed: 11/11/2022]
Abstract
To review indications and risk factors for exploratory celiotomy secondary to acute colic in the horse; decision making for and during surgery; and prognosis for return to function after exploratory celiotomy for the practicing veterinarian. Data sources included scientific reviews and original research publications from veterinary sources, as well as clinical data specifically in regard to underlying disease and survival rates from a tertiary referral hospital where exploratory celiotomy is commonly performed. There is a high positive predictive value of specific clinical preoperative parameters of the equine acute abdomen, many of which rely on techniques available to field practitioners, relative to the need for surgical intervention. Decision making regarding surgical procedure or even intraoperative euthanasia depends on owner expectations. Survival rates following exploratory celiotomy range from fair to excellent (60%-100%) depending on underlying lesion and return to athleticism following celiotomy is good to excellent (76%-90%). A knowledge base of indications for and rates of survival from colic requiring exploratory celiotomy in the horse is of paramount importance to the equine practitioner. Preconceived notions of poor survival rates are rampant among horse owners, and owners rely on their primary veterinarian's advice for continuation to referral center and in further treatment including exploratory celiotomy.
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24
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Bergen T, Haspeslagh M, Wiemer P, Swagemakers M, van Loon G, Martens A. Surgical treatment of epiploic foramen entrapment in 142 horses (2008–2016). Vet Surg 2019; 48:291-298. [DOI: 10.1111/vsu.13161] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 12/05/2018] [Accepted: 12/15/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Thomas Bergen
- Department of Surgery and Anesthesiology of Domestic Animals, Faculty of Veterinary MedicineGhent University Merelbeke Belgium
- Clinique Equine d'Acy‐Romance Acy‐Romance France
| | - Maarten Haspeslagh
- Department of Surgery and Anesthesiology of Domestic Animals, Faculty of Veterinary MedicineGhent University Merelbeke Belgium
| | - Peter Wiemer
- Department of Surgery and Anesthesiology of Domestic Animals, Faculty of Veterinary MedicineGhent University Merelbeke Belgium
- De Lingehoeve Diergeneeskunde Lienden The Netherlands
| | - Michaël Swagemakers
- Department of Surgery and Anesthesiology of Domestic Animals, Faculty of Veterinary MedicineGhent University Merelbeke Belgium
| | - Gunther van Loon
- Department of Large Animal Internal Medicine, Faculty of Veterinary MedicineGhent University Merelbeke Belgium
| | - Ann Martens
- Department of Surgery and Anesthesiology of Domestic Animals, Faculty of Veterinary MedicineGhent University Merelbeke Belgium
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25
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Scharner D, Gittel C, Winter K, Blaue D, Schedlbauer C, Vervuert I, Brehm W. Comparison of incisional complications between skin closures using a simple continuous or intradermal pattern: a pilot study in horses undergoing ventral median celiotomy. PeerJ 2018; 6:e5772. [PMID: 30430040 PMCID: PMC6231425 DOI: 10.7717/peerj.5772] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 09/17/2018] [Indexed: 11/28/2022] Open
Abstract
Background Development of incisional complications following ventral median celiotomy might depend on suture pattern for skin closure. Methods In this prospective study, 21 healthy male horses underwent celiotomy. Skin closure was either performed via a continuous percutaneous pattern (CO group; 5 warmbloods/5 ponies) or an intradermal pattern (ID group; 5 warmbloods/6 ponies). Follow-up examination of the incisional site included daily monitoring for edema, dehiscence, and drainage. Transcutaneous ultrasound was performed at Days 3, 6, and 10 as well as on Week 8 and 12 to evaluate size of edema and presence or absence of sinus formation, and hernia formation. Prevalence of incisional infection on base of positive microbiological analysis at any time up to Day 10 was evaluated and compared between ID and CO group. Furthermore, edema size was analysed by a linear mixed-effect model for group and time dependency. Results Observed incisional complications included edema (9/10 in CO, 10/11 in ID), suture sinus formation (2/10 in CO, 1/11 in ID), surgical site infection (2/10 in CO, 0/11 in ID), and incisional hernia (1/10 in CO, 0/11 in ID). The overall prevalence of incisional infection was 9.5% without significant differences between both groups (20% in CO, 0% in ID; p = 0.214). Edema size was not dependent on time or group (p = 0.545 and p = 0.627, respectively). Discussion CO and ID suture pattern are appropriate for skin closure following ventral median celiotomy in horses. None of the animals in the continuous ID group developed surgical site infections, even without the use of antibiotics.
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Affiliation(s)
- Doreen Scharner
- Department for Horses, University of Leipzig, Leipzig, Germany
| | - Claudia Gittel
- Department for Horses, University of Leipzig, Leipzig, Germany
| | - Karsten Winter
- Institute of Anatomy, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Dominique Blaue
- Institute of Animal Nutrition, Nutrition Diseases and Dietetics, University of Leipzig, Leipzig, Germany
| | - Carola Schedlbauer
- Institute of Animal Nutrition, Nutrition Diseases and Dietetics, University of Leipzig, Leipzig, Germany
| | - Ingrid Vervuert
- Institute of Animal Nutrition, Nutrition Diseases and Dietetics, University of Leipzig, Leipzig, Germany
| | - Walter Brehm
- Department for Horses, University of Leipzig, Leipzig, Germany
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26
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Ziegler AL, Freeman CK, Fogle CA, Burke MJ, Davis JL, Cook VL, Southwood LL, Blikslager AT. Multicentre, blinded, randomised clinical trial comparing the use of flunixin meglumine with firocoxib in horses with small intestinal strangulating obstruction. Equine Vet J 2018; 51:329-335. [PMID: 30156312 DOI: 10.1111/evj.13013] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 08/21/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND Small intestinal strangulating obstruction (SISO) is associated with endotoxaemia which leads to an increased risk of death. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used to treat signs of endotoxaemia by inhibiting cyclo-oxygenases (COX). COX-1 is expressed constitutively and promotes gut barrier function, whereas COX-2 is inducible and contributes to the signs of endotoxaemia. In preclinical SISO trials, intestinal barrier recovery was more complete with reductions in endotoxin permeability in horses treated with COX-2 selective NSAIDs as compared with horses treated with flunixin meglumine. OBJECTIVES We hypothesised that treatment of post-surgical SISO horses with firocoxib (COX-2 selective) would reduce the signs of endotoxaemia to a greater extent than flunixin meglumine (nonselective COX inhibitor) while continuing to provide similar levels of pain control. STUDY DESIGN Blinded randomised clinical trial. METHODS In addition to clinical monitoring, preoperative and 12-, 24- and 48-h post-operative plasma samples were assessed for prostaglandin E2 (PGE2 ), thromboxane B2 (TXB2 ), TNF⍺ and soluble CD14 (sCD14). RESULTS In 56 recruited SISO horses, either flunixin meglumine (1.1 mg/kg, i.v., q12h) or firocoxib (0.3 mg/kg, i.v. loading dose; 0.1 mg/kg, i.v., q24h) was given in the post-operative period in three university hospitals from 2015 to 2017. COX-2 selectivity was confirmed by a relative lack of inhibition of the COX-1 prostanoid TXB2 by firocoxib and significant inhibition by flunixin meglumine (P = 0.014). Both drugs inhibited the COX-2 prostanoid PGE2 . There were no significant differences in pain scores between groups (P = 0.2). However, there was a 3.23-fold increased risk (P = 0.04) of increased plasma sCD14 in horses treated with flunixin meglumine, a validated biomarker of equine endotoxaemia. MAIN LIMITATIONS Horses were all treated with flunixin meglumine prior to referral. In addition, many horses were treated with lidocaine, which has been shown to mitigate the deleterious effects of flunixin meglumine. CONCLUSIONS In SISO cases, firocoxib reduced a biomarker of endotoxaemia as compared with flunixin meglumine while continuing to provide similar levels of pain control.
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Affiliation(s)
- A L Ziegler
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - C K Freeman
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - C A Fogle
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - M J Burke
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - J L Davis
- Department of Biomedical Sciences and Pathobiology, Virginia Tech, Blacksburg, Virginia, USA
| | - V L Cook
- Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, Michigan, USA
| | - L L Southwood
- Department of Clinical Studies, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - A T Blikslager
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
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27
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Li X, Zou B, Zhao N, Wang C, Du Y, Mei L, Wang Y, Ma S, Tian X, He J, Tong A, Zhou L, Han B, Guo G. Potent Anti-adhesion Barrier Combined Biodegradable Hydrogel with Multifunctional Turkish Galls Extract. ACS APPLIED MATERIALS & INTERFACES 2018; 10:24469-24479. [PMID: 29974740 DOI: 10.1021/acsami.8b10668] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Xiaoling Li
- State Key Laboratory of Biotherapy and Cancer Center, and Department of Neurosurgery, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu 610041, P. R. China
| | - Bingwen Zou
- State Key Laboratory of Biotherapy and Cancer Center, and Department of Neurosurgery, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu 610041, P. R. China
| | - Na Zhao
- School of Pharmacy, Shihezi University, and Key Laboratory of Xinjiang Phytomedicine Resource and Utilization, Ministry of Education, Shihezi 832002, P. R. China
| | - Chao Wang
- National Engineering Research Center for Synthesis of Novel Rubber and Plastic Materials, Yanshan Branch, Beijing Research Institute of Chemical Industry, SINOPEC, Beijing 102500, P. R. China
| | - Ying Du
- National Engineering Research Center for Synthesis of Novel Rubber and Plastic Materials, Yanshan Branch, Beijing Research Institute of Chemical Industry, SINOPEC, Beijing 102500, P. R. China
| | - Lan Mei
- State Key Laboratory of Biotherapy and Cancer Center, and Department of Neurosurgery, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu 610041, P. R. China
| | - Yuelong Wang
- State Key Laboratory of Biotherapy and Cancer Center, and Department of Neurosurgery, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu 610041, P. R. China
| | - Shangzhi Ma
- School of Pharmacy, Shihezi University, and Key Laboratory of Xinjiang Phytomedicine Resource and Utilization, Ministry of Education, Shihezi 832002, P. R. China
| | - Xing Tian
- School of Pharmacy, Shihezi University, and Key Laboratory of Xinjiang Phytomedicine Resource and Utilization, Ministry of Education, Shihezi 832002, P. R. China
| | - Jun He
- State Key Laboratory of Biotherapy and Cancer Center, and Department of Neurosurgery, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu 610041, P. R. China
| | - Aiping Tong
- State Key Laboratory of Biotherapy and Cancer Center, and Department of Neurosurgery, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu 610041, P. R. China
| | - Liangxue Zhou
- State Key Laboratory of Biotherapy and Cancer Center, and Department of Neurosurgery, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu 610041, P. R. China
| | - Bo Han
- School of Pharmacy, Shihezi University, and Key Laboratory of Xinjiang Phytomedicine Resource and Utilization, Ministry of Education, Shihezi 832002, P. R. China
| | - Gang Guo
- State Key Laboratory of Biotherapy and Cancer Center, and Department of Neurosurgery, West China Hospital, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu 610041, P. R. China
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Isgren CM, Salem SE, Townsend NB, Timofte D, Maddox TW, Archer DC. Sequential bacterial sampling of the midline incision in horses undergoing exploratory laparotomy. Equine Vet J 2018; 51:38-44. [PMID: 29679416 PMCID: PMC6585715 DOI: 10.1111/evj.12958] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 03/31/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is limited information about bacterial isolates that are present on the equine midline incision during and following exploratory laparotomy. OBJECTIVES To investigate the bacterial species cultured from the ventral midline pre-, intra- and post- laparotomy, whether particular bacterial isolates are associated with the development of surgical site infections (SSIs) and to report the antimicrobial resistance phenotypes of these isolates. STUDY DESIGN Prospective cohort study. METHODS The ventral midline of 31 horses undergoing exploratory laparotomy was sampled for bacterial culture at set time-points pre, intra and post-operatively. Inclusion criteria were that horses must have undergone exploratory laparotomy within 90 min of the initial colic examination upon hospital admission and must not have been placed in a stable prior to surgery. SSI was defined as any purulent or serous discharge from the laparotomy incision of >24 h duration. RESULTS Seven horses (22.6%) developed a SSI. None of the variables tested were associated with the altered risk of SSI. The prevalence of a positive bacterial culture from the incision increased progressively over time and a variety of bacteria were isolated. A positive intra-operative culture was not a predictor of SSI; and when a SSI did occur, it was due to a different bacterial isolate. MRSA and ESBL-producers were identified in the post-operative period in one and four different horses respectively, but none of these developed a SSI. MAIN LIMITATIONS Sampling was limited to hospitalisation and no culture results were available for horses developing SSI following hospital discharge. CONCLUSIONS A variety of bacterial species may be isolated from equine laparotomy incisions peri-operatively without development of SSI. SSI does not appear to be solely related to bacterial contamination of the incision peri-operatively and other mechanisms such as bacteraemia merit further investigation.
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Affiliation(s)
- C M Isgren
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Leahurst, UK.,Department of Equine Clinical Science, Institute of Veterinary Science, University of Liverpool, Leahurst, UK
| | - S E Salem
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Leahurst, UK.,Department of Surgery, Faculty of Veterinary Medicine, Zagazig University, Zakazik, Egypt
| | - N B Townsend
- Three Counties Equine Hospital, Stratford Bridge, Ripple, Tewkesbury, UK
| | - D Timofte
- Institute of Veterinary Science, University of Liverpool, Leahurst, UK.,Institute of Infection and Global Health, University of Liverpool, Leahurst, UK
| | - T W Maddox
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Leahurst, UK
| | - D C Archer
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Leahurst, UK.,Department of Equine Clinical Science, Institute of Veterinary Science, University of Liverpool, Leahurst, UK
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Broyles AH, Hopper SA, Woodie JB, Ruggles AJ. Clinical outcomes after colopexy through left ventral paramedian incision in 156 thoroughbred broodmares with large colon disorders (1999-2015). Vet Surg 2018; 47:490-498. [DOI: 10.1111/vsu.12791] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 07/22/2017] [Accepted: 07/31/2017] [Indexed: 11/28/2022]
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30
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Freeman DE. Fifty years of colic surgery. Equine Vet J 2018; 50:423-435. [DOI: 10.1111/evj.12817] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 12/05/2017] [Accepted: 01/10/2018] [Indexed: 12/21/2022]
Affiliation(s)
- D. E. Freeman
- Department of Large Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville Florida USA
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31
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Gitari A, Nguhiu J, Varma V, Mogoa E. Occurrence, treatment protocols, and outcomes of colic in horses within Nairobi County, Kenya. Vet World 2017; 10:1255-1263. [PMID: 29184373 PMCID: PMC5682272 DOI: 10.14202/vetworld.2017.1255-1263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 09/15/2017] [Indexed: 11/16/2022] Open
Abstract
Aim: The aim of this study was to determine the treatments and their outcomes in horses with colic in Nairobi County, Kenya. Materials and Methods: This is a retrospective study to determine the occurrence, treatments, pain management, and outcomes of colic in horses in Nairobi County. Association between pain management protocols and the outcomes of colic with regard to recovery or death was also determined. Data collected from four equine practitioners were organized manually and given numerical codes as appropriate to facilitate entry into the computer. The coded data were entered into Microsoft Excel 2010 and exported to StatPlus pro 5.9.8 statistical package for analysis. Simple association tests were done between various factors and occurrence of colic. Results: The incidence of colic for the 11 years was 3.1%, which constituted 68.0% spasmodic colic, 27.8% impaction colic, and 4.2% displacement colic. Flunixin meglumine as a nonsteroidal anti-inflammatory drug (NSAID) was used as the only pain management treatment in 85.3% of the cases, flunixin meglumine and butorphanol as NSAID-OPIOD combination in 6.4% of the cases, while buscopan as an antispasmodic was recorded in 5.9% of the cases mainly in spasmodic colic. Univariate analysis revealed simple association between various factors and the type of colic a horse was having. There was an association between the type of colic and the decision-making on the pain management protocol to use, whether single analgesic protocol (χ2=22.5, p<0.001) or use of analgesic combinations (χ2=18.3, p<0.001). The type of colic strongly influenced the decision for performing nasogastric intubation (χ2=265, p<0.001), but performing nasogastric intubation was weakly (χ2=4.9, p=0.03) associated with horse recovery from colic. Type of colic also strongly influenced the need for the use of metabolic stimulants, particularly vitamin B-complex (χ2=99.3, p<0.001). Recovery or death of the horse from colic was strongly associated with the type of colic (χ2=250, p<0.001). The possibility of recurrence of colic was weakly (χ2=4.6, p=0.04) determined by the type of colic, a horse had. Multivariate logistic regression revealed that the main cause of death was intestinal displacement and the majority of the horses with intestinal displacement died (β-estimate 2.7, odds ratio=0.07, p=0.007) compared to horses that had impaction colic. Conclusion: The incidence of colic is 3.1%, and the most common type of colic is spasmodic followed by impaction. The most common pain management protocol for colic is NSAIDs, mainly flunixin meglumine, followed by flunixin-butorphanol combination. Surgery for horses with colic in Nairobi County is not commonly done due to impeding poor prognoses. The horse owners tend to prefer euthanasia for such cases.
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Affiliation(s)
- Anderson Gitari
- Department of Clinical Studies, Faculty of Veterinary Medicine, College of Agriculture and Veterinary Sciences, University of Nairobi, Nairobi, Kenya
| | - James Nguhiu
- Department of Clinical Studies, Faculty of Veterinary Medicine, College of Agriculture and Veterinary Sciences, University of Nairobi, Nairobi, Kenya
| | - Vijay Varma
- Department of Clinical Studies, Faculty of Veterinary Medicine, College of Agriculture and Veterinary Sciences, University of Nairobi, Nairobi, Kenya
| | - Eddy Mogoa
- Department of Clinical Studies, Faculty of Veterinary Medicine, College of Agriculture and Veterinary Sciences, University of Nairobi, Nairobi, Kenya
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Archer DC. Equine colic: putting the puzzle together. Vet Rec 2017; 181:289-290. [DOI: 10.1136/vr.j4161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Debra C. Archer
- Philip Leverhulme Equine Hospital, University of Liverpool; Leahurst Campus, Neston CH64 7TE
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33
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Bauck AG, Easley JT, Cleary OB, Graham S, Morton AJ, Rötting AK, Schaeffer DJ, Smith AD, Freeman DE. Response to early repeat celiotomy in horses after a surgical treatment of jejunal strangulation. Vet Surg 2017; 46:843-850. [DOI: 10.1111/vsu.12670] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 12/23/2016] [Accepted: 02/03/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Anje G. Bauck
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
| | - Jeremiah T. Easley
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
| | - Orlaith B. Cleary
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
| | - Sarah Graham
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
| | - Alison J. Morton
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
| | - Anna K. Rötting
- Department of Comparative Biosciences; University of Illinois, College of Veterinary Medicine; Urbana Illinois
| | - David J. Schaeffer
- Department of Comparative Biosciences; University of Illinois, College of Veterinary Medicine; Urbana Illinois
| | - Andrew D. Smith
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
| | - David E. Freeman
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine; University of Florida; Gainesville Florida
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34
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Affiliation(s)
- D. Freeman
- College of Veterinary Medicine; University of Florida; Gainesville Florida USA
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35
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Scharner D, Winter K, Brehm W, Kämpfert M, Gittel C. Incisional complications following ventral median coeliotomy in horses. Does suturing of the peritoneum reduce the risk? Tierarztl Prax Ausg G Grosstiere Nutztiere 2017; 45:24-32. [PMID: 27831593 DOI: 10.15653/tpg-160536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 09/08/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Despite advances in surgical technique in abdominal surgery, incisional complications are frequently reported following ventral midline laparotomy in horses. The aim of this study was to determine the incidence of incisional complications at our clinic and to identify possible risk factors. Furthermore, we investigated whether suturing the peritoneum leads to a reduction of incisional complications. MATERIAL AND METHODS In this retrospective study, records of patients of the Large Animal Clinic for Surgery of the University of Leipzig from January 2010 to December 2015 were analysed. Horses with ventral midline laparotomy following colic were included in the study. Evaluated parameters comprised breed, sex, age of the horse, localisation of the colic disease, invasiveness of the surgical intervention, duration of general anaesthesia, suture pattern of the laparotomy wound and postoperative fever or leukopenia. Incisional complications included suture dehiscence, exudation from the wound and incisional hernia formation. Wound oedema formation was evaluated separately. RESULTS Incisional complications in the form of exudation and suture dehiscence occurred in 8.9% (18/202) of the horses. Postoperative hernia formation was observed in 5.2% (9/173) of patients. Breed, sex, localisation of the colic disease, invasiveness of the surgical intervention, duration of general anaesthesia and postoperative leukopenia did not influence the frequency of incisional complications. An increased risk of incisional complications was found in horses aged 20 years and older (odds ratio [OR] 17.90), in animals with postoperative fever (OR 7.48) and in horses with unsutured peritoneum (OR 7.68). Furthermore, patients with moderate and severe wound oedema displayed a significantly increased risk for the development of incisional complications. CONCLUSION AND CLINICAL RELEVANCE Suture pattern is the only risk factor that can be directly influenced by the surgeon. Because a peritoneal suture is associated with a decreased risk of incisional complications, it should be standard practice when closing a laparotomy wound in the horse.
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Affiliation(s)
- Doreen Scharner
- PD Dr. Doreen Scharner, Chirurgische Tierklinik, Veterinärmedizinische Fakultät der Universität Leipzig, An den Tierkliniken 21, 04103 Leipzig, E-Mail:
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36
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Findley JA, Salem S, Burgess R, Archer DC. Factors associated with survival of horses following relaparotomy. Equine Vet J 2016; 49:448-453. [DOI: 10.1111/evj.12635] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 08/23/2016] [Indexed: 11/28/2022]
Affiliation(s)
- J. A. Findley
- School of Veterinary Science/Institute of Infection and Global Health and School of Veterinary Sciences; University of Liverpool; Neston UK
| | - S. Salem
- Department of Surgery; Faculty of Veterinary Medicine; Zagazig University; Zagazig Eygpt
| | - R. Burgess
- School of Veterinary Science/Institute of Infection and Global Health and School of Veterinary Sciences; University of Liverpool; Neston UK
| | - D. C. Archer
- School of Veterinary Science/Institute of Infection and Global Health and School of Veterinary Sciences; University of Liverpool; Neston UK
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37
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Salem SE, Proudman CJ, Archer DC. Has intravenous lidocaine improved the outcome in horses following surgical management of small intestinal lesions in a UK hospital population? BMC Vet Res 2016; 12:157. [PMID: 27459996 PMCID: PMC4962447 DOI: 10.1186/s12917-016-0784-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 07/20/2016] [Indexed: 12/14/2022] Open
Abstract
Background Perioperative lidocaine treatment is commonly used in horses that undergo surgical treatment of colic, to prevent or treat postoperative ileus and reduce the effects of intestinal ischaemia-reperfusion injury. However, its clinical efficacy has not been evaluated in a large population of horses undergoing small intestinal surgery. The aim of the current study was to evaluate whether systemic lidocaine administration reduced the prevalence, volume and duration of postoperative reflux and improved rates of survival following surgical treatment of small intestinal lesions. Data were collected as a part of two prospective studies investigating postoperative survival of surgical colic patients admitted to a UK equine referral hospital during the periods 2004–2006 and 2012–2014. Kaplan-Meier plots of cumulative probability of survival and the log-rank test were used to compare survival between horses that did or did not receive lidocaine. The Wilcoxon rank-sum test was used to compare the total reflux volume and duration of reflux between the groups. A multivariable Cox proportional hazards model was used to identify pre- and intraoperative risk factors for non-survival. Results Data from 318 horses were included in the final analysis. The overall prevalence of postoperative reflux was 24.5 %. This was significantly higher (34.8 %) in horses admitted in 2012–2014 compared to the 2004–2006 cohort (16.7). Perioperative lidocaine treatment had no effect on total reflux volume, duration of reflux or rates of postoperative survival nor was it a risk factor associated with altered postoperative survival. Variables identified to be associated with increased risk of postoperative mortality included packed cell volume on admission (hazard ratio [HR] 1.03 95 %, 95 % confidence interval [CI] 1.004–1.06, p = 0.024), heart rate on admission (HR 1.014, 95 % CI 1.004–1.024, p =0.008) and duration of surgery (HR 1.007, 95 % CI 1.002–1.01, p = 0.008). Conclusions Lidocaine therapy had no effect on the prevalence of postoperative reflux, total reflux volume and duration of reflux nor did it have any effect on postoperative survival in horses undergoing surgical management of small intestinal disease for treatment of colic. There is a need for a well-designed multicentre, prospective randomised controlled trial to fully investigate the efficacy of lidocaine across different hospital populations. Electronic supplementary material The online version of this article (doi:10.1186/s12917-016-0784-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shebl E Salem
- Institute of Infection and Global Health, Department of Epidemiology and Population Health, University of Liverpool, Wirral, CH64 7TE, UK.,Department of Surgery, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Chris J Proudman
- School of Veterinary Medicine, University of Surrey, Guildford, GU2 7TE, UK
| | - Debra C Archer
- Institute of Infection and Global Health, Department of Epidemiology and Population Health, University of Liverpool, Wirral, CH64 7TE, UK. .,Philip Leverhulme Equine Hospital, School of Veterinary Science, University of Liverpool, Wirral, CH64 7TE, UK.
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