Characterising equine abdominal lipomata: Can histological features improve the understanding of pathogenesis and risk?

BACKGROUND

Strangulating lipomata are the most common cause of small intestinal strangulating obstruction. Evaluation of histological features of pathological and non-pathological lipomata, and the histological properties of omental and retroperitoneal fat have not been described.

OBJECTIVES

To characterise histological features of equine abdominal lipomata, omental and retroperitoneal adipose tissue, and associations between them.

STUDY DESIGN

Prospective observational anatomic (gross and histological).

METHODS

Horses undergoing emergency laparotomy for management of abdominal pain in a single hospital were recruited. Signalment was recorded. Gross features of lipomata that were a cause of strangulating obstruction (pathological lipomata [PAL]), and lipomata that were currently not causing an intestinal obstruction (pedunculated [PEL] or non-pedunculated [NPL]) were recorded. Lipomata that were removed intra-operatively, or following owner-requested euthanasia, as well as omentum or retroperitoneal adipose tissue, where excised routinely as part of routine management (or post-euthanasia) were fixed in 10% neutral-buffered formalin prior to staining (haematoxylin and eosin, picrosirius red). Descriptive statistical analyses were performed. Pearson's chi-square, Fisher's exact or Kruskal-Wallis tests, as appropriate, were used to assess associations. Significance was p < 0.05.

RESULTS

Seventy-four horses were enrolled; 71 lipomata, 48 retroperitoneal adipose samples, and 26 omental samples underwent evaluation. Increasing age was predictive of lipomata presence and PAL/PEL. Neither omental nor retroperitoneal adipose tissue histological features were correlated with lipomata presence or type. PAL were more likely to exhibit capsule formation (PAL: 70%, NPL: 42%, p = 0.03), and had a higher vascular density (median 10.6; IQR: 8.8-16.8; p = 0.05), compared with NPL. PEL were more likely to exhibit steatonecrosis (PEL: 92%, NPL: 33%, p = 0.01) and had increased mineralisation (PEL: 67%, NPL: 17%, p = 0.05) compared with NPL.

MAIN LIMITATIONS

Small sample size.

CONCLUSIONS

Histological features of omental and retroperitoneal fat do not predict presence of lipomata or type. However, there are histological features of PAL and PEL which may be related to pathological potential.

Assessment of peripheral blood neutrophil respiratory burst, phagocytosis and apoptosis in obese non-insulin dysregulated horses

Obesity is a highly prevalent condition in horses. Dysfunctional neutrophil activity has been reported in metabolically healthy obese humans, but minimal data exist regarding horses. The present study evaluated the effect of obesity on apoptosis, phagocytosis and oxidative burst activity of peripheral blood neutrophils from lean and obese non-insulin dysregulated horses. Seven lean (BCS, body condition score 4-6/9) and five obese (BCS 8-9) horses were enrolled in the study. All animals underwent two metabolic tests (OGT, oral glucose test; IRT, insulin response test) before their selection to ensure their metabolic status (non-insulin dysregulated). A single blood sample was obtained from each horse, and a discontinuous density gradient was carried out to isolate neutrophils. Phagocytosis, apoptosis and reactive oxygen species (ROS) production assays were performed for each animal. All statistical analyses were performed with unpaired two-tailed t-tests. Results indicate that neutrophils from obese non-insulin dysregulated horses have a significantly increased ROS production (P < .0001), with no changes observed on phagocytosis (P > .05) or apoptosis (P > .05) when compared to the control group. In conclusion, our results demonstrate that obesity per se, in absence of other endocrine disorders, alters neutrophil reactive oxygen species production. More research is needed to understand the role of obesity on the equine immune system of horses, and its role in the development of endocrine disorders.

EQUIFAT: A novel scoring system for the semi-quantitative evaluation of regional adipose tissues in Equidae

Anatomically distinct adipose tissues represent variable risks to metabolic health in man and some other mammals. Quantitative-imaging of internal adipose depots is problematic in large animals and associations between regional adiposity and health are poorly understood. This study aimed to develop and test a semi-quantitative system (EQUIFAT) which could be applied to regional adipose tissues. Anatomically-defined, photographic images of adipose depots (omental, mesenteric, epicardial, rump) were collected from 38 animals immediately post-mortem. Images were ranked and depot-specific descriptors were developed (1 = no fat visible; 5 = excessive fat present). Nuchal-crest and ventro-abdominal-retroperitoneal adipose depot depths (cm) were transformed to categorical 5 point scores. The repeatability and reliability of EQUIFAT was independently tested by 24 observers. When half scores were permitted, inter-observer agreement was substantial (average κ_w: mesenteric, 0.79; omental, 0.79; rump 0.61) or moderate (average κ_w; epicardial, 0.60). Intra-observer repeatability was tested by 8 observers on 2 occasions. Kappa analysis indicated perfect (omental and mesenteric) and substantial agreement (epicardial and rump) between attempts. A further 207 animals were evaluated ante-mortem (age, height, breed-type, gender, body condition score [BCS]) and again immediately post-mortem (EQUIFAT scores, carcass weight). Multivariable, random effect linear regression models were fitted (breed as random effect; BCS as outcome variable). Only height, carcass weight, omental and retroperitoneal EQUIFAT scores remained as explanatory variables in the final model. The EQUIFAT scores developed here demonstrate clear functional differences between regional adipose depots and future studies could be directed towards describing associations between adiposity and disease risk in surgical and post-mortem situations.