Comparison of chlorhexidine and alcohol-based antisepsis on the paralumbar fossa in cattle.

OBJECTIVE: To determine skin reaction, post-treatment reduction (immediate effect), and 1 hour post-treatment reduction (sustained effect) of aerobic bacterial colony forming units (CFU) following three antiseptic protocols in cattle. STUDY DESIGN: Prospective, randomized experimental study. ANIMALS: Eighteen cows. METHODS: Three sites in each paralumbar fossa were clipped and randomly assigned to one of three treatment groups: 5 minute 4% chlorhexidine gluconate scrub (CHG); 90 second 80% ethanol scrub (ET); 90 second 70% isopropyl alcohol scrub (IPA). All sites were monitored at all sampling time points and at 24 hours following treatment for adverse skin reaction. Samples were collected pre-, immediately post-, and 1 hour post-treatment and plated in duplicate. Bacterial counts were shifted to eliminate zeroes, log10 transformed, and averaged. ANOVA was used to compare differences in mean reduction in log10 CFU/ml between groups. RESULTS: Reduction in log10CFU/ml was more pronounced immediately after application of IPA (p = .001) and ET (p = .001) than CHG. This reduction was better sustained after preparation with CHG than ET (p = .005) but not IPA. Immediate and sustained reductions in bacterial loads did not differ after application of IPA or ET. No adverse skin reactions were noted. CONCLUSIONS: Skin preparation with alcohol-based antiseptics was well tolerated and improved immediate bacterial reduction compared to CHG. This reduction was better sustained 1 hour after application of CHG than ET, but no difference was detected between CHG and IPA. CLINICAL RELEVANCE: Lack of adverse skin reaction and performance provide evidence to support skin preparation with alcohol-based antiseptics in cattle.

Comparison of chlorhexidine and alcohol-based antisepsis of the distal limbs of horses.

BACKGROUND: An alcohol-based rub has been confirmed effective at reducing bacterial counts on equine skin. Skin sites with expected high bacterial burden have not been tested or has a comparison to a common protocol been performed. OBJECTIVES: To determine if ethanol-based antisepsis reduces bacterial counts on the equine distal limb comparable to a current chlorhexidine scrub method and determine the most effective application technique for the product. STUDY DESIGN: Randomised trial. METHODS: Forty-one horses were used in the study. By horse, each limb was randomly assigned to a treatment group: 5min scrub using 4% chlorhexidine gluconate to a clipped site (CHG); 90s scrub using 80% ethanol to a clipped site (ETC); 90s contact with 80% ethanol applied as a spray to a clipped site (ETS) and 90s scrub using 80% ethanol to an unclipped site (ETUC). Samples were collected pre- and post-treatment and plated in duplicate. Bacterial counts were log10 transformed and averaged between duplicates. A linear mixed model was used to compare mean log10 CFU/mL reduction between groups. A cost-benefit analysis was performed. RESULTS: There was no significant difference in mean log10 CFU/mL reduction between CHG and ETC in either fore- or hindlimbs. In forelimbs, there was no significant difference in mean log10 CFU/mL reduction between any groups. In hindlimbs, CHG had significantly greater mean log10 CFU/mL reduction than ETUC and ETS. No significant difference in cost-benefit was found between CHG and ETC. Significant differences were noted between CHG and both ETUC and ETS. MAIN LIMITATIONS: Researchers were not blinded to treatment group during sample collection. CONCLUSIONS: This study showed no significant difference in reduction in bacterial counts on the distal limb of horses between CHG and ethonol (ET) when applied as a scrub to a clipped site and there was no significant difference in cost-benefit between these treatments.

Clinical findings, diagnoses, and outcomes of horses presented for colic to a referral hospital in Atlantic Canada (2000-2015).

Medical records of equine patients presented for signs of abdominal pain to the Atlantic Veterinary College Teaching Hospital between 2000 and 2015 were reviewed. A total of 575 patients were enrolled, and the most common clinical findings, diagnoses, and outcomes are described. Potential predictors of survival to discharge were assessed. The most common diagnosis was large colon impaction (18.4%), followed by large colon volvulus (6.2%). Overall survival to discharge was 69%. The survival rates for horses were 82.9% for those with no diagnosis, 74.6% for those with large intestine lesions, and 38.5% for those with small intestine lesions. Significant predictors for non-survival were increasing age, increasing duration of colic signs, severity of colic, and a lesion in the small intestine. These data are important for veterinarians in the region who are treating cases of equine colic and advising clients.

Trouvailles cliniques, diagnostics et issues de chevaux présentés pour colique à un centre de référence dans les provinces atlantiques canadiennes (2000­2015). Les dossiers médicaux de patients équins présentés pour des signes de douleur abdominale à l'hôpital d'enseignement vétérinaire du Atlantic Veterinary College entre 2000 et 2015 ont été revus. Un total de 575 patients furent recrutés, et les trouvailles cliniques, diagnostics et issues les plus fréquents sont décrits. Les prédicteurs potentiels de survie jusqu'au congé sont évalués. Le diagnostic le plus fréquent était l'impaction du côlon (18,4 %), suivi du volvulus du côlon (6,2 %). La survie globale jusqu'au congé était de 69 %. Les taux de survie pour les chevaux étaient de 82,9 % pour ceux sans diagnostic, 74,6 % pour ceux avec des lésions au gros intestin et de 38,5 % pour ceux avec des lésions au petit intestin. Les prédicteurs significatifs pour la non-survie étaient une augmentation de l'âge, une augmentation de la durée des signes cliniques, la sévérité des coliques et une lésion au petit intestin. Ces données sont importantes pour les vétérinaires en région qui traitent les cas de cliques équines et conseillent les clients.(Traduit par Dr Serge Messier).

Equine Skin Antisepsis Using an Alcohol-Based Rub.

Alcohol-based antisepsis has been extensively studied in human health care, but only little information is available regarding efficacy and tolerance in other species. The purpose of this study was to determine if an alcohol-based antiseptic is effective at reducing bacterial counts on equine skin and the appropriate contact time to do so, without causing any adverse skin reactions. Samples were collected before and after preparation from clipped sites over both jugular veins of horses and were plated on 3M Petrifilm Aerobic Count Plates in duplicate. Trial 1 tested an alcohol-based product (ET-80% ethanol) against a control of sterile saline at a contact time of 180-second. Trial 2 tested two different contact times of ET-90 and 180 seconds. All samples were assessed for colony-forming unit counts using an automated 3M Petrifilm reader. Data were analyzed by Kruskal-Wallis test, and the significance was set at P < .05. The results determined that ET had a mean 2.95 log10 reduction from prepreparation to postpreparation colony-forming unit counts. A significant difference in log reduction between ET and control (P = .0033) was observed. There was no difference in log10 reduction between the two contact times (P = .75). Mild urticaria was the only skin reaction observed and was often present in both ET and control groups. These findings demonstrate that ET is effective at reducing bacterial counts on equine skin at a contact time of 90 seconds without producing significant adverse skin reaction.

Observational study on the occurrence of surgical glove perforation and associated risk factors in large animal surgery.

OBJECTIVE: To determine the incidence of and associated risk factors for glove perforation in large animal surgery. STUDY DESIGN: Prospective observational cohort study. SAMPLE POPULATION: Surgical gloves (n = 917) worn during 103 large animal surgical procedures. METHODS: Gloves worn by personnel involved in sterile preparation and surgical procedures were tested for perforation by 2 previously validated methods, water leak test (WLT) and electroconductivity testing (ECT). The association between surgical and glove-related variables and glove perforation was assessed by using a multivariable mixed-effect logistic regression model. RESULTS: At least 1 glove perforation was detected in 66% of surgical procedures, and 17.9% (164/917) of gloves tested were identified as perforated. All perforations were detected by ECT, whereas only 110/178 (61.8%) were detected by WLT. All perforations detected by WLT were also detected by ECT. The risk of glove perforation increased with duration of wear (>60 minutes odds ratio [OR] 2.3, 95% CI 1.4-3.7; P < .001) and with invasiveness of procedures (OR 7.9, 95% CI 3.2-19.5; P < .001). Primary surgeons were at higher risk for glove perforation than first (OR 1.7, 95% CI 1.1-2.5; P = .008) and second (OR 3.4, 95% CI 2-6.7; P < .001) assistants. Only 25% of glove perforations were detected intraoperatively by the wearer. CONCLUSION: Incidence of glove perforation is similar in large animal, human, and small animal surgery and is influenced by duration of wear, invasiveness of the surgery, and role of the wearer. ECT is more sensitive than WLT for detection of glove perforation.

Antibacterial Efficacy of Several Surgical Hand Preparation Products Used by Veterinary Students.

OBJECTIVE: To compare the antibacterial efficacy of different surgical hand antisepsis protocols used by veterinary students. STUDY DESIGN: Prospective, randomized, controlled study. STUDY POPULATION: Third year veterinary students (n=45). METHODS: The participants were randomly assigned to 4 of the following 12 hand preparation product/time combinations: nonabrasive hand scrub method with 4% chlorhexidine gluconate (CH); hand rub with a mixture of 30% 1-propanol and 45% 2-propanol solution (MPS), 70% 2-propanol solution (IPS), or 61% ethanol solution with 1% chlorhexidine gluconate (ES/CH), with a contact time of 1.5, 3, or 5 minutes. Antibacterial efficacy was assessed after surgical hand preparation and at the end of surgery. Log reductions of total bacterial colony forming unit (CFU)/mL and positive aerobic culture rates were compared using multivariable analysis of variance and multivariable logistic regression, respectively. RESULTS: After surgical hand preparation, CH and ES/CH provided significantly higher log CFU reduction and lower positive culture rate for Gram-positive and spore-forming bacteria compared to MPS and IPS. Increase in contact time did not provide significant improvement in bacterial reduction. At the end of surgery, ES/CH provided significantly higher log CFU reduction compared to IPS and lower positive culture rate for Gram-positive bacteria compared to CH, MPS, and IPS. Increase in contact time significantly improved log CFU reduction in ES/CH and MPS groups. CONCLUSION: In our population of veterinary students ES/CH hand rubs or CH scrubs were more effective in reducing bacterial CFU during surgical hand preparation than MPS or IPS.

Use of lomustine (CCNU) in a case of cutaneous equine lymphoma.

A 12-year-old gelding was diagnosed with recurrent lymphoma in multiple cutaneous sites. A highly invasive preputial mass caused urethral obstruction. The horse was treated with surgery and chemotherapy consisting of lomustine (CCNU) and prednisolone. The treatment was well-tolerated and effective. This is the first reported use of lomustine (CCNU) in a horse for the treatment of equine lymphoma.

Utilisation de lomustine (CCNU) dans un cas de lymphone cutané équin. Un hongre âgé de 12 ans a été diagnostiqué avec un lymphome récurrent sur plusieurs sites cutanés. Une masse préputiale hautement invasive causait une obstruction urétrale. Le cheval a été traité par chirurgie et chimiothérapie composée de lomustine (CCNU) et de prednisolone. Le traitement a été efficace et bien toléré. Il s'agit de la première utilisation signalée de la lomustine (CCNU) chez un cheval pour le traitement d'un lymphome équin.(Traduit par Isabelle Vallières).

Comparison of the effects of xylazine bolus versus medetomidine constant rate infusion on the stress response, urine production, and anesthetic recovery characteristics in horses anesthetized with isoflurane.

OBJECTIVE: To compare the effect of xylazine bolus versus medetomidine constant rate infusion (MCRI) on serum cortisol and glucose concentrations, urine production, and anesthetic recovery characteristics in dorsally recumbent, spontaneously breathing, isoflurane-anesthetized horses. DESIGN: Prospective, randomized crossover study. ANIMALS: 10 healthy Standardbreds. PROCEDURES: Horses were premedicated with xylazine or medetomidine IV. Anesthesia was induced with diazepam and ketamine and maintained with isoflurane for 150 minutes. For the xylazine treatment, end-tidal isoflurane concentration was maintained at 1.7% and xylazine (0.2 mg/kg [0.09 mg/lb]), IV) was administered as a bolus at the end of anesthesia. For the MCRI treatment, end-tidal isoflurane concentration was maintained at 1.4% and medetomidine (0.005 mg/kg/h [0.0023 mg/lb/h], IV) was infused throughout anesthesia. Serum cortisol and glucose concentrations were measured before, during, and after anesthesia. Urine specific gravity and volume were measured during anesthesia. Unassisted anesthetic recoveries were recorded by a digital video camera for later evaluation by 2 observers who were blinded to treatment. RESULTS: Serum cortisol concentration was lower and serum glucose concentration was higher with MCRI treatment, compared with xylazine treatment. Time to sternal recumbency was longer with MCRI treatment, but no difference was seen between treatments for times to extubation, first movement, or standing. Objective (mean attempt interval) and subjective (visual analog score) recovery scores were significantly better with MCRI treatment, compared with xylazine treatment. CONCLUSIONS AND CLINICAL RELEVANCE: In isoflurane-anesthetized horses, premedication and administration of medetomidine as a constant rate infusion resulted in decreased serum cortisol concentration, increased serum glucose concentration, and superior anesthetic recovery characteristics, compared with conventional treatment with xylazine.

Extensive nasal septum resection in horses using a 3-wire method.

OBJECTIVE: To describe a surgical technique for, and report outcome after, extensive nasal septum resection in horses with congenital or acquired septal diseases. STUDY DESIGN: Retrospective study. ANIMALS: Horses (5) with nasal septal deformity. METHODS: Under general anesthesia, obstetrical wires were preplaced around the ventral, caudal, and dorsal aspects of the nasal septum by combinations of manual guidance (ventral and caudal wires) and use of a trephine hole on the dorsal mid-line (dorsal and caudal wires). The rostral part of the septum was incised with a scalpel and the ventral, dorsal, and caudal septal incisions were made with the preplaced wires. After septum removal, the nasal cavity packed with a tampon and a temporary tracheotomy was performed. RESULTS: The diseased nasal septum was completely removed in all horses. It was possible to direct the caudal cut at a sufficient angle so that the remaining stump was in a wide part of the nasal passage, where it would have minimal effect on airflow. Four horses healed, and returned to intended use but continued to make a slight respiratory noise during exercise. At 13 months after surgery, 1 horse with a concurrent wry nose was retired from race training after 2 additional surgeries failed to relieve exercise intolerance at high speed. CONCLUSIONS: The 3 wire-cut method of nasal septum resection was technically easy to perform and safe, allowed return to function in most horses, and produced an excellent cosmetic appearance. CLINICAL RELEVANCE: This technique for nasal septum resection allows removal of a large portion of the nasal septum and provides a safe alternative to conventional techniques of nasal septum resection in the horse.

Effects of sodium hyaluronate and methylprednisolone acetate on proteoglycan synthesis in equine articular cartilage explants.

OBJECTIVE: To determine effects of sodium hyaluronate (HA) on corticosteroid-induced cartilage matrix catabolism in equine articular cartilage explants. SAMPLE POPULATION: 30 articular cartilage explants from fetlock joints of 5 adult horses without joint disease. PROCEDURE: Articular cartilage explants were treated with control medium or medium containing methylprednisolone acetate (MPA; 0.05, 0.5, or 5.0 mg/mL), HA (0.1, 1.0, or 1.5 mg/mL), or both. Proteoglycan (PG) synthesis was measured by incorporation of sulfur 35-labeled sodium sulphate into PGs, and PG degradation was measured by release of radiolabeled PGs into the medium. Total glycosaminoglycan (GAG) content in media and explants and total explant DNA were determined. RESULTS: Methylprednisolone acetate caused a decrease in PG synthesis, whereas HA had no effect. Only the combination of MPA at a concentration of 0.05 mg/mL and HA at a concentration of 1.0 mg/mL increased PG synthesis, compared with control explants. Methylprednisolone acetate increased degradation of newly synthesized PGs into the medium, compared with control explants, and HA alone had no effect. Hyaluronate had no effect on MPA-induced PG degradation and release into media. Neither MPA alone nor HA alone had an effect on total cartilage GAG content. Methylprednisolone acetate caused an increase in release of GAG into the medium at 48 and 72 hours after treatment. In combination, HA had no protective effect on MPA-induced GAG release into the medium. Total cartilage DNA content was not affected by treatments. CONCLUSIONS AND CLINICAL RELEVANCE: Our results indicate that HA addition has little effect on corticosteroid-induced cartilage matrix PG catabolism in articular cartilage explants.

Association between cribbing and entrapment of the small intestine in the epiploic foramen in horses: 68 cases (1991-2002).

OBJECTIVE: To determine whether there was an association between a history of cribbing and epiploic foramen entrapment (EFE) of the small intestine in horses. DESIGN: Retrospective study. ANIMALS: 68 horses examined at the University of Illinois or the University of Liverpool veterinary teaching hospitals. PROCEDURE: For horses examined at the University of Illinois that underwent surgery because of strangulating small intestine lesions, information about cribbing was obtained through telephone calls with owners. For horses examined at the University of Liverpool that underwent surgery for colic for any reason, information about cribbing was obtained through a preoperative questionnaire. RESULTS: 13 of 19 (68%) horses with EFE examined at the University of Illinois had a history of cribbing, compared with only 2 of 34 (6%) horses with other strangulating small intestine lesions (odds ratio, 34.7; 95% confidence interval, 6.2 to 194.6). Similarly, 24 of 49 (49%) horses with EFE examined at the University of Liverpool had a history of cribbing, compared with 72 of 687 (10.5%) horses with colic caused by other lesions (odds ratio, 8.2; 95% confidence interval, 4.5 to 15.1). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that there may be an association between cribbing and EFE in horses, with horses with a history of cribbing more likely to have EFE than horses without such a history.

Life-threatening hemorrhage from enterotomies and anastomoses in 7 horses.

OBJECTIVE: To report our experience with horses that presumptively had severe intraluminal hemorrhage from enterotomy or anastomosis. STUDY DESIGN: Clinical study. ANIMALS: Six adult horses and 1 adult donkey. METHODS: A retrospective study was conducted at the University of Illinois (April 1994 to December 2001) to determine the clinical course and outcome of horses with melena and/or anemia and evidence of life-threatening hemorrhage from intestinal incisions. Medical records of all horses that had colic surgery were reviewed to determine the proportion of horses with this complication. In addition, horses that fit the same criteria identified in 3 other veterinary clinics were included. RESULTS: Three horses (1.3%) of those that had enterotomy or anastomosis at the University of Illinois and 4 horses from other clinics had complications presumptively related to severe hemorrhage from these intestinal procedures. Melena became evident within 72 hours of surgery and lasted 12 to 96 hours. Six horses had an acute and severe drop in packed cell volume (PCV), increased heart rates, and other signs of acute hemorrhage, and 1 horse had signs of colic postoperatively. Horses were administered intravenous formalin (3 horses) and whole blood transfusions (4 horses). Repeat celiotomy was performed on 2 horses. In 1 of these horses, a bleeding artery was ligated in the edge of the original enterotomy, and, in the other, a 25-cm-diameter intraluminal blood clot was found occluding the pelvic flexure. A horse that had jejunocolostomy for cecal impaction was not treated for hemorrhagic shock but was euthanatized and necropsied. Necropsy revealed blood-filled bowel from the jejunocolostomy to the anus. One of the remaining 6 horses died of enterocolitis and 5 survived to discharge. CONCLUSIONS: Hemorrhage from incisional edges, particularly in the large intestine, should be considered a rare but possibly fatal complication of enterotomy or anastomosis in horses. CLINICAL RELEVANCE: To prevent fatal hemorrhage from incisional edges during enterotomy or anastomosis, large vessels should be ligated at the original surgery, and hemostatic effects of different closure techniques should be considered. No intraoperative or postoperative findings were useful to predict this complication, and response to supportive medical therapy was favorable.

Clinical signs and treatment of chronic uterine torsion in two mares.

Two mares were evaluated because of chronic uterine torsions of 2 and 4 weeks' duration; both were pyrectic, anemic, tachycardic, and anorectic, had signs of depression, and had an abnormal uterus and contents on transrectal examination. Both mares underwent cesarean section for lysis of adhesions from the uterus to the peritoneum, correction of the torsion, and ovariohysterectomy Both mares recovered with only minor complications and returned to be used as riding horses. Chronic uterine torsion should be considered in mares in late stages of gestation that have vague clinical signs and transrectal palpation findings that are unlike those described in typical cases of uterine torsion. Prognosis for life can be good after treatment by ventral midline celiotomy, cesarean section, correction of the torsion, and ovariohysterectomy.