Spontaneous cecal perforation in a cat diagnosed with ultrasonography.

An 8-year-old cat was presented for an acute history of anorexia, marked abdominal pain, and hyperthermia. Ultrasonography showed a cecal perforation with focal steatitis and adjacent free gas bubbles, consistent with focal peritonitis. Surgery confirmed the imaging findings. An enterectomy was performed with the removal of the cecum and ileocolic valve, and anastomosis between the ileum and colon was performed. Histology revealed transmural enteritis and chronic severe pyogranulomatous peritonitis with intralesional plant fragments.

Colonic sand impaction with cecal rupture and peritonitis in an adult African savanna elephant, and review of noninfectious causes of gastrointestinal disease in elephants.

Gastrointestinal disorders are among the most common disease processes in captive elephants. Colic is a frequent clinical presentation and may have several infectious and noninfectious causes. Ingestion of sand has been reported in elephants living in enclosures with loose sandy soils. Similar to the situation in horses, sand ingestion can cause intestinal impaction and colic in elephants. Here we describe a case of colonic sand impaction with cecal rupture and peritonitis in an African savanna elephant from a zoologic collection that died after several days of colic. On autopsy, abundant, gritty, sandy material was found within a segment of colon immediately aboral to the cecum. There was a full-thickness tear in the cecal wall, free intestinal contents within the abdominal cavity, and peritonitis. To our knowledge, the postmortem examination of an elephant with sand impaction and cecal rupture has not been reported previously; this condition should be included among the differential diagnoses in elephants with colic. We review the reports of noninfectious causes of gastrointestinal disease in elephants, which include cases of small intestinal and colonic torsion and of intestinal obstruction by fecal boluses.

How to perform a percutaneous cecal or colonic trocarization in horses with severe abdominal tympany.

BACKGROUND: Cecal or colonic gas tympany of any cause may result in increased intraabdominal pressure, causing a significant decrease in venous return and cardiac output. Trocarization of the large colon or cecum in the event of large intestinal tympany may resolve gas distension and accompanying increased intraabdominal pressures sufficiently enough to promote resolution of a displaced large colon. Furthermore, trocarization of the medical colic may decrease morbidity and mortality associated with severe intraabdominal hypertension. DESCRIPTION: This how-to description details the technique of transcutaneous trocarization of the large colon and cecum in the standing horse using a 14-gauge catheter. SUMMARY: Trocarization is not a substitute for surgery in the severely gas-distended painful horse exhibiting signs of colic that require surgery; however, it is a viable medical therapy with minimal risk that alleviates gas distention and may assist with correction of a colonic displacement in the horse. KEY POINTS: The majority of colic episodes involving the large colon can be managed medically without surgical intervention. Auscultation and percussion of the paralumbar fossa area will solicit an audible "ping" (gas/fluid interface), thus targeting the appropriate site for trocarization. Percutaneous trocarization allows for rapid controlled decompression of colonic or cecal tympany, permitting improvement of both ventilation and perfusion. In situations where a displacement or primary colonic or cecal tympany is suspected, trocarisation is deemed successful if the horse has resolution of colic signs and the physical examination parameters return to normal. Trocarization may be clinically advantageous by requiring less pain medication, decreased time in the hospital, decreased costs, and avoidance of surgical intervention; yet, this therapy should not take place of surgical intervention if deemed necessary.

Dual-phase computed tomography angiography of intestinal carcinoid tumor as a lead point for cecocolic intussusception in a dog.

In an 8-year-old Labrador Retriever with progressive anorexia, constipation, and depression, CT revealed intussusception of the cecum into the ascending colon and a small cecal mass showing strong enhancement on arterial phase. The ileocecocolic junction was surgically resected and histologically diagnosed as cecocolic intussusception with carcinoid tumor. The carcinoid tumor worked as a lead point of intussusception in this case. Dual phasic CT is useful to assess the presence of gastrointestinal tumors as lead points in old dogs with intussusception.

Successful surgical resolution of a ceco-cecal intussusception in a 15-month-old Angus heifer.

A 15-month-old Angus heifer was presented for anorexia and abdominal discomfort. Transabdominal ultrasound was suggestive of a ceco-cecal intussusception. Exploratory laparotomy confirmed the diagnosis and a cecectomy was performed. The heifer recovered well and continued to gain weight after discharge. This is the first report of a heifer with ceco-cecal intussusception in North America.

Correction chirurgicale réussie d'une intussusception caeco-cæcale chez une génisse de race Angus âgée de 15 mois. Une génisse de race Angus âgée de 15 mois est présentée pour une anorexie et des signes d'inconfort abdominal. Une échographie transabdominale révèle la présence d'une intussusception caeco-caecale. Le diagnostic est confirmé par laparotomie exploratrice et une typhlectomie est réalisée. La génisse a bien récupéré après l'opération et a continué à prendre du poids après sa sortie de l'hôpital. Ceci est le premier rapport de cas d'une génisse atteinte d'une intussusception caeco-caecale en Amérique du Nord.(Traduit par Dr Thibaud Kuca).

Cecal infarction in neonatal calves.

Cecal infarction is an uncommon lesion in calves that results in localized peritonitis and, on occasion, perforation with secondary diffuse peritonitis and death. This lesion in calves has not been described previously. We reviewed the postmortem cases of cecal infarction in dairy calves ≤30 d of age that had been submitted over the course of 5 y to the Tulare branch of the California Animal Health and Food Safety Laboratory System. The area of cecal infarction and the associated lesion margins were examined histologically. Ischemic necrosis of the mucosal side of the cecal wall with various degrees of neutrophilic inflammation of subjacent tissues was found consistently, and thrombosis and vascular occlusion within the areas of necrosis and inflammation was found in 21 of 34 cases. Cecal infarction cases were then compared to controls using a retrospective matched case-control study design. Cases ( n = 34) and controls ( n = 86) were compared with respect to bacteremia (as defined by pure culture of a single bacterial agent from lung and/or liver), species of bacteria isolated, and for the presence of K99 Escherichia coli (calves ≤5 d), attaching and effacing E. coli, Cryptosporidium (calves ≥5 d of age), Salmonella isolation from the intestine, rotavirus, Bovine coronavirus, and Bovine viral diarrhea virus. In addition, the presence of rumenitis or abomasitis, and omphalitis were compared between cases and controls. There were no significant differences in ruminal, abomasal, or umbilical cord tissue inflammation, or pathogen test-positive status between cases and controls.

Ultrasonographic, endoscopic and histological appearances of the caecum in cats presenting with chronic clinical signs of caecocolic disease.

Objectives This study aimed to describe the ultrasonographic, endoscopic and histological characteristics of the caecum and ileocaecocolic junction in cats suffering from chronic clinical signs compatible with caecocolic disease. Methods Cats presenting with clinical signs suggestive of a caecocolic disease were prospectively recruited. All cats underwent an ultrasonographic examination of the caecum, ileum, colon, ileocolic lymph nodes and local mesenteric fat, in addition to comprehensive abdominal ultrasonography. This was followed by a colonoscopy with a macroscopic assessment of the caecocolic mucosa; caecocolic tissue samples were systematically collected for histologic analysis. Results Eighteen cats were included. Eleven of 18 cats had ultrasonographic abnormalities adjacent to the ileocaecocolic junction (lymphadenopathy, local steatitis) and 13/18 cats had abnormalities directly related to the junction (wall thickening, loss of wall layering). Seventeen of 18 cats had at least one ultrasonographic abnormality. Endoscopically, hyperaemia, oedema, discoloration and/or erosions were found in all cats. Each cat was classified as having mild or moderate-to-severe lesions according to endoscopic results; no classification could be established statistically for ultrasonographic results. The accentuation of the dimpled pattern tended to be inversely related to the severity of endoscopic lesion scoring. Histologically, a large proportion of cats showed typhlitis (13/16), one had lymphoma and two were normal. All cats with typhlitis also had colitis. There was only slight agreement between endoscopic and histological caecal results regarding the severity of lesions. Loss of caecal wall layering on ultrasound was found in 7/18 cats and, surprisingly, did not appear as a reliable predictor of the severity of inflammation or of malignancy; neither did local steatitis nor lymph node size. Conclusions and relevance Ultrasonography and endoscopy should not be used as the sole methods to investigate the ileocaecocolic region in cats with clinical signs suggestive of caecocolic disease. The presence of chronic clinical signs should routinely prompt histological biopsy.

Concentrations of serum amyloid A and plasma fibrinogen in horses undergoing emergency abdominal surgery.

OBJECTIVE: To compare the perioperative response of serum amyloid A (SAA) to fibrinogen in horses requiring exploratory celiotomy for colic and to determine if SAA could be used to predict complications and outcome. DESIGN: Prospective observational clinical study. SETTING: University teaching hospital. ANIMALS: Eighteen horses undergoing exploratory celiotomy for colic. Inclusion criteria for the study included survival and anesthetic recovery from exploratory celiotomy, no history of surgery within the past year. INTERVENTIONS: Blood was obtained via jugular venipuncture before surgery (time 0) and at 24, 48, 72, and 96 hours after recovery from anesthesia. MEASUREMENTS AND MAIN RESULTS: Quantitative and semiquantitative fibrinogen, SAA, total nucleated cell counts, and total protein were evaluated at each time point. Multivariable linear regression was used to assess differences at each time point and after grouping horses according to duration of colic prior to surgery, strangulating surgical lesion or not, presence of systemic inflammatory response syndrome (SIRS) on admission, and postsurgical complications. Significant (P < 0.05) increases in SAA concentrations occurred in all cases after surgery compared to fibrinogen concentration, which only demonstrated a mild, clinically insignificant increase postsurgery. SAA concentrations were also significantly increased (P < 0.05) in cases identified with SIRS prior to surgery and postoperatively at 48 (P = 0.05) and 72 hours (P = 0.02) in horses that developed complications. CONCLUSIONS: Measurement of SAA is a more sensitive indicator of inflammation than fibrinogen in the perioperative period of horses requiring exploratory celiotomy for colic. Serial measurement of SAA at 48, 72, and 96 hours after surgery may be helpful to determine risk of complications and guide postoperative management. Measurement of SAA on admission also allows for quantification of SIRS when it is detected clinically.

Ileo-ceco-rectal Intussusception Requiring Intestinal Resection and Anastomosis in a Tawny Eagle (Aquila rapax).

A 23-year-old male tawny eagle (Aquila rapax) was examined because of sudden onset of lethargy, regurgitation, and hematochezia. An intestinal obstruction was suspected based on radiographic findings, and an ileo-ceco-rectal intussusception was confirmed by coelioscopy. A 14.3-cm section of intestine was resected before an intestinal anastomosis was done. Coelomic endoscopic examination confirmed a postsurgical complication of adhesions between the intestinal anastomosis and the dorsal coelomic wall, resulting in a partial luminal stricture and requiring surgical removal of the adhesions. Rectoscopy was useful in diagnosing a mild luminal stricture related to the second surgery. Complete recovery was observed 2 months after surgery. Lack of further complications in the 2 years after surgery demonstrates good tolerance of intestinal resection and anastomosis of a large segment of bowel in an eagle. This report is the first reported case of intussusception in an eagle and emphasizes the potential use of endoscopic examination in the diagnosis as well as in the management of complications.

Pharmacokinetics and oral bioavailability of amoxicillin in chicken infected with caecal coccidiosis.

Chicken infected with caecal coccidiosis (Eimeria tenella) was used to evaluate the effect of coccidiosis on the pharmacokinetic and bioavailability of amoxicillin. The level of amoxicillin was estimated by high-performance chromatography (HPLC) to calculate the pharmacokinetic parameters and oral bioavailability. For i.v. injection of amoxicillin, Vd and CL were 0.29 and 0.27 (mg/kg)/(µg/mL)/h, respectively. Compared with healthy chicken, intravenous injection of amoxicillin in the infected chicken showed higher distribution and elimination constants, delayed clearance and statistically significant higher AUC and MRT. Oral administration in healthy chicken was accompanied by rapid absorption and high bioavailability with Tmax , Cmax and F about 1.03 h, 3.26 µg/mL and 40.2, respectively. Furthermore, oral administration in the infected chicken produced higher mean absorption time, delayed Tmax, lower Cmax, smaller AUC value and lower bioavailability (16.76). Based on these results, monitoring and adjustment of amoxicillin dosing could be practiced during the presence of coccidiosis. The measured Cmax values suggest the administration of 1.3-folds of the normal dose to maintain the normal maximal serum concentrations of amoxicillin in chicken infected with caecal coccidiosis.

Occurrence of Incisional Complications After Closure of Equine Celiotomies With USP 7 Polydioxanone.

OBJECTIVES: To report the occurrence of, and risk factors associated with, incisional complications of equine ventral median celiotomies closed with USP 7 polydioxanone (7PD). STUDY DESIGN: Retrospective case series. SAMPLE POPULATION: Horses (n = 73; 75 celiotomies). METHODS: Medical records (2000-2010) were retrieved and reviewed for horses that had a ventral celiotomy closed with 7PD and survived ≥14 days. Follow-up (>1 year) was obtained from the medical record, owner, or referring veterinarian. Independent variables were selected based on risk factors identified in previous studies, perceived clinical relevance, and if there were adequate data recorded in the medical record. Statistical analysis, including multivariable logistic regression with a forward-building model process, was performed to evaluate variables associated with incisional complications. RESULTS: One or more incisional complication(s) occurred in 19 celiotomies (25.3%) during hospitalization or after discharge including: drainage (25.3%), infection (12.0%), and partial dehiscence (5.3%). Two of 63 horses (3.2%) available for follow-up developed an incisional hernia. Variables associated with incisional complications after multivariate analysis included: number of days hospitalized, surgery time, postoperative colic, and postoperative fever. CONCLUSION: Overall occurrence of incisional herniation after closure of ventral celiotomies with 7PD was low.

Short-term complications after colic surgery in geriatric versus mature non-geriatric horses.

OBJECTIVE: To compare in geriatric and mature horses the occurrence of short-term complications and short-term outcome associated with complications after colic surgery. STUDY DESIGN: Retrospective case-control study. SAMPLE POPULATION: Horses aged ≥20 years (geriatric, n = 78) and 4-15 years (mature non-geriatric, n = 156) that had exploratory celiotomy for colic and survived recovery from general anesthesia. METHODS: Medical records (2000-2010) of horses that recovered from general anesthesia after colic surgery were reviewed. Postoperative complications evaluated included postoperative reflux (POR), diarrhea, inappetence, fever, leukopenia, incisional infection, incisional dehiscence, thrombophlebitis, colic, repeat celiotomy, pneumonia, and laminitis. Short-term outcome (alive vs. dead at hospital discharge) of geriatric and mature horses with these complications were compared. Data were analyzed using a χ(2) or Fisher's exact test or an ANOVA. Level of significance P < .05. RESULTS: Geriatric horses had higher odds of having a small intestinal strangulating lesion than mature horses. A higher proportion of geriatric horses had POR and inappetence; however, there was no difference in the proportion of geriatric and mature horses with small intestinal strangulating lesions having POR. Short-term outcome with and without complications was similar between the 2 age groups. CONCLUSION: Geriatric and mature horses have similar occurrences of short-term complications and short-term outcomes associated with complications after colic surgery.

Outcome of Surgical and Medical Management of Cecal Impaction in 150 Horses (1991-2011).

OBJECTIVE: To evaluate short- and long-term outcome after medical and surgical management of horses with cecal impaction and to determine reasons for death or euthanasia. STUDY DESIGN: Retrospective case series. ANIMALS: Horses (n = 150). METHODS: Data collected from medical records (1991-2011) of horses with a diagnosis of cecal impaction, included signalment, history of recent disease/surgical procedure, admission data, management (medical, typhlotomy alone, jejunocolostomy), complications, and outcome. Short-term outcome (alive or dead at discharge) and long-term outcome (alive or dead at ≥1 year) were determined by telephone interview. Data were analyzed using a χ(2) or Fisher's exact test. Level of significance was P < .05. RESULTS: Of 150 horses hospitalized with a diagnosis of cecal impaction, 102 (68%) had a history of recent disease or a surgical procedure. Thirty-eight horses (25%) had cecal perforation at admission and 3 horses (2%) were euthanatized without treatment. Of 109 horses treated, 59 (54%) were managed medically and 50 (46%) surgically (typhlotomy [26]; jejunocolostomy [24]). The proportion of horses alive at hospital discharge was significantly lower for horses managed medically (61%) compared with surgically (82%; P = .02) but there was no difference between horses managed with typhlotomy alone (77%) or with jejunocolostomy (88%; P = .47). There were 57% of horses managed medically alive at 1 year. There was a similar proportion of horses alive at 1 year after typhlotomy alone (73%) and jejunocolostomy (70%; P = .86). CONCLUSIONS: Compared to the recent reports, the proportion of horses alive at hospital discharge was lower for both medically and surgically managed horses with cecal impaction. There was decreased survival for horses treated medically than those treated surgically; however, no significant difference was seen in survival between horses managed with typhlotomy alone versus jejunocolostomy.

[Ceco-cecal intussusception in a Simmental heifer]. / Caeco-caecale Invagination bei einem Simmentaler Rind.

This report describes the clinical, laboratory and ultrasonographic findings in a Simmental heifer with a ceco-cecal intussusception. The general condition of the heifer was moderately reduced and it showed mild colic signs. Physical examination revealed a firm longish mass visible and palpable in the right flank. Findings upon rectal examination, fecal output und defecation were normal. Ultrasound examination of the mass revealed features typical for an intussusception. Based on the slow development of symptoms, normal fecal output and ultrasonography findings, a ceco-cecal intussusception was diagnosed. Right flank laparatomy was performed under general anaesthesia, and an end-to-side anastomosis between the jejunum and the spiral colon was made after resection of the intussuscepted intestines. Recovery was uneventful.

Assessment of the excretion time of electronic capsules placed in the intestinal lumen of cows with cecal dilatation-dislocation, healthy control cows, and cows with left displacement of the abomasum.

OBJECTIVE: To analyze the transit time from various locations in the intestines of cows with cecal dilatation-dislocation (CDD), healthy control cows, and cows with left displacement of the abomasum (LDA). ANIMALS: 15 cows with naturally occurring CDD (group 1), 14 healthy control cows (group 2), and 18 cows with LDA (group 3). PROCEDURES: 5 electronic transmitters were encased in capsules and placed in the lumen of the ileum, cecum, proximal portion of the colon, and 2 locations in the spiral colon (colon 1 and colon 2) and used to measure the transit time (ie, time between placement in the lumen and excretion of the capsules from the rectum). Excretion time of the capsules from each intestinal segment was compared among groups. RESULTS: Cows recovered well from surgery, except for 1 cow with relapse of CDD 4 days after surgery and 2 cows with incisional infection. High variability in capsule excretion times was observed for all examined intestinal segments in all groups. Significant differences were detected for the excretion time from the colon (greater in cows with CDD than in healthy control cows) and cecum (less in cows with LDA than in cows of the other 2 groups). CONCLUSIONS AND CLINICAL RELEVANCE: The technique developed to measure excretion time of capsules from bovine intestines was safe and reliable; however, the large variability observed for all intestinal segments and all groups would appear to be a limitation for its use in assessment of intestinal transit time of cattle in future studies.

Dilatação do ceco em bezerros: relato de casos / Cecal dilatation in calves: case reports

A dilatação do ceco (DC) é um transtorno digestivo de natureza fermentativa com maior ocorrência em vacas de leite, sendopoucos os relatos sobre a sua ocorrência em bezerros. Portanto, este trabalho teve como objetivo relatar as manifestações clínicocirúrgicas,laboratoriais e anatomopatológicas da DC diagnosticada em quatro bezerros, atendidos na Clínica de Bovinos, CampusGaranhuns da Universidade Federal Rural de Pernambuco (UFRPE). Ao exame clínico dos animais constatou-se um quadro deapatia, desidratação, alteração no apetite, motilidade do rúmen, abomaso e intestinos diminuída e ainda, fezes escassas e diarreicas.Observou-se um aumento na região da fossa paralombar direita e na auscultação, com auxílio da percussão, verificou-se umaressonância timpânica (“tilintar”). O hemograma revelou uma leucocitose por neutrofilia com desvio para esquerda regenerativo,linfocitose e monocitose, e ainda, uma hiperfibrinogenemia. Na análise do fluido ruminal verificou-se uma elevação do teor decloretos (>30mEq/L). Foi indicada uma laparotomia exploratória na região do flanco direito, em dois dos bezerros, sendo possívelconfirmar a DC. Em função da gravidade da lesão e condição clínica precária todos os animais vieram a óbito. Na necropsia,além da DC, foram evidenciadas alterações secundárias a esta enfermidade. Ratifica-se neste trabalho que a DC em bezerrosé uma enfermidade de baixa ocorrência, podendo afirmar que o prognóstico é ruim na maioria dos casos, quando diagnosticadatardiamente.

Cecal dilatation is a fermentative disorder of the digestive tract that has a greater occurrence in dairy cows and few reports incalves. Therefore, this study aimed to report the clinical, surgical, laboratorial findings and pathological lesions of the cecal distentionin four calves that were diagnosticated and treated at the Clínica de Bovinos, Campus Garanhuns, Universidade Federal Ruralde Pernambuco (UFRPE). The clinical findings were apathy, dehydration, lack of appetite, decrease in ruminal, abomasal andintestinal motility and diarrheal and scarce feces. The abdomen was distended on the right side (paralumbar fossa) and there wasa tympanic resonance in the same area. The blood assays have shown leukocytosis with neutrophilia with a regenerative left shift,lymphocytosis and monocytosis, and also hyperfibrinogenemia. The ruminal fluid analysis showed a high content of chlorides(>30mEq/L). Exploratory laparotomy on the right flank was performed on two calves that confirmed cecal distention. The severityof the injury and poor clinical condition lead animals to death. At necropsy, in addition to DC, minor changes were observed inthis disease. Is ratified this study that DC is a disease in calves of low occurrence and can say that the prognosis is poor in mostcases, when diagnosed late.