Epidemiological and pathological aspects of noninfectious diseases of the gastrointestinal tract in 114 horses in Southern Brazil / Aspectos epidemiológicos e patológicos de doenças não infecciosas do trato gastrointestinal de 114 equinos no sul do Brasil

Equine colic is one of the most common cause of death in horses, but few studies have investigated specifically the conditions at the necropsy. This study aimed to describe the epidemiological and pathological features of noninfectious diseases of the gastrointestinal tract in horses. A retrospective study was conducted in search of cases of these diseases affecting horses from 2005 to 2017. During this period, 114 horses died of noninfectious diseases of the gastrointestinal tract, and the main causes were: primary gastric dilation (27/114), volvulus (27/114), enterolithiasis (20/114), rectal (colonic) perforation (15/114), gastric or cecocolonic impaction (10/114), incarcerations (6/114), intussusception (4/114), and others (5/114). Mixed breeds horses (56/114) and males (69/114) were mostly affected. The horses had a median and mean age of 10 and 10.9-years old, respectively. Primary gastric dilation was characterized by distension of the stomach by moderate to large amounts of content, which in 21 cases caused tearing of the stomach wall at the greater curvature (peritonitis), and the main predisposing factor was alimentary overload (17/27). Intestinal volvulus occurred within the small intestine (14 cases) and within the large intestines (13 cases). Grossly, there was intestinal ischemia with reddened to deep-black serosa and diffusely red mucosae. Enterolithiasis caused partial or complete obstruction of the right dorsal colon (9/20), transverse colon (4/20), small colon and right dorsal colon (3/20), rectum and right dorsal colon (2/20), and small colon (2/20). Viscera perforation and peritonitis occurred in 11 cases. Rectal (colonic) perforation involved the rectum (10/15), rectum/small colon (4/15), and the small colon (1/15). It was characterized by a focally extensive transmural tearing, associated with reddened borders, and retroperitoneal to diffuse peritonitis. Palpation related iatrogenic injuries (11/15) were the main cause...(AU)

A cólica em equinos é considerada como a principal causa de morte de cavalos, porém poucos estudos têm investigado especificamente as condições envolvidas através da necropsia. O objetivo desse estudo foi descrever os aspectos epidemiológicos e patológicos de doenças não infecciosas do trato gastrointestinal de equinos. Foi conduzido um estudo retrospectivo em busca de casos dessas doenças envolvendo cavalos de 2005 a 2017. Durante esse período, 114 equinos morreram devido a doenças não infecciosas do trato gastrointestinal, e as principais causas foram: dilatação gástrica (27/114), vólvulos (27/114), enterolitíase (20/114), ruptura retal (colônica) (15/114), compactação gástrica ou cecocolônica (10/114), encarceramentos (6/114), intussuscepções (4/114), e outros (5/114). Animais sem raça definida (56/114) e machos (69/114) foram mais afetados. Os equinos apresentavam uma média e mediana de idade de 10 e 10,9 anos, respectivamente. A dilatação gástrica primária era caracterizada por distensão do estômago por moderada a grande quantidade de conteúdo, que em 21 casos provocava ruptura da parede gástrica na curvatura maior (peritonite), e o principal fator predisponente foi sobrecarga alimentar (17/27). Vólvulo intestinal ocorreu no intestino delgado e no intestino grosso (14 e 13 casos, respectivamente). Macroscopicamente, havia isquemia intestinal com serosa avermelhada a enegrecida e mucosa difusamente avermelhada. A enterolitíase causou obstrução parcial ou completa do cólon dorsal direito (9/20), cólon transverso (4/20), cólon menor e cólon dorsal direito (3/20), cólon menor (2/20), e reto e cólon maior direito (2/20). Perfuração de vísceras e peritonite foram observadas em 11 casos. A ruptura retal (colônica) envolveu o reto (10/15), reto/cólon menor (4/15) e cólon menor (1/15). Essa era caracterizada por ruptura transmural focalmente extensa, com bordos avermelhados e peritonite retroperitoneal a difusa...(AU)

Epidemiological and pathological aspects of noninfectious diseases of the gastrointestinal tract in 114 horses in Southern Brazil / Aspectos epidemiológicos e patológicos de doenças não infecciosas do trato gastrointestinal de 114 equinos no sul do Brasil

Equine colic is one of the most common cause of death in horses, but few studies have investigated specifically the conditions at the necropsy. This study aimed to describe the epidemiological and pathological features of noninfectious diseases of the gastrointestinal tract in horses. A retrospective study was conducted in search of cases of these diseases affecting horses from 2005 to 2017. During this period, 114 horses died of noninfectious diseases of the gastrointestinal tract, and the main causes were: primary gastric dilation (27/114), volvulus (27/114), enterolithiasis (20/114), rectal (colonic) perforation (15/114), gastric or cecocolonic impaction (10/114), incarcerations (6/114), intussusception (4/114), and others (5/114). Mixed breeds horses (56/114) and males (69/114) were mostly affected. The horses had a median and mean age of 10 and 10.9-years old, respectively. Primary gastric dilation was characterized by distension of the stomach by moderate to large amounts of content, which in 21 cases caused tearing of the stomach wall at the greater curvature (peritonitis), and the main predisposing factor was alimentary overload (17/27). Intestinal volvulus occurred within the small intestine (14 cases) and within the large intestines (13 cases). Grossly, there was intestinal ischemia with reddened to deep-black serosa and diffusely red mucosae. Enterolithiasis caused partial or complete obstruction of the right dorsal colon (9/20), transverse colon (4/20), small colon and right dorsal colon (3/20), rectum and right dorsal colon (2/20), and small colon (2/20). Viscera perforation and peritonitis occurred in 11 cases. Rectal (colonic) perforation involved the rectum (10/15), rectum/small colon (4/15), and the small colon (1/15). It was characterized by a focally extensive transmural tearing, associated with reddened borders, and retroperitoneal to diffuse peritonitis. Palpation related iatrogenic injuries (11/15) were the main cause. Impactions affected the large colon (7/10), the cecum (2/10), and the stomach (1/10). Incarcerations consisted of inguinoscrotal hernias (2/6), small intestine entrapment by a mesenteric failure (2/6), diaphragmatic hernia, and umbilical eventration. Grossly, the organs were constricted by a hernial ring, with intestinal ischemia and reddened to dark-red serosa. Predisposing factors included previous surgeries (2/6) and patent inguinal ring (1/6). Intussusception involved the small intestine (3/4) and ileocecum (1/4). Foals with lack of colostrum intake and concomitant pneumonia was a characteristic presentation (3/4). Grossly, the intussusceptum slipped into intussuscipiens, with diffuse deep black-red discoloration. Other causes included large colon displacement (2/5), extrinsic and intrinsic obstruction of the small intestine (2/5), and an intestinal adenocarcinoma. Noninfectious gastrointestinal diseases are major causes of death in horses. Epidemiological and gross features of the conditions should be accounted to obtain a final diagnosis of the cause of the colic.(AU)

A cólica em equinos é considerada como a principal causa de morte de cavalos, porém poucos estudos têm investigado especificamente as condições envolvidas através da necropsia. O objetivo desse estudo foi descrever os aspectos epidemiológicos e patológicos de doenças não infecciosas do trato gastrointestinal de equinos. Foi conduzido um estudo retrospectivo em busca de casos dessas doenças envolvendo cavalos de 2005 a 2017. Durante esse período, 114 equinos morreram devido a doenças não infecciosas do trato gastrointestinal, e as principais causas foram: dilatação gástrica (27/114), vólvulos (27/114), enterolitíase (20/114), ruptura retal (colônica) (15/114), compactação gástrica ou cecocolônica (10/114), encarceramentos (6/114), intussuscepções (4/114), e outros (5/114). Animais sem raça definida (56/114) e machos (69/114) foram mais afetados. Os equinos apresentavam uma média e mediana de idade de 10 e 10,9 anos, respectivamente. A dilatação gástrica primária era caracterizada por distensão do estômago por moderada a grande quantidade de conteúdo, que em 21 casos provocava ruptura da parede gástrica na curvatura maior (peritonite), e o principal fator predisponente foi sobrecarga alimentar (17/27). Vólvulo intestinal ocorreu no intestino delgado e no intestino grosso (14 e 13 casos, respectivamente). Macroscopicamente, havia isquemia intestinal com serosa avermelhada a enegrecida e mucosa difusamente avermelhada. A enterolitíase causou obstrução parcial ou completa do cólon dorsal direito (9/20), cólon transverso (4/20), cólon menor e cólon dorsal direito (3/20), cólon menor (2/20), e reto e cólon maior direito (2/20). Perfuração de vísceras e peritonite foram observadas em 11 casos. A ruptura retal (colônica) envolveu o reto (10/15), reto/cólon menor (4/15) e cólon menor (1/15). Essa era caracterizada por ruptura transmural focalmente extensa, com bordos avermelhados e peritonite retroperitoneal a difusa. Traumas relacionados à palpação (11/15) foram a principal causa. Compactações afetaram o cólon maior (7/10), ceco (2/10) e estômago (1/10). Encarceramentos consistiram em hérnias inguinoescrotais (2/6), encarceramento de alças intestinais por falha no mesentério (2/6), hérnia diafragmática e eventração umbilical. Macroscopicamente, os órgãos estavam constritos por um anel hernial, com isquemia intestinal e serosa avermelhada a vermelho-escura. Fatores predisponentes incluíram cirurgias prévias (2/6) e anel inguinal patente (1/6). Intussuscepções envolveram o intestino delgado (3/4) e íleoceco (1/4). A apresentação característica foi em potros com falta de colostro e concomitante pneumonia. Macroscopicamente, o intussuscepto deslizava em direção ao intussuscepiente, exibindo coloração vermelho-enegrecida difusa. Outras causas incluíram deslocamento de cólon maior (2/5), obstrução extrínseca e intrínseca do intestino delgado (2/5), e um caso de adenocarcinoma intestinal. Doenças não infecciosas são importantes causas de morte em equinos. Os aspectos epidemiológicos e macroscópicos das condições devem ser considerados para o que o diagnóstico final da causa da cólica seja obtido.(AU)

Avaliação anatomopatológica das complicações da peritonite fecal em equinos tratados com lavagem peritoneal / Anatomopathological evaluation of fecal peritonitis complications in horses treated with peritoneal lavage

Background: Reproductive management in horses when performed with malpractice or by an unqualified person can cause many lesions of various degrees. When the rectum is affected it can compromise the mucous layer of the rectal ampulla and may even cause total perforation of this intestinal segment. Once the rectum ruptured, its contents gets into the abdominal cavity and generates severe abdominal infection, which may cause intense adhesions between organs and even to the abdominal wall and requires a particular intensive intervention. This work reports the use of peritoneal lavage protocol in three horses with septic peritonitis caused by rectal laceration, correlating with post-mortem findings.Cases: Three horses were referred to the Veterinary Hospital Rancho Belo Vista, in the city of Serra - ES, with an accident report during reproductive management in different properties. In all cases, blood loss and loss of continuity of the rectal mucosa were reported by the technicians. Patients were referred at different post-accident times. When they arrived at the hospital, they were examined and a sample of blood and peritoneal fluid were collected and sent to the laboratory. They presented intense apathy, mucosa coloration ranging from hyperemic to pale with halo toxemia, high cardiac and respiratory rate, reduction of globular volume and prolonged time of capillary refill. Patients were given fluid therapy support with lactated Ringers solution and systemic therapy protocols such as antibiotic therapy, peritoneal lavage with antibiotic containing solution and anticoagulant, and other supportive treatments were instituted. Peritoneal lavages were instituted every eight hours, in the first 48 hours and every twelve hours, until five days were completed. All patients had to be sacrificed. Euthanasia occurred at different times according to response to treatment and onset of clinical signs of shock.[...](AU)

Avaliação anatomopatológica das complicações da peritonite fecal em equinos tratados com lavagem peritoneal / Anatomopathological evaluation of fecal peritonitis complications in horses treated with peritoneal lavage

Background: Reproductive management in horses when performed with malpractice or by an unqualified person can cause many lesions of various degrees. When the rectum is affected it can compromise the mucous layer of the rectal ampulla and may even cause total perforation of this intestinal segment. Once the rectum ruptured, its contents gets into the abdominal cavity and generates severe abdominal infection, which may cause intense adhesions between organs and even to the abdominal wall and requires a particular intensive intervention. This work reports the use of peritoneal lavage protocol in three horses with septic peritonitis caused by rectal laceration, correlating with post-mortem findings.Cases: Three horses were referred to the Veterinary Hospital Rancho Belo Vista, in the city of Serra - ES, with an accident report during reproductive management in different properties. In all cases, blood loss and loss of continuity of the rectal mucosa were reported by the technicians. Patients were referred at different post-accident times. When they arrived at the hospital, they were examined and a sample of blood and peritoneal fluid were collected and sent to the laboratory. They presented intense apathy, mucosa coloration ranging from hyperemic to pale with halo toxemia, high cardiac and respiratory rate, reduction of globular volume and prolonged time of capillary refill. Patients were given fluid therapy support with lactated Ringer’s solution and systemic therapy protocols such as antibiotic therapy, peritoneal lavage with antibiotic containing solution and anticoagulant, and other supportive treatments were instituted. Peritoneal lavages were instituted every eight hours, in the first 48 hours and every twelve hours, until five days were completed. All patients had to be sacrificed. Euthanasia occurred at different times according to response to treatment and onset of clinical signs of shock.[...]

ENFERMIDADES PULMONARES E INTESTINAIS DIAGNOSTICADAS EM EQUINOS NO SUL DO BRASIL

Doenças relacionadas ao sistema alimentar são tidas como a principal causa de morte de equinos, enquanto doenças respiratórias são a quarta a quinta maior causa de morte na espécie. Todavia, os aspectos patológicos de ambas são pobremente descritos na literatura. Dessa forma, nessa tese estão incluídos quatro manuscritos abordando esse tema. O primeiro manuscrito teve o objetivo de descrever os aspectos patológicos e microbiológicos de lesões pulmonares de equinos abatidos em matadouro-frigorífico. Um total de 84 amostras foi analisada, e um diagnóstico final conclusivo foi obtido em 74. Broncopneumonia supurativa foi o principal diagnóstico (50/74), seguido por pneumonia eosinofílica granulomatosa (9/74), obstrução aérea recorrente (7/74), fibrose pulmonar (4/74), hemorragia pulmonar (3/74) e pitiose pulmonar (1/74). As broncopneumonias foram causadas principalmente por Streptococcus equi subsp. equi (21/50). O segundo manuscrito teve o objetivo de descrever os aspectos macroscópicos, microscópicos e etiológicos relacionados a pneumonias e pleurites diagnosticadas em 50 equinos necropsiados de 2005 a 2017 no Sul do Brasil. Pneumonias supurativas foram as principais condições diagnosticadas (17/50), e foram subdivididas em agudas (8/17), subagudas (6/17) e crônicas (3/17) baseadas nos padrões morfológicos das lesões. Streptococcus sp. foi identificado em 11 desses casos através de cultivo bacteriano ou exame imuno-histoquímico. As outras lesões foram classificadas em pneumonias piogranulomatosas por Rhodococcus equi (14/50), pneumonias aspirativas (5/50), pneumonias micóticas por Aspergillus spp. (4/50), pneumonias broncointersticiais por Influenza A (3/50), pleurites (3/50) e pneumonias embólicas (3/50). Pneumonias são causas significativas de morte em equinos no Sul do Brasil, sendo as pneumonias supurativas e piogranulomatosas as principais condições. Os aspectos epidemiológicos, patológicos, bacteriológicos e imuno-histoquímicos são essenciais para a obtenção do diagnóstico final. O terceiro manuscrito teve o objetivo de descrever os achados patológicos de enterites e tiflocolites parasitárias fatais em equinos. Dez cavalos apresentavam enterite e/ou tiflocolite parasitária fatal, e as principais causas foram: tiflocolite por ciatostomíneos (6/10), enterite por Eimeria leuckarti (1/10), enterite por Strongyloides westeri (1/10), colite por Balantidium coli (1/10) e infecção por múltiplos agentes (1/10). A tiflocolite por ciatostomíneos exibia acentuado espessamento de mucosa, com nódulos multifocais elevadas contendo parasitas filiformes. Microscopicamente, a mucosa e submucosa exibiam estruturas parasitárias encistadas envoltas por inflamação eosinofílica e granulomatosa. A enterite por E. leuckarti exibia macrogamontes, microgamontes e oocistos no interior de células do hospedeiro. A enterite por S. westeri exibia atrofia de vilosidades com numerosas estruturas parasitárias encistadas na mucosa. O quarto manuscrito teve o objetivo de descrever os aspectos epidemiológicos e patológicos de doenças não infecciosas do trato gastrointestinal de equinos necropsiados entre 2005 e 2017 no Sul do Brasil. Durante esse período, 114 equinos morreram devido a doenças não infecciosas do trato gastrointestinal, e as principais causas foram: dilatação gástrica primária (27/114), vólvulos (27/114), enterolitíase (20/114), ruptura (colônica) retal (15/114), compactação gástrica ou cecocolônica (10/114), encarceramentos (6/114), intussuscepções (4/114) e outros (5/114). Doenças não infecciosas do trato gastrointestinal, assim como enterites e tiflocolites parasitárias, são importantes causas de morte em equinos. Os aspectos epidemiológicos, macroscópicos e microscópicos das condições devem ser considerados para que um diagnóstico conclusivo da causa da cólica seja obtido.

Diseases related to the alimentary system are the main cause of death in horses, while respiratory diseases are fourth to fifth most common causes of death. Yet, the pathological features of both are poorly described. Thus, four manuscripts on this subject are included on this thesis. The first manuscript aimed to describe the pathological and microbiological features of lung lesions in slaughtered horses. A total of 84 samples were analyzed, and a final diagnosis was obtained in 74. Suppurative bronchopneumonia was the main diagnosis (50/74), followed by granulomatous eosinophilic pneumonia (9/74), recurrent airway obstruction (7/74), lung fibrosis (4/74), lung hemorrhage (3/74), and pythiosis (1/74). Bronchopneumonia was caused mainly by Streptococcus equi subsp. zooepidemicus (21/50). The second manuscript aimed to describe the gross, microscopic and etiologic findings related to pneumonia and pleuritis in 50 horses necropsied between 2005 and 2017 in Southern Brazil. Suppurative pneumonia was the main condition diagnosed (17/50), and was further divided into acute (8/17), subacute (6/17), and chronic (3/17) based on the morphological pattern of lesions. Streptococcus sp. was identified through bacterial culture or immunohistochemistry in eleven cases of these cases. The following lesions were pyogranulomatous pneumonia by Rhodococcus equi (14/50), aspiration pneumonia (5/50), mycotic pneumonia by Aspergillus spp. (4/50), bronchointerstitial pneumonia by Influenza A (3/50), pleuritis (3/50), and embolic pneumonia (3/50). Pneumonia is a significant cause of death in horses in Southern Brazil, with suppurative and pyogranulomatous pneumonia as the main conditions. Epidemiological, pathological, bacteriological, and immunohistochemical features are essential to obtain a final diagnosis. The third manuscript aimed to describe the pathological findings of fatal parasite-induced enteritis and typhlocolitis in horses. Ten horses had fatal parasitic enteritis and/or typhlocolitis, and the main causes were: cyathostominae typhlocolitis (6/10), Eimeria leuckarti enteritis (1/10), Strongyloides westeri enteritis (1/10), Balantidium coli colitis related to cyathostominae (1/10), and infection by multiple agents (1/10). Cyathostominae typhlocolitis showed marked mucosal thickening, with multifocal elevated nodules containing tangled filiform parasites. Microscopic examination revealed that the mucosa and submucosa had encysted parasitic structures surrounded by eosinophilic and granulomatous inflammation. E. leuckarti enteritis had macrogamonts, microgamonts, and oocysts inside the host cells. S. westeri enteritis had atrophy of the villi with numerous mucosal encysted parasitic structures. B. coli typhlocolitis showed severe diffuse mucosal reddening, with microscopic superficial mucosal necrosis associated with multiple protozoan trophozoites. The fourth manuscript aimed to to describe the epidemiological and pathological features of noninfectious diseases of the gastrointestinal tract in horses necropsied between 2005 and 2017 in Southern Brazil. During this period, 114 horses died due to noninfectious diseases of the gastrointestinal tract, and the main causes were: primary gastric dilation (27/114), volvulus (27/114), enterolithiasis (20/114), rectal (colonic) perforation (15/114), gastric or cecocolonic impaction (10/114), incarcerations (6/114), intussusception (4/114), and others (5/114). Noninfectious gastrointestinal diseases, as well as parasite-induced enteritis and typhlocolitis, are important causes of death in horses. Epidemiological, gross and microscopical features of the conditions should be accounted to obtain a final diagnosis of the cause of the colic.

Perfuração intestinal como complicação de ovariosalpingohisterectomiavia NOTES transluminal pura em cadela relato de caso / Intestinal perforation as a complication of ovariosalpingohysterectomy via NOTES pure translumenalin bitches - case report

Descreve-se um caso de perfuração de reto como complicação de ovariosalpingohisterectomia (OSH)via cirurgia endoscópica transluminal por orifícios naturais (NOTES) total transvaginal em cadela. Paraa ovariosalpingohisterectomia, realizou-se incisão da mucosa vaginal onde alocou-se uma cânula de11mm, através da qual foi introduzido um endoscópio rígido com canal de trabalho. Devido a repleçãodo intestino grosso, a extremidade do endoscópio ocasionou a perfuração da porção final do reto. Semremover o endoscópio, converteu-se o procedimento para celiotomia mediana associada à osteotomiapúbica para exposição do sítio de perfuração e síntese intestinal. Conclui-se que a perfuração intestinal éuma complicação passível de ocorrer durante a cirurgia de NOTES total, sendo a conduta cirúrgica adotadasatisfatória no controle da infecção abdominal e no manejo dessa complicação.AU

Describes a case of rectal perforation as a complication of ovariosalpingohisterectomy (OSH) via transluminalendoscopic surgery by natural orifices (NOTES) total transvaginal on bitches. For the OSH, theyperformed an incision of the vaginal mucosa which was allocated through a 11mm cannula, throughwhich a rigid endoscope was introduced as the working channel. Due to the repletion of the large intestine,the endoscope extremity resulted in the perforation of the final portion of the rectum. Without removingthe endoscope, the procedure was converted to median celiotomy associated with pubic osteotomyfor the exposure of the perforation site and intestinal synthesis. The authors conclude that intestinal perforationis a complication liable to occur during the total NOTES surgery, whereas the adopted surgicalprocedure was satisfactory in the control and management of this complication.AU

Perfuração intestinal como complicação de ovariosalpingohisterectomiavia NOTES transluminal pura em cadela – relato de caso / Intestinal perforation as a complication of ovariosalpingohysterectomy via NOTES pure translumenalin bitches - case report

Descreve-se um caso de perfuração de reto como complicação de ovariosalpingohisterectomia (OSH)via cirurgia endoscópica transluminal por orifícios naturais (NOTES) total transvaginal em cadela. Paraa ovariosalpingohisterectomia, realizou-se incisão da mucosa vaginal onde alocou-se uma cânula de11mm, através da qual foi introduzido um endoscópio rígido com canal de trabalho. Devido a repleçãodo intestino grosso, a extremidade do endoscópio ocasionou a perfuração da porção final do reto. Semremover o endoscópio, converteu-se o procedimento para celiotomia mediana associada à osteotomiapúbica para exposição do sítio de perfuração e síntese intestinal. Conclui-se que a perfuração intestinal éuma complicação passível de ocorrer durante a cirurgia de NOTES total, sendo a conduta cirúrgica adotadasatisfatória no controle da infecção abdominal e no manejo dessa complicação.

Describes a case of rectal perforation as a complication of ovariosalpingohisterectomy (OSH) via transluminalendoscopic surgery by natural orifices (NOTES) total transvaginal on bitches. For the OSH, theyperformed an incision of the vaginal mucosa which was allocated through a 11mm cannula, throughwhich a rigid endoscope was introduced as the working channel. Due to the repletion of the large intestine,the endoscope extremity resulted in the perforation of the final portion of the rectum. Without removingthe endoscope, the procedure was converted to median celiotomy associated with pubic osteotomyfor the exposure of the perforation site and intestinal synthesis. The authors conclude that intestinal perforationis a complication liable to occur during the total NOTES surgery, whereas the adopted surgicalprocedure was satisfactory in the control and management of this complication.