RESUMEN
Equine minimally invasive surgical techniques are frequently utilized in the treatment of a variety of conditions. Standing sedated endoscopic surgery is commonly selected in horses, requiring specialized facilities, anesthetic protocols, and surgeon and assistant expertise. This review examines current methods and potential strategies in equine soft tissue surgery, in which there is an emphasis on laparoscopic urogenital and gastrointestinal diagnostic and therapeutic procedures. Thoracoscopy is less frequently reported in horses and may be underutilized. Optimizing procedures and outcomes in soft tissue surgery relies on innovation and interdisciplinary collaboration. Modern advances in surgical equipment and emerging medical technologies support development in these fields. Participation in continuing education is effective in acquiring and sustaining knowledge and skills and improving clinical practice. Forums with an integrated approach could rapidly expand knowledge across species.
RESUMEN
OBJECTIVE: The objective was to describe the successful thoracoscopic treatment of esophageal entrapment resulting from a vascular ring anomaly (VRA) comprising a persistent right aortic arch (PRAA) and left ligamentum arteriosum (LA) in a Babydoll sheep wether. STUDY DESIGN: Case report. ANIMAL: Eight month old Babydoll sheep wether, 13 kg. METHODS: The patient presented with a weight half that of its sibling, persistent regurgitation following eating, and delayed growth noted from the age of approximately 2 months, coinciding with the introduction of solid feed into the diet. Plain thoracic radiographs were within normal limits but computed tomography angiography (CTA) confirmed multiple congenital vascular anomalies. The primary finding was esophageal and tracheal entrapment by a PRAA and left LA. Thoracoscopic transection of the LA was performed with a bipolar vessel sealing device with the aid of transesophageal endoscopy. RESULTS: Immediate improvement in attitude and absence of regurgitation were observed. The patient was discharged and subsequently reintroduced to grazing and long-stem hay, which were previously not tolerated. By 6 months post discharge, the patient's weight was 36 kg, comparable to an age-matched sibling and considered appropriate for the stage of growth. CONCLUSION: Thoracoscopic transection of the LA in sheep is a feasible treatment for esophageal compression resulting from a VRA. Surgical intervention resolved the clinical signs and allowed normal digestive rumination, restoring bidirectional esophageal function in a ruminant.
Asunto(s)
Toracoscopía , Animales , Toracoscopía/veterinaria , Toracoscopía/métodos , Ovinos , Anillo Vascular/veterinaria , Anillo Vascular/cirugía , Enfermedades de las Ovejas/cirugía , Masculino , Femenino , Aorta Torácica/cirugía , Aorta Torácica/anomalíasRESUMEN
OBJECTIVE: To describe the ureteropyeloscopic removal of a nephrolith in a horse. ANIMALS: A 19 year old Hanoverian gelding with history of urolithiasis requiring surgical intervention. STUDY DESIGN: Case report METHODS: The horse presented with signs of abdominal straining and stranguria. A proximal urethral calculus was palpable externally within the perineal urethra. Perineal urethrostomy (PU) at the location of the urethral calculi was performed to remove the urethral obstruction. Left nephrolithiasis was then treated by endoscopic retrieval, inserting the endoscope through the PU. The procedures were performed over 2 consecutive days, with the horse standing and sedated. Medical therapy included antimicrobial and anti-inflammatory treatment. RESULTS: The ureteropyeloscopic removal of a nephrolith from the left renal pelvis was completed. No complications were appreciated following the procedure, and the horse was able to return to athletic activity within 2 weeks. The horse had no further clinical signs referable to urinary dysfunction 7 months later. CONCLUSION: Ureteropyeloscopic removal of a nephrolith from the renal pelvis is technically feasible in the equine patient and preserves function of the affected kidney. The availability of a treatment that maintains renal function is a distinct benefit over unilateral nephrectomy, particularly when treating a condition that frequently involves both kidneys.
Asunto(s)
Enfermedades de los Caballos , Cálculos Renales , Obstrucción Uretral , Urolitiasis , Animales , Enfermedades de los Caballos/cirugía , Caballos , Cálculos Renales/veterinaria , Masculino , Uretra , Obstrucción Uretral/cirugía , Obstrucción Uretral/veterinaria , Urolitiasis/veterinaria , Procedimientos Quirúrgicos Urológicos/veterinariaRESUMEN
OBJECTIVE: To compare pain-related responses in mares receiving topical or injected anesthesia of the ovarian pedicle prior to standing unilateral laparoscopic ovariectomy. STUDY DESIGN: Prospective randomized, blinded, placebo-controlled study. ANIMALS: Fifteen healthy research mares. METHODS: Mares were restrained in stocks and administered sedation. A right or left paralumbar ovariectomy was performed by using a laparoscopic portal and two instrument portals. Mares were divided into two treatment groups, and equal volumes of mepivacaine anesthesia were administered either topically (n = 8) or by injection into the ovarian pedicle (n = 7). Saline controls were simultaneously administered topically (n = 7) or by injection (n = 8), and surgeons were blinded to the treatment group. Ovarian removal was performed with traumatic forceps and a blunt tip vessel sealer and divider. Pain responses were measured by operative visual analog scale (VAS) scoring and perioperative serum cortisol response. Visual analog scale and serum cortisol were compared between groups by using Mann-Whitney testing. Serum cortisol concentrations were evaluated using repeated-measures one-way analysis of variance. RESULTS: Ovaries were removed in all mares by using the described technique without operative complications. Quantity of sedation required to complete the procedure, operative VAS scores, and perioperative cortisol concentrations did not differ between treatment groups. CONCLUSION: Application of topical mepivacaine to the ovary provided intraoperative analgesia similar to injection of the ovarian pedicle when performing unilateral standing laparoscopic ovariectomy in mares. CLINICAL SIGNIFICANCE: Topical anesthesia application to the ovary could provide an alternative to laparoscopic needle use, reducing the risk of inadvertent trauma to the pedicle or other visceral organs during laparoscopic ovariectomy.
Asunto(s)
Anestesia Local/veterinaria , Caballos/cirugía , Laparoscopía/veterinaria , Mepivacaína/administración & dosificación , Ovariectomía/veterinaria , Anestésicos Locales/administración & dosificación , Anestésicos Locales/farmacología , Animales , Femenino , Laparoscopía/métodos , Mepivacaína/farmacología , Ovariectomía/métodos , Ovario/cirugía , Estudios ProspectivosRESUMEN
OBJECTIVE: To describe the treatment of goats with urethral obstruction secondary to urolithiasis by combining tube cystostomy and urethrotomy. ANIMALS: Eight male goats. STUDY DESIGN: Short case series. METHODS: Medical records (September 2012-September 2017) of male goats treated for obstruction secondary to urolithiasis with tube cystostomy and urethrotomy were reviewed. Data collected included signalment, history, physical examination findings, diagnostic results, perioperative treatments, operative details, hospitalization duration, intraoperative and postoperative complications, urolith analysis, and time to restoration of urethral patency. Long-term follow-up (>12 months) was obtained by email or telephone interviews of owners or by clinical examination. RESULTS: Seven of eight goats were castrated males of various of breeds. All goats were tachycardic with urethral pulsation at admission. Uroliths were composed of calcium carbonate in four goats and silica in one goat. All goats regained urethral patency during hospitalization, and all were discharged alive from the hospital. Seven goats were alive at long-term follow-up. Postoperative complications included persistent urethral obstruction requiring a second urethrotomy 2 days postoperatively, premature dislodgement of the bladder catheter and jejunal obstruction secondary to adhesions, and recurrence of obstructive urolithiasis within the proximal perineal urethra requiring a second surgery 8 months later (1 each). Long-term outcome was good, with urethral patency beyond 12 months in six of eight goats. CONCLUSION: Combining tube cystostomy and urethrotomy restored urethral patency in goats with urethral obstruction from uroliths. Although none of the complications seemed directly related to the urethrotomy, formation of abdominal adhesions and recurrence of urolithiasis affected long-term outcomes. CLINICAL SIGNIFICANCE: Uroliths that do not dissolve in acidic urine may be more frequent in some practices. The combined approach of tube cystostomy and urethrotomy appears to successfully restore urethral patency with promising long-term outcomes.
Asunto(s)
Cistostomía/veterinaria , Enfermedades de las Cabras/cirugía , Obstrucción Uretral/veterinaria , Animales , Cistostomía/métodos , Cabras , Masculino , Recurrencia , Resultado del Tratamiento , Uretra/cirugía , Obstrucción Uretral/patología , Obstrucción Uretral/cirugía , Cálculos Urinarios/complicaciones , Urolitiasis/cirugíaRESUMEN
OBJECTIVE: To determine the temperature of a vessel sealer and divider device during unilateral paralumbar laparoscopic ovariectomy in standing, sedated mares. STUDY DESIGN: Prospective study. ANIMALS: Fifteen healthy research mares. METHODS: Healthy mares with normal ovarian palpation and ultrasonographic appearance were enrolled. Horses were restrained in standing stocks and sedated. A right or left paralumbar ovariectomy was performed with a laparoscopic portal and 2 instrument portals. Ovaries were excised with traumatic forceps and a blunt tip vessel sealer and divider. Temperatures of the vessel sealer and divider were recorded with a thermocouple device adhered to the tip of the instrument. Variables were reported as median and interquartile range (IQR). RESULTS: Surgical time was 30 minutes (IQR, 25-32) including use of the vessel sealer and the divider for 4.1 minutes (IQR, 3.2-5.8). The tip of the instrument reached temperatures of 77°C (IQR, 72-85) during activation and 64°C (IQR, 61-67) at end cycle. The median increase in end-cycle instrument tip temperature per activation cycle was 2°C (IQR, -1-6). All mares returned to their intended use. CONCLUSION: Despite the instrument temperatures observed during unilateral laparoscopic ovariectomy, surgical complications were minimal. The clinical relevance of the increase in instrument tip temperature of the vessel sealer and divider is presently unclear, but surgeons should use the instrument with caution, especially in close proximity to viscera. The increase in temperature observed at the tip of the vessel sealer and divider during unilateral ovariectomy could be associated with morbidity. The clinical relevance of instrument tip heating during other procedures, such as adhesiolysis and intestinal resection, is unknown and should be evaluated.
Asunto(s)
Caballos/cirugía , Laparoscopía/veterinaria , Ovariectomía/veterinaria , Instrumentos Quirúrgicos , Temperatura , Animales , Femenino , Laparoscopía/instrumentación , Ovariectomía/instrumentación , Ovario/cirugía , Estudios ProspectivosRESUMEN
OBJECTIVE: To describe clinical findings, surgical treatment, and outcome associated with duodenoduodenostomy for treatment of duodenal obstruction secondary to adhesions associated with the sigmoid flexure of the duodenum. STUDY DESIGN: Retrospective study (1996-2016). ANIMALS: Fourteen Holstein cattle. METHODS: Medical records of cows treated at 3 academic surgical referral centers with duodenoduodenostomy for duodenal obstruction secondary to adhesions associated with the sigmoid flexure of the duodenum were reviewed. Data that were collected included signalment, physical examination results, laboratory results, diagnostic findings, treatments, and survival to discharge. Owners were contacted for follow-up information. RESULTS: Affected cattle ranged in age from 4 months to 5 years. Electrolyte abnormalities, including severe hypochloremia, were present in all cases. Abnormalities included cranial duodenal distension without concurrent distension of the descending duodenum and palpable focal adhesions in the region of the sigmoid flexure of the duodenum. Duodenoduodenostomy involved a stapled (n = 11) or sutured (n = 3) side-to-side anastomosis between the cranial duodenum and descending duodenum. Thirteen of 14 cattle that were treated with duodenoduodenostomy survived to hospital discharge. Long-term follow-up was available in 8 cows, and 7 of those 8 survived for at least 1 year. CONCLUSION: Short- and long-term survival were favorable after duodenoduodenostomy in cattle with adhesions associated with the sigmoid flexure of the duodenum. CLINICAL SIGNIFICANCE: Duodenoduodenostomy results in acceptable survival and future productivity in cows with obstruction at the sigmoid flexure of the duodenum.
Asunto(s)
Enfermedades de los Bovinos/cirugía , Obstrucción Duodenal/veterinaria , Anastomosis Quirúrgica/métodos , Anastomosis Quirúrgica/veterinaria , Animales , Bovinos , Enfermedades de los Bovinos/mortalidad , Enfermedades de los Bovinos/patología , Colorado , Obstrucción Duodenal/cirugía , Femenino , Humanos , Masculino , New York , Quebec , Estudios Retrospectivos , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
OBJECTIVE: To compare survival and complications in horses undergoing large colon resection with either sutured end-to-end or stapled functional end-to-end anastomoses. STUDY DESIGN: Retrospective cohort study. ANIMALS: Twenty-six client-owned horses with gastrointestinal disease. METHODS: Retrospective data were retrieved from the medical records of 26 horses undergoing colectomy, including 14 horses with sutured end-to-end and 12 horses with stapled functional end-to-end anastomoses, between 2003 and 2016. Records were evaluated for signalment, medical and surgical treatments, and survival to hospital discharge. Long-term follow-up was obtained through owner contact. Continuous variables were compared with Mann-Whitney tests. Fisher's exact testing was used to compare survival to hospital discharge. Survival time was compared by constructing Kaplan-Meier survival curves and performing log-rank curve comparison testing. RESULTS: Mean age of horses undergoing colectomy was 13 years. Reason for colectomy was prophylaxis (12) or salvage (14). Mean surgical time was 169 minutes. Mean hospitalization time was 9 days, which did not differ with anastomosis type (P = .62). Nine of 12 horses undergoing stapled functional end-to-end anastomosis and 12 of 14 horses undergoing sutured end-to-end anastomosis survived to hospital discharge (P = .63). Survival time did not differ with anastomosis technique (P = .35). CONCLUSION: Short- and long-term survival outcomes are not different between sutured end-to-end or stapled functional end-to-end anastomoses in horses undergoing colectomy.
Asunto(s)
Anastomosis Quirúrgica/veterinaria , Colectomía/veterinaria , Enfermedades de los Caballos/cirugía , Complicaciones Posoperatorias/veterinaria , Animales , Estudios de Cohortes , Colectomía/métodos , Colorado/epidemiología , Femenino , Caballos , Estimación de Kaplan-Meier , Masculino , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
OBJECTIVE: To develop a novel technique for left paralumbar laparoscopic bilateral ovariectomy in standing, sedated mares. STUDY DESIGN: Prospective descriptive clinical study. ANIMALS: Twelve client-owned mares. METHODS: Healthy mares with normal ovarian palpation and ultrasonographic appearance were enrolled. Horses were restrained in standing stocks and administered a variable rate infusion of sedation. A left paralumbar bilateral ovariectomy was performed with 1 laparoscopic and 3 instrument portals. Access to the right ovary was facilitated by retracting the descending colon and associated mesentery with a fan retractor. Ovaries were removed with traumatic forceps, and a blunt tip vessel sealing device. A laparoscopic portal within the 17th intercostal space provided good visualization of the right ovary and reduced interference between instrumentation. Complications were recorded during hospitalization. In addition, an owner follow-up questionnaire was used to determine complications after discharge from the hospital. RESULTS: Left paralumbar bilateral ovariectomy was successful in all 12 mares, with a mean surgical time of 76 ± 8 minutes. Postoperative complications occurred in 4/12 (33%) mares and included fever, mild colic, incisional swelling, and azotemia. Complications resolved and mares returned to full activity, with complete owner satisfaction. CONCLUSIONS: Bilateral ovariectomy can be successfully achieved with minimal morbidity in standing mares with normal ovarian ultrasonographic appearance via left paralumbar laparoscopy.
Asunto(s)
Caballos/cirugía , Laparoscopía/veterinaria , Ovariectomía/veterinaria , Animales , Femenino , Ovariectomía/métodos , Complicaciones Posoperatorias/veterinaria , Estudios ProspectivosRESUMEN
A foal born with assisted delivery developed rib fractures and a diaphragmatic hernia. The hernia was repaired using surgical mesh. The filly was healthy 42 months later. Dystocia is a risk factor for rib fractures and traumatic acquired diaphragmatic herniation. Surgical mesh repair is an option for diaphragmatic defects.
Réparation d'une hernie diaphragmatique acquise à l'aide d'un treillis chirurgical chez un poulain. Un poulain né lors d'une parturition assistée a développé des fractures des côtes et une hernie diaphragmatique. La hernie a été réparée à l'aide d'un treillis chirurgical. La pouliche était en santé 42 mois plus tard. La dystocie est un facteur de risque pour les fractures des côtes et une hernie diaphragmatique acquise lors d'un traumatisme. Le treillis chirurgical est une option pour les défauts diaphragmatiques.(Traduit par Isabelle Vallières).
Asunto(s)
Hernia Diafragmática Traumática/veterinaria , Mallas Quirúrgicas/veterinaria , Animales , Animales Recién Nacidos , Diafragma/lesiones , Distocia/veterinaria , Femenino , Hernia Diafragmática Traumática/cirugía , Caballos , Embarazo , Fracturas de las Costillas/veterinaria , Resultado del TratamientoRESUMEN
OBJECTIVES: 1) To identify factors associated with short-term survival and time to death after hospital discharge in horses with nephrosplenic entrapment (NSE). 2) To compare the frequency of recurrent colic episodes in horses with and without laparoscopic closure of the nephrosplenic space. STUDY DESIGN: Historical cohort with a nested case control. ANIMALS: Client-owned horses. METHODS: Medical records of horses treated for NSE from January 1, 2002 to June 1, 2014 were reviewed. Data collected included signalment, physical examination parameters, laboratory results, diagnostic findings, and treatments. Factors associated with short-term survival to discharge were analyzed with a multivariable logistic regression model and time to death after hospital discharge was analyzed with a Cox proportional hazards model. RESULTS: During the study period, 211 horses had 231 NSE events and 192/211 (91%) horses survived to discharge. A positive difference in packed cell volume (PCV at admission - PCV after treatment) was associated with reduced odds of nonsurvival with each increment (OR: 0.899, 95% CI 0.816-0.991, P=.03) while the presence of concurrent alimentary lesions (OR: 8.47, 95% CI 1.42-50.4, P=.02) were significantly associated with increased odds of nonsurvival in the short term. Of 156 horses that survived to discharge for which follow-up was available, 152 (97%) were alive for ≥1 year. Increasing age (incremental years) at hospital admission was significantly associated with death after discharge (hazard ratio 1.078, 95% CI 1.002-1.16, P=.049). Recurrence of NSE was documented in 49/211 (23%) horses. The overall change in colic score indicated a reduction in colic in horses following laparoscopic closure of the nephrosplenic space compared with horses that did not have closure of the nephrosplenic space (P<0.001). CONCLUSION: An increase in PCV from admission to after treatment and concurrent abdominal lesions were associated with increased odds of nonsurvival to discharge in horses with NSE. Horses that underwent laparoscopic closure had reduced colic episodes compared with horses without laparoscopic closure.
Asunto(s)
Cólico/veterinaria , Enfermedades del Colon/veterinaria , Enfermedades de los Caballos/cirugía , Laparoscopía/veterinaria , Animales , Cólico/cirugía , Enfermedades del Colon/cirugía , Femenino , Caballos , Laparoscopía/métodos , Masculino , Recurrencia , Estudios RetrospectivosRESUMEN
OBJECTIVE: To report the results of a survey of opinions on current treatments and estimated outcomes of ascending colon volvulus in horses. STUDY DESIGN: Web-based survey. SAMPLE POPULATION: American College of Veterinary Surgeons (ACVS) Diplomates (n = 151) who perform gastrointestinal surgery in horses. METHODS: ACVS Diplomates with credentials in the large animal specialty obtained by examination in 2010 or earlier (n = 410) were solicited by e-mail to complete a web-based survey designed to determine ascending colon volvulus treatment preferences and outcomes. RESULTS: Responses were obtained from 162 ACVS Diplomates, of which 151 currently performed gastrointestinal surgery in horses. Horses surgically treated with ascending colon volvulus accounted for ≤ 20 cases/year and primary treatment was most often anatomic reduction with or without pelvic flexure enterotomy. Median estimated survival rate was 70% and surgical treatments were not associated with estimated survival (P = .27). Diplomates identified early surgical correction as the single most important factor impacting survival of horses surgically treated for ascending colon volvulus. CONCLUSIONS: Reported survival rates for horses with ascending colon volvulus were good. Respondents indicated this might be due in part to early surgical treatment. Survey investigations can provide preliminary data for future prospective studies and facilitate a consensus among Diplomates in treatment of surgical disease.
Asunto(s)
Colon Ascendente/cirugía , Procedimientos Quirúrgicos del Sistema Digestivo/veterinaria , Enfermedades de los Caballos/cirugía , Vólvulo Intestinal/veterinaria , Pautas de la Práctica en Medicina , Animales , Canadá , Procedimientos Quirúrgicos del Sistema Digestivo/estadística & datos numéricos , Caballos , Humanos , Vólvulo Intestinal/cirugía , Estudios Prospectivos , Sociedades Científicas , Encuestas y Cuestionarios , Estados Unidos , Medicina VeterinariaRESUMEN
BACKGROUND: In horses undergoing celiotomy for acute gastrointestinal pain, identification of variables correlating with lesion severity and location, and survival provide veterinarians and owners with information that aids in making informed decisions regarding appropriate treatment. Muscle enzyme activity is often increased in horses undergoing celiotomy for acute gastrointestinal pain and it is not known if muscle enzyme activity increase is specific to lesion type or impacts prognosis for survival. The objective of this study was to evaluate the relationship of pre-operative increase in muscle enzyme activities with intestinal lesion characteristics, specifically lesion location (large versus small intestine) and whether it was strangulating versus nonstrangulating, and case survival in horses undergoing celiotomy for acute gastrointestinal pain. METHODS: Records of 241 horses undergoing exploratory laparotomy for colic were reviewed retrospectively. Evaluation of preoperative plasma aspartate aminotransferase (AST), creatine kinase (CK), sorbitol dehydrogenase (SDH), and gamma-glutamyltransferase (GGT) activities, fibrinogen and glucose concentrations, and hematocrit (HCT) and their association with gastrointestinal lesion characteristics and survival was performed. RESULTS: Pre-operative increase in plasma CK and AST activity, and HCT and decrease in plasma bilirubin concentration were significantly associated with presence of lesions resulting in intestinal ischemia. Increase in plasma CK activity and HCT were significantly associated with a decreased probability of survival to hospital discharge. Plasma GGT and SDH activity, and glucose and fibrinogen concentration were not significantly associated with survival or severity of disease in multivariate analysis. CONCLUSIONS: Plasma muscle enzyme activity may be useful as a prognostic indicator in equine colic cases. Given that increases in plasma CK and AST activity were significantly associated with nonsurvival and the presence of intestinal ischemia, preoperative increase in these enzyme activities could assist in identification of disease severity and prognosis of horses undergoing celiotomy for acute gastrointestinal pain. Further study is indicated to elucidate the etiology of increased muscle enzyme activity in horses with surgical colic disease observed in this preliminary study.
Asunto(s)
Enfermedades Gastrointestinales/veterinaria , Enfermedades de los Caballos/sangre , Músculo Esquelético/enzimología , Dolor/veterinaria , Animales , Aspartato Aminotransferasas/sangre , Glucemia , Creatina Quinasa/sangre , Fibrinógeno , Enfermedades Gastrointestinales/cirugía , Enfermedades de los Caballos/cirugía , Caballos , L-Iditol 2-Deshidrogenasa/sangre , Dolor/cirugía , gamma-Glutamiltransferasa/sangreRESUMEN
BACKGROUND: Naturally occurring gastrointestinal disease is an important cause of acute hypoproteinemia in adult horses and hydroxyethyl starch colloid fluid treatment is a component of supportive care in these cases to improve plasma volume and maintain colloid osmotic pressure (COP). The objectives of the present study were to compare 2 formulations of high molecular weight hydroxyethyl starch and their relative effect on COP, acid-base status, and survival of horses with acute hypoproteinemia secondary to gastrointestinal disease. METHODS: Twenty adult horses, ≥ 1 year of age, were prospectively enrolled, with informed client consent, if they developed acute hypoproteinemia, defined as a plasma total protein <5.0 g/dL or albumin <2.2 g/dL during hospitalization while undergoing treatment for gastrointestinal disease. Horses were randomly assigned to receive a rapid infusion of either 6% hydroxyethyl starch in 0.9% saline or 6% hydroxyethyl starch in lactated ringers solution at a dose of 10 ml/kg. Venous blood gas analysis, COP, and PCV were evaluated before and after colloid administration. RESULTS: For both groups, average COP prior to treatment was 11.0 mmHg (9.7 - 12.2 mmHg) and post colloid treatment was 13.2 mmHg (12.0 -14.7 mmHg) [Normal range 18 - 22 mmHg]. COP was significantly increased with colloid treatment (p<0.001) but this increase was not significantly different between treatment groups. Venous pH did not change significantly with treatment. Twelve horses survived to hospital discharge and survival did not differ significantly between treatment groups. CONCLUSIONS: Post-treatment COP improved approximately 20% regardless of the formulation used, however, values did not reach the normal range of COP observed in healthy horses. Acid-base parameters were not significantly impacted by either treatment. Further study is needed to determine how these two products compare with regards to other outcome measures. Evaluation of the relative effects of colloid formulation in horses with clinical disease is a future area of interest.
Asunto(s)
Coloides/farmacología , Enfermedades Gastrointestinales/veterinaria , Enfermedades de los Caballos/tratamiento farmacológico , Derivados de Hidroxietil Almidón/farmacología , Presión Osmótica/efectos de los fármacos , Animales , Coloides/química , Femenino , Enfermedades de los Caballos/sangre , Caballos , Derivados de Hidroxietil Almidón/química , Soluciones Isotónicas/química , Soluciones Isotónicas/farmacología , Masculino , Lactato de RingerRESUMEN
A 14-year-old Trakehner gelding was evaluated for recurrent colic, with episodes occurring over 1 year. Signs were consistent with intermittent ascending colon obstruction and hematochezia. Necropsy examination revealed an ulcerated mass extending into the lumen of the right dorsal ascending colon. Gross and histologic appearance and immunoreactivity to c-kit (CD117), desmin, vimentin, and smooth muscle actin, were consistent with a diagnosis of gastrointestinal stromal tumor.
Tumeur ventrale gastro-intestinale du côlon produisant des coliques et de l'hématochézie et des coliques récurrentes chez un hongre à sang chaud. Un hongre Trakehner âgé de 14 ans a été évalué pour des coliques récurrentes et les épisodes duraient depuis 1 an. Les signes étaient conformes à une obstruction intermittente du côlon ascendant et à l'hématochézie. La nécropsie a révélé une masse ulcéreuse s'étendant dans la lumière du côlon ascendant dorsal droit. L'apparence brute et histologique et l'immunoréactivité à c-kit (CD117), à la desmine, à la vimentine et à l'actine des muscles lisses étaient conformes au diagnostic de tumeur ventrale gastro-intestinale.(Traduit par Isabelle Vallières).
Asunto(s)
Cólico/veterinaria , Neoplasias del Colon/veterinaria , Hemorragia Gastrointestinal/veterinaria , Tumores del Estroma Gastrointestinal/veterinaria , Enfermedades de los Caballos/diagnóstico , Animales , Cólico/etiología , Neoplasias del Colon/patología , Hemorragia Gastrointestinal/etiología , Tumores del Estroma Gastrointestinal/complicaciones , Tumores del Estroma Gastrointestinal/patología , Enfermedades de los Caballos/patología , Caballos , MasculinoRESUMEN
BACKGROUND: Persistent hemorrhage of testicular vessels is a potentially life-threatening complication of equine castration. Frequently, general anesthesia is required to retrieve and ligate the bleeding vasculature when standing wound packing and retrieval of the spermatic cord are unsuccessful. We propose standing laparoscopic ligation of the testicular arteries via the paralumbar fossa as a rapid, effective means of halting hemorrhage while avoiding castration site trauma as well as the cardiovascular and recovery risks of general anesthesia. METHODS: Two geldings, 6 and 9 months old, presented for emergency treatment of severe post-castration hemorrhage of 10 and 24 h durations, respectively. Both geldings underwent standing laparoscopy under light sedation and the testicular vessels were ligated using a bipolar vessel-sealing device. RESULTS: Testicular vessel sealing was successfully performed in both geldings by standing laparoscopy and resulted in immediate cessation of hemorrhage. In one case, a left paralumbar fossa approach allowed coagulation of both the left and right spermatic vessels. The procedure time was 25 and 35 min. No complications occurred, and both geldings recovered uneventfully. CONCLUSIONS: Standing, laparoscopic ligation of the testicular arteries is a feasible emergency treatment in young geldings and can be applied in cases of uncontrolled post-castration hemorrhage.
RESUMEN
Primary hyperthyroidism is a rarely diagnosed endocrinopathy in equids and there have been no previous reports of structural and functional cardiac changes associated with hyperthyroidism in these species. This case report investigates a 20-year-old mule gelding that presented for a three-month history of thin body condition despite polyphagia, with a heart murmur and elevated free and total thyroid hormone concentrations. On presentation, physical exam revealed a body condition score of two out of nine, persistent tachycardia, pansystolic heart murmur and firm bilateral ventral proximal cervical masses. Bloodwork confirmed markedly elevated free T4, total T4 and T3 concentrations. Echocardiogram demonstrated left ventricular concentric hypertrophy with increased ventricular and atrial systolic function. Bilateral thyroidectomy was performed under standing sedation without complications. Histopathology demonstrated adenocarcinoma of the left thyroid gland and multiple adenomas with osseous metaplasia within the right thyroid. The mule was supplemented with levothyroxine sodium two weeks post-op after a thyroid panel demonstrated undetectable concentrations. Polyphagia resolved following surgery and the mule began gaining weight. Echocardiographic changes improved but did not resolve at two years post-operative. Continued bi-annual follow up and monitoring of thyroid levels was recommended. This case represents the first documentation of hemodynamically relevant cardiac remodeling in an equid associated with primary hyperthyroidism.
RESUMEN
BACKGROUND: Prospective clinical study of blood lactate concentration in horses undergoing colic surgery is needed to determine utility in outcome prediction. OBJECTIVES: To evaluate venous lactate measurements in horses following colic surgery, including immediately after anesthetic recovery and daily throughout hospitalization, as well as to determine if lactate concentrations were significantly higher in horses that developed postoperative complications or did not survive to hospital discharge. METHODS: Horses > 1 year of age undergoing surgery for colic and recovered from general anesthesia were sampled. A portable lactate meter was used to measure venous samples collected immediately following anesthetic recovery and daily throughout hospitalization. Complications arising during hospitalization and survival to hospital discharge were recorded. RESULTS: Fifty one horses were enrolled, ranging in age from 2 to 29 years. Lactate concentration immediately following anesthetic recovery was higher in horses that developed complications during hospitalization (p = 0.046). The odds of developing complications postoperatively were doubled for horses with a venous lactate concentration > 5 mmol/L. Lactate measurements in non-survivors were significantly higher compared to survivors by 96 h postoperatively (p < 0.006). CONCLUSIONS: Higher venous lactate concentrations in the postoperative colic period were associated with an increased risk of complications and death. Results suggest horses with higher venous lactate measurements in recovery are more likely to have postoperative complications, with the odds of developing complications doubled for horses with a venous lactate > 5 mmol/L. Evaluation of venous lactate could provide information on prognosis in the postoperative period for horses with surgical colic.
Asunto(s)
Cólico , Procedimientos Quirúrgicos del Sistema Digestivo , Enfermedades de los Caballos , Animales , Cólico/cirugía , Cólico/veterinaria , Procedimientos Quirúrgicos del Sistema Digestivo/veterinaria , Enfermedades de los Caballos/cirugía , Caballos , Ácido Láctico , Complicaciones Posoperatorias/veterinaria , Estudios ProspectivosRESUMEN
OBJECTIVE: To report the clinical outcomes of horses with chronic guttural pouch infection characterized by accumulation of mucopurulent material following transpharyngeal diode laser fenestration. ANIMALS: 13 client-owned horses. PROCEDURES: Horses undergoing diode laser fenestration for chronic guttural pouch infection were identified by medical record search. Signalment, disease history, presence of mucopurulent empyema or chondroids, and pre- and postoperative therapy were recorded. Owners were contacted for follow-up information at a minimum of 6 months following surgery. RESULTS: 13 horses underwent laser fenestration for chronic guttural pouch infection. Thirteen had mucopurulent nasal discharge on presentation, and 3 were coughing. At follow-up, 12 horses treated with transpharyngeal diode laser fenestration had complete resolution of nasal discharge and coughing. One horse, despite resolution of guttural pouch infection on endoscopy, continued to have nasal discharge and coughing attributed to concurrent equine asthma syndrome. All owners expressed satisfaction with the surgical procedure and clinical resolution of guttural pouch infection. CLINICAL RELEVANCE: This surgical technique for transpharyngeal diode laser fenestration of the guttural pouch was uncomplicated to perform and well tolerated in sedated horses and attributed to resolution of clinical signs associated with guttural pouch infection, and owners reported a high satisfaction with the clinical outcome. Implementing this surgical technique could be considered to hasten resolution of chronic guttural pouch disease in horses with few technique-related complications.
Asunto(s)
Empiema , Trompa Auditiva , Enfermedades de los Caballos , Caballos , Animales , Enfermedades de los Caballos/cirugía , Trompa Auditiva/cirugía , Empiema/veterinaria , Endoscopía/veterinariaRESUMEN
Surgical repair is frequently effective at resolving uroperitoneum in foals, though complications occur. Despite their occurrence, management strategies used to address these complications, and their impact on survival are not clearly defined. To better describe the complications following surgical correction of uroperitoneum and to document treatment strategies and outcomes after intervention, a multi-center retrospective case series was performed. Medical record data of foals undergoing surgical treatment for uroperitoneum were retrieved from three surgical centers, and cases identified with complications or comorbidities were reviewed. Long-term follow-up was obtained through owner contact. Of 45 foals with uroperitoneum, 13 (29%) had complications or comorbidities following surgical repair. Uroperitoneum recurred in 9 (20%) foals 12-264 hours after surgery. Foals with recurrence were managed medically with an indwelling urinary catheter, repeat celiotomy, or were euthanized. Other comorbidities following repair included sepsis and persistent azotemia. One horse developed cystic calculi 14 months later. Urinary catheters maintained for 3-7 days in combination with medical and surgical interventions successfully resolved uroperitoneum. The decision to debride bladder tear edges or the selection of suture material or pattern did not impact recurrence or survival. Six (67%) foals with recurrent uroperitoneum survived to hospital discharge; 86% survived if treatment was attempted. Four (80%) of cases treated for recurrent uroperitoneum were alive without active medical problems >2 years later. Despite recurrence, medical or surgical treatment of recurrent uroperitoneum enables short-term survival, and maintenance of long-term health. Indwelling urinary catheters should be considered in select cases with recurrent uroperitoneum.