Meta-analysis of the effects of lidocaine on postoperative reflux in the horse.

OBJECTIVE: To determine the efficacy of lidocaine at reducing incidence of postoperative reflux (POR) in horses by using quantitative statistical analysis. STUDY DESIGN: Systematic meta-analytical review. SAMPLE POPULATION: Studies on horses undergoing gastrointestinal surgery for small intestinal lesions, identified by systematic search between 2001 and 2017. METHODS: A search with PubMed/MEDLINE, Web of Science, and Google Scholar was performed, followed by secondary searches of veterinary trade journals and bibliographies of relevant articles. The primary outcome measure for this study was the effect of lidocaine therapy on the odds of POR. Subgroup analysis assessed included the timing of lidocaine therapy, incidence of mortality, and incidence of repeat celiotomy. A meta-analysis was performed with a random effects model, with the effect size calculated as an odds ratio (OR) with 95% confidence intervals (CI). Statistical significance was set at P < .05. RESULTS: Among 1933 peer reviewed publications that met the initial search criteria, 12 relevant studies were available for analysis. Lidocaine was associated with an increased incidence of diagnosis of POR (OR 6.3, 95% CI [1.4, 27.0], P = .01). Horses treated with lidocaine were more likely to survive to discharge (OR 6.8, 95% CI [3.9, 11.7], P < .01). CONCLUSION: Lidocaine was associated with an increased survival rate in horses undergoing exploratory celiotomy for small intestinal disease according to this meta-analysis of the recent literature. CLINICAL SIGNIFICANCE: This body of published evidence provides support to administer lidocaine in horses to improve survival rather than preventing POR.

Fatal pulmonary hemorrhage in a horse during bronchoalveolar lavage - single case report.

BACKGROUND: Pulmonary hemorrhage is a rare cause of death in horses. Hemorrhage within the respiratory tract has many causes, including mycosis of the guttural pouch, invasive procedures causing serious trauma to nasal conchae, or lung biopsy. We report on a rare case of a fatal pulmonary hemorrhage in a horse after a severe cough during bronchoalveolar lavage. To the best of our knowledge, this is the first report of spontaneous hemorrhage in a horse during bronchoalveolar lavage. CASE PRESENTATION: A 21-year-old mare which belonged to the didactic herd of The Faculty of Veterinary Medicine underwent BAL procedure for training purposes. Clinical examination prior to the procedure did not reveal any abnormalities and the horse had been classified as healthy. The horse was sedated with 0.01 mg/kg of detomidine and 0.01 mg/kg of butorphanol. The silicon BAL catheter was passed through the nasal passage into the trachea and then into the bronchus. Before catheter was wedged, the mare began to cough heavily and massive haemorrhage from mouth and nostrils occurred. Despite fluid therapy, shock occurred within 15 min and the mare was euthanized. Upon necropsy, site of hemorrhage was identified in the left lobar caudal bronchi, from a large blood vessel running directly beneath the bronchial wall. Upon histology, a chronic lympho-plasmocytic inflammatory process in left bronchi was identified. Moreover, Masson's trichrome staining revealed severe, perivascular fibrosis. CONCLUSION: Although BAL is a relatively safe procedure, and such complications should be treated as extremely rare, this case indicates that, in some individuals with specific subclinical problems, even mild physical force such as a cough can lead to rupture of the artery.

Plasma transfusions in horses with typhlocolitis/colitis.

The outcome of treatment of horses with plasma for typhlocolitis/colitis at the Ontario Veterinary College-Health Sciences Centre was evaluated. Horses with typhlocolitis/colitis that received a plasma transfusion had higher odds of dying than did non-transfused horses. The clinical usefulness of transfusing plasma to hospitalized hypoproteinemic horses is questioned.

Transfusions de plasma chez les chevaux atteints de typhlocolite/colite. Les résultats du traitement des chevaux à l'aide de plasma pour la typhlocolite/colite au Health Sciences Centre de l'Ontario Veterinary College ont été évalués. Les chevaux atteints de typhlocolite/colite qui avaient reçu une transfusion de plasma présentaient une probabilité accrue de décès par rapport aux chevaux qui n'avaient pas reçu une transfusion. L'utilité clinique de la transfusion de plasma aux chevaux hypoprotéinémiques hospitalisés est remise en question.(Traduit par Isabelle Vallières).

Effects of hyaluronate-carboxymethylcellulose membranes on the clinical outcome of horses undergoing emergency exploratory celiotomy.

OBJECTIVE: To determine the influence of hyaluronate-carboxymethylcellulose (HA-CMC) membranes applied to intestinal anastomoses or enterotomies on postoperative complications after emergency exploratory celiotomy. STUDY DESIGN: Multicenter retrospective case-controlled series. ANIMALS: Adult horses (59 in the HA-CMC group and 91 controls). METHODS: Medical records from 4 referral hospitals were searched for horses ≥1 year of age, treated between 2008 and 2014 with emergency exploratory celiotomy, and surviving at least 24 hours postoperatively. Horses receiving repeat celiotomy during the same hospitalization were excluded. Horses who received HA-CMC were matched with controls who did not receive HA-CMC but had similar intestinal lesions and procedures at the same referral hospital. Postoperative complications (colic, nasogastric reflux, fever, incisional infection, and septic peritonitis), duration of hospitalization, and survival were compared between groups. Data were compared between horses by t test, Wilcoxon signed rank test, and χ2 test. RESULTS: The volume of nasogastric reflux at admission (P = .02) and the duration of administration of lidocaine after surgery (P = .02) were greater in horses with HA-CMC membranes than in controls. No difference in postoperative complications or survival was detected between groups: 48 of 59 (81%) horses treated with HA-CMC survived until discharge from the hospital compared with 80 of 91 (88%) horses in the control group (P = .27). Fifteen of 21 horses treated with HA-CMC and 30 of 43 horses in the control group survived >12 months after hospital discharge. CONCLUSION: Application of HA-CMC membranes to anastomoses or intestinal incisions did not influence postoperative complications or survival after emergency celiotomy compared with controls. CLINICAL SIGNIFICANCE: The safety and efficacy of HA-CMC membrane application to intestinal sites during colic surgery in horses is equivocal.

Surgical management of postcastration spermatic cord stump infection in horses: A retrospective study of 23 cases.

OBJECTIVE: To report the surgical management and the short- and long-term follow-up of postcastration spermatic cord infection in horses. STUDY DESIGN: Retrospective case series. ANIMALS: Twenty-three client-owned horses. METHODS: Medical records (2001-2017) of horses that had been surgically treated for spermatic cord stump infection after castration were reviewed. Time from castration to presentation, diagnostic procedures, surgical complications, bacterial culture and ancillary testing, and survival to discharge were collected. Long-term follow-up was obtained by owner survey when possible. Descriptive statistics were used to report results. RESULTS: Horses ranged in age from 2 to 14 years (mean age 4.1) and presented 33 days (median; range, 12-3561) after castration. Five of 23 horses required revision surgery because of hemorrhage (2) or persistent infection (3). All horses survived to discharge. Long-term follow up was available for 16 horses at a mean time of 27.4 months postsurgery (range 6-135). Complete resolution of clinical signs and return to previous use was documented in 14 of 16 horses; 1 horse had persistent purulent drainage and a second horse was retired because he did not return to adequate performance. CONCLUSION: Postcastration infection of the spermatic cord had a favorable prognosis for short- and long-term survival in this population, although complications included postoperative hemorrhage and persistent infection. CLINICAL SIGNIFICANCE: This study describes the treatment of postcastration infection of the spermatic cord which results in a good survival rate.

Investigation of perioperative and anesthetic variables affecting short-term survival of horses with small intestinal strangulating lesions.

OBJECTIVE: To determine if preoperative and intraoperative physiologic variables, and surgical factors correlate with survival to anesthetic recovery or hospital discharge, repeat celiotomy, and postoperative nasogastric intubation (NGT) in horses undergoing exploratory celiotomy for small intestinal (SI) strangulating lesions. STUDY DESIGN: Retrospective case series. ANIMALS: Horses that had surgical correction of SI strangulating lesions (n = 258). METHODS: Medical records (January 2000-December 2014) of horses that had surgical correction of SI strangulating lesions were reviewed. Data collection included signalment, preoperative physical examination variables, hematologic values, presence of gastric reflux, peritoneal fluid analysis, intraoperative physiologic variables, intraoperative findings/treatments, and arterial blood gas values. Risk factors for survival to anesthetic recovery and hospital discharge were determined using exact logistic regression. RESULTS: Survival to anesthetic recovery was 76% and survival to discharge after anesthetic recovery was 79%. The difference between abdominal and peripheral lactate concentrations and intraoperative tachycardia were associated with not surviving to anesthetic recovery or hospital discharge. Intraoperative hypotension, hypocapnia, and low intraoperative packed cell volume (PCV) were negative predictors of survival to anesthetic recovery. Low intraoperative PCV was also associated with NGT postoperatively. Performing resection-anastomosis and jejunocecostomy were associated with repeat celiotomy and with not surviving to hospital discharge. CONCLUSION: Several hematological and cardiorespiratory variables show good correlation with short-term survival in horses undergoing surgery for SI strangulating lesions. These variables are easily measured and could be useful for prognosticating survival in horses presenting with SI strangulating lesions.

Duodenojejunal mesenteric rents: Survival and complications after surgical correction in 38 broodmares (2006-2014).

OBJECTIVES: To describe short-term and long-term survival of horses with duodenojejunal mesenteric rents, and to examine the association of selected preoperative, intraoperative, and postoperative factors with survival or colic after discharge, in horses with duodenojejunal mesenteric rents. STUDY DESIGN: Retrospective case series. ANIMALS: Horses undergoing surgery for correction of small intestinal lesions secondary to duodenojejunal mesenteric rents (n = 38). METHODS: Medical records (2006-2014) of horses admitted to a referral hospital in Kentucky were reviewed. Data for preoperative and intraoperative findings, postoperative complications, and short-term survival to discharge were recorded Long-term (>12 months) survival was determined by follow-up telephone query. Association of factors with survival and colic after discharge was determined using logistic regression. RESULTS: All 38 horses were Thoroughbred broodmares. Short-term survival was 76% overall and 88% among horses that recovered from general anesthesia. Long-term survival was 74% overall and 97% for mares that survived to discharge. All long-term survivors and 85% of mares that recovered from general anesthesia returned to use for breeding. The odds of survival were significantly higher for horses ≤10 years of age (OR = 6.2; 95% CI, 1.1-34.4). Failure to close the rent was associated with increased odds of colic after discharge, but had no effect on survival. CONCLUSION: Short-term and long-term survival was high relative to prior reports and mares surviving to discharge following mesenteric rent surgery had an excellent prognosis for long-term survival. Based on our data, closure of rents is recommended to prevent recurrence of colic, but may be unnecessary for survival.

What's New in Old Horses? Postmortem Diagnoses in Mature and Aged Equids.

Postmortem findings in 241 equids admitted to a teaching hospital that were at least 15 years old at autopsy were reviewed (1) to determine disease prevalence, (2) to compare the cause of death (or euthanasia) in equids 15 to 19 years of age (n = 116) with that in equids ≥20 years of age (n = 125), and (3) to catalog coexisting lesions in equids with pituitary pars intermedia dysfunction (PPID). Breed and sex were evenly distributed between the age groups. Death or euthanasia was attributed to disease of the digestive system (41.5%), pituitary gland (12.9%), locomotor system (10.0%), nervous system (7.9%), cardiovascular system (4.6%), urinary system (4.6%), reproductive system (4.2%), respiratory system (4.2%), integumentary system (4.2%), lymphoid system (2.5%), liver (2.5%), or systemic neoplasia (1.2%). Nervous system disease was more common in the 15- to 19-year group; urinary tract disease was more common in the ≥20-year group. Neoplastic disease, regardless of systemic location, was the basis for death or euthanasia in 18.7% of all equids. Squamous cell carcinoma, lymphoma, and melanoma were the most common malignant neoplasms. PPID was the most common specific diagnosis, based on the postmortem presence of hyperplasia or adenoma, and was the reason for euthanasia in 47.7% of 65 equids with PPID. The most common nonpituitary causes for death or euthanasia in equids with PPID were colic, lameness, cancer, and spinal cord disease. Coexisting conditions in equids with PPID that were not considered the basis for euthanasia included neoplasms, infections, lameness, and recurrent airway obstruction.

Risk Factors Associated With Survival to Hospital Discharge of 54 Horses With Fractures of the Radius.

OBJECTIVE: To determine (1) survival to discharge of horses with radial fractures (excluding osteochondral fragmentation of the distal aspect of the radius and stress fractures); and (2) risk factors affecting survival to hospital discharge in conservative and surgically managed fractures. STUDY DESIGN: Case series. ANIMALS: Horses (n = 54). METHODS: Medical records (1990-June 2012) and radiographs of horses admitted with radial fracture were reviewed. Horses with osteochondral fragmentation of the distal aspect of the radius or stress fractures were excluded. Evaluated risk factors were age, fracture configuration, surgical repair method, surgical duration, hospitalization time, implant failure rate, and surgical site infection (SSI) rate. RESULTS: Of 54 horses, overall survival to discharge was 50%. Thirteen (24%) were euthanatized on admission because of (1) fracture severity; (2) presence of an open fracture; or (3) financial constraints. Fourteen (26%) horses with minimally displaced incomplete fractures were conservatively managed and 12 (86%) survived to discharge. Twenty-seven (50%) horses had surgical treatment by open reduction and internal fixation (ORIF) and 15 (56%) survived to hospital discharge. Open fractures were significantly more likely to develop SSI (P = .008), which also resulted in a 17-fold increase in implant failure (P < .005). Six of 8 surgically managed horses with an open fracture did not survive to discharge. Outcome was also adversely affected by age (P < .005) and surgical duration > 168 minutes (P < .027). Presence of SSI trended toward a decreased survival rate (P = .09). CONCLUSION: Prognosis for survival to discharge with minimally displaced incomplete fractures is good. Young horses have a good prognosis survival to discharge for ORIF, whereas ORIF in adult horses has a poor prognosis and SSI strongly correlates with catastrophic implant failure.

End-to-Side Versus Side-to-Side Jejunocecostomy in Horses: A Retrospective Analysis of 150 Cases.

OBJECTIVES: To determine factors associated with postoperative reflux, postoperative colic, repeat celiotomy, and survival in horses after end-to-side (E2S) or side-to-side (S2S) jejunocecostomy. STUDY DESIGN: Retrospective, multicenter study. SAMPLE POPULATION: Horses (n = 150). METHODS: Admissions, intra- and postoperative data were collected from medical records of horses that had E2S or S2S jejunocecostomy. Descriptive statistics were calculated and data were analyzed using parametric and nonparametric tests, linear and multivariate logistic regression with significance set at P < .05. Kaplan-Meier estimate of the survival function was performed. RESULTS: One hundred fifty horses (S2S = 90, E2S = 60) were included. S2S procedures were performed using staples (n = 57) or hand-sewn (33). Method of anastomosis was not significantly associated with development of postoperative reflux or colic, repeat celiotomy, whether the horse was alive at hospital discharge or 12 months after discharge. The number of years that the principal surgeon was boarded by the American College of Veterinary Surgeons significantly affected whether the horse was discharged from the hospital alive (P = .003). Age (P = .006) was significantly associated with 12-month survival. Increased age (P = .013) and administration of prokinetic medication (P = .0006) were significantly associated with development of postoperative reflux. Sixty-eight (76%) horses with S2S and 52 (87%) horses with E2S were discharged alive. CONCLUSION: Age, patient related variables, and surgeon experience may influence morbidity and mortality more than method of jejunocecostomy.

Retrospective Comparison of Gastrosplenic Entrapment of the Small Intestine to Other Strangulating Small Intestinal Lesions in Adult Horses.

OBJECTIVE: To compare clinical data of horses with entrapment of the small intestine by the gastrosplenic ligament (ESIGL) to clinical data of horses with other strangulating small intestinal lesions. STUDY DESIGN: Retrospective case series. METHODS: Medical records (January 2001-December 2011) of horses that had exploratory celiotomy for acute abdominal pain associated with strangulating small intestinal lesions were reviewed. Signalment, physical examination findings, clinicopathologic variables, surgical findings and surgical procedures performed, postoperative data and short-term survival were recorded. RESULTS: Clinical findings included excessive nasogastric reflux and abnormal abdominal fluid. Horses with ESIGL were significantly more likely to require intestinal resection and anastomosis and produced significantly less reflux postoperatively than horses with other strangulating small intestinal obstructions. Geldings were significantly more likely to develop ESIGL than mares or stallions. Quarter Horse or Quarter Horse type breeds were predisposed to ESIGL. Survival to hospital discharge in horses with ESIGL (16/22; 72.7%) was significantly higher than that of horses with other strangulating small intestinal obstructions (92/183; 50%). CONCLUSIONS: ESIGL was more prevalent in this population of horses evaluated for acute abdominal pain than in previous studies, accounting for 10.7% of all horses with strangulating small intestinal lesions. Geldings and Quarter Horse or Quarter Horse related breeds are predisposed to this condition. The prognosis for survival to hospital discharge was fair to good.

Anthrax vaccine associated deaths in miniature horses.

During a widespread anthrax outbreak in Canada, miniature horses were vaccinated using a live spore anthrax vaccine. Several of these horses died from an apparent immune-mediated vasculitis temporally associated with this vaccination. During the course of the outbreak, other miniature horses from different regions with a similar vaccination history, clinical signs, and necropsy findings were found.

Vaccin contre l'anthrax associé à la mort de chevaux miniatures. Durant une vaste éclosion d'anthrax au Canada, des chevaux miniatures ont été vaccinés en utilisant un vaccin à base de spores viables d'anthrax. Plusieurs chevaux sont morts d'une vasculite d'origine immunologique associée temporellement avec cette vaccination. Pendant l'éclosion, on a trouvé d'autres chevaux miniatures de régions différentes présentant une anamnèse de vaccination, de signes cliniques et de résultats d'autopsie semblables.(Traduit par Isabelle Vallières).

Common clinical findings identified in working equids in low- and middle-income countries from 2005 to 2021.

Despite several millions of working equids worldwide, there are few published studies regarding the epidemiology of their health and welfare. Data collected by non-governmental organisations (NGOs) operating in the working equid sphere therefore have important epidemiological value and could be used towards animal health surveillance. The aim of this study was to identify common clinical findings and mortality patterns of working equids in low- and middle-income countries and investigate their epidemiology using data collected from an international NGO. A retrospective analysis was conducted to determine the proportion of clinical findings and mortality risk by equid species, year and region. Negative binomial regression models were generated to investigate differences in mortality risk and proportion of key clinical findings between equid species, hemispheres and calendar month. A total of 4,313,606 presentations were reported from 14 countries between January 2005 and March 2021 (mean 22,121; SD ± 7,858 per month). Wounds and abscesses were the most reported clinical finding for all equid species (mean proportion 35%; SD ±0.19 of all findings). A higher proportion of wounds (mean proportion 41.7%; SD±0.2) was recorded in donkeys than mules or horses (P<0.001). Mules had higher reported mortality risk (1.2%; 95% CI 0.94-1.46%) than horses (0.4%; 95% CI 0.36-0.55%; p<0.001) or donkeys (0.2%; 95% CI 0.14-0.22%). Work-related wounds were the predominant finding in working equids, particularly so in donkeys. Prevention strategies should focus on improvements to work equipment and practices for all equids. Future investigations required include refinement of diagnostic approaches for donkeys and investigation of risk factors to understand the higher mortality in mules. Routine monitoring of clinical findings reported by national or international NGOs could be included in animal health surveillance strategies, although standardisation of data for this purpose is needed so that changes in prevalence following implementation of prevention strategies can be monitored.

Use of physiologic and arterial blood gas variables to predict short-term survival in horses with large colon volvulus.

OBJECTIVE: To determine if preoperative physical examination and blood work values, intraoperative physiologic variables, and intraoperative treatments can be correlated with survival to anesthetic recovery and short-term survival to hospital discharge in horses that undergo exploratory celiotomy for large colon volvulus (LCV) with and without colon resection. STUDY DESIGN: Retrospective case series. ANIMALS: Horses (n = 156) undergoing exploratory celiotomy for correction of LCV ≥ 360(ο) . METHODS: Medical records (January 2000-December 2009) of horses that had surgical correction of LCV ≥ 360(ο) were reviewed. Data collection included signalment, preoperative physical examination variables and hematologic values as well as intraoperative physiologic variables, intraoperative treatments, and arterial blood gas values. Risk factors for survival to anesthetic recovery and hospital discharge were determined using exact logistic regression. RESULTS: High preoperative heart rate and packed cell volume were associated with not surviving to anesthetic recovery or hospital discharge. A low intraoperative total serum protein concentration was associated with not surviving to anesthetic recovery or to hospital discharge. Intraoperative tachycardia and hypercapnia were associated with not surviving to hospital discharge. Intraoperative hypotension was a negative predictor of survival to anesthetic recovery. There was no increase in death for horses in which a resection and anastomosis was performed compared with those having manual correction. CONCLUSIONS: Several hematologic and cardiorespiratory variables that are easily measured preoperatively and intraoperatively show good correlation with postanesthetic survival in horses undergoing surgical correction of LCV. These measurements might be useful for prognosticating survival in horses admitted for correction of LCV ≥ 360(ο) .

Pathology of Clostridium perfringens type C enterotoxemia in horses.

Clostridium perfringens type C is an important cause of enteritis and enterocolitis in foals and occasionally in adult horses. The disease is a classic enterotoxemia, and the enteric lesions and systemic effects are caused primarily by beta toxin, 1 of 2 major toxins produced by C. perfringens type C. Until now, only sporadic cases of C. perfringens type C equine enterotoxemia have been reported. We present a comprehensive description of the lesions in 8 confirmed cases of type C enterotoxemia in foals and adult horses. Grossly, multifocal to segmental hemorrhage and thickening of the intestinal wall were most common in the small intestine, although the colon and cecum were also frequently affected. All horses had variable amounts of fluid, often hemorrhagic intestinal contents. The most characteristic microscopic lesion was necrotizing or necrohemorrhagic enteritis, with mucosal and/or submucosal thrombosis. Numerous gram-positive rods were occasionally seen in affected mucosa. A definitive diagnosis of C. perfringens type C enterotoxemia in all 8 cases was based on the clinical history, gross and histologic lesions, and detection of the beta toxin in intestinal contents.

Use of pelvic flexure biopsy scores to predict short-term survival after large colon volvulus.

OBJECTIVE: To (1) determine if histologic scores of pelvic flexure biopsies can predict short-term survival in horses with large colon volvulus (LCV) and (2) identify clinical variables predictive of short-term survival. STUDY DESIGN: Case series. ANIMALS: Horses (n = 28) with LCV (≥ 360°). METHODS: Medical records (January 2000-February 2008) of 28 horses were reviewed and clinical data recorded. Pelvic flexure biopsies were reviewed by 2 board-certified veterinary pathologists, unaware of clinical history and outcome, using 2 scoring systems. Exact logistic regression analysis was used to determine the relationship between histopathology scores (tissue viability), clinical data, and short-term survival (hospital discharge). RESULTS: Twenty-four horses (86%) survived to hospital discharge. Using a similar cutoff, neither scoring system was capable of predicting short-term survival. One scoring system failed to correctly predict clinical outcome in 5/25 horses (20%) and the other failed in 6/28 horses (22.4%). Heart rate (at admission and 24 hours after surgery) and packed cell volume 24 hours after surgery were significantly associated with short-term survival. CONCLUSION: Histopathologic evaluation of pelvic flexure biopsies did not accurately predict short-term survival in a significant proportion of horses with LCV in this study.

Clinical evaluation of a closed, one-stage, stapled, functional, end-to-end jejuno-ileal anastomosis in 5 horses.

This study describes the outcome and complications in horses that had a closed, one-stage, stapled, functional, end-to-end (COSFE) jejuno-ileal anastomosis (JIA) following resection of compromised small intestine. Medical records were reviewed to identify all horses that had a COSFE JIA performed during exploratory laparotomy and to determine post-operative complications and final outcome. All 5 horses that were identified had successful COSFE JIA with resection of various amounts of distal jejunum and proximal ileum. Post-operative ileus occurred in 1 of the 5 horses. All horses survived at least 1 year after surgery. The survival times and incidence of post-operative ileus compared favorably with published results for other types of small intestinal resection and anastomoses. A COSFE JIA is a viable surgical procedure to correct lesions of the distal jejunum and proximal ileum.This study describes the outcome and complications in horses that had a closed, one-stage, stapled, functional, end-to-end (COSFE) jejuno-ileal anastomosis (JIA) following resection of compromised small intestine. Medical records were reviewed to identify all horses that had a COSFE JIA performed during exploratory laparotomy and to determine post-operative complications and final outcome. All 5 horses that were identified had successful COSFE JIA with resection of various amounts of distal jejunum and proximal ileum. Post-operative ileus occurred in 1 of the 5 horses. All horses survived at least 1 year after surgery. The survival times and incidence of post-operative ileus compared favorably with published results for other types of small intestinal resection and anastomoses. A COSFE JIA is a viable surgical procedure to correct lesions of the distal jejunum and proximal ileum.

RésuméÉvaluation clinique d'une anastomose jéjuno-iléale fermée, en un temps, agrafée, fonctionnelle et termino-terminale chez 5 chevaux. Cette étude décrit le résultat et les complications d'une anastomose jéjuno-iléale (AJI) fermée, en un temps, agrafée, fonctionnelle et termino-terminale (FTAFTT) chez des chevaux après la résection d'un petit intestin compromis. Les dossiers médicaux ont été examinés pour identifier tous les chevaux qui avaient subi une AJI FTAFTT durant une laparotomie exploratoire et déterminer les complications postopératoires et le résultat final. Les 5 chevaux qui ont été identifiés ont tous subi une AJI FTAFTT réussie avec résection de diverses quantités du jéjunum distal et de l'iléon proximal. Une occlusion intestinale postopératoire s'est produite chez 1 des 5 chevaux. Tous les chevaux ont survécu au moins 1 an après la chirurgie. Le temps de survie et l'incidence d'une occlusion intestinale postopératoire ont présenté une comparaison favorable avec les résultats publiés pour d'autres types de résection du petit intestin et d'anastomoses. Une AJI FTAFTT est une intervention chirurgicale viable pour corriger les lésions du jéjunum distal et de l'iléon proximal.(Traduit par Isabelle Vallières).

Pelvic flexure enterotomy closure in the horse with a TA-90 stapling device: a retrospective clinical study of 84 cases (2001-2008).

Our objective was to compare survival and complication rates of horses undergoing pelvic flexure enterotomy closure with a TA-90 stapler to those with hand-sewn closure. Medical records of horses undergoing pelvic flexure enterotomy between 2001 and 2008 were reviewed. History, clinical signs, surgical findings, surgical techniques, and post-operative complications were recorded. Long-term outcome was established by telephone questionnaire. Of 84 pelvic flexure enterotomies performed, 70 were stapled and 14 were hand-sewn. Seventy-seven horses survived to discharge (91.7%). There were no significant associations between survival and closure technique (P = 0.69). Follow-up was available for 54 horses; 50 survived long-term (93.0%). No statistical significance was identified between long-term survival and closure method (P = 0.39). Forty horses went on to athletic performance (80.0%). TA-90 stapled closure of pelvic flexure enterotomies is a safe technique resulting in survival and complication rates equivalent to those of hand-sewn closure.

Perioperative risk factors for mortality and length of hospitalization in mares with dystocia undergoing general anesthesia: a retrospective study.

This study investigated associations between perioperative factors and probability of death and length of hospitalization of mares with dystocia that survived following general anesthesia. Demographics and perioperative characteristics from 65 mares were reviewed retrospectively and used in a risk factor analysis. Mortality rate was 21.5% during the first 24 h post-anesthesia. The mean ± standard deviation number of days of hospitalization of surviving mares was 6.3 ± 5.4 d. Several factors were found in the univariable analysis to be significantly associated (P < 0.1) with increased probability of perianesthetic death, including: low preoperative total protein, high temperature and severe dehydration on presentation, prolonged dystocia, intraoperative hypotension, and drugs used during recovery. Type of delivery and day of the week the surgery was performed were significantly associated with length of hospitalization in the multivariable mixed effects model. The study identified some risk factors that may allow clinicians to better estimate the probability of mortality and morbidity in these mares.

Endocrine dysregulation in critically ill foals and horses.

Critical illness challenges many endocrine homeostatic systems to overcome diseases, stress, and hostile conditions that threaten survival. Coordinated and consecutive responses by the autonomic nervous system, endocrine metabolic adaptations to mobilize and conserve energy and electrolytes, cardiovascular adjustments to maintain organ perfusion, and immunomodulation to overcome infections and inflammation are required. Because most admissions to equine intensive care units are related to horses with gastrointestinal disease and septic foals, most endocrine information during critical disease are generated from these populations. This article presents an overview on endocrine responses to critical illness in horses and foals and also some comparative information.