Using Artificial Intelligence to Predict Survivability Likelihood and Need for Surgery in Horses Presented With Acute Abdomen (Colic).

Artificial intelligence and machine learning have promising applications in several medical fields of diagnosis, imaging, and laboratory testing procedures. However, the use of this technology in the veterinary medicine field is lagging behind, and there are many areas where it could be used with potentially successful outcomes and results. In this study, two critical predictions were explored in horses presented with acute abdomen (colic) using this technology. Those were the need for surgical intervention and survivability likelihood of affected horses based on clinical data (history, clinical examination findings, and diagnostic procedures). The two prediction parameters were explored using the application of Decision Trees, Multilayer Perceptron, Bayes Network, and Naïve Bayes. The machine learning algorithms were able to predict the need for surgery and survivability likelihood of horses presented with acute abdomen (colic) with 76% and 85% accuracy, respectively. The application of this technology in the different clinical fields of veterinary medicine appears to be of a value and warrants further investigation and testing.

Primary gastric rupture in 20 horses from Midwestern Brazil: case report / Ruptura gástrica primária em 20 equinos no Centro-Oeste do Brasil: relato de caso

An 11-year (2007-2018) survey of epidemiological, clinical and pathological findings of horses with primary gastric rupture (PGR) was conducted. Twenty horses presented PGR, nine (45%) horses were clinically evaluated, eleven (55%) were sent dead, and all animals were necropsied. PGR contributed to a prevalence of 0.31% (9/2,868) of all equid attendances, 1.83% (9/491) of colic cases, and 4.1% (20/487) of all equid necropsies. Highly fermentable feed (n=7), gastric impaction (n=4), and perforating gastric ulcer (n=1) were the main causes of PGR; whilst eight horses presented idiopathic gastric rupture. Clinically evaluated horses were tachycardic, tachypneic, febrile, dehydrated, with increased abdominal tension, abnormal mucous membranes and reduced to absent intestinal borborygmi. Improper dietary management, such as the ingestion of low-quality roughage and highly fermentable feedstuffs were detected as the main factors associated with PGR in Midwestern Brazil. It is important to raise awareness in horse owners about proper feed management to minimize PGR.(AU)

Foi realizado um levantamento de 11 anos (2007-2018) dos achados epidemiológicos, clínicos e patológicos de equinos com ruptura gástrica primária (RGP). Vinte equinos apresentaram RGP, dos quais nove (45%) foram avaliados clinicamente e 11 (55%) foram enviados mortos, sendo todos os animais necropsiados. A RGP contribuiu com prevalência de 0,31% de todos os atendimentos de equídeos (9/2.868), 1,83% (9/491) dos casos de cólica, e 4,1% (20/487) das necropsias em equídeos. Alimentos altamente fermentáveis (n=7), compactação gástrica (n=4) e perfuração de úlcera gástrica (n=1) foram as principais causas de RGP, enquanto oito equinos tiveram ruptura gástrica idiopática. Os equinos avaliados clinicamente apresentaram-se taquicárdicos, taquipneicos, febris, desidratados, com mucosas anormais, aumento da tensão abdominal e motilidade intestinal reduzida. O manejo inadequado da dieta, como a ingestão de forragens de baixa qualidade e alimentos altamente fermentáveis, foi o principal fator de risco associado à RGP no Centro-Oeste do Brasil. É importante aumentar a conscientização dos proprietários de equinos sobre o manejo alimentar adequado para minimizar a RGP.(AU)

Prognostic relevance of pre- and postoperative plasma l-lactate measurements in calves with acute abdominal emergencies.

In both human and veterinary medicine, l-lactate is a well-established prognostic biomarker of disease severity and mortality and has also attracted increasing attention in bovine medicine due to the availability and validation of cheap and portable l-lactate analyzers. The aim of the present study was to evaluate the prognostic accuracy of plasma L-lactate measurements in calves with acute abdominal emergencies before and during the initial therapeutic period after surgical intervention. A prospective observational study was carried out involving 83 hospitalized calves up to an age of 7 mo, which required surgical intervention for reasons of an acute abdominal emergency such as gastrointestinal ileus or peritonitis. Plasma l-lactate (L-LAC) concentrations were determined immediately before initiation of surgery and 6, 12, 24, 48, and 72 h later. The outcome of calves was evaluated 3 mo after discharge by a phone call to the farmer, and a positive outcome was defined if the calf was still alive and the owner was satisfied with the animal's postsurgical progress. A total of 29% of calves were discharged from the hospital and the proportion of calves with a positive outcome after the 3-mo period was 24%. At all sampling times during the first 48 h after initiation of surgical intervention, calves with a negative outcome had significantly higher L-LAC than calves with a positive outcome. A binary logistic regression analysis indicated that the odds for a negative outcome during the 3-mo observation period increased by a factor of 1.23 [95% confidence interval (CI): 1.04-1.44] for every mmol/L increase of L-LAC before initiation of surgical intervention, but by a factor of 5.29 (95% CI: 1.69-16.6) and 5.92 (95% CI: 1.29-27.3) at 12 and 24 h, respectively. The largest area under the receiver operating characteristic curve for L-LAC was observed at 12 h (0.91; 95% CI: 0.83-0.99), and a cut-point of 2.75 mmol/L was identified that had a sensitivity and specificity for predicting a negative outcome of 68 and 100%, respectively. In conclusion, persistent hyper-l-lactatemia during the early postoperative period is a more reliable indicator for a negative outcome in calves with acute surgical abdominal emergencies than hyper-l-lactatemia before initiation of surgical intervention. Postoperative measurements of L-LAC are therefore a clinically useful tool to identify patients with an increased risk for a negative outcome at an early stage after surgical intervention was carried out.

Changes in saliva analytes in equine acute abdominal disease: a sialochemistry approach.

BACKGROUND: The biochemical components of saliva can change in certain pathologies in horses, for example in acute abdominal disease. The aim of this study was (1) to evaluate if a panel of biochemical analytes usually used in serum can be measured in saliva of horses and (2) to study the possible changes of these biochemical analytes in saliva of horses affected by acute abdominal disease. A panel of 23 analytes was analytically validated in saliva of horses and possible changes in these analytes in a pilot study with six healthy horses and six horses with acute abdominal disease were evaluated. The analytes with significant changes were then evaluated in a larger population of 20 healthy and 37 diseased horses. RESULTS: Seven analytes showed significant increases in the pilot study which were confirmed in the larger population. The analytes which showed significant changes, and their median fold increase and significance shown in the larger population were salivary γ-glutamyl transferase (gGT, 2.3 fold, P = 0.001), creatine kinase (CK, 6.2 fold, P < 0.001), urea (2.3 fold, P = 0.001), total bilirubin (2.6 fold, P < 0.001), total proteins (3.2 fold, P < 0.001), phosphorus (P, 4.5 fold, P < 0.001) and alpha-amylase (sAA, 8.5 fold, P < 0.001). Total proteins, P and sAA showed sensitivities higher than 70% at their optimal cut-off points and a specificity of 100% in differentiating between healthy horses and those with acute abdominal disease. CONCLUSIONS: A panel of 23 biochemical analytes can be measured in saliva of horses, where gGT, CK, urea, total bilirubin, total protein, P and sAA levels are raised in horses with acute abdominal disease.

Exploratory Celiotomy in the Horse Secondary to Acute Colic: A Review of Indications and Success Rates.

To review indications and risk factors for exploratory celiotomy secondary to acute colic in the horse; decision making for and during surgery; and prognosis for return to function after exploratory celiotomy for the practicing veterinarian. Data sources included scientific reviews and original research publications from veterinary sources, as well as clinical data specifically in regard to underlying disease and survival rates from a tertiary referral hospital where exploratory celiotomy is commonly performed. There is a high positive predictive value of specific clinical preoperative parameters of the equine acute abdomen, many of which rely on techniques available to field practitioners, relative to the need for surgical intervention. Decision making regarding surgical procedure or even intraoperative euthanasia depends on owner expectations. Survival rates following exploratory celiotomy range from fair to excellent (60%-100%) depending on underlying lesion and return to athleticism following celiotomy is good to excellent (76%-90%). A knowledge base of indications for and rates of survival from colic requiring exploratory celiotomy in the horse is of paramount importance to the equine practitioner. Preconceived notions of poor survival rates are rampant among horse owners, and owners rely on their primary veterinarian's advice for continuation to referral center and in further treatment including exploratory celiotomy.

Salivary alpha-amylase activity and cortisol in horses with acute abdominal disease: a pilot study.

BACKGROUND: The aim of this study was to evaluate salivary alpha-amylase (sAA), considered a non-invasive biomarker for sympathetic nervous system (SNS) activity, and salivary cortisol as possible pain-induced stress biomarker, in horses with acute abdominal disease. Therefore, a prospective observational study was performed in which both biomarkers were analyzed in a group of horses with acute abdomen syndrome, and compared with a group of healthy control horses by an unpaired Student's t-test. In addition, the possible relationship between both biomarkers, the score in Equine Acute Abdominal Pain scales version 1 (EAAPS-1 scale), Heart Rate (HR) and Respiratory Rate (RR), plasma lactate, the systemic inflammatory response syndrome (SIRS) score and serum amyloid A (SAA) concentration was assessed by a Spearman correlation test. RESULTS: A total of 30 horses were included in the study, 19 with acute abdominal disease diagnosed as large colon displacements, simple impactions of the pelvic flexure, spasmodic colics and enteritis and 11 healthy ones. sAA activity (24.5 median-fold, P <  0.0001) and salivary cortisol (1.7 median-fold, P <  0.01) were significantly higher in horses with acute abdomen than in healthy horses. sAA activity was significantly correlated with EAAPS-1 scale (r = 0.78, 95% confidence interval [CI] 0.38-0.89, P < 0.001) and SIRS score (r = 0.49, 95% CI 0.03-0.78, P < 0.05). Neither sAA nor salivary cortisol correlated with HR, RR, plasma lactate and SAA. CONCLUSIONS: Although this study should be considered as preliminary one, alpha-amylase measurements in saliva could be a biomarker of pain-induced stress in horses with acute abdominal disease.

Utility of two-view vs. three-view abdominal radiography in canines presenting with acute abdominal signs.

There are clear differences in the normal radiographic appearance of the abdominal organs between a left lateral vs. a right lateral view. While a few veterinary academic institutions have transitioned to a three-view abdominal radiographic study protocol, obtaining only two views of the canine abdomen remains the current standard in veterinary medicine. In this combined retrospective and prospective, case-controlled study, 48 canine patients presenting with signs of acute abdomen were recruited. Four board-certified veterinary radiologists and four general practice veterinarians with greater than 3 years of experience in small animal practice were asked to determine if 10 predetermined findings were present within the set of images and if surgery was recommended based on those findings. Image readers were unaware of the clinical history. Three-view studies did not yield statistically significantly greater accuracy than two-view studies when evaluating all readers together. No statistically significant associations between the availability of the third view and increased accuracy or confidence were found in evaluations of general practitioners specifically. Evaluation of three-view radiographic examination, as compared to two-view examination, did not have perceived or statistically significantly increased diagnostic utility. Based on our findings, there is no statistically increased utility to justify a standard three-view abdominal radiographic examination over a two-view study for canines presenting with signs of acute abdomen.

Diagnostic Approach to the Acute Abdomen.

The acute abdomen is a term used to characterize an animal presented as an emergency, in a more or less severe critical state, and for which medical and possibly surgical treatment will be necessary. To succeed, the clinician should use a systematic approach, have an excellent knowledge of the bovine abdominal anatomy, and have a good understanding of the pathophysiology of abdominal pain. Good clinical judgment, critical analysis, and good client communication skills are also essential. This article presents and discusses those necessary skills in the context of field practice.

Mesenteric thrombus associated with pulmonary, splenic, portal, and caval thrombi in a dog that was presented for an acute abdomen.

A 6-year-old Labrador retriever dog was presented for acute abdominal pain. A tentative diagnosis of mesenteric thrombosis was established antemortem. The dog was treated with supportive care and anti-coagulation but was ultimately euthanized due to disease-related complications. Necropsy examination confirmed an acute mesenteric thrombus along with widespread thromboembolic disease. Potential causes were protein-losing nephropathy, hepatopathy, and/or corticosteroid administration.

Thrombose mésentérique associée à des thromboses pulmonaire, splénique, portale et cavale chez un chien présenté pour un abdomen aigu. Un Labrador de 6 ans est présenté pour abdomen aigu. Un diagnostic de thrombose mésentérique est établi. Malgré le traitement, l'animal est euthanasié. L'autopsie confirme la thrombose de l'artère mésentérique ainsi que d'autres organes intra-abdominaux. Les causes potentielles sont une fuite urinaire de protéines, une atteinte hépatique, et/ou un traitement stéroïdien.(Traduit par les auteurs).

Use of a Boari flap and renal descensus as treatment for proximal ureteral rupture in a cat.

CASE DESCRIPTION A 6-year-old neutered male domestic shorthair cat was evaluated because of signs of abdominal pain and anuria of 12 hours' duration after vehicular trauma. CLINICAL FINDINGS Lethargy, mydriasis, bradycardia, abdominal distension, and signs of pain on abdominal palpation were observed. Abdominal ultrasonography revealed moderate urinary bladder distension without evidence of free abdominal fluid; hematologic evaluation revealed leukocytosis with high BUN and serum creatinine concentrations. TREATMENT AND OUTCOME The patient was hospitalized, medical stabilization was attempted, and an indwelling urinary catheter was placed. Urinary output was < 1 mL/kg/h (< 0.45 mL/lb/h), and signs of abdominal pain persisted despite treatment. The next day, ultrasonographic examination revealed fluid in the retroperitoneal space, and ureteral rupture was suspected. Exploratory laparotomy confirmed retroperitoneal fluid accumulation; a large hematoma surrounded the right kidney and perirenal structures. An abdominal drain was placed to aid patient stabilization. Three days later, IV pyelography revealed rupture of the proximal part of the right ureter. Ureteroneocystostomy was performed with elongated cystoplasty through a Boari flap and caudal transposition of the right kidney (renal descensus). On follow-up examination 18 months after treatment, the cat was free of clinical signs, and results of ultrasonography, CBC, and serum biochemical analysis were unremarkable. CLINICAL RELEVANCE Results suggested that a Boari flap procedure with renal descensus could be a feasible alternative in the management of proximal ureteral rupture in cats, but research is needed in this area.

[Comparison of the findings of rectal examination and ultrasonographic findings in horses with colic]. / Vergleich rektaler und sonographischer Untersuchungsbefunde bei der Kolik des Pferdes.

OBJECTIVE: The examination of patients suffering from an acute abdomen routinely comprises both clinical and rectal examinations, and is ever more frequently accompanied by an ultrasonographic abdominal examination. The aim of the study was to compare the findings as defined through rectal examination with the results of the ultrasonographic examination for different forms of colic. MATERIAL AND METHODS: In a retrospective study, the patient records of the Large Animal Clinic of the University of Leipzig from 2012 and 2013 were analysed, and those of horses suffering from colic were included. Diagnoses made through rectal and ultrasonographic examination were grouped and compared with the diagnoses made during colic surgery or pathologic examination, which served as the gold standard. Horses that underwent conservative treatment had a definitive diagnosis assigned only in cases where a pathognostic rectal finding defined the diagnosis. Based on these data, sensitivity, specificity and positive and negative predictive values were calculated for both techniques. RESULTS: Ultrasonography was more sensitive than rectal examination in cases of small intestinal occlusion (97.1% vs. 50.7%), torsion of the large colon in the long axis (63.2% vs. 26.3%) and dislocation of the large colon into the nephrosplenic space (90.9% vs. 72.7%). Rectal examination was more sensitive than ultrasonographic examination in cases of other types of dislocation of the large colon (96.5% vs. 8.8%) and of constipations of the large colon (93.6% vs. 29.8%). CONCLUSION AND CLINICAL RELEVANCE: In cases of severe diseases, including small intestinal occlusions and torsions of the large colon, ultrasonography helps to better identify and more precisely diagnose conditions that in most cases require abdominal surgery than rectal examination. Therefore, under hospital conditions, it is highly advisable to include ultrasonography in the routine examination of the equine acute abdomen. However, this technique does not replace the traditional rectal examination, which is superior in the diagnosis of dislocations and constipations of the large colon as well as diseases of the caecum.

Ultrasound of the equine acute abdomen.

Abdominal ultrasound is an invaluable aid in the evaluation of the colic patient but can be heavily influenced by patient preparation, individual horse-to-horse variation, availability of ultrasound transducers, technique, experience level of the examiner, and complexity of the abdominal disorder. This article describes ultrasonographic anatomy of the normal equine abdomen and technique for examination of the equine colic patient. Common abnormalities of the stomach, small intestine, large intestine, and peritoneal cavity are described along with other abnormalities that may be discovered with abdominal ultrasonography of the colic patient, such as masses, urolithiasis, cholelithiasis, and thoracic or cardiac lesions.

Atypical presentation of ovarian remnant syndrome in a dog.

A 2 yr old spayed female dog presented for evaluation of abdominal pain, decreased appetite, dysuria, and frantic licking of her vulva. A midventral, soft, fluctuant mass was detected on abdominal palpation. Diagnostic testing and exploratory celiotomy revealed remnant ovarian tissue and a cystic uterine remnant. The ovary and cystic uterine remnant were removed and submitted for histopathological evaluation. Ovarian remnant syndrome (ORS) is an infrequently encountered condition of dogs. This dog had none of the classic signs of estrus associated with ORS but instead presented for sharp, intermittent, abdominal pain that is similar to women with ORS.

Diagnostic accuracy of the SNAP and Spec canine pancreatic lipase tests for pancreatitis in dogs presenting with clinical signs of acute abdominal disease.

OBJECTIVES: To (i) assess the clinical diagnostic accuracy of SNAP canine pancreatic lipase (cPL) and specific canine pancreatic lipase (Spec cPL) and (ii) assess the agreement of an abnormal test result between SNAP cPL and Spec cPL in dogs presenting with acute abdominal disease. DESIGN: Prospective observational cohort study. SETTING: University teaching hospital emergency center. ANIMALS: Thirty-eight client-owned dogs that presented with acute abdominal disease, with a known final diagnosis between March 2009 and April 2010. Dogs were retrospectively assigned into 2 groups, dogs with acute pancreatitis (AP) (Group 1) and dogs without AP (Group 2). INTERVENTIONS: Paired serum samples obtained within 24 hours of presentation were analyzed using the SNAP cPL test and Spec cPL assay. MEASUREMENTS AND RESULTS: SNAP cPL clinical sensitivity and specificity was 82% (9/11 dogs of group 1) and 59% (16/27 dogs of group 2), respectively. Spec cPL clinical sensitivity and specificity was 70% (7/10 dogs of group 1) and 77% (20/26 dogs of group 2), respectively. Accuracy of the SNAP and Spec cPL for a clinical diagnosis of pancreatitis was found to be 66% and 75%, respectively. Agreement between a positive SNAP (cPL ≥ 200 µg/L) and a clinical diagnosis pancreatitis resulted in κ = 0.33. Agreement between an increased Spec (cPL ≥ 400 µg/L) and a clinical diagnosis of pancreatitis resulted in a κ = 0.43. The agreement between SNAP and Spec cPL (cPL ≥ 200 µg/L) for the entire cohort resulted in κ = 0.78. CONCLUSION: SNAP cPL and Spec cPL results may provide a "false positive" diagnosis of pancreatitis in up to 40% of dogs presenting with acute abdominal disease. There is good overall agreement between SNAP cPL and Spec cPL; however, there were 4/38 dogs with positive SNAP cPL and "normal" Spec cPL.

Ultrasonographic examination in non-human primates with acute abdomen signs.

BACKGROUND: The acute abdomen is any abdominal disorder resulting in pain, shock, or sepsis. Although it has a multifactorial etiology, the primary cause is gastrointestinal tract pathology. The aim of this study was to assess the contribution of abdominal ultrasound as a complementary diagnostic tool in non-human primates with an acute abdomen. METHODS: Three different non-human primates with clinical signs of acute abdomen were evaluated as follows: a chimpanzee (Pan troglodytes), a tufted capuchin (Cebus apella), and a black-tufted marmoset (Callithrix penicillata). RESULTS: Ultrasonographic examination assisted in the identification of a variety of differential diagnoses and was used in decision-making for exploratory laparotomy, which was performed in two animals. Ultrasound examination confirmed the source of the acute abdomen as the gastrointestinal tract in the three animals studied. CONCLUSIONS: Abdominal ultrasound is a useful technique for the investigation of signs of acute abdomen in non-human primates.

Comparison between survey radiography, B-mode ultrasonography, contrast-enhanced ultrasonography and contrast-enhanced multi-detector computed tomography findings in dogs with acute abdominal signs.

Contrast-enhanced multi-detector computed tomography (CE-MDCT) is used routinely in evaluating human patients with acute abdominal symptoms. Contrast-enhanced ultrasound (CEUS) continues to be in its infancy as it relates to evaluation of the acute abdomen. The purpose of this study was to compare survey radiography, B-mode ultrasound, CEUS, and CE-MDCT findings in canine patients presenting with acute abdominal signs; with a focus on the ability to differentiate surgical from non-surgical conditions. Nineteen dogs were prospectively enrolled. Inclusion required a clinical diagnosis of acute abdominal signs and confirmed surgical or non-surgical causes for the clinical signs. Agreement for the majority of recorded imaging features was at least moderate. There was poor agreement in the identification of pneumoperitoneum and in the comparison of pancreatic lesion dimensions for B-mode vs. CEUS. The CT feature of fat stranding was detected in cases including, but not limited to, gastric neoplasia with perforation, pancreatitis, and small intestinal foreign body. Ultrasound underestimated the size and number of specific lesions when compared with CE-MDCT. Contrast-enhanced ultrasound was successful in detecting bowel and pancreatic perfusion deficits that CE-MDCT failed to identify. Accuracy for differentiation of surgical vs. non-surgical conditions was high for all modalities; 100%, 94%, and 94% for CE-MDCT, ultrasonography and survey radiography respectively. Findings indicated that CE-MDCT is an accurate screening test for differentiating surgical from non-surgical acute abdominal conditions in dogs. Focused CEUS following CE-MDCT or B-mode ultrasonography may be beneficial for identifying potentially significant hypoperfused lesions.

Serum amyloid A and haptoglobin concentrations in serum and peritoneal fluid of healthy horses and horses with acute abdominal pain.

BACKGROUND: Peritoneal fluid (PF) analysis is a valuable diagnostic tool in equine medicine. Markers such as serum amyloid A (SAA) and haptoglobin (Hp) could facilitate the diagnosis of inflammatory abdominal conditions. OBJECTIVES: The objectives were to (1) establish reference intervals (RI) for SAA and Hp in serum and PF in healthy horses, (2) compare SAA and Hp concentrations between healthy horses and horses with colic, and (3) to assess the correlation between serum and PF concentrations. METHODS: Serum amyloid A and Hp concentrations were determined by automated assays in prospectively enrolled healthy reference horses and horses with colic. RIs were calculated, group concentrations were compared by Student's t-test, and Pearson's correlation for serum and PF concentrations were determined. RESULTS: In healthy horses (n = 62) the measurements for SAA were below the detection limit (0.5 mg/L) in 94% of serum samples and 98% of PF samples. Horses with colic (n = 61) had statistically significantly increased SAA concentrations in serum (P < .0001) and PF (P = .0013). While PF Hp concentrations were increased in horses with colic the serum concentrations of Hp were decreased (P < .0001). There was a strong correlation between paired serum and PF SAA concentrations (n = 94, R = .72, P < .0001), whereas the correlation between paired serum and PF Hp was weak (n = 94, R = .22, P = .0382). Finally, horses with colic tended to have serum SAA and PF Hp concentrations above the RIs. CONCLUSIONS: With the apparent difference between healthy horses and horses with colic and the presently established RIs, serum SAA and PF Hp concentrations represent potential valuable diagnostic markers for inflammatory abdominal conditions in that species.

Feasibility for using dual-phase contrast-enhanced multi-detector helical computed tomography to evaluate awake and sedated dogs with acute abdominal signs.

Canine patients with acute abdominal signs are often clinically unstable and need a rapid and accurate diagnosis. Contrast-enhanced multi-detector computed tomography (CT) is the current modality of choice for evaluating acute abdominal pain in people. We hypothesized that contrast-enhanced multi-detector CT would be a feasible and safe technique for use in awake and lightly sedated dogs with acute abdominal signs. Eighteen client-owned dogs were enrolled, all presenting with acute abdominal signs. Dogs were scanned using a dual-phase protocol that included precontrast, arterial, and portal venous phases. Eight dogs were scanned awake and ten were given light sedation as chosen by the primary care clinician. Two observers who were unaware of clinical findings and sedation status scored image quality for each scan by consensus opinion. Mean serum creatinine in the sedated group was higher than in the awake group but was within the normal reference range. Other laboratory and physiologic measures did not differ between awake and sedated groups. No IV contrast-related adverse reactions were seen. Median scan time for all patients was less than 10 min. Sixteen of 18 contrast-enhanced multi-detector CT scans were scored fair to excellent in diagnostic quality, with no statistical difference in diagnostic quality for awake vs. sedated patients. Causes for two poor quality diagnostic scans included severe beam hardening from previously administered barium contrast agent and severe motion artifacts. We conclude that dual-phase contrast-enhanced multi-detector CT is a feasible and safe technique for evaluating awake and minimally sedated dogs presenting with acute abdominal signs.

Abdômen agudo em equídeos no semiárido da região nordeste do Brasil / Acute abdomen in equidae in the semiarid of the Brazilian Northeast

Foram revisados os casos de abdômen agudo de origem gastrintestinal em equídeos atendidos no Hospital Veterinário da Universidade Federal de Campina Grande, em Patos, Paraíba. No período de janeiro de 2001 a dezembro de 2010. Setenta (4,5%) do total de 1542 equídeos atendidos no período apresentaram quadro clínico de cólica, sendo 60 equinos, cinco muares e cinco asininos. A compactação de cólon maior foi a causa mais frequente de cólica, diagnosticada em 37,14% dos casos, seguida por compactação de cólon menor (10%) e corpo estranho de cólon menor (7,14%). Em quatro casos as cólicas foram causadas pela presença de fitobezoares no intestino grosso, sendo dois deles associados ao consumo de vagens de Prosopis juliflora. Em cinco casos foi observada a presença de corpos estranhos no cólon menor e em um caso os corposestranhos foram encontrados no cólon maior, sendo principalmente sacos plásticos. As lesões estrangulantes do intestino delgado foram observadas em quatro casos. Outras causas foram cólica espasmódica (dois casos por parasitose e dois por ingestão de resíduos domiciliares), sobrecarga gástrica (três casos) e deslocamento de cólon maior que foi diagnosticado em dois animais. Laceração de cólon menor, torção de ceco, compactação de ceco e timpanismo por consumo de Manihot esculenta foram diagnosticados em uma única ocasião. O principal fator de risco para o desenvolvimento de cólicas foi o consumo de Pennisetum purpureum, Brachiaria decumbens, Sorghum spp. ou Echinochloa polystachya picados manualmente ou em picotadeira ou triturados em forrageira (OR=4,03; P=0,007). Como resultado da baixa qualidade dos alimentos ingeridos, a frequência dos atendimentos de equídeos portadores de cólica foi significativamente maior no segundo semestre (época da seca na região estudada) (OR=2,61; P<0,01). Concluiu-se que a oferta de volumoso de baixa qualidade na seca contribui para a alta frequência de casos de cólica e que o manejo alimentar tem um papel importante na ocorrência da doença e, por isso, a sua melhoria pode influenciar positivamente na redução do número de casos de cólica em equídeos no semiárido nordestino.

The cases of equidae acute abdomen diagnosed in the Veterinary Hospital of the Federal University of Campina Grande, in the semiarid of the Brazilian Northeast were reviewed. From January 2001 to December 2011, 70 (4.5%) equidae out of 1542 were affected by colic, including 60 horses, 4 mules, and 6 donkeys. Large colon impaction diagnosed in 37.14% of the cases was the most frequent cause of colic, followed by small colon impaction (10%) and foreign body in the small colon (7.14%). In four cases, colics were caused by phytobezoars in the large gut, two of which were associated with the ingestion of large amounts of fresh Prosopis juliflora pods. Six cases of colic by foreign bodies, mainly plastic bags, were observed, five located in the small colon and one in the large colon. Strangulating small intestinal lesions were observed in four cases. Other causes of colic were spasmodic colic (two cases due to gastrointestinal parasites and two due to consumption of home residues), and gastric impaction (three cases). Large colon displacement was diagnosed twice. Laceration of the small colon, cecal torsion, and bloat by ingestion of Manihot esculenta were diagnosed once. The main risk factor for the occurrence of colic was the ingestion of choped Pennisetum purpureum, Brachiaria spp., Sorghum spp. or Echinochloa polystachya (OR=4.03; P=0.007). As a result of the low quality of the foods the frequency of colic was significantly higher during the dry season (second semester) (OR=2.61; P<0.01). It is concluded that feeding with low quality forages during the dry season contributes with the high frequency of cases of colic in the Brazilian semiarid, and that is necessary to improve food quality and food management to try to decrease the frequency of this syndrome in the region.

Alterações clínicas e laboratoriais em equinos adaptadosa dieta com nível elevado de concentrado e submetidos àsobrecarga dietética com amido / Clinical and laboratorial changes in horses adapted to diet with high levels of concentratedand submitted to dietetic starch overload

Este trabalho teve como objetivo avaliar o efeito da sobrecarga dietética com amido em equinos adaptados a dieta comnível elevado de concentrado. Seis equinos adultos foram previamente adaptados à dieta composta por feno de coastcross e concentrado na proporção de 60:40 e, posteriormente submetidos à infusão gástrica de 17,6 g amido/kg de pesocorporal. Os equinos foram avaliados por meio de exames clínicos e laboratoriais até 36 horas após a sobrecarga. Umequino veio a óbito 32 horas após a sobrecarga, apresentando quadro clínico de endotoxemia e laminite. Não houvediferença ( P > 0,05) nas frequências cardíaca e respiratória, temperatura retal, tempo de preenchimento capilar etemperatura superficial dos cascos dos equinos durante o experimento. Houve tendência ao aumento na motilidadeintestinal, seguido de aumento na fluidez das fezes. O volume globular e a concentração de proteína plasmática totalaumentaram ( P < 0,05) 24 horas após a sobrecarga quando comparados aos valores basais, de 26,7 a 32,0% e de 7,1e 8,1 g/dL, respectivamente. Os neutrófilos bastonetes aumentaram ( P < 0,05) durante o período de avaliação, comvalores variando de 0,1 a 0,7 x 103/μL antes da sobrecarga e 24 horas após, respectivamente, enquanto os eosinófilosapresentaram redução. A concentração plasmática de lactato teve aumento discreto com diferença ( P < 0,05) antes, 20 e28 horas após a sobrecarga, com valores de 0,7, 1,0 e 1,2 mmol/L, respectivamente. Conclui-se que equinos consumindodieta com elevado nível de concentrado e submetidos à sobrecarga dietética com amido apresentam alterações clínicas elaboratoriais moderadas, porém, casos graves, seguidos do óbito, podem ocorrer devido à variação individual.

This work was carried out to evaluate the effect of dietetic starch overload in horses adapted to diets with high levelof concentrated. Six crossbreed mature horses were previously adapted to diet composed by coast cross hay andconcentrate in a 60:40 proportion and later submitted to gastric infusion of 17.6 g starch/kg body weight. The horseswere evaluated by clinical and laboratorial examination until 36-hour after overload. One horse died 32 hours afteroverload, presenting clinical signs of endotoxemia and laminitis.No differences ( P > 0.05) were observed in heartand respiratory rate, rectal temperature, capillary refill time and hoof temperature of horses. There was a tendency toincrease intestinal mobility following by fluidity of faeces. Increase ( P < 0.05) in packed cell volume and total plasmaprotein were observed 24 hours after overload when compared to baseline, from 26.7 to 32.0% and 7.1 to 8.1 g/dL,respectively. Neutrophils increased ( P < 0.05) during the evaluation period, with values varying of 0.1 to 0.7 x 103/μLbefore overload and 24 hours after, respectively, while the eosinophils decreased. The plasma lactate concentration wasslight increased with difference (p < 0.05) before, 20 and 28 hours after overload, with values of 0.7, 1.0 and 1.2 mmol/L,respectively. It was concluded that horses consuming diets with high levels of concentrated and submitted to dieteticstarch overload had clinical and laboratory changes moderate, however, severe cases, followed by death may occur dueto individual variation.