Resolution of chronic regurgitation in an 8 month old Babydoll sheep by thoracoscopic treatment of a vascular ring anomaly.

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.

Serial venous lactate measurement following gastrointestinal surgery in horses.

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.

Clinical outcome of horses with guttural pouch infection following transpharyngeal fenestration.

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.

Ureteropyeloscopic removal of a nephrolith from a 19 year old Hanoverian gelding.

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.

Complications and Comorbidities in Foals Undergoing Surgical Repair for Uroperitoneum.

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.

Outcomes following single, caudally based bilateral versus unilateral frontonasal sinusotomy for treatment of equine paranasal sinus disease.

BACKGROUND: Bilateral sinus disease is relatively uncommon in horses, accounting for 3%-4.5% of horses with sinonasal disease, but may require bilateral paranasal surgery for complete resolution. Complications and recurrence following bilateral sinusotomy have not been reported or compared to those following unilateral procedures. OBJECTIVE: To describe clinical features and outcomes in horses undergoing standing single, caudally based bilateral frontonasal sinusotomy compared to unilateral frontonasal surgery. METHODS: Records of horses (n = 37) undergoing surgical treatment for sinus disease (five bilateral, 32 unilateral) were retrospectively reviewed (2010-2017) for signalment, presenting complaint, duration of signs preoperatively, diagnostic imaging, treatments administered, duration hospitalization, complications, and owner satisfaction with the procedure. Mann-Whitney testing was used to compare age, duration of hospitalization, and follow-up time in horses undergoing unilateral or bilateral procedures. Fisher's exact testing was used to determine if sex predilection was present for unilateral or bilateral disease. Survival time and time to recurrence were compared by Kaplan-Meier survival curves and log-rank curve comparison testing. Significance was assessed at p < 0.05. RESULTS: Length of signs prior to admission did not differ between horses with unilateral and bilateral disease (p = 0.09), but there was a tendency for horses with bilateral disease to have clinical signs for longer. Age (p = 0.19) and hospitalization duration (p = 0.53) did not differ between horses undergoing unilateral versus bilateral procedures. Recurrence or failure to resolve signs was reported in 11/32 (34%) of unilateral and 0/5 bilateral cases (p = 0.07). CONCLUSIONS: The bilateral single, caudally based sinusotomy approach may be considered to effectively treat bilateral paranasal sinus disease without concern for increased risk of life-threatening complications or longer hospitalization duration than would be typical for unilateral sinusotomy procedures.

Investigation of neonatal disorders in New World camelids and factors associated with death during and after hospitalization of affected crias.

OBJECTIVE: To assess signalment, clinical findings, and treatments for New World camelids (NWCs) hospitalized for evaluation and treatment of neonatal disorders and investigate associations between these factors and death during and after hospitalization. ANIMALS: 267 NWCs ≤ 30 days of age. PROCEDURES: Medical records of a veterinary teaching hospital were retrospectively reviewed to identify NWCs admitted for evaluation and treatment of neonatal disorders between 2000 and 2010. Signalment, physical examination data, diagnostic findings, treatments, and outcomes were recorded. Factors were examined for association with death during hospitalization and the overall hazard of death by use of multivariable logistic regression and Cox proportional hazards analysis, respectively. RESULTS: The sample comprised alpacas (n = 255) and llamas (12). Median age at admission was 3 days, and median hospitalization time was 2 days; 208 of the 267 (77.9%) neonatal NWCs survived to hospital discharge. Factors associated with increased odds of death during hospitalization included prematurity or dysmaturity, hypothermia, sepsis, toxic changes in neutrophils, and undergoing surgery. The odds of death during hospitalization also increased as anion gap increased. After discharge, 151 of 176 (85.8%) animals had follow-up information available (median follow-up time, 2,932 days); 126 (83%) were alive and 25 (17%) had died. Prematurity or dysmaturity, congenital defects, sepsis, oxygen administration, and undergoing surgery as a neonate were associated with an increased hazard of death; the hazard of death also increased as serum chloride concentration at the time of hospitalization increased. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested the prognosis for survival during and after hospitalization is good for most NWCs hospitalized because of neonatal disorders.

Laparoscopic Ovariectomy in a Domestic Yak.

Owners of a juvenile domestic yak elected bilateral ovariectomy to prevent future reproduction. The yak was noted to be healthy at presentation. Both ovaries were removed using a laparoscopic approach as follows: after induction and maintenance of general inhalant anesthesia, 15 degrees Trendelenburg positioning was required to view the ovaries. Ovariectomy was conducted within a surgical time of 50 minutes. Due to the small ovarian size, portal enlargement was not necessary for removal. Mild hemorrhage from the left ovarian pedicle was controlled with application of a vessel-sealing device. Postoperative complications were not encountered during hospitalization. At 12 months following surgery, the yak was healthy, and the owner was highly satisfied with the procedure. The described approach was successful for performing laparoscopic ovariectomy in a juvenile yak. Positioning for surgery was similar to other small ruminant species. Further case enrollment is needed to optimize the surgical approach and better describe clinical outcomes.

Evaluation of the Element point-of-care blood gas analyzer for use in horses.

OBJECTIVE: To compare the Element point-of-care (POC) portable blood gas analyzer with a laboratory-based bench-top reference analyzer using whole blood samples obtained from horses presenting to a referral center with various disorders in order to determine agreement between these analyzers. DESIGN: Prospective clinical study. SETTING: The study was conducted at a university teaching hospital at moderate altitude. ANIMALS: One hundred paired samples from 80 horses >1 year of age were collected after obtaining informed client consent. Fifty paired samples were from patients admitted for elective procedures and considered to be healthy, and 50 paired samples were emergency admissions and considered to be critically ill. MEASUREMENTS AND MAIN RESULTS: Paired whole blood samples were evaluated on both the Element POC and Radiometer ABL 800 FLEX analyzers simultaneously, and results were compared. Pearson correlation coefficients between analyzers were calculated. To assess agreement, scatter and Bland-Altman plots were evaluated, and mean difference and 95% limits of agreement were calculated for each analyte. Correlation was either good (0.8-0.92) or excellent (>0.93) for the majority of analytes. All analytes apart from hemoglobin had acceptable agreement, with ≥80% of individual results within agreement targets. Precision targets were acceptable for most analytes, with partial pressure of carbon dioxide (pCO2 ) and calcium (Ca2+ ) exceeding precision targets. CONCLUSIONS: The portable Element POC system had acceptable agreement with the ABL 800 FLEX bench-top analyzer currently in use at the study center when evaluating the majority of analytes from equine whole blood samples.

Combined tube cystostomy and urethrotomy for the treatment of urethral obstruction due to urolithiasis in goats.

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.

Prospective randomized investigation of topical anesthesia during unilateral laparoscopic ovariectomy in horses.

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.

A retrospective cohort study of racing performance in Quarter Horses undergoing prosthetic laryngoplasty for treatment of recurrent laryngeal neuropathy.

OBJECTIVE To determine effects of prosthetic laryngoplasty on return to racing, performance index, and career longevity in racing Quarter Horses with recurrent laryngeal neuropathy (RLN) and to evaluate performance variables for horses with RLN undergoing prosthetic laryngoplasty, compared with a control horse population. DESIGN Multicenter, retrospective cohort study. ANIMALS 162 racing Quarter Horses with RLN treated with prosthetic laryngoplasty (case horses) and 324 racing Quarter Horse without RLN (control horses). PROCEDURES Medical and race records of case and control horses examined at 5 referral centers between January 2000 and December 2015 were reviewed retrospectively. Two control horses were matched with each case horse. Return to racing, earnings, number of racing starts, performance index, and career longevity were evaluated. RESULTS The odds of returning to racing did not differ significantly between case and control horses but decreased with increasing age. Neither racing starts nor career longevity were affected by prosthetic laryngoplasty or by RLN grade. In fact, horses undergoing laryngoplasty for treatment of RLN and horses with the lowest RLN grade before surgery had higher performance indices after the surgery, compared with indices for control horses. CONCLUSIONS AND CLINICAL RELEVANCE The faster speeds and shorter distances raced with Quarter Horses could alter how RLN impacts respiratory variables and performance in Quarter Horses, compared with other racehorse breeds. Further study is needed to understand the impacts of RLN and surgical treatments for RLN in racing Quarter Horses.

Laparoscopic ovariohysterectomy in goats.

OBJECTIVE To describe a minimally invasive 3-portal laparoscopic approach for elective ovariohysterectomy and the outcome of that procedure in a population of goats. DESIGN Descriptive clinical study. ANIMALS 16 healthy client-owned goats. PROCEDURES Food but not water was withheld from all goats for 24 hours before the procedure. Goats were anesthetized and positioned in dorsal recumbency. Three laparoscopic portals were created in the caudoventral portion of the abdomen, and the abdomen was insufflated to a maximum pressure of 10 mm Hg. A blunt-tip vessel sealer and divider device was used to transect the left and right mesovarium and mesometrium and uterus, and the resected tissue was removed from the abdomen. After hemostasis was verified, the portals were closed in a routine manner and anesthesia was discontinued. Goats were discharged from the hospital 24 hours after the procedure, and owners were contacted by telephone or email to obtain short- and long-term follow-up information by use of standardized questions. RESULTS All procedures were performed by a surgeon and assistant surgeon. The procedure was not complex and was easily learned. No intraoperative complications were reported, and only 1 goat required rescue analgesia post-operatively. No other postoperative complications were recorded. Median surgery time was 43 minutes (range, 20 to 65 minutes). All owners were satisfied with the outcome of the procedure, and several perceived that the procedure improved goat behavior. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that laparoscopic ovariohysterectomy was a viable alternative for elective sterilization of female goats.

Comparison of two techniques for transpharyngeal endoscopic auditory tube diverticulotomy in the horse.

Auditory tube diverticula, also known as guttural pouches, are naturally occurring dilations of the auditory tube in horses that communicate with the nasopharynx through a small ostium. Infection and select other conditions can result in inflammation and narrowing of the nasopharyngeal ostium, which prevents drainage of fluid or egress of air and can lead to persistent infection or guttural pouch tympany. Auditory tube diverticulotomy allows continuous egress from the auditory tube diverticula and is a feature of disease treatment in horses, in which medical treatment alone is not successful. Transpharyngeal endoscopic auditory tube diverticulotomy was performed using a diode laser either at a single dorsal pharyngeal recess location or bilaterally caudal to the nasopharyngeal ostium in 10 horse head specimens. Both methods resulted in clear communication between the nasopharynx and auditory tube diverticula. Diverticulotomy performed in the dorsal pharyngeal recess required less laser energy and activation time and had a shorter surgical duration than diverticulotomy performed caudal to the nasopharyngeal ostium. Further study related to the clinical application of both techniques is warranted.

Duodenoduodenostomy for obstruction of the sigmoid flexure of the duodenum in cattle.

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.

Vessel sealer and divider instrument temperature during laparoscopic ovariectomy in horses.

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.

Technique-associated outcomes in horses following large colon resection.

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.

Left paralumbar laparoscopic bilateral ovariectomy in mares.

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.

Laparoscopic Closure of the Nephrosplenic Space in Horses with Nephrosplenic Colonic Entrapment: Factors Associated with Survival and Colic Recurrence.

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.

Laparoscopic inguinal hernioplasty in a ram.

CASE DESCRIPTION: A 4-month-old Hampshire ram underwent open right inguinal herniorrhaphy and unilateral castration following herniation that developed after a kick injury. Seven months later, the ram was reevaluated because of scrotal swelling of 1 month's duration as well as suspected left inguinal hernia. CLINICAL FINDINGS: The ram had marked scrotal swelling. Palpation of the left testicle revealed no abnormalities. Ultrasonographic examination revealed heterogenous tissue within the cranial and medial portions of the scrotum with pronounced accumulation of hypoechoic fluid at the scrotal apex. Examination findings indicated left-sided indirect inguinal herniation of omentum. TREATMENT AND OUTCOME: To preserve fertility, left inguinal hernioplasty without castration was performed. The ram was anesthetized and placed in dorsal recumbency, and laparoscopic abdominal evaluation revealed omental entrapment within the left inguinal ring. The omentum was removed, and a polypropylene mesh was secured over the internal inguinal ring with an articulating hernia stapler. Following mesh placement, a dorsally based peritoneal flap was elevated and secured over the mesh repair. The ram recovered well from surgery; there was no repeated herniation following the surgical correction, and the ram was able to breed successfully without complication. CLINICAL RELEVANCE: Laparoscopic mesh hernioplasty can be successful in rams with inguinal hernias when preservation of fertility is preferred.