Outcome following emergency laparotomy in 33 UK donkeys: A retrospective multicentre study.

BACKGROUND: Emergency laparotomies in donkeys are infrequently performed and there is limited literature on the subject. OBJECTIVES: To determine findings and associated outcomes of exploratory laparotomies in donkeys. STUDY DESIGN: Descriptive retrospective study. METHODS: Donkeys undergoing emergency exploratory laparotomy for investigation and treatment of colic at seven UK referral hospitals between 2005-2017 were included. Data were retrieved from available hospital records. Descriptive statistics and inferential statistical analysis of outcomes of interest was performed in three steps. RESULTS: Thirty-three cases fulfilled the inclusion criteria. Clinical signs on presentation were available for 32 donkeys, of which 53.1% (17/32) presented for investigation of colic while in 46.9% (15/32) the presenting complaint was non-specific. Primary lesion location included small intestine (42.4%, 14/33), large colon (39.3%, 13/33), caecum (6.1%, 2/33), stomach (6.1%, 2/33) and 6.1% (2/33) had multiple abnormal findings without a clear primary lesion. Overall survival to discharge was 54.5% (18/33). Five donkeys (15.2%, 5/33) were euthanased at surgery and of those recovering from general anaesthesia a further 35.7% (10/28) were euthanased or died prior to discharge. Six donkeys (21.4%, 6/28) required a second laparotomy of which 4 (66.7%, 4/6) survived. Post-operative complications occurred in 82.1% (23/28) of cases and included hyperlipaemia (42.9%, 12/28), incisional complications (21.4%, 6/28), ileus (21.4%, 6/28) and persistent colic (17.9%, 5/28). When adjusted for other complications, donkeys with primary gastric lesions were less likely to have presented with severe colic compared with those with primary small intestinal lesions (OR: 0.07, 95% CI 0.01-0.95, p = 0.05). Only age was positively associated with death prior to discharge (OR: 1.18, 95% CI 1.03-1.36, p = 0.02). MAIN LIMITATIONS: Small sample size and retrospective design. CONCLUSION: Donkeys with abdominal lesions may present with a range of signs often not including colic. Surgical findings were diverse and survival to discharge appears to be lower than in horses.

Surgical removal of intra-articular loose bodies from the cervical articular process joints in 5 horses.

OBJECTIVE: To describe the surgical removal of intra-articular loose bodies (LBs) from the cervical articular process joints (APJs) in five horses and to describe the outcome of the surgery. STUDY DESIGN: Short case series. ANIMALS: Five client-owned horses with naturally occurring LBs within the cervical APJs. METHODS: Medical records were reviewed of horses that were diagnosed with LBs of the cervical APJs on computed tomography (CT), where the LBs were subsequently removed surgically. Details of case selection and surgical technique were reviewed along with postoperative complications and clinical outcome. Histopathology was performed on LBs in some cases. RESULTS: Surgery was performed on six APJs in five horses. Of the 14 LBs identified with CT, 13 were successfully removed from the C4/C5, C5/C6 and C6/C7 articulations. No surgical complications were encountered, and clinical signs of cervical dysfunction improved in all horses. All clinical cases returned to ridden work by 6 months post surgery. Histopathologic examination revealed the removed structures to be osteochondral or chondral loose bodies consisting of cartilaginous proliferation with or without ossification and central necrosis. CONCLUSIONS: Surgical removal of LBs is achievable from the cervical APJs and can result in the resolution of cervical pain. This procedure offers a new treatment option for management of selected horses with cervical pain, following thorough assessment and CT imaging.

Osteomyelitis and osteonecrosis after intraosseous perfusion with gentamicin.

OBJECTIVE: To describe and discuss previously unreported complications associated with intraosseous perfusion with gentamicin in horses. STUDY DESIGN: Case report. ANIMALS: Ten-year-old Warmblood gelding. METHODS: Intraosseous perfusion with gentamicin into the proximal phalanx (P1) was used as part of the treatment regimen for distal interphalangeal joint and navicular bursa synovial sepsis. Although the sepsis responded favorably complications developed at the perfusion site, including persistent osteomyelitis, progressive osteonecrosis, and ultimately pathologic fracture of P1. RESULTS: The progression of the clinical signs and findings at necropsy are suggestive of a toxic osteonecrosis secondary to intraosseous perfusion. CONCLUSIONS: Further work is needed to investigate the effects of high dose gentamicin on equine mesenchymal cells that may be achieved during intraosseous perfusion. CLINICAL RELEVANCE: Lower doses of perfusate within the medullary canal of P1 or alternative perfusion sites should be considered.