RESUMO
REASONS FOR PERFORMING THE STUDY: Intestinal hyperammonaemia (HA) has been infrequently reported in individual horses; however, there have been no studies describing clinical and laboratory data as well as short- and long-term outcome in a larger number of cases. OBJECTIVES: To describe clinical and laboratory data and short- and long-term outcome in a large group of horses with intestinal HA. METHODS: Multi-centred, retrospective study; case records of horses with HA were reviewed and any horse with a clinical or post mortem diagnosis of intestinal HA was included. Hyperammonaemia was defined as a blood ammonium (NH(4) (+)) concentration ≥60 µmol/l and horses with a diagnosis of primary hepatic disease were excluded. Relevant data were recorded and, if appropriate, data from survivors were compared to nonsurvivors to identify potential prognostic indicators. RESULTS: Thirty-six cases, 26 mature horses and 10 foals with intestinal HA were identified. Case histories included diarrhoea, colic and neurological signs and the most common clinical diagnosis was colitis and/or enteritis. The most common clinical and laboratory abnormalities included tachycardia, increased packed cell volume, hyperlactataemia and hyperglycaemia. Fourteen horses (39%) survived to discharge; NH(4) (+) concentration on admission was the only parameter significantly associated with survival. All surviving horses and foals for which follow-up information was available recovered completely and returned to their intended use without further complications. CONCLUSIONS AND POTENTIAL RELEVANCE: Intestinal HA occurs in mature horses and foals and can be associated with severe clinical and laboratory abnormalities; further studies are required to investigate predisposing factors and delineate possible differences in aetiologies.
Assuntos
Doenças dos Cavalos/patologia , Hiperamonemia/veterinária , Enteropatias/veterinária , Animais , Feminino , Cavalos , Hiperamonemia/patologia , Enteropatias/patologia , Masculino , Estudos RetrospectivosRESUMO
REASON FOR PERFORMING STUDY: It is a clinical impression that horses diagnosed with a right dorsal displacement (RDD) of the large colon, are more likely to suffer from recurrent episodes of colic post operatively, compared to other forms of nonstrangulating large colon displacement. OBJECTIVES: To investigate whether the type of nonstrangulating large colon displacement identified at exploratory laparotomy would influence long-term outcome. HYPOTHESIS: Horses identified with a RDD of the large colon at exploratory laparotomy would be more likely to experience recurrent episodes of post operative colic than other types of displacement. MATERIALS AND METHODS: Medical records for horses undergoing an exploratory laparotomy, from 2000-2008, for a nonstrangulating large colon displacement were reviewed. Data retrieved included: subject details, previous medical history, details of current episodes of colic, results of preoperative examination, surgical findings and procedures, post operative management and complications. Follow-up information was obtained by reference to computerised clinical records and by telephone questionnaire administered to the horse's owner or carer, and included details of any colic episodes exhibited by the horse after discharge and whether a repeat celiotomy had been required to resolve the colic episodes. RESULTS: There were 165 surgeries identified, in 154 horses. It was found that those horses with RDD were significantly more likely to experience recurrent episodes of colic requiring veterinary intervention post operatively compared to other types of displacement. CLINICAL RELEVANCE: Long-term prognosis and likelihood of post operative complications is an important consideration for both owners and veterinarians.
Assuntos
Cólica/veterinária , Doenças do Colo/veterinária , Doenças dos Cavalos/cirurgia , Complicações Pós-Operatórias/veterinária , Animais , Cólica/complicações , Doenças do Colo/complicações , Doenças do Colo/cirurgia , Cavalos , Estudos Retrospectivos , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Procedimentos Cirúrgicos Operatórios/veterináriaRESUMO
REASONS FOR PERFORMING STUDY: The influence of synovial fluid culture on short- and long-term prognosis of cases with septic synovitis requires study. HYPOTHESES: Horses with a positive bacterial culture from septic synovial fluid are less likely to survive or return to successful athletic function than those with a negative bacterial culture from septic synovial fluid. METHODS: Records of mature horses presented to 2 equine referral hospitals for investigation of suspected septic synovitis were examined. Horses (n=206) were included in the study if synovial fluid was submitted for full laboratory examination, including bacterial culture. A diagnosis of septic synovitis was based on a nucleated cell count>30x10(9) cells/l or>90% neutrophils and other clinical, cytological and bacteriological parameters. Long-term follow-up was obtained by telephone questionnaire. Univariate analysis, using the Fisher's exact test, was used for all outcomes. RESULTS: Fourteen (20.9%) of 67 horses with a positive bacterial culture from synovial fluid were subjected to euthanasia because of persistent synovial sepsis compared to 2 (1.44%) of 139 with negative bacterial cultures (P<0.001). Overall survival and successful long-term return to function in horses with a positive bacterial culture was 50% (24/48 horses) compared to 70.5% (74/105) in culture negative horses (P=0.01). In horses that survived to be discharged, successful long-term return to function was not significantly different between culture positive and culture negative groups. Growth of Staphylococcus aureus from synovial fluid did not affect short-term survival to discharge from the hospital compared to other positive bacterial culture; however, successful long-term return to function was only 30.4% (4/13) in horses from which S. aureus was cultured compared to 73.9% (17/23) of horses in which other bacteria were cultured (P=0.015). CONCLUSIONS AND POTENTIAL CLINICAL RELEVANCE: Horses with a positive bacterial culture from a septic synovitis have a poorer prognosis for survival to discharge from hospital and overall long-term return to function than horses that yielded no bacterial growth. When S. aureus was cultured, the long-term prognosis was poorer.
Assuntos
Infecções Bacterianas/veterinária , Doenças dos Cavalos/microbiologia , Artropatias/veterinária , Líquido Sinovial/microbiologia , Animais , Antibacterianos/uso terapêutico , Infecções Bacterianas/terapia , Doenças dos Cavalos/terapia , Cavalos , Artropatias/microbiologia , Artropatias/terapia , Estudos RetrospectivosRESUMO
BACKGROUND: Previous studies investigating factors associated with survival following endoscopic treatment of contamination/sepsis of the calcaneal bursa are limited. OBJECTIVES: To investigate the factors associated with survival in horses with contamination/sepsis of the calcaneal bursae treated endoscopically and to describe the bacterial isolates involved in the synovial infections. STUDY DESIGN: Retrospective analysis of clinical records. METHODS: Medical records from 128 horses with contamination/sepsis of the calcaneal bursae treated by endoscopic lavage at seven equine hospitals were reviewed. A follow-up questionnaire was used to determine survival and return to athletic performance. Descriptive statistics and Cox proportional hazards survival models were used to determine factors associated with survival. RESULTS: Horses underwent one (n = 107), two (n = 19), or three (n = 2) surgeries. Survival to hospital discharge was 84.4%. Univariable survival analysis revealed that administration of systemic antimicrobials prior to referral was associated with reduced mortality (hazard ratio, [HR] 0.41, 95% CI 0.18-0.91, P = 0.03). Increased mortality was associated with bone fracture/osteomyelitis (HR 2.43, 95% CI 1.12-5.26, P = 0.03), tendon involvement (≥30% cross sectional area) (HR 3.78 95% CI 1.78-8.04, P = 0.001), duration of general anaesthesia (HR 1.01, 95% CI 1.00-1.02, P = 0.04), post-operative synoviocentesis (HR 3.18, 95% CI 1.36-7.43, P = 0.006) and post-operative wound dehiscence (HR 2.5, 95% CI 1.08-5.65, P = 0.04). Multivariable Cox proportional hazards model revealed reduced mortality after systemic antimicrobial administration prior to referral (HR 0.25, 95% CI 0.11-0.60, P = 0.002) and increased mortality with tendinous involvement (≥30% cross-sectional area) (HR 7.92, 95% CI 3.31-19.92, P<0.001). At follow-up (median 30 months, range 0.25-13 years, n = 70) 87.1% horses were alive, 7.1% had been euthanised due to the calcaneal injury and 5.7% had been euthanised for unrelated reasons. From 57 horses with athletic performance follow-up, 91.2% returned to the same/higher level of exercise, 5.3% to a lower level and 3.5% were retired due to persistent lameness of the affected limb. MAIN LIMITATIONS: Retrospective study and incomplete follow-up. CONCLUSION: Endoscopic treatment of contamination/sepsis of the calcaneal bursae has an 84% survival rate to hospital discharge. Tendinous involvement reduced survival whilst systemic antimicrobials administration prior to referral improved survival.
Assuntos
Doenças dos Cavalos , Sepse/veterinária , Animais , Estudos de Coortes , Desbridamento/veterinária , Cavalos , Estudos Retrospectivos , Irrigação Terapêutica/veterinária , Resultado do TratamentoRESUMO
Eleven limbs taken postmortem from 10 lame horses were examined by MRI in a low-field 0.27T system designed for standing horses and a high-field 1.5T system used to examine anaesthetised horses. Nine limbs were examined in the foot/pastern region and two in the fetlock region, and the results were compared with gross pathological examinations and histological examinations of selected tissues. The appearance of normal tissues was similar between the two systems, but the anatomical arrangement of the structures was different due to differences in positioning, and a magic angle artefact was observed at different sites in some imaging sequences. Articular cartilage could be differentiated into two articular surfaces in most joints in the high-field images but could generally be separated only at the joint margins in the low-field images. Abnormalities of tendon, ligament and bone detected by gross examination were detected by both forms of MRI, but some details were clearer on the high-field images. Articular cartilage found to be normal on pathological examination was also classified as normal on MRI, but lesions in articular cartilage detected on pathological examination were identified only by high-field MRI. An abnormality was detected on MRI of all the limbs that had abnormal navicular flexor fibrocartilage on pathological examination.
Assuntos
Doenças dos Cavalos/diagnóstico , Coxeadura Animal/diagnóstico , Imageamento por Ressonância Magnética/veterinária , Animais , Cadáver , Cartilagem/patologia , Pé/patologia , Doenças do Pé/diagnóstico , Doenças do Pé/patologia , Doenças do Pé/veterinária , Doenças dos Cavalos/patologia , Cavalos , Coxeadura Animal/patologia , Ligamentos/patologia , Extremidade Inferior/patologia , Imageamento por Ressonância Magnética/métodos , Tendões/patologiaRESUMO
A valid, reliable and usable scale is needed for assessing severity of acute abdominal pain in horses. The study aim was to compare three different scales: (1) the equine acute abdominal pain scale (EAAPS); (2) a scale described by Mair and Smith (2005; M and S); and (3) a numerical rating scale (NRS). Forty brief films of horses (35 of colic cases and five of control horses) were randomly presented to 46 equine veterinarians from different countries. Participants, randomly divided into three groups, each used one scale. Five randomly selected films were shown twice for determining intra-observer reliability. Speed, ease of use and face validity of the scales were evaluated based on expert opinion. Response rate was excellent: 89% for the EAAPS (16/18), and 100% for the M and S (18/18) and NRS groups (10/10). The intraclass correlation (ICC) of 0.86 [95% confidence interval (CI); 0.80-0.92] for EAAPS indicated significantly better inter-observer reliability compared to 0.68 for the M and S and 0.71 for the NRS. Moreover, intra-observer reliability of EAAPS (weighted κ 0.95 [95%CI; 0.92-0.98]) was superior to the other scales (weighted κ 0.78, 0.77, for the M and S and NRS, respectively). Other validity measures (convergent, extreme group, predictive validities), usability (time taken to score the films-speed) and the ease of use of the scales were not significantly different. Face validity (endorsement by experts) was better for the M and S scale than for the EAAPS. The EAAPS showed superior reliability, the M and S scale better face validity, with comparable usability and other tests of validity.
Assuntos
Cólica/veterinária , Doenças dos Cavalos/fisiopatologia , Medição da Dor/veterinária , Dor Aguda/veterinária , Animais , Cólica/fisiopatologia , Feminino , Cavalos , Masculino , Variações Dependentes do Observador , Distribuição Aleatória , Reprodutibilidade dos Testes , Médicos VeterináriosRESUMO
REASONS FOR PERFORMING STUDY: Currently, there is a lack of available evidence-based data concerning the optimum treatments for horses affected by different types of colic and this precludes the application of clinical audit in this area. In order to accumulate such data, a large-scale, multicentre database of the outcomes of colic surgery is proposed. The attitudes of surgeons is an important consideration in determining the feasibility of developing this database. OBJECTIVES: To assess attitudes and opinions of equine surgeons concerning clinical audit and to assess the perceived advantages and problems of setting up a large-scale international audit/database of colic surgery. METHODS: Interviews were conducted with 30 equine surgeons (large animal/equine surgeons who are diplomates of either the American College of Veterinary Surgeons or the European College of Veterinary Surgeons). Questionnaires were sent by e-mail to 98 equine surgeons. RESULTS: Face to face interviews were conducted (n = 30) and 43/98 completed questionnaires received (44%). The results of the 2 techniques were very similar. There was generally a high level of interest in the development of a large scale database of colic surgery, but perceived problems included time to collect and submit data, and confidentiality issues. A minority of surgeons reported that they were undertaking any form of specific monitoring of the results of colic surgery within their hospitals. CONCLUSIONS: There is a good level of interest among equine surgeons to develop a large scale database of colic surgery and most would be willing to contribute data from their own hospitals provided that data collection is quick and easy, and that confidentiality is maintained.
Assuntos
Auditoria Clínica/organização & administração , Cólica/veterinária , Doenças dos Cavalos/cirurgia , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Cirurgia Veterinária/normas , Médicos Veterinários/psicologia , Animais , Competência Clínica , Cólica/cirurgia , Confidencialidade , Coleta de Dados , Bases de Dados Factuais , Medicina Baseada em Evidências , Conhecimentos, Atitudes e Prática em Saúde , Cavalos , Humanos , Cirurgia Veterinária/métodos , Cirurgia Veterinária/estatística & dados numéricos , Inquéritos e Questionários , Resultado do TratamentoRESUMO
REASON FOR PERFORMING STUDY: Constriction of the digital flexor tendon sheath (DFTS) and its contents by the palmar/plantar annular ligament (PAL) is well recognised. However, primary injury of the PAL has not been well documented. OBJECTIVES: To describe the clinical features of PAL injury, determine its prevalence with or without subcutaneous fibrosis and/or concurrent injury within the DFTS, and assess response to treatment. METHODS: Horses were selected for inclusion based upon clinical features consistent with PAL injury and the presence of a thickened PAL (> or =2 mm) verified ultrasonographically. A retrospective analysis of case records from 3 clinics was performed. Details of breed, age and use, and results of clinical and ultrasonographic assessments and response to treatment were recorded. Horses were treated conservatively or surgically by desmotomy of the PAL, with or without tenoscopic evaluation of the DFTS. A telephone questionnaire was performed to assess response to treatment. RESULTS: Seventy-one horses were included in the study and middle aged or older general purpose riding horses predominated. PAL desmopathy occurred more frequently in hind- than in forelimbs. The method of treatment, thickness of the PAL or presence of subcutaneous fibrosis did not significantly affect prognosis; however, <50% of horses were able to return to athletic function. There was a trend for horses with PAL desmopathy alone to have the best outcome. Bilateral thickening of the PAL or concurrent fore- and hindlimb injuries had a negative effect on prognosis, as did the simultaneous presence of subcutaneous fibrosis and lesions within the DFTS. CONCLUSIONS AND CLINICAL RELEVANCE: PAL injury is characterised by a convex contour of the palmar/plantar aspect of the fetlock, associated with thickening of the ligament with or without subcutaneous fibrosis. Bilateral PAL thickening is common in older horses, ponies and cobs; however, bilateral PAL enlargement is often present with only unilateral lameness. Treatment methods used in this study did not appear to influence outcome significantly.
Assuntos
Doenças dos Cavalos/cirurgia , Coxeadura Animal/etiologia , Ligamentos Articulares/patologia , Ligamentos Articulares/cirurgia , Traumatismos dos Tendões/veterinária , Fatores Etários , Animais , Feminino , Membro Anterior , Membro Posterior , Doenças dos Cavalos/patologia , Cavalos , Coxeadura Animal/patologia , Coxeadura Animal/cirurgia , Masculino , Prognóstico , Descanso , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Traumatismos dos Tendões/patologia , Traumatismos dos Tendões/cirurgia , Resultado do TratamentoRESUMO
Twelve horses underwent standing laparoscopic ovariectomy using electrocoagulation and fine dissection as the only means of achieving haemostasis of the severed ovarian pedicle. Four mares had bilateral ovariectomy performed as a treatment for aggressive behaviour thought to be associated with the oestrous cycle. Eight mares had unilateral ovariectomy performed for removal of a granulosa thecal cell tumour (GCT). Electrocoagulation provided an effective means of haemostasis in both normal and pathological ovaries. Only one case (removal of a GCT) had mild haemorrhage following electrocoagulation, necessitating the need for the application of endoscopic clips to achieve haemostasis. Six of the horses developed minor wound complications (none of them requiring any additional treatment). Long-term follow-up information showed complete resolution of abnormal behaviour in all eight horses with GCTs, but in one of the four horses with normal ovaries the aggressive behaviour had not been completely resolved.
Assuntos
Eletrocoagulação/veterinária , Doenças dos Cavalos/cirurgia , Cavalos/cirurgia , Laparoscopia/veterinária , Ovariectomia/veterinária , Complicações Pós-Operatórias/veterinária , Agressão , Animais , Eletrocoagulação/efeitos adversos , Feminino , Seguimentos , Tumor de Células da Granulosa/cirurgia , Tumor de Células da Granulosa/veterinária , Hemostasia , Doenças dos Cavalos/sangue , Doenças dos Cavalos/psicologia , Cavalos/psicologia , Laparoscopia/efeitos adversos , Neoplasias Ovarianas/cirurgia , Neoplasias Ovarianas/veterinária , Ovariectomia/efeitos adversos , Ovariectomia/métodos , Complicações Pós-Operatórias/epidemiologia , Tumor da Célula Tecal/cirurgia , Tumor da Célula Tecal/veterinária , Resultado do TratamentoRESUMO
The records of 65 horses with peritonitis examined at two UK referral centres over a period of 12 years were reviewed. Peritonitis was defined in terms of the horse's peritoneal fluid containing more than 5 x 10(9) nucleated cells/l. Horses that had developed peritonitis after abdominal surgery or a rupture of the gastrointestinal tract were excluded. Of the 65 horses, 56 (86 per cent) survived to be discharged. Follow-up information was obtained from practice records and telephone calls to the owners for 38 of the horses. Of these, 32 (84 per cent) had survived for at least 12 months and were considered to be long-term survivors; the others six were euthanased within 12 months. Thirteen (34 per cent) of the horses discharged had experienced complications that could have been sequelae to peritonitis and eight of the 13 were euthanased. The cause of the peritonitis was identified in 15 cases; survival rates were lowest in horses with peritonitis secondary to urinary tract involvement or intra-abdominal masses. Of the other 50 cases, 47 (94 per cent) survived to discharge, but two were euthanased owing to recurrent colic.
Assuntos
Doenças dos Cavalos/mortalidade , Peritonite/veterinária , Animais , Antibacterianos/uso terapêutico , Eutanásia Animal , Feminino , Seguimentos , Doenças dos Cavalos/tratamento farmacológico , Doenças dos Cavalos/terapia , Cavalos , Masculino , Peritonite/mortalidade , Peritonite/terapia , Prognóstico , Estudos Retrospectivos , Análise de Sobrevida , Resultado do Tratamento , Reino Unido/epidemiologiaRESUMO
BACKGROUND: An accurate, minimally invasive, ante-mortem diagnostic test for equine grass sickness (EGS) is currently lacking. Although histological examination of haematoxylin and eosin-stained rectal biopsies for chromatolytic neurons is insensitive as a diagnostic test for EGS, we hypothesised that its diagnostic accuracy could be improved by immunolabelling for ß-amyloid precursor protein (ß-APP), which has increased expression in cranial cervical ganglia (CCG) neuronal perikarya in EGS. OBJECTIVES: To develop a grading scheme for assessing the distribution and intensity of ß-APP immunoreactivity within individual rectal submucosal neurons and subsequently to determine the value of the distribution of different grades of neurons in EGS diagnosis. STUDY DESIGN: Retrospective case-control diagnostic accuracy study. METHODS: Initially, a standardised grading scheme was developed and ß-APP immunoreactivity in individual neuronal perikarya and axons was compared in sections of CCG and ileum from EGS and control horses. The grading scheme was then refined before being blindly applied to submucosal neurons in rectal biopsies derived from 21 EGS and 23 control horses. RESULTS: ß-APP immunoreactivity was increased in neuronal perikarya and axons in sections of CCG, ileum and rectum from EGS horses compared with controls. For rectal biopsies, a mean immunoreactivity grade exceeding 1.1 was 100% specific and sensitive for EGS, and the presence of at least one neuron with diffuse labelling of the entire cytoplasm (grade 3) was 95% sensitive and 100% specific for EGS. MAIN LIMITATIONS: Although the diagnostic criteria facilitated the discrimination of the EGS and control biopsies evaluated in this study, further prospective validation using a larger sample set is required. CONCLUSIONS: Histological assessment of ß-APP immunolabelled rectal biopsies is more sensitive than conventional histological examination in EGS diagnosis. Further validation is required before this technique can be advocated for use in clinical decision making.
Assuntos
Peptídeos beta-Amiloides/metabolismo , Doenças dos Cavalos/diagnóstico , Imuno-Histoquímica/veterinária , Reto/patologia , Peptídeos beta-Amiloides/química , Animais , Doenças do Sistema Nervoso Autônomo , Biópsia , Estudos de Casos e Controles , Cavalos , Neurônios/metabolismo , Estudos RetrospectivosRESUMO
REASONS FOR PERFORMING STUDY: Post operative complications following exploratory laparotomy can be potentially life-threatening, increase post operative morbidity and result in an increase in the length of hospitalisation of the affected individual. No study has evaluated the efficacy of specific strategies to reduce the incidence of post operative incisional complications. HYPOTHESIS: The use of an abdominal bandage following colic surgery through a celiotomy incision would significantly reduce the prevalence of post operative incisional complications. METHODS: A controlled, randomised clinical trial to test the hypothesis was devised. Horses eligible for inclusion in the study were assigned randomly either to the study or control group following recovery from general anaesthesia. Any post operative incisional complications occurring during hospitalisation were recorded. Long-term follow-up was obtained via telephone questionnaires. Absolute risk reduction (ARR) and number needed to treat (NNT) were calculated. Multivariable analyses were conducted for all outcomes of interest. RESULTS: There was an ARR of the likelihood of developing a post operative incisional complication of 45% when using compared to not using an abdominal bandage in the post operative period. Therefore, it would be necessary to treat 2.2 horses with an abdominal bandage in order to prevent one horse developing any post operative incisional complications. CONCLUSIONS: Although incisional complications continue to be a problem following an exploratory celiotomy for colic, the proportion of horses affected was significantly reduced by use of a bandage. POTENTIAL RELEVANCE: Using an abdominal bandage following an exploratory laparotomy may help reduce the prevalence of post operative incisional complications, and prevent the development of potentially life-threatening complications.
Assuntos
Bandagens/veterinária , Cólica/veterinária , Doenças dos Cavalos/cirurgia , Laparotomia/veterinária , Complicações Pós-Operatórias/veterinária , Animais , Cólica/mortalidade , Cólica/cirurgia , Feminino , Doenças dos Cavalos/mortalidade , Cavalos , Laparotomia/efeitos adversos , Laparotomia/métodos , Masculino , Análise Multivariada , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Fatores de Risco , Fatores de Tempo , Resultado do TratamentoRESUMO
REASONS FOR PERFORMING STUDY: Incisional drainage and suppuration occurs commonly following exploratory laparotomy; any technique with the potential to reduce the incidence of this complication warrants investigation. OBJECTIVES: To determine if abandoning the use of subcutaneous sutures in laparotomy wound closure is safe and whether it reduces the risk of suppuration. METHODS: A randomised controlled study was carried out at 2 referral hospitals in the UK, involving 309 horses undergoing exploratory laparotomy; 150 horses underwent '2-layer' closure without a subcutaneous suture, while 159 underwent conventional '3-layer' closure. Information regarding degree of oedema and gross types of discharge was recorded daily; suppuration was defined as discharge of pus. Telephone follow-up was carried out 30 days after hospital discharge to identify those complications occurring after that date and, thereafter, every 3 months. The influence of closure method on risk of wound suppuration was assessed by Chi-squared analysis and by logistic regression. Time to suppuration was modelled using a Cox proportional hazards model. RESULTS: No catastrophic failures of 2-layer closures were recorded. Prevalence of suppuration was not significantly different, being 18.7% and 23.9% for 2- and 3-layer closures, respectively (OR = 1.37, 0.79-2.37, P = 0.263). CONCLUSIONS AND POTENTIAL RELEVANCE: This study found no significant difference in prevalence or rate of wound suppuration in 2-layer closures compared to conventional 3-layer closure. Two-layer closure is recommended as a safe alternative means of achieving ventral midline abdominal closure in horses.
Assuntos
Cólica/veterinária , Doenças dos Cavalos/cirurgia , Laparotomia/veterinária , Supuração/veterinária , Infecção da Ferida Cirúrgica/veterinária , Técnicas de Sutura/veterinária , Animais , Distribuição de Qui-Quadrado , Cólica/cirurgia , Edema/epidemiologia , Edema/prevenção & controle , Edema/veterinária , Cavalos , Estimativa de Kaplan-Meier , Laparotomia/efeitos adversos , Laparotomia/métodos , Modelos Logísticos , Razão de Chances , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/veterinária , Prevalência , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Supuração/epidemiologia , Supuração/prevenção & controle , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/prevenção & controle , Técnicas de Sutura/efeitos adversos , Fatores de Tempo , CicatrizaçãoRESUMO
The records of 41 horses with previously undiagnosed foot pain that had been examined by standing magnetic resonance imaging were reviewed and follow-up information was obtained from their owners two years after the examination. A range of soft tissue and osseous abnormalities were identified, with multiple lesions frequently occurring. Deep digital flexor tendonitis was recorded in 12 of the horses, and distension of the distal interphalangeal joint was identified in 15, but it was not always associated with lameness; in contrast, distension of the navicular bursa was always associated with lameness in the seven affected horses. Navicular bone lesions were identified in 13 of the horses, often in the absence of radiographic changes. Follow-up information was obtained for 35 of the horses, 27 of which were alive; of these, 16 had returned to their previous level of performance. Of the five horses with navicular bursal changes, four had been euthanased owing to lameness and the other had returned to work at a reduced level.
Assuntos
Doenças do Pé/veterinária , Doenças dos Cavalos/diagnóstico , Coxeadura Animal/diagnóstico , Imageamento por Ressonância Magnética/veterinária , Animais , Diagnóstico Diferencial , Feminino , Doenças do Pé/diagnóstico , Doenças dos Cavalos/etiologia , Cavalos , Coxeadura Animal/etiologia , Imageamento por Ressonância Magnética/métodos , Masculino , Dor/diagnóstico , Dor/etiologia , Dor/veterinária , Articulação do Dedo do PéRESUMO
REASONS FOR PERFORMING STUDY: Septic digital tenosynovitis is a serious problem in the horse, with a poor prognosis being reported for recovery. HYPOTHESIS: The occurrence of septic digital tenosynovitis would significantly reduce the likelihood of a horse returning to its previous level of athletic function. METHODS: Medical records of 90 horses treated for septic digital tenosynovitis were reviewed. Data retrieved included age, sex, location of inciting cause of sepsis, time from onset of clinical signs to presentation for treatment, and whether the horse survived to be discharged. Long-term outcome was determined through telephone questionnaires. Univariate analyses of categorical variables were conducted for each outcome. RESULTS: Overall, 87.8% of horses (79/90) survived to be discharged from the hospital. Only one factor examined was shown to have a significant effect on outcome. A delay of 1-7 days between onset of clinical signs and presentation for treatment reduced significantly the likelihood of the horse surviving to be discharged from the hospital. Of the horses discharged from the hospital, long-term follow-up was available for 72 horses, with 54.2% (39/72) returning to their previous level of athletic function. CONCLUSIONS: Only approximately 50% of horses treated for septic digital tenosynovitis returned to their previous level of athletic function following resolution of synovial sepsis. POTENTIAL RELEVANCE: Accurate figures allowing a realistic assessment of the athletic future of a horse following treatment for septic digital tenosynovitis are of value to both the owner and treating veterinarian.
Assuntos
Doenças dos Cavalos/fisiopatologia , Condicionamento Físico Animal , Tenossinovite/veterinária , Animais , Intervalos de Confiança , Feminino , Doenças dos Cavalos/mortalidade , Cavalos , Masculino , Razão de Chances , Prognóstico , Estatísticas não Paramétricas , Inquéritos e Questionários , Análise de Sobrevida , Tenossinovite/mortalidade , Tenossinovite/fisiopatologia , Fatores de Tempo , Resultado do TratamentoRESUMO
REASONS FOR PERFORMING STUDY: Equine motor neuron disease (EMND) was diagnosed in 3 horses maintained on lush, grass-based pasture. This contrasted with North American studies which identified limited or no access to green herbage as an important risk factor for EMND. HYPOTHESIS: Grazing horses that have an apparently adequate intake of pasture herbage to meet normal equine vitamin E requirements can develop EMND. METHODS: Owners of 32 European horses diagnosed with EMND completed a questionnaire regarding intrinsic, managemental, nutritional and environmental factors that could potentially be risk factors for EMND, and also regarding clinical signs, treatments and case outcome. Plasma/serum vitamin E data for these horses were supplied by the veterinarians. No control population was studied. RESULTS: Thirteen of 32 horses (termed the 'grazing' group) had part- or full-time access to grass-based pasture at the onset of EMND (median duration at pasture 12 h/day, range 3-24 h). Five of these horses were at pasture for at least 235 h/day at the onset of EMND, 2 of which were at pasture for at least 23.5 h/day throughout the year. Despite grazing, all these horses had a low vitamin E status. The remaining 19 horses resembled those cases reported from North America, in that they had no or limited access to pasture. CONCLUSIONS AND POTENTIAL RELEVANCE: A diagnosis of EMND should not be discounted on the basis that a horse has access, even full-time, to lush grass-based pasture. Inadequate vitamin E intake was probably not the sole cause of either the EMND or the low vitamin E status in the grazing horses; the latter was probably the result of abnormal bioavailability or excessive utilisation of vitamin E.
Assuntos
Fenômenos Fisiológicos da Nutrição Animal , Doenças dos Cavalos/etiologia , Doença dos Neurônios Motores/veterinária , Poaceae , Vitamina E , Ração Animal , Animais , Disponibilidade Biológica , Cruzamento , Meio Ambiente , Feminino , Doenças dos Cavalos/sangue , Cavalos , Masculino , Doença dos Neurônios Motores/sangue , Doença dos Neurônios Motores/etiologia , Necessidades Nutricionais , Estado Nutricional , Fatores de Risco , Inquéritos e Questionários , Vitamina E/administração & dosagem , Vitamina E/sangue , Deficiência de Vitamina E/sangue , Deficiência de Vitamina E/complicações , Deficiência de Vitamina E/veterinária , Vitaminas/administração & dosagem , Vitaminas/sangueRESUMO
Recognition of artefacts is an essential component of the accurate interpretation of diagnostic images. This study aimed to investigate the presence of magic angle effect in the superficial digital flexor tendon (SDFT) in the equine proximal pastern region. The proximal pastern of four cadaver limbs was imaged using a 0.27 Tesla magnet with high-resolution sequences that are commonly utilised in clinical equine practice. The limbs were imaged in a neutral position and positions that simulated the horse 'leaning in', 'leaning out' and having internal and external rotation of the distal limb. Signal intensity changes in the SDFT were described and compared. The simulated 'leaning in' and external rotation positions resulted in increased signal intensity in the axial and middle thirds of the lateral half of the SDFT on sequences with short echo times. The simulated 'leaning out' and internal rotation positions resulted in increased signal intensity in the axial and middle thirds of the medial half of the SDFT on sequences with short echo times. These signal intensity changes did not occur or were only mild and inconsistent on T2 fast spin echo sequences with longer echo times. The increases in signal intensity in the SDFT are consistent with a position-induced magic angle artefact that has been noted in clinical cases. Attention to positioning of the equine distal limb is essential during clinical imaging; radiologists should be aware of position-induced artefacts to ensure accurate image interpretation.
Assuntos
Pé/diagnóstico por imagem , Imageamento por Ressonância Magnética/veterinária , Tendões/diagnóstico por imagem , Animais , Artefatos , Cadáver , Articulações do Pé/diagnóstico por imagem , Cavalos , Posicionamento do Paciente/veterináriaRESUMO
REASONS FOR PERFORMING STUDY: Survey data on equine tumours are sparse compared with other species and may have changed over time. OBJECTIVES: To describe the most frequently diagnosed equine tumours recorded by a diagnostic pathology laboratory over 29 years, to identify background factors associated with tumour type, and to identify any changes in the tumours diagnosed or the background of cases submitted during the study period. STUDY DESIGN: Observational; cross-sectional analysis of records of a diagnostic pathology laboratory. METHODS: The records of all neoplastic equine histology submissions to the University of Bristol (January 1982-December 2010) were accessed from a database, and a list of diagnoses compiled. The 6 most commonly diagnosed tumour types were analysed using logistic regression to identify background factors associated with tumour type. The overall population of equine tumour submissions and the relative frequency of diagnosis of the most common tumour types were compared between decades. RESULTS: There were 964 cases included. The most frequently diagnosed tumours were: sarcoid (24% cases), squamous cell carcinoma (SCC) (19%), lymphoma (14%), melanoma (6%), gonadal stromal tumour (6%) and mast cell tumour (MCT) (4%). With sarcoid, Thoroughbred/Thoroughbred cross and gelding as reference categories: increasing age was significantly associated with the odds of each of the other tumour types, mares were at reduced risk of SCC, Arab/Arab cross had a higher risk of MCT, Cob/Cob cross had an increased risk of SCC and MCT, and ponies had an increased risk of melanoma. The mean age of submissions increased in each successive decade and the breed composition became broader. Sarcoids and lymphoma formed a smaller proportion of diagnoses in later decades. CONCLUSIONS: The types of tumours submitted to this laboratory have changed over the last 3 decades. Current data inform clinicians and researchers and further studies are warranted to follow trends.
Assuntos
Doenças dos Cavalos/epidemiologia , Neoplasias/veterinária , Animais , Estudos Transversais , Bases de Dados Factuais , Feminino , Doenças dos Cavalos/diagnóstico , Doenças dos Cavalos/patologia , Cavalos , Masculino , Neoplasias/diagnóstico , Neoplasias/epidemiologia , Neoplasias/patologia , Fatores de Risco , Reino Unido/epidemiologiaRESUMO
Histological evidence of fibrosis affecting the outer layer of the large intestinal tunica muscularis was identified in five of 32 horses affected by colic. In three cases, foci of pale eosinophilia and vacuolation of myocytes were observed. These findings are suggestive of a degenerative and fibrotic abnormality in the outer layer of the tunica muscularis of the large intestinal smooth muscle of some horses with colic.
Assuntos
Cólica/veterinária , Doenças dos Cavalos/patologia , Intestino Grosso/patologia , Músculo Liso/patologia , Animais , Cólica/patologia , Feminino , Fibrose/patologia , Cavalos , MasculinoRESUMO
REASONS FOR PERFORMING STUDY: A minority of equine colic cases prove fatal unless treated surgically; however, few studies have considered long-term survival and complication rates, and few have attempted to identify factors that might affect outcomes. Such information is required for owners and veterinary surgeons to make informed decisions about the most appropriate treatment for individual cases. OBJECTIVES: To document short-term survival rates of 300 horses undergoing colic surgery and analyse factors that might have predisposed to short-term death. METHODS: History, clinical and surgical findings, treatments and outcomes of 300 surgical colic cases (1994-2001) were reviewed. Comparisons among groups of discrete data were made using chi-squared or Student's t tests as appropriate. Significance was set at P < 0.05, and 95% confidence intervals were calculated for percentages. RESULTS: The short-term survival rate (to discharge) was 70.3% for all horses and 83.1% for those recovering from anaesthesia; for horses that had a single laparotomy it was 87.2%. The most common reasons for death/euthanasia in the post operative period after a single laparotomy were persistent pain/colic, post operative ileus and grass sickness. Horses with lesions involving the small intestine and caecum had lower survival rates (75.2 and 66.7%, respectively) than those with large colon or small colon lesions (89.9 and 100%, respectively). The survival rate for ischaemic/strangulating lesions (68.9%) was lower than for simple obstructions (90.5%). CONCLUSIONS: Short-term survival of horses undergoing exploratory laparotomy for acute colic is dependent on many factors, including the nature of the underlying disease, cardiovascular status and post operative complications. POTENTIAL RELEVANCE: These retrospective studies may be used as a basis for prospective studies assessing treatments that could ultimately improve survival and decrease complication rates.