Medical management of sand enteropathy in 62 horses.

REASONS FOR PERFORMING STUDY: Medical management of sand enteropathy is common in equine practice, but the clinical features and outcomes associated with medically managed sand enteropathy are not well described. OBJECTIVES: To review clinical features, therapeutic approaches and outcomes associated with primary medical management of sand enteropathy in the mature horse. METHODS: Medical record databases at 3 equine referral hospitals from January 2000 to April 2010 were reviewed for cases of sand enteropathy diagnosed via abdominal radiographs in mature horses that were initially managed medically. Data were collected and descriptive analyses compiled. Uni- and multivariate logistic regression was used to evaluate factors potentially associated with treatment failure. RESULTS: The medical records of 62 horses were analysed; 90% of horses survived to discharge and 50% of horses that had repeat abdominal radiographs taken demonstrated improvement in the degree of sand accumulation after treatment. Nine horses underwent exploratory laparotomy during hospitalisation, and colonic sand impaction was found in all 9, with a concurrent gastrointestinal lesion identified in 7. Four horses were subjected to euthanasia during or after surgery because of disease severity or complications. Need for exploratory laparotomy was the factor most strongly associated with nonsurvival. CONCLUSIONS: These data suggest that medical management can result in clinical and radiographic resolution of uncomplicated sand enteropathy in mature horses, and is associated with a good prognosis. Horses with sand enteropathy that exhibit persistent colic signs despite medical management are likely to have a concurrent gastrointestinal lesion, so prompt exploratory laparotomy should be considered in such cases. POTENTIAL RELEVANCE: Uncomplicated sand enteropathy can be managed medically in mature horses, and serial abdominal radiography can be used to monitor sand clearance. Surgery to evaluate for and correct concurrent gastrointestinal lesions should be recommended without delay in horses showing persistent colic signs.

A review of foal diarrhoea from birth to weaning.

Diarrhoea is among the most common clinical complaints in foals. Aetiologies, diagnostic testing and recommended interventions for specific causes of enterocolitis are summarised. Many mild to moderately affected foals can be managed in an ambulatory setting, while others will benefit from more intensive care at a referral centre.

Risk factors for nosocomial Salmonella infection among hospitalized horses.

OBJECTIVE: To identify risk factors for nosocomial Salmonella infections among hospitalized horses. DESIGN: Longitudinal study. ANIMALS: 1,583 horses hospitalized in an intensive care unit between January 1992 and June 1996. PROCEDURE: Survivor functions were used to estimate time to shedding salmonellae for various Salmonella serotypes. Survival analysis was then used to determine how variables associated with patient management, environmental conditions, hospital conditions, and other disease processes affected the risk of nosocomial Salmonella infection. RESULTS: 78 horses shed Salmonella organisms: 35 shed Salmonella krefeld, 26 shed S typhimurium, and 17 shed other Salmonella serotypes. Mean time from admission to shedding was significantly longer for horses shedding S krefeld or S typhimurium than for horses shedding other Salmonella serotypes. Therefore, infection with S krefeld or S typhimurium was considered nosocomial. Seven variables were found to be significantly associated with risk of nosocomial Salmonella infection: mean number of horses in the hospital shedding S krefeld during the 4 days prior to and the day of admission, mean number of horses shedding S typhimurium during this period, a diagnosis of large colon impaction, withholding feed, number of days fed bran mash, duration of treatment with potassium penicillin G, and mean daily ambient temperature. CLINICAL IMPLICATIONS: Results suggest that risk of nosocomial Salmonella infections is greater for horses with large colon impactions. In addition to implementing hospital protocols that minimize cross contamination between patients, strategies to reduce the risk of nosocomial Salmonella infection should include minimizing use of potassium penicillin G and regulation of environmental temperature in the hospital.

Influence of fecal shedding of Salmonella organisms on mortality in hospitalized horses.

OBJECTIVES: To predict mortality of horses by use of clinical data from the first day of hospitalization, to determine whether fecal shedding of Salmonella organisms is related to severity of clinical disease, and to determine the impact of fecal shedding of Salmonella organisms on mortality. DESIGN: Prospective study. ANIMALS: 1,446 hospitalized horses. PROCEDURE: Medical information was obtained from horses hospitalized in an intensive care unit or isolation facility during a 4.5-year period. A model was created to predict mortality, using covariates determined on the day of admission. Predicted mortality provided a measure of clinical condition. Predicted mortality was compared between horses that were and were not shedding Salmonella organisms in their feces to determine whether shedding was associated with severity of disease. Predicted and observed mortality between horses were also compared to evaluate the association between fecal shedding of Salmonella organisms and mortality. RESULTS: 92 horses were identified as shedding Salmonella organisms. In a multivariable model, 4 variables (heart rate, respiratory rate, rectal temperature, and clinical management) were associated with mortality. A higher predicted probability of death was observed in horses that shed Salmonella krefeld or more than 1 serotype. Relative risk (RR) of mortality was high for horses shedding S typhimurium (RR, 1.94; 95% confidence interval, 1.04 to 3.59) and multiple serotypes (RR, 4.75; 95% confidence interval, 2.29 to 9.84). When the clinical condition (i.e., prior predicted probability of death) was taken into consideration, fecal shedding of Salmonella organisms was not significantly associated with mortality. CLINICAL IMPLICATIONS: In this horse population, fecal shedding of S krefeld was associated with more severe clinical conditions at the time of admission; however, fecal shedding of Salmonella organisms during hospitalization did not alter predicted mortality.

Comparison of cupric and sulfate ion effects on chronic selenosis in rats.

The ameliorating effects of Cu++ and SO4--ions on concurrent selenite toxicity were compared in two factorial experiments using 60 weanling rats each. In the first experiment, 0, 500 and 1,000 mg Cu (as CuCl2)/kg diet were fed in conjunction with 0, 5, 10 and 20 mg Se (as Na2SeO3)/kg diet. In the second experiment, the treatments were 0, 500 and 1,000 mg SO4 (as Na2SO4)/kg fed in conjunction with 0, 5, 10 and 20 mg Se/kg diet. A paired-feeding experiment using 10, 15 and 20 mg Se/kg diet was also conducted with 28 rats to compare the influence of inanition in control and selenite-fed rats. Cupric++ ion, but not SO4--ion, prevented mortality among selenite-intoxicated rats. There were significant Cu X Se interaction effects on feed intake, daily gain, packed cell volume (PCV), serum Cu and Fe, sperm counts, and weights of liver, kidney and testis. There were main effects of Cu and Se on serum Se and liver Cu. In Exp. 2 there were significant SO4 X Se interaction effects on feed intake, daily gain, serum Cu and testis weight. There were main effects of Se on PCV, sperm count, serum testosterone, liver Se, liver Cu and the absolute weights of liver and kidney. The only main effect of SO4 was that of increased liver Cu concentrations. Among the pair-fed rats, the selenite-fed rats, with one exception, died before their paired rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of slow scan television and direct viewing of radiographs.

Slow scan television equipment (SSTV) can transmit images of radiographs using an inexpensive camera, TV monitor and ordinary telephone lines, and has potential for use in communities without radiologists. We compared the accuracy with which nine experienced radiologists could perceive abnormal findings in each of two viewing conditions: (1) SSTV viewing of an image on a television monitor and (2) direct viewing on a light box. Each finding was categorized as readily, moderately or barely visible. The nine radiologists had scores using SSTV that were significantly worse (p less than .005) than the standard, whereas the scores using direct viewing were not significantly different from the standard. The present generation of SSTV equipment is not yet adequate for routine reading of radiographs, although the concept of SSTV still has considerable potential.