Small Colon Faecalith with Large Colon Displacement in Ten Cases (2015-2023): A Detailed Case Description and Literature Review.

Small colon impaction can result in accumulation of ingesta, gas, and fluid orally to the impaction site in horses. Large colon tympany, which is caused by ingesta fermentation, can be a predisposing factor for intestinal displacement. The aim of this study is to report the history, clinical, and surgical findings of horses and ponies referred for abdominal pain not responsive to drugs where a right dorsal displacement (RDD) or large colon volvulus (LCV), together with a small colon faecalith (SCF), were diagnosed during surgery. This study included a total of five horses and five ponies. Based on clinical features, ultrasonographic examination, and rectal palpation, an initial suspected diagnosis of RDD, LCV or severe large colon and caecum distension was made in all clinical cases. Due to the lack of response to medical treatment or worsening of colic symptoms, surgery was performed in all horses: diagnosis of RDD or LCV was made and a SCF was incidentally detected in all cases. While exploratory laparotomy was carried out in all the patients for the presence of a large colon issue, it was probably subsequent to an obstruction of the small colon caused by the presence of an SCF, which is generally difficult to diagnose. This study reported the presence of SCF as a possible cause of secondary RDD or LCV in horses and ponies that, to the authors' knowledge, has never been reported.

Post-mortem ultrasonographic and computed tomographic features of the anatomical variations and acquired pathological bony changes of the lumbosacroiliac region in a mixed population of horses.

BACKGROUND: Transrectal ultrasonography is the best technique for evaluating the ventral aspect of the lumbosacral and sacroiliac regions yet this diagnostic technique does not always lead to a final diagnosis of back pain in horses. OBJECTIVES: To describe anatomical variations and acquired pathological bony changes (APBCs) in the lumbosacral and sacroiliac regions detected by ultrasonography (US) and computed tomography (CT) examinations on specimens. We hypothesised that age, body mass, previous use and anatomical variations may be correlated with the presence and/or severity of APBCs. STUDY DESIGN: Descriptive cadaver study. METHODS: Lumbosacroiliac specimens were obtained from 51 horses that died or were euthanised for reasons other than the study and underwent US and CT examinations post-mortem. RESULTS: Forty-two specimens were analysed. The most prevalent lumbosacral disc morphology was type 2 (21/42), and protrusions were found in 15/42 specimens. Abnormal echogenicity of the L5-L6 and lumbosacral discs was detected in 11/42 and 30/42 specimens, respectively. Abnormalities in the size of the L5-L6 disc were found in 10/42 specimens and correlated with promontorium localisation (Cramér's V coefficient [V] = 0.42) and lumbosacral disc morphology (type 1: V = 0.41; type 5: V = 0.69). The most prevalent orientation of the L6 spinous process (SP) was convergent (24/42). The promontoria were mostly located between L6 and S1 (36/42). Lumbosacral spondylosis was detected in 24/42 specimens and spondylolisthesis in one. Age was associated with the severity of APBCs in the sacroiliac joints, lumbosacral intertransverse joints, articular process joints, spondylosis and L6 or S1 bone plate irregularities. Lumbosacral spondylosis or L6 extremitas caudalis irregularity was associated with lumbosacral angulation, variability in the size of the L5-L6 disc and localisation of the promontorium, L6 SP orientation and L6 extremitas caudalis irregularity with abnormal echogenicity of the LS disc. MAIN LIMITATIONS: Lack of information on clinical signs. CONCLUSIONS: High variability and prevalence of the anatomical variations and APBCs in the lumbosacroiliac region were observed, and correlations between some anatomical variations and APBCs and between APBCs and age were reported.

Short-Term Survival and Postoperative Complications Rates in Horses Undergoing Colic Surgery: A Multicentre Study.

The occurrence of colic could be influenced by the characteristics of a population, geographical area, and feeding management. The aim of this study was to report the short-term postoperative complications and survival rates and to identify factors that might affect the outcome of horses that underwent colic surgery in three Italian surgical referral centres. Data of horses subjected to colic surgery in three referral centres (2018-2021) were analysed. Comparisons of the outcomes were performed using a Mann-Whitney or a Chi square test. Areas under the receiver operating characteristic (ROC) curve and multivariable logistic regression analysis were used for parameters that were significant in the previous univariate analysis. The goodness-of-fit of the model was assessed using the Akike information criterion (AIC). Significance was defined as p < 0.05, and odds ratios and 95% confidence intervals were calculated as percentages. A total of 451 horses were included. The survival rate was 68.5% of all of the horses that underwent colic surgery and 80% of the horses surviving anaesthesia. Age, BCS, PCV and TPP before and after surgery, amount of reflux, type of disease, type of lesion, duration of surgery, surgeon's experience, and amount of intra- and postoperative fluids administered influenced the probability of short-term survival. The multivariate analysis revealed that PCV at arrival, TPP after surgery, and BCS had the highest predictive power. This is the first multicentre study in Italy. The results of this study may help surgeons to inform owners regarding the prognosis of colic surgery.

Post-Mortem Computed Tomographic Features of the Most Caudal Lumbar Vertebrae, Anatomical Variations and Acquired Osseous Pathological Changes, in a Mixed Population of Horses.

The radiographic, ultrasonographic, and scintigraphic findings of horses with thoracolumbosacral pain have been previously reported. In this study, the computed tomographic appearance of anatomical variations and pathological changes of the equine caudal lumbar region through a post-mortem examination were investigated. A total of 40 horses that had died or were submitted for euthanasia, for reasons unrelated to the study, were included in the study. From all the specimens, the modified vertebral system was adopted to evaluate and describe the four most caudal lumbar vertebrae, which were numbered from a caudal reference point (lumbosacral junction), with the segment number designated within parentheses (i.e., L(i)-L(iv)). Contact of the spinous processes was detected in 21 specimens (54%) and fusion in 6 specimens (15%). Lumbar spondylosis was seen in 17 specimens (42.5%), more commonly on the lateral aspect or on both ventral and lateral aspects in 12 specimens (71%). The presence of spondylosis was found more commonly in older horses (p < 0.001). There was no difference in bony density in specimens with spondylosis or spinous processes contact compared to specimens without. The highest prevalence of bony changes was found at L(ii)-L(i) intertransverse joints in 28 specimens (97%) on the left and in 22 specimens (96%) on the right side. Spondylolisthesis and partial fusion of the L(ii)-L(i) vertebral disc were found in association with degenerative pathologies. This study showed a high frequency of several anatomical variations and acquired osseous pathological changes in the most caudal lumbar vertebrae via a CT examination.

Age and sex correlate with bony changes and anatomic variations of the lumbosacroiliac region of the vertebral column in a mixed population of horses.

OBJECTIVE: To provide a postmortem description of anatomic variations and changes of the lumbosacroiliac region in horses. The authors hypothesized that lesion severity would increase with age and body weight and correlate to anatomic variations. SAMPLES: Lumbosacroiliac vertebral specimens from 38 horses (mean age, 16 years; range, 5 to 30 years) that died or were euthanized for reasons unrelated to the study between November 2019 and October 2021. PROCEDURES: The lumbosacroiliac region of the vertebral column was removed from each cadaver. After dissection, disarticulation, and boiling, the anatomic specimens were examined for anatomic variations and osseous changes of the articular process joints (APJs), intertransverse joints (ITJs), and sacroiliac joints (SIJs). The lengths of L6-S1 intertransverse articular surfaces were measured and their ratios calculated. Descriptive statistics were obtained, and the χ2 test was used to assess differences in anatomic variations and abnormal changes of the APJs, ITJs, and SIJs. RESULTS: The most common anatomic variation was a sacrum-like shape of the transverse processes of L6 (29/38 [76%]) and converging orientation of dorsal spinous process of L6 (33/38 [87%]). The highest prevalence of bony changes was detected at L5-L6 (right, 34/38 [89%]; left, 33/38 [87%]) and L6-S1 APJs (right, 38/38 [100%]; left, 37/38 [97%]) and at SIJs (right, 32/38 [86%]; left, 31/38 [82%]). The shape of L6 transverse processes differed between breed (P = .01) and was associated with presence of L4-L5 ITJs (P < .01). CLINICAL RELEVANCE: Age and sex were associated with changes of the sacral dorsal spinous processes, ITJs, and APJs. The clinical significance of these findings could not be confirmed based on the study limitations.

Multimodal Diagnostic Imaging to Identify Septic Apophysitis of the Proximal Humerus in a Thoroughbred Foal.

A 4-month-old Thoroughbred filly was referred for evaluation of severe left forelimb lameness of 24 hours duration. Radiographic projections of the shoulder revealed mild irregularity and sclerosis of the proximal humeral apophysis. Ultrasonographic examination showed a moderate increase in the amount of anechogenic synovial fluid within the intertubercular bursa and scapulohumeral joint, and irregularity of the ossifying bone surface of the intermediate tubercle of the humerus. Computed tomographic (CT) examination revealed a circular hypoattenuating area at the level of the proximal apophysis of the humerus. CT imaging in this case was essential for an early identification of the septic foci and it allowed ultrasound-guided sample from the lesion for the selection of targeted antibiotic therapy.

Comparison of Mesh and Barbed Suture for Laparoscopic Nephrosplenic Space Ablation in Horses.

Nephrosplenic space (NSS) ablation has been demonstrated to be an effective technique for prevention of left dorsal displacement of the large colon and multiple laparoscopic techniques, among which ablation with mesh or with a barbed suture, have been proposed. Our objective was to compare two laparoscopic techniques for closure of the NSS in twenty-eight horses diagnosed with nephrosplenic entrapment. Medical records of horses that had laparoscopic NSS ablation in two referral centers between 2017-2019 were retrieved. Duration of surgery, complications, and short- and long-term follow-up information were collected and compared. Costs were also calculated and compared. All horses met the inclusion criteria: 9 had NSS ablation with a mesh implant (group M), 19 with barbed suture material (group B). One horse in group B had recurrent colic after discharge. At control laparoscopy after 5 months, the NSS resulted in still not being ablated because of a failure of the suture. In group M, three horses had recurrent colic. One was successfully treated medically, one died of unknown causes and the third required a second laparoscopic suturing at 3-6 months because of failure of the mesh implant. The mean time of surgery and costs were lower in group B compared to group M. The barbed suture technique was faster, more cost-effective and had a lower complication rate than the mesh implant.

Successful Surgical and Medical Management of a Pararectal Abscess in a Horse.

Pararectal abscesses are life-threatening conditions that can rupture and cause septic peritonitis. The objective of this case report is to describe aggressive treatment of a pararectal abscess to allow a quick return to competitions. A 14-year-old pony was admitted to the Veterinary Teaching Hospital (VTH) of the University of Perugia because of a suspected intra-abdominal mass. Two weeks earlier, it exhibited clinical signs compatible with colic which was treated medically; however, because of the persistence of a firm mass on the right side of the abdomen noted on rectal palpation, the pony was admitted to the VTH. Based on rectal palpation, rectal ultrasound, neutrophilic leukocytosis, hyperfibrinogenemia, and elevated alkaline phosphatase, the diagnosis of a pararectal abscess was made. The horse was treated with ceftiofur IM and MgSO4/paraffin oil via a nasogastric tube. Standing surgical drainage of the abscess with placement of an indwelling drain was performed, followed by daily lavages with rifampicin and acetylcysteine along with Ringer lactate solution with subsequent passive drainage. A bacterial culture revealed the presence of Streptococcus zooepidemicus that was treated with oral rifampicin. Standing laparoscopy revealed adhesions to the rectum. An epidural catheter was placed for repeated delivery of morphine sulfate. The pony was monitored daily by rectal examination, while complete blood count, fibrinogen, serum amyloid A, and abdominal ultrasound (to assess the size of the abscess) were repeated weekly. The pony progressively improved and was discharged one month later, shortly returning to competitions. This report emphasizes the importance of combining medical and surgical treatments for pararectal abscesses.