Comparison of the antisecretory effects of omeprazole when administered intravenously, as acid-stable granules and as an oral paste in horses.

The antisecretory activity of omeprazole on gastric acid when administered i.v., intragastrically or per os, was evaluated in 2 female and 3 castrated male horses. Each horse had been prepared with a chronic indwelling gastric cannula. A single i.v. administration of omeprazole (1.5 mg/kg bwt) was effective in abolishing basal and pentagastrin (PG)-stimulated acid secretion. Once daily, nasogastric administration of omeprazole in acid-stable granules for 5 days inhibited acid secretion in a dose-dependent manner: 57% (1.5 mg/kg bwt) and 98% (5.0 mg/kg bwt) reduction of PG-stimulated acid secretion. The degree of inhibition was maintained over a 19 day treatment period with once daily dosing. A prototype oral paste formulation containing either acid-stable omeprazole granules or uncoated omeprazole powder was equipotent when compared to a similar dosage of acid-stable omeprazole granules administered by nasogastric tube. A dose-dependent inhibition was seen with the oral paste formulation containing omeprazole powder: 55% (1.5 mg/kg bwt) and 77% (3.0 mg/kg bwt) reduction of PG-stimulated acid secretion after 5 days. Therefore, a paste formulation of omeprazole powder may offer an effective, easily administered, once daily acid inhibitory treatment for gastric ulcer disease in horses.

Effects of omeprazole on healing of naturally-occurring gastric ulcers in thoroughbred racehorses.

Seventeen Thoroughbred horses with moderate to severe gastric ulceration were purchased from a race track within 10 days of racing and were treated once daily with either omeprazole (9 horses) or vehicle (8 horses) and evaluated gastroscopically for ulcer healing. Horses were administered omeprazole (1.5 mg/kg bwt/day) or vehicle by nasogastric tube once daily. Gastroscopic examination was performed on Days 0, 4, 7, 11, 14, 17, 21, 24 and 28, until lesions healed completely. Selected images of gastric lesions were captured by computer at each endoscopic examination, with a measuring caliper included in captured images. The area and perimeter of lesions were measured by computer and healing rates of specific lesions were determined by calculating the rate of linear advance of the margins toward the centre of the lesion. Additionally, the number of days to complete healing of the entire gastric squamous mucosa was compared between treatment groups. Gastric lesions healed at a significantly faster rate in horses receiving omeprazole than in vehicle-treated horses (P < 0.001). Complete healing of the entire stomach occurred in 10-21 days in omeprazole-treated horses, and 14-28 days in 3 of 8 vehicle-treated horses, with the remaining vehicle-treated horses having unhealed lesions on Day 28. In addition, 5 vehicle-treated horses developed new lesions in the squamous epithelial mucosa during the trial; no new lesions were observed in the omeprazole-treated group.

Surgical management of urolithiasis in small ruminants.

Twenty-one cases of urolithiasis in small ruminants were examined to evaluate the efficacy of various surgical treatments. Of 21 cases, all but 1 had multiple calculi. Urethral process amputation and medical therapy either did not relieve the obstruction or provided only temporary relief (< 36 hours) in 14 of 16 cases. In 2 cases, obstruction recurred in 1 year and 4 years, respectively, after urethral process amputation. Ten of 13 animals that had perineal urethrostomy (PU) experienced short-term complications, including postoperative hemorrhage, dehiscence of the surgical wound, and subcutaneous accumulation of urine. Urethral stricture occurred in 7 of 9 animals in which follow-up information was obtained, and long-term survival was 55%. Cystotomy alone was performed on 8 of 21 cases, and 7 of 8 (88%) were healthy at the time of follow-up. In order to relieve the obstruction with cystotomy alone, multiple attempts at normograde and retrograde flushing were required. Cystotomy allowed removal of multiple calculi, bidirectional flushing of the urethra, and posed less risk for short-term postoperative complications and urethral stricture. These data suggest that cystotomy was more effective than PU for the management of urolithiasis in small ruminants.

Pedunculated lipomas as a cause of intestinal obstruction in horses: 17 cases (1983-1990).

The medical records of 17 horses that were evaluated and treated because of colic caused by pedunculated lipomas between 1983 and 1990 were reviewed. The mean age of the horses was 16.6 +/- 3.9 years (range, 10 to 26 years), which was significantly greater than that of the population of horses evaluated because of colic (control population) during the same period. There were significantly more geldings (76.5%), compared with the control population. Nasogastric reflux ranged from 1 to 16 L in 8 horses and was not obtained in 9 horses. Abdominal palpation per rectum revealed small intestinal distention in 13 horses, displaced large colon in 7 horses, and large colon impaction in 2 horses. Peritoneal fluid was abnormal in 11 of 12 horses from which it was obtained successfully. One horse was euthanatized after unsuccessful medical treatment. Surgery was performed in 16 horses. Lipomas were blindly resected in 5 horses or exteriorized and resected in 6 horses. The method used to resect the lipoma was not recorded in 5 horses. The ileum and/or jejunum was strangulated in 15 horses, the small colon was strangulated in 1 horse, and the jejunum was obstructed in 1 horse. The length of intestine resected ranged from 0.15 to 7.2 m. Fourteen horses survived surgery, of which 11 were discharged from the hospital (short-term survival rate of 78.6%). Excluding 2 horses lost to follow-up evaluation, 6 of 12 horses that survived surgery were alive 2 to 56 months following surgery (long-term survival rate of 50%), and 9 of 15 horses died or were euthanatized (fatality rate of 60%).

Effects of antibiotic prophylaxis on postoperative complications after rumenotomy in cattle.

A single preoperative dose of antibiotic proved as effective as a preoperative and 7-day postoperative course in reducing complications following rumenotomy in cattle. Exploratory rumenotomy was performed on 29 healthy Angus steers, which were allotted to the following treatment groups: (1) no antibiotic therapy, (2) single-dose, preoperative, antibiotic prophylaxis, using potassium penicillin G, and (3) preoperative potassium penicillin G prophylaxis, followed by a 7-day postoperative course of procaine penicillin G. Steers receiving antibiotics had significantly greater postoperative feed intake, lower rectal temperatures, and fewer abscesses at the surgical site than those receiving no antibiotics. There was no significant difference between animals receiving a single preoperative dose of antibiotic and those treated for an additional 7 days after surgery. In human medicine, it is generally agreed that a single preoperative dose of antibiotic offers effective prophylaxis. There are few published reports on antimicrobial prophylaxis in the veterinary literature, particularly in regard to large animals. Considering USDA requirements for milk withholding times and withdrawal times prior to slaughter for food animals receiving antibiotics, the findings of this study have medical as well as economic value.

Leiomyoma of the small colon in a horse.

A leiomyoma of the small colon was discovered incidentally in a 4-year-old Thoroughbred gelding during colic surgery to correct large colon displacement. The mass and 20 cm of small colon were resected, and an end-to-end anastomosis was performed. A postoperative fecal impaction proximal to the anastomosis responded after 5 days to administration of intravenous fluids, analgesics, and stool softeners.

Bovine esophageal surgery.

Esophageal disorders are relatively uncommon in cattle. The most frequently encountered problem is foreign-body obstruction, or choke. Other disorders may include perforation, rupture, stricture, diverticulum, and megaesophagus. Factors responsible for the high rate of complications associated with esophageal surgery include the lack of a serosal layer, movement during deglutition and reverse peristalsis, and an easily interrupted segmental blood supply. Important considerations of esophageal surgery include minimization of blood supply disruption, avoidance of transverse esophageal incisions whenever possible, provision of leak-proof closure of an incision or anastomosis and adequate drainage for the surrounding soft tissues, and restriction of postoperative oral alimentation and handling.