A matter of differentiation: equine enteroids as a model for the in vivo intestinal epithelium.

Epithelial damage due to gastrointestinal disorders frequently causes severe disease in horses. To study the underlying pathophysiological processes, we aimed to establish equine jejunum and colon enteroids (eqJE, eqCE) mimicking the in vivo epithelium. Therefore, enteroids were cultivated in four different media for differentiation and subsequently characterized histomorphologically, on mRNA and on protein level in comparison to the native epithelium of the same donor horses to identify ideal culture conditions for an in vitro model system. With increasing enterocyte differentiation, the enteroids showed a reduced growth rate as well as a predominantly spherical morphology and less budding compared to enteroids in proliferation medium. Combined or individual withdrawal of stem cell niche pathway components resulted in lower mRNA expression levels of stem cell markers and concomitant differentiation of enterocytes, goblet cells and enteroendocrine cells. For eqCE, withdrawal of Wnt alone was sufficient for the generation of differentiated enterocytes with a close resemblance to the in vivo epithelium. Combined removal of Wnt, R-spondin and Noggin and the addition of DAPT stimulated differentiation of eqJE at a similar level as the in vivo epithelium, particularly with regard to enterocytes. In summary, we successfully defined a medium composition that promotes the formation of eqJE and eqCE consisting of multiple cell types and resembling the in vivo epithelium. Our findings emphasize the importance of adapting culture conditions to the respective species and the intestinal segment. This in vitro model will be used to investigate the pathological mechanisms underlying equine gastrointestinal disorders in future studies.

Trephination versus Minimally Invasive Transnasal Approaches for the Diagnosis and Treatment of Sinus Disease in Horses.

This retrospective case series aims to highlight the advantages and disadvantages of different treatment options for sinus disease in horses, with a special focus on surgical approaches. The medical records of 25 horses with sinusitis which presented to the equine hospital, Vetmeduni Vienna, between August 2020 and January 2022 were analysed. In 11 cases, conservative treatment by the transnasal endoscopic lavage of the affected sinuses through the sinonasal channel or through a developed, pre-existing sinonasal fistula was performed. In the remaining 14 cases, openings into the sinus for subsequent lavage were surgically created either via classical trephination/bone flaps (8) or by transnasal endoscopically guided minimally invasive approaches (8). In some cases (2), a combination of classical extra-nasal and minimally invasive transnasal approaches was required. The minimally invasive techniques used were comprised of laser surgery (3), electrosurgery (3) and balloon sinoplasty (2). The sinusitis and underlying diseases were successfully treated in all of the horses until hospital discharge. Long-term follow-up could be obtained only from a small number of patients due to the temporal proximity (the study began two years ago) to their initial discharge from the hospital, but they showed the continuous resolution of clinical signs in all cases in which follow up data were available. The results of this case series indicate that if surgical intervention is required, minimally invasive techniques appear to be a promising and potentially cheaper alternative to classical extra-nasal approaches for the treatment of sinus disease in selected cases. In the future, the use of these techniques should be considered more commonly with the broader availability of improved endoscopes and instruments. Additionally, by using small-diameter endoscopes, the need for any surgical intervention might be significantly reduced in many cases.

A Descriptive Study of the Clinical Presentation, Management, and Outcome of Horses with Acute Soft Tissue Trauma of the Tarsus and the Association with Synovial Involvement.

The tarsus is one of the most common areas of traumatic injury with associated synovial involvement (SI) in horses. The aim of this retrospective study was to describe the clinical presentation, diagnostic procedures, management (emphasizing the type, duration, and route of antimicrobial administration), and outcome of cases with acute soft tissue trauma to the tarsal region. The presenting clinical features, the results of diagnostic modalities, and the initial response to therapy were assessed for their usefulness to predict SI. Medical records of 72 cases were included and SI was diagnosed in 34 cases (47.2%). Increased synovial effusion, lameness on admission (OR = 4.1; 95%CI 1.0-16.4), persistent lameness (OR = 5.7; 95%CI 1.8-17.9), increased blood SAA values (≥200 mg/L) from initial to second measurement (OR = 4.3; 95%CI 1.2-15.5), and wound location on the plantar/plantarolateral/plantaromedial compared to the lateral aspect of the tarsus (OR = 7.0; 95%CI 1.6-30.9) were associated with SI. Radiographs, ultrasonography, and the use of pressure testing when a wound was present proved to be useful in correctly diagnosing SI. The median duration of systemic antimicrobial administration was 8 (IQR: 5 to 9) days and most horses received local antimicrobial therapy. This study highlights several relevant clinical features and their association with SI and emphasizes the usefulness of local antimicrobial therapy in these cases.

Clinical findings, diagnoses, and outcomes of horses presented for colic to a referral hospital in Atlantic Canada (2000-2015).

Medical records of equine patients presented for signs of abdominal pain to the Atlantic Veterinary College Teaching Hospital between 2000 and 2015 were reviewed. A total of 575 patients were enrolled, and the most common clinical findings, diagnoses, and outcomes are described. Potential predictors of survival to discharge were assessed. The most common diagnosis was large colon impaction (18.4%), followed by large colon volvulus (6.2%). Overall survival to discharge was 69%. The survival rates for horses were 82.9% for those with no diagnosis, 74.6% for those with large intestine lesions, and 38.5% for those with small intestine lesions. Significant predictors for non-survival were increasing age, increasing duration of colic signs, severity of colic, and a lesion in the small intestine. These data are important for veterinarians in the region who are treating cases of equine colic and advising clients.

Trouvailles cliniques, diagnostics et issues de chevaux présentés pour colique à un centre de référence dans les provinces atlantiques canadiennes (2000­2015). Les dossiers médicaux de patients équins présentés pour des signes de douleur abdominale à l'hôpital d'enseignement vétérinaire du Atlantic Veterinary College entre 2000 et 2015 ont été revus. Un total de 575 patients furent recrutés, et les trouvailles cliniques, diagnostics et issues les plus fréquents sont décrits. Les prédicteurs potentiels de survie jusqu'au congé sont évalués. Le diagnostic le plus fréquent était l'impaction du côlon (18,4 %), suivi du volvulus du côlon (6,2 %). La survie globale jusqu'au congé était de 69 %. Les taux de survie pour les chevaux étaient de 82,9 % pour ceux sans diagnostic, 74,6 % pour ceux avec des lésions au gros intestin et de 38,5 % pour ceux avec des lésions au petit intestin. Les prédicteurs significatifs pour la non-survie étaient une augmentation de l'âge, une augmentation de la durée des signes cliniques, la sévérité des coliques et une lésion au petit intestin. Ces données sont importantes pour les vétérinaires en région qui traitent les cas de cliques équines et conseillent les clients.(Traduit par Dr Serge Messier).

Observational study on the occurrence of surgical glove perforation and associated risk factors in large animal surgery.

OBJECTIVE: To determine the incidence of and associated risk factors for glove perforation in large animal surgery. STUDY DESIGN: Prospective observational cohort study. SAMPLE POPULATION: Surgical gloves (n = 917) worn during 103 large animal surgical procedures. METHODS: Gloves worn by personnel involved in sterile preparation and surgical procedures were tested for perforation by 2 previously validated methods, water leak test (WLT) and electroconductivity testing (ECT). The association between surgical and glove-related variables and glove perforation was assessed by using a multivariable mixed-effect logistic regression model. RESULTS: At least 1 glove perforation was detected in 66% of surgical procedures, and 17.9% (164/917) of gloves tested were identified as perforated. All perforations were detected by ECT, whereas only 110/178 (61.8%) were detected by WLT. All perforations detected by WLT were also detected by ECT. The risk of glove perforation increased with duration of wear (>60 minutes odds ratio [OR] 2.3, 95% CI 1.4-3.7; P < .001) and with invasiveness of procedures (OR 7.9, 95% CI 3.2-19.5; P < .001). Primary surgeons were at higher risk for glove perforation than first (OR 1.7, 95% CI 1.1-2.5; P = .008) and second (OR 3.4, 95% CI 2-6.7; P < .001) assistants. Only 25% of glove perforations were detected intraoperatively by the wearer. CONCLUSION: Incidence of glove perforation is similar in large animal, human, and small animal surgery and is influenced by duration of wear, invasiveness of the surgery, and role of the wearer. ECT is more sensitive than WLT for detection of glove perforation.