Small-colon rupture attributable to granulosa cell tumor in a mare

A large granulosa cell tumor was believed to be responsible for causing obstruction and subsequent rupture of the small colon in a 10-year-old Quarter Horse mare. Two months earlier, a mass, tentatively diagnosed as granulosa cell tumor of the left ovary, had been identified by means of rectal palpation and ultrasonography. The mare was evaluated for clinical signs of acute, severe, abdominal pain, increased heart rate, cyanotic mucous membranes, clinical dehydration, with high PCV, leukopenia, and extreme abdominal distension. A large soft tissue mass and taut band that constricted the lumen of the small colon were palpable per rectum. Septic peritonitis was diagnosed on the basis of results of abdominocentesis. Exploratory surgery revealed extensive fecal contamination of the abdominal viscera, and the mare was euthanatized because of the resultant poor prognosis. At necropsy, the small colon was occluded by a taut, left broad ligament and the ovarian mass that was proved to be a granulosa cell tumor. The occlusion had caused impaction of the small colon, with subsequent perforation at the level of the broad ligament.     

Intra-abdominal hemorrhage associated with a granulosa-thecal cell neoplasm in a mare

A 9-year-old American Saddlebred mare was referred because of abdominal distention and signs of abdominal pain. Copious peritoneal fluid obtained by abdominocentesis appeared to be frank blood. Rectal and ultrasonographic evaluation of the abdomen revealed a large mass at the distal tip of the right uterine horn. The mare was euthanatized and necropsied and the mass was determined to be a granulosa-thecal cell neoplasm. The most common clinical sign of granulosa-thecal cell neoplasm is infertility or abnormal sexual behavior. Hemoperitoneum is infrequently associated with neoplasms in horses.     

Intestinal adenocarcinoma causing recurrent colic in the horse

An 8-year-old, Thoroughbred-cross mare presented with recurrent colic. Exploratory laparotomy revealed a large mass near the right dorsal colon; white, raised foci on the liver; and enlarged mesenteric lymph nodes. Cytological examination of biopsies revealed neoplastic cells. The diagnosis of adenocarcinoma was confirmed by histological examination.     

Surgical Treatment of an Abdominal Abscess Caused by a Migrating Iron Wire From the Ventral Colon,a Case Report

A 13-year-old mare presented for evaluation of recurrent colic episodes. The horse was diagnosed with a mass within the spleen at the ultrasound examination of the abdomen; the levels of Serum Amyloid A and the fibrinogen were high and so a presumptive diagnosis of an abscess involving the spleen was made base on clinical, ultrasonographic and laboratory findings and it was decided to perform n exploratory laparotomy for a definitive diagnosis and possible treatment. Upon abdominal exploration a mass involving the spleen, the lateral wall of the ventral colon adherent to the left abdominal wall was diagnosed and with an intraoperative ultrasound examination a linear hyperechoic foreign body was diagnosed within the mass. It was removed through an enterotomy of the left ventral colon that allowed the digital exploration of the mass without spilling of pus within the peritoneal cavity. The horse was discharged and the long term follow-up revealed no complications and no more signs of abdominal pain.     

Use of a hand-assisted laparoscopic technique for removal of a uterine leiomyoma in a standing mare

A 20-year-old Thoroughbred mare was evaluated because of a 2-year history of infertility. The mare had normal estrous cycles and had been bred 7 times by different stallions. Ultrasonographic examination revealed a homogeneous hyperechoic intramural mass in the tip of the right uterine horn; the mass was also detected via hysteroscopy Unilateral ovariectomy and partial hysterectomy were performed by use of a hand-assisted laparoscopic technique. Leiomyoma was diagnosed via histologic examination of the mass. Unilateral ovariectomy and partial hysterectomy are recommended in mares with leiomyoma in a uterine horn, especially if the tumor is associated with infertility. The hand-assisted laparoscopic technique allows direct visualization of abdominal structures and accurate placement of ligatures without applying tension on the broad ligament, and eliminates the risks and costs of general anesthesia.     

Entrapment of the small colon through a mesocolic rent in a mare

A 6-year-old mare was presented for acute abdominal pain unresponsive to analgesics. Exploratory laparotomy revealed entrapment of the small colon through a 12 cm rent in the mesocolon. The incarcerated small colon was manually reduced and the rent in the mesocolon was sutured closed. The mare made excellent postoperative recovery and was discharged from the hospital 4 days later. The cause of the rent, which was chronic in appearance, is unknown.     

Omental fibrosarcoma in a horse

A 13-year-old Thoroughbred mare had a 2-week history of weight loss and intermittent fever. Examination of abdominal and pleural fluid revealed peritonitis and pleuritis. Ultrasonography of the ventral abdominal midline revealed an intra-abdominal mass. Exploratory celiotomy was performed, but the mass was not surgically excisable. The mare was euthanatized and necropsied. Histologically, the mass was determined to be a fibrosarcoma of omental origin.     

Uterine torsion diagnosed in a mare at 515 days' gestation

A pregnant mare with a history of prolonged gestation (～515 days) and suspected diagnosis of fetal mummification was examined. Rectal palpation revealed that the left broad ligament of the uterus was dorsal and medial to the right uterine ligament and it was not possible to observe the cervix during vaginal examination. Transabdominal ultrasound revealed fluid in the uterus, fetal membranes and the uterine walls defined and thickened. Free fluid was not seen in the peritoneal cavity. Laboratory tests (blood cell count and clinical chemistry) were normal. Based on clinical history, physical examination and ultrasound findings, a chronic uterine torsion with fetal death was diagnosed and the mare was subjected to exploratory celiotomy. The uterus was strongly adhered to the peritoneum of the ventral abdominal wall and there were multiple adhesions to the colon. Hysterotomy was performed to remove the fetus and to permit repositioning of the uterus. When the fetus was removed, a large devitalised grey tissue area of the right ventral uterine horn was observed. Multiple adhesions prevented a rescue hysterectomy and euthanasia of the patient was performed. During the necropsy, a 180° cranial cervix clockwise uterine torsion was observed. This rare case of uterine torsion appears to be the most chronic case reported in the equine literature.     

Large colon strangulation due to a diaphragmatic hernia in a mare: A case report

This report describes a case of diaphragmatic hernia with incarcerated large colon in a 16-year-old Tennessee Walking Horse mare. This mare was presented with an acute episode of abdominal pain that was not responsive to analgesic therapy. Treatment consisted of resection of the devitalized large colon and closure of the rent in the diaphragm.     

Haemoabdomen secondary to granulomatous periarteritis due to parasitism with Halicephalobus gingivalis in a mare

A 22‐year‐old Quarter Horse mare exhibited neurological signs consisting of head pressing, central blindness, minimal ataxia and dysphagia. Despite treatment, the mare collapsed and died shortly after onset of signs. On necropsy, there were approximately 15 l of free blood in the abdominal cavity. A 12 × 4 cm diameter, irregularly‐shaped, nodular, firm, tan/yellow mass was found adhered to the outer surface of the right lateral aspect of the caudal abdominal aorta. A similar mass also affected the caudal aspect of the right kidney. Histopathology of the aortic and renal masses revealed multiple coalescing granulomas containing intralesional nematodes compatible with Halicephalobus gingivalis. Inflammatory cells disrupted the aortic tunica adventitia as well as the outer tunica media. Similar exudate also affected the cerebrum, cerebellum and brainstem. Polymerase chain reaction amplification and sequencing of a portion of the large subunit ribosomal ribonucleic acid gene were performed using previously published primers for H. gingivalis to confirm the identity of the nematode. Although rupture of a blood vessel could not be demonstrated grossly, the histological findings suggest that inflammation may have breached a small calibre artery and caused the haemoabdomen.     

Marsupialization of an abdominal abscess caused by Serratia marcescens in a mare

An intra-abdominal abscess was diagnosed in a 7-year-old mare by palpation per rectum and from abnormal clinicopathologic findings. Initial treatment with procaine penicillin for 21 days was unsuccessful in halting the deterioration of the physical condition of the mare. Surgical exploration of the abdomen revealed a mass in the wall of the left ventral colon. Drainage was achieved by marsupialization. Serratia marcescens was isolated from the abscess. Recovery appeared complete, and the mare has resumed broodmare capability.     

Small intestinal adenocarcinoma in a horse

A 21-year-old mare was evaluated for intermittent episodes of apparent abdominal pain of 6 month's duration. Abdominal palpation per rectum revealed distended small intestine in the caudal portion of the abdomen. Ventral midline celiotomy revealed a mass in the midjejunal region. The mass was resected, and a side-to-side anastomosis performed. The histologic diagnosis was tubular adenocarcinoma of the small intestine. The mare was still alive 13 months after surgery.     

Renal carcinoma in a horse

A poorly performing nine-year-old thoroughbred mare was presented because of chronic weight loss. On rectal examination an abdominal mass was palpated and, on percussion of the right flank from the 11th to 13th intercostal space, a large area of dullness was delineated. Biopsies taken from the liver region and through the rectum revealed a malignant metastasising tumour of the urinary system. After euthanasia, the post mortem findings confirmed the presence of a papillary renal carcinoma with multiple metastases into the omentum and peritoneum.     

Septic peritonitis due to colonic perforation associated with aberrant migration of a Gasterophilus intestinalis larva in a horse

An adult quarter horse mare was presented with acute colic and fever. Physical examination and abdominocentesis showed septic peritonitis, and the mare was euthanatized. Necropsy and histopathologic examination revealed a focal partial perforation of the right ventral colon, which contained a single bot fly larva, identified as a third-instar larva of Gasterophilus intestinalis. This larva was embedded deep within the muscularis and the submucosa. Although bot fly larvae are known to attach to aberrant sites within the digestive tract, this is the first known report of deep penetration of the colon by a gasterophilus larva, with the resulting leakage of intestinal content leading to septic peritonitis.     

Extensive resection and anastomosis of the descending (small) colon in a mare following strangulation by a mesenteric lipoma

A 17-year-old Quarter Horse, Arabian crossbred mare presented with a history of having had abdominal pain for 2 d. At surgery there was 2.6 m of descending colon strangulated within the pedicle of a mesenteric lipoma. The lipoma was resected and the descending colon appeared viable so was replaced, and the mare recovered from anaesthesia. Post-operatively, the mare failed to stabilise so was taken back to surgery. There was 2 m of infarcted descending colon which was resected and anastomosed. A drain and stainless steel stay sutures were incorporated into the ventral suture line. Post-operatively the ventral wound became infected but was resolved with therapy. The diagnosis, surgical and post-operative management and outcome are discussed.     

Penetrating thoracic injury with associated abdominal visceral involvement in a mare

A mare was presented for evaluation of a penetrating thoracic injury. Surgical exploration of the thoracic wound was performed, revealing diaphragmatic perforation and the presence of a foreign body lodged in the right dorsal colon. The foreign body was removed through the thoracic deficit, the colon repaired and the thoracic wound closed utilising a latissimus dorsi muscle flap. It can be concluded that successful management of thoracic wounds with concurrent abdominal viscera involvement is achievable if minimal contamination is evident. In addition reconstruction of large thoracic defects with primary muscle flaps is a viable option in the horse.     

Displacement of the large colon associated with nonsurgical correction of large-colon entrapment in the renosplenic space in a mare

Nonsurgical correction of a renosplenic entrapment of the large colon was attempted in a mare, using a rolling technique. After correction, the mare had initial improvement in clinical signs, but later developed signs of abdominal discomfort. A ventral midline celiotomy was performed, and a pelvic flexure impaction and large intestinal volvulus were found and corrected.     

Ascites in a 13‐year‐old miniature horse mare with an ovarian granulosa theca‐cell tumour: A manifestation of Meigs' syndrome?

A 13‐year‐old miniature horse mare presented for evaluation of ascites. Abdominal ultrasound showed severe free peritoneal fluid accumulation as well as a caudal abdominal mass. The peritoneal fluid was characterised as a transudate with no evidence of sepsis. Surgical exploration of the abdomen was performed; copious free peritoneal fluid and a large right ovarian mass were discovered. The abnormal ovary was removed, and the mass was determined histologically to be a benign granulosa theca‐cell tumour. Although there was mild peritoneal fluid accumulation in the immediate post operative period, the ascites effectively resolved with removal of the tumour, and the mare returned to a normal lifestyle. This is similar to reports of Meigs' syndrome in human women, in which a benign ovarian mass of significant size causes ascites that resolves once the mass is removed.     

Megacolon with myenteric hypoganglionosis in a foal

A 6-month-old Clydesdale filly had chronic abdominal distention and intermittent febrile episodes. Abdominal surgery revealed impaction of the right dorsal colon, which was relieved by evacuation of contents through an enterotomy. Four days after surgery, abdominal distention recurred and progressed. The filly was euthanatized. Necropsy revealed the right dorsal colon to be markedly distended with digesta. Microscopically, there was a marked reduction in myenteric ganglion cells in the right dorsal colon and cecum and mild to moderate reduction of myenteric ganglion cells in the left ventral and transverse colon.     

Choledocholithotripsy in a mare

Obstructive choledocholithiasis in a 12-year-old mare was corrected surgically by choledocholithotripsy. The mare had a history of chronic weight loss, intermittent fever, partial anorexia, jaundice, recurrent abdominal pain, and an abdominal mass palpable per rectum. Values for alkaline phosphatase, bilirubin, gamma-glutamyl transferase, sorbitol dehydrogenase, and bromsulpthalein half-life were increased and bilirubinuria was evident before surgery. Two liver biopsies revealed periportal and portal fibrosis, bile duct proliferation, cholestasis, and variable amounts of hepatocellular necrosis, with infiltration by polymorphonuclear cells. Immediate clinical improvement was seen after surgery, and results of selected liver function tests gradually returned to normal. Since surgery, the mare has returned to her normal weight, has remained clinically normal for liver disease for 28 months, and has been useful as a broodmare.