Gastric impaction associated with displacement and volvulus of the large colon in seven mature horses

Gastric impaction associated with large colon volvulus (LCV) was identified in seven horses. Right dorsal displacement of the large colon and suspected nephrosplenic entrapment was identified in 2 of the 7 horses as well as LCV with concurrent gastric impaction. All horses underwent surgery for LCV and none survived. Five horses died or were subjected to euthanasia intraoperatively or in recovery. One horse was subjected to euthanasia post operatively due to persistent gastric reflux, following resolution of the gastric impaction. One horse was subjected to euthanasia post operatively due to a suspected gastric rupture, which was confirmed on post mortem examination. It is hypothesised that a large mass in the cranial abdomen, such as a gastric impaction may disrupt the normal anatomical large colon alignment or may cause colonic motility or microbiota alterations, and thus increase the risk of large colon displacement and volvulus.     

Clinical manifestations of tansy ragwort poisoning

The clinical signs of tansy ragwort poisoning are variable and in 5 cases included diarrhea, tenesmus, ascites, bloody feces, icterus, paresis, CNS involvement, rectal prolapse, poor appetite and weight loss. It is thus apparent that the disease can be confused clinically with many others, and tansy ragwort poisoning should be considered in animals exhibiting ascites, diarrhea and rectal prolapse. Several cases of tansy ragwort (Senecio jacobaea) poisoning occurring from 1969 to 1976 are reported to illustrate the numerous clinical pictures that might confront a practitioner. The disease is sporadic in this area. The poisonous principles in tansy ragwort are pyrrolizidine alkaloids, which cause gradual alteration and necrosis of liver cells with replacement by fibrous tissue. The development of signs in all of these cases could be attributed to failure of one or more liver functions.     

Primary gastric impaction in horses: A retrospective study of 20 cases (2005–2008)

Primary gastric impaction is an uncommon condition. Furthermore, the factors associated with gastric impaction and the optimal method of treatment are not clear. The aim of this article is to describe the clinical findings, treatment and outcome of horses with a primary gastric impaction. Medical records of horses that presented with a primary gastric impaction between 2005 and 2008 were reviewed and 20 horses with a primary gastric impaction identified. Diagnosis of a primary gastric impaction was made if the horse had been fasted for a minimum of 16 h, a concretion of ingesta precluded visualisation of the margo plicatus and there was no evidence of concurrent intestinal pathology. Thirteen of 20 (65%) horses were presented on an emergency basis. The most common complaint was inappetence (50%) followed by acute colic (35%) and recurrent colic (35%). On initial examination for colic, all horses had a normal heart rate and 7 of 20 (35%) had decreased gastrointestinal borborygmi. All horses were treated with enteral fluid therapy. The median dose of fluids administered per day was 5 doses (range 1–8 doses) of 2–10 l of isotonic electrolyte solution. The median length of treatment until resolution was 2 days (range 1–5 days). Eighteen of 20 (90%) horses survived to discharge. Primary gastric impaction appears to be a condition with clinical signs of inappetence and mild abdominal discomfort. This is the largest group of horses reported that were treated with enteral fluid therapy for a gastric impaction and it was concluded that enteral fluid therapy was of value in this study.     

Primary gastric impaction in a pony

Primary gastric impaction developed in a pony as a result of the ingestion of persimmon seeds and mesquite beans. Clinical signs included mild abdominal pain, prolonged recumbency, anorexia, and lethargy. When medical therapy was unsuccessful, an exploratory laparotomy was performed. Previously, gastric impaction has been associated with signs of severe abdominal pain. Gastric impaction should be considered in cases of abdominal crisis of long duration and mild pain.     

Gastric impaction and obstruction of the small intestine associated with persimmon phytobezoar in a horse

Signs of mild colic, intermittent lethargy, and weight loss of 6 weeks' duration in a 2-year-old Quarter Horse gelding were attributed to persimmon (Diospyros virginiana) phytobezoar formation. Diagnosis of the phytobezoar was facilitated by gastric endoscopy. Signs of gastrointestinal tract obstruction were associated with a large phytobezoar in the lumen of the stomach, gastric ulceration, and obstruction of the small intestine (as a consequence of fragmentation of the primary bezoar). Conservative treatment, using mineral oil and dioctyl sodium sulfosuccinate, was unsuccessful. A celiotomy was performed, and gastric impaction and partial obstruction of the small intestine associated with phytobezoar formation and fragmentation were identified. The horse made a complete recovery following removal of all phytobezoars. Persimmon phytobezoar should be considered in the fall and winter as a possible cause of lethargy, colic, and weight loss in horses allowed access to persimmon fruit.     

Gastric ulceration in horses: 91 cases (1987-1990).

Gastroendoscopy was performed on 111 horses (1 to 22 years old) that had signs of abdominal discomfort of variable duration and severity. At least 1 episode of colic had been observed within 48 hours of examination in 31 horses. Recurrent episodes of colic were observed in 28 horses within 2 to 10 days of examination, 31 horses within 11 to 30 days, 12 horses within 31 to 60 days, and in 9 horses at more than 60 days after the initial examination. Gastric ulceration was found in 91 of 111 horses examined. Other abnormalities involving the gastrointestinal tract or other abdominal viscera were not found on examination in 57 of 91 horses with gastric ulcers. The most frequent concurrent abnormalities found in the remaining 34 horses with gastric ulcers were impaction of the large colon (n = 6), colonic tympany (n = 6), peritonitis (n = 6), gastric impaction (n = 4), ileocecal intussusception (n = 3), small-colon impaction (n = 4), and proximal enteritis (n = 2). Thirteen horses with gastric ulceration underwent abdominal surgery, and in 5 horses, lesions were not found at surgery. Gastric ulceration was determined to be the primary cause of colic in 31 horses on the basis of the lack of other abnormalities, clinical response to treatment with histamine type-2 receptor (H2) antagonists, and confirmation of improvement or resolution of gastric ulceration via endoscopy. Gastric ulceration was the suspected cause of colic in 26 other horses on the basis of the lack of other abnormalities, severity of lesions, and clinical response to treatment with H2 antagonists.(ABSTRACT TRUNCATED AT 250 WORDS)     

Two cases of equine primary gastric impaction

The clinical details of two cases of equine primary gastric impaction are described and the syndromes of gastric impaction and dilatation are discussed. Both cases of gastric impaction were successfully treated by gastrotomy and evacuation of the gastric contents.     

Senecio jacobaea: deceiving beauty. Senecio jacobaea poisoning

In a cattle herd problems were noticed during 1.5 years, characterised by emaciation and loss of milk production with lower fat- and protein%, tenesmus, central nervous symptoms (aggression, circling and blindness), diarrhoea, eczema solare and death. Clinical, laboratory and post mortem examinations did not reveal a specific cause at first. An intoxication was suspected based on the clinical symptoms, the course of the disease in sick animals and severe liver cirrhosis found in a sudden death cow: The animals were fed grassilage derived from an air force base on which an overwhelming amount of tansy ragwort (Senecio jacobaea) was present. On subsequent microscopic examination of the livers of 11 slaughtered clinically healthy animals all of these showed fibrosis in varying extension. Cirrhosis and fibrosis of the liver and the clinical symptoms are all features of chronic pyrrolyzidine alkaloidosis. Tansy ragwort poisoning has not been diagnosed in the Netherlands for years. The rise in cases is due to more extensive use of land.     

Primary gastric rupture in 47 horses (1995–2011)

The purpose of this retrospective case-control study was to identify factors associated with primary gastric rupture and to investigate if there were differences between etiologies of primary gastric rupture. Compared to the general colic population, Quarter horses were under-represented and Friesians and draft breeds were over-represented in 47 cases of primary gastric ruptures. Horses with primary gastric rupture typically presented with severe clinical and clinicopathological derangements. There were 24 idiopathic gastric ruptures, 20 gastric impaction associated ruptures, and 3 perforating gastric ulcers. Thoroughbred horses were over-represented in the idiopathic gastric rupture group compared to other breeds and etiologies. This study suggests the presence of important breed predispositions for development of gastric rupture. Further study is necessary to identify if these predispositions are associated with management factors or breed-specific disorders.     

Effects of dietary supplementation with butylated hydroxyanisole, cysteine, and vitamins B on tansy ragwort (Senecio jacobaea) toxicosis in ponies

Dried tansy ragwort, which contains pyrrolizidine alkaloids, was fed as 10% of a complete diet to ponies, with and without a mixture of additives. The additives provided a dietary supplement equivalent to 1% cysteine, 0.75% butylated hydroxyanisole, 200 micrograms of vitamin B12/kg of feed, and 5 mg of folic acid/kg of feed. The additives did not alter tansy ragwort toxicity, as assessed by survival time, liver changes, sulfobromophthalein (BSP) clearance rate, serum gamma-glutamyl transpeptidase activity, and plasma amino acid patterns. In ponies fed tansy ragwort, BSP clearance rate was a sensitive indicator of liver damage, and decreased to about 20% of control values. gamma-Glutamyl transpeptidase activities showed considerable variability, but generally were elevated in animals fed tansy ragwort. Liver iron and copper concentrations increased, and liver zinc concentrations decreased in tansy ragwort-fed ponies. Plasma amino acid patterns in tansy ragwort-fed ponies showed changes typical of those observed in liver disease.     

Ileal impaction in the horse

Twelve cases of ileal impaction in the horse were reviewed. Clinical features of the disease included evidence of mild abdominal pain, reduced or absent intestinal sounds, rectally palpable distended small intestine, gastric reflux, and in the early stages, normal peritoneal fluid. Surgical correction of the impaction was accomplished in 10 horses. Of 8 horses discharged from the hospital, 7 returned to full function. It was concluded that the shorter the duration of colic before surgical intervention, the better the prognosis.     

Effects on cattle and their calves of tansy ragwort (Senecio jacobaea) fed in early gestation

Tansy ragwort (Senecio jacobaea) fed to pregnant cows on gestation days 15 through 30 in lethal and near-lethal doses did not cause detectable damage to 100-day-old or to full-term fetuses as determined by gross examinations, serum enzyme tests chosen to detect hepatic changes, and by histopathologic examinations. Some cows that appeared normal during gestation expired soon after parturition from typical seneciosis apparently triggered by parturition stress. Pregnant cows fed 12% smaller tansy ragwort doses on gestation days 30 through 45 had only minimal serum enzyme changes and gave birth to normal calves that had normal serum enzymes up to 64 days after parturition.     

Case control study to investigate risk factors for impaction colic in donkeys in the UK

Impaction colic is the single most common type of colic diagnosed in a large population of donkeys (more than 2000 animals) at The Donkey Sanctuary, UK and the fatality rate from the disease is high. Here we identify risk factors for impaction colic in this population during 2006 using an unmatched case control study. There were 71 cases of impaction colic and multivariable analysis identified a number of variables associated with the disease. Management factors that increased the risk of impaction included paper bedding, feeding of concentrates, limited access to pasture and increasing number of carers. In addition health variables that were associated with an increased risk of impaction colic were weight loss, recent vaccination and a number of dental abnormalities. This study has identified variables which may help to identify donkeys at high risk of impaction colic; those with a history of weight loss and with concurrent dental pathology. Furthermore the study has also identified a number of variables that may be targeted to reduce the incidence of impaction colic in this donkey population, such as modification of concentrate feeding practices and pasture access.     

Acute necrotising pancreatitis following grain overload in a donkey

A donkey developed abdominal discomfort and distension together with cardiovascular collapse and gastric reflux 24 to 36 hours after ingesting a large amount of poultry feed. Rectal findings prompted a laparotomy that identified extensive gastric dilation, an empty, atonic small intestine, dry colonic content and an easily corrected caecal displacement. These findings were not consistent with the severity of the signs, which were attributed to endotoxaemia. The donkey was euthanased during recovery. Necropsy revealed acute necrotising pancreatitis with massive gastric dilation and right dorsal colon impaction. The clinicopathological features of acute equine pancreatitis associated with grain overload are discussed.     

Ileal impaction in 245 horses: 1995-2007

The objective of this study was to identify parameters that would assist in determining the probability of a successful outcome with medical management versus surgical intervention in horses with ileal impaction. Medical records of 245 horses admitted for ileal impaction were reviewed and placed into 2 groups: medical (med) and surgical (sx) treatment. Persistence of abdominal pain, gastric reflux, frequency of analgesic administration, and 1-year survival were evaluated. There were no differences in signalment, abdominal pain, or heart rate among groups; however, significantly more sx horses had peritoneal fluid abnormalities (51%) and produced gastric reflux (62%) than did med horses (38% and 15%, respectively). Eighty-nine percent of med horses required repeated analgesic administration for successful resolution. One-year survival was 91% for sx horses and 92% for med horses. Horses with ileal impaction responsive to analgesic therapy with minimal gastric reflux are likely to be managed successfully with medical treatment. Horses with persistent abdominal pain and gastric reflux are candidates for surgery.     

Idiopathic gastric rupture in a Friesian foal

Acute idiopathic gastric rupture resulted in sudden death of a 4.5-months-old healthy Friesian foal. No morphological lesions were present which could explain the preceding gastric impaction. In this case hypodypsia may have been (partially) responsible for the impaction as only a mechanical drinking apparatus, unsuitably for horses, was available.     

Tansy ragwort poisoning in a horse in southern Ontario

Bizarre behavior, apparent lameness, and colic were noticed in 1 of 3 horses on a pasture overgrown by weeds during a drought. Liver failure and hepatoencephalopathy were diagnosed, caused by pyrrolizidine alkaloid toxicosis associated with consumption of tansy ragwort. The horse made a full recovery when removed from the pasture.     

Treatment of equine gastric impaction by gastrotomy

A 6‐year‐old Warmblood gelding was referred for treatment of a traumatic shoulder wound and while hospitalised developed a large gastric impaction which was unresponsive to medical management. Gastrotomy as a treatment for gastric impactions is rarely attempted in adult horses due to the limited surgical access to the stomach. This report describes the successful surgical treatment of the impaction by gastrotomy and management of the post operative complications encountered.     

Canine gastric dilatation-volvulus

Gastric dilatation-volvulus (GDV) is a dramatic and enigmatic disease of large and giant breed dogs characterised by the rapid accumulation of gas in the stomach. This causes gastric dilatation, twisting of the stomach about its long axis, compression of surrounding organs, hypovolaemic and cardiogenic shock, and if untreated, death. It has been estimated that the disease afflicts approximately 60,000 dogs in the USA each year with a mortality rate ranging from 7 to 60 per cent depending on accessibility to adequate veterinary care. The cause is unknown. While diet was at one time believed to be associated with the genesis of the disease, critical review of available data provides no evidence to support this hypothesis. A variety of predisposing or risk factors have been identified but none is suspected of being the cause, indeed, the disorder may have a multiple aetiology. Current thinking suggests that the final common pathway in the development of GDV may be an inhibition of gastric motility and emptying. This could come about through a primary disruption of normal gastric electrical patterns or through the effect of extraneous stressful events that disrupt gastric motility. After dilatation a series of potentially lethal events is unleashed which include compression of the caudal vena cava, pooling of blood in the microcirculation of the viscera and hindlimbs, metabolic acidosis, gastric necrosis, cardiac arrhythmias, disseminated intravascular coagulation, hypotensive and cardiogenic shock and death. Nevertheless, even advanced cases can survive if treated appropriately. If the cause could be identified logical prophylaxis might follow. Studies at the University of Florida have failed to demonstrate any effect of diet on gastric function in large breed dogs, suggesting that diet is probably not the cause of the disease. Researchers at Colorado State University also found no association with diet in clinical patients. Recent studies at the University of Florida have revealed distinct abnormalities in gastric electrical activity in GDV patients. In human patients these abnormalities, called dysrhythmias, have been associated with gastric distention, bloating, delayed emptying, nausea and retching. Unfortunately, dysrhythmias are also present, albeit to a lesser degree, in experimental GDV. These findings leave unanswered the question as to whether abnormalities in gastric motility play a role in the genesis of GDV.     

Effects of dietary supplementation with ethoxyquin, magnesium oxide, methionine hydroxy analog, and B vitamins on tansy ragwort (Senecio jacobaea) toxicosis in beef cattle

Dried tansy ragwort containing pyrrolizidine alkaloids was fed as 2.5% of a complete (control) diet to Hereford steers, with and without (basal) a mixture of additives. The additives provided a dietary supplement equivalent to 0.1% ethoxyquin, 1% methionine hydroxy analog, 2% MgO, 2.7 mg of vitamin B6/kg of diet, 50 micrograms of vitamin B12/kg of diet, 0.45 g of folic acid/kg of diet, and 0.2 g of cobalt/kg of diet. The additives did not alter tansy ragwort toxicity substantially, as assessed by liver histologic changes, sulfobromophthalein clearance rate, and serum gamma-glutamyl transpeptidase activity. After 281 days, 1 of 4 steers fed the basal diet was alive, whereas 3 of 4 steers in the basal plus additives group were alive, suggesting some protective activity. The chronic lethal dose of tansy ragwort in steers was 3.6% of initial body weight.