Treatment of right dorsal ulcerative colitis in a horse

Excessive administration of phenylbutazone was associated with development of right dorsal ulcerative colitis. The clinical signs of right dorsal colitis include chronic colic and weight loss. The laboratory abnormalities include panhypoproteinemia and a high WBC count in the abdominal fluid. Medical management of the chronic colic and protein-losing enteropathy associated with the ulcerative lesions in the right dorsal colon and surgical bypass of the right dorsal colon did not result in long-term resolution of clinical signs. Resection of the ulcerated right dorsal colon through a right lateral approach at the 16th rib resulted in resolution of intestinal protein loss and colic. The results of this case suggest that surgical resection of the ulcerated right dorsal colon may be the recommended treatment for right dorsal ulcerative colitis.     

Ileal diverticulum as a cause of chronic colic in a horse

A 4-year-old Thoroughbred gelding with a history of chronic colic was referred for evaluation of signs of abdominal pain. Exploratory laparotomy revealed a diverticulum of the distal portion of the ileum located between the layers of the mesentery. The diverticulum was similar in location and appearance to acquired ileal diverticula described in human beings. Complete bypass of the diverticulum by ileocecostomy resulted in apparent resolution of the chronic colic in this horse.     

Cholangiohepatitis and pancreatitis secondary to severe gastroduodenal ulceration in a foal

A 2-month-old foal was presented with clinical signs of colic. Gastroduodenal ulceration was suspected. A poor response to medical treatment and signs of gastroduodenal obstruction led to celiotomy and an attempted bypass procedure. The foal was euthanized and postmortem examination revealed gastric ulceration, segmental duodenal stenosis, and severe chronic cholangiohepatitis and pancreatitis.     

Chronic intestinal intussusception in two horses

In 2 cases of chronic intestinal intussusception in horses, one involved jejunum and the other, ileum. The only clinical signs observed were intermittent colic. Surgery was performed on both horses, with successful outcomes.     

Pancreatic adenocarcinoma in a donkey. Use of laparoscopy to aid the diagnosis

Pancreatic adenocarcinoma was diagnosed in a 15‐year‐old donkey that presented with signs of chronic laminitis, weight loss and chronic colic. An intra‐abdominal mass was identified by exploratory laparoscopy, and this was subsequently confirmed to be a pancreatic adenocarcinoma at post mortem examination. Unlike most previously reported cases of pancreatic disease in equids, this donkey had no clinicopathological evidence of an associated hepatopathy.     

Acute phase proteins in grass sickness (equine dysautonomia)

Four acute phase proteins were assayed in the serum of normal horses and those with acute, subacute and chronic grass sickness, colic and inflammatory conditions, in order to investigate their diagnostic value in grass sickness. The grass sickness and inflammation group had a significantly increased haptoglobin concentration (P less than 0.01-P less than 0.001). Orosomucoid was elevated in acute, subacute and chronic grass sickness and inflammation (P less than 0.001, P less than 0.001, P less than 0.05 and P less than 0.05, respectively). Highest concentrations of haptoglobin and orosomucoid were recorded in subacute grass sickness. Ceruloplasmin was significantly higher in acute grass sickness cases than all other groups except the colic group (P less than 0.05-P less than 0.01). alpha 2-macroglobulin was significantly higher in acute grass sickness than normal, colic and chronic grass sickness cases (P less than 0.01, P less than 0.05 and P less than 0.05). The time scale of changes suggests that the stimulus to haptoglobin and orosomucoid synthesis occurs at the onset of clinical signs whereas the increase in ceruloplasmin and alpha 2-macroglobulin is more likely to reflect haemoconcentration.     

Chronic vomiting associated with a gastric carcinoid in a cat.

A geriatric domestic shorthair cat was presented for evaluation of chronic vomiting. Chronic renal failure was diagnosed on the basis of physical examination findings and results of a serum biochemical profile and urinalysis. Endoscopically obtained gastric biopsies were suggestive of a carcinoid tumor. Subsequently, an exploratory celiotomy with partial gastrectomy was performed. Histopathological and electron microscopic analysis of surgical biopsy specimens confirmed the diagnosis of a gastric carcinoid, which has not been previously reported in the cat. Following complete excision, the cat remained clinically stable and free of signs of gastrointestinal disease for 4 months before requiring treatment for progressive renal failure.     

Alternative diagnoses in the colic patient

Despite clinical signs compatible with obstruction or ischemia of the gastrointestinal tract, the clinician occasionally is unable to identify a gastrointestinal cause for colic. In this article, disorders not originating from obstruction or ischemia of the gastrointestinal tract but causing real or apparent abdominal pain are presented as alternative causes of colic. In addition, colic of gastrointestinal origin may be the primary inciting factor or a secondary complication of an alternative disorder, causing colic-like signs. Recognition of alternative diagnoses relies on a thorough and consistent approach to the clinical assessment of the equine colic patient and helps to ensure appropriate patient management.     

Inflammatory bowel disease in horses: 11 cases (1988-1998).

OBJECTIVE: To determine clinical and surgical abnormalities in, and long-term outcome of, horses that undergo surgery because of colic secondary to inflammatory bowel disease (IBD). DESIGN: Retrospective study. ANIMALS: 11 horses. PROCEDURE: Medical records of horses that had undergone abdominal surgery and in which IBD had been diagnosed on the basis of histologic examination of intestinal biopsy specimens were reviewed. RESULTS: 5 horses were examined because of acute colic and 6 were examined because of chronic colic. At surgery, all 11 horses had edematous or hemorrhagic bowel segments suggestive of IBD. In addition, 6 horses had circumferential mural bands (CMB) causing constriction of the small (4 horses) or large (2) intestine. Intestinal resections were performed in 7 horses. All 11 horses survived surgery and were discharged from the hospital; 10 horses were still alive at the time of follow-up (1.5 to 7 years after surgery). CLINICAL IMPLICATIONS: Results suggest that IBD is an uncommon cause of colic in horses. Surgical resection of segments of intestine with constrictive CMB may relieve clinical signs of colic. Horses with IBD that had surgery had a good prognosis for long-term survival.     

Chronic intermittent colic in a mare attributed to uterine marbles

A 13‐year‐old Quarter Horse mare presented for evaluation of chronic intermittent colic. Following extensive diagnostics, abdominal radiographs revealed two round, radiopaque objects in the caudal abdomen. Palpation per rectum and transrectal ultrasonography of the reproductive tract confirmed that the round objects were uterine marbles. Dinoprost tromethamine (Lutalyse, 5 mg i.m. q. 24 h for 2 days) was administered to bring the mare into oestrus, and both uterine marbles were manually removed from the uterus following digital dilation of the relaxed cervix. Follow‐up with the owner 12 months after discharge revealed that the mare had shown no further signs of abdominal discomfort since having the uterine marbles removed. To the authors' knowledge, this is the first published report of chronic intermittent colic attributed to uterine marbles in a mare.     

Lymphosarcoma and associated immune-mediated hemolytic anemia and thrombocytopenia in horses

Three horses with equine lymphosarcoma were examined because of clinical signs including chronic weight loss, respiratory distress, peripheral edema, and chronic colic. Clinicopathologic findings included evidence of an immune-mediated hemolytic anemia. Immune-mediated thrombocytopenia also was diagnosed in 1 of the horses and suspected in another. One horse died in spite of treatment, 1 died 5 hours after surgical removal of a tumor encircling the jejunum, and 1 was euthanatized because of deteriorating condition. Necropsy of each horse revealed extensive neoplastic infiltration of peripheral lymph nodes and abdominal or thoracic viscera with neoplastic lymphocytes.     

Concentrations of serum amyloid A and lipopolysaccharide-binding protein in horses with colic

OBJECTIVE: To determine concentrations of 2 acute-phase proteins (serum amyloid A [SAA] and lipopolysaccharide-binding protein [LBP]) in serum samples obtained from horses with colic and identify relationships among these acute-phase proteins and clinical data. ANIMALS: 765 horses with naturally developing gastrointestinal tract diseases characterized by colic (ie, clinical signs indicative of abdominal pain) and 79 healthy control horses; all horses were examined at 2 university teaching hospitals. PROCEDURE: Serum concentrations of SAA and LBP were determined by immunoturbidometric and dot-blot assays, respectively. RESULTS: SAA and LBP concentrations were determined for 718 and 765 horses with colic, respectively. Concentrations of SAA were significantly higher in nonsurvivors than in survivors, and horses with enteritis or colitis and conditions characterized by chronic inflammation (eg, abdominal abscesses, peritonitis, or rectal tears) had SAA concentrations significantly greater than those for horses with other conditions. Serum concentrations of LBP did not correlate with outcome, disease process, or portion of the gastrointestinal tract affected. CONCLUSIONS AND CLINICAL RELEVANCE: Circulating concentrations of SAA were significantly higher at admission in horses with colic attributable to conditions having a primary inflammatory cause (eg, enteritis, colitis, peritonitis, or abdominal abscesses) and were higher in horses that failed to survive the episode of colic, compared with concentrations in horses that survived. Serum concentrations of LBP did not correlate with survival. Analysis of these findings suggests that evaluation of SAA concentrations may be of use in identifying horses with colic attributable to diseases that have inflammation as a primary component of pathogenesis.     

An unusual cause of colic in a neonatal foal

A case of a neonatal foal with acute colic and respiratory distress is described. The foal presented with signs of acute colic and was treated medically. The foal did not respond to treatment and 2 h after admission the foal began to demonstrate signs of respiratory distress. Thoracic and abdominal radiographs were obtained and a diagnosis of a diaphragmatic hernia was made. Surgical repair of the hernia was recommended but the owner declined and the foal was subjected to euthanasia. Post mortem findings confirmed the diagnosis and revealed that the defect was of congenital origin. Congenital diaphragmatic hernia is an unusual cause of colic in a neonatal foal.     

Concurrent atypical myoglobinuria and colon displacement in a filly

An 18‐month‐old pony filly was examined for acute colic and abdominal distension. The signs of colic failed to resolve following analgesic treatment. At exploratory laparotomy, a right dorsal displacement of the large colon was identified and corrected. On recovery from anaesthesia, the pony developed signs of widespread myopathy, confirmed by serum biochemistry evaluations. Myopathy consistent with atypical myoglobinuria was confirmed post mortem.     

Atresia coli in the foal: a review of six cases.

Physical examination and exploratory celiotomy were performed on five neonatal foals presented with signs of acute colic. Atresia coli was confirmed in each foal during surgery. The most consistent finding on physical examination was the absence of meconium staining following repeated enemas. The large, transverse and/or small colon were involved in all foals. One eight month aborted foetus was submitted for necropsy and diagnosed as having atresia coli and congenital hydrocephalus. Atresia coli should be considered for neonatal foals with signs of acute colic.     

Splenic abscesses due to migrant metallic wires from small intestine in a horse

This reports discusses a perforating metallic wire that was suspected of causing chronic weight loss, inappetance and pyrexia in a 15‐year‐old Standardbred gelding, due to the fact that during the previous 18 months, 6 horses coming from the same yard were referred for recurrent or acute colic related to the ingestion of metallic wires. Splenomegaly was detected ultrasonographically and confirmed during surgery. During necropsy, 2 metallic wires 0.2 mm in diameter and 3–4 cm long were found in a markedly enlarged spleen with several nonencapsulated abscesses. Metallic wire perforation and migration through the lower alimentary tract may involve different abdominal quadrants (intestine, abdominal wall, spleen, liver) and lead to different clinical syndromes as acute or recurrent colic and weight loss. A clinical diagnosis is challenging as the clinical signs are often nonspecific and prognosis is generally considered poor.     

Evaluation of a method to experimentally induce colic in horses and the effects of acupuncture applied at the Guan-yuan-shu (similar to BL-21) acupoint

OBJECTIVE: To evaluate the reliability of a method for inducing colic via small intestinal distention in horses and to examine the analgesic potential of bilateral electroacupuncture (EAP) at the Guan-yuan-shu (similar to BL21) acupoint. ANIMALS: 5 healthy adult horses, each with a gastric cannula. PROCEDURE: A polyester balloon connected to an electronic barostat was introduced into the duodenum via the gastric cannula. At 2 specified intervals (before and after commencement of EAP), the balloon was inflated to a barostat-controlled pressure that induced signs of moderate colic. Each inflation was maintained for 10 minutes. Heart and respiratory rates were continuously recorded. Frequency of various clinical signs of colic was recorded by 2 trained observers during various combinations of balloon inflation and EAP. Each horse received each of 5 treatment protocols (EAP at 20 Hz, sham EAP at 20 Hz, EAP at 80: 120 Hz dense:disperse, sham EAP at 80: 120 Hz dense:disperse, no treatment). Sham EAP was at a point located 2 cm lateral to the Guan-yuan-shu acupoint. RESULTS: Duodenal distention consistently induced a significant increase in frequency of signs of colic. None of the EAP protocols caused a significant reduction in frequency of these clinical signs during distention. CONCLUSIONS AND CLINICAL RELEVANCE: The method described is reproducible and highly controllable method for inducing colic that involved duodenal distention that should be useful in evaluating the efficacy of various analgesic strategies. Bilateral EAP at the Guan-yuan-shu acupoint was ineffective in reducing signs of discomfort induced by this method.     

Distal aortic aneurysm presumed to be secondary to an infected umbilical artery in a foal

Abstract

CASE HISTORY:?A 3-month-old female Warmblood foal was presented after displaying signs of colic with pyrexia for 5 days.

CLINICAL AND PATHOLOGICAL FINDINGS:?The foal continued to show signs of colic, frequently passed urine, and was pyrexic with an elevated white blood cell count. The umbilical stalk was thickened but there was no evidence of purulent material. Exploratory laparotomy revealed an enlarged left umbilical artery remnant tightly adhered to the bladder wall. The left umbilical artery continued to an aneurysm involving the distal aorta. The foal was subject to euthanasia and post-mortem examination confirmed a spherical aortic aneurysm, in the dorsal midline caudal to the kidneys that contained a large thrombus. Histopathological examination revealed inflammation and necrosis of the tunica intima and tunica media of the left umbilical artery with suppuration and bacterial colonies evident in the periarterial tissues.

DIAGNOSIS:?Infected aortic aneurysm presumably caused by an umbilical artery infection.

CLINICAL RELEVANCE:?A previously undetected umbilical infection appears to have resulted in an unusual delayed complication causing signs of colic in a foal. Veterinarians should be aware of this condition, and the possibility that it may be a cause of signs of colic in foals. Diagnosis based on ultrasonography should be possible, but may require sedation, visceral analgesia and careful examination.     

Diagnosing disorders of the equine oesophagus

Most disorders of the equine cervical oesophagus present with a similar range of clinical signs, resulting from acute, chronic or recurrent impediment to the transit of ingesta and saliva. These include profuse frothy nasal discharge and dysphagia with gagging and coughing. Rupture of the cervical oesophagus is characterised by a painful ventral swelling at the affected site with crepitus, cellulitis and potential drainage of necrotic material. Disorders of the thoracic and abdominal segments of the oesophagus are less well recognised and clinical signs are more insidious in onset. Catastrophic damage to the thoracic oesophagus may occur without previous signs of obstruction. Pyrexia, tachycardia, tachypnoea and vague colic signs may be the first manifestations of perforation of the thoracic oesophagus, resulting from a progressive septic pleural effusion. Rupture of the thoracic oesophagus should be a differential in any horse presenting with an unexplained pleural effusion and ruled out by careful endoscopic examination.     

IMAGING DIAGNOSIS—TRAUMATIC ABOMASITIS CAUSED BY FOREIGN BODIES IN A COW

A 2‐year‐old Holstein cow presented with a history of colic signs of 3 days’ duration that had not responded to routine medical therapy. Physical examination findings were consistent with tachycardia and colic. Ultrasonographic examination of the abomasum revealed a thin hyperechoic line producing a cone shadow. Radiography of the cranial abdomen revealed two radiopaque objects within the abomasum. Right paracostal laparotomy and abomasotomy permitted palpation and manual removal of two metallic foreign bodies and a small quantity of gravel. The animal recovered well after surgery and no signs of colic were observed. Her appetite and rumination were also improved.