Antithrombin III activity in horses with colic: an analysis of 46 cases

Antithrombin-III (AT-III) activity was measured at the time of admission in 46 horses referred with colic. Differences in AT-III activities between animals treated medically or surgically and survivors or non-survivors were compared. The mean AT-III values for the horses treated medically (76.2 per cent), surgical survivors (69.5 per cent) and surgical non-survivors (55.9 per cent) were significantly different from the reference value for healthy adults (92 to 108 per cent). The mean AT-III activity of the survivors was significantly (P less than 0.01) greater than that of the nonsurvivors. The majority of the survivors (11 to 13 horses) had AT-III activities exceeding 60 per cent of normal, whereas that of 10 of the 14 non-survivors was less than 60 per cent of normal. There was an apparent distinction between the survivors and non-survivors at approximately 60 per cent of normal AT-III activity.     

Risk factors associated with colic in horses

Many factors have been identified as risk factors for colic in horses in several epidemiological studies. The aim of our paper was to review the results of 12 epidemiological studies, in order to assess the impact of each risk factor for colic. According to the literature, the factors that increase the risk of colic are feeding practices (type and quality of food, type and changes of feeding), the intrinsic factors of horses (sex, age and breed), management (type and changes of housing and activity), medical history (a previous colic, administration of a medical treatment) and parasite control (the presence of worms and type of deworming program). Several individual factors were incriminated as risk factors by all the studies. Nevertheless, the different studies did not always agree on the role of other risk factors. The conclusions were tightly related to several criteria in the selection of the study population, like the type of the epidemiological study, the number and the origin of horses included and the location of the study.     

The coagulation system in horses with colic

Colic in horses very often induces changes in the coagulation system causing the development of disseminated intravascular clotting. It is promoted by blood concentration and an increase in exposition of coagulation activators with a simultaneous decrease in coagulation inhibitors activity, mainly antithrombin III. Progressing blood platelets aggregation supports production of microthromboses and plugging capillary vessels. The progression of this processes causes complications in basic disease and becomes the reason for therapeutic failure. Determination of coagulation system indexes such as the number of platelets, prothrombin time, activated partial thromboplastin time, thrombin time, concentration of fibrinogen and fibrinogen degradation products, and D-dimmer and antithrombin III contents enables diagnosis and facilitates appropriate therapy of colic in horses.     

Salmonella shed by horses with colic

Salmonella was isolated from 13 of 100 colicky horses admitted to a referral hospital. Seven horses were shedding the microorganism at or soon after hospital admission. A unique serotype was introduced into the hospital by a horse not shedding Salmonella at admission. It was concluded that 8 horses were infected before admission. Whether the remaining 5 horses were infected before or after admission could not be determined. Salmonella senftenberg was the most commonly isolated serotype from colicky horses and from horses with salmonellosis that were not colicky on hospital admission during the survey period. This organism was rarely isolated at the hospital before initiation of this survey.     

Feeding practices associated with colic in horses.

OBJECTIVE: To determine whether specific feeding practices were associated with development of colic in horses. DESIGN: Prospective matched case-control study. ANIMALS: 364 horses examined by veterinarians in private practice in Texas because of colic (cases; n = 182) or any other reason (controls; 182). PROCEDURE: Participating veterinarians were sent forms at the beginning of the study to collect information on signalment, feeding management practices, farm management practices, and preventive medical treatments. Case and control horses were compared by use of conditional logistic regression to identify factors associated with colic. RESULTS: Risk factors for colic were a recent change in batch of hay, decreased exposure to pasture, a recent change in type of grain or concentrate fed, feeding > 2.7 kg (6 lb) of oats/d, feeding hay from round bales, and Thoroughbred breed. Recent anthelmintic administration decreased the risk of colic. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that certain changes in diet (eg, change in batch of hay, change in type of grain or concentrate, feeding hay from round bales) and management (eg, decreased availability of pasture) increase the risk of colic in horses.     

Hypoxaemia during anaesthesia in seven horses with colic

Anaesthetic records of horses with colic anaesthetised between June 1987 and May 1989 were reviewed. pH and blood gas analyses were performed during 157 operations from which the horses were allowed to recover. A PaO₂ of 8.0 kPa or less was measured during anaesthesia in seven of these horses. The horses were of different breeds, ages and sexes. Anaesthesia was induced with xylazine, guaifenesin and ketamine in four horses and with xylazine, guaifenesin and thiobarbiturate in three horses. Anaesthesia was maintained with inhalation anaesthetic agent and oxygen: isoflurane in five horses, halothane in one horse, and initially halothane but later isoflurane in one horse. Systolic arterial pressures during anaesthesia ranged from 80 to 150 mmHg, diastolic arterial pressures were between 60 and 128 mmHg, and heart rates were between 28 and 44 beats /min. Controlled ventilation was initiated at the start of anaesthesia. PaCO₂ exceeded 6.7 kPa in three horses but was subsequently decreased by adjustment of the ventilator. PaO₂ of 8.0 kPa or less was measured during early anaesthesia, with one exception, and persisted for the duration of anaesthesia. The horses' inspired air was supplemented with oxygen during recovery from anaesthesia, at which time measurement of blood gases in three horses revealed no increase in PaO₂. Recovery from anaesthesia was uneventful. The surgical problems involved primarily the large intestine in five horses and the small intestine in two horses. Six horses were discharged from the hospital alive; one horse was reanaesthetised later the same day and destroyed without regaining consciousness. We concluded that none of the objective values recorded during the pre-anaesthetic evaluation could have been used to predict the complication of intraoperative hypoxaemia. We observed that once hypoxaemia developed it persisted for the duration of anaesthesia and even into the recovery period when the horses were in lateral recumbency and regaining consciousness. We assume that the altered metabolism from anaesthetic agents and hypothermia combined with adequate peripheral perfusion contributed to the lack of adverse consequences in six of the horses. The contribution of hypoxaemia to the deteriorating condition of the seventh horse is speculative.     

Serum tumor necrosis factor activity in horses with colic attributable to gastrointestinal tract disease.

Over a 24-month period, serum tumor necrosis factor (TNF) activity was determined in 289 horses with colic attributable to gastrointestinal tract disease. Serum TNF activity was quantitated by use of a modified in vitro cytotoxicity bioassay, using WEHI 164 clone-13 murine fibrosarcoma cells. Causes for colic, determined by clinical and laboratory evaluation, exploratory celiotomy, or necropsy included: gastrointestinal tract rupture (GTR); ileal impaction; small intestinal strangulating obstruction (SIO); proximal enteritis (PE); transient small intestinal distention; large-colon displacement; large-colon volvulus; large-colon impaction; colitis; small-colon obstruction; peritonitis; and unknown. Each diagnosis was placed into 1 of 3 lesion categories: inflammatory disorders (GTR, PE, colitis, peritonitis); strangulating intestinal obstruction (SIO, large-colon volvulus); and nonstrangulating intestinal obstruction (ileal impaction, transient small intestinal distension, large-colon displacement, large-colon impaction, small-colon obstruction, unknown). The prevalence of high serum TNF activity and/or mortality were evaluated. Differences were tested at significance level of P less than 0.05. Approximately 20% of the 289 horses has serum TNF activity greater than that found in clinically normal horses (greater than 2.5 U/ml). Twenty-three horses (8%) had marked increase in serum TNF activity (greater than or equal to 10 U/ml) which was more prevalent among horses with SIO and PE than in horses of other diagnostic groups, except those with GTR. Mortality and marked increase in serum TNF activity were greater in horses with intestinal inflammatory disorders or strangulating intestinal obstruction than in horses with nonstrangulating intestinal obstruction.(ABSTRACT TRUNCATED AT 250 WORDS)     

Surgical colic in racing endurance horses

A retrospective study was performed of horses that developed colic during endurance racing, and subsequently required surgery. Fifteen horses met the inclusion criteria, of which 13 (87%) had small intestinal volvulus. Nine of the 15 horses (60%) had a small intestinal resection and anastomosis performed. Post operative ileus, particularly in those horses that had a resection performed, was a common complication. Eleven of the 15 (73%) survived, and 4 (27%) have since raced.     

Use of clinical pathology in evaluation of horses with colic

Clinical pathology is a valuable adjunct to physical examination of cases of colic. The present review considers evaluation of cases of colic for three main purposes: (1) making a prognosis, (2) deciding whether to operate, and (3) making a diagnosis. Blood tests noted to be useful for prognostication were hematocrit, lactate and urea nitrogen concentrations, pH, anion gap, fibrin/fibrinogen degradation products, antithrombin III activity, prothrombin time, and thrombin time. Horses with a poor prognosis often have relative polycythemia, marked lactic acidosis, high anion gap, azotemia, and coagulation abnormalities evidenced by increased fibrin/fibrinogen degradation products, decreased antithrombin III activity, and prolonged prothrombin and thrombin times. The decision to operate is usually a clinical one, supported by relative polycythemia, hyperglycemia, and, possibly, abnormal peritoneal fluid analysis. Diagnosis of the primary problem (causing the colicky signs) is also often based largely on physical examination. However, peritoneal fluid analysis provides worthwhile data, especially in cases of peritonitis or intestinal ischemia and infarction.     

Histologic findings in the gastrointestinal tract of horses with colic

Thirty horses were admitted to the University of Georgia Veterinary Medical Teaching Hospital with colic severe enough to warrant surgery and/or euthanasia. Gastrointestinal tracts of these 30 horses were histologically examined for morphologic changes. The horses were grouped according to cause of the colic (ie, simple obstruction, strangulation obstruction, thromboemboli, and inflammation). Lesions were graded as to severity, and grade scores were correlated with survival or nonsurvival. Mucosal changes developed distal and proximal to the primary lesion site and, although there were some differences between groups, changes characteristic of ischemia were common to all groups. The predictability of lesion grades of 2 or higher for nonsurvivability (90%) indicates that intestinal biopsy may have prognostic value in the postsurgical evaluation and management of equine colic.     

Risk factors of colic in horses in Austria

A hospital‐based case study was conducted at the University of Veterinary Medicine Vienna for a 1‐year period. The purpose of this study was to determine possible alterable and non‐alterable risk factors of equine colic in Austria. The investigated parameters were obtained from hospital medical records (individual factors, duty of the horse, deworming, change in diet and water intake), from questionnaires (feed intake, watering types, housing and pasture practices) and from http://www.orf.at (weather‐related factors). Moreover, 221 collected feed samples were investigated through hygienic quality sensory evaluation and mould, yeast and bacteria presumptive samples were confirmed by microbiological investigation. Variables that were observed from the hospital medical records and found to be significantly associated with colic in a univariate analysis were included in multivariate analysis and the only remaining risk factor was decreased water consumption (p < 0.001, OR = 5.025). Consequently, a total of 2743 horses and 366 cases of colic were observed during the study period. The risk factors for colic in Austria were identified for the first time in this study and these increased risk factors were decreased water consumption, high amount of concentrate intake (p = 0.037), low hygienic quality of hay (p = 0.027) and high temperature on the arrival date (p = 0.003). Results suggest that the occurence of colic may not stop, but may decrease with better feed management practices in Austria.     

Effect of hydroxyethyl starch solution in normal horses and horses with colic or acute colitis

Hydroxyethyl starch (HES) solution is an effective colloidal infusion solution in humans for treatment of hypovolaemic shock, but it has not been compared with fluids currently available for use in horses. On the basis of plasma-expanding effect of HES in normal horses, a 10% medium-molecular 200/0.5 solution of HES was subsequently tested in hypovolaemic horses. Six normal horses were given five protocols of a single infusion of HES at varying dosage rates (5, 10, 15 ml HES/kg), as well as isotonic saline (15 ml/kg) and hypertonic saline (4 ml/kg b.w.). Dehydrated horses suffering from acute colitis or those which had been treated surgically for ileus of the small or large intestine were given an i.v. infusion of 10 ml HES/kg in combination with 10 ml saline/kg. Clinical data and blood samples for testing were taken before the infusion, and then 10 min, 1 h, 2, 4, 6, 8, 10, 12 and 24 h after infusion (a.i.). A significant decrease in haematocrit was observed in protocol 1-5 for a period of up to 4, 4, 10 h, 10 min and up to 10 min; in group of colitis, during the entire 24-h testing period, and in groups of ileus of small intestine and of large intestine, up to 4 and 10 h a.i. HES decreases better and longer-lasting haematocrit and total protein than either isotonic or hypertonic saline. Half-life of HES increases due to higher dosage (5.83, 7.63 and 11.48 h) and distribution is exclusively intravascular. In normal horses of protocol 1-3 using HES aPTT, sodium and potassium were within the physiological range. Serum amylase activity is increased in horses using HES. On the basis of this clinical study, the decreasing effect of urea and creatinine in colic patients after surgery and fewer instances of postoperative ileus a dosage of 10 ml HES/kg could be recommended.     

Evaluation of activated neutrophils in the blood of horses with colic

OBJECTIVE: To evaluate the activation status of neutrophils in blood samples obtained from horses with naturally occurring colic associated with strangulating obstruction, nonstrangulating obstruction, or inflammatory bowel disease. ANIMALS: 30 horses with naturally occurring colic and 30 healthy control horses. PROCEDURE: Activation status of neutrophils was determined by assessing the number of neutrophils that could pass through filters with 5-microm pores, cell-surface CD11-CD18 expression, and alterations in size and granularity of neutrophils. RESULTS: Horses with impaction or gas colic did not have evidence of activated neutrophils. Horses with inflammatory bowel disease consistently had evidence of activated neutrophils, including decreased leukocyte deformability, increased CD11-CD18 expression, increased neutrophil size, and decreased neutrophil granularity. Horses with strangulating colic had variable results. Of horses with strangulating colic, 7 of 14 had marked changes in filtration pressures, 5 of 14 had increased CD11-CD18 expression, 6 of 14 had changes in neutrophil size, and 5 of 14 had changes in neutrophil granularity. Among horses with strangulating colic, changes in deformability, size, and granularity of neutrophils correlated with an adverse outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Activated neutrophils were detected in all horses with inflammatory bowel disease and a few horses with strangulating colic. Correlation of activated neutrophils with horses that had strangulating colic that died or were euthanatized indicates that activated neutrophils are a negative prognostic indicator. Additional studies are needed to determine whether activated neutrophils contribute directly to the adverse outcome in horses with strangulating colic.     

Peritoneal concentrations of transforming growth factor beta in horses with colic

Reasons for performing the study: In man, peritoneal transforming growth factor beta (TGF‐β) is associated with peritoneal diseases and subsequent adhesion formation. No studies on plasma and peritoneal TGF‐β concentrations in horses with colic are available. Objectives: 1) To determine both plasma and peritoneal TGF‐β₁ and TGF‐β₃ concentrations in horses with different types of colic (not previously subjected to abdominal surgery); 2) to compare these concentrations according to the type of peritoneal fluid (transudate, modified transudate and exudate); and 3) to compare and correlate plasma and peritoneal concentrations of TGF‐β₁ and TGF‐β₃ and the types of peritoneal fluid according to the colic group and outcome. Methods: Peritoneal fluid and plasma samples from 78 horses with colic and 8 healthy horses were obtained. Patients were classified according to diagnosis (obstructions, enteritis, ischaemic disorders and peritonitis), peritoneal fluid analysis (transudate, modified transudate and exudate), and outcome (survivors and nonsurvivors). Plasma and peritoneal TGF‐β₁ and TGF‐β₃ concentrations were determined by ELISA. Data were analysed by parametric and nonparametric tests. P≤0.05 was considered as statistically significant. Results: Concentrations of peritoneal fluid TGF‐β₁ were significantly (P = 0.01) higher in horses with peritonitis in comparison with all other colic groups and controls. Horses with ischaemic lesions had significantly (P = 0.01) higher concentrations of peritoneal TGF‐β₁ in comparison with controls and the group of horses with obstructions. Peritoneal TGF‐β₁ concentration also was significantly (P = 0.01) higher in exudates in comparison with transudates. Peritoneal TGF‐β₁ and TGF‐β₃ concentrations and plasma TGF‐β₁ concentration were significantly increased in nonsurvivors compared to survivors (P = 0.001, P = 0.004 and P = 0.05, respectively). Conclusions: Peritoneal TGF‐β₁ concentration was higher in horses with severe gastrointestinal diseases (ischaemic intestinal lesions and peritonitis), in horses with an altered peritoneal fluid (exudate), and in nonsurvivors. Potential relevance: Peritoneal TGF‐β concentration increases in horses with severe gastrointestinal disease as an anti‐inflammatory response.     

Cardiorespiratory effects of enoximone in anaesthetised colic horses

Reasons for performing study: No studies have been reported on the effects of enoximone in anaesthetised colic horses. Objective: To examine whether enoximone improves cardiovascular function and reduces dobutamine requirement in anaesthetised colic horses. Methods: Forty‐eight mature colic horses were enrolled in this prospective, randomised clinical trial. After sedation (xylazine 0.7 mg/kg bwt) and induction (midazolam 0.06 mg/kg bwt, ketamine 2.2 mg/kg bwt), anaesthesia was maintained with isoflurane in oxygen and a lidocaine constant rate infusion (1.5 mg/kg bwt, 2 mg/kg/h). Horses were ventilated (PaCO₂<8.00 kPa). If hypotension occurred, dobutamine and/or colloids were administered. Ten minutes after skin incision, horses randomly received an i.v. bolus of enoximone (0.5 mg/kg bwt) or saline. Monitoring included respiratory and arterial blood gases, heart rate (HR), arterial pressure and cardiac index (CI). Systemic vascular resistance (SVR), stroke index (SI) and oxygen delivery index (DO₂I) were calculated. For each variable, changes between baseline and T10 within each treatment group and/or colic type (small intestines, large intestines or mixed) were analysed and compared between treatments in a fixed effects model. Differences between treatments until T30 were investigated using a mixed model (α= 0.05). Results: Ten minutes after enoximone treatment, CI (P = 0.0010), HR (P = 0.0033) and DO₂I (P = 0.0007) were higher and SVR lower (P = 0.0043) than at baseline. The changes in CI, HR and SVR were significantly different from those after saline treatment. During the first 30 min after enoximone treatment, DO₂I (P = 0.0224) and HR (P = 0.0003) were higher than after saline administration. Because the difference in HR between treatments was much clearer in large intestine colic cases, an interaction was detected between treatment and colic type in both analyses (P = 0.0076 and 0.0038, respectively). Conclusions: Enoximone produced significant, but short lasting, cardiovascular effects in colic horses. Potential relevance: Enoximone's cardiovascular effects in colic horses were of shorter duration than in healthy ponies.     

Clinical comparison of two regimens of lidocaine infusion in horses undergoing laparotomy for colic

ObjectiveTo compare, in horses undergoing laparotomy for colic, the effects of administering or not administering a loading intravenous (IV) bolus of lidocaine prior to its constant rate infusion (CRI). Effects investigated during isoflurane anaesthesia were end-tidal isoflurane concentration (Fe’ISO), cardiovascular function, anaesthetic stability and the quality of recovery.Study designProspective, randomized clinical study.AnimalsThirty-six client-owned horses.MethodsHorses were assigned randomly to receive lidocaine as a CRI (50 μg kg⁻¹ minute⁻¹) either preceded (LB) or not preceded (L) by a loading dose (1.5 mg kg⁻¹ IV over 15 minutes). Lidocaine infusion (LInf) was started (T0) within 20 minutes after induction of general anaesthesia and discontinued approximately 30 minutes before the end of surgery. Anaesthetic depth, Fe’ISO, intra-operative physiological parameters and quality of recovery were assessed or measured. Data were analysed using one-way anova, t-test, Fisher test, Wilcoxon and Kruskal–Wallis tests as appropriate (p < 0.05).ResultsMean ± SD Fe’ISO was 1.21 ± 0.08% in group LB and 1.23 ± 0.06% in group L. Heart rate was significantly higher in group L than in group LB at times T5-T15, T25, T35 and T95. No difference was found between groups in other measured physiological values, nor in any measure taken to improve these parameters. Recovery phase was comparable and satisfactory in all but one full term pregnant horse in group L which fractured a femur during recovery.ConclusionPreloading with a lidocaine bolus prior to a CRI of lidocaine did not influence isoflurane requirements, cardiopulmonary effects (other than a reduction in heart rate at some time points) or recovery compared to no preloading bolus.Clinical relevanceA loading dose of lidocaine prior to CRI does not confer any advantage in horses undergoing laparotomy for colic.     

Demographics and costs of colic in Swedish horses

BACKGROUND: Colic is an important cause of morbidity and mortality in horses. In Sweden, an insurance database with diagnostic medical information is maintained on >30% of the nation's horse population. HYPOTHESIS: The objective was to describe the occurrence of colic, defined by costly veterinary care and life claims, in horses at 1 insurance company during 1997-2002. HORSES: All horses (<21 years of age) with complete insurance for veterinary care and life during the period 1997-2002 were included. METHODS: Colic was defined as conditions where the main clinical sign was abdominal pain and the problem was related to the gastrointestinal system. The analyses included measures of incidence by sex, breed group, age categories, geographical location (urban/other), survival to and survival after colic, medical cost for colic, and multivariable modeling of risk factors related to the event of colic. RESULTS: In all, 116,288 horses contributed to 341,564 horse years at risk (HYAR). There were 3,100 horses with a colic diagnosis, of which 27% were settled for life insurance. The median gross cost for veterinary care was 4,729 Swedish Kronor (SEK). The overall occurrence and mortality rate of colic was 91 and 24 events per 10,000 HYAR. Survival after colic at 1 month was 76% (95% confidence interval: 75-78%). CONCLUSIONS AND CLINICAL IMPORTANCE: The occurrence of colic varied with breed group, age, and season. The mortality rates probably reflected the true mortality of colic. The veterinary care rates most likely underestimated of the risk colic because they represent relatively costly events.