Surgical Treatment of Septic Jugular Thrombophlebitis in Nine Horses

Objective: To report a technique for surgical treatment of septic jugular thrombophlebitis unresponsive to medical treatment. Study Design: Case series. Animals: Horses (n=9) with septic jugular thrombophlebitis unresponsive to medical treatment. Methods: Jugular vein thrombectomy was performed under standing sedation and local anesthesia. The contents of the affected portion of vein were removed by multiple incisions in the vein, with the incisions left open to drain and heal by second intention. Results: The technique was curative in all instances, although 2 horses required a 2nd procedure. One horse required ligation of the linguofacial vein to control postsurgical hemorrhage. Conclusions: The technique is an effective surgical treatment for septic jugular thrombophlebitis unresponsive to medical treatment. Clinical Relevance: Jugular vein thrombectomy is a straightforward technique, and has minimal postoperative complications. It allows expedient and cost‐effective resolution of medically recalcitrant cases of septic jugular thrombophlebitis.     

Use of newly developed assays for protein C and plasminogen in horses with signs of colic

Protein C content and plasminogen activity were measured in plasma from 100 horses with signs of colic. Data were analyzed by grouping horses 4 ways. Each horse was allotted to 1 of 2 outcome groups (survivors and nonsurvivors), 1 of 3 broad-category diagnosis groups (inflammatory disorders, strangulating obstructions, and all other gastrointestinal disorders), and 1 of 2 clinical management groups (medical and surgical). In a fourth grouping, all horses (although numbers of horses included in each subgroup were small) were assigned either to specific diagnostic groups that had high expectation for activated hemostasis (intestinal ischemia, endotoxemia, jugular thrombosis, peritoneal adhesions, and laminitis) or to a control group, in which active hemostasis was unlikely. Within 2 to 24 hours after admission, nonsurvivors developed lower protein C content than did survivors. Protein C content and plasminogen activity became low during hospitalization in horses with strangulating obstructions and in horses having surgery. The results from the grouping by specific diagnosis must be considered pilot data because the numbers of horses in each subgroup were small. Although not statistically significant, trends were noticed in protein C and plasminogen: (1) horses with intestinal ischemia and endotoxemia developed low protein C content and plasminogen activity, (2) protein C content became low in horses that developed peritoneal adhesions or laminitis, and (3) plasminogen activity became low in horses that developed jugular thrombosis. Low protein C content or low plasminogen activity, or both, may be useful as predictors for outcome and for these specific complications of equine colic.(ABSTRACT TRUNCATED AT 250 WORDS)     

A Reproducible Venous Thrombosis Model in Horses Induced by the Combination of an Endothelial Lesion and Blood Flow Stasis

Because of the high incidence of thromboembolic diseases in humans, experimental models of thrombosis have been widely developed in different animal species. The pathogenesis of thrombosis is associated with three components, first outlined by Virchow in 1856: vessel injury, stasis, and hypercoagulability. Based on this concept, the purpose of the present investigation was to create an innovative model of jugular thrombophlebitis in horses that included components of Virchow's triad and excluded surgical procedures. Eighteen horses were subjected to blood vessel injury through the coadministration of sclerosing agents (glucose and ethanolamine oleate) and transitory occlusion of the jugular flow by manual compression. Thrombus formation was followed by ultrasonography imaging, and all horses developed jugular thrombophlebitis, showing that the proposed model was effective. Once occlusive thrombophlebitis was induced, jugular venous pressure cranial to the lesion was evaluated and yielded increased values, suggesting cephalic hypertension. Biochemical tests were performed to verify hepatotoxicity and nephrotoxicity after the ethanolamine injection, but no abnormalities were observed. Five horses were then euthanized to evaluate the vascular, hepatic, and renal tissues. The jugular vein wall had increased thickness, inflammatory cell influx, endothelial destruction, and thrombus firmly adhered to the vessel intima. Histological evaluation of the hepatic and renal tissues was normal. The present thrombophlebitis model in the jugular vein of the horse is simple and reproducible, providing a useful tool for investigating acute and chronic venous thrombosis because the model allows evaluation of different aspects of the prevention, pathogenesis, and treatment of this disease.     

Effects of 5% and 10% Guaifenesin Infusion on Equine Vascular Endothelium

Twelve horses of various breeds and either sex were anesthetized with xylazine and ketamine injected into a median or lateral thoracic vein. During anesthesia, with the horse in sternal recumbency, a 14-gauge, 8.9 cm catheter was inserted into each jugular vein by using aseptic technique. Guaifenesin in water (100 mg/kg or a maximum dose of 50 grams) was infused into one jugular vein and an equal volume of 0.9% saline solution was infused into the other jugular vein. Seven horses received 10% guaifenesin, and five horses received 5% guaifenesin. The catheters were removed before the horses recovered from anesthesia. The horses were euthanatized approximately 48 hours later, and the jugular veins were removed for histologic examination. Adherent thrombus material was observed in all veins exposed to 10% guaifenesin and in one vein exposed to 5% guaifenesin. No evidence of thrombus was observed in four veins infused with 5% guaifenesin or in those infused with saline solution. These findings are of particular significance with horses at increased risk for thrombosis or thrombophlebitis.     

Enhanced plasma availability of moxidectin in fasted horses

The influence of fasting prior to treatment on plasma availability and kinetic disposition of moxidectin was studied in horses. Eight adult crossbred saddle horses were allocated to two experimental groups of four horses. One group was fasted for 24 hours before treatment and the other group received their usual feed. Both groups were treated with an oral gel formulation of moxidectin at the manufacturers recommended therapeutic dose of 0.4 mg/kg. Blood samples were collected by jugular puncture at different times between 0.5 and 50 days. After plasma extraction and derivatization, samples were analyzed by HPLC with fluorescence detection. Computerized pharmacokinetic analyses were done. Fasting induced marked modifications in the pharmacokinetic behavior of moxidectin in the horse. An extended absorption process, and significantly higher area under the curve (AUC) values were obtained in the fasted animals compared to those fed their usual rations. It is suggested that fasting decreases intestinal transit time, and may have prolonged time for absorption of moxidectin. Since, biliary excretion and intestinal secretion are major routes of moxidectin elimination, fasting may have reduced bile flow and intestinal secretion. Fasting before treatment may be a useful tool for improved anthelmintic treatment in horses.     

Risk factors for salmonellosis in hospitalized horses

A case-control study to identify risk factors associated with isolation of Salmonella was accomplished, using data from records of horses hospitalized in the period July 1971 through June 1982. Horses in which nasogastric tubes were passed were at 2.9 times greater risk of having Salmonella isolated, compared with horses that did not undergo this procedure. Horses treated with antibiotics parenterally were at 6.4 times greater risk, and those treated with antibiotics orally and parenterally were at 40.4 times greater risk of developing salmonellosis, compared with horses not receiving such treatment. Horses admitted because of colic were 4.2 times as likely to have Salmonella isolated as those admitted for other reasons. Breed, age, and type of surgery did not appear to be risk factors. The risk factors identified and the magnitude of their association with Salmonella isolation were similar to those observed in a preceding study.     

Partial aneurysmectomy and autologous patch venoplasty in a horse diagnosed with pseudoaneurysm of the jugular vein

Experience with vascular pathology and vascular surgery, especially with the use of grafts, is limited in horses. Only one case of a venous aneurysm has been described in the horse, but without successful surgical correction. This case report describes the treatment of a 3-year-old female pony presented with an intermittent localised swelling of the left jugular vein after a previous thrombophlebitis. Ultrasonographic examination revealed a large jugular vein pseudoaneurysm. Treatment consisted of a partial aneurysmectomy preserving the healthy medial wall of the jugular vein. An autologous saphenous vein patch technique was used to reconstruct the vein with the largest possible lumen to minimise thrombus formation. Anticoagulants, antimicrobial and anti-inflammatory drugs were administered pre- and post-operatively. Follow-up ultrasound examinations initially showed local narrowing of the graft. At 2 and 8 months post-operatively, no external deformation of the jugular vein was visible and ultrasonography revealed patent blood flow with only a slight difference in lumen diameter. The patch venoplasty proved a viable surgical technique for jugular vein reconstruction resulting in a sufficient lumen, no thrombus formation and a good cosmetic and functional outcome.     

Strangulating obstruction caused by intestinal herniation through the proximal aspect of the cecocolic fold in 9 horses

OBJECTIVE: To report the clinical and surgical findings and outcome for horses with strangulating obstruction caused by herniation through the proximal aspect of the cecocolic fold. STUDY DESIGN: Retrospective study. ANIMALS: Nine horses. METHODS: Medical records were reviewed for clinical signs, surgical findings and technique, and outcome. Cadaver ponies and necropsy specimens were also used to study the regional anatomy of the cecocolic fold. RESULTS: The ileum and distal jejunum were strangulated in 8 horses, whereas in 1 horse the small intestine and the left ascending colons were incarcerated in a rent in the cecocolic fold. Two horses were euthanatized at surgery, 6 horses had a small intestinal resection (mean length, 3 m; range, 1.5-6.4 m) and an end-to-side jejunocecostomy, and the entrapment was reduced without resection in the horse that had small intestine and ascending colon incarceration; cecocolic fold defects were not closed. One horse was euthanatized 36 hours after surgery because of endotoxemia. Six horses were discharged; 4 were available for long-term follow-up, of which 2 were euthanatized, and 2 were euthanatized 12 and 18 months after surgery because of colic signs. Variations in thickness of the cecocolic fold were observed in specimens obtained from necropsy of other horses and ponies. CONCLUSIONS: Reasons for this defect are unknown, although observed anatomic differences in cecocolic fold thickness may contribute to the development of defects. CLINICAL RELEVANCE: Reduction of the entrapped bowel is easiest when traction is placed on the bowel at a 90 degrees to the base of the cecum. Intestinal incarceration through rents within the proximal part of the cecocolic fold should be considered as a differential diagnosis for strangulating obstruction in horses.     

Clinicopathologic evidence of disseminated intravascular coagulation in horses with acute colitis

OBJECTIVE: To detect subclinical disseminated intravascular coagulation (DIC) in horses with colitis and to determine any association between the diagnosis of subclinical DIC and outcome or occurrence of complications in horses with colitis. DESIGN: Prospective study. ANIMALS: 37 horses admitted to a veterinary teaching hospital for treatment of acute colitis. PROCEDURE: Coagulation profiles were obtained on each horse 0, 24, and 48 hours after admission. Six tests were performed: platelet count, plasma fibrinogen concentration, prothrombin time, activated partial thromboplastin time, antithrombin activity, and serum fibrin degradation products concentration. RESULTS: A clinicopathologic diagnosis of subclinical DIC was made if 3 of the 6 tests had abnormal results at any 1 sample period. No horse had clinical signs of DIC at the time of sampling. Twelve of 37 (32%) horses met the criteria for diagnosis of subclinical DIC within a 1-year period. Outcome was defined as survival or nonsurvival. Five of 12 horses with subclinical DIC and 2 of 25 horses without subclinical DIC did not survive. Crude odds ratio analysis revealed a horse with acute colitis was 8 times as likely to die or be euthanatized if a diagnosis of subclinical DIC was made. CONCLUSIONS AND CLINICAL RELEVANCE: Clinicopathologic evidence of DIC is common and is significantly associated with a poor outcome in horses with acute colitis. Treatment of subclinical DIC may influence outcome in horses with acute colitis.     

Association between exercise-induced pulmonary hemorrhage and performance in Thoroughbred racehorses

OBJECTIVE: To determine whether exercise-induced pulmonary hemorrhage (EIPH) was associated with racing performance inThoroughbred horses not medicated with furosemide and not using nasal dilator strips. DESIGN: Observational cross-sectional study. ANIMALS: 744 two- to 10-year-old Thoroughbred horses racing in Melbourne, Australia. PROCEDURE: Horses were enrolled prior to racing, and a tracheobronchoscopic examination was performed after 1 race. Examinations were recorded on videotape, and presence and severity (grade 0 to 4) of EIPH were subsequently determined by 3 observers blinded to the horses' identity. Race records were abstracted for each horse examined. RESULTS: Overall, 52.1% of horses eligible for participation in the study were examined, and horses that were examined did not differ from horses that were not examined in regard to age, sex distribution, or proportion of horses that won or finished in the first 3 positions. Horses with EIPH grades < 1 were 4.0 times as likely to win, 1.8 times as likely to finish in the first 3 positions, and 3.03 times as likely to be in the 90th percentile or higher for race earnings as were horses with grades > 2. Horses with EIPH grades > 1 finished significantly farther behind the winner than did horses without EIPH. However, odds that horses with grade 1 EIPH would win or finish in the first 3 positions were not significantly different from odds for horses without EIPH. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that EIPH is associated with impaired performance in Thoroughbred racehorses not medicated with furosemide and not using nasal dilator strips.     

Clostridium botulinum type-C intoxication associated with consumption of processed alfalfa hay cubes in horses

An episode of nervous system dysfunction was observed in horses on 17 premises in 4 counties of southern California. Thirty-eight horses were affected, and 31 of those died. The common clinical signs of disease in the affected horses were: increased appetite; anxious attitude; rythmic, intermittent muscle tremors in the area of the tricep muscles; decreased palpebral tone; mydriasis; small hard fecal balls; and tendency to become sternally recumbent with the neck extended. The temporal distribution of cases on all 17 premises suggested a relationship between exposure to a common batch of alfalfa hay cubes and manifestations of similar clinical signs of disease in affected horses. Fifteen horses were submitted for necropsy. Diagnosis of botulism was established on the basis of detection of type-C1 toxin in the feed, in intestinal contents of 1 horse, and in the liver of the aforementioned horse and another horse. Toxigenic strains of Clostridium botulinum type-C were isolated from intestinal contents of 5 affected horses, one of which also contained type-C1 and type-C2 toxins. Seven of 10 horses treated with type-C antitoxin and plasma obtained from horses hyperimmunized with C botulinum type-C toxoids survived.     

Epilepsy in horses: Aetiological classification and predictive factors

Reasons for performing the study: In contrast with reports in man and small animals, a systematic classification of seizures in horses is lacking. Objectives: The purpose of this study was to classify seizures based on their aetiology and to characterise epilepsy in 104 horses presented for seizures at the Ohio State University Veterinary Medical Center between 1988 and 2009. Methods: In a retrospective observational study, seizures were classified by aetiology based on history, clinical observations, diagnostic investigations (e.g. electroencephalograms, cerebrospinal fluid and computed tomography imaging of the head) and post mortem examinations, when available. Univariate and multivariate logistic regression analyses were performed. Results: Epilepsy (i.e. 2 or more recurrent seizures) was identified in 70% of cases, and further classified as symptomatic (i.e. structural brain pathology, 35.6% of cases), cryptogenic (i.e. unknown, 54.8% of cases) and idiopathic (i.e. suspected genetic predisposition, 2.7% of cases). Normal neurological examination on admission, the presence of seizures unprovoked by any identified factors and paroxysmal epileptiform activity on electroencephalogram recordings were all strongly (P<0.05) correlated with epilepsy on univariate analysis. For a horse with generalised seizures, the odds of having epilepsy was 7 times lower compared with a similar horse with partial seizures (P<0.05) in multivariate modelling. Conclusions: Seizure aetiology was symptomatic or cryptogenic in most horses, whereas reactive seizures and idiopathic epilepsy were less common. Potential relevance: This study is the first attempt to classify seizures and to characterise epilepsy in a referral-based equine population. Predictive factors of epilepsy in horses were similar to those reported in other species and may assist the clinician with the early diagnosis of epilepsy.     

Effects of Jugular Vein Occlusion on Cardiovascular Parameters in Horses During Exercise on a Treadmill

The purpose of the present investigation was to examine the effects of unilateral and bilateral jugular vein occlusion by temporary surgical ligature on the heart rate and arterial and venous blood pressure in sedentary horses during progressive treadmill exercise. Six horses performed three exercise tests (ET). ET1, considered the control, was performed in horses without jugular occlusions. ET2 and ET3 were performed with unilateral and bilateral occlusion by temporary surgical ligature of the jugular veins, respectively. Heart rate, arterial pressure, and pressure of the occluded jugular vein were evaluated. Clinically, the horses presented apathy, head edema, congested mucous membranes, increased capillary refill time, and dysphagia. These signs were observed with the unilateral jugular vein occlusion and became more evident with the bilateral occlusion. Comparing ETs, no differences were observed in heart rate. However, jugular occlusions promoted a decrease in the mean arterial pressure and a severe increase in jugular pressure. Head edema caused by the jugular vein occlusion in the horses could interfere with the autonomic cardiovascular regulation of arterial blood pressure during exercise, likely leading to an impairment of tissue perfusion. Jugular occlusion, even unilateral, also causes severe head venous congestion, leading to venous hypertension that was aggravated by exercise, which could risk development of cerebral edema and neurological damage. The present results obtained from sedentary horses are preliminary data that lead us to suggest that sport horses presenting jugular occlusive thrombophlebitis, even unilateral, may be prevented from performing athletic activities.     

Evaluation of an outbreak of West Nile virus infection in horses: 569 cases (2002)

OBJECTIVE: To characterize an outbreak of West Nile virus (WNV) infection in horses in North Dakota in 2002, evaluate vaccine effectiveness, and determine horse characteristics and clinical signs associated with infection. DESIGN: Retrospective study. ANIMALS: 569 horses. PROCEDURE: Data were obtained from veterinary laboratory records, and a questionnaire was mailed to veterinarians of affected horses. RESULTS: Affected horses were defined as horses with typical clinical signs and seroconversion or positive results of virus isolation; affected horses were detected in 52 of the 53 counties and concentrated in the eastern and northeastern regions of the state. Among affected horses, 27% (n = 152) were vaccinated against WNV, 54% (309) were not, and 19% (108) had unknown vaccination status; 61 % (345) recovered, 22% (126) died, and 17% (98) had unknown outcome. The odds of death among nonvaccinated horses were 3 and 16 times the odds among horses that received only 1 or 2 doses of vaccine and horses that were vaccinated according to manufacturer's recommendations, respectively. Horses with recumbency, caudal paresis, and age > 5 years had higher odds of death, whereas horses with incoordination had lower odds of death, compared with affected horses without these characteristics. CONCLUSIONS AND CLINICAL RELEVANCE: Vaccination appears to have beneficial effects regarding infection and death caused by WNV.     

Determination of lactate concentrations in blood plasma and peritoneal fluid in horses with colic by an Accusport analyzer

BACKGROUND: Intestinal hypoperfusion can lead to increased lactate concentrations in plasma and peritoneal fluid of horses with colic. HYPOTHESIS: The purposes of this study were to (1) evaluate the reliability of the Accusport analyzer to assess peritoneal fluid lactate (PFL) concentrations in healthy horses and those with colic, (2) identify clinical features associated with abnormal blood plasma lactate (BPL) and PFL concentrations, and (3) evaluate the prognostic value of BPL and PFL. ANIMALS: BPL and PFL were determined in 20 healthy horses and in 106 horses with colic. RESULTS: The Accusport was reliable for determining BPL concentrations < 13 mM and PFL concentrations < 20 mM. Multivariate analysis indicated that PCV and the need for intestinal resection were independently associated with the BPL; pulse, PCV, venous pO2, the presence of necrotic intestine, an increased amount of peritoneal fluid, and fluid total protein content were independently associated with PFL. With a 1 mM increase in BPL or PFL, the respective odds ratios for required abdominal surgery increase to 1.23 (BPL) and 1.58 (PFL), odds ratios for a required intestinal resection increase to 1.20 (BPL) and 1.41 (PFL), and odds ratios for developing ileus increase by 1.33 (BPL) and 1.36 (PFL). PFL concentrations of 1, 6, 12, and 16 mM correspond to a probability of death of 11, 29, 63, and 82%, respectively, in horses without strangulating obstruction and of 25, 52, 82, and 92%, respectively, in horses with strangulating obstruction. CONCLUSION: PFL is more useful and sensitive than BPL for prognostic purposes in horses with colic.     

Retrospective evaluation of factors associated with the risk of seropositivity to Ehrlichia risticii in horses in New York State.

A retrospective study was designed to determine the distribution of equine monocytic ehrlichiosis among the equine population in New York state, and to identify factors associated with risk of disease. Serum samples submitted to the diagnostic laboratory of the university during the period from January 1985 through December 1986 were examined for antibodies to Ehrlichia risticii, using the indirect fluorescent antibody technique. Factors evaluated included geographic origin and date of submission of the sample, and age, breed, and sex of the horse. Logistic regression analysis was used to identify which factors were significantly associated with the risk of seropositivity to E risticii, while simultaneously controlling for other factors. Of the 2,579 tested samples, 1,950 (76%) had positive results. Factors significantly associated with risk of seropositivity to E risticii were: breed of the horse (Thoroughbreds were 3 times more likely to have been exposed to E risticii, compared with non-Standardbred, non-Thoroughbred breeds); sex (female horses were 2.7 times more likely to have been exposed, compared with male horses); age of the horse (the risk of being exposed to E risticii increased with age, peaked at around 12 years, and decreased thereafter); and month of submission (horses tested during November and December had the highest odds of being seropositive [odds ratio = 2.1], and horses tested during March through April were least likely to be seropositive [odds ratio = 0.5], compared with horses tested during January and February).     

Prognostic features and clinical presentation of acute idiopathic enterocolitis in horses

Clinical and hematological changes observed on presentation of 47 horses referred to the Ontario Veterinary College with acute idiopathic colitis were analyzed for their prognostic features. Cases of acute enterocolitis were characterized by fever, dehydration, abnormalities of serum electrolyte concentrations, azotemia, hypoalbuminemia, and increased serum concentrations of muscle enzymes. Severely dehydrated horses were seven times more likely to die or be euthanized than those that were not dehydrated. Other factors associated with failure to survive included the following: increased hematocrit, increased number of band neutrophils, increased serum creatinine and urea concentrations, and decreased blood pH and increasingly negative base excess. The results of multivariate variable analysis (stepwise logistic regression) suggested that, among the variables tested, base excess was the best predictor of death or survival. Twenty of 47 horses died or were euthanized. Reasons for death or euthanasia included: severe disseminated intravascular coagulation, unresponsiveness of severe metabolic acidosis and hypoproteinemia to treatments, and severity of colonic lesions on exploratory laparotomy. Of the surviving horses, three developed chronic laminitis (two were destroyed) and five developed jugular vein thrombosis. Fourteen of 16 horses for which subsequent histories were available returned to normal function.

Early recognition of the disease, combined with early and aggressive correction of dehydration and of acid-base imbalance, may be important determinants of survival in horses with acute idiopathic colitis.

     

Effects of small- and large-volume resuscitation on coagulation and electrolytes during experimental endotoxemia in anesthetized horses

BACKGROUND: Small-volume resuscitation (SVR) has been advocated in place of large-volume isotonic resuscitation for the treatment of endotoxemia in horses. The effects of this type of therapy during experimental endotoxemia on electrolytes and coagulation have not been evaluated in the horse. As part of a larger project, the objective of this study was to determine the effects of SVR (hypertonic saline solution [HSS] plus hetastarch [HES]) on coagulation and serum electrolytes concentration, and to compare SVR with large- and small-volume isotonic resuscitation during experimental endotoxemia in anesthetized horses. HYPOTHESIS: SVR does not affect coagulation parameters or serum electrolyte concentrations when compared with either small- or large-volume isotonic crystalloids. ANIMALS: Horses were randomly assigned to 1 of 3 groups. Under halothane anesthesia, endotoxemia was induced by administering 50 microg/kg Escherichia coli endotoxin i.v. The horses were treated for 30 minutes with 15 mL/kg of balanced polyionic crystalloid solution (control), 60 mL/kg of balanced polyionic crystalloid solution (ISO), or 5 mL/kg of HSS followed by 10 mL/kg HES (HSS-HES). METHODS: Prospective randomized trial. RESULTS: Significant differences in coagulation parameters were not found among the groups. Thrombocytopenia was severe in all 3 groups. Serum ionized calcium concentration significantly decreased from baseline in control and ISO groups but not in the HSS-HES group. CONCLUSIONS AND CLINICAL IMPORTANCE: These results suggest that the HSS-HES combination, at the dosage used in this study had no adverse effects on coagulation beyond those produced by endotoxemia. HSS-HES may have a protective effect against endotoxemia-induced ionized hypocalcemia.     

Risk factors for development of acute laminitis in horses during hospitalization: 73 cases (1997-2004)

OBJECTIVE: To identify risk factors for development of acute laminitis in horses during hospitalization for illness or injury. DESIGN: Retrospective case-control study. ANIMALS: 73 horses that developed laminitis (case horses) and 146 horses that did not develop laminitis (control horses) during hospitalization. PROCEDURES: Case and control horses were matched in a 2:1 ratio by the date on which each horse was evaluated. Potential risk factors investigated included age, breed, and sex; highest and lowest values recorded during hospitalization for fibrinogen concentration, WBC count, PCV, and total solids concentration; and comorbid disease states, including pneumonia, endotoxemia, diarrhea, medically treated colic, surgically treated colic, pituitary adenoma, retained placenta or metritis, forelimb lameness, hind limb lameness, acute renal failure, and vascular abnormalities. A univariate screening of all potential risk factors was performed to determine which variables should be selected for further analysis. All factors found to be associated with development of laminitis were included in a multivariate conditional logistic regression model. RESULTS: Development of laminitis was marginally associated with lowest and highest fibrinogen concentrations, highest PCV, and lowest total solids concentration and significantly associated with pneumonia, endotoxemia, diarrhea, abdominal surgery for colic, and vascular abnormalities. In the multivariate analysis, only endotoxemia was significantly associated with laminitis. CONCLUSIONS AND CLINICAL RELEVANCE: Endotoxemia is an important risk factor for development of acute laminitis in horses during hospitalization for medical or surgical conditions. Early recognition of endotoxemia, or the potential for it to develop in certain disease states, and initiation of treatment directed at endotoxemia or its consequences may help prevent laminitis in horses during hospitalization.     

Small intestinal segmental volvulus in horses after gastroscopy: Four cases (2011–2012)

Gastroscopy is the most common technique used in veterinary medicine to evaluate the stomach in horses and to date, no complications have been described associated with the procedure. This paper reports 4 cases developing a nonstrangulating segmental volvulus of the small intestine after gastroscopy at 3 referral institutions over a 2 year period. After performing diagnostic gastroscopy, all horses developed acute and severe clinical signs of colic unresponsive to medical management. Time range between gastroscopy and onset of colic signs varied from 10 min to 3 h. An exploratory laparotomy revealed a nonstrangulating segmental volvulus of the small intestine that was manually corrected without need for resection in all horses. In all cases, affected small intestine was severely gas distended. Three of those horses survived to discharge and were alive at follow‐up. One horse was subjected to euthanasia 2 days after surgery due to diffuse intestinal lymphoma.