Acellular dermal graft for repair of abdominal wall defects in rabbits

Sixteen clinically healthy New Zealand white rabbits of either sex were divided into 2 equal groups (I and II) of 8 animals each. Under thiopental sodium (2.5%) anaesthesia a 2 x 3 cm full-thickness abdominal wall defect in the mid-ventral abdominal wall was created and repaired with an acellular dermal graft (ADG) in all the animals of group I (test group). In animals of group II (control group) a full-thickness linear midline abdominal muscular wall incision was made and repaired with a continuous suture pattern using 2-0 nylon.     

Surgical repair of a congenital lateral abdominal wall hernia in a neonatal foal

A 16‐hour‐old Quarter Horse filly presented for evaluation of a soft mass in the right caudoventral lateral abdominal wall. Radiography and ultrasonography confirmed the presence of a nonreducible lateral abdominal wall hernia with small intestine located between the skin and body wall. The size of the defect itself could not be imaged and the filly was taken to surgery. A 4 cm vertical defect that appeared congenital was found in the transverse abdominal muscle and was repaired by primary apposition. This case report describes the repair and outcome of this unusual type of congenital hernia.     

Congenital retrosternal (Morgagni) diaphragmatic hernias in three horses

CASE DESCRIPTION: 3 Horses were examined and treated because of sudden onset of signs of abdominal pain. CLINICAL FINDINGS: All horses had a retrosternal (Morgagni) hernia involving the right side of the diaphragm. In each horse, the large colon was incarcerated in a right muscular defect in the diaphragm with a large hernial sac. TREATMENT AND OUTCOME: Definitive surgical repair of the hernia was not performed during the initial celiotomy. The hernia was repaired with mesh herniorrhaphy, but without resection of the hernia sac in 2 horses. For 1 horse, conservative management was applied. In the 2 horses treated with surgical correction, no major postoperative complications developed, and all 3 horses have been free of signs of abdominal pain. CLINICAL RELEVANCE: Horses with retrosternal hernias involving the diaphragm can develop clinical signs of intermittent obstruction of the large colon and chronic colic. In horses, retrosternal diaphragmatic hernias appear to develop exclusively in the right ventral aspect of the diaphragm and could represent an embryologic defect of diaphragm formation. Affected horses can be successfully treated with mesh herniorrhaphy or, in some instances, with conservative management.     

Intra‐abdominal hypertension in horses

Intra‐abdominal hypertension (IAH) may lead to a multiple organ dysfunction syndrome associated with significant dysfunction of the cardiovascular, respiratory, renal, gastrointestinal and central nervous systems of human patients. A recent prospective multicentre epidemiological investigation in man concluded that IAH was associated with an increased risk of mortality in critically ill patients. In this review, we present current information pertaining to the potential clinical importance of IAH in the context of equine clinical practice. In conclusion, consideration of intra‐abdominal pressure should be a part of the clinical assessment of patient well‐being in critically ill equine patients.     

Blood glucose in horses with acute abdominal disease

BACKGROUND: Hyperglycemia in critically ill humans is associated with increased glucose production and insulin resistance and is associated with death. This might also be true in horses presenting with acute abdominal disease. HYPOTHESIS: Throughout hospitalization, hyperglycemia will be common in adult horses presenting with acute abdominal disease. Hyperglycemia will be associated with a worse prognosis for survival to hospital discharge. ANIMALS: Two hundred sixty-nine adult horses with acute abdominal disease. METHODS: Observational retrospective study. Records were reviewed for 269 horses that had glucose data analysed and recorded at the time of hospital admission: 154 horses had a first sample after admission; 110 horses at 24 hours after admission; 74 horses at 36 hours after admission; and 49 horses at 48 hours after admission. Logistic regression analyses were performed to investigate the association of glucose concentrations with survival, in addition to the association of glucose concentrations with surgical, small intestinal, strangulating lesions, and lesions requiring a resection. RESULTS: Of 269 horses presenting with acute abdominal disease, 50.2% had blood glucose concentrations greater than the reference range (75.6-131.4 mg/dL); 0.4%, below the reference range; and 49.4%, within the reference range at admission. Of 269 horses, 2.3% had blood glucose concentrations below the reference range at some point during the first 48 hours of hospitalization, all of which had strangulating intestinal lesions. Horses that did not survive to hospital discharge had a higher mean blood glucose concentration at admission; at the first sample after admission; at 24, 36, and 48 hours after admission; and higher maximum and minimum blood glucose concentrations in the first 24 hours after admission. CONCLUSIONS AND CLINICAL IMPORTANCE: Derangements of blood glucose concentration are common in horses with acute abdominal disease. Hyperglycemia is much more common than hypoglycemia in these animals. Hyperglycemia in the first 48 hours of hospitalization is associated with a worse prognosis for survival to hospital discharge.     

Strangulated umbilical hernias in horses: 13 cases (1974-1985)

The medical records of 13 horses with strangulated umbilical hernias were reviewed. Typical history included increased swelling, warmth, and firmness of the hernial sac. Enterocutaneous fistulas had developed in 2 horses. Four horses had signs of abdominal pain. Surgery was performed on all horses, and the hernia was reduced by an open reduction technique. Incarcerated tissue included omentum (1 horse), jejunum (5), ileum (4), cecum (1), and ventral colon (2). All horses survived and were discharged from the hospital. Follow-up information on 9 horses (5 to 52 months after discharge) revealed no complications in 6 horses. Of the remaining 3 horses, one horse was euthanatized 5 months after discharge because of laminitis. One horse had persistent drainage from the skin incision requiring removal of nonabsorbable suture material 8 months after discharge. One foal required a second surgery because of signs of abdominal pain 17 days after the initial surgery. The foal was euthanatized during surgery because of severe peritonitis secondary to anastomotic leakage.     

Complications of umbilical hernias in horses: 13 cases (1972-1986)

Of 147 horses treated for umbilical hernias over a 13.5-year period, 13 horses (8.8%) developed complications in association with umbilical defects. Six horses had intestinal incarceration; the incarceration was reduced manually in 3 horses before admission, resolved without treatment in 2 others, and was surgically reduced in one. Herniorrhaphy was performed on 4 of the 5 horses in which the incarceration did not require surgical reduction, and the fifth was managed conservatively. A horse with a parietal hernia and a horse with intestinal stragulation were treated surgically; in the latter, the involved intestine was resected. These 8 horses recovered. Three horses developed an umbilical abscess and 2 developed an enterocutaneous fistula through their umbilical hernias. Four of these horses responded well to surgery, but one horse with an enterocutaneous fistula died from electrolyte imbalances and peritonitis after an unsuccessful attempt at simple closure. The results of this study confirmed that complications of umbilical hernias are rare in horses; however, when they do develop, they may be one of various forms, some of which are insidious in onset.     

Hoof wall wound repair

REASONS FOR PERFORMING STUDY: Surgical stripping of the hoof wall results in a wound that heals remarkabley well. In contrast, lamellae recovering from laminitis are often deformed. Investigating lamellar wound healing may aid understanding of laminitis. OBJECTIVES: To document temporal changes in the lamellar basement membrane (BM), dermis and epidermis after surgery. METHODS: Wall strips were made in the dorsal hoof wall midline of 6 mature horses. Immunohistochemistry was used to document changes in the basement membrane (BM) and detect proliferation of epidermal cells in lamellar tissues harvested at intervals. A conforming metal plate was screwed to the hoof wall to maintain alignment of the wound edges. RESULTS: Wall stripping caused lamellar tips to snap and remain behind in the dermis along with the majority of the lamellar BM and some lamellar basal cells. Three days later the BM was intact and new lamellae had been reconstructed by proliferation of surviving epidermal cells. By 5 days the surface of the stripped zone was covered with yellow epidermis that subsequently thickened and hardened. Eventually the hoof wall deficit was replaced by new wall growing down from the coronet. The conforming metal plate and post operative analgesic ensured minimal lameness. CONCLUSIONS AND POTENTIAL RELEVANCE: In wall stripped lamellae the BM survives virtually intact and is used as a template for proliferating cells, from snapped-off lamellar tips, to migrate and quickly achieve repair to near normality. In laminitis epidermal dysadhesion and lamellar BM destruction occurs and lack of a functional BM template may explain the prolonged and abnormal repair of affected lamellae.     

Objective radiographic assessment of abdominal sand accumulation in horses.

Gastrointestinal sand accumulation is a common cause of equine colic. Subjective assessment of sand accumulation on abdominal radiographs has been used as a diagnostic aid; however, there is poor correlation between clinical, diagnostic, and surgical findings. The purpose of this study was to develop an objective method of assessing radiographic sand accumulation in order to improve the diagnostic utility of radiography for sand colic. Fifty-one equine abdominal radiographic examinations were reviewed, with approximately half of the imaged patients having a clinical diagnosis of sand colic. Initially, four observers independently reviewed these radiographic studies to subjectively decide whether or not sand accumulation was sufficient to cause colic. Subsequently, an objective scoring system was developed using various radiographic parameters that yielded a score ranging from one to 12 for quantity and apparent density of sand accumulation. Inter- and intraobserver results using the subjective scoring method had significant differences among all observers. Subjective assessment was also deemed to be inaccurate for colic prediction. Using the objective scoring system, there were no significant differences between or within the observers' results. A score of seven out of 12 was found to have an 83% likelihood of being associated with a positive diagnosis of sand colic. The designed objective scoring method creates a more uniform and accurate method to assess the sand accumulation.     

A new surgical technique For repair of perineal hernias in the dog

A new surgical technique is described for the repair of perineal hernias. Transposition of both the internal obturator muscle and the superficial gluteal muscle together was used to repair 52 hernias in 44 dogs. The technique gave a strong pelvic diaphragm, fewer postoperative complications than other techniques and good long term results.