Myeloperoxidase assay in plasma and peritoneal fluid of horses with gastrointestinal disease

Gastrointestinal disorders, especially strangulating intestinal obstructions, are still a major cause of illness and death in the horse. Circulating lipopolysaccharides may activate both neutrophils and monocytes. The activated neutrophils release myeloperoxidase (MPO), a specific enzyme with strong oxidative activity. The aim of this study was to evaluate MPO concentrations in the plasma and peritoneal fluid (PF) of horses with colic and to check the hypothesis that these concentrations would be higher in a case of strangulating obstruction than in cases of nonstrangulating disease. By using a specific enzyme-linked immunosorbent assay for equine MPO, we determined the MPO concentrations in horses admitted to a clinic for colic. Horses with nonstrangulating or strangulating obstruction of the large intestine (NSLI or SLI), strangulating obstruction of the small intestine (SSI), or inflammatory bowel disease (IBD) were compared with healthy horses. The horses with SLI, SSI, or IBD had significantly higher MPO levels in plasma and PF than did those in the other 2 groups. The mean plasma level was significantly higher in the horses with NSLI than in the healthy horses. High MPO values in PF indicated necrotic bowel. These results show that neutrophil activation occurs during nonstrangulating and strangulating intestinal obstruction in horses and that the plasma and PF MPO concentrations may be a marker of the severity of the disease.     

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.     

Prevalence and prognostic importance of hypomagnesemia and hypocalcemia in horses that have colic surgery

OBJECTIVE: To determine the prevalence of hypomagnesemia and hypocalcemia in horses with surgical colic. ANIMALS: 35 horses with surgically managed colic. PROCEDURE: Serum concentrations of total magnesium (tMg2+) and calcium (tCa2+), as well as ionized magnesium (iMg2+) and calcium (iCa2+) were analyzed before surgery and 1, 3, 5, and 7 days following surgery. A lead-II ECG and pertinent clinical data were also obtained at each time. RESULTS: Preoperative serum tMg2+ and iMg2+ concentrations were below the reference range in 6 (17%) and 19 (54%) horses, respectively. Serum concentrations of tCa2+ and iCa2+ were less than the reference range in 20 (57%) and 30 (86%) horses before surgery. Horses with strangulating lesions of the gastrointestinal tract had significantly lower preoperative serum concentrations of iMg2+ and iCa2+, as well as a higher heart rate than horses with nonstrangulating lesions. Horses that developed postoperative ileus had significantly lower serum concentrations of iMg2+ after surgery. Serum concentrations of magnesium and calcium (total and ionized) correlated significantly with the PR, QRS, QT, and corrected QT (QTc) intervals. Horses that were euthanatized at the time of surgery (n = 7) had significantly lower preoperative serum concentrations of iMg2+, compared with horses that survived. Neither serum magnesium nor calcium concentrations were predictors of hospitalization time or survival. CONCLUSIONS AND CLINICAL RELEVANCE: Hypomagnesemia and hypocalcemia were common during the perioperative period, particularly in horses with strangulating intestinal lesions and ileus. Serum concentrations of tMg2+ and tCa2+ were less sensitive than iMg2+ and iCa2+ in detecting horses with hypomagnesemia and hypocalcemia.     

The usability of peritoneal lactate concentration as a prognostic marker in horses with severe colic admitted to a veterinary teaching hospital

Colic can be a life‐threatening condition in horses and there is a need for parameters that can help determine the prognosis and need for surgery. The aim of the study was to investigate whether peritoneal fluid (PF) lactate concentration is useful for this purpose in horses with severe colic presented to a veterinary hospital. During a 16 month period, the peritoneal fluid (PF) lactate concentration was measured in 74 of 760 colic horses admitted to the Utrecht University equine clinic using a portable analyser. When comparing survivors and nonsurvivors, heart rate, PF and blood lactate concentrations and blood glucose concentration were significantly higher in horses that did not survive. No horse with a PF lactate concentration >9.4 mmol/l survived. The presence of a strangulating lesion was also significantly associated with nonsurvival, as was PF colour: no horse with red PF survived in the present series. In horses with yellow PF, the blood glucose concentration was correlated with the presence of a strangulating intestinal lesion. Peritoneal lactate concentrations can be easily and rapidly measured using a portable analyser and may be useful in assessing the prognosis and/or need for surgery in equine colic cases.     

Plasma serotonin in horses undergoing surgery for small intestinal colic

This study compared serotonin concentrations in platelet poor plasma (PPP) from healthy horses and horses with surgical small intestinal (SI) colic, and evaluated their association with postoperative ileus, strangulation and non-survival. Plasma samples (with EDTA) from 33 horses with surgical SI colic were collected at several pre- and post-operative time points. Serotonin concentrations were determined using liquid-chromatography tandem mass spectrometry. Results were compared with those for 24 healthy control animals. The serotonin concentrations in PPP were significantly lower (P < 0.01) in pre- and post-operative samples from surgical SI colic horses compared to controls. However, no association with postoperative ileus or non-survival could be demonstrated at any time point. In this clinical study, plasma serotonin was not a suitable prognostic factor in horses with SI surgical colic.     

Clinical comparison between a continuous Lembert pattern wrapped in a carboxymethylcellulose and hyaluronate membrane with an interrupted Lembert pattern for one-layer jejunojejunostomy in horses

Reasons for performing study: Although experimental studies have demonstrated differences in performance between methods for handsewn jejunojejunostomy in horses, information on clinical results after different methods of anastomosis are rare. Hypothesis: A continuous Lembert pattern wrapped in a carboxymethylcellulose and hyaluronate membrane would perform better than an interrupted Lembert pattern for jejunojejunostomy in horses. Methods: Data was reviewed on 32 horses that underwent jejunojejunostomy from 1993–2002. Kaplan‐Meier analyses and rates for post operative colic and death were used to compare outcomes after an interrupted Lembert pattern (15 horses with strangulating lesions and 5 horses with nonstrangulating lesions) and a continuous Lembert pattern with membrane (12 horses with strangulating diseases). Results: None of the 32 horses had post operative ileus or post operative endotoxaemia. One horse with a continuous pattern required a repeat celiotomy for anastomotic impaction. Short‐term survivals for the interrupted Lembert were 100% (nonstrangulating lesions) and 93% (strangulating lesions) and for the continuous pattern 92% (all strangulating). Long‐term rates for mortality and colic episodes were less for the continuous Lembert pattern with membrane compared with the interrupted Lembert for strangulating lesions (P<0.05) and were less for strangulating lesions than for nonstrangulating lesions (P<0.05). For strangulating lesions, Kaplan‐Meier analyses yielded a survival probability of 70% for up to 9 years after the interrupted Lembert pattern and 80% for up to 5 years for the continuous Lembert pattern. Conclusions and relevance: Both Lembert patterns performed well in clinical use, although the continuous pattern with the carboxymethylcellulose and hyaluronate membrane had superior long‐term outcomes with less colic and mortality from colic.     

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.     

Ultrasonographic features of pedunculated lipomas in two horses

Small intestine strangulation by pedunculated lipomas is a common cause of acute colic in horses. However, diagnosis of this condition prior to surgery may be difficult due to the poor specificity of the clinical signs. We describe the ultrasonographic findings of 2 horses presented for acute colic with a diagnosis of strangulating lipoma confirmed in surgery. Lipomas were identified as rounded and well‐defined, homogeneous hyperechoic structures, surrounded by distended small intestine loops and peritoneal fluid. Ultrasonographic identification of lipomas should be attempted during an abdominal scan, especially in horses with evidence of small intestinal ileus and/or obstruction.     

Short-and long-term evaluation of surgical treatment of strangulating obstructions of the small intestine in horses: a review of 224 cases

A retrospective study was carried out of 224 horses operated for strangulating small intestine obstructions. Fifty-four horses were euthanized and 5 horses died during surgery which means that 165 (73%) were allowed to recover. Of these, 53 horses were euthanized or died in the clinic and 112 (50%) were discharged from the hospital. Of 90 horses available for follow-up 1 year postoperatively, 76 (84%) were still alive. The most important causes of death or reasons for euthanasia in the direct post-operative period were post-operative paralytic ileus, (adhesive) peritonitis and intra-abdominal haemorrhage. After discharge from the hospital the reasons were (adhesive) peritonitis and (recurrent) colic. Of the horses which survived for at least 1 year, 16% sometimes suffered from colic, 12% experienced problems with incisional woundhealing and 4% suffered from jugular vein thrombosis. All were in good or reasonable condition and 88% performed at (approximately) the same level as before the operation. The type of surgical intervention (i.e. enterotomy, enterectomy) did not significantly influence the outcome of surgery, whereas the type of anastomosis did. End-to-end jejunojejunostomy had a better prognosis than side-to-side jejunocaecostomy. It was concluded that strangulating obstructions of the small intestine still carry a poor to guarded prognosis. Mortality was highest in the direct peri-operative period. Once discharged from hospital, prognosis can be considered to be fair to good. Attempts to improve outcome should be directed at a better handling of the ileal stump during surgery and at the prevention of post-operative ileus and the formation of adhesions.     

Risk factors associated with development of postoperative ileus in horses.

OBJECTIVE: To determine risk factors associated with development of postoperative ileus in horses undergoing surgery for colic. DESIGN: Case-control study. ANIMALS: 69 horses that developed ileus after surgery for colic and 307 horses that did not develop postoperative ileus. PROCEDURE: Signalment, history, clinicopathologic data, treatment, lesions, and outcome were obtained from medical records. RESULTS: Variables associated with increased risk of postoperative ileus included age > 10 years, Arabian breed, PCV > or = 45%, high serum concentrations of protein and albumin, anesthesia > 2.5 hours' duration, surgery > 2 hours' duration, resection and anastomosis, and lesions in the small intestine. Enterotomy reduced the risk of postoperative ileus. After multivariate logistic regression, the final model included the variables Arabian breed, PCV > or = 45%, lesion type, duration of surgery (> 2 hours vs < or = 2 hours), and pelvic flexure enterotomy. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that by evaluating certain factors, horses at increased risk of postoperative ileus may be recognized before the condition develops. Preventative treatment and early intervention may be instituted in these horses. Shortening surgery time and performing an enterotomy may decrease the probability of horses developing postoperative ileus.     

The characteristics of intestinal injury peripheral to strangulating obstruction lesions in the equine small intestine.

Recent studies suggest that horses requiring surgical correction of strangulating intestinal obstruction may develop post operative complications as a result of ischaemia/reperfusion injury. Therefore, the mucosal and serosal margins of resected small intestine from 9 horses with small intestinal strangulating lesions were examined for evidence of ischaemia/reperfusion injury. Severe mucosal injury and marked elevations in myeloperoxidase activity were detected at ileal resection margins (n = 4), whereas the mucosa from proximal jejunal (n = 9) and distal jejunal (n = 5) resection margins was normal. However, the serosa from jejunal resection margins had evidence of haemorrhage and oedema, and the proximal jejunal serosa had significantly increased numbers of neutrophils. Histological injury in ileal stumps is indicative of the inability fully to resect the ileum in horses with distal small intestinal strangulations. One of 4 horses subjected to ileal resection was subjected to euthanasia and found to have a necrotic ileal stump. Evidence of serosal injury and neutrophil infiltration in the proximal jejunal resection margins may predispose horses to post operative adhesions. Four of 8 horses discharged from the hospital suffered from recurrent colic in the post operative period.     

Surgery: Short‐ and long‐term evaluation of surgical treatment of strangulating obstructions of the small intestine in horses: A review of 224 cases

Summary

A retrospective study was carried out of 224 horses operated for strangulating small intestine obstructions. Fifty‐four horses were euthanized and 5 horses died during surgery which means that 165 (73%) were allowed to recover. Of these, 53 horses were euthanized or died in the clinic and 112 (50%) were discharged from the hospital. Of 90 horses available for follow‐up 1 year postoperatively, 76 (84%) were still alive. The most important causes of death or reasons for euthanasia in the direct post‐operative period were post‐operative paralytic ileus, (adhesive) peritonitis and intra‐abdominal haemorrhage. After discharge from the hospital the reasons were (adhesive) peritonitis and (recurrent) colic. Of the horses which survived for at least 1 year, 16% sometimes suffered from colic, 12% experienced problems with incisional woundhealing and 4% suffered from jugular vein thrombosis. All were in good or reasonable condition and 88% performed at (approximately) the same level as before the operation.

The type of surgical intervention (i.e. enterotomy, enterectomy) did not significantly influence the outcome of surgery, whereas the type of anastomosis did. End‐to‐end jejunojejunostomy had a better prognosis than side‐to‐side jejunocaecostomy.

It was concluded that strangulating obstructions of the small intestine still carry a poor to guarded prognosis. Mortality was highest in the direct peri‐operative period. Once discharged from hospital, prognosis can be considered to be fair to good. Attempts to improve outcome should be directed at a better handling of the ileal stump during surgery and at the prevention of post‐operative ileus and the formation of adhesions.     

Colic in geriatric compared to mature nongeriatric horses. Part 2: Treatment,diagnosis and short‐term survival

Reason for performing study: Owners and veterinarians are often concerned about mortality of geriatric horses following colic surgery. Objective: To compare treatment, diagnosis and short‐term survival for geriatric compared to mature nongeriatric horses with colic. Methods: Medical records of horses admitted with a presenting complaint of colic between 2000 and 2006 were reviewed. Geriatric horses were aged ≥16 years (n = 300) and subcategorised as age ≥20 years (n = 134). Mature nongeriatric horses were age 4–15 years (n = 300). Information obtained included medical (included horses subjected to euthanasia without surgery) vs. surgical management, lesion location, type and classification, surgical procedures performed and short‐term survival. Data were analysed using a Chi‐squared test or an analysis of variance. Level of significance was P<0.05. Results: The overall short‐term survival of geriatric horses was lower than that for mature horses (59 vs. 76%, respectively). The survival of medically managed geriatric horses was lower than that for mature horses (58 vs. 80%, respectively). The survival of surgically managed geriatric horses was not different to that for mature horses (59 vs. 70%, respectively) except for geriatric horses age ≥20 years (53%). There was no difference in survival between geriatric and mature horses with small (86 and 83%, respectively) or large (78 vs. 70%, respectively) intestinal strangulating lesions or those undergoing jejunojejunostomy (75 vs. 70%, respectively). Geriatric horses with a large colon simple obstruction had a lower survival compared to mature horses (80 vs. 97%, respectively). Conclusions and potential relevance: The survival of geriatric horses with a strangulating lesion or requiring jejunojejunostomy was not different to that for mature horses. Geriatric horses presenting with colic were more likely than mature horses to be subjected to euthanasia without surgery (i.e. lower survival with medical treatment). Geriatric horses undergoing surgery for a large colon simple obstruction had a lower survival than mature horses.     

The Influence of Training and Simulated Race on Horse Plasma Serotonin Levels

Exercise represents a physical stress that challenges homeostasis affecting central and peripheral serotoninergic systems. The influence of the exercise on circulating serotonin (5-hydroxytryptamine [5-HT]) levels depends on training state as well as the exercise protocol. The purpose of the present research was to determine changes of plasma 5-HT in sport horses in response to training (T) and simulated race (SR) and in addition to assess the possible presence of significant differences on circulating 5-HT between two different sessions of exercise. In particular, the research was carried out on 18 trained horses performing daily training and race activity. Plasma 5-HT levels were analyzed in platelet poor plasma fraction by ELISA assay at T0 (before exercise), T1 (30 minutes after exercise) and T2 (2 hours after exercise). The hypothesis was that both exercise sessions could affect plasma 5-HT levels. Results showed a significant increase of plasma 5-HT levels at T1, compared with T0, both after simulated race and training activity. These effects are probably related to an increased 5-HT release from platelets and/or an increased peripheral 5-HT synthesis induced from exercise. At T2, plasma 5-HT concentrations showed a significant decrease to physiological levels in both sessions. Moreover, plasma 5-HT levels at T1 (SR) were significantly higher than those at T1 (T). Targeting peripheral 5-HT could be useful to assess the physiological adaptability of horses to the exercise, together with other selection techniques of sport horses.     

Evaluation of plasma catecholamine and serum cortisol concentrations in horses with colic

OBJECTIVE: To evaluate plasma epinephrine and norepinephrine concentrations and serum cortisol concentration in horses with colic and assess the relationship of these variables with clinical signs, routinely measured clinicopathologic variables, and outcome in affected horses. DESIGN: Prospective observational study. ANIMALS: 35 horses with colic. PROCEDURE: Blood samples were collected within 30 minutes of arrival at the veterinary hospital from horses referred because of colic. Plasma and serum samples were analyzed for cortisol, epinephrine, norepinephrine, lactate, and electrolyte concentrations and acid-base variables. Heart rate at admission and outcome (survival or nonsurvival) were recorded. Univariate logistic regression was used to calculate crude (unadjusted) odds ratios and 95% confidence intervals. RESULTS: Of the 35 horses with colic, 26 survived. Higher plasma epinephrine, plasma lactate, and serum cortisol concentrations were significantly associated with increased risk of nonsurvival, but plasma norepinephrine concentration was not associated with outcome. Plasma epinephrine concentration was significantly correlated with heart rate (r = 0.68), plasma lactate concentration (r = 0.87), blood pH (r = -0.83), anion gap (r = 0.74), and base excess (r = -0.81). CONCLUSIONS AND CLINICAL RELEVANCE: The risk of death appears to be greater in colic-affected horses with high circulating concentrations of epinephrine and cortisol. The correlation of epinephrine with other biochemical markers of illness severity and with heart rate indicates that the degree of sympathetic activation in horses with colic can be inferred from routinely measured variables.     

Colic in geriatric compared to mature nongeriatric horses. Part 1: Retrospective review of clinical and laboratory data

Reason for performing study: It is the impression of some surgeons that geriatric horses have a lower survival rate compared to mature nongeriatric horses following colic surgery. One possible reason for this is that geriatric horses may be more critically ill at admission and have more severe disease than mature nongeriatric horses. Objective: To compare admission historical, physical examination and laboratory data for geriatric and mature nongeriatric horses referred for signs of colic. Methods: Medical records of horses admitted with a presenting complaint of colic between 2000 and 2006 were reviewed. Geriatric horses ≥16 years (n = 300) and mature nongeriatric horses 4–15 years (n = 300). Information obtained included duration of colic prior to admission, admission level of pain, heart rate, intestinal borborygmi, packed cell volume (PCV), plasma creatinine and blood lactate concentrations and peritoneal fluid total protein. Data were analysed using a Chi‐squared test or an analysis of variance. Level of significance was P<0.05. Results: There was no difference between geriatric and mature horses in the duration of colic prior to admission or in admission heart rate, PCV, or plasma creatinine or blood lactate concentrations. However, geriatric horses were more likely to be moderately painful and less likely to be bright and alert than mature horses; and less likely to have normal intestinal borborygmi than mature horses. Peritoneal fluid total protein concentration was higher in geriatric than mature horses. Conclusions and potential relevance: Geriatric horses presenting with signs of colic had a similar admission cardiovascular status based on heart rate, PCV, and plasma creatinine and blood lactate concentration to mature horses. Geriatric horses, however, may have different causes of colic, which may be more serious than mature horses based on pain, lack of intestinal borborygmi and peritoneal fluid total protein concentration.     

Activin A as a novel biomarker of equine inflammatory abdominal disease: preliminary findings

This study evaluated the inflammatory mediator activin A in horses with acute abdominal disease and compared this putative novel biomarker with serum amyloid A (SAA). Thirty-three adult horses referred for evaluation of acute abdominal disease were grouped into three lesion categories, non-strangulating, strangulating or inflammatory. Eleven healthy adult horses served as controls. Serum activin-A was significantly increased in animals with inflammatory or strangulating lesions compared with controls. Horses with non-strangulating, strangulating or inflammatory lesions had significantly elevated SAA concentrations. Activin A, along with other biomarkers, may be useful in monitoring inflammation in cases of acute abdominal disease in horses. Further validation is warranted to determine the utility of this biomarker in evaluating the effectiveness of novel anti-inflammatory treatments for equine colic and endotoxaemia.     

Analysis of Sodium Carboxymethylcellulose Administration and Related Factors Associated with Postoperative Colic and Survival in Horses with Small Intestinal Disease

Objective— To analyze the effect of the intraoperative use of sodium carboxymethylcellulose (CBMC) and related perioperative factors on postoperative colic and survival in horses that had abdominal surgery for colic.
Study Design— Retrospective study.
Animals— Horses (n=203) that had surgery for small intestinal disease; 33 horses had intraoperative administration of CBMC.
Methods— Information was obtained from medical records for 170 horses that had surgery for colic before use of CBMC and 33 horses that had intraoperative CBMC. Kaplan–Meier survival curves were used to estimate median survival time and a Cox proportional hazards model was used to estimate the hazard ratio for the effect of CBMC and other perioperative variables on survival.
Results— Seventy-five percent of horses administered CBMC survived to 180 days, whereas 75% of untreated horses survived 8 days (median survival time=18 days). Horses not administered CBMC were twice as likely to die compared with horses administered CBMC. Horses that had postoperative ileus (POI) were 1.4 times more likely to die than horses without ileus. Similarly, horses with signs of colic after surgery were 1.3 times more likely to die than horses without postoperative signs of colic.
Conclusions— CBMC administration is seemingly protective against death and prolongs survival when used intraoperatively in horses with small intestine disease, particularly horses with postoperative colic or POI. Both POI and colic increased risk of death after surgery.
Clinical Relevance— Intraoperative administration of CBMC in horses that have surgery for small intestinal disease may improve survival, possibly by reducing early adhesion formation.     

Resection and Anastomosis of the Descending Colon in 43 Horses

Objectives: To determine (1) the short‐ (to hospital discharge) and long‐ (>6 months) term survival, (2) factors associated with short‐term survival, and (3) the perioperative course for horses with resection and anastomosis of the descending colon. Study Design: Multicentered case series. Animals: Horses (n=43) that had descending colon resection and anastomosis. Methods: Medical records (January 1995–June 2009) of 7 equine referral hospitals were reviewed for horses that had descending colon resection and anastomosis and were recovered from anesthesia. Retrieved data included history, results of clinical and clinicopathologic examinations, surgical findings, postsurgical treatment and complications, and short‐term survival (hospital discharge). Long‐term survival was defined as survival ≥6 months after hospital discharge. Results: Of 43 horses, 36 (84%) were discharged from the hospital. Twenty‐eight of 30 horses with follow‐up information survived ≥6 months. No significant associations between perioperative factors and short‐term survival were identified. Lesions included strangulating lipoma (n=27), postfoaling trauma (4), infarction (4), intraluminal obstruction (2), and other (6). Common postoperative complications included fever and diarrhea. During hospitalization 7 horses were euthanatized or died because of septic peritonitis (3), endotoxemia (3), and colic and ileus (1). Conclusions: Descending colon resection and anastomosis has a favorable prognosis for hospital discharge and survival ≥6 months. The most common cause of small colon incarceration was strangulating lipoma. Clinical Relevance: Complications include postoperative fever and diarrhea but the prognosis is good after small colon resection and anastomosis.     

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.