Hand-assisted laparoscopic reattachment of a mesoduodenojejunal defect in a broodmare

In this report, a jejunal entrapment through a presumptive chronic mesenteric defect extending over approximately 20 cm of the duodenojejunal region was found as a cause of acute onset colic in a multiparous broodmare. Mesenteric reattachment during the initial exploratory laparotomy was deemed unsafe given the majority of the avulsion could only be palpated deep within the abdomen. Following recovery and an uneventful parturition 12 days later, the mare returned 18 days post-foaling for attempted, standing laparoscopic reattachment of the mesentery. The procedure was converted to a hand-assisted technique and reattachment completed using a mechanical suturing device and knotless, unidirectional barbed suture. The mare was discharged 3 days post-operatively, bred 28 days following discharge and a singleton pregnancy confirmed 15 days post-ovulation and 46 days following laparoscopy. There were no signs of abdominal discomfort noted in the first 8 months following surgery. In summary, a standing, right-sided hand-assisted laparoscopic approach provided effective visibility to the mesoduodenojejunal region.     

Chronic intermittent colic in a mare attributed to uterine marbles

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

Case Report: Recurrence of a Gastrosplenic Ligament Entrapment

A 12-year-old American Quarter Horse gelding presented for evaluation of colic signs. The patient was diagnosed with a gastrosplenic entrapment at surgery. The entrapment was reduced, a jejunoileostomy was performed removing approximately 1m of jejunum and distal ileum, and the patient recovered uneventfully from anesthesia. The patient was discharged 12 days postoperatively. The same horse represented 17 months after the initial surgery for evaluation of signs of colic. A small intestinal strangulation was diagnosed based on the clinical and laboratory examination findings. It was elected to euthanize the horse. Necropsy examination diagnosed a gastrosplenic ligament entrapment of the mid-to-distal jejunum.     

Entrapment of the small colon through a mesocolic rent in a mare

A 6-year-old mare was presented for acute abdominal pain unresponsive to analgesics. Exploratory laparotomy revealed entrapment of the small colon through a 12 cm rent in the mesocolon. The incarcerated small colon was manually reduced and the rent in the mesocolon was sutured closed. The mare made excellent postoperative recovery and was discharged from the hospital 4 days later. The cause of the rent, which was chronic in appearance, is unknown.     

Thoracotomy for repair of a large dorsal diaphragmatic hernia in an 18‐year‐old mare

An 18‐year‐old Arabian‐mix mare was presented with a history of severe colic. Emergency exploratory celiotomy revealed diaphragmatic hernia, with a large rent in the left dorsal aspect of the diaphragm and large colon volvulus. Attempts to close the defect in the diaphragm in dorsal recumbency were unsuccessful. Therefore, a thoracic approach through lateral thoracotomy was elected, and a mesh was attached to the diaphragm using skin staples. While in dorsal recumbency, the mare suffered from significant respiratory acidosis. Thus, the mare was tilted into reverse Trendelenburg (30° head upward) and ventilation improved markedly. The mare recovered uneventfully, and was doing well 5 years after surgery.     

Segmental ischaemic necrosis of the jejunum in a post-partum mare due to two mesenteric avulsions

This report describes segmental ischaemic necrosis of the small intestine 4 days after foaling in a 9-year-old Arabian mare. The jejunal mesentery was avulsed from the intestine in two locations for 20 and 200 cm, resulting in intestinal necrosis, in the absence of entrapment or strangulation. This case highlights the need to consider the possibility of mesenteric injury when a post-partum mare presents mild signs of abdominal pain.     

Gabapentin for the treatment of neuropathic pain in a pregnant horse

CASE DESCRIPTION: A 24-year-old 732-kg (1,610-lb) pregnant Belgian draft horse mare developed neuropathy and signs of intractable pain following colic surgery. CLINICAL FINDINGS: Following recovery from colic surgery to treat compression of the small and large intestines because of a large fetus, the mare was noticed to have signs of femoral neuropathy involving the left hind limb. Within 36 hours after recovery, the mare developed signs of severe pain that were unresponsive to conventional treatment. No gastrointestinal tract or muscular abnormalities were found, and the discomfort was attributed to neuropathic pain. TREATMENT AND OUTCOME: The mare was treated with gabapentin (2.5 mg/kg [1.1 mg/lb], PO, q 12 h). Shortly after this treatment was initiated, the mare appeared comfortable and no longer had signs of pain. Treatment was continued for 6 days, during which the dosage was progressively decreased, and the mare was discharged. The mare subsequently delivered a healthy foal. CLINICAL RELEVANCE: Gabapentin appeared to be a safe, effective, and economical treatment for neuropathic pain in this horse.     

Displacement of the large colon associated with nonsurgical correction of large-colon entrapment in the renosplenic space in a mare

Nonsurgical correction of a renosplenic entrapment of the large colon was attempted in a mare, using a rolling technique. After correction, the mare had initial improvement in clinical signs, but later developed signs of abdominal discomfort. A ventral midline celiotomy was performed, and a pelvic flexure impaction and large intestinal volvulus were found and corrected.     

Partial gastrectomy and total splenectomy for the treatment of a gastric mass in a horse

A 9-year-old cob mare with a history of recurrent colic presented during an acute colic episode. Ultrasonography revealed a mass emanating from the greater curvature of the stomach and was tightly adhered to the cranial edge of the spleen. Partial gastrectomy and total splenectomy were performed via a midline celiotomy incision. The mass was subsequently confirmed to be granulomatous inflammation, postulated to be secondary to a penetrating injury to the stomach. Post-operatively, the mare had episodes of recurrent colic that were successfully managed with optimisation of the horse's diet and feeding regime. At 10 months’ post-operatively the mare was managed on full turn out, with no evidence of colic and had returned to the previous level of ridden work. The horse then presented 14 months post-operatively with severe colic due to a large colon impaction and displacement and was euthanased. This is the first report to describe successful partial gastrectomy as a treatment option for a gastric mass in the horse.     

Septic peritonitis in a Percheron mare associated with Clostridium haemolyticum

This report describes an 11‐year‐old Percheron mare that presented with signs of colic and was ultimately diagnosed with bacterial peritonitis of unknown origin. Bacterial culture of a peritoneal fluid sample isolated 2 Clostridial species, one of which was strongly suspected to be Clostridium haemolyticum. The horse was markedly hypoalbuminaemic at presentation, leading to the development of low oncotic pressure and ventral oedema. The mare was administered a low molecular weight/low molar substitution hydroxyethyl starch solution in conjunction with other therapies that resulted in marked improvement of clinical signs. The purpose of this report is to describe the clinical findings associated with equine peritonitis associated with C. haemolyticum, a rarely identified pathogen in the horse. Secondly, this report serves to describe the beneficial effects of tetrastarch administration in a clinical case with severe hypoalbuminaemia and ventral oedema.     

Acupuncture and traditional Chinese veterinary medicine for treatment of a mare with rectal paralysis

An 8‐year‐old Appaloosa mare with rectal paralysis due to a cosmetic ethanol ‘tail block’ was treated with traditional Chinese veterinary medicine treatments including acupuncture and herbal medicine. Her rectal and tail tone gradually improved after the treatment. At 4 months after initial presentation, the mare was able to produce faecal piles on a regular basis, and manual evacuations were no longer needed. Significant improvement was within 30 days of beginning treatment. At 8 months, the owner indicated that the mare had normal defaecation, was able to swish the tail from side to side and lift the tail to urinate, and had no evidence of straining to defaecate or colic.     

Intestinal carcinoid in a mare: an etiologic consideration for chronic colic in horses

Intestinal carcinoid, or argentaffinoma, should be an etiologic consideration for horses with chronic colic. A mare was referred with a history of chronic colic. Previously, the signs of colic had subsided in response to impiric treatment, but recent episodes of colic did not. Clinical signs and results of physical examination supported the finding of strangulating obstruction of the small intestine. Exploratory celiotomy revealed internal herniation with simultaneous volvulus of the jejunum and accompanying carcinoid.     

Treatment using cannabidiol in a horse with mechanical allodynia

A 4-year-old Quarter Horse mare was seen in the field by Colorado State University's Equine Sports Medicine Service for a 5-week history of marked sensitivity to touch near the withers/shoulder region. On examination, the mare showed a marked adverse response to light touch over the caudal neck and withers region. Diagnostic imaging of the caudal neck, withers and shoulder region showed no significant abnormalities. Vital parameters, complete blood count and chemistry profile were also within normal limits, as was a reproductive ultrasound examination. The mare received dexamethasone, gabapentin, magnesium/vitamin E, prednisolone and aquapuncture with no improvement in clinical signs. The mare was then started on pure crystalline cannabidiol (250 mg by mouth twice daily), which resolved the clinical signs after 2 days.     

Case report of atypical infiltrative lipomatosis of the equine mesojejunum

A 25‐year‐old mare was examined for persistent colic. Over the previous month, the mare had experienced several episodes of mild recurrent colic. The episode of colic persisted for 18 h and the pain became unresponsive to analgesic therapy. Euthanasia was undertaken. Post mortem examination revealed an atypical infiltrative lipoma of the mesojejunum, confirmed histopathologically. To the authors' knowledge, this is the first case report of a diffuse infiltrative lipoma of the equine mesojejunum.     

Rupture of the mesocolon as a cause of recurrent colic in a showjumper mare

An 11‐year‐old Italian Saddlebred showjumper mare was referred for investigation of recurrent colic. The mare had undergone surgery for left dorsal displacement of the ascending colon 5 years previously and had subsequently experienced several episodes of colic that had responded to medical treatment. Due to deterioration of the mare's clinical condition in the last episode, characterised by unrelenting pain and worsening of the cardiovascular parameters, the mare underwent repeat surgery for suspected colonic displacement. Exploratory laparotomy revealed a complete rupture of the mesocolon of the ascending colon. The mesocolon was repaired and the mare recovered uneventfully. She returned to training and competition and only a single episode of mild transient colic was recorded in the follow‐up.     

Panniculitis in a horse with peripancreatitis and pancreatic fibrosis.

A 22-year-old pinto mixed breed mare was admitted for evaluation of severe colic signs and gastric reflux. Multiple nonpainful, variably sized hard masses were palpated in the subcutis over the thorax, abdomen, and hindquarters of the horse. The mare was diagnosed with sterile peritonitis and had systemically high gamma-glutamyltransferase, amylase, and lipase. Three days into treatment she became febrile with signs of persistent and mild abdominal discomfort; euthanasia was elected. Necropsy revealed peripancreatitis, pancreatic fibrosis, abdominal steatitis and panniculitis. Panniculitis associated with peripancreatitis has been described in humans and dogs but not in horses. Pathogenic models for this entity are discussed.     

Jejunoileal incarceration and strangulation through a splenic defect in a mare.

A 6-year-old, standardbred mare was presented for colic of 12 h duration. Transrectal palpation revealed intestinal distension of unknown cause. The mare was euthanized. At necropsy, segmental jejunoileal incarceration and strangulation through an opening in the spleen was observed. This opening was considered to be a congenital defect.