Internal (intra‐abdominal) herniation in the horse

Internal abdominal hernias are an uncommon occurrence in the horse. Protrusion of an abdominal organ or viscus may occur through a normal or pathological aperture within the peritoneal cavity, and incarceration of bowel through such an opening may lead to a strangulating obstruction of the intestine, characterised by luminal blockage and concurrent vascular compromise. As such, entrapment of bowel in internal hernias can represent an important indication for colic surgery in the horse.     

Eosinophilic intestinal diseases of the horse

Eosinophilic intestinal diseases of the horse are not commonly reported. Similar diseases are reported in man, but for either species, these eosinophilic diseases, are poorly understood. Eosinophilic intestinal disease may be accompanied by eosinophilic disease of other organs, or eosinophilia may be restricted to the intestine. When infiltration of eosinophils is restricted to the intestine, horses have a good prognosis for resolution of clinical signs, even though the treatment may include celiotomy with intestinal decompression or resection and administration of a corticosteroid. When eosinophilic intestinal disease is accompanied by infiltration of other organs, such as skin, pancreas, lungs or liver, the horse's prognosis for survival is very poor.     

Small intestinal volvulus in 115 horses: 1988-2000

OBJECTIVE: To evaluate the historical data, signalment, clinical signs, results of laboratory analyses, treatment, and outcome of horses with small intestinal (SI) volvulus. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: One hundred and fifteen client-owned horses, aged 1 month to 21 years. METHODS: Clinical signs, laboratory data, surgical or necropsy findings, and outcome for horses with SI volvulus were obtained from medical records, identified by computer search and manual review. RESULTS: There was no statistical difference in signalment between cases and the hospital population. Seventy-four percent of horses were >/=3 years. There were considerable variations in clinical signs on admission; high heart rate and signs of severe pain were not consistent features. Examination per rectum identified distended small intestine in only 69% of horses. One hundred horses had surgery, and small intestine resection was performed in 25. Eighty-four horses were recovered from surgery, and 67 horses survived to hospital discharge (80% of horses recovered from surgery, 58% of 115 horses). Forty-eight percent that were ultimately discharged had a post-operative complication and these horses had a longer average stay than horses with no complication (11 days versus 8.9 days). CONCLUSIONS: We identified 115 horses with primary SI volvulus over a 12-year period. We found that the population of horses with this lesion was older than has previously been reported and that the prognosis for post-operative survival to hospital discharge is good (80%). Post-operative complications were common, and affected approximately half the horses that were ultimately discharged from the hospital. CLINICAL RELEVANCE: This information may aid diagnosis and prognosis and guide decision making for horses with this condition.     

Small intestinal biopsy and resection in standing sedated horses

Diagnostic laparotomy and laparoscopy are surgical techniques commonly used for the investigation of chronic abdominal disease and weight loss. They can both be usefully carried out in the standing sedated horse, allowing a thorough examination of the dorsal abdominal cavity and biopsies to be harvested. Small intestinal disease is an important cause of weight loss and recurrent colic. Inflammatory or neoplastic bowel disease may not always be apparent grossly and histopathological assessment of full thickness biopsies may be required to provide a definitive diagnosis. Details of cases of 15 horses that underwent small intestinal biopsy or enterectomy while sedated and standing are presented. Three incisional infections occurred causing delayed wound healing. Three horses were subjected to euthanasia before hospital discharge: two had persistent gastric reflux and one had colitis. A further six were subjected to euthanasia in the first 4 months due to their underlying inflammatory bowel condition. One horse was subjected to euthanasia for severe laminitis that was presumed to be caused by treatment with a corticosteroid 4 years later, and one died of acute colic 2.3 years after successful resection and anastomosis. Five horses were alive at the time of review, median 2.7, range 1.2–4.3 years. Overall therefore, 3 (20%) horses died during hospitalisation and 5 (33%) were still alive at the end of the study. Results from this series suggest that minimising the number of intestinal biopsies may reduce morbidity, but the underlying pathological process appears to be the most important prognostic factor for survival. Resection and anastomosis in the standing sedated horse proved feasible.     

Jejunal incarceration by an omental tear in a dog.

A 2-year-old male mixed-breed dog was examined after being hit by a car, and exploratory celiotomy revealed jejunal incarceration through an omental tear. The affected intestinal segment was distended and black, and had small serosal tears. Clinical signs of disease and hematologic, serum biochemical findings during surgery were consistent with concurrent diagnosis of sepsis. The dog responded to supportive treatment and resection of the affected intestinal segment by jejunal end-to-end anastomosis.     

Small intestinal adenocarcinoma in a horse

A 21-year-old mare was evaluated for intermittent episodes of apparent abdominal pain of 6 month's duration. Abdominal palpation per rectum revealed distended small intestine in the caudal portion of the abdomen. Ventral midline celiotomy revealed a mass in the midjejunal region. The mass was resected, and a side-to-side anastomosis performed. The histologic diagnosis was tubular adenocarcinoma of the small intestine. The mare was still alive 13 months after surgery.     

Hypoglycemia and hepatic ischemic necrosis after small intestinal incarceration through the epiploic foramen in a horse.

A 16-year-old stallion was presented to the Louisiana State University Veterinary Teaching Hospital for evaluation of acute abdominal pain. Physical examination and diagnostic procedures indicated a strangulating obstruction of the small intestine. At exploratory celiotomy, a strangulating incarceration of the jejunum through the epiploic foramen was found. The incarcerated small intestine was reduced, then resection of the nonviable bowel and anastomosis performed. After surgery, the horse exhibited clinical signs and laboratory findings associated with hypoglycemia and died in spite of emergency treatment. On post-mortem examination, a large thrombus was present in the portal vein at the level of the epiploic foramen and the liver had multiple large infarcted areas. The post-operative signs of hypoglycemia and necropsy findings of widespread hepatic ischemic necrosis are complications of epiploic foramen incarceration of the small intestine not previously reported and may in part explain the high mortality rate described for this lesion.     

Incarceration of the caecum through a rent in the gastrosplenic ligament

A 3-year-old Thoroughbred gelding presented with acute signs of colic and tachycardia. Transabdominal ultrasonography revealed a viscus visible on the left and right sides of the cranioventral abdomen with a mural thickness of up to 1.6 cm. Exploratory laparotomy was performed under general anaesthesia. This revealed that the caecum was incarcerated through a rent in the gastrosplenic ligament, and the caecal apex was in the left caudal abdomen. The ventral aspect of the gastrosplenic ligament was ligated and transected. The caecum was freed, and normal orientation confirmed. The horse recovered uneventfully from surgery. Caecal mural thickness was monitored using daily ultrasonography, until normal. The horse was discharged from the hospital 11 days post-operatively. Five months later, the horse returned to race training.     

Small colon obstruction by an ovarian pedicle as an acquired condition in a foal

This report describes the clinical course and the surgical findings in a 7‐day‐old foal referred for signs of abdominal pain. The foal underwent abdominal celiotomy due to the degree of pain unresponsive to medical treatment and, upon exploration, an ovarian pedicle was found to be wrapped around the small colon. The lesion was corrected, the foal recovered well from anaesthesia, and a 4 month follow‐up revealed no other signs of abdominal pain or complications.     

Simultaneous presence of a seminoma and a leiomyoma in the testes of a horse

An 18‐year‐old stallion was presented for castration because of insidious, bilateral scrotal enlargement of one year's duration. The left testis was firm, while the right was soft and lobulated; both were larger than normal. Palpation of the scrotum and its contents did not cause the horse to show signs of discomfort. Ultrasonography of scrotal contents revealed abnormal, heterogeneous tissue with ill defined regions of hyper‐ and hypoechogenity throughout both testes. Several hours after admission the horse developed severe signs of colic. On the basis of anamnesis, clinical findings, and results of ultrasonography and transrectal palpation bilateral testicular neoplasia and incarcerated inguinal hernia were tentatively diagnosed. Because the horse's owner did not consent to surgical treatment, the stallion was subjected to euthanasia. Histological and immunohistochemical examination of the testicular tissue collected post mortem revealed a seminoma in the left testis and a leiomyoma in the right testis. The post mortem examination also revealed incarceration of the small intestine in addition to the testicular tumours. To our knowledge, this is the first report of the simultaneous presence of bilateral, yet different testicular tumour types in a stallion.     

Single‐port laparoscopic incisional hernia repair in a horse

A 16‐year‐old Italian Saddle Horse gelding was referred for treatment of an incisional hernia that developed 7 months after a ventral midline laparotomy for treatment of acute abdominal pain. Physical examination revealed a hernia approximately 20 cm long and 15 cm wide on the ventral aspect of the abdomen. Ultrasonography revealed the dimensions of the hernia ring to be approximately 15 cm in length and 10 cm in width. A single‐port laparoscopic incisional hernia repair using an operating 0° laparoscope was performed with an appropriately sized (24 × 18 cm) piece of mesh fixed in place with simple interrupted transabdominal sutures. At 4 weeks post operatively, follow‐up physical examination and ultrasonography confirmed healing of the surgical site with no evidence of hernia recurrence. The same evaluation was done 6 months post operatively, and the horse returned to its previous level of activity 8 months post operatively. In horses, laparoscopic application of mesh should be considered among the treatment options for incisional hernia. In the present case, this technique was performed with a single port using an operative laparoscope, in contrast to the multiportal techniques reported previously. The case presented here demonstrates that single‐port laparoscopic herniorrhaphy is feasible, and allows proper placement of an expanded polytetrafluoroethylene intraperitoneal mesh in horses     

Outbreak of Lawsonia intracellularis on a Standardbred breeding farm in North Carolina

Lawsonia intracellularis is a cause of protein‐losing enteropathy in weanling foals commonly causing signs including diarrhoea, oedema and unthrifty appearance. It has previously been reported as sporadic cases throughout the USA, Canada and Europe. Only recently have outbreaks on a single farm location been reported. The cases reported here are an example of multiple foals on a single farm testing serologically positive for L. intracellularis. These foals ranged in severity from asymptomatic to severely hypoproteinaemic and septic; however, none of the foals ever displayed diarrhoea, which is the most common presenting sign of this disease process.     

Parainguinal laparotomy as an alternative surgical approach for removal of an enterolith in the small colon of a horse

This report describes the use of a parainguinal approach to the abdomen to remove an obstruction in the small colon that could not be removed using an initial ventral midline approach. The use of a parainguinal approach should be considered for removal of an obstruction in the distal portion of the small colon.     

Idiopathic perforating ulceration of the small intestine in five adult horses

Perforating ulceration of the small intestine was diagnosed in 5 adult horses. Affected horses presented with signs of low‐grade colic, depression and inappetance. Abdominal paracentesis yielded abnormal peritoneal fluid in all cases. Perforating ulcers were located at the mesenteric border in 4 horses and the ileum in one horse. All horses had diffuse septic peritonitis. The aetiology of the condition is unknown.     

Effects of mosapride on motility of the small intestine and caecum in normal horses after jejunocaecostomy

The purpose of the present study was to evaluate the prokinetic effects of mosapride with non-invasive assessment of myoelectrical activity in the small intestine and caecum of healthy horses after jejunocaecostomy. Six horses underwent celiotomy and jejunocaecostomy, and were treated with mosapride (treated group) at 1.5 mg/kg per osos once daily for 5 days after surgery. The other six horses did not receive treatment and were used as controls (non-treated group). The electrointestinography (EIG) maximum amplitude was used to measure intestinal motility. Motility significantly decreased following surgery. In the treated group, the EIG maximum amplitude of the small intestine was significantly higher than in the controls from day 6~31 after treatment. These findings clearly indicate that mosapride could overcome the decline of intestinal motility after jejunocaecostomy in normal horses.