Abdominal adhesions after small intestinal surgery in the horse

One hundred thirteen of 172 horses (66%) undergoing exploratory celiotomy for a small intestinal lesion survived 4 or more days after surgery. Intra-abdominal adhesions causing clinical problems requiring additional surgery or euthanasia were documented in 25 horses (22.1%). Problems developed in significantly more males than females. The most common initial small bowel lesion was ileal impaction (12 horses); 21 horses underwent small intestinal resection or bypass. However, there was no significant difference in the incidence of intra-abdominal adhesions between horses that underwent intestinal resection or bypass and those that did not. Only 4 of the 25 horses (16%) with problems associated with postoperative adhesions survived. The mean interval between surgical procedures or between the initial procedure and euthanasia for all horses was 84 days (range, 7-512 days; median, 25 days). However, 70% of the subsequent celiotomies were performed within 60 days of the previous surgery. The mean interval between celiotomies was 221 days (range, 9-512 days) for the survivors and 61 days (range, 7-358 days) for the nonsurvivors. These results indicated that most of the problems related to postoperative intra-abdominal adhesions occurred within 2 months of the initial small intestinal surgery. Furthermore, the earlier development of postoperative adhesions was associated with a poorer prognosis for survival.     

Abdominal Adhesions after Small Intestinal Surgery in the Horse

One hundred thirteen of 172 horses (66%) undergoing exploratory celiotomy for a small intestinal lesion survived 4 or more days after surgery. Intra-abdominal adhesions causing clinical problems requiring additional surgery or euthanasia were documented in 25 horses (22.1%). Problems developed in significantly more males than females. The most common initial small bowel lesion was ileal impaction (12 horses); 21 horses underwent small intestinal resection or bypass. However, there was no significant difference in the incidence of intra-abdominal adhesions between horses that underwent intestinal resection or bypass and those that did not. Only 4 of the 25 horses (16%) with problems associated with postoperative adhesions survived. The mean interval between surgical procedures or between the initial procedure and euthanasia for all horses was 84 days (range, 7–512 days; median, 25 days). However, 70% of the subsequent celiotomies were performed within 60 days of the previous surgery. The mean interval between celiotomies was 221 days (range, 9–512 days) for the survivors and 61 days (range, 7–358 days) for the nonsurvivors. These results indicated that most of the problems related to postoperative intra-abdominal adhesions occurred within 2 months of the initial small intestinal surgery. Furthermore, the earlier development of postoperative adhesions was associated with a poorer prognosis for survival.     

Putative intestinal hyperammonaemia in horses: 36 cases

Reasons for performing the study: Intestinal hyperammonaemia (HA) has been infrequently reported in individual horses; however, there have been no studies describing clinical and laboratory data as well as short‐ and long‐term outcome in a larger number of cases. Objectives: To describe clinical and laboratory data and short‐ and long‐term outcome in a large group of horses with intestinal HA. Methods: Multi‐centred, retrospective study; case records of horses with HA were reviewed and any horse with a clinical or post mortem diagnosis of intestinal HA was included. Hyperammonaemia was defined as a blood ammonium (NH₄⁺) concentration ≥60 µmol/l and horses with a diagnosis of primary hepatic disease were excluded. Relevant data were recorded and, if appropriate, data from survivors were compared to nonsurvivors to identify potential prognostic indicators. Results: Thirty‐six cases, 26 mature horses and 10 foals with intestinal HA were identified. Case histories included diarrhoea, colic and neurological signs and the most common clinical diagnosis was colitis and/or enteritis. The most common clinical and laboratory abnormalities included tachycardia, increased packed cell volume, hyperlactataemia and hyperglycaemia. Fourteen horses (39%) survived to discharge; NH₄⁺ concentration on admission was the only parameter significantly associated with survival. All surviving horses and foals for which follow‐up information was available recovered completely and returned to their intended use without further complications. Conclusions and potential relevance: Intestinal HA occurs in mature horses and foals and can be associated with severe clinical and laboratory abnormalities; further studies are required to investigate predisposing factors and delineate possible differences in aetiologies.     

Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 3: Long-term complications and survival

REASONS FOR PERFORMING STUDY: Few studies have evaluated long-term survival and complication rates in horses following surgical treatment of colic, making it difficult to offer realistic advice concerning long-term prognosis. OBJECTIVE: To review the complications occurring after discharge from hospital and survival to >12 months after surgery of 300 horses undergoing exploratory laparotomy for acute colic. Pre-, intra- and post operative factors that affected long-term complications and long-term survival were assessed. METHODS: History, clinical findings, surgical findings and procedures and post operative treatments of 300 consecutive surgical colic cases (1994-2001) were reviewed. Long-term follow-up information was retrieved from case records and telephone enquiries from owners. RESULTS: The long-term (>12 months) survival rate for 204 horses discharged after colic surgery and for which follow-up information was available was 84%. The most common complication after discharge was colic, affecting 35.1% of horses following a single laparotomy. Colic was most common in horses that had had small intestinal obstructions, bowel resection or post operative ileus. Abdominal adhesions were most common in horses that presented with severe colic due to strangulation of small intestine. Ventral hernia formation occurred in 8% of horses, and was most common in horses that had had post operative wound drainage or infection. CONCLUSIONS: This study identified various factors that appear to predispose horses to long-term complications after colic surgery. POTENTIAL RELEVANCE: Further evaluation of strategies that might reduce the incidence of such complications are needed; in particular, the value of intraperitoneal heparin should be evaluated, and procedures designed to reduce the rates of wound drainage and infection assessed.     

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)     

Haematogenous septic arthritis in foals: Short‐ and long‐term outcome and analysis of factors affecting prognosis

Synovial sepsis represents a major cause of morbidity and mortality in foals; however, there are no studies focusing on foals particularly at risk during the first 2 months of life. Our objective was to analyse outcome in foals aged <2 months with haematogenous septic arthritis and to identify prognostic factors and compare the effects of two different lavage procedures on outcome. Sixty foals with synovial sepsis were used for our retrospective study in which medical records, online data and telephone interviews were utilised to analyse prognostic factors, and determine short‐ and long‐term survival and athletic performance of foals treated at Evidensia Equine Specialist Hospital, Helsingborg, between 2008 and 2014. Overall survival to discharge was 80% (48/60). Time to long‐term follow‐up ranged from 6 months to 6.5 years. Forty/60 (67%) horses survived long‐term. Four/8 (50%) of the nonsurvivors at long‐term follow‐up had been subjected to euthanasia due to sequelae of joint sepsis. Of the long‐term survivors, 37/40 (92.5%) achieved athletic soundness. Overall long‐term outcome for athletic soundness was 37/60 (62%). Prognostic factors based on historical, clinical or laboratory data, or the use of through‐and‐through needle lavage compared to endoscopic lavage as the first procedure, could not be identified. The present study demonstrates a more favourable prognosis than previously reported, with 80% of foals with synovial sepsis surviving to discharge, and approximately 60% achieving athletic soundness. However, the study was limited by a small population size, which may account for the failure to verify statistically significant prognostic factors.     

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.     

Survival after small intestine resection and anastomosis in horses

The authors examined factors influencing survival in 140 horses that recovered from anesthesia after small intestinal resection between 1968 and 1986, using Kaplan-Meier estimated survival curves and the Cox proportional hazards regression model. Seventy-two horses (51%) died during the initial postoperative period, 19 horses (14%) died after discharge from the hospital, 33 horses (24%) were alive, and 16 horses (11%) were classified as censored. Mean age at surgery was 8 years. Horses 15 years of age or older, Arabians and Stallions, were overrepresented in the hospital population. The most common reason for resection was strangulation of bowel through a mesenteric rent. The mean and 50% median survival times were 1540 and 27 days, respectively. Horses admitted after January 1, 1980, had a significantly longer survival than those admitted before that time. Survival was longer after anastomosis of two small intestinal segments than after anastomosis of a small intestinal segment to the cecum; however, the length of bowel resected and the method of anastomosis had no demonstrable influence on survival. Of the variables studied, the heart rates at presentation and 24 hours after surgery were the most accurate predictors of survival.     

Survival after Small Intestine Resection and Anastomosis in Horses

The authors examined factors influencing survival in 140 horses that recovered from anesthesia after small intestinal resection between 1968 and 1986, using Kaplan-Meier estimated survival curves and the Cox proportional hazards regression model. Seventy-two horses (51%) died during the initial postoperative period, 19 horses (14%) died after discharge from the hospital, 33 horses (24%) were alive, and 16 horses (11%) were classified as censored. Mean age at surgery was 8 years. Horses 15 years of age or older, Arabians and Stallions, were overrepresented in the hospital population. The most common reason for resection was strangulation of bowel through a mesenteric rent. The mean and 50% median survival times were 1540 and 27 days, respectively. Horses admitted after January 1, 1980, had a significantly longer survival than those admitted before that time. Survival was longer after anastomosis of two small intestinal segments than after anastomosis of a small intestinal segment to the cecum; however, the length of bowel resected and the method of anastomosis had no demonstrable influence on survival. Of the variables studied, the heart rates at presentation and 24 hours after surgery were the most accurate predictors of survival.     

Follow-up evaluation of horses after neonatal intensive care

A follow-up study was conducted on 131 foals that were less than 7 days old when admitted to the University of Florida Veterinary Medical Teaching Hospital between 1981 and 1983. Of the 71 foals (54%) that survived to be discharged, 39 (55%) were alive at follow-up evaluation, 19 (27%) could not be located, and 13 (18%) had died. The owners of surviving foals were sent questionnaires and 72% responded. The horses were visited and examined, if geographically possible, and an age-matched stablemate or a sibling also was evaluated and used as a control. Thirteen foals (10% of total admitted) died 1 day to 2 years after discharge. Four (8%) died from suspected sequelae of their neonatal illness. Three other foals appeared stunted as yearlings, but by 2 years of age equaled or passed their stablemates and/or siblings in physical development. The owners' estimated value of the survivors averaged +29,812. The actual selling price of horses that went through sales ranged from +7,000 to +210,000. Most of the horses became useful, athletic adults; several have won major stakes races. All living foals appeared unaffected by the physiologic disorders and treatments they encountered as neonates and compared favorably with stablemates and siblings.     

Clinical assessment and outcome of three techniques for jejunal resection and anastomosis in horses: 59 cases (1989-2000)

OBJECTIVE: To compare postoperative complications, short- and long-term survival, and surgical times for hand-sewn end-to-end (EE), stapled functional end-to-end (FEE), and stapled side-to-side (SS) anastomotic techniques for jejunal resection in horses. DESIGN: Retrospective study. ANIMALS: 59 horses. PROCEDURE: Medical records were reviewed to obtain signalment, diagnosis, treatment, and outcome for horses that underwent jejunojejunostomy in our hospital. Only horses that recovered from anesthesia were included in the study. RESULTS: Among the 59 horses, there were 33 EE, 15 FEE, and 11 SS anastomoses. No difference was found in duration of surgery among the 3 techniques. The most common postoperative complications were colic episodes (56%), ileus (53%), diarrhea (20%), and adhesions (15%). Horses with SS anastomosis had a significantly shorter duration of postoperative ileus than the EE group did. No significant difference in duration of postoperative ileus was found among the other groups. No difference was found among the 3 anastomotic techniques in regard to survival rate at the time of discharge, 6 months after surgery, or 1 year after surgery. Overall survival rates after jejunal anastomosis were 88% at the time of discharge, 65% at 6 months after surgery, and 57% at > or = 1 year after surgery. CONCLUSIONS AND CLINICAL RELEVANCE: The hand-sewn EE, stapled FEE, and stapled SS anastomotic techniques should be considered equivalent methods for small intestinal anastomosis in the horse. However, the stapled SS technique may be preferred because of possible decreased duration of postoperative ileus.     

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.     

Incarceration of the Small Intestine in the Epiploic Foramen Report of 19 Cases (1983–1992)

The medical records of 19 horses referred for colic and subsequently found (18 confirmed, 1 suspected) to have small intestinal incarceration through the epiploic foramen were reviewed. These horses were of various ages and breeds; they had clinical signs of colic for an average duration of 13.5 hours before examination. Seventeen horses had nasogastric reflux, and 15 had palpable small intestinal distention. Three horses were killed during surgery because of severe intestinal damage. Of the remaining 16 horses, 13 required intestinal resection and anastomosis. The length of incarcerated small intestine varied from 8 cm to 17.6 m. The ileum was involved in 12 cases. In one horse, the mesoduodenum was disrupted before surgery, causing intra-abdominal bleeding; incarceration of bowel was not found during surgery. The short-term (1 month) survival rate was 74% (14 of 19 cases), and the long-term survival rate was 63% (12 of 19 cases). The follow-up period was 3 months to 45 months (mean 17.2 ± 7.2 months).     

Retrospective evaluation of repeat celiotomy in 53 horses with acute gastrointestinal disease

Fifty-three of 648 horses (8.2%) treated surgically for acute gastrointestinal obstruction were subjected to repeat celiotomy. Forty horses (75%) recovered from anesthesia after repeat celiotomy, and 26 horses (49%) were discharged from the clinic. Excluding two horses lost to follow-up, 10 of 51 horses (20%) survived long term. Horses subjected to repeat celiotomy had a significantly lower long-term survival rate than horses subjected to a single celiotomy. Twenty-eight horses had mechanical obstructions, and 22 had functional obstructions at the second surgery. Significantly more horses with mechanical obstructions recovered from anesthesia, but there was no difference in short-term or long-term survival. Seventy-seven percent of horses were subjected to two celiotomies without being discharged from the clinic between procedures. The intervals between primary and repeat celiotomies ranged from less than 24 hours to 4 years, with 89% of them being less than 2 months. Horses with functional obstructions at the second surgery had a significantly shorter interval between surgeries than horses with mechanical obstructions. Twenty-three horses had sequelae of the primary celiotomy, 19 had progression of their original disease, 8 had recurrence of the same condition, and 3 had unrelated problems. Intestinal ischemic necrosis was the most common diagnosis at repeat celiotomy, and small intestinal obstruction by adhesions was the second most frequent.     

Retrospective Evaluation of Repeat Celiotomy in 53 Horses with Acute Gastrointestinal Disease

Fifty-three of 648 horses (8.2%) treated surgically for acute gastrointestinal obstruction were subjected to repeat celiotomy. Forty horses (75%) recovered from anesthesia after repeat celiotomy, and 26 horses (49%) were discharged from the clinic. Excluding two horses lost to follow-up, 10 of 51 horses (20%) survived long term. Horses subjected to repeat celiotomy had a significantly lower long-term survival rate than horses subjected to a single celiotomy. Twenty-eight horses had mechanical obstructions, and 22 had functional obstructions at the second surgery. Significantly more horses with mechanical obstructions recovered from anesthesia, but there was no difference in short-term or long-term survival. Seventy-seven percent of horses were subjected to two celiotomies without being discharged from the clinic between procedures. The intervals between primary and repeat celiotomies ranged from less than 24 hours to 4 years, with 89% of them being less than 2 months. Horses with functional obstructions at the second surgery had a significantly shorter interval between surgeries than horses with mechanical obstructions. Twenty-three horses had sequelae of the primary celiotomy, 19 had progression of their original disease, 8 had recurrence of the same condition, and 3 had unrelated problems. Intestinal ischemic necrosis was the most common diagnosis at repeat celiotomy, and small intestinal obstruction by adhesions was the second most frequent.     

Survival rates for horses undergoing stapled small intestinal anastomosis: 84 cases (1988-1997)

OBJECTIVE: To determine whether location and type of small intestinal anastomosis and other variables were associated with short- and long-term survival rates in horses undergoing stapled small intestinal anastomosis. DESIGN: Retrospective study. ANIMALS: 84 horses that underwent small intestinal anastomosis. PROCEDURE: Medical records from 1988 to 1997 were examined for horses that underwent stapled small intestinal anastomosis. Horses were allotted into 4 groups: jejunojejunostomy (n = 27), jejunoileostomy (11), jejunoileocecostomy with small intestinal resection (20), and jejunoileocecostomy without small intestinal resection (26). Survival rates and other variables were determined. RESULTS: Horses that underwent jejunoileocecostomy without resection had a significantly higher survival rate at all intervals than did horses in the other 3 groups. At 180 and 365 days after surgery, horses that underwent jejunojejunostomy had a significantly lower survival rate than those that underwent jejunoileocecostomy with intestinal resection. Horses that underwent jejunoileocecostomy with intestinal resection had a significantly higher survival rate at 1 year, compared with the combined jejunojejunostomy and jejunoileostomy groups. Preoperative heart rate was inversely associated with survival rate. Overall survival rates at discharge and 1 year were 81 and 56%, respectively. For horses that underwent small intestinal resection, survival rates at discharge and 1 year were 65 and 47%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Horses that underwent anastomosis of the small intestine to the cecum without resection had the highest survival rate, compared with horses that required intestinal resection. In some instances, resection and anastomosis involving the cecum had better prognosis than resections involving 2 segments of the small intestine.     

Diaphragmatic hernia in horses: 44 cases (1986–2006)

Objectives – To present a case series of horses diagnosed with diaphragmatic hernia, and to determine the significance of (1) historical information, examination findings, and laboratory data; and (2) exploratory laparotomy or necropsy findings on short- and long-term outcome.
Setting – University Referral Hospital.
Design – Retrospective study.
Animals – Forty-four horses/foals admitted between 1986 and 2006 with a diagnosis of diaphragmatic hernia made either at exploratory laparotomy or necropsy.
Interventions – None.
Measurements and Main Results – Information from the medical records included history, clinical examination findings at presentation, and findings of exploratory laparotomy or necropsy. Logistic regression or the Fisher exact test was used to determine factors associated with survival. Outcome was defined as survival to discharge (short-term survival), and long-term survival was defined as horses alive at least 1-year post surgery. Of the 44 horses, 18 died or were euthanized before surgery. Twenty-six were taken to surgery, 17 were euthanized. Nine horses recovered from anesthesia, 7 of which survived to hospital discharge. Of these, 5 were alive at long-term follow-up. Survival was significantly associated with the age of the horse (≤2 y old) at presentation, presence of normal peritoneal fluid at presentation, amount of compromised viscera at surgery (<50% small intestine), and the size (<10 cm) and location (ventral) of the diaphragmatic tear.
Conclusion – This study confirms that size and location of the lesion do play a significant role in prognosis. And, although the prognosis for horses with diaphragmatic hernia is poor, if horses have operable lesions there is a fair prognosis for long-term survival.     

Idiopathic focal eosinophilic enteritis associated with small intestinal obstruction in 6 horses

OBJECTIVE: To report the history, clinical findings, and outcome of horses with idiopathic focal eosinophilic enteritis associated with acute small intestinal obstruction. STUDY DESIGN: Retrospective study. ANIMALS: Six horses with idiopathic focal eosinophilic enteritis. METHODS: Retrospective review of medical records of horses with idiopathic focal eosinophilic enteritis, with acute abdominal pain and small intestinal obstruction, associated with a focal region of eosinophilic enteritis of unknown cause. Information retrieved from the medical records included signalment, physical examination, laboratory findings, surgical procedure, histologic diagnosis, and postoperative management. Outcome was determined by telephone communication with owners. RESULTS: Six horses met the selection criteria. Horses had persistent pain, distended small intestine, and nasogastric reflux. Idiopathic focal eosinophilic enteritis lesions associated with a small intestinal obstruction were treated surgically by intestinal resection and anastomosis or wedge resection. There were no observed complications associated with extension of the disease from the lesion site. Five horses were alive at follow-up 5 to 60 months after surgery. CONCLUSIONS: Although the cause of these focal eosinophilic enteritis lesions is unknown, the long-term outcome after lesion resection was favorable. CLINICAL RELEVANCE: Small intestinal obstruction associated with a focal eosinophilic enteritis lesion may be a cause of acute abdominal pain in horses. Horses apparently have a good prognosis after lesion resection.     

Exploratory celiotomy for suspected urinary tract disruption in neonatal foals: a review of 18 cases

The medical records of 18 neonatal foals, in which exploratory celiotomies were performed for suspected urinary tract lesions, were reviewed. Despite clinical signs and laboratory values indicative of disruption of the urinary tract, three foals did not have a site of urinary tract leakage at surgery. Eight foals had ruptured bladders and seven foals had urachal lesions. Ultrasonography was used as a pre-operative diagnostic procedure in eight foals to evaluate the presence of free peritoneal fluid and urinary tract integrity. Nine foals were alive six months after discharge. Seven of the nine non-surviving foals died or were destroyed because of fungal or bacterial infections.     

Study of the short- and long-term outcomes of 65 horses with peritonitis

The records of 65 horses with peritonitis examined at two uk referral centres over a period of 12 years were reviewed. Peritonitis was defined in terms of the horse's peritoneal fluid containing more than 5 x 10(9) nucleated cells/l. Horses that had developed peritonitis after abdominal surgery or a rupture of the gastrointestinal tract were excluded. Of the 65 horses, 56 (86 per cent) survived to be discharged. Follow-up information was obtained from practice records and telephone calls to the owners for 38 of the horses. Of these, 32 (84 per cent) had survived for at least 12 months and were considered to be long-term survivors; the others six were euthanased within 12 months. Thirteen (34 per cent) of the horses discharged had experienced complications that could have been sequelae to peritonitis and eight of the 13 were euthanased. The cause of the peritonitis was identified in 15 cases; survival rates were lowest in horses with peritonitis secondary to urinary tract involvement or intra-abdominal masses. Of the other 50 cases, 47 (94 per cent) survived to discharge, but two were euthanased owing to recurrent colic.