Correlation Between Peritonitis and Incisional Infections in Horses

Surgical site infection of abdominal incisions is an important complication after laparotomy with increased risk of incisional hernia formation in horses. This study aims to evaluate the healing process of abdominal incisions and correlate peritonitis with the occurrence of surgical site infection and incisional hernias. Nine horses underwent standardized laparotomy, intestinal exploration, and induced septic peritonitis. Standardized relaparotomy was performed two (n = 3), four (n = 3), and six (n = 3) months later to evaluate the abdominal cavity for adhesions and to collect the sutured ventral abdominal wall to evaluate and prepare it for histopathological and tensile strength study. All horses presented with endotoxemia, controllable peritonitis, heat and touch-sensitive ventral abdominal edema and surgical wound infection with presence of purulent discharge. Adhesion of the cecum or colon to the internal portion of the surgical wound was observed. Healing of the infected surgical wounds occurred by second intention and a space between the rectus abdominis muscles developed because of the presence of a scar, which was related to incisional hernia. In the histopathological evaluation, the collagen content increased, and the inflammation decreased over time. The tensile strength increased over time and was highest after 6 months. After the second surgical intervention, there was no infection of the surgical wound in any of the animals and healing by first intention occurred. Surgical site infection may be a symptom of peritonitis in horses recovering from abdominal surgery. Infected surgical wounds heal by second intention, which favors the spacing of rectus abdominis muscle and the formation of incisional hernia.     

Histological Changes in the Deep Branch of the Lateral Palmar Nerve of Horses With Induced Proximal Suspensory Desmitis

Desmitis of the proximal aspect of the suspensory ligament, or interosseus medius muscle, of the pelvic or thoracic limb is a commonly diagnosed cause of lameness of performance horses. Despite medical treatments available for horses with proximal suspensory desmitis (PSD), most horses treated medically for PSD of a pelvic limb remain persistently lame; this persistent lameness may be the result of a neuropathy caused by compression of nerves by an enlarged suspensory ligament. Few horses with PSD of a thoracic limb remain persistently lame. Based on the results of reports citing successful treatment of horses chronically lame because of PSD of a pelvic or thoracic limb, by excising a portion of the deep branch of the lateral plantar or palmar nerve (DBLPlN/DBLPaN), we theorized that persistent lameness of horses caused by PSD of a thoracic limb may also be due to compression of nerves that supply the ligament. The aim of this study was to determine if histological signs of compression neuropathy of the DBLPaN are present in horses with PSD in a thoracic limb. To test this hypothesis, we induced PSD by instilling collagenase into the ligament and then examined the DBLPaN after harvesting this nerve 2 months later. We found that the DBLPaNs of all treated limbs showed histologic changes suggestive of nerve compression. We conclude that studies examining the DBLPaN of horses with naturally occurring PSD for histological evidence of neuropathy are warranted.     

Effects of Topical Application of Sunflower-Seed Oil on Experimentally Induced Wounds in Horses

The objectives were to evaluate clinical and histopathological aspects of topical application of sunflower-seed oil (Helianthus annuus) on the healing process of experimentally induced wounds in lumbar and metacarpal areas of healthy horses. Six adult horses were used. Eight wounds were surgically produced on each horse: two 6.25-cm² wounds cranial to the sacrum on each side of the lumbar region and two 2.89-cm² wounds close to the proximal epiphysis of the metacarpus on the lateral aspect of each forelimb. Left side was used for macroscopic observations and right side for histopathological analysis. The experimental lesions were treated daily with sunflower-seed oil, whereas saline solution was used in control lesions. Macroscopic and histopathological analyses were performed on tissue harvested at 3, 7, 14, and 21 days. Complete healing time for all wounds was recorded. For lumbar region’s wounds, a contraction of 90.78% was recorded for those treated with oil and of 79.27% for control wounds after 21 days of treatment. For metacarpal region’s wounds, a contraction of 47.63% was recorded for wounds treated with oil and of 30.21% for control wounds. Wounds in the sunflower-seed oil treatment group had an elevation of polymorphonuclear cells, a newly formed vascular bed during the inflammatory phase, and a better alignment of collagen fibers during the remodeling phase. In conclusion, topical application of sunflower-seed oil was beneficial in the healing process of experimentally induced skin wounds in horses, with best results for treatment of lumbar wounds, making it a therapeutic option in equine wound healing.     

Plasma Concentration of Glucosamine and Chondroitin Sulfate in Horses after an Oral Dose

This study was conducted to study absorption of glucosamine (GlucN) and chondroitin sulfate (CS) in horses immediately after feeding. Six mature mares were used in a replicated 3 × 3 Latin-square-designed experiment. The experiment consisted of three 15-day periods, which included 10 days of diet adaptation followed by a 5-day sampling period. Blood was drawn after feeding on one day during each sampling period. Horses were fed a control diet (40% hay, 60% concentrate) balanced to meet NRC requirements for maintenance of mature horses (NRC, Nutrient requirements of horses, 1989). In one experimental diet, 2.0 g CS and 5.5 g GlucN were added to the basal ration at each feeding. In the other experimental diet, 3.5 g CS and 8.5 g GlucN were added to the basal ration at each feeding. After collections, blood was centrifuged and plasma was harvested and stored until analyzed for the presence of each compound. Analyses for plasma GlucN were performed using high-performance liquid chromatography. CS in the plasma was analyzed using a color reagent, dimethylmethylene blue, followed by ultraviolet spectrophotometry. There were no significant differences (P < .05) in the concentration of either CS or GlucN in plasma, when comparing the three different diets. This leads to a conclusion that these compounds were not absorbed intact through the intestinal wall into the bloodstream. This poses a question as to whether oral forms of these compounds are absorbed and are able to migrate to joints through the blood to improve joint function.     

Adverse Effects of Zilpaterol Administration in Horses: Three Cases

Three healthy horses were fed the beta-adrenergic agonist feed additive zilpaterol at a dosage of 0.17 mg/kg body weight to study zilpaterol elimination kinetics. Soon after ingestion of zilpaterol, the horses developed skeletal muscle tremors and tachycardia. A 75 to 87.5% reduced dose of zilpaterol was fed to the horses 24 hours after the initial dose; administration was discontinued thereafter. The horses exhibited restlessness, muscle tremors, and profuse sweating 20 to 25 minutes after ingestion of zilpaterol. Tachycardia developed within 40 minutes and took up to 2 weeks to resolve. Muscle tremors lasted up to 1 week. The most pronounced derangements in serum biochemistry were increased activities of lactic dehydrogenase, creatine kinase, and aspartate transferase, indicating muscle damage. The most severely affected horse also had transient azotemia, hematuria, and proteinuria, suggesting renal damage. All three horses recovered without treatment and were clinically normal 2 to 3 weeks after the initial dose of zilpaterol. Because of their anabolic properties, beta-adrenergic feed additives are considered a risk for abuse in performance horses, despite the absence of Food and Drug Administration approval for such use. Oral administration of zilpaterol to horses at the dosage indicated for use in cattle may result in prolonged adverse effects, including tachycardia, muscle tremors, and renal damage.     

Evaluation of Urinary Variables as Diagnostic Indicators of Acute Kidney Injury in Egyptian Draft Horses Treated With Phenylbutazone Therapy

The present study was undertaken to evaluate the diagnostic significance of various urinary variables to detect acute kidney injury (AKI) in Egyptian draft horses treated with phenylbutazone (PBZ) therapy. Medical records of 52 draft horses, with a history of musculoskeletal painful conditions and treated frequently with various daily doses of injectable PBZ, were reviewed. Of those 52 horses, 38 were enrolled in this study. AKI was tentatively diagnosed based on thorough history and clinical findings and in conjunction with multiple biochemical screening tests. Accordingly, diseased horses were categorized into two main groups; the first group included 14 horses with prerenal azotemia, whereas the second group included 24 horses with renal azotemia. Biochemically, urinary malondialdehyde, urinary gamma-glutamyl transferase/creatinine (Cr) ratio, urinary protein/Cr ratio, urinary glucose, urinary sodium, fractional excretion of sodium, and renal failure index were significantly higher (P < .05) in horses of group 2 than those of group 1. However, values of urinary Cr, urine/plasma Cr ratio, urinary urea, and urine/plasma urea ratio were significantly decreased (P < .05) in horses of group 2. Analysis of receiver operating characteristic curve showed high sensitivity and specificity of most tested urinary variables as well as their derived indices for detection of AKI in diseased horses. Our findings suggest that the examined urinary variables as well as their ratios are helpful in documenting AKI associated with PBZ nephrotoxicity in Egyptian draft horses; however, their interpretation should be done in the light of the specific clinical setting and in conjunction with a thorough clinical and physical examination.     

Occurrence of Trypanosoma evansi in Horses in the State of Minas Gerais,Brazil

Ttrypanosomosis caused by Trypanosoma evansi is a condition that causes significant losses to farmers in endemic areas. This study aimed to report one case of trypanosomiasis in the municipality of Itabira, state of Minas Gerais, Brazil. In November 2010, on a farm with 16 horses, three horses had clinical signs of anemia, limb edema, weight loss, lameness, muscle atrophy, and incoordination of the hind limbs. Trypanosomosis was suspected, and the animals with clinical signs were treated with two doses of diminazene aceturate (7 mg/kg, intramuscular) every 7 days; the treated animals recovered from the clinical symptoms. Blood samples were collected from six horses on the farm, including the three treated animals, to perform polymerase chain reaction specific for T evansi. Four samples were polymerase chain reaction negative, including those collected from three treated horses. However, two other asymptomatic horses were positive for the parasite based on the molecular testing. Based on the results, we concluded that the initial clinical suspect of trypanosomosis was correct, and the treatment used was effective. Probably the disease was introduced to Minas Gerais State through a stallion, which acquired the infection in an endemic area in southern Brazil.     

Tramadol Effects on Lameness Score After Inhibition of P-GP by Ivermectin Administration in Horses: Preliminary Results

This study aimed to evaluate the effects and lameness degree in horses administered tramadol after the P-glycoprotein (P-gp) enteric inhibitor ivermectin. Six horses were randomly distributed into three groups, which received two different doses of tramadol by a nasogastric tube: 1 mg/kg (tramadol group 1(GT1)), 4 mg/kg (tramadol group 4 (GT4)), and tramadol 1 mg/kg combined with ivermectin 0.2 mg/kg PO (ivermectin tramadol group (GT1 + Ive)), with one-week washout interval. Heart rate (HR), respiratory rate (RR), intestinal motility, body temperature, and the degree of lameness were evaluated for 360 minutes. The blood gas parameters were evaluated at 0, 60 minutes, and 120 minutes. There were no differences in HR and the degree of lameness. Hypomotility occurred in GT1 and GT4 only at the end of the evaluation period, and RR increased in all groups. We conclude that inhibition of enteric P-gp by ivermectin did not alter the effects of tramadol, suggesting that tramadol is not a substrate for P-gp. However, future studies should be conducted to assess the interaction between P-gp inhibitors on the pharmacokinetics of tramadol.     

Efficacy of Hyperimmunized Plasma in the Treatment of Horses with Acute Colitis

Colitis in the adult horse is a life-threatening clinical condition that can be caused by any of several enteric pathogens. This study was conducted to determine whether treating horses with plasma obtained from donors that were hyperimmunized against the common equine diarrheal pathogens Clostridium difficile, Clostridium perfringens, and Salmonella sp shortens the duration of diarrhea in acute colitis. To evaluate the efficacy of plasma treatment, 42 horses with acute onset of diarrhea were studied. Horses were enrolled if they were of age >1 year, duration of diarrhea at presentation was <72 hours, and they had not received equine plasma within the last 3 months. In addition, the serum cortisol concentrations of horses with acute diarrhea were studied.Horses were randomized to receive hyperimmunized plasma, control plasma (collected from nonimmunized horses), or no plasma therapy. Clinical parameters and fecal consistency were observed until resolution, discharge, or death, and complete blood counts (CBCs) and biochemical profiles were collected throughout the study. A total of 38 horses completed the study. The mean duration of diarrhea was 40.7 ± 9.8 (mean ± SEM) hours, 119.2 ± 56.1 hours, and 72.0 ± 24.5 hours for the hyperimmunized plasma, normal plasma (NP), and control groups, respectively. Using survival analysis techniques, this difference did not achieve statistical significance (P = .374). Serum cortisol was found to be increased in all horses at presentation and to decrease with time in all treatment groups. There was no difference in cortisol concentrations between the three treatment groups studied (P = .237).     

Evaluation of Plasma Detectable Concentrations of Two Lidocaine Transdermal Formulations and Their Analgesic Effect in the Horse

Transdermal absorption of four lidocaine (L) patches (5%) was compared with the transdermal absorption of L cream (5%) to evaluate the pharmacokinetics of the two formulations applied on the same anatomic region under dressing in eight horses. The animals were also assessed for antinociceptive effect after removal of the patches and cream, using a psychophysical method visual analog scale, by pricking the patient's skin to test the response to pain. Horses were randomly assigned to four treatment groups: in groups I and II, four L patches were applied for a period of 24 hours with and without alcohol precleaning, respectively; in group III, 5% L cream was applied every 2 hours over a 24-hour period on the same anatomic site. Group IV was the control. No clinical side effects were noted with either formulation. L was detectable in plasma 6 to 24 hours after application of the patches, and the highest plasma concentrations were reached between 12 and 18 hours. The use of alcohol to preclean the skin appeared to reduce the transdermal drug absorption over time. After L cream application, the peak plasma drug concentration occurred at 24 hours. Nociception assessment after L patch or L cream application showed a decreased response when the L cream was used. The results of this study showed that there was minimal absorption from the L patches compared with the L cream in horses. Also, the L cream treatment reduced significantly the intensity of nociception quality as measured by the visual analog scale.     

Application of Platelet-Rich Gel to Enhance Wound Healing in the Horse: A Case Report

A large torn wound of the dorsal elbow region was observed in a 17-year-old Arabian mare. Surgical reconstruction was performed with the horse in standing sedation, but suture dehiscence occurred 2 days later. Autologous platelet-rich gel (PRG) was then applied to the wound every 3 weeks for a total of 3 administrations to accelerate good-quality healing. The wound had healed rapidly and completely within 5 months of the first PRG treatment, without chronic effects or formation of exuberant tissue granulation and with minimum scarring. This case report suggests that topical treatment with autologous PRG, as additional therapy, might be considered beneficial in the management of large-wound healing in horses, and it can be regarded as safe and inexpensive treatment that can be used in field.     

Tissue Doppler Imaging and Two-dimensional Speckle Tracking of Left Ventricular Function in Horses Affected with Recurrent Airway Obstruction before and after Clenbuterol Treatment

Cardiac effects of the β₂-adrenergic agent clenbuterol have been the focus of many studies, but effects on myocardial velocities and myocardial deformation parameters have not yet been evaluated in horses affected with recurrent airway obstruction (RAO) using tissue Doppler imaging (TDI) and two-dimensional speckle tracking (2DST). In our study, 7 horses affected by RAO were treated over 14 days with clenbuterol, 0.8 μg/kg every 12 hours. Standard echocardiographic, TDI (pulsed wave and color TDI), and 2DST examinations were performed before and after the treatment period. Myocardial function was recorded in the right parasternal short-axis view. Percent of fractional shortening and two-dimensional echocardiography (2DE) measurements did not show any significant changes after 2 weeks of treatment. Early diastolic velocity, E, increased significantly after clenbuterol in the left ventricular free wall (LVFW; P = .001). The E/late diastolic velocity (A) quotient (P = .003) and the isovolumetric contractility (P = .035) also increased significantly after treatment. Time parameters, particularly the time interval between the Q-wave in the echocardiograph and atrial release, the time of diastole and Tei index (parameter of global ventricular function), decreased significantly after clenbuterol administration in the LVFW (P = .014/P = .028/P = .015, respectively). The 2DE speckle tracking revealed a significant increase of the early diastolic systolic strain rate (P = .01) in the LVFW after therapy. In conclusion, 2 weeks of treatment with clenbuterol at a dosage of 0.8 μg/kg every 12 hours led to improved cardiac function in severely RAO-affected horses. This could be a sign of myocardial restoration (re-remodeling) after therapy.     

Platelet-Rich Plasma as an Adjunctive Therapy for the Management of a Severe Chronic Distal Limb Wound in a Foal

Distal limb wounds are frequent in horses after traumatic events. The use of platelet-rich plasma (PRP) represents a simple method of treating wounds in equines. A case of a chronic severely contaminated distal limb wound in an 8-month-old foal is presented. The patient was managed with the combination of standard wound therapy (debridement and bandages), surgery, and PRP obtained by a manual tube protocol. No complications were observed with the PRP treatment, and the foal was fully recovered 2 months later. The results from this case report indicate that PRP and its by-products (platelet-poor plasma) could be used as an adjunctive treatment in severe distal limb wounds in horses. A clinical controlled study should be performed to test this hypothesis.     

Mineral Status and Interrelationship in Soil,Forage, and Blood Serum of Horses in the Rainy and Dry Seasons

The objective was to evaluate the content of P, Ca, Mg, K, Na, Cu, Fe, Zn, Se, and Mn in soil, forage, and serum of horses in several production units (PU) during rainy and dry seasons and predict their concentration in serum from their content in soil and forage. Soil and pastures were sampled in the dry (November–December) and in rainy seasons (June–July), and blood samples were collected from the jugular vein of 76 horses in both seasons at four PU. The experimental design was a completely random design within a 4 × 2 (PU × season) factorial arrangement of treatments. Concentration of minerals in soil differed (P < .05) among PU, and contents of P, Ca, Mg, and K were low; Zn and Fe were high; and Cu and Mn were adequate. Mineral concentrations in forage differed among PU and season, and among PU within season (interaction P < .05). Contents of Ca, Mg, Na, Zn, and Cu were low; Fe was high; and P, K, Se, and Mn adequate. The mineral concentration in equine blood serum differed (P < .05) among PU and season. Overall, there were deficiencies of P, Ca, Mg, Na, Cu, and Se, but adequate amounts of K, Zn, and Fe. There are imbalances of minerals in soil and forages which effected their concentration inequine blood.     

Histologic Evaluation of Palmar Digital Nerves after Perineural Injection of 2% Ammonium Chloride in Miniature Horses

Neurolytic compounds are widely used by equine practitioners for the management of lameness, mostly related to the foot. The present study aimed to evaluate the neurotoxicity of 2% ammonium chloride (2% AC) applied adjacent to the palmar digital nerves in six miniature horses. The 2% AC and 0.9% saline solution were randomly injected into three and one palmar digital nerve of each horse, respectively. Nerve samples were collected by neurectomy performed under general anesthesia at 5, 12, 19, 35, 47, and 62 days after treatment, with one horse per day of surgery. The inflammatory reaction to perineural injection was evaluated by an increase of pastern superficial skin temperature through thermography 24 hours after treatments. Histological lesions were classified as absent, mild, moderate, and severe Wallerian degeneration. An increase of 2.43 ± 0.79°C and 1.69 ± 0.55°C was observed in the 2% AC and control groups, respectively (P > .05). Moreover, histologic lesions were observed after perineural injection of 2% AC (severe, n = 5/18; moderate, n = 4/18; mild, n = 5/18; and absent, n = 4/18) and saline solution (moderate, n = 3/6; mild, n = 1/6; and absent, n = 2/6) (P = .46). The 2% AC demonstrated to be as safe as 0.9% saline solution, producing mild to severe Wallerian degeneration for up to 62 days after injection with no interference in further neurectomy.     

Rupture of the Vinculum in Association with Tendon Injury within the Digital Flexor Tendon Sheath in Two Horses

The following report documents an unusual anatomical finding in two cases of aseptic tenosynovitis of the digital flexor tendon sheath. Disruption of the vinculum attachment between the palmar/plantar border of the superficial digital flexor tendon and the adjacent palmar/plantar annular ligament was identified in combination with other tendon pathology within the digital flexor tendon sheath. This tenoscopic finding has not been described previously in the literature.     

Autologous Platelet Concentrates as a Treatment of Horses with Osteoarthritis: A Preliminary Pilot Clinical Study

The clinical effect of the intra-articular injection of an autologous platelet concentrate (PC) in four horses with osteoarthritis was evaluated. The degree of lameness and joint effusion and clinical follow-up were recorded. Three injections of PC were performed at 2-week intervals. Horses were evaluated before each injection and two months after the last treatment. Clinical follow-up was conducted for 1 year. Count of platelets, leukocytes, and determination of transforming growth factor beta-1 (TGF-β₁) levels per milliliter PC were performed, as well as leukocyte count, cytology, and protein levels in synovial fluid. PC produced a statistically significant improvement in both the degree of lameness and joint effusion (P < .05). The most marked improvement was observed 2 months after the last treatment and apparently persisted for 8 months. A mean of 250 ± 71.8 × 10⁶ platelets, 8.68 ± 3.78 leukocytes × 10⁶, and 12,515 ± 2,443 pg of TGF-β₁ per milliliter PC were obtained. The evaluated synovial fluid parameters remained between normal values. No adverse clinical signs resulted from this treatment. Despite the seemingly positive effects of this substance, the clinical use of PC cannot be recommended until further studies with higher numbers of cases and longer follow-up can be undertaken.     

Evaluation of the healing of surgically created small colon serosal lesions in horses, treated by homologous pericardium implantation: An experimental study

The healing of serosal lesions created in the small colon of horses and treated by homologous pericardium implantation was evaluated. A standing left flank laparotomy was performed in 6 horses. The small colon was partially exposed, and a defect measuring 2 × 2 cm was created in the serosa between the mesenteric border and the anti-mesenteric taenia. A square piece of homologous pericardium preserved in a 98% glycerin solution was rehydrated, dried, and sutured over the defect. Recovery of the animals was uneventful, with no signs of abdominal discomfort and no significant changes in physiologic variables, intestinal motility, behavior, appetite, or defecation pattern. The same was true for the erythrogram (packed cell volume, red cell count, and hemoglobin concentration), leukogram, and plasma fibrinogen values. The animals were reoperated on through the ventral midline approach after 4, 5, 6, 7, 8, and 35 weeks, respectively, and the implants were inspected visually and collected for microscopic study. No adhesions were found. Initially, there was a rim of fibrotic tissue covering the suture line, which regressed over time and was no longer evident after 7 weeks. From that moment on, progressive integration of the implant to the intestinal serosa was observed. Histopathologic examination revealed a late healing process, with infiltration of mononuclear cells, fibroblasts, neovascularization, and mature collagen fibers, which increased in intensity up to 6 weeks and then progressively regressed. At 5 weeks, it was already difficult to distinguish between the implant and the intestinal serosa. Our conclusion was that homologous pericardium implants have good acceptance in intestinal serosal lesions in horses and offer a good perspective for clinical application.