Small intestine adenocarcinoma in conjunction with multiple adenomas causing acute colic in a horse.

An 11-year-old Andalusian stallion developed marked signs of colic associated with an acute small intestine obstruction. Exploratory laparotomy revealed a distal jejunum full-thickness wall induration and multiple small adherent intraluminal masses. Fifteen centimeters of jejunum, including the induration, and several intraluminal masses were resected. Histologic examination revealed an adenocarcinoma and multiple polypoid adenomas. The horse was discharged, and no complications were reported 12 months postoperatively. Colic was considered secondary to partial jejunal lumen obstruction by the adenocarcinoma. Adenocarcinoma recurrence or transformation from remaining adenomas into an adenocarcinoma is still a major risk.     

Congenital malformation of the large colon causing colic in a horse

An abnormal mesocolic attachment which resulted in a stellate malformation of the left colon adjacent to the pelvic flexure was suspected to be the cause of intermittent episodes of colic in a horse. Resection and side-to-side anastomosis of the large colon at the level of the sternal and diaphragmatic flexures was performed and the horse made an uneventful recovery from surgery. Only minor serum biochemical changes were observed in the initial postoperative period. The abnormal mesocolic attachment was probably a congenital anomaly.     

Bilateral ovarian adenocarcinoma in a mare causing haemoperitoneum and colic

Abstract

CASE HISTORY: A 13-year-old Thoroughbred mare was presented with a history of mild colic over 3 days. This colic had acutely exacerbated and was unresponsive to analgesic treatment, and was referred to Massey University Veterinary Teaching Hospital.

CLINICAL FINDINGS: On examination the heart rate was 100 beats per minute, and mucous membranes were pale and tacky. A large mass was detected on transrectal palpation in the caudal abdomen to the left of midline. Explorative laparotomy revealed severe haemoperitoneum and several masses that were associated with the reproductive tract. The mare was then subject to euthanasia. On post-mortem examination, adjacent and attached to each ovary were soft, lobulated dark red masses up to 200 mm in diameter. Similar masses were present in the omentum and on the peritoneal surface of the diaphragm and the serosa of the spleen and liver. Histopathology revealed that the neoplastic component of the masses comprised proliferating cuboidal to columnar cells forming disorganised acini and cords separated by dense collagenous stroma. Immunohistochemistry showed the neoplastic cells were positive for cytokeratin AE1/AE3 and vimentin, but negative for cytokeratin 7 and inhibin α.

DIAGNOSIS: Bilateral ovarian adenocarcinoma with transcoelomic metastasis and terminal decompensation due to rupture of a neoplastic mass and consequent haemoperitoneum.

CLINICAL RELEVANCE: To the authors' knowledge, bilateral ovarian adenocarcinoma has not been previously reported in a horse. Ovarian adenocarcinoma should be considered when horses present with haemoperitoneum and colic. Further research is required on the immunohistochemical differentiation of adenocarcinoma of ovarian and intestinal origin in the horse.     

Psychogenic colic in a horse

A 4-year-old mixed-breed gelding was presented with colic-type behavior of 5 days' duration that included pawing, looking at the flank area, and kicking and biting at the abdomen and flank when it was eating hay or grain. Medical evaluation did not reveal the cause of the "colic." During its stay in the hospital, the horse improved as regarded the colic-type behavior while eating, but resumed this behavior when it was able to see hay that it was not allowed to eat. It was determined that the persistent colic-type behavior developed as a result of the horse having been repeatedly displaced from its food by other horses. When the horse performed the colic-type behavior, the owner would remain with it and effectively protect it from competitors. The initial bout of colic may have been a result of true colic, psychosomatic colic secondary to stress, redirected aggression, or displacement activity.     

A giant nonstrangulating mesenteric lipoma as a cause of recurrent colic in a horse

Colic is a major cause of veterinary attendance in general practice and although most colic episodes remain isolated, recurrence may occur and definitive diagnosis can be difficult to obtain. This report describes an unusual presentation of a lipoma in a middle‐aged horse presented for recurrent colic. A massive lipoma causing a nonstrangulating space occupying obstruction of the small intestine was found during an exploratory celiotomy and was considered to be the most likely cause of the recurrent episodes of abdominal discomfort.     

Molecular insights into dietary induced colic in the horse

Equine colic, a disorder manifested in abdominal pain, is the most frequent cause of emergency treatment and death in horses. Colic often requires intestinal surgery, subsequent hospitalisation and post operative care, with a strong risk of complications arising from surgery. Therefore strategies that explore approaches for preventing the condition are essential. To this end, a better understanding of the factors and mechanisms that lead to the development of colic and related intestinal diseases in the horse allows the design of preventive procedures. Colic is a multifactorial disorder that appears to be induced by environmental factors and possibly a genetic predisposition. One factor that seems to influence the risk of developing colic is the excessive consumption of diets containing high levels of carbohydrates. Therefore, major efforts have been made by various laboratories and institutions across the world to study the type and digestibility of various feed in order to formulate accurate and safe feed components and proportions. However, relatively little work has been carried out to characterise, in detail, the carbohydrate digestive and absorptive capacity and mechanisms underlying the potential adaptive response of equine gut epithelium to a changing diet. This review focuses on advances made towards understanding the molecular and cellular mechanisms involved in digestion and absorption of dietary carbohydrates in the equine gastrointestinal tract and the implication of these processes for the whole body physiology. It addresses the underlying mechanisms that may govern the adaptive response of equine small intestine to increased dietary hydrolysable carbohydrates. Furthermore, it describes changes that occur in the equine large intestinal microbiology and host tissue biology brought about by alterations in diet and in colic. It is hoped that a better understanding of the molecular and cellular processes that play important roles in the physiology and pathology of the equine gastrointestinal tract will assist the development of effective strategies to prevent equine colic.     

Neurologic signs and hyperammonemia in a horse with colic

A 23-year-old Thoroughbred gelding was referred for the evaluation of acute onset of ataxia and depression, and a 2-day history of fever. On physical examination, the gelding was profoundly depressed and 10-12% dehydrated. The horse appeared very unstable, with a wide-based stance in the hind limbs, severe symmetric ataxia in all 4 limbs, and proprioceptive deficits in both hind limbs. Nasogastric intubation produced 4 L of brown, fetid reflux, and rectal examination revealed mild small intestinal and cecal distention. Hematologic abnormalities included neutropenia with toxic change, compatible with acute inflammation and endotoxemia, and prolonged coagulation times. Serum biochemical abnormalities included prerenal azotemia. metabolic acidosis, and electrolyte abnormalities consistent with enteritis. Blood ammonia concentration was markedly increased (406 micromol/L; reference interval 4-49 micromol/L), however, serum bile acids concentration and hepatic enzyme activities were within reference intervals. Histopathologic examination of a liver biopsy revealed no abnormalities and results of tests for several infectious agents were negative. Clinical signs resolved with correction of the dehydration and electrolyte abnormalities and with antibiotic therapy. The horse was diagnosed with hyperammonemic neuropathy associated with gastrointestinal disease. In such cases, hyperammonemia is caused by increased production of ammonia by organisms in the gastrointestinal tract in combination with increased gut permeability that facilitates ammonia absorption.     

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.     

Intestinal decompression: preliminary study in the horse

A technique of nasoduodenal (N-D) intubation and intestinal decompression was developed and used in the horse to explore the prevention of gastric and intestinal distention after abdominal surgical operation. Three styles of tubes (2 single-lumen tubes and 1 double-lumen tube) were positioned in the duodenum of 12 mature horses (10 experimental and 2 clinical) during laparotomy (without enterotomy), and an iatrogenic occlusion at the small intestine was created and later released in the 10 experimental horses. The 2 clinical horses had an exploratory laparotomy to correct a natural obstruction of the small intestine. After each horse recovered from surgical manipulation, suction was used to keep fluids from accumulating in the cranial part of the gastrointestinal tract. In 5 of the 12 horses, the most simple N-D tube was positioned successfully and functioned properly. Three of the 5 horses which were fasted before surgical manipulation (to obtain an empty stomach) survived without postsurgical complications. Volume of reflux material was measured. Clinical data, such as periods of comfort during decompression without giving analgesics, were recorded. Necropsies were done on 10 of the 12 horses (9 experimental and 1 clinical). Although already tested in 2 clinical horses, use of the N-D tube remains experimental, and the N-D tube functioned only in horses which were fasted before surgical manipulation. Perfection of a safe and dependable means of emptying the equine stomach of its solid ingesta before gastrointestinal intubation is done, is the next step in affording greater clinical application of the N-D tube for gastrointestinal decompression.     

Perirectal abscess, colic, and dyschezia in a horse

A quarter horse gelding with intermittent colic was diagnosed with a perirectal abscess and dyschezia. Rectal ultrasonography identified a multiloculated, fluid-filled mass. A perirectal abscess was diagnosed when the mass ruptured and drained into the rectum. The abscess was treated successfully with warm soapy water enemas and trimethoprim and sulfamethoxazole.