Jejunoileal anastomosis following small intestinal resection in horses: seven cases (1999-2001)

OBJECTIVE: To report the postoperative outcome in horses undergoing jejunoileal anastomosis performed with a 2-layer simple continuous technique. DESIGN: Retrospective study. ANIMALS: 7 horses. PROCEDURE: Information regarding signalment, clinical signs, findings at surgery, and postoperative complications was obtained from medical records of horses that underwent exploratory ventral midline celiotomy, small intestinal resection, and jejunoileal anastomosis to correct various small intestinal strangulating lesions. Follow-up information was obtained via telephone conversations with owners or trainers. RESULTS: Six males and 1 female of various breeds aged 10 months to 27 years and weighing 312 to 785 kg (686.4 to 1,727 lb) were included. The most common complications were mild to moderate tachycardia and mild to moderate signs of abdominal pain. Two horses developed incisional infections and soft, fluctuant swelling at the incision site following resolution of the infection. Follow-up time ranged from 7 to 17 months after surgery. Owners reported no further colic episodes and no diet change necessary following surgery. All horses had returned to their intended level of use. CONCLUSIONS AND CLINICAL RELEVANCE: Advantages to the jejunoileal technique include maintaining the normal ileocecal valve and a postoperative recovery period similar to that described following other small intestinal anastomoses. Jejunoileal anastomosis is a viable alternative to ileal bypass. This technique appears to result in a postoperative complication rate similar to that reported following jejunojejunostomy procedures.     

Surgical management of small intestinal incarceration through the gastrosplenic ligament: 14 cases (1994-2006)

OBJECTIVE: To determine prevalence, clinical findings, and long-term survival rate after surgery associated with incarceration of the small intestine through the gastrosplenic ligament (ISIGL) in horses. DESIGN: Retrospective case series. ANIMALS: 14 horses with ISIGL. PROCEDURES: Medical records of horses with ISIGL examined between January 1994 and December 2006 were reviewed. Signalment, initial physical examination findings, results of abdominal fluid analysis, and clinical laboratory values were recorded, along with surgical findings, including segment of incarcerated intestine and surgical procedures performed. Long-term survival data were obtained through client interviews. RESULTS: Clinical findings included small intestinal distention identified via rectal palpation (10/14 horses) or transabdominal ultrasonography (8/11), nasogastric reflux (4/14), and abnormal abdominal fluid (9/9). All horses required intestinal resection and anastomosis. Postoperative complications included adynamic ileus (5/14 horses), incisional infection (4/14), diarrhea (3/14), and laminitis (1/14). No breed or age predilection was detected, although geldings were at increased risk for ISIGL. Long-term survival rate was 79% (11/14 horses). CONCLUSIONS AND CLINICAL RELEVANCE: ISIGL was an uncommon cause of colicin this hospital population. With appropriate surgical intervention and postoperative management, the long-term prognosis for surgically treated horses was fair to good.     

Traumatic brain injury in horses: 34 cases (1994-2004)

OBJECTIVE: To investigate the clinical, clinicopathologic, and diagnostic characteristics; treatment; and outcome associated with acute traumatic brain injury (TBI) in horses and assess risk factors for nonsurvival in TBI-affected horses. DESIGN: Retrospective case series. ANIMALS: 34 horses with TBI. Procedures-Medical records of horses that had sustained trauma to the head and developed neurologic signs were reviewed. Data that included signalment, clinicopathologic findings, diagnosis, treatment, and outcome were analyzed. Clinicopathologic variables among horses in survivor and nonsurvivor groups were compared, and risk factors for nonsurvival were determined. RESULTS: Median age of affected horses was 12 months. Findings of conventional survey radiography of the head alone failed to identify all horses with fractures of the calvarium. Horses with basilar bone fractures were 7.5 times as likely not to survive as horses without this type of fracture. Depending on clinical signs, horses received supportive care, osmotic or diuretic treatments, antimicrobials, anti-inflammatory drugs, analgesics, or anticonvulsants. Twenty-one (62%) horses survived to discharge from the hospital. In the nonsurvivor group, mean PCV was significantly higher, compared with the value in the survivor group (40% vs 33%). Risk factors associated with nonsurvival included recumbency of more than 4 hours' duration after initial evaluation (odds ratio, 18) and fracture of the basilar bone (odds ratio, 7.5). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that prognosis for survival in horses with acute TBI may be more favorable than previously reported. Among horses with TBI, persistent recumbency and fractures involving the basilar bones were associated with a poor prognosis.     

Heel bulb lacerations in horses: 101 cases (1988-1994)

OBJECTIVE: To determine clinical history, structures involved, treatment, and outcome of lacerations of the heel bulb and proximal phalangeal region (pastern) in horses. DESIGN: Retrospective study. ANIMALS: 101 horses. PROCEDURES: Medical records of horses with lacerations of the heel bulb and pastern were reviewed, and follow-up information was obtained. RESULTS: 75 horses were Quarter Horses. Most horses were not treated with antimicrobial drugs prior to referral. Mean +/- SD time from injury to referral was 24 +/- 45 hours (range, 1 to 168 hours). Lacerations were most frequently caused by contact with wire or metal objects. In 17 horses, lacerations involved synovial structures; the distal interphalangeal joint was most commonly affected. One horse was euthanatized after initial examination. Wound treatment consisted of cleansing, lavage, debridement, lavage of affected synovial structures, suturing of fresh wounds, and application of a foot bandage or cast. Fifty-six horses were treated with systemically administered antimicrobial drugs. Follow-up information was collected for 61 horses. Fifty-one horses returned to their intended use and had no further complications; 10 horses had complications associated with the wound, and of those horses, 5 were euthanatized and 1 horse died from an unrelated cause. Horses with lacerations that involved synovial structures had worse outcomes than horses with lacerations that did not involve synovial structures. CONCLUSIONS AND CLINICAL RELEVANCE: Horses that sustain heel bulb lacerations can successfully return to their intended use. Involvement of the distal interphalangeal joint is associated with poor prognosis.     

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.     

Congestive heart failure in horses: 14 cases (1984-2001)

OBJECTIVE: To identify clinical signs, underlying cardiac conditions, echocardiographic findings, and prognosis for horses with congestive heart failure. DESIGN: Retrospective study. ANIMALS: 14 horses. PROCEDURE: Signalment; history; clinical signs; clinicopathologic, echocardiographic, and radiographic findings; treatment; and outcome were determined by reviewing medical records. RESULTS: All 14 horses were examined because of a heart murmur; tachycardia was identified in all 14. Twelve horses had echocardiographic evidence of enlargement of 1 or more chambers of the heart. Other common clinical findings included jugular distention or pulsation, crackles, cough, tachypnea, and ventral edema. Nine horses had signs consistent with heart failure for > 6 days. Underlying causes for heart failure included congenital defects, traumatic vascular rupture, pericarditis, pulmonary hypertension secondary to heaves, and valvular dysplasia. Seven horses were euthanatized after diagnosis of heart failure; 5 were discharged but were euthanatized or died of complications of heart disease within 1 year after discharge. The remaining 2 horses were discharged but lost to follow-up. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that congestive heart failure is rare in horses. A loud heart murmur accompanied by either jugular distention or pulsation, tachycardia, respiratory abnormalities (crackles, cough, tachypnea), and ventral edema were the most common clinical signs. Echocardiography was useful in determining the underlying cause in affected horses. The long-term prognosis for horses with congestive heart failure was grave.     

Risk factors for reduced postoperative fecal output in horses: 37 cases (1997-1998)

OBJECTIVE: To determine prevalence and risk factors for development of ileus of the large intestine after surgery in horses, identified by reduced postoperative fecal output (RPFO). DESIGN: Retrospective study. ANIMALS: 37 horses that developed RPFO after undergoing general anesthesia for reasons unrelated to the gastrointestinal tract. PROCEDURE: Fecal output was obtained from medical records as number of defecations per 24-hour period after surgery; RPFO was defined as < or = 3 defecations per 24-hour period after surgery. The reference population included 48 horses that defecated > or = 4 times during the same period. Demographic, clinical, and surgical variables were evaluated for their association with development of RPFO by use of logistic regression analysis. RESULTS: Ten (12%) horses, all of which had RPFO, developed signs of colic after surgery. Horses > or = 5 years old that underwent orthopedic procedures of > 60 minutes' duration and that did not receive phenylbutazone after surgery were at significant risk for developing RPFO. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that after surgery unrelated to the gastrointestinal tract in horses, there is an intermediate clinical phase characterized by reduced fecal output preceding overt signs of colic. Recognition of RPFO may reduce morbidity and mortality of such horses.     

Mesenteric rents as a source of small intestinal strangulation in horses: 15 cases (1990-1997)

OBJECTIVE: To describe the clinical findings in horses with small intestinal strangulation through mesenteric rents, and to determine the recurrence and survival rates after surgery. DESIGN: Retrospective study. ANIMALS: 15 horses with small intestinal obstruction via a mesenteric rent. PROCEDURE: Medical records of horses with obstruction of the small intestine via a mesenteric rent between January 1990 and December 1997 were reviewed. The signalment, history, initial physical examination findings, results of abdominocentesis, and clinical laboratory values were recorded. Surgical findings, including location of the mesenteric rent and surgical procedure performed, were recorded. Short- and long-term survival rates were calculated. RESULTS: Most mesenteric rents were located in the mesentery of the small intestine (13 horses). Two horses had multiple mesenteric defects. Seven horses were euthanatized at surgery because of an inability to reduce the entrapped intestine (3 horses), uncontrollable hemorrhage (2), inability to close the rent (1), and the amount of compromised intestine involved (1). Seven horses required intestinal resection and anastomosis. The median length of intestine resected was 2.6 m (range, 0.6 to 4.5 m). The mesenteric rents created during resection were not closed in 2 horses. One of these 2 horses subsequently developed a strangulating obstruction through the open rent. Seven of 15 horses in our study were discharged from the hospital (i.e., short-term survival rate of 47% [7/15]). Long-term follow-up information was available for 5 of the 7 horses (follow-up duration of 5 months to 9 years), of which 2 died as a result of colic, and 1 horse was euthanatized because of severe arthritis (i.e., long-term survival rate of 40% [2/5]). CONCLUSIONS AND CLINICAL RELEVANCE: Inability to reduce the intestinal obstruction, severe hemorrhage from the mesentery, and the length of intestine involved are the main factors that decrease survival rates in horses with small intestinal strangulation caused by mesenteric rents.     

Comparison of duodenitis/proximal jejunitis and small intestinal obstruction in horses: 68 cases (1977-1985)

Sixty-eight horses with colic caused by small intestinal disease were allotted into 2 groups of 34 on the basis of recorded findings during exploratory celiotomy, necropsy, or response to medical treatment alone. Signalment, history, physical examination findings, and laboratory findings were compared between the group of horses with small intestinal obstruction and the group with duodenitis/proximal jejunitis. A significantly greater proportion of horses with duodenitis/proximal jejunitis were older than 2 years old (P less than 0.05). Differences in sex or breed distribution, or in seasonality of the 2 disease syndromes were not observed. Horses with duodenitis/proximal jejunitis had significantly greater signs of depression than those with small intestinal obstruction (P less than 0.01), and horses with small intestinal obstruction had significantly greater signs of abdominal pain (P less than 0.05). The mean heart and respiratory rates were significantly lower (P less than 0.01) and the volume of nasogastric reflux was significantly greater (P less than 0.05) in the group of horses with duodenitis/proximal jejunitis. Sections of small intestine that were palpable per rectum were less distended and there were more auscultable borborygmi in horses with duodenitis/proximal jejunitis, compared with those with small intestinal obstruction (P less than 0.05 and P less than 0.01). The group of horses with duodenitis/proximal jejunitis had lower mean plasma potassium and higher mean plasma bicarbonate concentrations (P less than 0.05) than the group with small intestinal obstruction. The mean nucleated cell count and total protein concentration of peritoneal fluid specimens were significantly less in the group with duodenitis/proximal jejunitis (P less than 0.01); however, these values were greater than normal.(ABSTRACT TRUNCATED AT 250 WORDS)     

Long-term survival and risk factors associated with biliary surgery in dogs: 34 cases (1994-2004)

OBJECTIVE: To determine factors associated with long-term survival after biliary surgery in dogs. DESIGN: Retrospective case series. ANIMALS: 34 dogs that underwent biliary surgery. PROCEDURES: Data extracted from medical records included sex, breed, body weight, age at surgery, history and clinical examination findings, preoperative and postoperative CBC, serum biochemical panel and coagulation profiles results, abdominal ultrasonographic findings, results of bacteriologic culture and histologic examination, surgical findings, postoperative complications, and survival time. Follow-up information was obtained from medical records or phone conversations with owners and referring veterinarians. RESULTS: Primary biliary findings included gallbladder mucocele (n = 20 dogs), inflammatory diseases (4), trauma (3), and neoplasia (1). Secondary biliary diseases included pancreatitis (n = 4), pancreatic neoplasia (1), and duodenal perforation (1). One- and 2-year survival rates were both 66%. Increasing age; gamma-glutamyltransferase activity; preanesthetic heart rate; BUN, phosphorus, and bilirubin concentrations; and the use of biliary diversion procedures were risk factors for death, although pancreatitis was not. However, poor long-term survival was associated with pancreatitis. CONCLUSIONS AND CLINICAL RELEVANCE: Long-term prognosis was guarded after biliary surgery in dogs. However, dogs that survived the early postoperative period had good long-term prognosis. Dogs with pancreatitis had poor prognosis. Overall, the prognosis was worse for dogs that underwent a biliary diversion, compared with dogs that did not.     

Surgical management of adrenal gland tumors with and without associated tumor thrombi in dogs: 40 cases (1994-2001)

OBJECTIVE: To compare pathologic findings and results of adrenalectomy for adrenal gland tumors in dogs with and without vena caval tumor thrombi. DESIGN: Retrospective study. ANIMALS: 40 dogs with adrenal gland tumors. PROCEDURE: Medical records were examined. An exact logistic regression analysis was used to evaluate associations between tumor type or right-sided versus left-sided tumor involvement and development of caval tumor thrombi and associations between tumor thrombi, tumor type, or right- versus left-sided location and perioperative complications and mortality rate. Survival was compared between dogs with and without tumor thrombi. RESULTS: Caval thrombi were detected in 25% of dogs, including 3 of 28 (11%) dogs with an adrenocortical tumor and 6 of 11 dogs with a pheochromocytoma. A caval tumor thrombus was detected in 6 of 17 right-sided and 4 of 20 left-sided tumors. Sensitivity and specificity of abdominal ultrasonography for detection of caval thrombi were 80 and 90%, respectively. Intraoperative and postoperative complications developed in 15 and 51% of dogs, respectively. The mortality rate was 22%. There were no significant differences in perioperative morbidity and mortality rates between dogs with and without tumor thrombi. CONCLUSIONS AND CLINICAL RELEVANCE: Caval thrombi associated with adrenal gland tumors are amenable to adrenalectomy and thrombectomy without significantly increased perioperative morbidity and mortality rates, assuming the surgeon is experienced in appropriate techniques.     

Tilt table recovery of horses after orthopedic surgery: fifty-four cases (1994-2005)

OBJECTIVE: To describe an assisted anesthetic recovery technique using a tilt table for horses after high-risk orthopedic-related procedures and to evaluate outcome. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Anesthetic recoveries (n=54) for 36 horses. METHODS: Medical records (April 1994-October 2005) for horses that had high-risk orthopedic surgery and recovery from general anesthesia on a tilt table were reviewed. Information about the surgical procedure, anesthetic and recovery period was analyzed. RESULTS: Of 54 anesthetic recoveries, 1 horse (1.9%) had complete failure of internal fixation during recovery and was euthanatized. Six (11% recoveries) horses failed to adapt to the tilt table system, which necessitated transfer to a conventional recovery room. Complications without important consequences for clinical outcome (skin abrasions, myositis, cast breakage, partial implant failure) occurred during 8 (15%) recoveries. CONCLUSIONS: A tilt table recovery system was associated with minimal incidence of serious complications. Potential disadvantages of the system are the number of personnel required, longer recovery time, and the need for a specialized table. CLINICAL RELEVANCE: A tilt table is a useful system for recovering horses believed to be at increased risk of injury during anesthetic recovery after high-risk orthopedic-related procedures.     

Large colon resection and anastomosis in horses: 52 cases (1996-2006)

Reasons for performing study: Large colon resection and anastomosis (LCRA) is the most aggressive method of surgical management of a colon with questionable viability. Currently, published studies are comprised mostly of broodmares and discuss short‐term survival. Objectives: To determine the prognosis for survival after LCRA in a diverse population of horses, report the incidence of post operative complications, and determine if associations between analysed variables and survival rate exist. Methods: The medical records of 52 horses that underwent LCRA were evaluated. Data were used to identify univariable associations with survival as well as complications related to LCRA. Chi‐square, odds ratio with 95% confidence interval, Mann‐Whitney or Kruskal‐Wallis tests were used, with significance set at P<0.05. Results: Forty‐four horses (84.6%) survived anaesthesia and recovery, 30 (57.7%) survived to be discharged from the hospital. Of the variables analysed, heart rate 24 h after recovery was significantly associated with mortality, as were endotoxaemia, ileus and peritonitis experienced post operatively. Conclusions: Heart rate 24 h after recovery may be a more reliable prognostic indicator than other analysed variables. Survival rate and complications after LCRA were similar to those previously reported. Potential relevance: By reporting on LCRA in a diverse group of horses, referral clinics with similar populations may have a better understanding of prognosis and complications associated with the procedure. When a colon with questionable viability is removed, waiting until 24 h after recovery may be advised to allow for a more informed decision regarding prognosis.     

Excision as treatment of dermal melanomatosis in horses: 11 cases (1994-2000)

OBJECTIVE: To determine whether excision was an acceptable treatment for dermal melanomatosis in horses. DESIGN: Retrospective study. ANIMALS: 11 horses with dermal melanomatosis involving the perineal, perianal, or perirectal region or ventral surface of the tail in which treatment consisted of tumor excision. PROCEDURE: Medical records were reviewed. Follow-up information was obtained from owners through telephone interviews. RESULTS: 9 of the 11 horses were alive at the time of follow-up interviews. None of the horses had regrowth at the surgery site where the primary tumor was removed. There were no confirmed clinical signs of internal metastasis. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that excision of dermal melanomatosis in horses may be a reasonable treatment option.     

Acute small intestinal obstruction associated with Parascaris equorum infection in young horses: 25 cases (1985-2004)

AIMS: To retrospectively evaluate the medical and surgical records of horses with acute small intestinal obstructions associated with Parascaris equorum infection; to describe the gastrointestinal lesions; and to determine the outcome of cases with such lesions. METHODS: Records of 25 horses with acute small intestinal obstruction associated with P. equorum between 1985 and 2004 were reviewed to determine signalment, history, physical examination, surgical or post-mortem findings, and outcome. RESULTS: All horses except one were less than 12 months old. Standardbreds were over-represented in the population studied. Sixteen horses (72%) had been administered anthelmintics, including pyrantel (n=8), ivermectin (n=7), and trichlorphon (n=1), within 24 h prior to the onset of colic. Of the 25 cases reviewed, 16 had simple obstructive ascarid impactions (SOAIs), and nine had complicated obstructive ascarid impaction (COAI) including volvulus (n=6) or intussusception (n=3), both concurrent with ascarid impaction of the small intestine. Short-term survival (discharge from hospital) occurred in 79% of horses treated for SOAI, and was 64% for all horses. Long-term survival (>1 year) occurred in 33% of horses with SOAI, and the overall long-term survival was 27% for all horses. Formation of adhesions was the most frequent finding associated with death for horses that did not survive long-term. CONCLUSIONS AND CLINICAL RELEVANCE: The incidence of anthelmintic treatment within 24 h of the onset of colic in this study population (72%) was higher than that previously reported. Resistance of P. equorum to ivermectin recently reported in Ontario may be associated with increased ascarid burdens, predisposing horses to ascarid impaction. The long-term survival of these horses was better than that reported previously.     

Survival and factors affecting survival in small ruminants and camelids attacked by dogs: 62 cases (1994–2004)

Objective: To determine the survival rates and factors affecting survival in small ruminants and camelids attacked by dogs. Design: Retrospective study. Setting: Two university teaching hospitals. Animals: Thirty goats, 28 sheep, 3 alpacas, and 1 llama. Measurements and main results: Medical records were reviewed to obtain signalment, time between injury and admission, hospitalization length, lesion site, treatment, complications, survival rate, and cost. Follow‐up information was obtained by telephone conversation with the owner. Sixty‐two patients met the inclusion criteria. Six animals were euthanized at admission and thus excluded. Of the 56 animals that were treated, 43 (77%) were discharged, 5 (9%) died, and 8 (14%) were euthanized. Animals that had thoracic or abdominal injuries, required surgery, or received more potent analgesic therapy were less likely to survive to discharge from hospital compared with animals that did not. Complications developed in 50 (82%) animals. Animals with respiratory complications were also less likely to survive to discharge from hospital than animals that did not. Long‐term follow up was available on 38/43 (88%) animals that were discharged. Thirty‐five of 38 (92%) animals were discharged and recovered from their injuries and 5 animals had long‐term complications. Conclusions: Small ruminants and camelids that are attacked by dogs have a good prognosis for short‐term survival. Short‐term survival is affected by lesion location and complications.     

Efficacy of metoclopramide for treatment of ileus in horses following small intestinal surgery: 70 cases (1989–1992)

Summary: In this retrospective study, postoperative ileus was studied in horses having resection of the small intestine followed by a jejunojejunal (n=35) or a jejunocaecal (n=35) anastomosis. Twenty-six horses received no metoclopramide, 27 received metoclopramide as an intermittent intravenous infusion and 17 horses received metoclopramide as a continuous intravenous infusion (0.04 mg/kg/hour). Horses receiving a continuous infusion of metoclopramide had a reduced total volume (P< 0.001), shorter duration (P< 0.001), and a slower rate (P< 0.001) of postoperative gastric reflux, and a shorter postoperative hospital stay (P< 0.01) when compared to horses receiving no metoclopramide and horses receiving metoclopramide as an intermittent infusion. Horses having jejunocaecostomy performed had a larger volume (P< 0.05), longer duration (P< 0.05), and a greater rate (P< 0.05) of postoperative gastric reflux, and a longer postoperative hospital stay (P< 0.001) than horses undergoing jejunojejunostomy. Horses that had an abdominal drain placed during surgery had a longer length of intestine resected (P< 0.05) and a longer postoperative hospital stay (P< 0.05) than horses without an abdominal drain. Horses that died or were euthanased during the postoperative period had a greater total volume (P< 0.05), longer duration (P< 0.05), and greater rate of postoperative gastric reflux (P< 0.01), a longer length of small intestine resected (P< 0.01), and a shorter postoperative hospital stay (P< 0.05) than horses that survived until discharge from the hospital. In a multivariate regression analysis the continuous infusion of metoclopramide was the only variable that contributed significantly to predicting the total volume (P< 0.001; r²= 0.24), duration (P< 0.001; r²= 0.24) and rate (P< 0.001; r²= 0.25) of postoperative gastric reflux. We concluded that metoclopramide given as a continuous intravenous infusion decreased the incidence and severity of ileus following small intestinal resection and anastomosis in horses.     

Prognostic factors and survival of horses with ocular/adnexal squamous cell carcinoma: 147 cases (1978-1988)

Between January 1978 and December 1988, 147 horses with ocular/adnexal squamous cell carcinoma (SCC) were admitted to the Colorado State University Veterinary Teaching Hospital (CSU-VTH). Diagnosis was confirmed by histologic examination of appropriate tissue specimens. Medical records and communication with owners, referring veterinarians, or both provided information regarding initial examination, treatment at the CSU-VTH, and final outcome. At initial examination, 123 (83.7%) horses had unilateral involvement and 24 (16.3%) horses had bilateral involvement. The nictitating membrane, nasal canthus, or both (28.1%); limbus (27.5%); and eyelid (22.8%) were most commonly affected. In addition to the ocular/adnexal location, SCC was found elsewhere in 14 (9.5%) horses at initial examination. Adequate follow-up (greater than or equal to 4 months) for examination of tumor recurrence and survival analysis was obtained for 125 (85.0%) cases. After treatment at the CSU-VTH, tumor recurred in 30.4% of the cases. Tumor location, multiple vs single tumors at initial diagnosis, and CSU-VTH treatment modality influenced the recurrence of tumors. Survival analysis revealed a good prognosis for horses with ocular/adnexal SCC. Although undefined, a conservative estimate of the median survival time was 47 months. Six factors (treatment prior to referral, tumor location, tumor size, single or multiple tumors, treatment modality at the CSU-VTH, and recurrence or nonrecurrence) were analyzed to determine their relation with survival. Treatment prior to referral, multiple vs single tumors at initial examination, and treatment modality used at the CSU-VTH did not influence survival. Tumor location influenced survival; SCC involving the eyelid or orbit was associated with the poorest prognosis. Tumor stage (maximal dimension) was inversely related with survival.(ABSTRACT TRUNCATED AT 250 WORDS)     

Ultrasonographic findings in horses with right dorsal colitis: five cases (2000-2001)

OBJECTIVE: To determine whether ultrasonography would be useful in the diagnosis of right dorsal colitis in horses. DESIGN: Retrospective study. ANIMALS: 5 horses with right dorsal colitis and 15 healthy adult horses. PROCEDURE: Mural thickness and appearance of the right dorsal colon were determined from ultrasonographic images obtained at right intercostal spaces 10, 11, 12, 13, and 14. RESULTS: The right dorsal colon could be imaged most consistently at the right 11th, 12th, and 13th intercostal spaces, below the margin of the lung and axial to the liver. Mural thickness measured from ultrasonographic images was significantly greater in horses with right dorsal colitis than in healthy horses. The right dorsal colon in affected horses had a prominent hypoechoic layer associated with submucosal edema and inflammatory infiltrates. Successful treatment of 1 horse with right dorsal colitis was associated with a decrease in mural thickness coincident with an increase in serum albumin and total protein concentrations and weight gain. A decrease in mural thickness was also observed in a second horse treated for right dorsal colitis that was not associated with healing of the right dorsal colon or an increase in serum albumin concentration but rather thinning of a segment of the right dorsal colon that eventually ruptured. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that ultrasonographic measurement of mural thickness and evaluation of the appearance of the right dorsal colon may be useful in the diagnosis of right dorsal colitis in horses.     

Evaluation of complications and prognostic factors associated with administration of total parenteral nutrition in cats: 75 cases (1994-2001)

OBJECTIVE: To determine frequency and types of complications, prognostic factors, and primary diseases affecting clinical outcome associated with administration of total parenteral nutrition (TPN) in cats. DESIGN: Retrospective study. ANIMALS: 75 cats that received TPN for > or = 12 hours. PROCEDURE: Medical records were reviewed, and information was obtained on signalment, history, problems at initial evaluation, physical examination findings, weight and changes in weight while receiving TPN, duration in the hospital before initiation of TPN, the type of TPN catheter used, duration of TPN administration, and final diagnosis. Laboratory results obtained immediately prior to TPN and at 24 and 96 hours following initiation of TPN administration were compared. RESULTS: Reports of weight loss at initial evaluation, hyperglycemia at 24 hours, or diagnosis of chronic renal failure were significantly associated with increased mortality rate. Greater serum albumin concentrations prior to and at 96 hours following TPN administration were significantly associated with decreased mortality rate. Mechanical and septic complications were infrequent and not associated with increased mortality rate. Most cats had multiple diseases. The overall mortality rate was 52%; among 75 cats, 36 recovered, 23 were euthanatized, and 16 died as a result of their primary illness or complications associated with their illness. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated high mortality rate in cats maintained onTPN that had multiple concurrent diseases associated with a poor prognosis. Indicators of poor prognosis included a history of weight loss, hyperglycemia at 24 hours following TPN administration, hypoalbuminemia, and chronic renal failure.