Surgical Treatment of Gastroduodenal Obstructions in Foals

Thirteen foals that ranged in age from 4 days to 4 months were presented for treatment of gastroduodenal obstruction. The site of obstruction was determined from examination of standing right lateral contrast radiographs of the caudal part of the thorax and abdomen. Depending on the site, the obstruction was bypassed by esophagogastrostomy, gastroduodenostomy, partial gastrectomy with gastroduodenostomy, duodenojejunostomy, or gastrojejunostomy followed by jejunojejunostomy. Six of the 13 foals (46%) survived. All foals with pyloric stenosis survived. Seven of eight foals with duodenal stenosis died. Deaths were due to complications unrelated to the primary gastroduodenal obstruction.     

Contracted Foal Syndrome Associated with Multiple Malformations in Two Foals

Congenital anomalies in horses are very rare, and contracted foal syndrome is one of the most commonly reported. This malformation is characterized by contraction of the joints of the forelimbs and/or hindlimbs. In addition, the syndrome can be characterized by vertebral column malformations, such as scoliosis or torticollis, and cranial deformity. The present report describes the radiological and necroscopical findings of multiple rare malformations in two foals. Both foals showed skeletal abnormalities and fenestration of the abdominal cavity. Other pathological findings include a interventricular septal defect in one and a unilateral hydronephrosis and partial hydroureter in the other foal. Although in this report a specific aetiology could not be provided, insecticides treatment provided during the second month of pregnancy might play a role in the pathogenesis of these malformations.     

Complications Associated with Proximal Duodenal Resection and Cholecystoduodenostomy in Two Cats

Two cats having resections of duodenal lesions involving the major duodenal papilla are described. The operative technique of cholecystoduodenostomy and the postoperative complications are presented. Pancreatic insufficiency and cholangitis developed in both cats and responded to specific treatment. Recommendations for performing successful cholecystoduodenostomy are made.     

Efficacy of Mass Antimicrobial Treatment of Foals with Subclinical Pulmonary Abscesses Associated with Rhodococcus equi

Background

Mass antimicrobial treatment of foals with small subclinical ultrasonographic pulmonary lesions is empirical practice on many farms with endemic disease caused by Rhodococcus equi.

Hypothesis

Mass antimicrobial treatment of foals with subclinical ultrasonographic pulmonary lesions is unnecessary.

Animals

One hundred and eight foals on a farm endemic for infections caused by R. equi.

Methods

Controlled, randomized, and double‐blinded prospective study. Foals with ultrasonographic evidence of pulmonary abscesses 5.0–10 cm in diameter (n = 108) were randomly allocated in 5 treatment groups: (1) tulathromycin IM; (2) doxycycline monotherapy PO; (3) doxycycline with rifampin PO; (4) azithromycin with rifampin PO, and (5) saline IM as a placebo. Physical examination and thoracic ultrasonography were performed by individuals unaware of treatment group assignment. Foals with evidence of disease progression were removed from the study and treated with azithromycin‐rifampin.

Results

Overall, 22/25 (88%) foals in the placebo group recovered without the need for treatment. The proportion of foals that had evidence of disease progression did not differ significantly between the treatment groups (P > .05). Although the median duration of treatment was significantly (P < .05) shorter in foals treated with azithromycin‐rifampin (46 days) compared with foals treated with the placebo (73 days), the time frame of ultrasonographic lesion resolution did not differ significantly between the treatment groups.

Conclusions and Clinical Importance

The majority of foals with subclinical pulmonary abscesses <10 cm in diameter recover without antimicrobial treatment and treatment of affected foals does not provide a clear benefit over administration of a placebo.     

Hepatic Abscesses Associated With Diabetes Mellitus in Two Dogs

Two diabetic dogs were presented for anorexia, persistent fever, and poor control of hyperglycemia. Both had neutrophilia with left shift, hypoalbuminemia, and increased serum alkaline phosphatase (SAP) activity. Radiography indicated intrahepatic gas densities in 1 dog and a hepatic mass in the other. Abdominal sonography demonstrated multiple well-demarcated hypoechoic hepatic lesions consistent with abscesses. Both dogs were successfully treated by surgical resection of the abscessed liver lobes inconjunction with antibiotics and supportive therapy. Good control of hyperglycemia was achieved in both dogs after recovery. Intracellular and extracellular Gram-negative rod-shaped bacteria were abundant in the abscesses from both dogs. These cases suggest an association between diabetes mellitus and hepatic abscessation.     

Factors Associated with Survival in Pathological Neonatal Equine Foals: Preliminary Results

Veterinary Research Communications -     

Laparoscopic Repair of Scrotal Hernia in Two Foals

Nonstrangulating indirect scrotal hernias were corrected in two 4-week-old Percheron foals by a laparoscopic technique. After laparoscopic reduction of herniated nonstrangulated small intestine each testes was retracted through the vaginal ring. The ligament of the tail of the epididymis was transected by electrocautery. The testicular vessels and nerves were isolated by cautery of the mesenteric portion of the mesorchium and then ligated. Staples were used to close the opening of the inguinal canal by apposing the peritoneal edges of the vaginal ring. Resection of umbilical stalk remnants via celiotomy performed in one foal after laparoscopic observation of enlargement of the right umbilical artery and urachus. No complications or recurrence of herniation had occurred 16 weeks after surgery.     

Factors Associated with Failure of Passive Transfer of Colostral Antibodies in Standardbred Foals

The records of 361 Standardbred mares and their 1986 or 1987 foals were evaluated to identify factors associated with failure of passive transfer (FPT) of colostral antibodies in equine neonates. Sixty-five foals (18%) were classified as FPT based on a serum immunoglobulin concentration of less than 400 mg/dl at 24 to 36 hours of age, determined by the glutaraldehyde coagulation test. The potential association of mare- and foal-related factors with FPT were assessed by reviewing a series of multiple logistic regression models. The season in which the mare foaled and foal exam score, a subjective assessment of foal vigor, maturity, and general health, were the primary factors associated with the development of FPT. Foals with FPT were more likely (odds ratio = 3.50; 95% confidence interval = 1.81-6.68) than normal foals to require medical therapy during the first 3 months after parturition.     

Priapism Associated with Lumbar Stenosis in a Dog

Priapism, a persistent long‐lasting involuntary erection of the penis, is uncommon in dogs. In this report, the case of a 13‐year‐old male Pointer, referred to our services due to persistent exposition of the penis, is described. This condition was consecutive to an intermittent priapism situation lasting for several days, which has been initially attributed to the inflammation and haematoma associated with a perianal bite. The owners became unable to retract the penis into the prepuce. At presentation, the dog was anorectic for 48 h, intolerant to manipulation, and showed poor body condition and unsteady locomotion. During physical evaluation, a marked engorgement of the local vessels in the prepuce and penis was found. An abdominal X‐ray was asked under the suspicion of a neurogenic origin for the clinical situation, which showed evidences of spondylosis. After discussion of the clinical condition, the owners asked for euthanasia. The necropsy confirmed the engorgement of the regional vessels deriving from the pudendal arteries and blood accumulation within all the cavernous spaces, accompanied by congestion and thrombosis within the erectile structures of the penis. No significant changes were observed in the pelvic organs that could be at the origin of priapism. The lumbar‐sacral spinal regions were carefully inspected and evidenced signs of L7‐S1 stenosis due to spondylosis. The case presented herein is a rare situation of priapism of neurogenic origin in a dog. Necropsy findings suggest that it was consecutive to cauda equina compression due to lumbar spinal stenosis.     

Surgical Correction of Bilateral Ectopic Ureters in Two Foals

Case reports of ectopic ureters in a 2 1/2-month-old colt and a 4 1/2-month-old filly are presented. Diagnosis was made by retrograde cystography and excretory urography. The ureters were surgically transposed into the bladder. A functional urinary system was reestablished in both foals, but they died of postoperative complications.     

Treatment of Congenital Pulmonic Stenosis in Two Dogs by Balloon Valvuloplasty

Balloon valvuloplasty was performed on two dogs with pulmonic valve stenosis. Immediately following balloon valvuloplasty, peak right ventricular systolic pressure declined from 92 to 44 mm Hg in the first dog and from 108 to 46 mm Hg in the second dog. The peak systolic pressure gradient across the pulmonic valve declined from 60 to 12 mm Hg in the first dog and from 84 to 22 mm Hg in the second dog. Hemodynamic improvement was sustained in both dogs at the time of recatheterization 3 months later. Both dogs tolerated the procedure well and there were no serious complications. It was concluded that balloon valvuloplasty offers an alternative to surgery for the treatment of valvular pulmonic stenosis in dogs. The exact indications for and limitations of balloon valvuloplasty must await the results of additional and more long-term studies.     

Efficacy of Gamithromycin for the Treatment of Foals with Mild to Moderate Bronchopneumonia

Background

Gamithromycin is active in vitro against the bacterial agents most commonly associated with bronchopneumonia in older foals. However, the clinical efficacy and safety of this drug have not been investigated.

Hypothesis

Gamithromycin is effective for the treatment of bronchopneumonia in foals.

Animals

One hundred and twenty‐one foals on a farm endemic for infections caused by Rhodococcus equi.

Methods

In a controlled, randomized, and double blinded clinical trial, foals with ultrasonographic evidence of pulmonary abscesses (abscess score 8.0–20 cm) were randomly allocated in 3 treatment groups: (1) gamithromycin IM q7 days (n = 40); (2) azithromycin with rifampin, PO q24h (n = 40); or (3) no antimicrobial treatment (controls; n = 41). Physical examination and thoracic ultrasonography were performed by individuals unaware of treatment group assignment. Foals that worsened were removed from the study.

Results

The proportion of foals that recovered without the need to be removed from the study was significantly higher for foals treated with gamithromycin (38 of 40) or azithromycin with rifampin (39 of 40) than for controls (32 of 41). Treatment with gamithromycin or with azithromycin‐rifampin resulted in a significantly faster decrease in the clinical score and abscess score compared to the controls. Adverse reactions characterized by colic (n = 18) and hind limb lameness (n = 14) were observed only in foals treated with gamithromycin.

Conclusion and Clinical Importance

Gamithromycin was noninferior to azithromycin with rifampin for the treatment of bronchopneumonia in the study population but had a higher frequency of adverse reactions.     

Vascular Injury Associated with Naturally Occurring Strangulating Obstructions of the Equine Large Colon

Ten horses were euthanatized before, during, or after surgery to correct severe volvulus of the large colon. At surgery, the colonic serosa changed from blue-gray, blue or purple toward a more normal pink in seven horses after the volvulus was corrected. The mucosa consistently remained black or dark red. Results of postmortem colonic microangiography revealed perfusion of the serosa and the circular and longitudinal muscle layers, but mucosal perfusion was limited by thrombosis in the muscularis mucosae and submucosa. There was evidence of thrombosis of the mesenteric colic vessels in six horses. Damage to the colonic vascular system, especially thromboembolism in the submucosa, may be an important limitation to colonic viability after surgical correction of volvulus of the large colon.     

犬胆结石引发肝外总胆管阻塞的诊治

1例贵宾犬出现呕吐、食欲不振、可视黏膜黄染和明显腹痛;血常规显示轻度贫血和白细胞总数升高;血清生化显示丙氨酸氨基转移酶、碱性磷酸酶、总胆红素升高,C-反应蛋白显著升高,胰腺特异性脂肪酶异常;B超显示胆囊和总胆管扩张,胆囊及总胆管内有胆结石。确诊为胆结石并继发慢性胆囊炎、肝外总胆管阻塞、急性胰腺炎、肝损伤,采用胆囊摘除术及总胆管切开术将结石取出,术后该犬恢复良好。     

Surgical Treatment of Gastric Outflow Obstruction in 40 Foals

Objective— To report short- and long-term survival and factors affecting outcome of foals after surgical correction of gastric outflow obstruction.
Study Design— Case series.
Animals— Foals (n=40) aged 5–180 days.
Methods— Clinical signs, laboratory data, diagnostic imaging, surgical findings, surgical procedures, medical treatment, and necropsy findings were retrieved from medical records. Outcome was obtained by reviewing performance, sales, and produce records or by telephone conversations with the owners.
Results— Gastric outflow obstruction was treated by gastroduodenostomy or by gastrojejunostomy with or without jejunojejunostomy. Long-term follow-up was available for 36 of 39 foals that survived to hospital discharge; 25 (69%) survived >2 years. All 8 foals with pyloric obstruction survived >2 years, whereas only 11 of 21 (52%) foals with duodenal obstruction survived >2 years. Six of 8 foals with obstruction of the duodenum and pylorus survived >2 years. Obstruction of the duodenum, adhesions to the duodenum, and postoperative ileus were significantly associated with decreased long-term survival.
Conclusions— Long-term outcome after gastric bypass procedures was substantially improved compared with previous reports. Factors that may have contributed to improved survival include better case selection and performing the gastrojejunostomy with the jejunum aligned from left to right.
Clinical Relevance— The prognosis for long-term survival after surgical bypass of pyloric obstruction is excellent. The overall prognosis for long-term survival after surgical bypass of duodenal obstruction is fair but should be considered guarded in those with pre-existing duodenal adhesions.     

Factors Associated with Survival in Septicemic Foals: 65 Cases (1988–1995)

In order to identify variables obtained at admission that could be used to predict survival in septicemic foals, medical records of 65 foals diagnosed with septicemia were reviewed. Initially, variables were analyzed independently (univariate analysis) for association with survival. Of the physical examination and historical data examined using univariate analysis, the ability to stand at admission, respiratory rate ≥ 60 breaths per minute (bpm), and normal-appearing mucous membranes were significantly associated with survival. Foals with history of induced parturition were significantly less likely to survive. The following hematologic and serum biochemical variables determined at admission were significantly associated with survival: white blood cell count a 6,000 cells/μL, neutrophil count <4,000 cells/μL, serum albumin concentration <2.2 g/dL, serum glucose concentration <120 mg/ dL, blood pH ≥ 7.35, and positive base excess. The administration of plasma at admission was significantly associated with survival. Stepwise multiple logistic regression analysis was performed to evaluate the association between survival and variables identified as significantly associated with survival in bivariate analysis. The final multivariate model selected included the variables standing, duration of clinical signs (24-hour intervals) prior to admission, respiratory rate a 60 bpm, neutropenia (> 4,000 cells/μL), and neonatal age category. The probability of survival was significantly increased for foals that were standing, had a respiratory rate a 60 bpm, and that had a neutrophil count <4,000 cells/μL at admission. Probability of survival was significantly decreased for foals that had a longer duration of clinical signs prior to admission. For each 24 hours of duration, the estimated risk of death was increased by 5.8-fold.