Evaluation of sodium carboxymethylcellulose for prevention of experimentally induced abdominal adhesions in ponies

Twelve ponies were used to evaluate the reliability of an abdominal adhesion model and the efficacy of intraperitoneal infusion of sodium carboxymethylcellulose in preventing abdominal adhesions. A celiotomy was performed on each of the 12 ponies and the serosa of the distal portion of the jejunum was abraded with a dry gauze sponge at 5 locations. In addition to the serosal damage, a single 2-0 chromic gut suture was placed through the seromuscular layer of the jejunum in the center of the abraded area. After closure of the celiotomy, a 1% solution of sodium carboxymethylcellulose (7 ml/kg of body weight) was infused into the peritoneal cavity of 6 ponies. The other ponies served as untreated controls. All ponies were euthanatized 14 days after surgery. All ponies in the control group had abdominal adhesions at the time of necropsy. Four of the 6 ponies in the treatment group were free of adhesions. There was a significant (P less than 0.0001) difference in the total number of adhesions between the 2 groups.     

One percent sodium carboxymethylcellulose prevents experimentally induced abdominal adhesions in horses

OBJECTIVE--To evaluate the efficacy of 1% sodium carboxymethylcellulose (SCMC) for prevention of experimentally induced abdominal adhesions in horses. STUDY DESIGN--Prospective, controlled, experimental study. ANIMAL POPULATION--Twelve healthy adult horses. METHODS--The effect of 1% SCMC on adhesion formation was evaluated in 12 healthy horses by using an established model of serosal trauma to induce intraabdominal adhesions. After ventral median celiotomy, 2 separate areas of the jejunum were abraded, and three 2-0 chromic gut sutures were placed in each abraded area. Jejunal resection and end-to-end anastomosis was performed at 2 sites distant to the abrasion sites. In treated horses (n = 6), 2 L of 1% SCMC was applied to the intestine before and after intestinal manipulation. In control horses (n = 6), 2 L of saline solution were applied to the intestine before and after surgical manipulation. All horses were euthanatized 10 days after surgery, and the abdominal cavity was evaluated for adhesion formation. The frequency of intraabdominal adhesions between groups was compared with a chi-square test. Statistical significance was set at P <.05. RESULTS--All control horses had intraabdominal adhesions. Fibrous adhesions were associated with both jejunal abrasion sites in 5 control horses. Fibrous adhesions were also associated with 1 or both jejunal anastomotic sites in 5 control horses. Only 1 treated horse developed adhesions at the jejunal abrasion sites, and no adhesions were present at the anastomotic sites in the treated horses. There were significantly fewer adhesions in the SCMC treatment group compared with the control group (P <.05). CONCLUSION--In this experimental model, application of 1% SCMC reduced the frequency of intraabdominal adhesions at areas of serosal abrasion and at jejunal anastomotic sites. CLINICAL RELEVANCE--In horses at an increased risk for developing intraabdominal adhesions after intestinal surgery, the use of 1% SCMC during celiotomy may decrease the frequency of adhesion formation.     

Comparison of two laparoscopic treatments for experimentally induced abdominal adhesions in pony foals

OBJECTIVE: To compare laparoscopic dissection with-laparoscopic dissection combined with abdominal instillation of ferric hyaluronate gel for the treatment of experimentally induced adhesions in pony foals. ANIMALS: 12 healthy pony foals. PROCEDURE: A serosal abrasion method was used to create adhesions at 4 sites on the jejunum (day 0). At day 7 laparoscopy was performed and the adhesions observed in each foal were recorded. In group-1 foals (n = 6), the adhesions were separated laparoscopically (treatment 1). In group-2 foals (n = 6), 300 mL of 0.5% ferric hyaluronate gel was infused into the abdomen after the adhesions were separated laparoscopically (treatment 2). At day 24, terminal laparoscopy was performed and the adhesions observed were recorded. Total number of adhesions within each group was compared between day 7 and 24. Data were analyzed to determine whether an association existed between the number of adhesions on day 24 and treatment type. RESULTS: At day 24, the number of adhesions was significantly decreased within each group, compared with the number of adhesions at day 7 (group-1 foals, 10 vs 22 adhesions; group-2 foals, 3 vs 20 adhesions). Treatment 1 was associated with a significantly higher number of adhesions at day 24, compared with treatment 2 (odds ratio, 4.54; 95% confidence interval, 1.03 to 23.02). CONCLUSION AND CLINICAL RELEVANCE: Abdominal instillation of 0.5% ferric hyaluronate gel after laparoscopic dissection was a more effective technique than laparoscopic dissection alone to treat experimentally induced adhesions in pony foals. Laparoscopic adhesiolysis following abdominal surgery in foals is a safe and effective technique.     

Effect of carboxymethylcellulose and a hyaluronate-carboxymethylcellulose membrane on healing of intestinal anastomoses in horses

OBJECTIVE: To evaluate the effect of sodium carboxymethylcellulose (SCMC) or a hyaluronate-carboxymethylcellulose membrane (HA membrane) on healing of the small intestine in horses. ANIMALS: 18 healthy adult horses. PROCEDURE: Midline celiotomy and 2 jejunal resection-and-anastomosis surgeries were performed. In treated horses, SCMC (n = 6) or a HA membrane (6) was applied to the jejunum to cover the anastomosis. There were 6 untreated control horses. Horses were euthanatized 10 days after surgery. For each horse, 1 anastomosis was used for histologic examination, and the second was used to determine intestinal bursting strength. Intestinal bursting tension, serosal granulation tissue, serosal fibrin deposition, and width of the fibrous seal at the anastomosis were compared among groups. RESULTS: 3 control horses had adhesions associated with the anastomosis, but none of the treated horses had adhesions associated with the anastomosis. Mean thickness of fibrin deposited on the serosal surfaces for the SCMC and HA-membrane groups was significantly less than that for control horses. Mean thickness of serosal granulation tissue, width of fibrous seal between inverted musculature, inflammatory cell infiltrate scores, and bursting tension did not differ significantly among groups. CONCLUSIONS AND CLINICAL RELEVANCE: Use of SCMC or application of a HA membrane to small intestinal anastomoses in horses resulted in fewer adhesions and decreased fibrin deposition, and it did not adversely affect anastomotic healing. In horses at increased risk for intra-abdominal adhesions, SCMC or application of HA membranes may decrease the frequency of adhesions without adversely affecting healing of small intestinal anastomoses.     

Evaluation of laparoscopic adhesiolysis for the treatment of experimentally induced adhesions in pony foals

OBJECTIVE: To assess the efficacy of laparoscopic adhesiolysis in the treatment of experimentally induced adhesions in foals. ANIMALS: 8 healthy pony foals. PROCEDURE: Celiotomy was performed and adhesions created at the jejunoileal junction and at sites 0.5 and 1 m proximal to this junction, using a serosal abrasion method. Ten days after celiotomy, exploratory laparoscopy was performed. Laparoscopic adhesiolysis was performed in the treatment group only (4 foals, randomly selected). Thirty days after the exploratory laparoscopy, a final laparoscopic examination was performed, and the foals were euthanatized. The number and characteristics of abdominal adhesions were recorded during laparoscopy 10 and 30 days after celiotomy and during necropsy. RESULTS: At 30 days after celiotomy, the number of adhesions in the control group was significantly higher than the number in the treatment group. In the control group, all adhesions observed during the exploratory laparoscopy were still evident at the final laparoscopy and necropsy. In the treatment group, adhesions did not form again after separation. During final laparoscopy and necropsy, a focal adhesion between the omentum and site of the initial laparoscope portal was observed in 5 of 8 foals. CONCLUSIONS AND CLINICAL RELEVANCE: The serosal abrasion model is useful for studying abdominal adhesions in foals. Laparoscopic adhesiolysis was an effective technique to break down experimentally induced adhesions in the early maturation stage of formation in pony foals. Studies are required to investigate prevention of de novo adhesions at the laparoscope portal sites.     

Evaluation of acetaminophen absorption in horses with experimentally induced delayed gastric emptying

OBJECTIVE: To evaluate the correlation between the half-time of liquid-phase gastric emptying (T50) determined by use of nuclear scintigraphy, using technetiumTc 99m pentetate, and absorption variables of orally administered acetaminophen in horses with experimentally delayed gastric emptying. ANIMALS: 6 mature horses. PROCEDURE: Delayed gastric emptying was induced by IV injection of atropine sulfate. Twenty minutes later, acetaminophen and technetium Tc 99m pentetate were administered simultaneously via nasogastric tube. Serial lateral images of the stomach region were obtained, using a gamma camera. Power exponential curves were used for estimation of T50 and modified R2 values for estimation of goodness-of-fit of the data. Serial serum samples were obtained, and acetaminophen concentration was determined, using fluorescence polarization immunoassay. Maximum serum concentration (Cmax), time to reach maximum serum concentration (Tmax), area under the curve for 480 minutes, and the appearance rate constant were determined, using a parameter estimation program. Correlations were calculated, using a Spearman rank correlation coefficient. RESULTS: A significant correlation was detected between T50 determined by use of scintigraphy and Tmax determined by use of acetaminophen absorption. Correlation between T50 and other absorption variables of acetaminophen was not significant. CONCLUSIONS AND CLINICAL RELEVANCE: The acetaminophen absorption method was a valid technique in this model of delayed gastric emptying in horses. The method may be a valuable tool for use in research as well as in clinical evaluation of gastric emptying in horses.     

Healing of experimentally induced corneal ulcers in horses

Corneal ulcers to the depth of the anterior third of the stroma were created surgically in both eyes of 10 ponies. One eye in each pony was treated topically with chloramphenicol and 1% atropine ophthalmic ointments 3 times per day; the contralateral eye was not treated topically. All ponies were given phenylbutazone orally for relief of ocular pain. Fluorescein-stained ulcers were measured once a day. The median healing time of the treated eyes (11 days) and the median healing time of the nontreated eyes (13.5 days) were found not to be significantly different. Clinically, however, more severe complications arose in the nontreated eyes.     

Evaluation of avocado and soybean unsaponifiable extracts for treatment of horses with experimentally induced osteoarthritis

OBJECTIVE: To evaluate the use of a combination of avocado and soybean unsaponifiable (ASU) extracts for the treatment of experimentally induced osteoarthritis in horses. ANIMALS: 16 horses. PROCEDURES: Osteoarthritis was induced via osteochondral fragmentation in 1 middle carpal joint of each horse; the other joint underwent a sham operation. Horses were randomly allocated to receive oral treatment with ASU extracts (1:2 [avocado-to-soybean] ratio mixed in 6 mL of molasses; n = 8) or molasses (6 mL) alone (placebo treatment; 8) once daily from days 0 to 70. Lameness, response to joint flexion, synovial effusion, gross and histologic joint assessments, and serum and synovial fluid biochemical data were compared between treatment groups to identify effects of treatment. RESULTS: Osteochondral fragmentation induced significant increases in various variables indicative of joint pain and disease. Treatment with ASU extracts did not have an effect on signs of pain or lameness; however, there was a significant reduction in severity of articular cartilage erosion and synovial hemorrhage (assessed grossly) and significant increase in articular cartilage glycosaminoglycan synthesis, compared with placebo-treated horses. CONCLUSIONS AND CLINICAL RELEVANCE: Although treatment with ASU extracts did not decrease clinical signs of pain in horses with experimentally induced osteoarthritis, there did appear to be a disease-modifying effect of treatment, compared with findings in placebo-treated horses. These objective data support the use of ASU extracts as a disease-modifying treatment for management of osteoarthritis in horses.     

Use of a high-molecular-weight carboxymethylcellulose in a tissue protective solution for prevention of postoperative abdominal adhesions in ponies

OBJECTIVE: To evaluate efficacy and safety of IP administration of high-molecular-weight carboxymethylcellulose (HMW CMC) for the prevention of postoperative intra-abdominal adhesions in ponies. ANIMALS: 10 ponies. PROCEDURE: A 1% solution of HMW CMC was instilled intra-abdominally prior to surgery in 5 ponies, whereas 5 control ponies did not receive HMW CMC. Postoperative adhesions were induced by use of a bowel-abrasion method comprising laparotomy, typhlotomy, and abrasion of jejunal serosa at multiple sites with placement of 3 sutures at each site. Day of surgery was day 0. After surgery, ponies were monitored, and hematologic, serum biochemical, and peritoneal fluid analyses were performed on days 1, 2, 3, 5, 7, and 10. On day 10, ponies were euthanatized. Intra-abdominal adhesions were recorded, and tissue samples were collected for histologic examination. RESULTS: A significantly greater number of adhesions, number of multiple adhesions, and mean incidence of adhesions were identified in control ponies, compared with CMC-treated ponies. Mean peritoneal fluid WBC count on day 7 and serum fibrinogen concentrations on days 5 and 7 were significantly higher in control ponies, compared with CMC-treated ponies. Results of serum biochemical analyses did not differ significantly between the 2 groups. CONCLUSIONS AND CLINICAL RELEVANCE: Intra-abdominal use of 1% HMW CMC during surgery was effective for preventing postoperative adhesions in ponies. Use of HMW CMC did not have detrimental effects on wound healing, intra-abdominal defenses, or patient health. A 1% solution of HMW CMC may be used routinely during abdominal surgery of horses for prevention of postoperative adhesions.     

Exercise-induced pulmonary hemorrhage in horses with experimentally induced allergic lung disease.

The lungs of sensitized horses were exposed to aerosolized ovalbumin. Some horses (n = 4) were given ovalbumin in 1 lung only, whereas in others (n = 7), ovalbumin or vehicle were inoculated in the cranial, ventral, and caudal regions of the caudal lung lobe. Horses were exercised 5 hours after ovalbumin exposure. Immediately before exercise, endoscopy failed to reveal any abnormality. After exercise, endoscopic examination of horses subjected to unilateral ovalbumin exposure revealed extensive blood in airways leading to the exposed lung in all horses. Blood was not observed in the airways leading to the control lung. Mean (+/- SEM) minimum volume of the exposed and control lungs was 9.5 +/- 1.5 and 5.5 +/- 1.6 L, respectively; this difference was statistically significant (P less than 0.05). Bronchoscopy of horses subjected to regional ovalbumin or vehicle exposure and exercise revealed a small amount of blood-tinged fluid in the bronchi serving the regions of the lung inoculated with ovalbumin. Minimum volumes of such regions were not significantly different from one another. However, their minimum volume was significantly (P less than 0.05) larger than that of vehicle-inoculated regions. Gross and histologic examination confirmed inflammation and hemorrhage in the ovalbumin-exposed, but not the control lungs or lung regions. Thus, exercise can cause blood from an injured region of lung to appear in the larger airways. Regional differences in lung structure and function do not influence the appearance of blood in the airways.     

Illness associated with abdominal adhesions in a cow

A mature Holstein cow became inappetent , dehydrated and weak, with a marked drop in milk production, 17 days after a dead calf was removed by cesarean section. Laparotomy revealed adhesions among the cecum, jejunum, colon, bladder and uterus. Transection of the adhesions resulted in recovery; however, the cow was sent to slaughter a month later because of apparent recurrence of the abdominal adhesions.     

Effect of experimentally induced endotoxemia on serum interleukin-6 activity in horses.

A study was conducted to determine whether serum interleukin-6 (IL-6) activity increased in horses during experimentally induced endotoxemia and whether serum IL-6 activity correlated to changes in clinical or laboratory data. Six clinically normal horses were given endotoxin IV (30 ng/kg of body weight) in 0.9% NaCl solution over 1 hour. Five of these and 1 additional horse served as controls and were given only 0.9% NaCl solution. Venous blood, for determination of serum IL-6 activity and WBC count, was collected before and at various times through 8 hours after the start of endotoxin or NaCl infusion. Rectal temperature and heart and respiratory rates were recorded throughout the study period. Serum IL-6 activity was determined by bioassay of proliferation of the B13.29 clone B.9 hybridoma cell line. From 1.5 through 5 hours after start of the infusion, serum IL-6 activity was significantly (P less than 0.05) increased in horses given endotoxin. Mean peak serum IL-6 activity was observed between 3 and 4 hours. In response to endotoxin infusion, horses became lethargic, tachycardic, and febrile. Leukopenia developed by 1 hour, followed by leukocytosis at 8 hours. Significant (P less than 0.05) positive association and linear correlation were apparent between mean serum IL-6 activity and mean rectal temperature in the group of horses that were given endotoxin. Changes from baseline were not evident in any of the clinical or laboratory values in horses given only NaCl solution.     

Evaluation of vaccination with Neospora caninum protein for prevention of fetal loss associated with experimentally induced neosporosis in sheep

OBJECTIVE: To evaluate the immunologic response of a killed tachyzoite vaccine against Neospora caninum and its effectiveness in preventing fetal loss associated with experimentally induced neosporosis in sheep. ANIMALS: 30 Dorset ewes. PROCEDURE: Ewes were randomly allocated to receive vaccination on days 1 and 60 of the study with a killed N caninum tachyzoite preparation in a commercially available adjuvant or a saline-adjuvant mixture. A ram was placed on pasture with the ewes from days 15 to 60. Blood was collected from ewes before primary and booster vaccinations and prior to experimental challenge with N caninum tachyzoite performed on day 90; sera were assessed via Neospora agglutination (NA) and immunofluorescence antibody (IFA) assays. Blood was collected from lambs before they suckled, and sera were tested for antibodies against N caninum. RESULTS: Of the 14 vaccinated ewes that became pregnant, 12 gave birth to live-born lambs; in contrast, 5 of 11 pregnant control ewes gave birth to live-born lambs. Whereas vaccination improved fetal survival in pregnant ewes challenged with N caninum tachyzoites, it did not appear to have any appreciable effect on transmission of N caninum to offspring, as indicated by results of NA and IFA assays. CONCLUSIONS AND CLINICAL RELEVANCE: The N caninum tachyzoite vaccine used in this study appeared to provide protection against fetal loss associated with experimentally induced neosporosis in a high proportion of pregnant ewes.     

Arthrotomy versus arthroscopy and partial synovectomy for treatment of experimentally induced infectious arthritis in horses.

To evaluate the clinical, laboratory, and histologic effects of 2 methods of treatment for infectious arthritis in horses, Staphylococcus aureus (3.4 to 3.9 x 10(3) colony-forming units) was inoculated into the tarsocrural joints of 8 horses on day 0. Each horse was treated with phenylbutazone (2 g, PO, q 24 h) and gentamicin sulfate (2.2 mg/kg of body weight, IV, q 8 h) for 14 days. On day 2, general anesthesia was induced, and each horse had 1 tarsocrural joint treated by arthrotomy, with removal of accessible fibrin and lavage with 3 L of sterile balanced electrolyte solution. An indwelling plastic drain was placed in the standing horse to provide a means for lavage with 3 L of balanced electrolyte solution twice daily for 72 hours. The contralateral tarsocrural joint was treated via arthroscopic debridement, synovectomy, and lavage with 3 L of balanced electrolyte solution. Arthrotomy and arthroscopic portals were allowed to heal by second intention. Lameness and thermographic examinations, analysis and bacteriologic culture of synovia, CBC, and WBC differential count were performed prior to inoculation and on days 1, 3, 6, 8, and 13. On day 14, each horse was euthanatized, and the joints were measured, opened, and photographed. Synovium and articular cartilage were obtained for semiquantitative histologic (H&E stain) and histochemical (safranin O fast green stain) evaluation. Lameness and joint circumference were significantly (P less than 0.05) greater in limbs treated by arthroscopy, synovectomy, and lavage. Arthrotomy with lavage eliminated the S aureus infection significantly (P less than 0.05) earlier than arthroscopy, synovectomy, and lavage, however, both treatments eliminated the infection in all but a single joint.(ABSTRACT TRUNCATED AT 250 WORDS)