Partial gastrectomy and total splenectomy for the treatment of a gastric mass in a horse

A 9-year-old cob mare with a history of recurrent colic presented during an acute colic episode. Ultrasonography revealed a mass emanating from the greater curvature of the stomach and was tightly adhered to the cranial edge of the spleen. Partial gastrectomy and total splenectomy were performed via a midline celiotomy incision. The mass was subsequently confirmed to be granulomatous inflammation, postulated to be secondary to a penetrating injury to the stomach. Post-operatively, the mare had episodes of recurrent colic that were successfully managed with optimisation of the horse's diet and feeding regime. At 10 months’ post-operatively the mare was managed on full turn out, with no evidence of colic and had returned to the previous level of ridden work. The horse then presented 14 months post-operatively with severe colic due to a large colon impaction and displacement and was euthanased. This is the first report to describe successful partial gastrectomy as a treatment option for a gastric mass in the horse.     

Disruption of the blood supply to the small colon following rectal prolapse and small colon intussusception in a mare

A coliky and depressed four year old Arabian mare was examined three days after replacement of a rectal prolapse that had occurred during parturition. Fresh blood was present in the rectum and a septic peritonitis was diagnosed based upon the clinical pathological examination of the peritoneal fluid. At laparotomy the terminal 1.3 meters of small colon was found to be necrotic as a result of rupture of the terminal mesocolon and associated blood vessels. Based upon the poor prognosis the mare was euthanized. Rupture of the mesocolon was thought to be a sequel to the rectal prolapse. The anatomy predisposing the horse to these events is discussed.     

Strangulation of the duodenum just oral to its caudal flexura caused by a volvulus

An 8-year-old Haflinger mare with a 10-day-old foal at foot was referred with mild abdominal pain. On the basis of clinical examination, blood and peritoneal fluid analysis, the cause of pain was suspected septic peritonitis. The horse was initially managed medically, with the horse placed in box confinement under close monitoring. No permission was given for an exploratory laparotomy, and it was decided to perform a diagnostic laparoscopy in the standing horse. The laparoscopy revealed a 360-degree anticlockwise partial duodenal volvulus of the caudal descending duodenum, which was manually reduced (hand-assisted laparoscopy). After the release, the mesentery of the duodenum showed an ischaemic band (yellowish white and dark red with a hyperaemic side) and the duodenum had a distinct ischaemic ring (orally and aborally) distinguishing the incarcerated part from the normal duodenum. Ten minutes after the release, the colour remained the same. In conjunction with the owner, it was decided to euthanise the pony. Pathology confirmed the presence of a strangulation ring and the ischaemic condition of the involved duodenum.     

Septicemia and peritonitis due to Actinobacillus equuli infection in an adult horse

Actinobacillus equuli is a rare cause of peritonitis in adult horses. Septicemia and peritonitis due to A. equuli were diagnosed at necropsy in an 8-year-old Saddlebred mare. The origin of the infection was not known; however, small necrotic colonic mucosal lesions presumed to have been caused by phenylbutazone treatment may have allowed bacterial invasion. A good response to antimicrobial treatment has been documented in the small numbers of previously reported acute cases of peritonitis. Because it is potentially treatable, it is important for pathologists and clinicians to identify horses with A. equuli peritonitis.     

Small-colon rupture attributable to granulosa cell tumor in a mare

A large granulosa cell tumor was believed to be responsible for causing obstruction and subsequent rupture of the small colon in a 10-year-old Quarter Horse mare. Two months earlier, a mass, tentatively diagnosed as granulosa cell tumor of the left ovary, had been identified by means of rectal palpation and ultrasonography. The mare was evaluated for clinical signs of acute, severe, abdominal pain, increased heart rate, cyanotic mucous membranes, clinical dehydration, with high PCV, leukopenia, and extreme abdominal distension. A large soft tissue mass and taut band that constricted the lumen of the small colon were palpable per rectum. Septic peritonitis was diagnosed on the basis of results of abdominocentesis. Exploratory surgery revealed extensive fecal contamination of the abdominal viscera, and the mare was euthanatized because of the resultant poor prognosis. At necropsy, the small colon was occluded by a taut, left broad ligament and the ovarian mass that was proved to be a granulosa cell tumor. The occlusion had caused impaction of the small colon, with subsequent perforation at the level of the broad ligament.     

Displacement of the large colon associated with nonsurgical correction of large-colon entrapment in the renosplenic space in a mare

Nonsurgical correction of a renosplenic entrapment of the large colon was attempted in a mare, using a rolling technique. After correction, the mare had initial improvement in clinical signs, but later developed signs of abdominal discomfort. A ventral midline celiotomy was performed, and a pelvic flexure impaction and large intestinal volvulus were found and corrected.     

Large colon strangulation due to a diaphragmatic hernia in a mare: A case report

This report describes a case of diaphragmatic hernia with incarcerated large colon in a 16-year-old Tennessee Walking Horse mare. This mare was presented with an acute episode of abdominal pain that was not responsive to analgesic therapy. Treatment consisted of resection of the devitalized large colon and closure of the rent in the diaphragm.     

Omental fibrosarcoma in a horse

A 13-year-old Thoroughbred mare had a 2-week history of weight loss and intermittent fever. Examination of abdominal and pleural fluid revealed peritonitis and pleuritis. Ultrasonography of the ventral abdominal midline revealed an intra-abdominal mass. Exploratory celiotomy was performed, but the mass was not surgically excisable. The mare was euthanatized and necropsied. Histologically, the mass was determined to be a fibrosarcoma of omental origin.     

Entrapment of the small colon through a mesocolic rent in a mare

A 6-year-old mare was presented for acute abdominal pain unresponsive to analgesics. Exploratory laparotomy revealed entrapment of the small colon through a 12 cm rent in the mesocolon. The incarcerated small colon was manually reduced and the rent in the mesocolon was sutured closed. The mare made excellent postoperative recovery and was discharged from the hospital 4 days later. The cause of the rent, which was chronic in appearance, is unknown.     

Suppurative splenitis and peritonitis in a horse after gastric ulceration caused by larvae of Gasterophilus intestinalis

A 12-year-old Thoroughbred mare, with a history of anorexia, dramatic weight loss, fluctuating pyrexia and intermittent diarrhoea after an episode of colic, was presented for examination with depression, emaciation and ataxia. Thoracic and abdominal paracenteses yielded copious quantities of inflammatory exudate. Palpation per rectum revealed an enlarged spleen. The primary alterations in haematology included a severe leucocytosis with a left shift, and a hyperproteinaemia characterised by hypoalbuminaemia and hypergammaglobulinaemia. Post-mortem examination revealed a low grade pleurisy and peritonitis with fluid accumulation in both cavities. A suppurative gastritis with full thickness perforations of the stomach wall associated with Gasterophilus intestinalis larvae had extended to the juxtaposed organ initiating an extensive suppurative splenitis. Streptococcus zooepidemicus was cultured.     

Uterine rupture as a postpartum complication in two mares

Uterine rupture was diagnosed in 2 postpartum mares with hemorrhagic vaginal discharge. Both mares had abdominal pain, as evidenced by pawing, kicking at the abdomen, or attempting to roll. Peritoneal fluid analysis was useful in establishing a diagnosis. One mare had many RBC in the peritoneal fluid and was anemic; this mare was managed medically with oxytocin, antibiotics, and blood transfusion. The mare was able to raise her foal to weaning age. The second mare had many RBC, degenerate neutrophils, and intracellular and extracellular bacteria in peritoneal fluid. Surgical repair of the uterus was performed, and the mare was treated for peritonitis. The mare later became pregnant.     

Mesenteric tears of the descending (small) colon as a postpartum complication in two mares.

Segmental ischemic necrosis of the descending colon associated with discrete tears of the mesocolon were diagnosed in 2 mares following foaling. After foaling, both mares had a slow onset of signs of abdominal pain and gradual deterioration of clinical status. Increases in peritoneal fluid total protein concentration and WBC count and a palpable impaction of the descending colon on examination per rectum were useful diagnostic aids. Surgical intervention was successful in one mare, but not in the other.     

Septic peritonitis in a Percheron mare associated with Clostridium haemolyticum

This report describes an 11‐year‐old Percheron mare that presented with signs of colic and was ultimately diagnosed with bacterial peritonitis of unknown origin. Bacterial culture of a peritoneal fluid sample isolated 2 Clostridial species, one of which was strongly suspected to be Clostridium haemolyticum. The horse was markedly hypoalbuminaemic at presentation, leading to the development of low oncotic pressure and ventral oedema. The mare was administered a low molecular weight/low molar substitution hydroxyethyl starch solution in conjunction with other therapies that resulted in marked improvement of clinical signs. The purpose of this report is to describe the clinical findings associated with equine peritonitis associated with C. haemolyticum, a rarely identified pathogen in the horse. Secondly, this report serves to describe the beneficial effects of tetrastarch administration in a clinical case with severe hypoalbuminaemia and ventral oedema.     

Gastric Torsion from an Intestinal Hernia Through a Rent in the Gastrosplenic Ligament in a Horse

The present report describes an 8-year-old gelding presenting with signs of severe abdominal pain. After performing a thorough physical examination, including rectal palpation and additional diagnostic tests, an exploratory laparotomy was recommended. The jejunum was found herniated through the gastrosplenic ligament, and the stomach was severely distended with gas. Given a poor prognosis, the horse was euthanized on the table. At necropsy, the stomach appeared dilated, with an 180° horizontal gastric torsion, from left (lateral) to right (medial), dividing the organ into dorsal and ventral compartments. We believe that the chronic traction exerted by an incarcerated and distended loop of jejunum, in the dorsal aspect of the gastrosplenic ligament, associated with trauma during episodes of intense rolling, enlarged the rent until it ruptured. Because of this rupture, the lateral dorsal aspect of the stomach became unattached, predisposing it to the torsion.     

Postpartum partial cystectomy through the vagina in a mare with everted partially necrotic bladder.

The bladder of a 750-kg Clydesdale mare had everted through the urethra into the vagina immediately after parturition. The bladder was reinverted into the peritoneal cavity by an attending veterinarian, but 4 days later, the bladder was everted again in the vagina. The mare was able to void urine through both ureters, which could be seen in the mucosal surface of the bladder. The everted bladder had become edematous and could not be reinverted through the urethra. A considerable portion of the fundus was necrotic. The mare was administered xylazine epidurally to induce perineal analgesia, and the necrotic portion of the bladder was resected and healthy bladder tissue was opposed with a double layer of simple continuous sutures. The urethral sphincter was longitudinally incised through the vaginal mucosa to allow reinversion of the bladder through the urethra. A purse-string suture inserted in the urethral opening decreased the urethral diameter and prevented recurrence of the condition. An inflated Foley catheter was maintained in the bladder for 5 days. The mare recovered normal urination after the catheter was removed.     

Septic peritonitis due to colonic perforation associated with aberrant migration of a Gasterophilus intestinalis larva in a horse

An adult quarter horse mare was presented with acute colic and fever. Physical examination and abdominocentesis showed septic peritonitis, and the mare was euthanatized. Necropsy and histopathologic examination revealed a focal partial perforation of the right ventral colon, which contained a single bot fly larva, identified as a third-instar larva of Gasterophilus intestinalis. This larva was embedded deep within the muscularis and the submucosa. Although bot fly larvae are known to attach to aberrant sites within the digestive tract, this is the first known report of deep penetration of the colon by a gasterophilus larva, with the resulting leakage of intestinal content leading to septic peritonitis.     

Hepatic lobe torsion in a horse

A 4-year-old Belgian mare was presented with a 1-week history of fever, suspected of being caused by peritonitis. The mare died before the diagnostic procedures had been completed; postmortem examination revealed torsion of the left medial lobe of the liver, resulting in diffuse necrosis of liver tissue and severe peritoneal effusion.     

Jejunojejunal Intussusception and Colonic Impaction in a 12-Day-Old Orphan Foal

A 12-day-old, 14.4-kg, female foal of Australian Miniature Pony breed was presented at the National Chung Hsing University Veterinary Medicine Teaching Hospital, Taiwan, with a history of weakness of 2 days’ duration. The mare died of unknown cause on the previous day. Abnormal findings during physical examination included an estimated dehydration of 3 to 5%, dark red oral mucous membranes, elevated heart and respiratory rates, stiffened feces, and absence of intestinal motility on auscultation. Continual nursing care was followed by intravenous fluid therapy and nonsteroidal anti-inflammatory drug and antibiotic treatment. The foal's condition deteriorated rapidly, and feeding was refused. Subsequently, she developed signs of pyrexia and panting. In spite of oxygen supplement, she died 18 hours after admission. Postmortem examination revealed the presence of a jejunojejunal intussusception, 20 cm in length; a torsion of jejunum proximal to the intussusception also was noted. An ulcerative lesion, 3 cm in diameter, was found on the mucosa of duodenum. Large amounts of sand, coat hair, and hay mantling in bloody discharge were observed in a colonic impaction. That it was an acute case was evident by the involvement of intussusception and ulceration, indicating desquamation of the necrotic epithelial cells with edema and distinct infiltration of neutrophils. These results suggested that a practical management strategy for nursing an orphan foal should be performed to avoid a similar case in the future.     

Cutaneous mucormycosis caused by Absidia corymbifera in a horse

A 5-year-old pregnant Spanish thoroughbred mare was presented with an extensive granulomatous lesion, of four months duration, on the left medial foreleg. On examination, the wound was covered by a large mass of ulcerated granulation tissue exuding thick serosanguinous fluid. The mare had not responded to previous treatment. Physical examination revealed no fever, no lameness and the presence of intense pruritus. A surgical resection was carried out to take samples for histopathology. On histopathologic examination the dermis and subcutaneous tissue showed large multifocal necrotic eosinophilic areas and inside these areas, irregularly ramified fungal hyphae. Microbiological examination showed abundant fungal growth and the strain corresponded to Absidia corymbifera . Treatment with amphotericin B was started but there was no improvement in the lesion. The mare aborted, became anorexic, had febrile episodes, had very poor body condition and was euthanized.     

Colonic sand impaction with cecal rupture and peritonitis in an adult African savanna elephant,and review of noninfectious causes of gastrointestinal disease in elephants

Gastrointestinal disorders are among the most common disease processes in captive elephants. Colic is a frequent clinical presentation and may have several infectious and noninfectious causes. Ingestion of sand has been reported in elephants living in enclosures with loose sandy soils. Similar to the situation in horses, sand ingestion can cause intestinal impaction and colic in elephants. Here we describe a case of colonic sand impaction with cecal rupture and peritonitis in an African savanna elephant from a zoologic collection that died after several days of colic. On autopsy, abundant, gritty, sandy material was found within a segment of colon immediately aboral to the cecum. There was a full-thickness tear in the cecal wall, free intestinal contents within the abdominal cavity, and peritonitis. To our knowledge, the postmortem examination of an elephant with sand impaction and cecal rupture has not been reported previously; this condition should be included among the differential diagnoses in elephants with colic. We review the reports of noninfectious causes of gastrointestinal disease in elephants, which include cases of small intestinal and colonic torsion and of intestinal obstruction by fecal boluses.