Continuous absorbable suture pattern in the closure of ventral midline abdominal incisions in horses

A retrospective study was performed to evaluate the healing of ventral midline abdominal incisions, closed with a simple continuous suture pattern using absorbable suture material, in 139 horses and foals. Dehiscence and incisional hernia developed separately in two horses. The low incidence of dehiscence and incisional hernia, compared with their reported incidence following the use of interrupted suture repair, leads the authors to recommend this alternative method of abdominal incision closure in horses. The security of closure is not sacrificed and the advantages of a rapid closure are desirable.     

Clinical evaluation of a jejunojejunal end‐to‐end anastomosis with skin staples with or without coverage by a mesenteric flap

This study describes a novel end‐to‐end‐jejunojejunal‐anastomotic technique using skin staples following resection of compromised small intestine. Five horses were referred with colic and underwent exploratory laparotomy, resection and anastomosis. No long‐term complications were recorded at 12 months. This safe and effective technique may be used in equine gastrointestinal surgery.     

Comparative evaluation of metallic skin staples or polypropylene sutures for primary closure of teat wounds in sheep

ABSTRACT

Aims

To compare stainless steel staples and polypropylene suture material for primary closure of wounds after teat amputation in ewes and to assess progress of healing in the presence or absence of intramammary infection (IMI).     

Comparison of gross and histologic tissue responses of skin incisions closed by use of absorbable subcuticular staples, cutaneous metal staples, and polyglactin 910 suture in pigs

OBJECTIVE: To assess gross and histologic tissue responses of skin incisions closed by use of absorbable subcuticular staples, cutaneous metal staples, and polyglactin 910 suture in pigs. ANIMALS: 8 purpose-bred disease-free pigs. PROCEDURE: Pigs were randomly allocated to 1 of 4 groups from which tissues were collected after death on postoperative days (PODs) 7, 14, 21, or 42. In each pig, 4 incisions were made; 1 was closed subcuticularly with 3-0 polyglactin 910 suture, 1 was closed with metal staples, and 2 were closed with absorbable subcuticular staples. Incision sites were grossly evaluated every 3 days after closure. At necropsy, incision sites and surrounding tissues were examined histologically; a histopathologic scoring system was used to quantitate healing and tissue response directed against the closure material. RESULTS: Postoperatively, the metal staples induced a severe inflammatory response, compared with minimal inflammation associated with the suture or absorbable subcuticular staples. Histologic evaluation of incisions on PODs 7, 14, and 21 revealed less severe inflammation associated with absorbable subcuticular staples than that associated with the other materials. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that absorbable subcuticular staples induced a less severe inflammatory response in the early stages of healing in pigs, compared with other commonly used methods of wound closure. Use of absorbable staples potentially combines the benefits of subcuticular closure with the speed and precision of staple placement.     

Case series: Persistent dorsal displacement of the soft palate in eight horses

Persistent dorsal displacement of the soft palate (pDDSP) is a relatively rare equine disorder. This case series reports histories and clinical findings in 8 cases of pDDSP, and outcome after treatment of concurrent epiglottic entrapment (n = 3), laryngeal tie‐forward (n = 6) ± laser staphylectomy (n = 2), and/or sectioning of mucosa ventral to the epiglottis and the hyoepiglotticus muscles (n = 2). Four of 6 horses that underwent tie‐forward ± laser staphylectomy had complete resolution of pDDSP and returned to their previous level of work, as did one horse that had a subepiglottic releasing incision. Correction of concurrent epiglottic entrapment in 3 horses with pDDSP did not result in resolution of pDDSP in any case. Previous laryngeal surgery including laryngoplasty and ventriculocordectomy appear to be risk factors for the development of pDDSP.     

Use of an absorbable haemostatic gauze product to control bleeding in 20 horses

The objective of this study was to report our experience with an absorbable haemostatic gauze product in 20 horses with traumatic or surgical haemorrhage. The product is made from oxidised, regenerated cellulose (ORC) and is approved for external use and currently being studied to control internal bleeding in surgical settings in human subjects. Treated horses were from both practice and university settings. Signalment, anatomic location, underlying cause of bleeding and outcome were recorded in the medical record. The size of gauze, approximate time until bleeding stopped, and pre- and post-ORC adjunctive treatments were also recorded. The ORC was used in a variety of anatomic locations, including castration site, foot, flank incisions, distal limb, tooth extraction sites and the perineal region. The bleeding stopped or slowed dramatically within 90 s in 15 of 20 cases. There were no recorded complications in any of the cases. While this clinical report does not attempt to prove efficacy of the product in horses, it does show that this ORC product, which has been approved for use as a haemostatic agent in human subjects, is safe and of practical value, and may be a useful and viable option for the control of haemorrhage in a variety of equine clinical settings.     

Removal of a metallic foreign body from the tongue of three horses

The objective of this case report is to describe the diagnostic and surgical techniques for removal of a metallic foreign body in the tongue of three adult horses. The three horses were presented for evaluation and treatment of dysphagia and marked hypersalivation of 3–5 days duration. Radiographs of the head revealed the presence of a metallic foreign body in the tongue of each horse. The foreign bodies could be precisely localised under general anaesthesia using palpation and lingual ultrasonography and/or lingual radiography in combination with a forceps as a marker. The foreign bodies were successfully removed using laparoscopic instruments creating minimal soft tissue trauma. The use of long (43 cm) small laparoscopic (5 mm) instruments enabled good visualisation of the surgical field, providing optimal conditions for successful minimally invasive surgical treatment of horses with foreign bodies in the tongue. The three horses made uneventful recoveries and 12 months after surgery were eating normally and could be ridden with a bit as per usual routine. It was concluded that using long laparoscopic instruments in combination with palpation, ultrasonography and/or radiography allowed removal of the foreign body creating minimal soft tissue trauma and allowing optimal conditions for a fast recovery.     

Case report of atypical infiltrative lipomatosis of the equine mesojejunum

A 25‐year‐old mare was examined for persistent colic. Over the previous month, the mare had experienced several episodes of mild recurrent colic. The episode of colic persisted for 18 h and the pain became unresponsive to analgesic therapy. Euthanasia was undertaken. Post mortem examination revealed an atypical infiltrative lipoma of the mesojejunum, confirmed histopathologically. To the authors' knowledge, this is the first case report of a diffuse infiltrative lipoma of the equine mesojejunum.     

The current status of antibiotic use in equine reproduction

Antibiotics are infused into the uterine lumen, added to semen extenders and given systemically for infections of the reproductive tract of the mare and stallion. Evidence‐based guidelines for determining treatment length and route of administration are limited and use is frequently based on convenience or tradition. Current recommended antibiotic use for the treatment of bacterial and fungal endometritis, placentitis and metritis in the mare and genital infections of the stallion are presented. Antibiotic classes used for reproductive problems are also reviewed.     

The use of progestins in equine medicine: A review

Progesterone is in constant fluctuation throughout the lifespan of the horse. As a key regulator of the hypothalamic–pituitary–gonadal axis, progesterone is involved in numerous aspects of reproduction. Synthetic analogs of progesterone, deemed progestins, are widely available to industry to act as progestogenic within the reproductive tract, although few are bioactive in the horse. Utilised to suppress oestrous, delay ovulation, maintain pregnancy, and for behavioural modifications, progestins are a commonly administered class of pharmaceuticals in veterinary medicine. In this review, we discuss the progestins available to equine industry, in addition to assessing efficacy, pharmacokinetics, and potential side effects following administration of each.     

Surgical treatment of uterine torsion using a ventral midline laparotomy in 19 mares

OBJECTIVE: To report on the outcome of surgical treatment of uterine torsion in preterm mares. DESIGN: Retrospective case series of pregnant mares with uterine torsion presented to the Clinic for Obstetrics, Gynaecology and Andrology of Large and Small Animals. METHODS: Hospital records of all pregnant mares that underwent ventral midline laparotomy for uterine torsion between 1998 and 2004 were reviewed. The signalment, history, clinical signs, results of diagnostic procedures, direction and degree of the uterine twist, treatment and outcome were retrieved from each case record. RESULTS: This study comprised 19 mares between months 5 and 11 of pregnancy (8.7 +/- 1.9) and suffering from uterine torsion. In all cases ventromedian laparotomy was carried out under general anaesthesia. Gastrointestinal disorders were also present in 52.6% of horses. Postoperative complications included subcutaneous seromas (five mares), peritonitis (one mare) and abortion (two mares). In four mares (21%) the operation was unsuccessful (i.e. these mares had to be euthanased intra- or postoperatively). Of the surviving 15 mares, 13 (86.6%) gave birth to viable foals at full term. The foals developed normally. Only two mares aborted. CONCLUSIONS: Because of its versatility the ventral midline approach should be considered for correction of uterine torsion. The approach has many advantages, including rapid and clear access to the abdominal cavity, safety, visual assessment of uterine wall viability, correction of concomitant gastrointestinal tract problems, and performance of hysterotomy or hysterectomy, if indicated. In this study, managing uterine torsion in this way resulted in a high percentage of cases (86.6%) in which pregnancy was maintained, with the birth of a viable, mature foal.     

Revisiting the use of hydroxyethyl starch solutions in equine fluid therapy

The last decade has led to major shifts in opinions on the use of hydroxyethyl starch (HES) solutions in fluid therapy, specifically in human patients with sepsis. The majority of evidence documenting adverse effects of HES solutions on coagulation and renal health come from studies in people. However, these findings have led to investigation into the safety of HES solutions in veterinary species. While there are now studies investigating the effects of HES solutions on coagulation and renal health in dogs, cats and horses, information regarding long-term follow-up, clinical significance of these changes and use of these solutions in critically ill animals is still lacking. The information presented here serves to review the physiology of oncotic pressure and the rationale behind colloid use, specifically HES solutions. Additionally, the foundation of arguments against the use of HES and the available literature regarding HES use in animals will be summarised.