Caecal intussusceptions in horses: a New Zealand perspective

Objective To establish the prevalence of intussusceptions involving the caecum in a population of horses admitted to a university hospital for colic. Design Retrospective clinical study Methods Medical records of all horses admitted to the Massey University Veterinary Teaching Hospital between 1991 and 2004 were examined for information of those horses diagnosed with an intussusception involving the caecum. Results A total of 135 horses were admitted for colic surgery during the study period and 61 horses had a diagnosis of ileocaecal (37), caecocaecal (5) or caecocolic intussusception (19) made either at surgery or necropsy. Of the horses with ileocaecal intussusception, 32 had an incomplete hand-sewn ileocaecostomy without reduction and 29 survived to discharge. All the horses with caecocaecal intussusceptions were diagnosed preoperatively via rectal examination and/or transabdominal ultrasound: 2 were euthanased at surgery and 3 survived to discharge. In the 19 horses with caecocolic intussusceptions, manually reduction at surgery was performed in 6 and 5 of them survived to discharge. A typhlectomy was performed via a colotomy in 6 horses, 3 of which survived to discharge. Conclusions The high prevalence of intussusceptions involving the caecum seen at this referral centre may indicate a higher prevalence in New Zealand than is reported elsewhere in the world. Clinical relevance Intussusceptions involving the caecum should be considered as a differential diagnosis in horses presenting with chronic low-grade colic. Transabdominal ultrasound is useful for identifying caecocaecal and caecocolic intussusceptions. Hand-sewn side-to-side incomplete ileocaecostomy is a quick, effective and safe method of surgical treatment of ileocaecal intussusceptions.     

Caeco-caecal and caeco-colic intussusception in two half-sibling Standardbred horses

This report describes caecal intussusception in two young half-sibling Standardbred horses. Both horses presented showing signs of low-grade abdominal pain. The horses remained haemodynamically stable despite signs of abdominal pain and associated tachycardia. Exploratory celiotomy was undertaken in both horses due to persistent abdominal pain and a poor response to administration of analgesic medications. Exploration of the abdomen revealed caeco-caecal intussusception in one horse and caeco-colic intussusception in the other horse. An underlying cause for caecal dysfunction and subsequent intussusception was not identified in either patient. Manual reduction of the intussusception was successful in both cases. The horses recovered uneventfully from surgery.     

Caecal intussusceptions in horses and the significance of Anoplocephala perfoliata

A caecocaecal intussusception in a pony and a caecocolic intussusception in a horse, both infected with Anoplocephala perfoliata, are described and the relevance of tapeworms in such intestinal disease of horses is reviewed.     

Control of helminth parasites in juvenile horses

Parasite control in juvenile horses remains a substantial challenge for veterinary practitioners and their clients. This age group is at risk for various types of parasitic disease because their worm burdens tend to be larger and more diverse than in mature horses. This contrast is largely attributable to marked differences in relative levels of acquired immunity. Frequent, perennial anthelmintic treatment is not a sustainable approach for parasite control in this age group, but the simple, surveillance‐based parasite control strategies recommended for mature horses are not appropriate for juveniles either. Maneuvering through the early years of a horse's life requires up‐to‐date knowledge about biology and epidemiology of the parasite species in play as well as local evidence regarding the anthelmintic resistance status of each herd. This article provides an overview of the most important helminth parasites to target in a control programme for juvenile horses, and highlights how the target species change as horses age. Young foals (<2 months) are exposed to Strongyloides westeri and Parascaris spp., whereas the primary target parasite in foals between age 2 months and weaning is Parascaris spp. Beyond weaning, the focus shifts away from ascarids, and the targets instead are strongyles and tapeworms. Gasterophilus spp. and Oxyuris equi are also discussed.     

Glanders and the risk for its introduction through the international movement of horses

Glanders is the contagious zoonotic disease caused by infection with Burkholderia mallei. It affects primarily horses, donkeys and mules. The disease was eradicated from large areas of the Western world in the early 20th century, but, over the last 10–20 years, has emerged and re‐emerged in areas in which it was previously unknown or had been eradicated. Although glanders was previously thought to manifest in only acute or chronic presentations, it now appears that B. mallei can produce latent infections similar to those caused by Burkholderia pseudomallei. These latent infections may or may not be detectable by current diagnostic tests. The diagnostic test currently recommended by the World Organisation for Animal Health (Office International des Epizooties [OIE]) for international trade in equids is the complement fixation test (CFT). This test has been shown to have varying sensitivities and specificities depending on the antigen and methodology used. False positives are problematic for the horse‐owner and veterinary authority, whereas false negatives may allow the reintroduction of B. mallei into B. mallei‐free areas. These gaps in knowledge of the epidemiology of glanders, and weaknesses in its diagnosis, coupled with the increased movement of equids, indicate that infection with B. mallei remains a major risk in the context of international movement of equids.     

Outcome and long‐term follow‐up of 20 horses undergoing surgery for caecal impaction: A retrospective study (2000–2008)

Reasons for performing study: If untreated, caecal impaction may progress to rupture of the caecum and reports of long‐term outcome for horses undergoing surgery for caecal impaction are required. Objectives: To describe short‐ and long‐term complication rates for horses undergoing surgery for caecal impaction in an otherwise life‐threatening gastrointestinal condition. Methods: Case records were reviewed for horses undergoing surgery for caecal impaction. Horses were included in the study if an abnormally large, fluid‐distended or feed‐impacted caecum was the primary diagnosis at surgery and excluded if the caecum had already ruptured upon opening the abdomen, necessitating euthanasia. Short‐term follow‐up data were obtained from clinical records; and included complications, repeat celiotomy and survival to discharge. Long‐term survival was defined as survival for >1 year post operatively. Long‐term follow‐up data were obtained through telephone interviews with owners and referring veterinary surgeons. Survival, occurrence of post operative colic and subsequent use of the horse were recorded. Results: Twenty horses underwent surgery for caecal impaction: 16 horses underwent caecal bypass (typhlotomy and removal of caecal contents, ileal transection followed by ileocolostomy); 3 underwent typhlotomy alone; and one horse underwent typhlotomy followed by a second procedure where caecal bypass was performed. Five horses (25%) were admitted for colic evaluation with primary caecal impactions, in 10/20 (50%) of cases the impaction was secondary to previous orthopaedic surgery and in 5/20 (25%) caecal impaction was identified at repeat celiotomy following a previous colic surgery. Sixty‐five percent (13/20) of horses survived to discharge; 11/13 (85%) of horses discharged survived long term; 100% (3/3) horses that received typhlotomy alone were discharged and survived long term. Conclusions: The prognosis following caecal impaction surgery is fair, if the horse survives to discharge then prognosis for long‐term survival is good. Potential relevance: Surgery for caecal impaction carries a fair prognosis for a potentially life threatening disease, in particular where caecal dysfunction is suspected.     

Pharmacokinetics of harpagoside in horses after intragastric administration of a Devil's claw (Harpagophytum procumbens) extract

Devil's claw is used for the treatment of inflammatory symptoms and degenerative disorders in horses since many years, but without the substantive pharmacokinetic data. The pharmacokinetic parameters of harpagoside, the main active constituent of Harpagophytum procumbens DC ex Meisn., were evaluated in equine plasma after administration of Harpagophytum extract FB 8858 in an open, single‐dose, two‐treatment, two‐period, randomized cross‐over design. Six horses received a single dose of Harpagophytum extract, corresponding to 5 mg/kg BM harpagoside, and after 7 days washout period, 10 mg/kg BM harpagoside via nasogastric tube. Plasma samples at certain time points (before and 0–24 hr after administration) were collected, cleaned up by solid‐phase extraction, and harpagoside concentrations were determined by LC‐MS/MS using apigenin‐7‐glucoside as internal standard. Plasma concentration‐time data and relevant parameters were described by noncompartmental model through PKSolver software. Harpagoside could be detected up to 9 hr after administration. C_max was found at 25.59 and 55.46 ng/ml, t_1/2 at 2.53 and 2.32 hr, respectively, and t_max at 1 hr in both trials. AUC_0–inf was 70.46 and 117.85 ng hr ml^?1, respectively. A proportional relationship between dose, C_max and AUC was observed. Distribution (V_z/F) was 259.04 and 283.83 L/kg and clearance (CL/F) 70.96 and 84.86 L hr^?1 kg^?1, respectively. Treatment of horses with Harpagophytum extract did not cause any clinically detectable side effects.