Characteristics and risk factors for failure of horses with acute diarrhea to survive: 122 cases (1990-1996)

OBJECTIVE: To characterize horses with acute diarrhea and determine risk factors for failure to survive. DESIGN: Retrospective study. ANIMALS: 122 adult horses admitted for acute diarrhea at the teaching hospital between Jan 1, 1990 and Dec 31, 1996. PROCEDURE: Medical records of horses with acute diarrhea were reviewed to abstract information regarding signalment, history, physical examination, clinicopathologic testing, treatment, and outcome. RESULTS: 91 of 122 (74.6%) horses lived and were discharged from the hospital. Horses with history of administration of antimicrobials for a problem preceding diarrhea were approximately 4.5 times less likely to survive. The following variables that had been determined at the time of admission were significantly associated with failure to survive: administration of antimicrobial drugs for another illness, serum creatinine concentration > 2.0 mg/dl, PCV > 45%, tachycardia (heart rate > 60 beats/min), and low serum total protein concentration. Prevalence of laminitis was 11.5%. CLINICAL IMPLICATIONS: Diarrheic horses that are azotemic and have clinicopathologic findings consistent with hemoconcentration and hypoproteinemia have a poor prognosis for survival. Antimicrobial administration may induce diarrhea, and antimicrobial-associated diarrhea may have a worse prognosis than other types of acute diarrhea.     

Water transport in the kidney and nephrogenic diabetes insipidus

Nephrogenic diabetes insipidus is caused by an inability of the kidney to concentrate urine despite adequate concentration of vasopressin in blood and is characterized by polyuria, polydipsia, and hyposthenuria in the presence of plasma hyperosmolality. Nephrogenic diabetes insipidus is the result of defects in water homeostasis in the kidney. Nephrogenic diabetes insipidus occurs when the kidneys cannot or do not respond to vasopressin. There are 2 categories of nephrogenic diabetes insipidus. Congenital nephrogenic diabetes insipidus is a rare, inherited, irreversible cause of polyuria and polydipsia in humans that is even rarer in animals. Acquired nephrogenic diabetes insipidus is more common and is often secondary to illness or medication that interferes with the action of vasopressin in the renal tubules. Unlike congenital nephrogenic diabetes insipidus, acquired or secondary nephrogenic diabetes insipidus is often reversible with correction of the associated or causative problem.     

Risk factors associated with development of postoperative ileus in horses.

OBJECTIVE: To determine risk factors associated with development of postoperative ileus in horses undergoing surgery for colic. DESIGN: Case-control study. ANIMALS: 69 horses that developed ileus after surgery for colic and 307 horses that did not develop postoperative ileus. PROCEDURE: Signalment, history, clinicopathologic data, treatment, lesions, and outcome were obtained from medical records. RESULTS: Variables associated with increased risk of postoperative ileus included age > 10 years, Arabian breed, PCV > or = 45%, high serum concentrations of protein and albumin, anesthesia > 2.5 hours' duration, surgery > 2 hours' duration, resection and anastomosis, and lesions in the small intestine. Enterotomy reduced the risk of postoperative ileus. After multivariate logistic regression, the final model included the variables Arabian breed, PCV > or = 45%, lesion type, duration of surgery (> 2 hours vs < or = 2 hours), and pelvic flexure enterotomy. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that by evaluating certain factors, horses at increased risk of postoperative ileus may be recognized before the condition develops. Preventative treatment and early intervention may be instituted in these horses. Shortening surgery time and performing an enterotomy may decrease the probability of horses developing postoperative ileus.     

Cytokine expression by neutrophils of adult horses stimulated with virulent and avirulent Rhodococcus equi in vitro

Rhodococcus equi is an intracellular pathogen of macrophages that causes rhodococcal pneumonia in foals and immunocompromised people. Evidence exists that neutrophils play a vital role in resistance to infection with R. equi; however, the means by which neutrophils exert their effects have not been clearly defined. In addition to directly killing bacteria, neutrophils also may exert a protective effect by linking innate and adaptive immune responses. In the present study we evaluated the cytokine expression profiles of adult equine neutrophils in response to stimulation with isogenic strains of virulent and avirulent R. equi in vitro. After 2 and 4 h incubation with virulent or avirulent R. equi, adult equine neutrophils expressed significantly (P < 0.05) greater tumor necrosis factor alpha (TNFα), interleukin (IL)-12p40, IL-6, IL-8 and IL-23p19 mRNA, but not interferon gamma (IFNγ) or IL-12p35 mRNA than unstimulated neutrophils. Furthermore, virulent R. equi induced significantly greater IL-23p19 mRNA than avirulent R. equi. These results demonstrate that R. equi-stimulated neutrophils are a source of many proinflammatory cytokines. Furthermore, these results suggest that IL-23 may be preferentially expressed over IL-12 in response to exposure with R. equi, and that this response may be more strongly induced by virulent R. equi than avirulent R. equi. Collectively, the data presented herein suggest a non-phagocytic role for neutrophils that may influence the type of adaptive immune response to R. equi.     

Investigation into intraoral approach for nerve block injection at the mental foramen in the horse

Invasive dental procedures performed in the standing, sedated horse are facilitated by local and regional anaesthesia. The traditional transcutaneous approach to the mental foramen is used to desensitise the incisive region including the mandibular incisors, but is not well tolerated by many sedated patients. In this study, a new, intraoral needle insertion technique for nerve block at the mental foramen was investigated. In 15 equine cadaver heads and two live horses, computed tomography (CT) was used to verify Tuohy needle placement into each mental foramen using an intraoral technique. Varying volumes of contrast medium (3, 6, 10 mL) were injected into the mandibular canal with and without digital occlusion of the mental foramen. The distance of retrograde flow was measured. Additionally, measurements were taken to determine the position of the mental foramen within the interdental space. Correct placement of Tuohy needles and injection of contrast medium into the mandibular canal using an intraoral approach at the mental foramen was achieved in all injections. Retrograde flow of contrast medium was accomplished with all volumes, regardless of occlusion. Although not statistically significant, the 10 mL group appeared to have a greater distance of flow. The needle insertion technique described here appears to be a potential alternative to traditional transcutaneous approaches to mental nerve block for procedures involving the incisive region. In addition, it was found that 79% of the mandibular canals injected with 10 mL of contrast medium had retrograde flow to the position of PM4, suggesting this method may be a useful alternative technique for nerve block for the more rostrally located cheek teeth. The location of the mental foramen was consistently found in the distal third of the interdental space (approximately 60–80% of the distance between the distal aspect of the lateral corner incisor and the mesial aspect of the second premolar).     

Meal size and starch content affect gastric emptying in horses

REASONS FOR PERFORMING STUDY: Feeding practices have been associated with colic in horses. If meal size and composition have an effect on gastric emptying, this could be one of the mechanisms by which feeding practices are related to the occurrence of colic. OBJECTIVES: To evaluate the effect of meal size and starch content on solid phase gastric emptying. METHODS: Solid phase gastric emptying of 3 different radiolabelled meals, small low-starch (SmLS), small high-starch (SmHS) and large high-starch (LgHS) meals, was measured in 5 horses by scintigraphy using 99mTc-disofenin. Data were compared among meals using nonlinear mixed-effects models and paired t tests. RESULTS: On a percentage basis, SmHS emptied significantly faster than LgHS and SmLS emptied significantly faster than SmHS meals. However, when meals of unequal size were compared by emptying rate in g/min and Kcal/min, LgHS emptied significantly faster than SmHS. CONCLUSIONS: Meal size and composition affect gastric emptying. POTENTIAL RELEVANCE: Further work needs to be performed in order to substantiate the possibility of a relationship between digestive functions and occurrence of colic and gastric ulcers.