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1.
OBJECTIVE: To assess the efficacy and kinetics of a continuous infusion modality for topical ophthalmic drug delivery via subpalpebral lavage in horses. ANIMALS STUDIED: Five ophthalmically normal horses PROCEDURES: A constant-rate continuous delivery pump was used to apply 0.01% fluorescein solution to the eyes of five ophthalmically normal horses via subpalpebral lavage. Fluorescein was applied at a rate of 0.14 mL/h for 72 h. Tear samples were collected from the ventral conjunctival fornix at regular intervals via capillary tube and tear fluorescein concentrations were determined via spectral assay. Laboratory studies to evaluate the procedures used in the study also were performed. RESULTS: Overall mean tear film fluorescein concentration was approximately 20% of the applied concentration of fluorescein. However, tear film fluorescein concentrations varied considerably between horses and over time. Dilution varied from 0.62% to 60% of the applied concentration. Air pockets sporadically appeared in subpalpebral lavage tubing lines, resulting in discontinuous topical application of fluorescein. CONCLUSIONS: Constant-rate delivery of ophthalmic medications using a continuous infusion pump may provide a valuable method of topical drug delivery if tear film dilution of drugs is taken into account.  相似文献   

2.
OBJECTIVE: To assess the effectiveness of free conjunctival grafts in the treatment of horses with a range of keratopathies. DESIGN: A retrospective clinical study of ten client-owned horses treated at Murdoch University Veterinary Hospital from May 1996 to September 2001. PROCEDURE: The suitability of patients for the surgical procedure was assessed using a slit lamp biomicroscope and by direct and indirect ophthalmoscopy. Surgery was performed with the aid of an operating microscope, under general anaesthesia. A subpalpebral ocular lavage catheter was used for administration of topical atropine and antibiotics postoperatively. RESULTS: In all ten horses the affected globe was saved. In nine of the horses vision in the eye was satisfactory 6 months after surgery, and in one horse the eye was blind. Complications included further corneal ulceration or eyelid abscessation and some loss of sutures, although these did not preclude a successful outcome. CONCLUSION: Free conjunctival grafts were successful in treating a range of keratopathies in the horse, and the technique offers a number of advantages over other forms of surgical intervention.  相似文献   

3.
The objective of this study was to evaluate fornix-based suture placement as a method for entropion correction in the dog. Lower eyelid entropion with resultant trichiasis was corrected in 10 dogs using fornix-based suture placement similar to that employed in the Quickert-Rathbun technique used in man. A double-ended suture was placed originating at the deepest extent of the fornix and exiting the lid 1-2 mm from the eyelid margin. Degree of correction was assessed visually immediately after surgery and at re-examination with a follow-up period of up to 6 months. Fornix-based suture placement led to immediate eversion of the eyelid in each case and thus amelioration of the trichiasis in all dogs. In two cases eyelid eversion initially appeared over-corrected and in two cases exposure of conjunctival tissue was evident initially at the palpebral margin. In all cases, however, such complications were transient with long-term results giving an acceptable apposition between ocular surface and eyelid margin in all adult dogs. In three juvenile dogs on which the technique was used, further surgical treatment was required as the puppies grew. Fornix-based suture placement is a novel approach to entropion correction in the dog which yields acceptable results in the majority of suitable cases without recourse to incisional surgery.  相似文献   

4.
The objective of this study was to evaluate the feasibility, efficacy and complications following lavage and drainage of the lateral compartment (LC) of the equine guttural pouch (GP) using a modified Garm's technique (MGT). In an ex vivo study (study 1), six cadaver heads were examined to assess the anatomical limits of the surgical approach and whether vital structures might be damaged. This was followed by an in vivo study (study 2) in which a lavage/drainage tube was placed for 3 days into each LC of four standing horses using the MGT. In both studies, the procedure offered direct access into the LC and indirect access into the medial compartments of the GP. In study 1, the MGT provided a rostroventral point of access allowing drainage of the LC, with no obvious iatrogenic damage. In study 2, the MGT permitted lavage of the entire GP in three healthy horses and one horse with mild GP empyema. The only major complication was development of emphysema of the lateral wall of one LC, with secondary collapse of the mucous membrane. The time for secondary wound healing was 12-14 days. The MGT can be performed safely in standing horses and may be of value in providing access for lavage and drainage in horses with mild GP empyema.  相似文献   

5.
A 5-mg hydroxypropyl cellulose soluble ocular insert was evaluated by placement in the upper and the lower conjunctival and bulbar nictitating membrane fornices in normal dogs. The insert was easily placed in the conjunctival fornices, but was difficult to place in the bulbar nictitating membrane fornix. The conjunctival inserts did not produce irritation of the cornea and the conjunctiva. Placement of the inserts beneath the nictitating membrane produced local irritation and chemosis. The sites of highest to lowest retention for the insert were upper conjunctival fornix, bulbar nictitating membrane fornix, and lastly, lower conjunctival fornix. Dissolution was nearly complete in 8 hours.  相似文献   

6.
OBJECTIVE: To describe the insertion technique, efficacy, and complications associated with the use of an active (closed-suction) abdominal drain in horses. STUDY DESIGN: Retrospective study. Animals-Sixty-seven horses with abdominal contamination treated by abdominal lavage and use of a closed-suction abdominal drain. METHODS: Medical records of horses (1989-1996) that had a closed-suction abdominal drain were reviewed. Follow-up information was obtained by telephone interviews with owners. RESULTS: Sixty-eight closed-suction abdominal drains were used in 67 horses that had abdominal contamination, peritonitis, or to prevent adhesion formation. The drain was placed under general anesthesia (62 horses) or in a standing position (6 horses). Abdominal lavage was performed every 4 to 12 hours and about 83% of the peritoneal lavage solution was retrieved. Minor complications associated with drain use occurred in 49% of the horses and included obstruction or slow passage of fluid through the drain in 18 horses (26%), leakage of fluid around the drain in 11 horses (16%), and subcutaneous fluid accumulation around the drain in 8 horses (12%). Incisional suppuration developed in 20 of 62 (32%) and incisional herniation in 5 of 46 (11%) horses. CONCLUSIONS: A closed-suction drain system was easily placed and was associated with only minor complications in most horses. CLINICAL RELEVANCE: Active abdominal drainage and lavage is a useful adjunct in the treatment of peritonitis or as a prophylactic procedure in horses at risk of developing septic peritonitis and abdominal adhesions. Clinicians should be aware of the high incidence of minor complications.  相似文献   

7.
OBJECTIVE: To describe the cells observed in conjunctival brush cytology (CBC) from normal horses and compare these findings with conjunctival structural histology so as to understand which cells are recovered from CBC. METHODS: This study was divided into three parts. (1) Conjunctival brush smears were collected from 20 healthy horses on both eyes and a differential count on 300 cells was carried out on May Grünwald-Giemsa (MGG) smears. (2) A similar protocol was used for whole eyes from five horses obtained rapidly after death from a slaughterhouse. The eyes were then assessed for conjunctival histology. (3) Cytobrush smears were collected from five healthy horses. Smears were examined after MGG or periodic acid Schiff (PAS) staining. RESULTS: The differential cell count showed a majority of deep and intermediate epithelial cells with very few superficial and goblet cells in both eyes. A stratified columnar to cuboidal epithelium was observed on nearly the whole surface of the conjunctiva. A stratified squamous type was observed at the palpebral and bulbar edges. Areas with highest mucus cell indices were found from the nasal to the temporal edge of the equine inferior conjunctiva in the upper palpebral segment near the fornix and in a part of the nasal fornix. In MGG smears no mucus cells were identified; however, they were numerous in PAS smears (22.6% +/- 11) and were mostly cylindrical cells (42.5% +/- 14.4 PAS positive). CONCLUSIONS: Cytobrush smears in the healthy horse are characterized by a majority of polyhedral and cylindrical cells and a few squamous cells. The cylindrical cells may be mucous cells and probably originate from the main stratified columnar to cuboidal epithelium.  相似文献   

8.
A lag-screw technique for transphyseal bridging of the medial aspect of the distal tibial physis in foals with tarsal valgus deformities and results of the technique in 11 foals (6 with bilateral tarsal valgus deformities and 5 with unilateral tarsal valgus deformities) are described. Briefly, horses were anesthetized, and a single stab incision was made through the skin to the underlying bone over the most distal aspect of the medial malleolus. A 20-gauge needle was placed in the incision to guide screw placement, and a lag screw was inserted parallel to the medial cortex of the tibia under radiographic guidance. Screws were removed when the tarsal valgus deformity was clinically assessed to have improved by at least 80%. Clinically, all horses had evidence of a tarsal valgus deformity of > 7 degrees prior to surgery. Mean age at the time of lag-screw implanation was 220 days (range, 116 to 364 days). Mean time the implant was in place was 62 days (range, 39 to 89 days). The tarsal valgus deformity resolved in all 11 horses with excellent cosmetic results.  相似文献   

9.
The clinical features and outcomes of equine ulcerative keratitis with and without conjunctival graft surgery were assessed using a retrospective study. Medical records of horses hospitalised from July 2000-January 2006 for ulcerative keratitis were included if a diagnosis of melting ulcer, descemetocele or iris prolapse was made, or if surgery was recommended due to severity of corneal disease, and aggressive medical therapy using a subpalpebral catheter was instituted. Treatment and outcome variables were evaluated with and without conjunctival graft surgery. Forty-one horses, 21 that had surgery and 20 for whom surgery was recommended but not performed, were included. Horses were hospitalised for an average of 24 days, with 37/41 melting ulcers, 17/41 descemetoceles and 3/41 iris prolapses, with no statistical difference in frequencies between groups. Bacterial or fungal organisms were cultured from 22/39 cases, with 10 Aspergillus spp. and 8 Pseudomonas spp. Infectious organisms were seen on corneal cytology in 23/30 cases. Surgical cases were hospitalised for an average of 4.9 days prior to surgery. Abdominal discomfort was observed in 8/41 hospitalised horses, with 5/8 operated horses developing caecal impactions. Thirty-five horses retained an intact globe, including 18/20 treated medically and 17/21 that had surgery. Hospitalisation cost was 24% more for cases that had surgery than for medical cases. It was concluded that there was no statistical difference in length or cost of hospitalisation between surgical and nonsurgical groups. Outcomes from both groups were similar, with a high frequency of globe retention.  相似文献   

10.
OBJECTIVES: The aim of this retrospective study was to summarize the most frequent clinical signs, ultrasonographic, and histological findings accompanying scleral rupture as a result of blunt trauma in dogs, cats, and horses. ANIMALS STUDIED AND PROCEDURES: Thirty small animals and three horses diagnosed with scleral rupture resulting from blunt trauma. B-mode ultrasonography was performed on 20 animals. Histopathology was carried out on 18 enucleated globes. RESULTS: In small animals, 80% presented hyphema, 60% subconjunctival hemorrhage, and 53% eyelid and conjunctival swelling. In horses, 100% presented eyelid and conjunctival swelling, 67% hyphema, subconjunctival hemorrhage, and collapsed anterior chamber. Ultrasonographic findings were an area with ill-defined scleral margins (90%), echoic/hyperechoic contents in the anterior and posterior chamber (55%) and in the vitreous (80%). In small animals, scleral rupture location noted on gross examination was: at the posterior pole (4), close to the optic nerve (3), near the limbus (2), and in the dorsal aspect of the globe (1). In horses, the lesion was located at the limbus (3). In small animals, histopathology showed presence of hemorrhage in the anterior, posterior chamber, and vitreous (94%), retinal detachment (94%), choroidal edema and hemorrhages (88%), and choroidal detachment as a result of suprachoroidal hemorrhage (88%). The same lesions were found in the globes of two horses. In small animals, rupture location noted on histopathology was: at the posterior pole (8), close to the optic nerve (4), near the limbus (1), near the ciliary body (1). CONCLUSIONS: The most frequent clinical signs observed were hyphema, subconjunctival hemorrhage, and eyelid and conjunctival swelling. Ultrasonographic findings suggestive for scleral rupture were ill-defined scleral borders and/or echoic/hyperechoic material in the cavities of the globe. On histopathology, lesions severely altering the anatomy of the eye structures were: hemorrhage into the chambers of the globe, subretinal and suprachoroidal hemorrhage leading to retinal and choroidal detachment, respectively. In small animals, the most frequent locations for scleral rupture were the posterior pole and close to the optic nerve, whereas in horses it was the limbus.  相似文献   

11.
The use of a laparoscopic suction-irrigation device in 2 standing horses for lavage of the abdomen for the treatment of primary suppurative peritonitis is reported. Two horses were presented with a 1- to 2-week history of weight loss. Abdominocentesis revealed highly elevated total nucleated cell count. Peritoneal lavage systems were placed in both horses, but complications prevented adequate lavage. Both horses underwent standing laparoscopy; the dorsal abdomen was explored and the abdomen was profusely lavaged, using a suction-irrigation device. The procedure was efficient and allowed adequate visualization of the dorsal abdomen and lavage. A successful outcome was achieved in both cases.Key clinical message:Lavage of the abdomen of horses with peritonitis can be achieved under standing sedation, using a laparoscopic technique. In appropriately selected cases, this allows for adequate visualization of the dorsal abdomen and efficacious abdominal lavage.  相似文献   

12.

Objective

The aim of this study was to describe the placement of subpalpebral lavage (SPL) systems in 12 dogs (15 eyes) intolerant of topical ocular medications to assess the suitability, complications encountered and owner perception of use.

Animals Studied

Retrospective review of dogs that underwent SPL placement for treatment of ocular disease at the Ophthalmology Department, University of Bristol Small Animal Hospital between 2017 and 2021.

Procedure(s)

Data recorded included signalment, history, diagnosis, treatment, reason for SPL placement, uni- or bilateral placement, duration of placement, complications, and outcome. Owner perception was assessed using an online questionnaire. Statistical analysis included McNemar and Wilcoxon signed-ranks tests.

Results

Twelve dogs (15 eyes) underwent SPL placement. Eleven owners completed the online questionnaire. Corneal ulceration was the most common disease requiring SPL placement (n = 13/15 eyes, 86.7%). Most cases received multimodal topical therapy (n = 9/15 eyes, 60.0%) via SPL. Owners administered medication 6.63 times daily via SPL (range 1–16 applications/day). All dogs requiring ongoing topical medication (n = 8/12, 66.7%) were trained to accept direct administration during SPL treatment. Statistically significant improvements in medication compliance, ease of application, and reduced perceived risk of iatrogenic ocular injury were reported by owners (p-value = .001, .004, and .031 respectively). Minor complications were infrequently reported but an excellent outcome was achieved for all eyes.

Conclusion

Subpalpebral lavage placement provides a practical and safe solution for the provision of frequent multimodal ocular medication when treating patients with a challenging temperament.  相似文献   

13.
This retrospective study describes placement of distal radial transphyseal screws in Thoroughbred yearlings with carpal varus deformities while standing, and identifes short- and long-term complications following the procedure. Data gathered from 2009 to 2013 identified 8 yearlings that met the inclusion criteria. Horses were sedated intravenously and a single 4.5-mm cortical screw was placed in the distal lateral radial physis following application of local anesthetic and surgical preparation of a pre-placed hole. All horses were evaluated weekly after surgery and screw removal was performed standing and under sedation when correction of the angular limb deformity was achieved. The mean time for screw removal was 46 days. No short- or long-term complications were identified. Findings indicate that placing a single transphyseal screw in the lateral aspect of the distal radial physis with the horse standing is a viable option to treat varus angular limb deformity of the carpus in horses.  相似文献   

14.

Objective

The aim of this study was to describe placement of a nictitating membrane flap as a treatment for corneal ulceration and bullous keratopathy in two horses.

Animals Studied

A 13-year-old American Saddlebred mare presented for severe corneal edema, superficial stromal ulceration, and a central bulla of the left eye. A 4-year-old Trakhener stallion also presented with a large axial bulla of the left eye with concurrent severe corneal edema and a deep stromal ulcer.

Procedure

A complete ophthalmic examination was performed. Samples were obtained for corneal cytology, and both horses were started on aggressive medical therapy. Both underwent general anesthesia for placement of a nictitating membrane flap and a subpalpebral lavage system (SPLS).

Results

Corneal cytology for each horse revealed a mixed bacterial population. Moderate Pseudomonas aeruginosa was cultured from the mare, while Aspergillus species and a few Enterococcus gallinarum were cultured from the stallion. The bullae in both horses resolved at 3 and 4 weeks and vision returned in the affected eye 4.5 and 3 months postoperatively at the last follow-up, respectively.

Conclusion

Aggressive medical management with concurrent placement of a nictitating membrane flap is effective to treat bullous keratopathy in two horses. The described treatments could be used to treat horses that develop severe or progressive bullous corneal lesions.  相似文献   

15.
The medical records of 39 dogs and 8 cats which had jejunostomy feeding tubes placed using modifications of a previously described surgical technique were retrospectively reviewed. Modifications included the addition of a suture to anchor the feeding tube to the jejunum, the use of a continuous circumferential suture to pexy the jejunum to the abdominal wall, and the placement of a skin suture that penetrated deep into the abdominal wall fascia. All tubes were placed during surgical treatment of a primary intraabdominal disease. Tubes were used for feeding from 1 to 41 days (average 9.7 days). Sixteen patients (34%) developed mild to moderate complications such as chewing at the tube, inadvertent tube removal, tube obstruction, and cellulitis around the ostomy site. Three patients (6%) developed severe complications associated with breakdown of the surgical site. The modified jejunostomy technique was effective for placement of jejunostomy tubes as a complementary procedure to exploratory celiotomy.  相似文献   

16.
OBJECTIVE: To evaluate the effect of an indwelling nasogastric tube on gastric emptying of liquids in horses. ANIMALS: 9 healthy adult horses. PROCEDURE: A randomized block crossover design was used. For treatment group horses, a nasogastric tube was placed and 18 hours later, acetaminophen was administered; the nasogastric tube remained in place until the experiment was complete. For control group horses, a nasogastric tube was passed into t stomach, acetaminophen was administered, and the nasogastric tube was removed immediately. Serial blood samples were collected 15 minutes before and after administration of acetaminophen. Serum concentration of acetaminophen was determined by use of fluorescence polarization immunoassay. The variables, time to maximum acetaminophen concentration (Tmax) and the appearance constant for acetaminophen (Kapp), were determined. The values for Kapp and Tmax in horses with and without prolonged nasogastric tube placement were compared. RESULTS: No significant difference was found in Kapp between horses with and without prolonged nasogastric tube placement; the median difference in Kapp was 0.01 min(-1) (range, -0.48 to 0.80 min(-1). No significant difference was found in Tmax between horses with and without prolonged nasogastric tube placement; the median difference in Tmax was 5 minutes (range, -30 to 50 minutes). Reanalysis of data following the removal of possible outlier values from 1 horse resulted in a significant difference in Tmax between horses with and without prolonged nasogastric tube placement. CONCLUSIONS AND CLINICAL RELEVANCE: Although no clinically important impact of 18 hours of nasogastric intubation was found on gastric emptying in healthy was found among horses.  相似文献   

17.
Objective  To evaluate whether equine serum administered via a simulated subpalpebral lavage system (SPL) supports proliferation of Streptococcus zooepidemicus or Pseudomonas aeruginosa within the tubing.
Procedures  A sterile i.v. catheter with injection cap was inserted into sterilized silicone tubing (Mila®). To mimic an SPL within the dorsal conjunctival fornix, the tubing was secured to an elevated platform. The tip of the tubing extended from the platform into a vial containing culture medium just inoculated with approximately 1.5 × 108 CFU/mL P. aeruginosa or S. zooepidemicus . To mimic administration of medication, the tubing was infused twice daily with equine serum, sterile saline (negative control), or culture medium (positive control) followed by air. Incubation was at 25 or 37 °C. At 24, 48, and 72 h postinoculation, samples were obtained for bacterial culture from one simulated SPL for each experimental variant. The following sections were cultured: (i) tubing tip previously submerged in the inoculated culture medium, (ii) tubing mid-section, and (iii) tip of the i.v. catheter. The experiment was performed in triplicate.
Results  Streptococcus zooepidemicus or P. aeruginosa were isolated from 100% of the tubing tips. Streptococcus zooepidemicus was isolated from one mid-section flushed with culture medium incubated at 37 °C. All other samples were negative for growth of the inoculated agents.
Conclusions  Streptococcus zooepidemicus and P. aeruginosa did not proliferate within silicone tubing infused with equine serum. These data suggest that topical serum can be safely administered through a superiorly placed SPL in clinical cases.  相似文献   

18.
The objective of this study is to describe the management and outcomes of eight horses with subchondral lucencies (SCLs) of the medial aspect of the antebrachiocarpal (ABC) joint. The medical records and radiographs of the carpi of 8 horses with SCLs of the medial aspect of the ABC joint were reviewed. Follow-up clinical information was obtained for 6–60 months (the median duration of 14 months). Treatment was successful if radiographic healing was apparent or lameness was reduced or eliminated. Four horses had SCLs in the distomedial radius (DMR) and four in the proximal aspect of the radiocarpal bone (RCB). Lameness was present in all horses with DMR SCLs and in one horse with an RCB SCL. Treatments included restriction of exercise (n = 3), intra-articular administration of corticosteroids (n = 2), or placement of a screw across the SCL (n = 3). Exercise restriction alone was successful in three nonlame horses younger than one year with proximal RCB SCL and intra-articular corticosteroid administration in the ABC joint in two horses aged 2 years or younger with DMR SCLs. A yearling with a large proximal RCB SCL and two horses aged 5 years or older with DMR SCLs were successfully treated with screw placement across the SCL. Exercise restrictions and intra-articular administration of corticosteroids were successful in management of DMR SCLs in five horses. Placing a screw across the SCL of three horses resulted in resolution of lameness and substantial improvement of the radiographic appearance of the lesion in the RCB or DMR.  相似文献   

19.
Objective —To evaluate the postoperative use of peritoneal lavage for prevention of experimentally induced intraabdominal adhesions in horses.
Study Design —Areas of serosal abrasion were created on the jejunum of 12 horses. Postoperatively, six horses had peritoneal lavage, and six horses did not (controls). The number of adhesions was determined at necropsy 2 weeks after surgery.
Animals or Sample Population—12 horses.
Methods —Five sites of jejunal serosal abrasion were created in each horse. A 32 French thoracic catheter was placed into the right ventral aspect of the abdomen before closure of the abdominal incision. Treated horses had abdominal lavage with 10 L of lactated Ringer's solution on four occasions, then catheters were removed from all horses 34 hours after celiotomy. Horses were necropsied at 2 weeks to quantify the number of intraabdominal adhesions.
Results —All control horses and one treated horse developed intraabdominal adhesions. The number of adhesions was significantly less ( P <.0293) in treated horses. No adverse inflammatory reactions appeared to be associated with repeated peritoneal lavage using lactated Ringer's solution or use of an abdominal drain.
Conclusions —Peritoneal lavage reduced the frequency of intraabdominal adhesions.
Clinical Relevance —When postoperative adhesions are likely to develop, postoperative peritoneal lavage may decrease the frequency of adhesion formation.  相似文献   

20.
Objective: To develop a tenoscopic approach for desmotomy of the accessory ligament of the deep digital flexor tendon (AL‐DDFT) in horses. Study Design: Experimental. Animals: Cadaveric forelimbs (n=10) and 4 forelimbs from 2 horses anesthetized for terminal teaching procedures, and 12 forelimbs of 6 experimental horses. Methods: Saline distention of the carpal flexor sheath facilitated insertion of an arthroscope into the distal medial aspect of the sheath between the AL‐DDFT and deep digital flexor tendon (DDFT). Location of an instrument portal on the lateral aspect of the metacarpus was identified with a needle. The lateral aspect of the AL‐DDFT was transected and the arthroscope and instrument were switched to transect the remaining fibers on the medial aspect. Cadaveric specimens were dissected for evaluation. Experimental horses were monitored for 30 days postoperatively. Results: Minor complications including incomplete division of the AL‐DDFT and shallow incision into the suspensory ligament were observed in some cadaver specimens. The AL‐DDFT was completely transected in all experimental horses with no suspensory ligament damage. Mean±SD surgical time (incision to skin closure) was 28.3±11.8 minutes. On ultrasonographic examination, transection of the AL‐DDFT was complete in all experimental horses. Minor DDFT fiber disruption was noted in 1 limb during ultrasound examination at day 30. Conclusions: A tenoscopic approach through the carpal flexor sheath provided adequate access for desmotomy of the AL‐DDFT.  相似文献   

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