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1.
Diagnostic laparotomy and laparoscopy are surgical techniques commonly used for the investigation of chronic abdominal disease and weight loss. They can both be usefully carried out in the standing sedated horse, allowing a thorough examination of the dorsal abdominal cavity and biopsies to be harvested. Small intestinal disease is an important cause of weight loss and recurrent colic. Inflammatory or neoplastic bowel disease may not always be apparent grossly and histopathological assessment of full thickness biopsies may be required to provide a definitive diagnosis. Details of cases of 15 horses that underwent small intestinal biopsy or enterectomy while sedated and standing are presented. Three incisional infections occurred causing delayed wound healing. Three horses were subjected to euthanasia before hospital discharge: two had persistent gastric reflux and one had colitis. A further six were subjected to euthanasia in the first 4 months due to their underlying inflammatory bowel condition. One horse was subjected to euthanasia for severe laminitis that was presumed to be caused by treatment with a corticosteroid 4 years later, and one died of acute colic 2.3 years after successful resection and anastomosis. Five horses were alive at the time of review, median 2.7, range 1.2–4.3 years. Overall therefore, 3 (20%) horses died during hospitalisation and 5 (33%) were still alive at the end of the study. Results from this series suggest that minimising the number of intestinal biopsies may reduce morbidity, but the underlying pathological process appears to be the most important prognostic factor for survival. Resection and anastomosis in the standing sedated horse proved feasible.  相似文献   

2.
BACKGROUND: Hyperglycemia in critically ill humans is associated with increased glucose production and insulin resistance and is associated with death. This might also be true in horses presenting with acute abdominal disease. HYPOTHESIS: Throughout hospitalization, hyperglycemia will be common in adult horses presenting with acute abdominal disease. Hyperglycemia will be associated with a worse prognosis for survival to hospital discharge. ANIMALS: Two hundred sixty-nine adult horses with acute abdominal disease. METHODS: Observational retrospective study. Records were reviewed for 269 horses that had glucose data analysed and recorded at the time of hospital admission: 154 horses had a first sample after admission; 110 horses at 24 hours after admission; 74 horses at 36 hours after admission; and 49 horses at 48 hours after admission. Logistic regression analyses were performed to investigate the association of glucose concentrations with survival, in addition to the association of glucose concentrations with surgical, small intestinal, strangulating lesions, and lesions requiring a resection. RESULTS: Of 269 horses presenting with acute abdominal disease, 50.2% had blood glucose concentrations greater than the reference range (75.6-131.4 mg/dL); 0.4%, below the reference range; and 49.4%, within the reference range at admission. Of 269 horses, 2.3% had blood glucose concentrations below the reference range at some point during the first 48 hours of hospitalization, all of which had strangulating intestinal lesions. Horses that did not survive to hospital discharge had a higher mean blood glucose concentration at admission; at the first sample after admission; at 24, 36, and 48 hours after admission; and higher maximum and minimum blood glucose concentrations in the first 24 hours after admission. CONCLUSIONS AND CLINICAL IMPORTANCE: Derangements of blood glucose concentration are common in horses with acute abdominal disease. Hyperglycemia is much more common than hypoglycemia in these animals. Hyperglycemia in the first 48 hours of hospitalization is associated with a worse prognosis for survival to hospital discharge.  相似文献   

3.
Survival after small intestine resection and anastomosis in horses   总被引：3，自引：0，他引：3  
The authors examined factors influencing survival in 140 horses that recovered from anesthesia after small intestinal resection between 1968 and 1986, using Kaplan-Meier estimated survival curves and the Cox proportional hazards regression model. Seventy-two horses (51%) died during the initial postoperative period, 19 horses (14%) died after discharge from the hospital, 33 horses (24%) were alive, and 16 horses (11%) were classified as censored. Mean age at surgery was 8 years. Horses 15 years of age or older, Arabians and Stallions, were overrepresented in the hospital population. The most common reason for resection was strangulation of bowel through a mesenteric rent. The mean and 50% median survival times were 1540 and 27 days, respectively. Horses admitted after January 1, 1980, had a significantly longer survival than those admitted before that time. Survival was longer after anastomosis of two small intestinal segments than after anastomosis of a small intestinal segment to the cecum; however, the length of bowel resected and the method of anastomosis had no demonstrable influence on survival. Of the variables studied, the heart rates at presentation and 24 hours after surgery were the most accurate predictors of survival.  相似文献   

4.
The authors examined factors influencing survival in 140 horses that recovered from anesthesia after small intestinal resection between 1968 and 1986, using Kaplan-Meier estimated survival curves and the Cox proportional hazards regression model. Seventy-two horses (51%) died during the initial postoperative period, 19 horses (14%) died after discharge from the hospital, 33 horses (24%) were alive, and 16 horses (11%) were classified as censored. Mean age at surgery was 8 years. Horses 15 years of age or older, Arabians and Stallions, were overrepresented in the hospital population. The most common reason for resection was strangulation of bowel through a mesenteric rent. The mean and 50% median survival times were 1540 and 27 days, respectively. Horses admitted after January 1, 1980, had a significantly longer survival than those admitted before that time. Survival was longer after anastomosis of two small intestinal segments than after anastomosis of a small intestinal segment to the cecum; however, the length of bowel resected and the method of anastomosis had no demonstrable influence on survival. Of the variables studied, the heart rates at presentation and 24 hours after surgery were the most accurate predictors of survival.  相似文献   

5.
OBJECTIVE: To determine clinical and surgical abnormalities in, and long-term outcome of, horses that undergo surgery because of colic secondary to inflammatory bowel disease (IBD). DESIGN: Retrospective study. ANIMALS: 11 horses. PROCEDURE: Medical records of horses that had undergone abdominal surgery and in which IBD had been diagnosed on the basis of histologic examination of intestinal biopsy specimens were reviewed. RESULTS: 5 horses were examined because of acute colic and 6 were examined because of chronic colic. At surgery, all 11 horses had edematous or hemorrhagic bowel segments suggestive of IBD. In addition, 6 horses had circumferential mural bands (CMB) causing constriction of the small (4 horses) or large (2) intestine. Intestinal resections were performed in 7 horses. All 11 horses survived surgery and were discharged from the hospital; 10 horses were still alive at the time of follow-up (1.5 to 7 years after surgery). CLINICAL IMPLICATIONS: Results suggest that IBD is an uncommon cause of colic in horses. Surgical resection of segments of intestine with constrictive CMB may relieve clinical signs of colic. Horses with IBD that had surgery had a good prognosis for long-term survival.  相似文献   

6.
Summary

A retrospective study was carried out of 224 horses operated for strangulating small intestine obstructions. Fifty‐four horses were euthanized and 5 horses died during surgery which means that 165 (73%) were allowed to recover. Of these, 53 horses were euthanized or died in the clinic and 112 (50%) were discharged from the hospital. Of 90 horses available for follow‐up 1 year postoperatively, 76 (84%) were still alive. The most important causes of death or reasons for euthanasia in the direct post‐operative period were post‐operative paralytic ileus, (adhesive) peritonitis and intra‐abdominal haemorrhage. After discharge from the hospital the reasons were (adhesive) peritonitis and (recurrent) colic. Of the horses which survived for at least 1 year, 16% sometimes suffered from colic, 12% experienced problems with incisional woundhealing and 4% suffered from jugular vein thrombosis. All were in good or reasonable condition and 88% performed at (approximately) the same level as before the operation.

The type of surgical intervention (i.e. enterotomy, enterectomy) did not significantly influence the outcome of surgery, whereas the type of anastomosis did. End‐to‐end jejunojejunostomy had a better prognosis than side‐to‐side jejunocaecostomy.

It was concluded that strangulating obstructions of the small intestine still carry a poor to guarded prognosis. Mortality was highest in the direct peri‐operative period. Once discharged from hospital, prognosis can be considered to be fair to good. Attempts to improve outcome should be directed at a better handling of the ileal stump during surgery and at the prevention of post‐operative ileus and the formation of adhesions.  相似文献   

7.
OBJECTIVE: To determine whether heavy (> or = 680 kg [> or = 1,500 lb]) draft horses undergoing surgical treatment for acute signs of abdominal pain were at a greater risk for anesthetic and postoperative complications and lower postoperative survival rates than light (< 680 kg) draft horses. DESIGN: Retrospective case series. ANIMALS: 72 draft horses. PROCEDURES: Medical records of draft horses that underwent exploratory celiotomy for signs of acute abdominal pain from October 1983 to December 2002 were reviewed. Medical records of draft horses in which a celiotomy was performed for correction of reproductive abnormalities were not included in the study. RESULTS: When compared with light draft horses, heavy draft horses had longer durations of anesthesia, more postoperative complications, and lower survival rates. Seventy-six percent of horses that recovered from anesthesia had postoperative complications. Postoperative complications associated with low survival rates included myopathy and neuropathy, ileus, diarrhea, and endotoxemia. All horses with postoperative myopathy and neuropathy died or were euthanized. The short-term survival rate for horses that recovered from anesthesia was 60%. Horses undergoing small intestinal surgery had a worse prognosis for short-term survival than those undergoing large intestinal surgery. The survival rate for horses for which long-term (> 1 year) follow-up information was available was 50%. CONCLUSIONS AND CLINICAL RELEVANCE: Draft horses weighing > 680 kg that underwent surgery because of acute signs of abdominal pain had longer durations of anesthesia, more postoperative complications, and higher mortality rates than draft horses weighing < 680 kg.  相似文献   

8.
Surgical Treatment of Sand Colic Results in 40 Horses   总被引：1，自引：0，他引：1  
A retrospective study of 40 horses that underwent surgical treatment for sand colic was performed. Three horses were euthanatized and one died during surgery. Of the 36 horses that recovered from anesthesia, five died before discharge from the hospital and seven died after discharge. Twenty-four horses survived at least 12 months. Sand impaction of the right dorsal colon was present in 26 horses. In addition to sand impaction, 10 horses also had colonic displacement or volvulus.  相似文献   

9.
A retrospective study was carried out of 224 horses operated for strangulating small intestine obstructions. Fifty-four horses were euthanized and 5 horses died during surgery which means that 165 (73%) were allowed to recover. Of these, 53 horses were euthanized or died in the clinic and 112 (50%) were discharged from the hospital. Of 90 horses available for follow-up 1 year postoperatively, 76 (84%) were still alive. The most important causes of death or reasons for euthanasia in the direct post-operative period were post-operative paralytic ileus, (adhesive) peritonitis and intra-abdominal haemorrhage. After discharge from the hospital the reasons were (adhesive) peritonitis and (recurrent) colic. Of the horses which survived for at least 1 year, 16% sometimes suffered from colic, 12% experienced problems with incisional woundhealing and 4% suffered from jugular vein thrombosis. All were in good or reasonable condition and 88% performed at (approximately) the same level as before the operation. The type of surgical intervention (i.e. enterotomy, enterectomy) did not significantly influence the outcome of surgery, whereas the type of anastomosis did. End-to-end jejunojejunostomy had a better prognosis than side-to-side jejunocaecostomy. It was concluded that strangulating obstructions of the small intestine still carry a poor to guarded prognosis. Mortality was highest in the direct peri-operative period. Once discharged from hospital, prognosis can be considered to be fair to good. Attempts to improve outcome should be directed at a better handling of the ileal stump during surgery and at the prevention of post-operative ileus and the formation of adhesions.  相似文献   

10.
The case records of 119 young horses (all less than age one year) that underwent an exploratory celiotomy during a 17 year period were examined to determine the surgical findings, short- and long-term outcome, and prevalence of small intestinal disease compared to previous reports in the mature horse. Physical and laboratory values were compared for long-term survivors vs. nonsurvivors and the frequency of post operative intra-abdominal adhesions was determined. The most common cause for exploratory celiotomy was small intestinal strangulation, followed by enteritis and uroperitoneum. Six horses died during surgery, 23 were subjected to euthanasia at the time of surgery due to a grave prognosis, and 17 horses died or were destroyed after surgery, prior to discharge from the hospital; the short-term survival was 61%. Nine horses were lost to follow-up. Forty-one horses survived long-term (at least 6 months after surgery), 15 died or were subjected to euthanasia after discharge for reasons related to the prior abdominal surgery, and 8 died or were destroyed after discharge due to unrelated reasons, making the long-term survival 45%. Fifty-three (45%) of the horses presented as neonates, and 66 (55%) presented age 3-12 months. Uroperitoneum and meconium impaction were the most common disease in the neonate. Intussusception and enteritis were the most common diseases in older foals. The overall prevalence of small intestinal disease was 44%. Significant elevations in packed cell volume, heart rate, nucleated cell counts and total protein in abdominal fluid and rectal temperature were observed in nonsurvivors compared to survivors. Nonsurvivors had significantly decreased serum bicarbonate, chloride, sodium, and venous pH values. There was no evidence that location of the lesion affected long-term survival. Horses with a simple obstruction had a higher survival percentage than those with a strangulating obstruction, and horses that underwent an intestinal resection had a lower long-term survival than those horses undergoing only intestinal manipulation. Nineteen (33%) of the foals examined after the original surgery had evidence of intra-abdominal adhesions. Nine of these (16%) had adhesions that caused a clinical problem.  相似文献   

11.
Objective To review the breed, age, gender, clinical and laboratory findings, treatment and outcome of horses with caecal disease presented to a referral centre. Design Retrospective study of 96 cases. Procedure The breed, age, and gender of the study population were compared with the corresponding hospital population for the same period. The means (± SD) for clinical and laboratory findings were recorded for each caecal disorder. Treatment was categorised as medical or surgical, and outcome was recorded. Results Caecal diseases included impaction (40% of total cases), rupture associated with concurrent unrelated disease (13%), rupture with parturition (9%), rupture with no associated disease (5%), infarction (11%), torsion (9%), abscess or adhesion (7%), tumour (3%), and miscellaneous conditions (3%). The breed or gender of affected horses did not differ from the hospital population, although horses > 15 years were more frequently represented (P < 0.05). This age group was specifically more predisposed to caecal impaction (P < 0.05), as were Arabian, Morgan, and Appaloosa breeds (P < 0.05). In horses with caecal impaction transrectal examination was the most useful diagnostic procedure; 90% of affected horses treated medically were discharged while horses treated by typhlotomy alone, or typhlotomy and blind end ileocolostomy, had survival rates to discharge of 71% and 86%, respectively. Horses with caecal rupture associated with concurrent un-related disease showed no signs of impending rupture; all were receiving phenylbutazone, all were euthanased, and 50% had caecal ulceration at necropsy. Of horses with caecal rupture with parturition 56% had prior dystocia; in two-thirds the site of rupture was the ileocaecal junction and all were euthanased. Horses with caecal rupture with no associated disease died or were euthanased; rupture was idiopathic. Horses with caecal infarction usually had signs of abdominal pain and abdominal fluid changes consistent with peritonitis; transrectal examination was nonspecific, and typhlectomy was successful in seven of eight horses. Horses with caecal torsion had signs of severe, acute abdominal pain and typhlectomy was successful in three of five horses. Diagnosis of caecal adhesion or abscess was assisted by transrectal palpation in two of seven horses and surgical treatment was successful in two of five horses. A caecal tumour was diagnosed in three horses aged 20 years or older that presented with chronic weight loss. Other caecal diseases were uncommon. Conclusion Caecal disease is uncommon in equids but some specific features of the history and physical findings can alert the veterinarian to the possibility of caecal involvement in horses with gastrointestinal dysfunction. Medical or surgical therapy can be effective in horses where caecal rupture has not occurred.  相似文献   

12.
We reviewed case records, necropsy reports, and histologic sections from 25 Thoroughbred racehorses that died suddenly at 3 Chicago racetracks. These were young horses ranging in age from 2 to 5 years. There were more females (n = 16) than males (n = 9), and the incidence of death increased slightly in the spring and summer. Twenty-one of the 25 horses died while racing or training. Only 8 of the 25 horses (32%) had lesions sufficient to account for the death. In 6 of those 8 cases, death was caused by massive thoracic or abdominal hemorrhage. The site or nature of the vascular defect in these cases could not be determined. One horse died of severe preexisting pulmonary disease, and one died of encephalitis and cardiac papillary muscle fibrosis. The cause of death was undetermined in 17 horses (68%). Nearly all horses had pulmonary edema, congestion, and/or hemorrhage. We postulate that these unexplained deaths were a result of exercise-induced acute cardiovascular failure.  相似文献   

13.
OBJECTIVE: To report the history, clinical findings, and outcome of horses with idiopathic focal eosinophilic enteritis associated with acute small intestinal obstruction. STUDY DESIGN: Retrospective study. ANIMALS: Six horses with idiopathic focal eosinophilic enteritis. METHODS: Retrospective review of medical records of horses with idiopathic focal eosinophilic enteritis, with acute abdominal pain and small intestinal obstruction, associated with a focal region of eosinophilic enteritis of unknown cause. Information retrieved from the medical records included signalment, physical examination, laboratory findings, surgical procedure, histologic diagnosis, and postoperative management. Outcome was determined by telephone communication with owners. RESULTS: Six horses met the selection criteria. Horses had persistent pain, distended small intestine, and nasogastric reflux. Idiopathic focal eosinophilic enteritis lesions associated with a small intestinal obstruction were treated surgically by intestinal resection and anastomosis or wedge resection. There were no observed complications associated with extension of the disease from the lesion site. Five horses were alive at follow-up 5 to 60 months after surgery. CONCLUSIONS: Although the cause of these focal eosinophilic enteritis lesions is unknown, the long-term outcome after lesion resection was favorable. CLINICAL RELEVANCE: Small intestinal obstruction associated with a focal eosinophilic enteritis lesion may be a cause of acute abdominal pain in horses. Horses apparently have a good prognosis after lesion resection.  相似文献   

14.
The records of 105 pregnant mares and 105 nonpregnant horses with colic admitted to an equine hospital were reviewed. The 2 groups had similar types of colic and short-term survivability. Of the 105 pregnant mares, 31 were treated medically and 74 required surgical intervention. Thirty-three of the 105 mares died or were euthanatized. Thirteen (18%) of the 72 remaining mares aborted. Of 4 mares with severe medical cases, 2 died, 1 aborted, and 1 aborted and died. Of 27 horses with medical cases that required less intensive treatment, none died and 2 aborted. Of the 74 horses that required surgery, 45 survived to termination of pregnancy (foaling or abortion); 36 of these mares (80%) had a live foal. The type of surgical lesion had no effect on pregnancy outcome. Stage of gestation at initial examination, duration of anesthesia, or intraoperative hypoxia or hypotension had no effect on pregnancy outcome. However, when hypoxia occurred during colic surgery in the last 60 days of pregnancy, the mares either aborted or delivered severely compromised foals that did not survive.  相似文献   

15.
OBJECTIVE: To evaluate the activation status of neutrophils in blood samples obtained from horses with naturally occurring colic associated with strangulating obstruction, nonstrangulating obstruction, or inflammatory bowel disease. ANIMALS: 30 horses with naturally occurring colic and 30 healthy control horses. PROCEDURE: Activation status of neutrophils was determined by assessing the number of neutrophils that could pass through filters with 5-microm pores, cell-surface CD11-CD18 expression, and alterations in size and granularity of neutrophils. RESULTS: Horses with impaction or gas colic did not have evidence of activated neutrophils. Horses with inflammatory bowel disease consistently had evidence of activated neutrophils, including decreased leukocyte deformability, increased CD11-CD18 expression, increased neutrophil size, and decreased neutrophil granularity. Horses with strangulating colic had variable results. Of horses with strangulating colic, 7 of 14 had marked changes in filtration pressures, 5 of 14 had increased CD11-CD18 expression, 6 of 14 had changes in neutrophil size, and 5 of 14 had changes in neutrophil granularity. Among horses with strangulating colic, changes in deformability, size, and granularity of neutrophils correlated with an adverse outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Activated neutrophils were detected in all horses with inflammatory bowel disease and a few horses with strangulating colic. Correlation of activated neutrophils with horses that had strangulating colic that died or were euthanatized indicates that activated neutrophils are a negative prognostic indicator. Additional studies are needed to determine whether activated neutrophils contribute directly to the adverse outcome in horses with strangulating colic.  相似文献   

16.
A retrospective study of the medical records of 33 horses was performed to determine the clinical and diagnostic abnormalities associated with temporohyoid osteoarthropathy. Data collected from medical records included signalment, presenting complaints, history, physical examination findings, laboratory data, results of diagnostic imaging studies, and treatments. Follow-up information was obtained from a review of case records; by telephone conversation with the owner, veterinarian, or trainer; or by both methods. Of 33 horses with temporohyoid osteoarthropathy, 29 presented with facial nerve (cranial nerve VII) deficits and 23 presented with vestibulocochlear nerve (cranial nerve VIII) deficits. Guttural pouch endoscopy was more reliable than radiography for diagnosis. Of horses with unilateral clinical signs, 22.6% actually had bilateral disease. Magnetic resonance imaging and computed tomography identified the lesions in all horses in which these tests were performed. Of 30 horses for which follow-up information was obtained, 20 (67%) were alive. Eight horses were euthanized and 1 died because of problems associated with temporohyoid osteoarthropathy. Nineteen of 20 surviving horses (95%) were considered by the owner or trainer to be suitable for athletic use. Twelve surviving horses (60%) had residual facial nerve deficits; 11 horses (55%) had residual vestibulocochlear nerve deficits. Horses with temporohyoid osteoarthropathy have a fair prognosis for return to some type of athletic function, but there is risk of acute death. The majority of horses would be expected to have some residual cranial nerve dysfunction, and it could take a year or longer for maximal improvement to occur.  相似文献   

17.
Twelve cases of ileal impaction in the horse were reviewed. Clinical features of the disease included evidence of mild abdominal pain, reduced or absent intestinal sounds, rectally palpable distended small intestine, gastric reflux, and in the early stages, normal peritoneal fluid. Surgical correction of the impaction was accomplished in 10 horses. Of 8 horses discharged from the hospital, 7 returned to full function. It was concluded that the shorter the duration of colic before surgical intervention, the better the prognosis.  相似文献   

18.
This study evaluated the inflammatory mediator activin A in horses with acute abdominal disease and compared this putative novel biomarker with serum amyloid A (SAA). Thirty-three adult horses referred for evaluation of acute abdominal disease were grouped into three lesion categories, non-strangulating, strangulating or inflammatory. Eleven healthy adult horses served as controls. Serum activin-A was significantly increased in animals with inflammatory or strangulating lesions compared with controls. Horses with non-strangulating, strangulating or inflammatory lesions had significantly elevated SAA concentrations. Activin A, along with other biomarkers, may be useful in monitoring inflammation in cases of acute abdominal disease in horses. Further validation is warranted to determine the utility of this biomarker in evaluating the effectiveness of novel anti-inflammatory treatments for equine colic and endotoxaemia.  相似文献   

19.
Plasma fibrinolytic activity was evaluated over 5 consecutive days in 59 horses admitted to the Large Animal Teaching Hospital with acute gastrointestinal diseases. Only horses hospitalized for at least 5 days were included in the study. Tissue plasminogen activator (tPA) and plasminogen activator inhibitor type-1 (PAI-1) were quantitated using standard chromogenic activity assays. Statistical analyses were performed using analysis of variance; differences were considered significant when P < .05. Activity of PAI-1, the primary endogenous inhibitor of fibrinolysis, was significantly increased on hospital days 2, 4, and 5 in horses that died, when compared with those that were discharged from the hospital. Plasma PAI-1 activity was not different at admission, but was significantly increased on hospital days 2 and 3 in horses that underwent surgery, when compared with those that did not, suggesting an acute phase response to surgical intervention. Horses with strangulating intestinal lesions had significantly increased PAI-1 activity on day 3, while PAI-1 activity was significantly greater in horses with inflammatory conditions at the time of admission, when compared with horses with strangulating or nonstrangulating/noninflammatory lesions. Among all horses, PAI-1 activity was significantly higher and tPA activity was significantly lower on day 2 when compared with other hospital days. These results suggest that fibrinolysis is inhibited early in the course of inflammatory gastrointestinal diseases and in response to surgery. In addition, among all horses, the prognosis for survival was poor for those with persistently increased PAI-1 activity, reflecting treatment failure and the loss of hemostatic regulation.  相似文献   

20.
Summary: In this retrospective study, postoperative ileus was studied in horses having resection of the small intestine followed by a jejunojejunal (n=35) or a jejunocaecal (n=35) anastomosis. Twenty-six horses received no metoclopramide, 27 received metoclopramide as an intermittent intravenous infusion and 17 horses received metoclopramide as a continuous intravenous infusion (0.04 mg/kg/hour). Horses receiving a continuous infusion of metoclopramide had a reduced total volume (P< 0.001), shorter duration (P< 0.001), and a slower rate (P< 0.001) of postoperative gastric reflux, and a shorter postoperative hospital stay (P< 0.01) when compared to horses receiving no metoclopramide and horses receiving metoclopramide as an intermittent infusion. Horses having jejunocaecostomy performed had a larger volume (P< 0.05), longer duration (P< 0.05), and a greater rate (P< 0.05) of postoperative gastric reflux, and a longer postoperative hospital stay (P< 0.001) than horses undergoing jejunojejunostomy. Horses that had an abdominal drain placed during surgery had a longer length of intestine resected (P< 0.05) and a longer postoperative hospital stay (P< 0.05) than horses without an abdominal drain. Horses that died or were euthanased during the postoperative period had a greater total volume (P< 0.05), longer duration (P< 0.05), and greater rate of postoperative gastric reflux (P< 0.01), a longer length of small intestine resected (P< 0.01), and a shorter postoperative hospital stay (P< 0.05) than horses that survived until discharge from the hospital. In a multivariate regression analysis the continuous infusion of metoclopramide was the only variable that contributed significantly to predicting the total volume (P< 0.001; r2= 0.24), duration (P< 0.001; r2= 0.24) and rate (P< 0.001; r2= 0.25) of postoperative gastric reflux. We concluded that metoclopramide given as a continuous intravenous infusion decreased the incidence and severity of ileus following small intestinal resection and anastomosis in horses.  相似文献   

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