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1.
Reason for performing study: Owners and veterinarians are often concerned about mortality of geriatric horses following colic surgery. Objective: To compare treatment, diagnosis and short‐term survival for geriatric compared to mature nongeriatric horses with colic. Methods: Medical records of horses admitted with a presenting complaint of colic between 2000 and 2006 were reviewed. Geriatric horses were aged ≥16 years (n = 300) and subcategorised as age ≥20 years (n = 134). Mature nongeriatric horses were age 4–15 years (n = 300). Information obtained included medical (included horses subjected to euthanasia without surgery) vs. surgical management, lesion location, type and classification, surgical procedures performed and short‐term survival. Data were analysed using a Chi‐squared test or an analysis of variance. Level of significance was P<0.05. Results: The overall short‐term survival of geriatric horses was lower than that for mature horses (59 vs. 76%, respectively). The survival of medically managed geriatric horses was lower than that for mature horses (58 vs. 80%, respectively). The survival of surgically managed geriatric horses was not different to that for mature horses (59 vs. 70%, respectively) except for geriatric horses age ≥20 years (53%). There was no difference in survival between geriatric and mature horses with small (86 and 83%, respectively) or large (78 vs. 70%, respectively) intestinal strangulating lesions or those undergoing jejunojejunostomy (75 vs. 70%, respectively). Geriatric horses with a large colon simple obstruction had a lower survival compared to mature horses (80 vs. 97%, respectively). Conclusions and potential relevance: The survival of geriatric horses with a strangulating lesion or requiring jejunojejunostomy was not different to that for mature horses. Geriatric horses presenting with colic were more likely than mature horses to be subjected to euthanasia without surgery (i.e. lower survival with medical treatment). Geriatric horses undergoing surgery for a large colon simple obstruction had a lower survival than mature horses.  相似文献   

2.
BACKGROUND: Intestinal hypoperfusion can lead to increased lactate concentrations in plasma and peritoneal fluid of horses with colic. HYPOTHESIS: The purposes of this study were to (1) evaluate the reliability of the Accusport analyzer to assess peritoneal fluid lactate (PFL) concentrations in healthy horses and those with colic, (2) identify clinical features associated with abnormal blood plasma lactate (BPL) and PFL concentrations, and (3) evaluate the prognostic value of BPL and PFL. ANIMALS: BPL and PFL were determined in 20 healthy horses and in 106 horses with colic. RESULTS: The Accusport was reliable for determining BPL concentrations < 13 mM and PFL concentrations < 20 mM. Multivariate analysis indicated that PCV and the need for intestinal resection were independently associated with the BPL; pulse, PCV, venous pO2, the presence of necrotic intestine, an increased amount of peritoneal fluid, and fluid total protein content were independently associated with PFL. With a 1 mM increase in BPL or PFL, the respective odds ratios for required abdominal surgery increase to 1.23 (BPL) and 1.58 (PFL), odds ratios for a required intestinal resection increase to 1.20 (BPL) and 1.41 (PFL), and odds ratios for developing ileus increase by 1.33 (BPL) and 1.36 (PFL). PFL concentrations of 1, 6, 12, and 16 mM correspond to a probability of death of 11, 29, 63, and 82%, respectively, in horses without strangulating obstruction and of 25, 52, 82, and 92%, respectively, in horses with strangulating obstruction. CONCLUSION: PFL is more useful and sensitive than BPL for prognostic purposes in horses with colic.  相似文献   

3.
REASONS FOR PERFORMING STUDY: The most common cause of death as a direct result of colic is acute circulatory failure secondary to intestinal ischaemia. Early and accurate recognition of ischaemic bowel is essential to decrease complications and increase survival. Blood to peritoneal lactate values have been evaluated as a prognostic indicator, but lactate values characterised by type of lesion have not been reported. HYPOTHESIS: Plasma and peritoneal lactate values are higher in horses with intestinal ischaemia secondary to a strangulating obstruction (ISSO). METHODS: Venous blood and peritoneal fluid were collected sequentially from 20 clinically healthy horses and 189 horses admitted for colic during a one-year period. Blood gas, pH, electrolyte (K+, Na+, Ca++, Cl-), glucose and lactate values were determined for blood and peritoneal fluid samples; other values recorded for peritoneal fluid included gross appearance, total protein and nucleated cell count. Information regarding diagnosis, treatment and outcome was retrieved from the medical records. RESULTS: Peritoneal and plasma levels of lactate were lower in control compared to clinical cases. Horses with ISSO had a higher peritoneal lactate value (8.45 mmol/l) than those with nonstrangulating obstruction (2.09 mmo/l). Factors with the strongest correlations with the presence of ISSO were changes in the gross appearance of the peritoneal fluid and values of peritoneal fluid chloride, pH and log10 lactate. CONCLUSIONS: Analysis of peritoneal fluid gross appearance, pH, lactate and chloride can be used for diagnosis of ISSO. POTENTIAL RELEVANCE: Peritoneal fluid lactate is a better predictor of ISSO than blood lactate and may aid in early detection of catastrophic peritoneal lesions such as intestinal strangulation and rupture.  相似文献   

4.
The objective of this prospective case-control study of 125 horses with gastrointestinal tract-induced colic was to determine whether heart rate (HR) and packed cell volume (PCV) can predict surgical versus medical treatment and its short-term survival (time of discharge of the patient). Sixty-four horses were treated medically and 61 surgically (29 small intestinal and 32 large intestinal cases). At admission, both PCV and HR were higher in horses treated surgically than in horses treated medically; however, with longer duration of colic before presentation, the PCV was higher in the small intestinal surgical group only. In addition, both PCV and HR were higher, and the duration of colic was longer in non-survivors compared to survivors. Binary logistic regression demonstrated a significant association between HR and type of treatment, and both HR and PCV were predictive of survival. Simple parameters such as HR and PCV provide useful information for management of colic cases.  相似文献   

5.
Twenty horses with small intestinal obstructions requiring surgery were evaluated prospectively. Ten horses lived (group 1) and 10 died (group 2). Eight of the horses in group 1 had simple obstruction and 7 of the horses in group 2 had strangulation obstruction. There was a significant difference (P less than 0.001) between the mean intraluminal hydrostatic pressure in horses of groups 1 and 2 (6.3 cm H2O and 15 cm H2O, respectively). The mean peritoneal fluid protein concentration in horses of groups 1 and 2 (2.8 mg/dl and 5.4 mg/dl, respectively) also differed significantly between groups (P less than 0.01). Histologic evaluation of the intestinal specimens from horses of group 1 (n = 3) and group 2 (n = 6) revealed more severe mucosal lesions in group 2. The measured values that were not significantly different between the 2 groups included PCV, total serum protein content, WBC count, anion gap, and duration of colic before admission. It was concluded that peritoneal fluid protein concentration and intraluminal hydrostatic pressure in small intestinal obstruction may be used as adjuncts to diagnosis and as prognostic indicators.  相似文献   

6.
Colic can be a life‐threatening condition in horses and there is a need for parameters that can help determine the prognosis and need for surgery. The aim of the study was to investigate whether peritoneal fluid (PF) lactate concentration is useful for this purpose in horses with severe colic presented to a veterinary hospital. During a 16 month period, the peritoneal fluid (PF) lactate concentration was measured in 74 of 760 colic horses admitted to the Utrecht University equine clinic using a portable analyser. When comparing survivors and nonsurvivors, heart rate, PF and blood lactate concentrations and blood glucose concentration were significantly higher in horses that did not survive. No horse with a PF lactate concentration >9.4 mmol/l survived. The presence of a strangulating lesion was also significantly associated with nonsurvival, as was PF colour: no horse with red PF survived in the present series. In horses with yellow PF, the blood glucose concentration was correlated with the presence of a strangulating intestinal lesion. Peritoneal lactate concentrations can be easily and rapidly measured using a portable analyser and may be useful in assessing the prognosis and/or need for surgery in equine colic cases.  相似文献   

7.
Background: Plasma d -dimer concentration is a useful marker to assess systemic coagulation and fibrinolytic activities in humans, dogs, and horses. Peritoneal fibrinolytic activity increases in horses with colic, especially in horses with endotoxin in the peritoneal fluid.
Hypothesis/Objectives: Peritoneal d -dimer concentration can be used to assess peritoneal fibrinolytic activity in horses with severe gastrointestinal (GI) disorders and altered peritoneal fluid.
Animals: Two hundred and twenty-one colic horses and 15 control horses.
Methods: Prospective observational clinical study. Blood and peritoneal fluid were collected on admission. Horses were grouped according to diagnosis, peritoneal fluid analysis, and outcome. Peritoneal d -dimer concentration was determined, together with peritoneal tissue-plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI-1) activities. Plasma d -dimer concentration also was measured.
Results: Peritoneal d -dimer concentration was significantly higher in all colic groups compared with controls, and in horses with enteritis, peritonitis, and ischemic disorders compared with horses with large intestinal obstructions. Peritoneal d -dimer concentration was significantly higher in horses with altered peritoneal fluid (modified transudate and exudate) compared with horses with normal peritoneal fluid analysis. Plasma d -dimer concentration also was significantly higher in the peritonitis group, and in horses with altered peritoneal fluid analysis. Peritoneal and plasma d -dimer concentrations also were significantly higher in nonsurvivors. Peritoneal d -dimer concentration was significantly correlated with decreased peritoneal t-PA activity and increased peritoneal PAI-1 activity.
Conclusions and Clinical Importance: Peritoneal d -dimer concentration is markedly higher in severe GI disorders, and it can be used to assess peritoneal fibrinolytic activity in horses with colic.  相似文献   

8.
Sixty-eight horses with colic caused by small intestinal disease were allotted into 2 groups of 34 on the basis of recorded findings during exploratory celiotomy, necropsy, or response to medical treatment alone. Signalment, history, physical examination findings, and laboratory findings were compared between the group of horses with small intestinal obstruction and the group with duodenitis/proximal jejunitis. A significantly greater proportion of horses with duodenitis/proximal jejunitis were older than 2 years old (P less than 0.05). Differences in sex or breed distribution, or in seasonality of the 2 disease syndromes were not observed. Horses with duodenitis/proximal jejunitis had significantly greater signs of depression than those with small intestinal obstruction (P less than 0.01), and horses with small intestinal obstruction had significantly greater signs of abdominal pain (P less than 0.05). The mean heart and respiratory rates were significantly lower (P less than 0.01) and the volume of nasogastric reflux was significantly greater (P less than 0.05) in the group of horses with duodenitis/proximal jejunitis. Sections of small intestine that were palpable per rectum were less distended and there were more auscultable borborygmi in horses with duodenitis/proximal jejunitis, compared with those with small intestinal obstruction (P less than 0.05 and P less than 0.01). The group of horses with duodenitis/proximal jejunitis had lower mean plasma potassium and higher mean plasma bicarbonate concentrations (P less than 0.05) than the group with small intestinal obstruction. The mean nucleated cell count and total protein concentration of peritoneal fluid specimens were significantly less in the group with duodenitis/proximal jejunitis (P less than 0.01); however, these values were greater than normal.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

9.
OBJECTIVE: To evaluate plasma epinephrine and norepinephrine concentrations and serum cortisol concentration in horses with colic and assess the relationship of these variables with clinical signs, routinely measured clinicopathologic variables, and outcome in affected horses. DESIGN: Prospective observational study. ANIMALS: 35 horses with colic. PROCEDURE: Blood samples were collected within 30 minutes of arrival at the veterinary hospital from horses referred because of colic. Plasma and serum samples were analyzed for cortisol, epinephrine, norepinephrine, lactate, and electrolyte concentrations and acid-base variables. Heart rate at admission and outcome (survival or nonsurvival) were recorded. Univariate logistic regression was used to calculate crude (unadjusted) odds ratios and 95% confidence intervals. RESULTS: Of the 35 horses with colic, 26 survived. Higher plasma epinephrine, plasma lactate, and serum cortisol concentrations were significantly associated with increased risk of nonsurvival, but plasma norepinephrine concentration was not associated with outcome. Plasma epinephrine concentration was significantly correlated with heart rate (r = 0.68), plasma lactate concentration (r = 0.87), blood pH (r = -0.83), anion gap (r = 0.74), and base excess (r = -0.81). CONCLUSIONS AND CLINICAL RELEVANCE: The risk of death appears to be greater in colic-affected horses with high circulating concentrations of epinephrine and cortisol. The correlation of epinephrine with other biochemical markers of illness severity and with heart rate indicates that the degree of sympathetic activation in horses with colic can be inferred from routinely measured variables.  相似文献   

10.
The reason for undertaking this study was that postoperative complications of colic surgery lead to patient discomfort, prolonged hospitalisation and increased cost. Potential risk factors for the 6 most common postoperative complications (jugular thrombosis, ileus, re-laparotomy, wound suppuration, incisional herniation and colic) were evaluated using multivariable models. Jugular thrombosis was associated significantly with heart rate greater than 60 beats/min and with increased packed cell volume (PCV) at admission. The risk of postoperative ileus also increased with increasing PCV at admission and was higher in horses recovering from pedunculated lipoma obstruction. Incisional herniation was strongly associated with wound suppuration and with increasing heart rate at admission. The emergence of cardiovascular parameters as risk factors for several postoperative complications is consistent with the hypothesis that endotoxaemia is important in the development of these complications. Early referral of colic cases, prior to the development of severe endotoxaemic shock, may minimise the risk of some postoperative complications. Horses that have suffered epiploic foramen entrapment, are more than 4 times as likely to undergo re-laparotomy than other horses. Horses that have suffered postoperative ileus have a similarly increased risk of undergoing re-laparotomy. The risk of postoperative colic is significantly associated with horses recovering from large colon torsion (>360 degrees) and with having undergone re-laparotomy. Hazard ratios (with 95% confidence intervals) for these last two effects are 3.1 (1.7, 5.7) and 3.4 (1.9, 6.2), respectively. Knowledge of the risk factors for postoperative complications allows more accurate prognostication postoperatively and suggests ways in which the risk of postoperative complications can be minimised.  相似文献   

11.
OBJECTIVE: To describe the demographic and clinical characteristics, management practices, and owner perception of a population of geriatric horses, and to compare these data with findings in a group of younger horses. DESIGN: Original study. ANIMALS: 218 horses. PROCEDURE: Data were collected via a survey tool from owners of 165 horses that were > or = 20 years of age and 53 horses that were < 20 years of age. RESULTS: Compared with young horses, the geriatric group included a significantly greater number of ponies; geriatric horses were also more likely to have a history of colic, dental disease, tumors, lameness, and pituitary disease, but not laminitis, diarrhea, allergies, respiratory tract disease, thyroid disease, or fractures. Horses that had participated in Western equestrian disciplines were more likely to have a history of lameness. Among old horses, those with pituitary dysfunction were more likely to have a history of laminitis than those without pituitary dysfunction. Geriatric horses were more likely to have long hair and shedding abnormalities than were younger horses. Owners perceived their horses as old at approximately 22 years of age. In horses older than 16.5 years of age, age was a negative factor in the purchase of horses. CONCLUSIONS AND CLINICAL RELEVANCE: Geriatric and young horses share some similar health problems, but old horses have distinct health problems and veterinary medical requirements. The management and athletic history of horses may influence health as they age.  相似文献   

12.
REASONS FOR PERFORMING STUDY: Increased plasma (5-HT) concentrations are reported in horses predisposed to develop laminitis and after i.v. infusion of endotoxins. In the equine jejunum contractile 5-HT1A-like receptors show tachyphylaxia upon prolonged activation with 5-HT. Therefore, increased systemic 5-HT release in colic horses could play a possible role in the pathophysiology of ileus. OBJECTIVE: To investigate possible increased systemic release of 5-HT in colic horses with compromised bowel and to identify the source of 5-HT overload. METHODS: Concentrations of 5-HT were determined in plasma and peritoneal fluid (PF) of healthy horses (n = 10), strangulating small intestinal colic horses (n = 18), nonsurgical colic horses (n = 10) and cryptorchid stallions (n = 6). It was attempted to identify the source of 5-HT overload by comparing the blood and PF 5-HT concentrations within horses and by assessing the in vivo platelet activation through determination of the beta-thromboglobulin (beta-TG)/platelet factor 4 (PF4) ratio. RESULTS: All horses in the strangulating small intestinal colic group had plasma (P = 0.006) and PF (P = 0.01) 5-HT concentrations above those found in the control group. Plasma beta-TG/PF4 ratio in these horses exceeded 2 in all cases, indicating in vivo platelet activation. Concentrations of 5-HT in PF of colic horses with compromised bowel were significantly lower than the corresponding plasma concentrations (P = 0.005). Potential relevance: In horses with compromised bowel, significant amounts of 5-HT can be released into the systemic circulation, through massive release of platelet-stored 5-HT. 5-HT is a very potent proinflammatory, vasoconstrictive and immunomodulatory agent. In view of the rapid and prolonged tachyphylaxia, shown for the jejunal 5-HT1A-like receptors, this increased systemic 5-HT release could play a role in the pathophysiology of ileus in horses.  相似文献   

13.
Two mature horses were examined for changes in laboratory and physical findings after experimentally induced bladder rupture. The postrupture laboratory diagnostic changes, which provide valuable information for a correct diagnosis are described. Hematology, serum and peritoneal fluid sodium, potassium, calcium, phosphorous, creatinine, urea nitrogen, albumin and peritoneal fluid components were measured and evaluated versus time. Hyponatremia and hyperkalemia occurred, as well as increased concentrations of peritoneal fluid potassium and inorganic phosphorus. In addition, peritoneal fluid creatinine:serum creatinine and peritoneal fluid urea nitrogen:serum urea nitrogen ratios were followed with time. Hematology and cytology of the peritoneal fluid showed an inflammatory response to urine contamination of the abdominal cavity. Physical findings of tachypnea and tachycardia as well as a mild colic were absent until nearly 50 hours postrupture. Based on these findings, it was concluded that the peritoneal fluid creatinine:serum creatinine ratio was the most useful antemortem laboratory diagnostic aid.  相似文献   

14.
Reasons for performing study: The incidence and implications of positive blood cultures in mature horses with diarrhoea is unknown. The diagnosis of bacteraemia may alter treatment and prognosis. Hypothesis: The proportion of horses with diarrhoea that are blood culture positive is higher than previously assumed and a positive blood culture has a negative impact on survival. Methods: Blood cultures were taken at admission and 24 h after admission from 31 mature horses with diarrhoea. Results: Nine (29%) horses were blood culture positive within 24 h of admission. Organisms isolated included Corynebacterium spp. (n = 6), Streptococcus spp. (n = 2), Pantoea agglomerans (n = 1), Gram‐negative rod (n = 1), Bacillus spp. (n = 1) and yeast (n = 1). Horses with positive blood cultures were significantly less likely to survive. Prior treatment with antimicrobial drugs had no significant effect on blood culture status. Horses with positive blood cultures had a significantly higher heart rate, packed cell volume (PCV) and plasma potassium concentration at admission, and a higher PCV and lower total plasma protein concentration 24 h after admission. Conclusions: Positive blood cultures occur more frequently than previously reported, and may have a negative impact on survival in horses with diarrhoea. Potential relevance: Results of blood cultures may be useful in formulating a prognosis for horses with diarrhoea. Further research is required to determine the effect of antimicrobial treatment on outcome.  相似文献   

15.
Reasons for performing the study: In man, peritoneal transforming growth factor beta (TGF‐β) is associated with peritoneal diseases and subsequent adhesion formation. No studies on plasma and peritoneal TGF‐β concentrations in horses with colic are available. Objectives: 1) To determine both plasma and peritoneal TGF‐β1 and TGF‐β3 concentrations in horses with different types of colic (not previously subjected to abdominal surgery); 2) to compare these concentrations according to the type of peritoneal fluid (transudate, modified transudate and exudate); and 3) to compare and correlate plasma and peritoneal concentrations of TGF‐β1 and TGF‐β3 and the types of peritoneal fluid according to the colic group and outcome. Methods: Peritoneal fluid and plasma samples from 78 horses with colic and 8 healthy horses were obtained. Patients were classified according to diagnosis (obstructions, enteritis, ischaemic disorders and peritonitis), peritoneal fluid analysis (transudate, modified transudate and exudate), and outcome (survivors and nonsurvivors). Plasma and peritoneal TGF‐β1 and TGF‐β3 concentrations were determined by ELISA. Data were analysed by parametric and nonparametric tests. P≤0.05 was considered as statistically significant. Results: Concentrations of peritoneal fluid TGF‐β1 were significantly (P = 0.01) higher in horses with peritonitis in comparison with all other colic groups and controls. Horses with ischaemic lesions had significantly (P = 0.01) higher concentrations of peritoneal TGF‐β1 in comparison with controls and the group of horses with obstructions. Peritoneal TGF‐β1 concentration also was significantly (P = 0.01) higher in exudates in comparison with transudates. Peritoneal TGF‐β1 and TGF‐β3 concentrations and plasma TGF‐β1 concentration were significantly increased in nonsurvivors compared to survivors (P = 0.001, P = 0.004 and P = 0.05, respectively). Conclusions: Peritoneal TGF‐β1 concentration was higher in horses with severe gastrointestinal diseases (ischaemic intestinal lesions and peritonitis), in horses with an altered peritoneal fluid (exudate), and in nonsurvivors. Potential relevance: Peritoneal TGF‐β concentration increases in horses with severe gastrointestinal disease as an anti‐inflammatory response.  相似文献   

16.
Reasons for performing study: Endotoxaemia is frequently presumed on the basis of clinical signs in horses with colic. Objective: Measurements of plasma endotoxin (LPS) are rarely made in clinical cases and there is little information on the correlations between this variable, clinical variables and outcomes. Objectives: To measure LPS levels in plasma of horses presented to the Philip Leverhulme Equine Hospital on admission and daily for up to 4 days and to relate LPS levels to selected clinical parameters, such as heart rate and packed cell volume, and outcomes. Methods: Blood samples were collected and stored at ‐20°C prior to assay of the plasma using a validated kinetic chromogenic Limulus amoebocyte lysate (LAL) assay. Clinical parameters and outcome variables were collected from hospital records. Associations were determined by Chi‐squared test and logistic regression analysis. Results: Daily blood samples were collected from 234 horses. LPS was detected in 26.5% of the study population and in 29% of those horses presented for colic. Horses providing samples with detectable LPS were more likely to die whilst in the hospital than those that did not (P = 0.045). Horses presenting with colic were more likely to have detectable LPS in their plasma than noncolic cases (P = 0.037), although LPS was detected in the plasma of 8 out of 42 noncolic horses. A horse that did not meet the study definition of clinical endotoxaemia was 10 times less likely to provide a positive LPS sample (OR 0.10, 95% CI: 0.05–0.22). Conclusions: The proportion of horses providing samples with detectable LPS was similar to other studies. Potential relevance: LPS was detected in the minority of horses presented with colic. Increased levels of LPS positively correlated with packed cell volume and with risk of mortality in colic cases.  相似文献   

17.
18.
Mortality rates for horses that have undergone emergency abdominal surgery are higher than for other procedures. Here, multivariable modelling of data from 774 surgical colic cases is used to identify pre-operative and anaesthesia-related variables associated with intra- and post-operative mortality. Intra-operative mortality was significantly (P<0.05), and positively associated with heart rate and packed cell volume (PCV) at admission, and negatively associated with the severity of pain. Post-operative mortality increased with increasing age and PCV at admission. Draught horses, Thoroughbreds and Thoroughbred-cross horses carried a significantly worse prognosis. We detected a small but significant variability in the risk of intra-operative death amongst referring veterinary surgeons. Different anaesthetic induction agents, inhalation maintenance agents and the use, or not, of intermittent positive pressure ventilation had no significant effect on risk of death. We conclude that cardiovascular compromise, level of pain, age, and breed are all associated with the risk of mortality in equine surgical colic cases.  相似文献   

19.
Simulated small intestinal volvulus in the anesthetized horse   总被引:1,自引:0,他引:1  
Experimental closed loop small intestinal volvulus was studied in the anesthetized horse. Volvulus was simulated by ligation of the mesenterial veins to a segment of small intestine. Physical signs and hemodynamic, hematologic, clinical chemical, bacteriologic and peritoneal fluid values were examined. Compared to conscious horses anesthesia highly delayed and modified the clinical signs of shock (changes in mucosal colour, dehydration, decreased skin temperature, elevated pulse rate, low blood pressures) and of small intestinal volvulus (altered peristalsis, gastric dilation). Plasma glucose response to shock was also modified by unconsciousness. However, a dose response relationship was indicated between the extent of small intestinal damage and clinical symptoms. The same was applicable to changes in blood pressures, blood acid-base balance, lactate, potassium, chloride, glucose, inorganic phosphorus, creatinine, creatine kinase, red blood cell and total white blood cell counts and serum total protein. The relationship was also indicated in the following peritoneal fluid values: volume, lactate, pH, total white cell counts, alkaline phosphatase and bacteriology. Changes related to shock (insufficient tissue perfusion) were low blood pressures and metabolic acidosis due to anaerobic glycolysis with accumulation of lactic acid. Also low plasma glucose and elevated plasma potassium, creatinine, inorganic phosphorus and creatine kinase were regarded as consequences of shock.  相似文献   

20.
Primary gastric impaction is an uncommon condition. Furthermore, the factors associated with gastric impaction and the optimal method of treatment are not clear. The aim of this article is to describe the clinical findings, treatment and outcome of horses with a primary gastric impaction. Medical records of horses that presented with a primary gastric impaction between 2005 and 2008 were reviewed and 20 horses with a primary gastric impaction identified. Diagnosis of a primary gastric impaction was made if the horse had been fasted for a minimum of 16 h, a concretion of ingesta precluded visualisation of the margo plicatus and there was no evidence of concurrent intestinal pathology. Thirteen of 20 (65%) horses were presented on an emergency basis. The most common complaint was inappetence (50%) followed by acute colic (35%) and recurrent colic (35%). On initial examination for colic, all horses had a normal heart rate and 7 of 20 (35%) had decreased gastrointestinal borborygmi. All horses were treated with enteral fluid therapy. The median dose of fluids administered per day was 5 doses (range 1–8 doses) of 2–10 l of isotonic electrolyte solution. The median length of treatment until resolution was 2 days (range 1–5 days). Eighteen of 20 (90%) horses survived to discharge. Primary gastric impaction appears to be a condition with clinical signs of inappetence and mild abdominal discomfort. This is the largest group of horses reported that were treated with enteral fluid therapy for a gastric impaction and it was concluded that enteral fluid therapy was of value in this study.  相似文献   

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