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1.
No published reports on the occurrence of Mendelson's syndrome (pneumonitis caused by aspiration during anaesthesia) in horses were found in the literature. Although the peculiar anatomy of the equine stomach makes horses less prone than other species to regurgitate, gastric reflux may still occur in horses with colic under certain circumstances. The colic horses in this report had in common stomach impaction, abdominal distention and preanaesthetic placement of a nasogastric tube, which was not withdrawn prior to induction. In both cases, a significant volume of gastric reflux was noted pouring from the endotracheal tube during general anaesthesia for exploratory laparotomy. It was hypothesised that the cause of gastric reflux was the combination of increased intra-abdominal pressure and patency of the cardia, and that inhalation of gastric content occurred at induction, before tracheal intubation. Treatment, which failed to improve oxygenation, consisted of repositioning of the horses to facilitate passive drainage of gastric content from the airways, active suction through the endotracheal tubes, ventilation strategies, improvement of haemodynamics to increase the pulmonary perfusion, and administration of bronchodilators. One horse was subjected to euthanasia owing to poor prognosis. Aspiration pneumonitis should be regarded as a life-threatening, although rare, perianaesthetic complication in equine colic cases. Patency of the cardia and increased intra-abdominal pressure are possible predisposing factors. Partial or even total withdrawal of the nasogastric tube prior to anaesthetic induction and tracheal intubation performed with the horse positioned in sternal recumbency may be undertaken as preventive measures in patients at high risk of developing Mendelson's syndrome.  相似文献   

2.
The purpose of this retrospective case-control study was to identify factors associated with primary gastric rupture and to investigate if there were differences between etiologies of primary gastric rupture. Compared to the general colic population, Quarter horses were under-represented and Friesians and draft breeds were over-represented in 47 cases of primary gastric ruptures. Horses with primary gastric rupture typically presented with severe clinical and clinicopathological derangements. There were 24 idiopathic gastric ruptures, 20 gastric impaction associated ruptures, and 3 perforating gastric ulcers. Thoroughbred horses were over-represented in the idiopathic gastric rupture group compared to other breeds and etiologies. This study suggests the presence of important breed predispositions for development of gastric rupture. Further study is necessary to identify if these predispositions are associated with management factors or breed-specific disorders.  相似文献   

3.
A computer-based search was conducted of medical and necropsy records of horses admitted to the teaching hospital from Jan 1, 1979, to Dec 31, 1987, to obtain the records of all horses admitted to the hospital for colic and subsequently found to have gastric rupture. Fifty cases of gastric rupture were found. The records were reviewed to obtain data regarding peritoneal fluid analysis. Cell counts of these samples were often erroneous because debris and clumps of bacteria were counted when most WBC were lysed. A cross-sectional study of gastric rupture cases versus all other colic cases regarding season of admission revealed that there was no association between season and the occurrence of gastric rupture. There was also no increased risk associated with age, gender, breed, and the occurrence of gastric rupture. One hundred colic cases, matched with the gastric rupture cases by year of admission, were randomly selected via a table of random numbers. A questionnaire regarding age, breed, gender, use of the horse, housing, diet, water source, deworming schedule, and medical history was completed from the medical records and phone conversations with the horse owners. The results indicated that horses on a diet of grass hay or grass/alfalfa hay only or those that drank water from a bucket, stream, or pond were at increased risk for having gastric rupture. In contrast, horses fed grain had a reduced risk.  相似文献   

4.
A retrospective study was performed of 181 horses that underwent an exploratory celiotomy because of acute abdominal disease. Forty-four horses died or were euthanized during surgery. Of the 137 horses that recovered from anesthesia, 72 died of associated diseases or complications, 86 were discharged from the hospital of which 60 survived at least 7 months. Horses with disorders affecting the small intestine had a significantly lower survival rate. Causes of death early in the postoperative period included long bone fracture, shock, ileus, gastric rupture, and peritonitis. After discharge from the hospital, deaths were attributed to colic of unknown cause, malabsorption syndrome, adhesive small bowel obstruction, small and large intestinal volvulus, perforated bowel, and laminitis. Of the 60 horses that were alive at the time of survey, 93.3% had returned to their previous use. A second occurrence of the initial acute abdominal disease was not documented in any horse.  相似文献   

5.
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6.
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   

7.
The objective of this study was to identify parameters that would assist in determining the probability of a successful outcome with medical management versus surgical intervention in horses with ileal impaction. Medical records of 245 horses admitted for ileal impaction were reviewed and placed into 2 groups: medical (med) and surgical (sx) treatment. Persistence of abdominal pain, gastric reflux, frequency of analgesic administration, and 1-year survival were evaluated. There were no differences in signalment, abdominal pain, or heart rate among groups; however, significantly more sx horses had peritoneal fluid abnormalities (51%) and produced gastric reflux (62%) than did med horses (38% and 15%, respectively). Eighty-nine percent of med horses required repeated analgesic administration for successful resolution. One-year survival was 91% for sx horses and 92% for med horses. Horses with ileal impaction responsive to analgesic therapy with minimal gastric reflux are likely to be managed successfully with medical treatment. Horses with persistent abdominal pain and gastric reflux are candidates for surgery.  相似文献   

8.
The records of 65 horses with peritonitis examined at two uk referral centres over a period of 12 years were reviewed. Peritonitis was defined in terms of the horse's peritoneal fluid containing more than 5 x 10(9) nucleated cells/l. Horses that had developed peritonitis after abdominal surgery or a rupture of the gastrointestinal tract were excluded. Of the 65 horses, 56 (86 per cent) survived to be discharged. Follow-up information was obtained from practice records and telephone calls to the owners for 38 of the horses. Of these, 32 (84 per cent) had survived for at least 12 months and were considered to be long-term survivors; the others six were euthanased within 12 months. Thirteen (34 per cent) of the horses discharged had experienced complications that could have been sequelae to peritonitis and eight of the 13 were euthanased. The cause of the peritonitis was identified in 15 cases; survival rates were lowest in horses with peritonitis secondary to urinary tract involvement or intra-abdominal masses. Of the other 50 cases, 47 (94 per cent) survived to discharge, but two were euthanased owing to recurrent colic.  相似文献   

9.
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   

10.
The purpose of the present study was to investigate the acid-base status and the concentration of organic acids in horses with colic caused by various disorders. Blood samples were collected from 50 horses with colic and from 20 controls. No intravenous fluids had been given prior to sample collection. Identified causes of colic included gastric ulceration, small intestinal volvulus, cecal intussusception, cecal rupture, colonic impaction, left dorsal colon displacement, right dorsal colon displacement, colonic volvulus, colitis, peritonitis, and uterine torsion. Thirty-seven horses recovered from treatment of colic, 8 horses were euthanized, and 5 died. Most cases were not in severe metabolic acidosis. In previous studies, most horses presented for diagnosis and treatment of colic were in metabolic acidosis and in shock.  相似文献   

11.
Risk factors for salmonellosis in hospitalized horses   总被引：3，自引：0，他引：3  
A case-control study to identify risk factors associated with isolation of Salmonella was accomplished, using data from records of horses hospitalized in the period July 1971 through June 1982. Horses in which nasogastric tubes were passed were at 2.9 times greater risk of having Salmonella isolated, compared with horses that did not undergo this procedure. Horses treated with antibiotics parenterally were at 6.4 times greater risk, and those treated with antibiotics orally and parenterally were at 40.4 times greater risk of developing salmonellosis, compared with horses not receiving such treatment. Horses admitted because of colic were 4.2 times as likely to have Salmonella isolated as those admitted for other reasons. Breed, age, and type of surgery did not appear to be risk factors. The risk factors identified and the magnitude of their association with Salmonella isolation were similar to those observed in a preceding study.  相似文献   

12.
The medical records of 19 horses referred for colic and subsequently found (18 confirmed, 1 suspected) to have small intestinal incarceration through the epiploic foramen were reviewed. These horses were of various ages and breeds; they had clinical signs of colic for an average duration of 13.5 hours before examination. Seventeen horses had nasogastric reflux, and 15 had palpable small intestinal distention. Three horses were killed during surgery because of severe intestinal damage. Of the remaining 16 horses, 13 required intestinal resection and anastomosis. The length of incarcerated small intestine varied from 8 cm to 17.6 m. The ileum was involved in 12 cases. In one horse, the mesoduodenum was disrupted before surgery, causing intra-abdominal bleeding; incarceration of bowel was not found during surgery. The short-term (1 month) survival rate was 74% (14 of 19 cases), and the long-term survival rate was 63% (12 of 19 cases). The follow-up period was 3 months to 45 months (mean 17.2 ± 7.2 months).  相似文献   

13.
Objective: To compare clinical findings in horses/foals with peritonitis that: (1) had no concurrent (NCA) versus a concurrent abnormality found during hospitalization, (2) survived to discharge versus did not survive to discharge, and (3) survived to discharge without surgery versus did not survive to discharge without surgery. Design: Retrospective study. Setting: George D. Widener Hospital for Large Animals at New Bolton Center. Animals: Horses/foals admitted between 1992 and 2002 with a diagnosis of peritonitis. A diagnosis of peritonitis within 4 days of presentation and peritoneal fluid nucleated cell count >10,000/μL were required for study inclusion. Horses/foals were excluded if the peritonitis was secondary to gastrointestinal or reproductive tract perforation, a complication of exploratory celiotomy, or if peritonitis was not diagnosed until surgery or necropsy. Interventions: None. Measurements and main results: Information obtained from the medical records included clinical findings at presentation and during the initial 4 days of hospitalization. Outcome was defined as: (1) NCA (yes/no), (2) survived to discharge (yes/no), and (3) survived to discharge without surgery (yes/no). Forty‐two percent (23/55) of horses/foals had NCA; 78% (43/55) survived to discharge, and 68% (36/55) survived to discharge without surgery. Horses/foals with peritonitis that had any one of the following clinical findings were likely to survive to discharge without surgery: no signs of abdominal pain, normal/improved rectal temperature, normal/improved intestinal borborygmi, normal fecal production, no abnormal findings on abdominal palpation per rectum, no nasogastric reflux, or yellow/orange peritoneal fluid. Conclusion: Clinical findings can be used to identify equine peritonitis cases that will respond favorably to medical therapy.  相似文献   

14.
The goal of this study was to determine the prevalence of gastric ulcers in horses with acute abdominal crisis (colic) and to examine the temporal effect of hospitalization on ulcer development in equine patients treated for colic. In addition, other factors that may be associated with gastric ulceration were also explored. The study design was a prospective original study incorporating 169 horses that presented to the George D. Widener Hospital for examination. One hundred and twelve horses presenting with the chief complaint of colic were included in the study group, and 57 horses that presented for non-colic or nonemergency complaints were evaluated and included as case controls. Gastroscopy was performed on equine patients presenting with the chief complaint of colic or horses presenting for reasons other than colic (control); mucosal changes were scored 0 to 3. Additionally, horses presenting for colic were gastroscopically evaluated twice during a 5-day period. Medical records were reviewed for history, clinical findings, laboratory results, and treatment. Seventy-six of 112 horses presenting with the chief complaint of colic had gastric ulceration compared with 41 of 57 horses in the control group. There was a significant association between age of the patient and chief complaint (ie, colic vs control) and between breed and chief complaint. There was no association between gastric ulcer score and chief complaint (colic vs control). Thirty-eight of the 112 horses presenting with colic deteriorated in ulcer score while hospitalized. Using a Pearson chi-squared test, there was no statistically significant association between gastric ulceration with age, breed, or sex. Horses with gastric ulceration in the colic group had lower packed cell volumes compared with horses presenting with colic without gastric ulcers, and this was statistically significant (P < .001). The high incidence of gastric ulceration in the study and control groups supports the reports of other investigators that gastric ulcers in horses, no matter the presenting complaint, are widespread. There was a significant association between breed and chief complaint (P = .005); however, breed and outcome of gastric ulceration were not related (Thoroughbreds were the least likely breed to present for colic). Although a trend in increasing gastric ulceration was seen in hospitalized colic patients, it was not statistically significant. This suggests that horses that are hospitalized may be at increased risk for developing gastric ulcers because of stress, feed deprivation, and administration of treatment. Thus, horses that present for colic should be gastroscopically evaluated if clinical signs raise the index of suspicion for gastric ulceration.  相似文献   

15.
Postoperative complications and mortality can occur many weeks or months after colic surgery. We are interested in the long-term outcome of these cases. This study documents patterns of mortality and morbidity among 341 horses that recovered from colic surgery March 1998-August 2000. The progress of each horse was rigorously followed by periodic telephone and postal questionnaires. Event time data were recorded for each animal and a total of 321 horse years of survival, together with death from all causes, colic-related death and various postoperative complications. Postoperative survival (of all horses excluding grass sickness cases) was triphasic over the first 600 days and there was marked mortality in the first 10 days postoperatively. The probability of survival postoperatively decreased to 0.87 by 10 days, 0.82 by 100 days and declined slowly to 0.75 at 600 days. Horses suffering from epiploic foramen entrapment had a significantly reduced probability of postoperative survival (RR = 2.1, P = 0.033). The causes of death for 104 horses that died postoperatively and the prevalence of postoperative complications are recorded for the study population. Postoperative colic was the most prevalent complication with 100 horses (29%) suffering one or more episodes. However, only 16 horses (4.6%) suffered 3 or more episodes. The incidence of postoperative colic was 0.55 episodes/horse year at risk. This study provides data that will inform the prognosis for postoperative colic cases and identifies epiploic foramen entrapment as carrying a worse prognosis for survival than other strangulating lesions.  相似文献   

16.
Ileus may occur in horses of all ages secondarily to drug administration, colic, exhaustion, peritonitis, or metabolic disorders. Ileus most commonly occurs following abdominal surgery for colic and is a significant cause of postoperative mortality in these horses. The most common clinical signs of ileus are decreased or absent intestinal sounds and gastric reflux. Ileus is treated by eliminating the initiating causes, correcting metabolic imbalances, decompressing distended bowel, providing analgesia, stimulating motility with drugs, and regulating exercise and feed and water intake.  相似文献   

17.
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   

18.
OBJECTIVE: To identify risk factors for enterolithiasis in horses. DESIGN: Matched case-control study. ANIMALS: 26 horses with enteroliths, 104 horses with other causes of colic that underwent surgery (52 horses, surgical control group) or were treated medically (52 horses, nonsurgical control group). PROCEDURE: Medical records were reviewed for horses with enteroliths and control horses. Information collected included signalment, anamnesis, and findings on physical examination and clinicopathologic testing at admission. Horses with enteroliths and control horses were compared by means of conditional logistic regression to identify factors associated with enterolithiasis. RESULTS: Horses that were fed alfalfa hay, spent < or = 50% of time outdoors, or were Arabian or miniature breeds had an increased risk of developing enteroliths. Horses with enteroliths were more likely to have been hyperbilirubinemic and to have had clinical signs > 12 hours prior to admission. CONCLUSIONS AND CLINICAL RELEVANCE: Breed and diet appear to influence the risk of enterolithiasis; other management factors also may influence development of enteroliths. Duration of clinical signs may be longer and signs may be less severe among horses with enteroliths, compared with horses with other causes of colic.  相似文献   

19.
OBJECTIVE: To determine the effects of indwelling nasogastric intubation on the gastric emptying rate of liquid in horses. ANIMALS: 6 healthy horses. PROCEDURES: Horses were assigned to treatment and control groups in a prospective randomized crossover study with a washout period of at least 4 weeks between trials. Acetaminophen (20 mg/kg) diluted in 1 L of distilled water was administered via nasogastric tube at time points of 0, 12, 30, 48, and 72 hours to evaluate the liquid-phase gastric emptying rate. In control horses, nasogastric tubes were removed after administration of acetaminophen. In horses receiving treatment, the tube was left indwelling and maintained for 72 hours. A 10-mL sample of blood was collected from a jugular vein immediately before and 20, 40, 60, 80, 100, 120, and 180 minutes after acetaminophen administration. Serum acetaminophen concentrations were measured by use of a colorimetric method. RESULTS: Peak serum acetaminophen concentration was significantly higher in the control group (38.11 microg/mL) than in the treatment group (29.09 microg/mL), and the time required to reach peak serum acetaminophen concentration was significantly shorter in the control group (22.79 minutes) than in the treatment group (35.95 minutes). CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that indwelling nasogastric intubation has a delaying effect on the gastric emptying rate of liquids. Veterinarians should consider the potential for delayed gastric emptying when placing and maintaining an indwelling nasogastric tube for an extended period of time after surgery. Repeated nasogastric intubation may be better than maintenance of an indwelling tube in horses with ileus.  相似文献   

20.
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   

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