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1.
OBJECTIVE: To report on the outcome of surgical treatment of acute abdominal crises in miniature breed horses. DESIGN: Retrospective case series of miniature horses presented to the University Veterinary Centre, Camden with an acute abdominal crisis. METHODS: Hospital records of all miniature horses that underwent ventral midline laparotomy for acute abdominal crisis between 1997 and 2001 were reviewed. The signalment, history, clinical signs, results of ancillary diagnostic procedures, location and type of intestinal lesion, treatment and outcome were retrieved from each case record. Long-term survival was determined by telephone interview of owners. RESULTS: Eleven miniature horses including five females and six males underwent ventral midline laparotomies for acute abdominal crisis during the study period. Ages ranged between 1 month and 19 years. Surgical findings included faecalith obstruction (seven horses), enterolith (one horse), strangulating lipoma of the descending colon (one horse), jejunal infarction (one horse), and caecal infarction (one horse). Long-term survival rate (minimum 12 months post surgery) was 55%. Six of eight horses with simple intraluminal obstructions survived, while the three horses with gastrointestinal lesions associated with vascular compromise were euthanased either at surgery (caecal infarction), or postoperatively, due to complications (strangulating lipoma of the descending colon, jejunal infarction). Postoperative complications in this study included impaction of the descending colon (two horses), diarrhoea (two horses), peritonitis (one horse), hyperlipaemia (two horses), incisional infection (two horses) and abdominal adhesions (one horse). Hyperlipidaemia was present in five of seven horses in which serum triglycerides were measured at presentation. CONCLUSIONS: Simple intraluminal obstructions of the large intestine were frequently encountered during exploratory laparotomy in miniature horses presented for acute abdominal crises, and their surgical treatment was associated with a good prognosis. In contrast, this study suggested that abdominal pain associated with vascular compromise of gastrointestinal tissues in miniature horses was associated with a poorer prognosis, consistent with reports in other horse breeds. Possible contributing factors to faecalith formation, including poor quality roughage, dental disease, and inadequate water consumption, should be recognised and avoided in miniature horses. Serum triglyceride concentrations should be measured in miniature horses presented for acute abdominal pain. If elevated, nutritional supplementation should be provided.  相似文献   

2.
REASONS FOR PERFORMING STUDY: Few studies have evaluated long-term survival and complication rates in horses following surgical treatment of colic, making it difficult to offer realistic advice concerning long-term prognosis. OBJECTIVE: To review the complications occurring after discharge from hospital and survival to >12 months after surgery of 300 horses undergoing exploratory laparotomy for acute colic. Pre-, intra- and post operative factors that affected long-term complications and long-term survival were assessed. METHODS: History, clinical findings, surgical findings and procedures and post operative treatments of 300 consecutive surgical colic cases (1994-2001) were reviewed. Long-term follow-up information was retrieved from case records and telephone enquiries from owners. RESULTS: The long-term (>12 months) survival rate for 204 horses discharged after colic surgery and for which follow-up information was available was 84%. The most common complication after discharge was colic, affecting 35.1% of horses following a single laparotomy. Colic was most common in horses that had had small intestinal obstructions, bowel resection or post operative ileus. Abdominal adhesions were most common in horses that presented with severe colic due to strangulation of small intestine. Ventral hernia formation occurred in 8% of horses, and was most common in horses that had had post operative wound drainage or infection. CONCLUSIONS: This study identified various factors that appear to predispose horses to long-term complications after colic surgery. POTENTIAL RELEVANCE: Further evaluation of strategies that might reduce the incidence of such complications are needed; in particular, the value of intraperitoneal heparin should be evaluated, and procedures designed to reduce the rates of wound drainage and infection assessed.  相似文献   

3.
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   

4.
Reasons for performing study: Results of surgical treatment of sinonasal disease in horses have been reported previously; however, this paper describes the outcome of horses in which a specific post operative treatment protocol was used. Objectives: The objectives of the study were to determine: 1) short‐ and long‐term outcome; 2) complications; and 3) recurrence rates of different disease processes, when horses were treated with a specific treatment protocol. Methods: Medical records of horses presented for surgical treatment of sinonasal disease from 1996–2007 were reviewed. Results and duration of surgical exploration were recorded. Post operatively, the sinus flaps were re‐opened with the horses standing and sedated. Number of horses requiring further treatment (debridement and/or lavage), median number of post operative days when the flap was re‐opened, median number of times the flap was opened and median duration of hospitalisation were recorded. Short‐ and long‐term survival and complication rates were determined. Results: Ninety‐one horses were included in the study. The sinus flaps were re‐opened with the horses standing a median of 3 days post operatively. Thirty‐nine horses (43%) required further treatment at this time and 89 horses (97%) survived to discharge. Incision infection was the most common complication encountered (29%). No horse required a blood transfusion. Recurrence rates were 5% for paranasal sinus cysts, 12% for progressive ethmoid haematoma and 50% for neoplasia. Conclusions: Rapid removal of the primary lesion followed by packing the sinuses and re‐evaluating in the standing horse in a more controlled environment offers a safe and effective means to thoroughly assess and treat sinonasal disease. Potential relevance: Surgical time, intraoperative haemorrhage, long‐term complications and recurrence rates of paranasal sinus diseases treated via frontonasal or maxillary sinus flap may be reduced using this technique.  相似文献   

5.
A study of 15 American miniature horses (AMH) that underwent surgical treatment for colic was performed. Information obtained from the medical records included signalment, clinical signs, type and location of gastrointestinal lesion, and postoperative complications. All 15 AMH had intraluminal obstructions, attributable to feed impactions (11 horses), enteroliths (2), and sand (2). The most common location of obstruction was the small colon, which was involved in 9 of the 15 cases. All 15 AMH survived and were discharged from the hospital. Six of the 15 AMH underwent subsequent surgical treatment for abdominal disorders. Elapsed time between the first and second operations ranged from 1 month to 5 years. Intestinal adhesions were observed in all AMH that were surgically treated twice. Thus, despite the fact that most of the AMH had a simple intraluminal obstruction, 40% (n = 6) developed adhesions that required or complicated a second surgery. Of the 15 AMH, 87% (n = 13) survived at least 12 months after the initial exploratory celiotomy. These findings suggest that most surgical abdominal conditions in AMH can be corrected; however, precautions should be taken to avoid or minimize adhesion formation.  相似文献   

6.
REASONS FOR PERFORMING STUDY: Early (acute) relaparotomy after surgery for equine colic is widely considered to be an acceptable treatment option for management of certain post operative complications. However, there is relatively little published information about resulting complication rates and short- and long-term outcomes. OBJECTIVES: To document the proportions, indications, complication rates and survival rates of horses undergoing acute relaparatomy following colic surgery. METHODS: History, clinical findings, surgical findings and procedures, post operative treatments and outcome of 300 consecutive surgical colic cases (1994-2001) were reviewed. Long-term follow-up information was retrieved from case records and telephone enquiries from owners. RESULTS: Acute relaparotomy was performed in 27/254 horses (10.6%) that recovered from initial general anaesthesia. The indications for relaparotomy included persistent pain, persistent ileus, peritonitis and wound breakdown. Of these 27 horses, 21 (77.8%) recovered from the second surgery, of which 8 (29.6%) died during the immediate post operative period. Thirteen of the 27 horses (48.2%) were discharged. Of these 13 horses, 5 (38.5%) were re-admitted to the hospital for surgical treatment of a subsequent bout of colic. The long-term survival rate for the 27 horses that underwent relaparotomy was 22.2%. Colic following discharge after relaparotomy was recorded in 69.2% of cases. CONCLUSIONS: Relaparotomy is necessary in approximately 10% of horses undergoing surgery for acute colic. Persistent pain and post operative ileus were the most common indications. The short-term survival rate for horses requiring relaparotomy was approximately 50% and the long-term survival rate 22%. Nearly 40% of horses surviving relaparotomy developed episodes of acute colic that necessitated further surgery. POTENTIAL RELEVANCE: Owners of horses requiring early (acute) relaparotomy should be advised of the high complication rates for this procedure.  相似文献   

7.
REASONS FOR PERFORMING STUDY: A minority of equine colic cases prove fatal unless treated surgically; however, few studies have considered long-term survival and complication rates, and few have attempted to identify factors that might affect outcomes. Such information is required for owners and veterinary surgeons to make informed decisions about the most appropriate treatment for individual cases. OBJECTIVES: To document short-term survival rates of 300 horses undergoing colic surgery and analyse factors that might have predisposed to short-term death. METHODS: History, clinical and surgical findings, treatments and outcomes of 300 surgical colic cases (1994-2001) were reviewed. Comparisons among groups of discrete data were made using chi-squared or Student's t tests as appropriate. Significance was set at P < 0.05, and 95% confidence intervals were calculated for percentages. RESULTS: The short-term survival rate (to discharge) was 70.3% for all horses and 83.1% for those recovering from anaesthesia; for horses that had a single laparotomy it was 87.2%. The most common reasons for death/euthanasia in the post operative period after a single laparotomy were persistent pain/colic, post operative ileus and grass sickness. Horses with lesions involving the small intestine and caecum had lower survival rates (75.2 and 66.7%, respectively) than those with large colon or small colon lesions (89.9 and 100%, respectively). The survival rate for ischaemic/strangulating lesions (68.9%) was lower than for simple obstructions (90.5%). CONCLUSIONS: Short-term survival of horses undergoing exploratory laparotomy for acute colic is dependent on many factors, including the nature of the underlying disease, cardiovascular status and post operative complications. POTENTIAL RELEVANCE: These retrospective studies may be used as a basis for prospective studies assessing treatments that could ultimately improve survival and decrease complication rates.  相似文献   

8.
REASONS FOR PERFORMING STUDY: Few studies have assessed short- and long-term complication rates of horses following surgical treatment of colic, a potentially fatal condition. Complications can lead to patient discomfort and increased costs; knowledge of predisposing factors may help to reduce complication rates. OBJECTIVES: To document and analyse short-term complications in 300 horses undergoing colic surgery, and to assess some of the possible predisposing factors. METHODS: History, clinical findings, surgical findings and procedures, and post operative treatments of 300 consecutive surgical colic cases (1994-2001) were reviewed. Comparisons among groups of discrete data were made using chi-squared or Student's t tests as appropriate. RESULTS: Short-term complications in 227 horses following a single laparotomy included colic/pain (28.2%), incisional drainage or infection (26.9%), post operative ileus (13.7%), severe endotoxaemic shock (12.3%), jugular thrombophlebitis (7.5%), septic peritonitis (3.1%) and colitis/diarrhoea (2.2%). Horses with small bowel obstruction had a higher rate of post operative ileus than those with large bowel obstruction. Rates of post operative pain and shock were higher in horses with small colon rather than large colon obstruction, and in those that had an ischaemic rather than a simple obstruction. The rate of wound complications increased with increasing total plasma protein concentration at admission. Horses that had a repeat laparotomy had a higher rate of wound complications compared to those that had a single laparotomy. Application of a stent bandage was associated with a higher rate of wound complications than if no stent was applied; however, application of an incise drape over the wound for recovery was associated with a lower rate of wound complications than for horses that had no protective covering of the wound. CONCLUSIONS: The most common short-term post operative complications following colic surgery were pain, incisional drainage, ileus, endotoxaemiac shock and jugular thrombophlebitis. Some factors that appeared to predispose to these complications were identified. Although many of these factors related to the underlying disease process, a number of factors, including surgical techniques, were identified that might be amenable to modification. POTENTIAL RELEVANCE: Prospective studies to assess the effects of modifying these factors on survival rates should be performed.  相似文献   

9.
The objectives of this study were (1) to determine the prevalence of pathological abdominal adhesion formation following exploratory laparotomy; (2) to establish the site of adhesion formation and its relationship to the initial lesion; (3) to ascertain whether the development of intra-abdominal adhesions decreases long-term survival and (4) to identify risk factors for adhesion formation. Of 1014 horses treated surgically for acute gastrointestinal disease, 113 (10.1%) were subjected to repeat laparotomy, with surgical records available for 99 of these cases. Pathological adhesions were the most common diagnosis at repeat laparotomy (28%), followed by complications associated with the anastomosis (16%). Adhesions were not associated with the site of the primary lesion, resection, or endotoxaemia, consistent with the hypothesis that surgical trauma is the most important stimulus in adhesion formation. Together these findings strongly support the need for pan-abdominal, rather than site-specific adhesion prevention measures in all horses undergoing exploratory laparotomy.  相似文献   

10.
OBJECTIVE: To compare postoperative complications, short- and long-term survival, and surgical times for hand-sewn end-to-end (EE), stapled functional end-to-end (FEE), and stapled side-to-side (SS) anastomotic techniques for jejunal resection in horses. DESIGN: Retrospective study. ANIMALS: 59 horses. PROCEDURE: Medical records were reviewed to obtain signalment, diagnosis, treatment, and outcome for horses that underwent jejunojejunostomy in our hospital. Only horses that recovered from anesthesia were included in the study. RESULTS: Among the 59 horses, there were 33 EE, 15 FEE, and 11 SS anastomoses. No difference was found in duration of surgery among the 3 techniques. The most common postoperative complications were colic episodes (56%), ileus (53%), diarrhea (20%), and adhesions (15%). Horses with SS anastomosis had a significantly shorter duration of postoperative ileus than the EE group did. No significant difference in duration of postoperative ileus was found among the other groups. No difference was found among the 3 anastomotic techniques in regard to survival rate at the time of discharge, 6 months after surgery, or 1 year after surgery. Overall survival rates after jejunal anastomosis were 88% at the time of discharge, 65% at 6 months after surgery, and 57% at > or = 1 year after surgery. CONCLUSIONS AND CLINICAL RELEVANCE: The hand-sewn EE, stapled FEE, and stapled SS anastomotic techniques should be considered equivalent methods for small intestinal anastomosis in the horse. However, the stapled SS technique may be preferred because of possible decreased duration of postoperative ileus.  相似文献   

11.
Melanocytic tumours are common in grey horses. Large tumours can obstruct the rectum, or prepuce, inhibit food intake and impinge upon the upper airway. Surgical excision is locally curative, but is controversial for large or confluent tumours. Limited information on outcome following surgical excision of large melanomas is available. The objective of this study was to report outcome following surgical excision of large (≥4 cm) melanocytic tumours in horses. Our hypothesis was that surgical excision of large (≥4 cm) single and coalescing melanomas would be locally curative. Medical records were reviewed and cases that underwent excision of a single or coalescing melanoma, with at least one lesion ≥4 cm in diameter, included. Follow‐up information was obtained a minimum of 12 months post‐surgery from owners and referring veterinarians via telephone interviews, questionnaire, or direct examination. A total of 48 cases were identified; 38 horses with follow‐up were included in the study. Tumours involved the parotid, perianal or mid‐cervical regions, ventral tail base, prepuce, penis, ear, or thoracic inlet. There were no cases of tumour regrowth following excision. Post‐operative complications occurred in five cases and were easily resolved in all but one. Continued or new growth of distant melanocytic tumours occurred in 50% of cases. Results suggest that excision of large melanocytic tumours in horses is a viable treatment option that is locally curative with minimal complications.  相似文献   

12.
Reasons for performing study: Infections are common complications in post operative colic patients. It is the impression of some surgeons that pyrexia in the early post operative period is a sign of infection and appropriate timing of perioperative antimicrobials will decrease the incidence of post operative infection. Objective: To determine the association between 1) post operative pyrexia and development of infection and 2) perioperative antimicrobial drug use and infection rate in post operative colic patients. Methods: Medical records of patients undergoing surgical treatment for colic were reviewed. Horses recovering from surgery and surviving >48 h were included. Data relating to case details, duration of surgery, post operative infection, peri‐ and post operative antimicrobial administration, presence, intensity and duration of pyrexia, were recorded. Data were analysed using standard statistical methods for simple comparisons between groups and by logistic regression for more complex comparisons. Results: One‐hundred‐and‐thirteen horses were included in the final analyses, 48 (43%) of which were diagnosed with a post operative infection. Duration of surgery and anaesthesia were associated with post operative infection. Eighty‐five percent of horses (n = 96) exhibited pyrexia (rectal temperature >38.3°C) post operatively. Peak temperature >39.2°C, time post surgery to peak temperature >48 h and duration of pyrexia >48 h were significantly associated with infection. In a combined model, time to first pyrexic >48 h post surgery, peak temperature and time to peak >48 h were equally weighted and the model's positive predictive value for post operative infection was 72%. Timing and dose rate of preoperative antimicrobials were not associated with infection but duration of post operative antimicrobial drug use was. Conclusion and clinical relevance: Slight to mild pyrexia (38–39.4°C) in the early post operative period is not necessarily associated with impending bacterial infection in colic patients and the use of antimicrobials in these patients may be costly and unnecessary.  相似文献   

13.
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   

14.
OBJECTIVE: A retrospective review of the medical records of 41 horses requiring abdominal surgery for sand colic. RESULTS: The diagnosis of sand colic was made when sand was found to be the cause of impaction of the gastrointestinal tract during surgical exploration. The most common clinical signs at presentation were abdominal pain, abdominal distension and diarrhoea. A statistically significant association was found between the respiratory rate on arrival and short-term survival. Sand impaction at multiple locations was detected in one-third of the horses. Concurrent pathology was detected in half of the horses. Four horses were euthanased during surgery; of those that recovered from surgery, 35/37 (95%) were discharged from hospital. Short- and long-term complications were similar to those previously reported. Long-term (1 year) survival of the horses discharged was 100%. CONCLUSION: The good prognosis for horses undergoing surgery for the treatment of sand impaction supports early surgical intervention in cases where large amounts of sand are suspected.  相似文献   

15.
REASONS FOR PERFORMING STUDY: Based on clinical observation, it is hypothesised that horses with duodenitis-proximal jejunitis (DPJ) that are treated surgically have a shorter duration, smaller volume, and slower rate of nasogastric reflux (NGR) compared to horses treated medically, are more likely to develop diarrhoea than medically managed cases, and have a higher incisional infection rate than a sample population of horses undergoing abdominal exploration for gastrointestinal disease other than DPJ. OBJECTIVES: To compare: 1) duration, volume and rate of NGR and the percentage of horses with diarrhoea between medically and surgically treated DPJ cases; and 2) incisional infection rate in horses with DPJ undergoing abdominal exploration to a sample population of horses undergoing abdominal exploration for gastrointestinal disease other than DPJ. METHODS: Medical records of cases with DPJ diagnosed 1995-2006 were reviewed. Information obtained included subject details, presenting clinical findings, treatment category (medical/surgical), complications (diarrhoea, incisional infection), and outcome (survival/nonsurvival). Data were analysed using a Chi-squared test and a mixed model analysis of variance. Level of significance was P<0.05. RESULTS: Compared to medical cases, surgical cases had significantly decreased survival, a longer duration and larger total volume of NGR, and were more likely to develop diarrhoea. The incisional infection rate for horses with DPJ undergoing abdominal exploration was 16% compared to 7% for the sample population of horses. CONCLUSIONS: Surgical treatment of horses with DPJ did not lead to resolution of NGR faster than medical treatment. Surgical cases were more likely to develop diarrhoea and did not have a significantly higher incisional infection rate than the sample population.  相似文献   

16.
Changes in management of the surgical colic patient over the last 30 years have resulted in considerable improvement in post operative survival rates. However, post operative complications remain common and these impact negatively on horse welfare, probability of survival, return to previous use and the costs of treatment. Multiple studies have investigated risk factors for post operative complications following surgical management of colic and interventions that might be effective in reducing the likelihood of these occurring. The findings from these studies are frequently contradictory and the evidence for many interventions is lacking or inconclusive. This review discusses the current available evidence and identifies areas where further studies are necessary and factors that should be taken into consideration in study design.  相似文献   

17.
Reason for performing the study: There are few published data regarding the success rates of cheek tooth (CT) removal by lateral buccotomy in the horse. Objectives: A retrospective study of 114 horses admitted to 2 private equine referral hospitals over a 10 year period (1999–2009), which underwent CT removal via a lateral buccotomy. Methods: Hospital records were analysed and details including case details, presenting complaint and results of all diagnostic tests and surgical reports were documented. Information obtained during post operative reassessment was also available for analysis. Long‐term follow‐up information (>2 months) was obtained for 112 horses. Results: Short‐term complications (<2 months) occurred in 24/77 horses (31%) undergoing exodontia of the maxillary CT and 10/37 horses (27%) involving mandibular CT, with the majority arising from partial wound dehiscence and infection following 16 extractions (47%). All healed well by second intention. Other complications included both temporary (n = 6) and permanent (n = 3) facial nerve paralysis, myositis (n = 4) and the inadvertent establishment of an oroantral fistula (n = 4). One myositis case was subjected to euthanasia 24 h post operatively. Five horses had persistent sinusitis following surgery due to dental remnants (n = 2) and excessive packing material (n = 1) found in the sinuses. No inciting cause could be found in the remaining 2 horses. One further horse suffered a fatal cardiac arrest at induction of anaesthesia. Of all horses, 92% operated on had returned to their previous level of work after >2 months with no complications. Conclusion: Horses with CT removal by a lateral buccotomy have a reasonable prognosis for long‐term outcome. Potential relevance: Performing a lateral buccotomy is a justified treatment alternative for the surgical removal of equine CT following unsuccessful attempts by standing oral extraction, offering advantages over alternatives such as retropulsion, endodontic therapy and periapical curettage.  相似文献   

18.
Reasons for performing study: The pattern of long‐term survival and specific factors associated with long‐term survival have not previously been evaluated in horses with a strangulating large colon volvulus (LCV). Objectives: To provide data on the long‐term survival of horses with LCV and to identify pre‐, intra‐ and post operative variables associated with survival. Methods: Clinical data and long‐term follow‐up information were obtained from 116 horses with a strangulating LCV (≥360°) undergoing general anaesthesia. Two multivariable Cox proportional hazards models for post operative survival time were developed: Model 1 included all horses and evaluated preoperative variables and Model 2 included horses that survived anaesthesia and evaluated pre‐, intra‐ and post operative variables. Results: The study population comprised 116 horses. Eighty‐nine (76.7%) survived general anaesthesia. Of these, the percentage that survived until discharge, to one year and to 2 years was 70.7%, 48.3% and 33.7%, respectively. Median survival time for horses that survived general anaesthesia was 365 days. In Model 1 increased preoperative packed cell volume (PCV) was significantly associated with reduced post operative survival (hazard ratio [HR] 1.08, 95% confidence interval [CI] 1.05–1.11). However, this effect changed over time. In Model 2 abnormal serosal colour intraoperatively (HR 3.61, 95% CI 1.55–8.44), increased heart rate at 48 h post surgery (HR 1.04, 95% CI 1.02–1.06), and colic during post operative hospitalisation (HR 2.63, 95% CI 1.00–6.95), were all significantly associated with reduced post operative survival. Conclusions: Survival time in horses with a LCV was associated with preoperative PCV, serosal colour, heart rate at 48 h post operatively and colic during post operative hospitalisation. Potential relevance: This study provides evidence‐based information on the long‐term survival of horses with LCV and identifies parameters that may assist decision‐making by clinicians and owners.  相似文献   

19.
One hundred thirteen of 172 horses (66%) undergoing exploratory celiotomy for a small intestinal lesion survived 4 or more days after surgery. Intra-abdominal adhesions causing clinical problems requiring additional surgery or euthanasia were documented in 25 horses (22.1%). Problems developed in significantly more males than females. The most common initial small bowel lesion was ileal impaction (12 horses); 21 horses underwent small intestinal resection or bypass. However, there was no significant difference in the incidence of intra-abdominal adhesions between horses that underwent intestinal resection or bypass and those that did not. Only 4 of the 25 horses (16%) with problems associated with postoperative adhesions survived. The mean interval between surgical procedures or between the initial procedure and euthanasia for all horses was 84 days (range, 7-512 days; median, 25 days). However, 70% of the subsequent celiotomies were performed within 60 days of the previous surgery. The mean interval between celiotomies was 221 days (range, 9-512 days) for the survivors and 61 days (range, 7-358 days) for the nonsurvivors. These results indicated that most of the problems related to postoperative intra-abdominal adhesions occurred within 2 months of the initial small intestinal surgery. Furthermore, the earlier development of postoperative adhesions was associated with a poorer prognosis for survival.  相似文献   

20.
Presently, intraocular lenses (IOLs) are not routinely implanted after equine cataract surgery. Subsequently, horses are visual but markedly farsighted (hyperopic). This report describes the surgical results and visual status after phacoemulsification and implantation of IOLs in mature horses with spontaneous cataracts. Six eyes of 5 mature horses underwent phacoemulsification and implantation of a +14 diopter (D) foldable IOL. Recheck ocular examinations were performed at 1, 4 and 24 weeks post operatively. Refractive error was recorded at 4 weeks post operatively. Visual status, refractive error and anterior chamber depth were recorded 24 weeks post operatively: 5 of 6 operated eyes remained visual and the average refractive error was +0.4 ± 1.1D. There was a significant difference between the 24 week post operative refractive error and the population mean of +10D (P<0.0001) for aphakic horses. The average post operative anterior chamber depth was 7.89 ± 1.55 mm. One globe was enucleated 2 months post operatively. Phacoemulsification with IOL implantation resulted in a significant reduction in post operative refractive error and restored vision to within 0.4D of emmetropia in 5 of 6 operated eyes. Implantation of a +14D IOL ameliorated the hyperopia documented in aphakic horses and improved the post operative visual acuity.  相似文献   

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