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1.
Medical records of 28 horses with impaction of the small colon were reviewed; 20 horses were admitted during the winter months. Diagnosis of small-colon impaction was made in 21 horses by rectal examination, and in 7 horses at exploratory celiotomy. Ten horses were treated medically, and 18 were treated surgically. Horses that were treated surgically were more likely to have abdominal distention than were those that responded to medical treatment (P less than 0.025). Signs of greater degree of abdominal pain and higher heart rate were seen in horses treated surgically, but these values were not significantly different from values in medically treated horses. Duration of hospitalization was less in horses treated medically (P less than 0.025). Long-term survival was higher for horses treated medically (P less than 0.025). All horses treated medically and 7 of the horses treated surgically were alive at follow-up evaluation, at least 1 year after discharge. Fever and diarrhea were common complications after surgery. Four horses were fecal culture-positive for Salmonella sp after surgery. Early and aggressive medical management of horses with impaction of the small colon is recommended.  相似文献   

2.
OBJECTIVE: To identify factors associated with development of small colon impaction in horses and with selection of medical versus surgical treatment and to determine the prognosis for affected horses following medical or surgical management. DESIGN: Retrospective case series. ANIMALS: 44 horses with primary impaction of the small colon. PROCEDURES: Medical records were reviewed for signalment, history, clinical findings, treatment (medical vs surgical), hospitalization time, and outcome. For comparison purposes, the same information was collected for 83 horses with primary impaction of the large colon. RESULTS: Diarrhea was the only factor found to be associated with development of small colon impaction. Horses with small colon impaction were 10.8 times as likely to have diarrhea at the time of initial examination as were horses with large colon impaction. Abdominal distension was the only factor associated with use of surgical versus medical treatment. Horses with small colon impaction that were treated surgically were 5.2 times as likely to have had abdominal distension at the time of admission as were horses with small colon impaction that were treated medically. Overall, 21 of 23 (91%) horses treated medically and 20 of 21 (95%) horses treated surgically survived to discharge. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that diarrhea may be a risk factor for development of small colon impaction and that horses with small colon impaction that have abdominal distension at the time of initial examination are more likely to require surgical than medical treatment.  相似文献   

3.
OBJECTIVE: To determine short- and long-term outcomes, including recurrence rates, for horses with cecal impaction treated medically or surgically. DESIGN: Retrospective case series. ANIMALS: 114 horses. PROCEDURES: Medical records were reviewed for information on signalment, history, clinical findings, treatment (medical vs surgical), and short-term outcome. Information on longterm outcome was obtained through a mail survey and telephone interview with owners. RESULTS: 54 horses were treated medically, 49 horses were treated surgically, and 11 horses were euthanized after initial examination without further treatment. Horses treated surgically were significantly more likely to have signs of moderate or severe pain than were horses treated medically. Forty-four of the 54 (81%) horses treated medically were discharged from the hospital. Twelve of the 49 horses treated surgically were euthanized at surgery because of cecal rupture. Thirty-five of the 37 (95%) horses that were allowed to recover from surgery were discharged from the hospital. In 34 horses treated surgically, typhlotomy without a bypass procedure was performed. Long-term (>or= 1 year) follow-up information was available for 19 horses treated medically and 28 horses treated surgically. Eighteen (95%) and 25 (89%) of the horses, respectively, were alive at least 1 year after treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that medical and surgical treatment were both associated with favorable outcomes in horses with cecal impactions. In this population, typhlotomy alone without cecal bypass was associated with a low recurrence rate. The long-term prognosis for horses that were discharged from the hospital was good.  相似文献   

4.
A caecal impaction can be caused by an accumulation of dry ingesta (type I) or abnormal caecal motility resulting in a feed impaction of fluid consistency (type II). Horses that develop a caecal impaction have often been administered a nonsteroidal anti-inflammatory drug (NSAID) during hospitalisation for treatment of a painful condition such as an ocular or orthopaedic disease. Clinical signs of caecal impaction can be mild, and progress to more moderate to severe signs of abdominal pain as the impaction enlarges. Since an impacted caecum has a high risk of rupture, early diagnosis and treatment are important. Horses with a caecal impaction can be treated medically or surgically, and treatment decisions are based on clinical signs, results of transrectal palpation, character of peritoneal fluid and response to medical management. For type I caecal impaction, medical management consists of aggressive fluid therapy, both intravenous and enteral, to soften ingesta. Fluid therapy can be combined with laxatives, motility-enhancing drugs and analgesic drugs. Surgery is indicated if results of transrectal abdominal examination indicate that the impaction is unchanged or has enlarged, signs of abdominal pain increase, or if there is cardiovascular deterioration. Horses with type II caecal impaction have a greater chance of survival if managed surgically. Using a ventral mid-line celiotomy approach, a caecal impaction can be resolved via a typhlotomy. When caecal motility is poor, or there are signs of chronic caecal dysfunction, a caecal bypass procedure (jejunocolostomy or ileocolostomy) should be considered. Although the prognosis for horses with a caecal impaction is claimed to be fair to good, choice of treatment is controversial and may influence prognosis. If the affected horse survives to discharge from the hospital, the long-term prognosis is generally good. Many retrospective studies of cases of caecal impaction are weakened by failure to distinguish between types I and II.  相似文献   

5.
OBJECTIVE: To compare the outcome of horses with nephrosplenic entrapment of the large colon (NSELC) treated surgically or medically by rolling, administration of phenylephrine hydrochloride (or both), and exercise. DESIGN: Retrospective study. ANIMALS: 11 medically treated horses and 8 surgically treated horses with NSELC. PROCEDURE: Medical records of horses with nephrosplenic entrapment between 1992 and 2002 were reviewed. Medically treated horses were included if diagnosis and outcome of treatment of nephrosplenic entrapment were confirmed via transrectal examination and ultrasonographic examination. Surgically treated horses were included if the diagnosis was confirmed by exploratory laparotomy. Horses in which the large colon was entrapped between the spleen and body wall were not included. RESULTS: Significant differences in mean age, heart rate, and duration of colic prior to treatment were not detected between horses treated surgically or medically. Ten medically treated horses recovered without complications, and 1 died. In the surgically treated group, 6 of 8 horses recovered without complications and 2 died. Mortality rate did not differ between treatments. Duration of hospitalization for medically treated horses was significantly shorter and the cost significantly less than for surgically treated horses. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that medical treatment of horses with NSELC via administration of phenylephrine hydro-chloride, rolling during general anesthesia, or both appears to be as effective as and less expensive than surgical treatment.  相似文献   

6.
Objective To review the breed, age, gender, clinical and laboratory findings, treatment and outcome of horses with caecal disease presented to a referral centre. Design Retrospective study of 96 cases. Procedure The breed, age, and gender of the study population were compared with the corresponding hospital population for the same period. The means (± SD) for clinical and laboratory findings were recorded for each caecal disorder. Treatment was categorised as medical or surgical, and outcome was recorded. Results Caecal diseases included impaction (40% of total cases), rupture associated with concurrent unrelated disease (13%), rupture with parturition (9%), rupture with no associated disease (5%), infarction (11%), torsion (9%), abscess or adhesion (7%), tumour (3%), and miscellaneous conditions (3%). The breed or gender of affected horses did not differ from the hospital population, although horses > 15 years were more frequently represented (P < 0.05). This age group was specifically more predisposed to caecal impaction (P < 0.05), as were Arabian, Morgan, and Appaloosa breeds (P < 0.05). In horses with caecal impaction transrectal examination was the most useful diagnostic procedure; 90% of affected horses treated medically were discharged while horses treated by typhlotomy alone, or typhlotomy and blind end ileocolostomy, had survival rates to discharge of 71% and 86%, respectively. Horses with caecal rupture associated with concurrent un-related disease showed no signs of impending rupture; all were receiving phenylbutazone, all were euthanased, and 50% had caecal ulceration at necropsy. Of horses with caecal rupture with parturition 56% had prior dystocia; in two-thirds the site of rupture was the ileocaecal junction and all were euthanased. Horses with caecal rupture with no associated disease died or were euthanased; rupture was idiopathic. Horses with caecal infarction usually had signs of abdominal pain and abdominal fluid changes consistent with peritonitis; transrectal examination was nonspecific, and typhlectomy was successful in seven of eight horses. Horses with caecal torsion had signs of severe, acute abdominal pain and typhlectomy was successful in three of five horses. Diagnosis of caecal adhesion or abscess was assisted by transrectal palpation in two of seven horses and surgical treatment was successful in two of five horses. A caecal tumour was diagnosed in three horses aged 20 years or older that presented with chronic weight loss. Other caecal diseases were uncommon. Conclusion Caecal disease is uncommon in equids but some specific features of the history and physical findings can alert the veterinarian to the possibility of caecal involvement in horses with gastrointestinal dysfunction. Medical or surgical therapy can be effective in horses where caecal rupture has not occurred.  相似文献   

7.
Objective : To describe signalment, clinical findings, imaging and treatment of intestinal sand impaction in the dog. Methods : Medical records of dogs with radiographic evidence of small intestinal sand impaction were reviewed. Results : Sand impaction resulting in small intestinal obstruction was diagnosed in eight dogs. All dogs presented with signs of vomiting. Other clinical signs included anorexia, lethargy and abdominal pain. Radiographs confirmed the presence of radio-opaque material consistent with sand causing distension of the terminal small intestine in all dogs. Four dogs were treated surgically for their impaction and four dogs were managed medically. Seven of the eight dogs survived. Clinical Significance : Both medical and surgical management of intestinal sand impaction in the dog can be effective and both afford a good prognosis for recovery.  相似文献   

8.
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   

9.
OBJECTIVE: To report the history, clinical findings, and outcome of horses with idiopathic focal eosinophilic enteritis associated with acute small intestinal obstruction. STUDY DESIGN: Retrospective study. ANIMALS: Six horses with idiopathic focal eosinophilic enteritis. METHODS: Retrospective review of medical records of horses with idiopathic focal eosinophilic enteritis, with acute abdominal pain and small intestinal obstruction, associated with a focal region of eosinophilic enteritis of unknown cause. Information retrieved from the medical records included signalment, physical examination, laboratory findings, surgical procedure, histologic diagnosis, and postoperative management. Outcome was determined by telephone communication with owners. RESULTS: Six horses met the selection criteria. Horses had persistent pain, distended small intestine, and nasogastric reflux. Idiopathic focal eosinophilic enteritis lesions associated with a small intestinal obstruction were treated surgically by intestinal resection and anastomosis or wedge resection. There were no observed complications associated with extension of the disease from the lesion site. Five horses were alive at follow-up 5 to 60 months after surgery. CONCLUSIONS: Although the cause of these focal eosinophilic enteritis lesions is unknown, the long-term outcome after lesion resection was favorable. CLINICAL RELEVANCE: Small intestinal obstruction associated with a focal eosinophilic enteritis lesion may be a cause of acute abdominal pain in horses. Horses apparently have a good prognosis after lesion resection.  相似文献   

10.
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   

11.
CASE DESCRIPTION: 3 Horses were examined and treated because of sudden onset of signs of abdominal pain. CLINICAL FINDINGS: All horses had a retrosternal (Morgagni) hernia involving the right side of the diaphragm. In each horse, the large colon was incarcerated in a right muscular defect in the diaphragm with a large hernial sac. TREATMENT AND OUTCOME: Definitive surgical repair of the hernia was not performed during the initial celiotomy. The hernia was repaired with mesh herniorrhaphy, but without resection of the hernia sac in 2 horses. For 1 horse, conservative management was applied. In the 2 horses treated with surgical correction, no major postoperative complications developed, and all 3 horses have been free of signs of abdominal pain. CLINICAL RELEVANCE: Horses with retrosternal hernias involving the diaphragm can develop clinical signs of intermittent obstruction of the large colon and chronic colic. In horses, retrosternal diaphragmatic hernias appear to develop exclusively in the right ventral aspect of the diaphragm and could represent an embryologic defect of diaphragm formation. Affected horses can be successfully treated with mesh herniorrhaphy or, in some instances, with conservative management.  相似文献   

12.
OBJECTIVE: To determine prevalence, clinical findings, and long-term survival rate after surgery associated with incarceration of the small intestine through the gastrosplenic ligament (ISIGL) in horses. DESIGN: Retrospective case series. ANIMALS: 14 horses with ISIGL. PROCEDURES: Medical records of horses with ISIGL examined between January 1994 and December 2006 were reviewed. Signalment, initial physical examination findings, results of abdominal fluid analysis, and clinical laboratory values were recorded, along with surgical findings, including segment of incarcerated intestine and surgical procedures performed. Long-term survival data were obtained through client interviews. RESULTS: Clinical findings included small intestinal distention identified via rectal palpation (10/14 horses) or transabdominal ultrasonography (8/11), nasogastric reflux (4/14), and abnormal abdominal fluid (9/9). All horses required intestinal resection and anastomosis. Postoperative complications included adynamic ileus (5/14 horses), incisional infection (4/14), diarrhea (3/14), and laminitis (1/14). No breed or age predilection was detected, although geldings were at increased risk for ISIGL. Long-term survival rate was 79% (11/14 horses). CONCLUSIONS AND CLINICAL RELEVANCE: ISIGL was an uncommon cause of colicin this hospital population. With appropriate surgical intervention and postoperative management, the long-term prognosis for surgically treated horses was fair to good.  相似文献   

13.
Impactions are the most common problem affecting the small colon in horses and are much more prevalent in ponies and miniature horses. Ventral midline laparotomy under general anaesthesia is the standard of care for this condition when medical management fails to resolve the impaction or when the impaction causes complete intraluminal obstruction and tympany. This case series reports the use of standing flank laparotomy (SFL) in 15 ponies with focal small colon impactions and one large breed horse with an elongated small colon impaction. All cases presented with signs of colic of 1–4 days' duration. The horses were initially vigorously treated with both enteral and parental fluids but failed to pass faeces, with no resolution of abdominal distention or pain. In all cases, a definitive diagnosis was made during SFL and the small colon appeared to be viable. The impaction was resolved by extraluminal massage. In the horse and in one pony, in addition to extraluminal massage, high enema was administered during surgery. Routine perioperative treatment with fluids, analgesics, antimicrobials and wound care was provided. All animals survived to discharge. The time from surgical resolution of the impaction to passing faeces was less than 2 h in all but one case. Median duration of hospitalisation was 2 days and all animals returned to their original use by 2 months. The encouraging results of this case series suggest that SFL is a viable alternative to ventral laparotomy for ponies and horses with either focal SCI or extensive SCI.  相似文献   

14.
OBJECTIVE: To compare outcome of surgical versus medical treatment of dogs with beta cell neoplasia. DESIGN: Retrospective study. ANIMALS: 39 dogs with clinical signs of hypoglycemia and serum glucose and insulin concentrations consistent with a diagnosis of beta cell neoplasia. PROCEDURE: Information on signalment; clinical history; physical examination findings; results of CBC, serum biochemical analyses, and urinalysis; serum glucose and insulin concentrations; results of thoracic radiography and abdominal ultrasonography; treatment and treatment complications; survival time; and cause of death were obtained from medical records. RESULTS: 26 dogs underwent exploratory celiotomy and partial pancreatectomy; 13 dogs were treated medically (i.e., dietary change and prednisone). Median survival time was significantly longer for dogs treated surgically than for dogs treated medically. Significant differences were not found in mean age, body weight, duration of clinical signs prior to diagnosis, serum glucose and insulin concentration, or results of other serum biochemical tests between dogs treated surgically and dogs treated medically; also, there was no significant correlation between any of these parameters and survival time for either group of dogs. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that exploratory celiotomy and partial pancreatectomy are indicated once a tentative diagnosis of beta cell neoplasia is established in dogs.  相似文献   

15.
OBJECTIVE: To determine prevalence and clinical features of pituitary pars intermedia dysfunction (PPID) in horses with laminitis. DESIGN: Case series. ANIMALS: 40 horses with laminitis. PROCEDURES: Horses with laminitis that survived an initial episode of pain and were not receiving medications known to alter the hypothalamic-pituitary-adrenal axis were tested for PPID by evaluation of endogenous plasma ACTH concentration. Signalment, suspected cause, month of onset and duration of laminitis, Obel grade of lameness, pedal bone rotation, physical examination findings, results of endocrine function tests, treatment, outcome, and postmortem examination findings were recorded. RESULTS: Prevalence of PPID as defined by a single high plasma ACTH concentration was 70%. Median age of horses suspected of having PPID (n = 28) was 15.5 years, and median age of horses without PPID (12) was 14.5 years. Laminitis occurred most frequently in horses with and without suspected PPID during September and May, respectively. Chronic laminitis was significantly more common in horses suspected of having PPID. In horses suspected of having PPID, the most common physical examination findings included abnormal body fat distribution, bulging supraorbital fossae, and hirsutism. Five horses suspected of having PPID had no clinical abnormalities other than laminitis. Seventeen horses suspected of having PPID that were treated with pergolide survived, and 3 horses that were not treated survived. CONCLUSIONS AND CLINICAL RELEVANCE: Evidence of PPID is common among horses with laminitis in a primary-care ambulatory setting. Horses with laminitis may have PPID without other clinical signs commonly associated with the disease.  相似文献   

16.
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   

17.
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   

18.
OBJECTIVE: To estimate prevalence of and identify risk factors for fecal Salmonella shedding among hospitalized horses with signs of gastrointestinal tract disease. DESIGN: Cross-sectional study. ANIMALS: 465 hospitalized horses with gastrointestinal tract disease. PROCEDURE: Horses were classified as positive or negative for fecal Salmonella shedding during hospitalization by means of standard aerobic bacteriologic methods. The relationship between investigated exposure factors and fecal Salmonella shedding was examined by means of logistic regression. RESULTS: The overall prevalence of fecal Salmonella shedding was 13%. Salmonella serotype Newport was the most commonly isolated serotype (12/60 [20%]), followed by Anatum (8/60 [13%]), Java (13%), and Saint-paul (13%). Foals with gastrointestinal tract disease were 3.27 times as likely to be shedding Salmonella organisms as were adult horses with gastrointestinal tract disease. Adult horses that had been treated with antimicrobial drugs prior to hospitalization were 3.09 times as likely to be shedding Salmonella organisms as were adult horses that had not been treated with antimicrobial drugs prior to hospitalization. Adult horses that underwent abdominal surgery were 2.09 times as likely to be shedding Salmonella organisms as were adult horses that did not undergo abdominal surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that a history of exposure to antimicrobial drugs prior to hospitalization and abdominal surgery during hospitalization were associated with Salmonella shedding in adult horses with gastrointestinal tract disease. Foals with gastrointestinal tract disease were more likely to shed Salmonella organisms than were adult horses with gastrointestinal tract disease.  相似文献   

19.
Gastroendoscopy was performed on 111 horses (1 to 22 years old) that had signs of abdominal discomfort of variable duration and severity. At least 1 episode of colic had been observed within 48 hours of examination in 31 horses. Recurrent episodes of colic were observed in 28 horses within 2 to 10 days of examination, 31 horses within 11 to 30 days, 12 horses within 31 to 60 days, and in 9 horses at more than 60 days after the initial examination. Gastric ulceration was found in 91 of 111 horses examined. Other abnormalities involving the gastrointestinal tract or other abdominal viscera were not found on examination in 57 of 91 horses with gastric ulcers. The most frequent concurrent abnormalities found in the remaining 34 horses with gastric ulcers were impaction of the large colon (n = 6), colonic tympany (n = 6), peritonitis (n = 6), gastric impaction (n = 4), ileocecal intussusception (n = 3), small-colon impaction (n = 4), and proximal enteritis (n = 2). Thirteen horses with gastric ulceration underwent abdominal surgery, and in 5 horses, lesions were not found at surgery. Gastric ulceration was determined to be the primary cause of colic in 31 horses on the basis of the lack of other abnormalities, clinical response to treatment with histamine type-2 receptor (H2) antagonists, and confirmation of improvement or resolution of gastric ulceration via endoscopy. Gastric ulceration was the suspected cause of colic in 26 other horses on the basis of the lack of other abnormalities, severity of lesions, and clinical response to treatment with H2 antagonists.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

20.
OBJECTIVE: To review the clinical findings, diagnosis and treatment of 51 horses with peritonitis attributed to Actinobacillus equuli. DESIGN: Retrospective study of clinical cases. METHODS: Breed, age and gender of horse, history, physical examination findings, treatment and outcome were determined from the hospital records of 51 horses in which a diagnosis of peritonitis attributed to A. equuli was made between January 1993 and June 1999. Results of abdominal fluid cytology and bacteriology, antimicrobial sensitivity patterns, haematology and faecal egg counts, when performed, were also retrieved. RESULTS: There was a variety of breeds of horses affected. There were 35 male and 17 female horses, aged from 9 months to 22 years, presented. Lethargy, signs of depression with mild to moderate signs of abdominal pain and inappetence were the most common reasons for presentation. Most horses had elevated heart and respiratory rates, an elevated rectal temperature and reduced intestinal borborygmi heard on auscultation of the abdomen. Abnormal colour with an elevated protein were features of an abdominal fluid sample in 98% of horses and a marked elevation in nucleated cell count was present in all samples. Pleomorphic gram-negative rods were seen on cytology in 53% of samples and a positive culture of A. equuli was returned in 72% of samples. Other laboratory findings in some horses included mild haemoconcentration, hypoproteinaemia, an elevated circulating nucleated cell count with a left shift, an elevation in fibrinogen concentration and an elevated faecal egg count. All horses demonstrated a rapid response to treatment with procaine penicillin alone, or a combination of procaine penicillin and gentamicin sulphate. Where antimicrobial sensitivity tests were performed, all but two isolates were sensitive to procaine penicillin. All horses responded to antimicrobial and supportive therapy and were discharged from hospital. CONCLUSION: Horses with A. equuli peritonitis present with similar clinical signs as horses with other causes of abdominal pain. However, these signs, when evaluated in conjunction with the results of abdominal fluid analysis and response to treatment, are characteristic of A. equuli peritonitis. Pleomorphic gram-negative bacteria may be seen on a cytological preparation of the abdominal fluid sample, and a positive bacterial culture may be obtained in some, but not all, cases. Most isolates are sensitive to procaine penicillin, so treatment with procaine penicillin and gentamicin sulphate is recommended until antimicrobial sensitivity is known.  相似文献   

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