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1.
Right dorsal colitis in horses has been associated with administration of phenylbutazone. Although reports of right dorsal colitis in this species have described surgical treatment associated with a poor prognosis, we have had success treating this condition medically. This report describes 5 horses with right dorsal colitis confirmed during celiotomy that were initially managed medically. All horses had a history of intermittent abdominal pain; weight loss was noted in only 1 horse. The doses (2.0 to 4.6 mg/kg PO bid) and duration (5 to 30 days) of administration of phenylbutazone were not unusually high relative to those recommended (4.4 mg/kg PO bid). Hypoproteinemia and hypoalbuminemia were observed in all horses at the time of admission; packed cell volume was low in 4 horses, and hypocalcemia was also observed in 4 horses. Three of 5 horses (60%) appeared to respond to dietary management and discontinuation of administration of nonsteroidal anti-inflammatory drugs. Dietary management consisted of feeding pelleted feed, and restricting or eliminating roughage for a period of at least 3 months. Two horses developed strictures of the right dorsal colon. One horse that developed a colonic stricture, possibly because its owners did not comply with recommendations for management, was subsequently treated surgically. The remaining horse that developed a stricture of the right dorsal colon was euthanized. These data indicate that some horses with right dorsal colitis can be successfully managed with medical treatment.  相似文献   

2.
Moderate to severe ulcerative colitis of the right dorsal colon was diagnosed by necropsy or by exploratory celiotomy and biopsy in 13 horses with a primary clinical complaint of either colic, diarrhea, or weight loss. Clinical signs varied from acute fulminating diarrhea (possibly with fever), colic, dehydration, endotoxic shock and death, to a chronic condition manifested by mild intermittent colic up to several months in duration, and weight loss with or without mild diarrhea. In a large percentage of the horses, those affected had been hypovolemic and received nonsteroidal anti-inflammatory drugs (NSAID) or had received inappropriately high doses of phenylbutazone before the onset of illness. Experimental treatment of two horses with high doses of a phenylbutazone oral paste preparation (6 gm once daily for 5 days) and limitation of their water intake to approximately one half of maintenance requirement (for 5 days) resulted in reproduction of ulcerative colitis involving only the right dorsal colon, which was apparent at necropsy examination 11 and 15 days after initiation of drug use. It was concluded that localized ulcerative lesions in the right dorsal colon may be a previously unreported manifestation of toxicity due to the administration of NSAID.  相似文献   

3.
Right dorsal colitis in horses is a disease characterised by mucosal ulceration and oedema that is localised to the right dorsal colon. It is considered one of the more severe adverse effects associated with the use of nonsteroidal anti‐inflammatory drugs (NSAIDs), particularly phenylbutazone. Diagnosis is typically made based on a history of NSAID administration, the presence of hypoproteinaemia and hypoalbuminaemia, as well as ultrasound evidence of thickening and oedema of the right dorsal colon wall. Definitive diagnosis is made at surgery or necropsy. Treatment involves discontinuation of NSAID therapy, dietary management, and mucosal protectants such as misoprostol and sucralfate. Prognosis is dependent upon early recognition and appropriate treatment. Horses on prolonged courses of NSAIDs should have frequent monitoring of serum total protein and albumin concentrations, as this is one of the earliest and most consistent clinicopathological findings.  相似文献   

4.
Colopexy of the Left Large Colon to the Right Large Colon in the Horse   总被引:1,自引:0,他引:1  
Three colopexy techniques were examined in 11 normal horses to determine which would prevent recurrence of targe colon displacement and volvulus. The medial free band of the left ventral colon was sutured to the medial free band of the right ventral colon (technique A). The free band of the left dorsal colon was sutured to the free band of the right dorsal colon (technique B). In technique C, both the ventral and dorsal colon were sutured as in techniques A and B, and the pelvic flexure was sutured to the mesocolon between the right dorsal and right ventral colon. Absorbable (surgical gut) and nonabsorbable (polypropylene) suture material were compared.
One horse from each group was euthanized 2 weeks and 6 months after surgery. The position of the colon and the integrity of the colopexy were examined. At necropsy, attempts were made to produce displacement and volvulus of the colon. In the remaining horses, exploratory celiotomy 1 year after surgery was used to examine the integrity of the colopexy.
Although all horses initially lost weight after surgery, all but one began gaining weight 2 to 4 weeks later and had attained their preoperative weight by 6 months. The horse that continued to lose weight was euthanized 2 months after surgery. Numerous small colon, omental, and large colon adhesions were found at necropsy.
For all colopexy techniques, the colopexy adhesion remained short and intact at polypropylene suture sites. At surgical gut sites, the adhesion had lengthened by 6 months and was absent at 1 year. At necropsy, all colopexies prevented manual displacement of the large colon and volvulus of the colon at the sternal and diaphragmatic flexures. The colopexies did not prevent manual creation of volvulus at the base of the colon. Technique A was the easiest to perform.  相似文献   

5.
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   

6.
Objective: To describe a novel surgical technique for management of right dorsal colitis in the horse. Study Design: Clinical report. Animals: 14‐year‐old Warmblood gelding. Methods: The horse was referred for treatment of a stromal abscess and signs of right dorsal colitis. Plasma chemistry revealed marked hypoproteinemia. Abdominal ultrasonographic examination showed a thickened right dorsal colon (RDC). Medical treatment was unsuccessful. With the horse in left lateral recumbency under general anesthesia, an approach to the right side of the abdomen through a 16th rib resection was made. The thoracic cavity was entered during the approach. Surgical resection of the RDC and side‐to‐side anastomosis of the diaphragmatic flexure to the small colon (bypass) was performed. The thoracic cavity was closed by attaching the diaphragm to the body wall and air was removed at the completion of surgery. Results: Resection of the RDC and bypass of the resected area was successfully performed. The colic signs and hypoproteinemia resolved. Complications of surgery included a deep surgical site infection with development of a large intrathoracic abscess. The abscess was managed with drainage and long‐term antimicrobial treatment. Conclusion: Right dorsal colitis can be treated successfully with resection and bypass of the RDC. In cases where the thoracic cavity is penetrated during the abdominal approach, the diaphragm should be sutured to the body wall at the beginning of surgery to avoid development of an infection within the thoracic cavity. Clinical Relevance: RDC resection and bypass may be an alternative approach for management of horses with right dorsal colitis.  相似文献   

7.
Ten normal horses had approximately 95% of the length of the large colon resected with a side-to-side anastomosis between right ventral and right dorsal colon performed with surgical stapling equipment. Four horses died shortly after surgery of colitis (1 horse) or failure of the TA 90 transection staple line (3 horses). Another horse died 4 months after surgery from disseminated streptococcal infection but had recovered well from the colon resection. Five horses survived long term (18 months) with no clinical evidence of adverse effects of the resection. Surviving horses had weight loss and soft fecal consistency for 3 to 12 weeks after surgery but returned to preoperative values within 12 months. At a second surgery 1 year later (5 horses) or at necropsy 4 months later (1 horse), fibrous omental adhesions were present over the transection staple line in four horses and over the anastomotic staple line in two horses. Omental adhesions to the everted staple line were moderate but not associated with any clinical sequellae. An incisional hernia was present in one horse. The anastomotic stomata measured between 8 and 9 cm, which was 60% of the size of the original surgically created stomata. Failure of the transection staple line occurred in the first three of five horses in which the procedure was attempted due to improper configuration of the staples or crushing of the tissue between the staples. Experience corrected this complication.  相似文献   

8.
During a 28 month period, 82 horses with clinical signs of abdominal pain were examined for left dorsal displacement of the large colon (LDDLC) using percutaneous ultrasound. Left dorsal displacement of the large colon was diagnosed when a gas echo dorsal to the spleen obliterated the dorsal splenic border, or when the colon was observed lateral to the spleen. In 42 horses, ultrasound confirmed a diagnosis of LDDLC and 40 horses had no evidence of LDDLC. There were five false negative results and no false positives. In four horses with LDDLC, the colon was displaced between the spleen and body wall; three of these colic episodes resolved with medical therapy and the fourth required a celiotomy to relieve a sand impaction. The remaining 38 horses had a renosplenic entrapment; surgical correction was elected in 4 horses, 21 horses were corrected by a nonsurgical rolling procedure, 12 were corrected at surgery after an unsuccessful rolling attempt, and one was corrected by rolling but required surgery later because of an additional lesion. Percutaneous abdominal ultrasound was a valuable aid in the diagnosis of LDDLC and in confirming correction of the displacement after a nonsurgical rolling procedure.  相似文献   

9.
OBJECTIVE: To determine whether ultrasonography would be useful in the diagnosis of right dorsal colitis in horses. DESIGN: Retrospective study. ANIMALS: 5 horses with right dorsal colitis and 15 healthy adult horses. PROCEDURE: Mural thickness and appearance of the right dorsal colon were determined from ultrasonographic images obtained at right intercostal spaces 10, 11, 12, 13, and 14. RESULTS: The right dorsal colon could be imaged most consistently at the right 11th, 12th, and 13th intercostal spaces, below the margin of the lung and axial to the liver. Mural thickness measured from ultrasonographic images was significantly greater in horses with right dorsal colitis than in healthy horses. The right dorsal colon in affected horses had a prominent hypoechoic layer associated with submucosal edema and inflammatory infiltrates. Successful treatment of 1 horse with right dorsal colitis was associated with a decrease in mural thickness coincident with an increase in serum albumin and total protein concentrations and weight gain. A decrease in mural thickness was also observed in a second horse treated for right dorsal colitis that was not associated with healing of the right dorsal colon or an increase in serum albumin concentration but rather thinning of a segment of the right dorsal colon that eventually ruptured. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that ultrasonographic measurement of mural thickness and evaluation of the appearance of the right dorsal colon may be useful in the diagnosis of right dorsal colitis in horses.  相似文献   

10.
Four horses operated on for left dorsal displacement of the large colon (LDDLC) had major intraoperative or postoperative complications. One horse was euthanatized during surgery because of extensive necrosis of the large colon. Three horses that were discharged after surgical correction of LDDLC were readmitted with signs of abdominal pain between 5 weeks and 13 months after surgery. Two horses had recurrence of LDDLC, and the third horse had an omental adhesion attached to and obstructing the pelvic flexure. The displacements were corrected, the adhesion was broken down, and the horses were discharged. One horse was readmitted a third time 16 months after the second surgery and required a third surgical correction of LDDLC.  相似文献   

11.
This report describes caecal intussusception in two young half-sibling Standardbred horses. Both horses presented showing signs of low-grade abdominal pain. The horses remained haemodynamically stable despite signs of abdominal pain and associated tachycardia. Exploratory celiotomy was undertaken in both horses due to persistent abdominal pain and a poor response to administration of analgesic medications. Exploration of the abdomen revealed caeco-caecal intussusception in one horse and caeco-colic intussusception in the other horse. An underlying cause for caecal dysfunction and subsequent intussusception was not identified in either patient. Manual reduction of the intussusception was successful in both cases. The horses recovered uneventfully from surgery.  相似文献   

12.
: Right dorsal colitis (RDC) is an ulcerative inflammatory bowel disorder of the horse that has been associated with the administration of non-steroidal anti-inflammatory drugs (NSAIDs), particularly in horses treated when dehydrated or toxaemic. The acute form of RDC may result in profuse diarrhoea, severe colic, dehydration, endotoxic shock and even death; the chronic form may be manifest by mild to moderate intermittent colic, ventral oedema and weight loss with or without diarrhoea. The most consistent laboratory findings are anaemia, hypoproteinaemia, hypoalbuminaemia and hypocalcaemia. Medical management of RDC requires avoidance of NSAIDs, of stressful experiences and of large-volume diets. Specific medications such as sucralfate and metronidazole have been used to treat RDC in the horse. The use of dietary additions such as psyllium and corn oil has been mentioned in the literature.RDC has not been reported previously in Ireland or Britain; here we report that the condition was diagnosed in three horses in Ireland on the bases of a history of phenylbutazone therapy, clinical signs, clinical pathology and ultrasonography. In two of the three horses the diagnosis was confirmed by direct inspection of the affected colon at celiotomy.  相似文献   

13.
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   

14.
The application of 99mTc-HMPAO labeled white blood cells to support the diagnosis of right dorsal ulcerative colitis was studied in two horses with a history and clinical signs consistent with phenylbutazone toxicity. These images were compared to a reference horse unaffected by right dorsal ulcerative colitis. Blood was collected aseptically in heparinized syringes from the patients for in vitro white blood cell (WBC) radiolabeling. The buffy coat was separated out and radiolabeled with 99mTc-HMPAO. The radiolabeled blood was re-injected i.v. and four images of the right and left side of the patient's abdomen were acquired at 4 hours and 20 hours post-injection. Results of the nuclear study revealed no abnormal findings in the abdomen at the four-hour post-injection images in any horse. Images obtained 20 hours post-injection revealed a linear uptake of radiolabeled WBCs in the right cranioventral abdomen in the region of the right dorsal colon in both horses with right dorsal ulcerative colitis. The reference horse had no radiopharmaceutical uptake in this region. This nuclear imaging study was a rapid, non-invasive method to identify right dorsal colon inflammation. These findings not only supported the diagnosis of right dorsal ulcerative colitis, but also facilitated appropriate medical management of each horse.  相似文献   

15.
The medical records of 10 horses with invasive neoplasms of the penis, prepuce, and/or superficial inguinal lymph nodes in which treatment involved en bloc resection and penile retroversion were reviewed. All were geldings and ranged in age from 12 to 25 years (mean, 19 years). Evaluation of biopsy specimens obtained before surgery confirmed lymphosarcoma in 1 horse and squamous cell carcinoma in 9 horses. Typical history included swelling, ulceration, and abscessation of the penis and prepuce and large superficial inguinal lymph nodes. Complications after surgery included dehiscence of the urethrostomy site (4 horses), dehiscence of the ventral skin incision (1 horse), urine scalding of 1 hind limb (1 horse), cystitis (1 horse), severe hemorrhage (1 horse), and diarrhea (1 horse). One horse was euthanatized during hospitalization, because of severe dehydration secondary to diarrhea. At necropsy, firm nodules were scattered in the pulmonary parenchyma, myocardium, thyroid gland, parathyroid glands, cranial mediastinum, kidneys, and hilar lymph nodes. Microscopic examination of the nodules revealed undifferentiated carcinoma. Nine horses were discharged from the hospital between 1 and 5 weeks after surgery. The mean follow-up interval was 27 months (range, 6 to 96 months). Eight horses had no evidence of recurrence. One horse had recurrence of neoplasm at 6 months and was euthanatized 12 months later.  相似文献   

16.
Laparoscopic repair of a small intestinal mesenteric rent in a broodmare   总被引:1,自引:0,他引:1  
OBJECTIVES : To describe standing laparoscopic repair of mesoduodenal rent inaccessible by ventral median celiotomy. STUDY DESIGN : Clinical case report. SAMPLE POPULATION : A 6-year-old Thoroughbred broodmare with a right displacement of the dorsal colon and small intestinal incarceration in a mesoduodenal rent. METHODS : Two days after correction of a right dorsal displacement of the ascending colon, small intestinal incarceration, and partial closure of mesoduodenal rent, standing left and right flank laparoscopy was used to explore the abdomen to identify the mesoduodenal defect. The mesenteric rent was repaired from right flank portals by approximation with hemostatic clips. RESULTS : Approximation of the mesoduodenal rent was achieved with laparoscopic clips. No further complications or signs of abdominal pain occurred over the following year. CONCLUSIONS : Mesenteric rents in the mesoduodenum can be repaired by laparoscopic techniques in the standing horse. CLINICAL RELEVANCE : Use of laparoscopic techniques in the standing horse should be considered for mesoduodenal rents that are not accessible form a ventral median celiotomy.  相似文献   

17.
Gastric impaction associated with large colon volvulus (LCV) was identified in seven horses. Right dorsal displacement of the large colon and suspected nephrosplenic entrapment was identified in 2 of the 7 horses as well as LCV with concurrent gastric impaction. All horses underwent surgery for LCV and none survived. Five horses died or were subjected to euthanasia intraoperatively or in recovery. One horse was subjected to euthanasia post operatively due to persistent gastric reflux, following resolution of the gastric impaction. One horse was subjected to euthanasia post operatively due to a suspected gastric rupture, which was confirmed on post mortem examination. It is hypothesised that a large mass in the cranial abdomen, such as a gastric impaction may disrupt the normal anatomical large colon alignment or may cause colonic motility or microbiota alterations, and thus increase the risk of large colon displacement and volvulus.  相似文献   

18.
Objective —To evaluate the postoperative use of peritoneal lavage for prevention of experimentally induced intraabdominal adhesions in horses.
Study Design —Areas of serosal abrasion were created on the jejunum of 12 horses. Postoperatively, six horses had peritoneal lavage, and six horses did not (controls). The number of adhesions was determined at necropsy 2 weeks after surgery.
Animals or Sample Population—12 horses.
Methods —Five sites of jejunal serosal abrasion were created in each horse. A 32 French thoracic catheter was placed into the right ventral aspect of the abdomen before closure of the abdominal incision. Treated horses had abdominal lavage with 10 L of lactated Ringer's solution on four occasions, then catheters were removed from all horses 34 hours after celiotomy. Horses were necropsied at 2 weeks to quantify the number of intraabdominal adhesions.
Results —All control horses and one treated horse developed intraabdominal adhesions. The number of adhesions was significantly less ( P <.0293) in treated horses. No adverse inflammatory reactions appeared to be associated with repeated peritoneal lavage using lactated Ringer's solution or use of an abdominal drain.
Conclusions —Peritoneal lavage reduced the frequency of intraabdominal adhesions.
Clinical Relevance —When postoperative adhesions are likely to develop, postoperative peritoneal lavage may decrease the frequency of adhesion formation.  相似文献   

19.
Studies in horses with experimental gastrointestinal fistulas may lead to rapid advancements in equine nutrition, as well as prevention and treatment of diseases such as colic and laminitis. The aim of this study was to devise a technique and a cannula to create a large fistula in the right dorsal colon (RDC). A total of 13 horses with normal gastrointestinal tract were used. After the administration of sedatives and local anesthetics, a segment of the right 16th rib was removed, a circular defect was created in the muscular wall, and the RDC was sutured to the muscular wall. The subcutaneous tissue and skin were closed over the attached RDC in eight horses (closed technique), or removed to expose the serosa of the colon sutured to the abdominal wall in five horses (open technique). A full thickness circular incision was made 2 to 6 weeks later to create a fistula. A cannula (diameter, 5 cm) made of natural rubber or silicon was inserted in the fistula. The open surgical technique was easier to perform and resulted in fewer complications. The cannula made of silicon resulted in less pruritus. One horse had a large colon torsion around the colopexy before fistula creation. One of the 12 fistulated horses had a large colon displacement 43 days after cannula insertion. These observations suggest that pexis of the RDC may predispose the horse to large colon displacement or volvulus. The open technique for the colopexy and the cannula made of silicon can be used for creation of a RDC fistula.  相似文献   

20.
Strangulated umbilical hernias in horses: 13 cases (1974-1985)   总被引:1,自引:0,他引:1  
The medical records of 13 horses with strangulated umbilical hernias were reviewed. Typical history included increased swelling, warmth, and firmness of the hernial sac. Enterocutaneous fistulas had developed in 2 horses. Four horses had signs of abdominal pain. Surgery was performed on all horses, and the hernia was reduced by an open reduction technique. Incarcerated tissue included omentum (1 horse), jejunum (5), ileum (4), cecum (1), and ventral colon (2). All horses survived and were discharged from the hospital. Follow-up information on 9 horses (5 to 52 months after discharge) revealed no complications in 6 horses. Of the remaining 3 horses, one horse was euthanatized 5 months after discharge because of laminitis. One horse had persistent drainage from the skin incision requiring removal of nonabsorbable suture material 8 months after discharge. One foal required a second surgery because of signs of abdominal pain 17 days after the initial surgery. The foal was euthanatized during surgery because of severe peritonitis secondary to anastomotic leakage.  相似文献   

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