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1.
OBJECTIVE: To describe surgical technique and outcome after laparoscopic closure of the nephrosplenic space for treatment of recurrent left dorsal displacement of the left colon (LDDLC) in standing horses. STUDY DESIGN: Retrospective study. ANIMALS: Forty-four horses with LDDLC. METHODS: Laparoscopic portals were located in the left flank region. After administration of etilefrin intravenously to contract the spleen, the dorsal splenic margin was sutured to the nephrosplenic ligament to obliterate the nephrosplenic space. Horses were re-examined (< or = 3 years) for history of recurrence. In addition, medical records of 4,852 horses treated for colic over 16 years were evaluated to establish incidence of LDDLC and recurrence after treatment. RESULTS: Splenic contraction facilitated suture placement and closure of the nephrosplenic space was achieved without complications. LDDLC recurrence did not occur although 5 horses had subsequent episodes of colic; 4 horses had displacement of the ascending colon between the spleen and body wall. Review of medical records revealed an incidence of LDDLC of 6% and recurrence of 21% in a population of horses with signs of colic. CONCLUSION: Laparoscopic closure of the nephrosplenic space, facilitated by etilefrin-induced splenic contraction can be efficiently performed in standing horses. CLINICAL RELEVANCE: Laparoscopic ablation of the nephrosplenic space should be considered in horses that are predisposed to recurrent LDDLC.  相似文献   

2.
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   

3.
OBJECTIVE: To evaluate outcome after laparoscopic closure of the nephrosplenic space in horses that had previous nephrosplenic entrapment of ascending colon (left dorsal displacement of the left colon; LDDLC). STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Horses that had previous LDDLC. METHODS: Medical records of horses that had LDDLC and subsequent laparoscopic nephrosplenic space closure between 2002 and 2004 were retrieved. Follow-up information was obtained by telephone interview of owners. Preoperative versus postoperative comparisons were: incidence of LDDLC, incidence of colic signs, and incidence of ventral celiotomy. Data were analyzed using a chi2-square test with significance set at P<.05. RESULTS: Ten horses met the inclusion criteria. Mean follow-up was 22 months. No horses had recurrence of LDDLC; however, 3 horses had colic signs subsequently that required surgical intervention. Over the follow-up period there was a significant decrease in the total incidence of colic and ventral celiotomy. Technique modifications included use of different cannula site locations, use of polyglyconate suture material for nephrosplenic space closure, and development of a custom cannula. CONCLUSIONS: Laparoscopic nephrosplenic space closure prevented recurrence of LDDLC, and significantly lowered the overall incidence of colic and ventral celiotomy. The custom-designed cannula provided good access to the operative site and no complications were encountered with use of polyglyconate suture material for nephrosplenic space closure. CLINICAL RELEVANCE: Closure of the nephrosplenic space will prevent LDDLC; however, other surgical lesions can occur.  相似文献   

4.
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5.
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   

6.
AIM: To review the outcome of cases of left dorsal displacement of the large colon (LDDLC) treated with phenylephrine HCl and mild exercise. METHODS: Physical parameters, laboratory data, ultrasonographic findings and outcome were analysed in a retrospective study of 12 horses with a confirmed diagnosis of LDDLC which were treated with phenylephrine HCl and mild exercise. RESULTS: Administration of phenylephrine HCl and mild exercise resulted in the resolution of LDDLC in 11 of 12 treated horses. One horse failed to resolve the entrapment and required surgical correction. CONCLUSION: Administration of phenylephrine HCl appears to be an effective treatment for horses with confirmed diagnosis of LDDLC presented with mild to moderate colonic distention.  相似文献   

7.
Visualization of colonic mesenteric vasculature during transabdominal ultrasonographic examination of horses with colic can be a predictor of right dorsal displacement of the large colon or 180° large colon volvulus, or both. Medical records of 82 horses having had surgical treatment of colic and having received a transabdominal ultrasonographic examination on admission were reviewed. Colonic mesenteric vessels were sonographically identified coursing laterally on the right side of the abdomen in 24 of the 82 cases. Horses with colonic vessels identified on ultrasound were 32.5 times more likely to be diagnosed at surgery with either large colon right dorsal displacement or 180° large colon volvulus than those in which vessels were not seen (P < 0.001). Visualization of colonic mesenteric vessels on ultrasound provided a sensitivity of 67.7%, specificity of 97.9%, positive predictive value of 95.8%, and negative predictive value of 81% for large colon right dorsal displacement or 180° large colon volvulus, or both.  相似文献   

8.
Objectives— To determine the relationship between plasma lactate concentration and colonic viability and survival in horses with ≥360° volvulus of the ascending colon.
Study Design— Retrospective study.
Animals— Horses (n=73) with ≥360° volvulus of the ascending colon.
Methods— Medical records (January 2000–November 2005) of all horses examined for colic at Michigan State University Veterinary Teaching Hospital were reviewed. Horses were included only if plasma lactate concentration was measured preoperatively and a diagnosis of ≥360° volvulus of the ascending colon was confirmed by surgery or necropsy. Non-survivors were only included if the ascending colon was evaluated histopathologically. Logistic regression analysis was used to model the relationship between lactate, colonic viability, and survival.
Results— Of 73 horses, 61 were discharged. Mean (±SD) plasma lactate concentration was significantly lower in survivors (2.98±2.53 mmol/L) compared with non-survivors (9.48±5.22 mmol/L; odds ratio [OR]=1.628, 95% confidence limit [CI]=1.259–2.105). Plasma lactate concentration was significantly lower in horses with a viable colon (3.30±2.85 mmol/L) compared with horses with a non-viable colon (9.1±6.09 mmol/L; OR=1.472, 95% CI=1.173–1.846). Plasma lactate concentration <6.0 mmol/L had a sensitivity of 84% and a specificity 83% for predicting horse survival.
Conclusions— Our results demonstrate a strong association between plasma lactate concentration at the time of hospital admission and outcome in horses with ≥360° volvulus of the ascending colon.
Clinical Relevance— Plasma lactate concentration may help predict colonic viability and horse survival after ascending colon volvulus in horses.  相似文献   

9.
Packed cell volume, total plasma protein, serum sodium, potassium, and ionized Ca2+ concentrations, and blood pH were determined at the time of admission and following surgery in 147 horses with acute abdominal crisis. Horses were allotted to 3 categories on the basis of the surgical lesion: (1) nonstrangulating obstruction of the ascending or descending colon (category A, n = 76), (2) strangulating and nonstrangulating infarction of the cecum or ascending colon (category B, n = 37), and (3) strangulating and nonstrangulating infarction of the small intestine (category C, n = 25). Horses with low serum ionized Ca2+ concentration following surgery were given 23% calcium gluconate (100 to 300 ml) IV to effect, and ionized Ca2+ concentration was determined following treatment. The serum ionized Ca2+ concentrations of horses in categories A, B, and C before and after surgery were lower than our normal laboratory reference range. Prior to surgery, serum ionized Ca2+ concentration measured from horses in category B and C was lower than that in horses in category A. There was no difference in ionized Ca2+ concentration in serum samples obtained before surgery in horses from category B and C, and in serum samples obtained following surgery. There was a decrease in ionized Ca2+ concentration during surgery in horses in category A. There was no change between preoperative and postoperative ionized Ca2+ concentration in the samples obtained from horses in category B and C. After calcium gluconate administration, all horses with low serum ionized Ca2+ after surgery had concentrations within our normal range. Measurement of serum ionized Ca2+ in horses with an acute abdominal crisis is recommended.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

10.
This retrospective case series reports on the clinical experiences of a group of Thoroughbred racehorses in training that were treated surgically for intermittent dorsal displacement of the soft palate (DDSP) using sternothyroideus tenectomy in combination with soft palate surgery. The 95 horses included in the study were Thoroughbred racehorses in training referred for surgical treatment of intermittent DDSP over a 10-year period. Return to racing was 94% (89/95). Total earnings increased for up to three starts before and after surgery in 65% of horses (62/95, P= .0006). Of the 58 horses that raced in three or more races before and after surgery, 71% (41/58) improved their total earnings. Mean days to first start were 106 days. Performance index improved in 64% of these horses (37/58). Sixty of the 95 horses (63%) raced in six or more races after surgery. Sternothyroideus tenectomy combination surgery had a good prognosis for improving earnings and performance index after surgery in this group of horses that were treated for a working diagnosis of intermittent DDSP.  相似文献   

11.
Activities of serum gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and alanine aminotransferase (ALT) were determined in healthy cats and in cats before and after treatment: common bile duct ligation, carbon tetrachloride administration, sham surgery, or anesthesia only. Significant (P less than 0.01) increases in serum GGT, ALP, and ALT occurred in cats with ligated bile ducts. Significant (P less than 0.01) increases in serum ALT occurred in carbon tetrachloride-treated cats. Increases of serum GGT, ALP, or ALT were not observed in cats subjected to sham surgery or anesthesia only compared with these cats' baseline values and values in healthy cats. Tissue GGT activity was measured in liver, renal cortex, jejunal mucosa, and bile ducts. There was a 1.5-fold increase in GGT activity in livers of cats with ligated bile ducts, compared with that in livers of healthy cats.  相似文献   

12.
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   

13.
Reason for performing study: It is a clinical impression that horses diagnosed with a right dorsal displacement (RDD) of the large colon, are more likely to suffer from recurrent episodes of colic post operatively, compared to other forms of nonstrangulating large colon displacement. Objectives: To investigate whether the type of nonstrangulating large colon displacement identified at exploratory laparotomy would influence long‐term outcome. Hypothesis: Horses identified with a RDD of the large colon at exploratory laparotomy would be more likely to experience recurrent episodes of post operative colic than other types of displacement. Materials and methods: Medical records for horses undergoing an exploratory laparotomy, from 2000–2008, for a nonstrangulating large colon displacement were reviewed. Data retrieved included: subject details, previous medical history, details of current episodes of colic, results of preoperative examination, surgical findings and procedures, post operative management and complications. Follow‐up information was obtained by reference to computerised clinical records and by telephone questionnaire administered to the horse's owner or carer, and included details of any colic episodes exhibited by the horse after discharge and whether a repeat celiotomy had been required to resolve the colic episodes. Results: There were 165 surgeries identified, in 154 horses. It was found that those horses with RDD were significantly more likely to experience recurrent episodes of colic requiring veterinary intervention post operatively compared to other types of displacement. Clinical relevance: Long‐term prognosis and likelihood of post operative complications is an important consideration for both owners and veterinarians.  相似文献   

14.
Objective – To determine: (1) changes in blood ammonia, bile acid (BA), bilirubin, triglyceride, and glucose concentrations and liver enzyme activities in perioperative colic patients and (2) the association between these laboratory findings and short‐term survival. Design – Prospective observational clinical study. Animals – Thirty‐two adult horses undergoing exploratory celiotomy for colic. Interventions – None. Measurements and Main Results – Blood samples were collected preoperatively and at 24–36 and 72–84 hours postoperatively and analyzed for blood ammonia, BA, bilirubin, triglyceride, and glucose concentrations and sorbitol dehydrogenase (SDH) and gamma glutamyl transferase (GGT) activities. Short‐term survival was defined as survival to hospital discharge. Data were analyzed using a Fisher's exact test and analysis of variance. Mildly increased blood ammonia concentrations were present in 2 horses at admission. Postoperative blood ammonia concentrations were within reference intervals in all horses. There were increases in liver enzyme activities as well as in BA, triglyceride, and total bilirubin concentrations. Horses with markedly increased admission BA concentrations and SDH activities did not survive. BA concentrations and SDH activities decreased postoperatively. There was no association between GGT activity and survival; GGT activity remained increased postoperatively. Blood triglyceride concentration was increased in almost all horses postoperatively; horses that did not survive had higher triglyceride concentrations at 24–36 hours postoperatively than horses that survived. Conclusion – Alterations in metabolism and hepatobiliary function are common in colic patients. The results of this study provide further prognostic indices for colic patients and highlight areas for improvement in patient management.  相似文献   

15.
Effects of induced cholestasis and hepatocellular necrosis and of fasting on serum biochemical constituents including bile acids, IgA, bilirubin, alkaline phosphatase, gamma-glutamyltransferase (GGT), arginase, and the clearance of sodium sulfobromophthalein were studied in 4 groups of equids. The reference value for serum bile acids, as determined by an enzymatic colorimetric procedure for horses and ponies was 5.94 +/- 2.72 mumol/L, there being no statistical difference for horses and ponies. Sample collection at time of feeding had no effect on serum bile acid concentration. Seemingly, serum bile acids, arginase, and GGT were the most sensitive indicators of cholestasis and/or hepatocellular necrosis and would form an essential minimum effective battery of tests to diagnose and prognose hepatic disease in equids. These tests provided a measure of hepatobiliary transport function (bile acids), cell necrosis (arginase), and cholestasis (GGT and bile acids).  相似文献   

16.
Effect of age on liver enzyme activities in serum of healthy quarter horses   总被引：2，自引：0，他引：2  
Serum alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), 5'nucleotidase (5'NT), sorbitol dehydrogenase (SDH), and aspartate transaminase activities were measured in 10 clinically healthy foals, 10 yearlings, and 10 two-year-old Quarter Horses. Enzyme activities in foals at 0.5 to 3 days, 2 to 3 weeks, and 5 to 7 weeks of age were compared with enzyme activities from yearling and 2-year-old horses. Multivariate analyses of variance revealed significantly higher enzyme values in foals (P less than 0.002). This increase was mainly a result of higher ALP and GGT activities, with lesser effects due to higher SDH and 5'NT activities. Standard deviations for ALP and GGT were also larger in foals than in adult horses. The wide variation of ALP and GGT activities may limit their usefulness in the diagnosis of hepatic disease in foals. Standard deviations for serum AST, SDH, and 5'NT activities were smaller. These enzymes may be indicators of hepatobiliary disease in foals. The high serum enzyme activities in healthy foals may reflect a physiologic difference between foals and adult horses. Relative hepatic mass (as a percentage of body weight) and enzyme activity per gram of hepatic tissue are high in young animals, indicating that the high serum enzyme activities in foals are due partly to a high rate of enzyme production and release.  相似文献   

17.
OBJECTIVE: To determine effects of dexamethasone on insulin sensitivity, serum creatine kinase (CK) activity 4 hours after exercise, and muscle glycogen concentration in Quarter Horses with polysaccharide storage myopathy (PSSM). ANIMALS: 4 adult Quarter Horses with PSSM. PROCEDURE: A 2 x 2 crossover design was used with dexamethasone (0.08 mg/kg) or saline (0.9% NaCl) solution administered IV every 48 hours. Horses were exercised on a treadmill daily for 3 wk/treatment with a 2-week washout period between treatments. Serum CK activity was measured daily 4 hours after exercise. At the end of each treatment period, serum cortisol concentrations were measured, a hyperinsulinemic euglycemic clamp (HEC) technique was performed, and muscle glycogen content was determined. RESULTS: Mean +/- SEM serum cortisol concentration was significantly lower after 48 hours for the dexamethasone treatment (0.38 +/- 0.08 mg/dL), compared with the saline treatment (4.15 +/- 0.40 mg/dL). Dexamethasone significantly decreased the rate of glucose infusion necessary to maintain euglycemia during the HEC technique, compared with the saline treatment. Muscle glycogen concentrations and mean CK activity after exercise were not altered by dexamethasone treatment, compared with the saline treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Dexamethasone significantly reduced whole-body insulin-stimulated glucose uptake in Quarter Horses with PSSM after a 3-week period but did not diminish serum CK response to exercise or muscle glycogen concentrations in these 4 horses. Therefore, a decrease in glucose uptake for 3 weeks did not appear to alleviate exertional rhabdomyolysis in these horses. It is possible that long-term treatment may yield other results.  相似文献   

18.
OBJECTIVE: To characterize clinical findings and compare effects of treatment and outcome for horses treated medically or surgically for impaction of the small colon. DESIGN: Retrospective study. ANIMALS: 84 horses with impaction of the small colon. PROCEDURE: Medical records were reviewed for history, physical examination findings, laboratory values, treatment, response to treatment, complications, out-come, and necropsy findings. RESULTS: 47 horses were treated medically and 37 horses were treated surgically. Significant differences between groups were not identified for duration of clinical signs, physical examination findings, or laboratory values. Horses treated surgically were hospitalized longer than horses treated medically. Complications recorded during hospitalization included diarrhea, jugular thrombophlebitis, recurrent colic, fever, and laminitis. Salmonella organisms were isolated from 20 horses. Horses treated surgically were more likely to have signs of moderate abdominal pain, gross abdominal distention, and positive results for culture of Salmonella spp than horses treated medically. Follow-up information was available for 27 horses treated medically and 23 horses treated surgically. Twenty-four (72%) and 21 (75%) of the horses, respectively, survived and were being used for their intended purpose at least 1 year after treatment. CLINICAL IMPLICATIONS: Colitis may be a predisposing factor for impaction of the small colon in horses. Prognosis for horses treated surgically or medically is fair.  相似文献   

19.
Reasons for performing study: Caudal descent of the larynx has been proposed to be associated with intermittent dorsal displacement of the soft palate (DDSP) as it leads to a loss of the seal between the epiglottis and soft palate but further investigation of this theory is required. Objectives: To evaluate laryngohyoid position of horses with persistent DDSP in comparison to horses with intermittent DDSP and evaluate the outcome of treatment. Hypotheses: Horses with persistent DDSP have a different laryngohyoid position compared to those with intermittent DDSP. Horses with persistent DDSP can be returned successfully to racing with a laryngeal tie‐forward procedure. Methods: Medical records of 15 racehorses presented for persistent DDSP between 2002 and 2007 were reviewed. Age, sex and breed matched horses diagnosed with intermittent DDSP were used as a comparison group. Treatment of all horses was performed by laryngeal tie‐forward, 8/15 horses with persistent DDSP had a subsequent laser staphylectomy. Preoperative laryngohyoid position was compared between the 2 groups using a radiographic reference system. Surgical effect on position was assessed by comparing pre‐ and post operative radiographic measurements. Outcome was assessed by return to racing and comparison of pre‐ and post operative race earnings ($). Results: Thirteen of 15 horses with persistent DDSP returned to racing. Seven of 15 horses were treated with laryngeal tie‐forward alone while 8/15 horses were also treated with a laser staphylectomy. Horses with persistent DDSP had a more caudal larynx (ossification of the thyroid cartilage) (13 mm, P = 0.014), a more caudal (10 mm, P = 0.044) and dorsal (7 mm, P = 0.01) basihyoid bone, and a more dorsal thyrohyoid‐thyroid articulation (10 mm, P = 0.002) than horses with intermittent DDSP. Conclusions and potential relevance: Racehorses with persistent DDSP can be treated successfully by laryngeal tie‐forward or by laryngeal tie‐forward followed by laser staphylectomy. Horses with persistent DDSP have a more caudal larynx and more caudal and dorsal basihyoid bone than horses with intermittent DDSP.  相似文献   

20.
Objectives – To measure serum alcohol dehydrogenase (ADH) activity in horses with acute intestinal obstruction and to determine the diagnostic and prognostic utility of this analyte. Design – Prospective observational study. Setting – University Veterinary Hospital. Animals – Thirty healthy horses (control group) and 77 horses with acute intestinal obstruction, including 36 horses with nonstrangulating obstruction (23 with left ventral colon impaction and 13 with left dorsal displacement [G1], 22 with small intestinal strangulation [G2], and 19 with colon torsion [G3]). Interventions – Serum ADH activity was assayed spectrophotometerically in all horses. Serum lactate concentration and hepatic enzyme (aspartate aminotransferase, gamma‐glutamyl transferase, glutamate dehydrogenase) activities were measured using an automatic analyzer. Measurements and Main Results – The median [interquartile range] serum ADH activity in healthy horses was 10.5 [8.7 – 11 U/L]. ADH activity was significantly increased (P<0.05) in G1=16.5 [13.8 – 18 U/L], G2=40 [20 – 74.9 U/L], and G3=63.2 [40 – 78 U/L] compared with healthy controls. Aspartate aminotransferase and glutamate dehydrogenase activities were also significantly increased in G3 in comparison with controls. ADH activity was correlated with serum lactate concentration in G1 and G3, respectively (P<0.01, r=0.55 and 0.8). Other liver enzymes did not show any significant correlation with lactate. ADH activity was directly related to the probability of strangulation; odds ratio=1.11. ADH activity >20 U/L had 80.6% specificity and 80.5% sensitivity for discriminating horses with strangulating obstruction. Twelve horses euthanized before surgery were excluded from the outcome analysis. Increasing ADH activity was associated with nonsurvival; odds ratio=1.03. ADH activity <80 U/L had 94.44% specificity and 66.67% sensitivity for survival. Conclusion – Serum ADH activity may be a useful clinical parameter in detecting intestinal strangulation in horses and may provide some prognostic value in horses with acute intestinal obstruction.  相似文献   

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