Topic:Adhesions
Lameness associated with the bicipital bursa in an Arab stallion. Severe, chronic lameness in the left forelimb of a five-year-old Arab stallion was localised to the bicipital bursa by local anaesthesia and gamma scintigraphy. Radiographic and ultrasonographic examinations of the proximal humeral tubercles and bicipital bursa revealed new bone production in the region of the intertubercular grooves and irregularities in the density of the soft tissues of the bicipital tendon and bursa. An endoscopic examination of the bicipital bursa with a standard arthroscope under general anaesthesia was a useful diagnostic procedure. The stallion was euthanased, and mark...
Chyloperitoneum and abdominal adhesions in a miniature horse. Chyloperitoneum is a potential cause of colic in horses. Although rare in horses, chyloperitoneum can develop secondary to tearing of mesenteric adhesions and rupture of mesenteric lymphatic vessels. The prognosis for horses with chyloperitoneum depends on the underlying cause and the response to treatment.
Endoscopic examination of the tarsal sheath of the lateral digital flexor tendon in horses. This study was designed to develop a reliable technique for endoscopic examination of the tarsal sheath of the lateral digital flexor tendon of horses. The anatomy of the tendon sheath and associated structures was studied in detail in cadavers before determining portals for the insertion of an arthroscope into the sheath. Approaches into the sheath through the proximal pouch and through the flexor retinaculum, at the level of the sustentaculum tali, were performed and compared in cadavers. The proximal pouch portal permitted visualisation only of the proximal half of the sheath, while the app...
Ultrasound as an aid for diagnosis of ovarian abscesses in two mares. This report describes two mares presented for evaluation of anorexia, fever of unknown origin, and weight loss. Clinical examination, laboratory findings, and transrectal ultrasonographic images suggested ovarian abscessation. One mare was successfully treated medically. Because of financial considerations, the second mare was euthanatized and a postmortem examination was performed. At necropsy, there was an enlarged right ovary with an adhesion to the large colon. Microscopic findings were characteristic of an ovarian abscess.
Use of laparoscopic equipment to divide abdominal adhesions in a filly. Exploratory laparoscopy of the right dorsal portion of the abdominal cavity was performed on a Standardbred filly because of signs of mild abdominal pain of 7 days' duration. On the basis of clinical examination, diagnosis was suppurative peritonitis, abdominal adhesions in the area of the right ovary, and right displacement and impaction of the pelvic flexure of the ascending colon. During laparoscopy, an abdominal adhesion between the right uterine horn, the cecum, and the pelvic flexure was identified. The abdominal adhesions were either stretched with laparoscopic forceps used as a probe o...
Evaluation of postoperative peritoneal lavage in standing horses for prevention of experimentally induced abdominal adhesions. To evaluate the postoperative use of peritoneal lavage for prevention of experimentally induced intraabdominal adhesions in horses. Methods: 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. Methods: 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...
Effect of omentectomy on adhesion formation in horses. To determine if omentectomy would decrease the frequency of postoperative intraabdominal adhesions. Methods: Retrospective study. Methods: 44 horses that had either two ventral median celiotomies or a ventral median celiotomy and a necropsy more than 4 days later; 19 of these horses had their omentum removed at the initial surgery. Methods: Data retrieved from the records included location and type of intraabdominal adhesions; location of the surgical lesion; relationship of adhesions to the surgical lesion; surgical procedures; duration of initial surgery; time interval between procedures; ag...
Closed one-stage functional end-to-end jejunojejunostomy in horses with use of linear stapling equipment. To use gastrointestinal linear stapling instrumentation to perform a closed one-stage functional end-to-end jejunojejunostomy in adult horses as an alternative to a stapled side-to-side jejunojejunostomy. Methods: Clinical outcome, anatomic and histological architecture, and anastomotic dimensions were determined at 2, 4, 8, 16, and 24 weeks postoperatively. Methods: 18 adult horses. Methods: The anastomosis and peritoneal cavity were inspected for adhesions. The diameter and circumference of the anastomosis and jejunum oral and aboral to the anastomosis were determined from digitized contrast...
Recurrent colic in the mature horse: a retrospective review of 58 cases. The clinical features of 58 horses presenting with recurrent colic examined over a 5 year period were reviewed. The horses were categorised into 3 groups on the basis of the history of colic episodes. Recurrent transient colic Group 1 was characterised by 3 or more episodes of transient colic (of apparently similar type) occurring within one month. Recurrent transient colic Group 2 was characterised by 3 or more episodes of transient colic occurring within one year. Recurrent prolonged colic was characterised by 3 or more episodes of prolonged colic occurring within one year. Fifteen horses we...
Chronic colic in the mature horse: a retrospective review of 106 cases. The clinical features of 106 horses presenting with chronic colic examined over a 5 year period were reviewed. Chronic colic was defined as colic signs observed daily for 3 days or longer, except when masked by analgesics. The diagnosed causes of chronic colic included colonic impaction (31%), peritonitis (16%), enteritis/colitis (7%), colonic displacement/torsion (6%) and lymphosarcoma (4%). A variety of other diseases were diagnosed in a small number of cases, including intestinal adhesions, ileal obstructions, grass sickness, liver disease, caecal impactions, thromboembolic disease, intussu...
Survey of diplomates of the American College of Veterinary Surgeons regarding postoperative intra-abdominal adhesion formation in horses undergoing abdominal surgery. To obtain information from specialists in equine surgery as to prevalence of, predisposing factors for, and methods to prevent postoperative adhesion formation in horses undergoing abdominal surgery. Methods: Survey. Methods: Surveys were mailed to 196 diplomates of the American College of Veterinary Surgeons involved in equine practice. Results: 60 (31%) surveys were returned. Most respondents (55/60) routinely informed clients of the risk of postoperative adhesion formation in horses with small intestinal lesions. When asked after which procedures they routinely used measures to prevent adhe...
Laparoscopic adhesiolysis in a horse. The purpose of this report was to describe the use of laparoscopy as a method of treatment for abdominal adhesions in the horse. Methods: Unilateral ovariectomy for removal of a granulosa cell tumor was performed through a diagonal paramedian approach in a 14-year-old Arabian mare. Progressive incisional swelling and hemorrhage culminated in acute incisional dehiscence with herniation of ileum on the sixth postoperative day. Septic peritonitis that responded to parenteral antibiotic therapy was identified 7 days after hernia repair. Seven days later, the mare had signs of abdominal pain, and a...
Evaluation of exploratory laparotomy in young horses: 102 cases (1987-1992). To determine, in a population of young horses, whether a variation exists among neonates, sucklings, weanlings, and yearlings regarding recovery from anesthesia, short- and long-term survival rates, and postoperative adhesion formation following exploratory laparotomy. Methods: Retrospective study. Methods: 102 horses < 25 months old that underwent exploratory laparotomy. Methods: Pre-, intra-, and postoperative information was retrieved from medical records, conversations with referring veterinarians, owners, or trainers, and race records. Survival rates (recovery from anesthesia and short- a...
Desmotomy for treatment of chronic desmitis of the accessory ligament of the deep digital flexor tendon in a horse. Chronic lameness was determined to be caused by desmitis of the accessory ligament of the deep digital flexor tendon and adhesions associated with these 2 structures. Desmotomy of the accessory ligament, resection of adhesions, and controlled exercise during convalescence resulted in return to normal use without apparent lameness.
Colopexy. Colopexy is a surgical procedure designed to create an adhesion from the ventral colon to the body wall to prevent recurrence of large colon volvulus or displacement, and is a useful technique to prevent recurrence of this disease. Colopexies usually are reserved for broodmares, because this is the population of horses that is most predisposed to recurrence of large colon volvulus.
Current concepts in management of abdominal adhesions. Adhesions are an important complication after abdominal surgery in horses and foals, especially after small intestinal resection and anastomosis. Prevention therapies used in horses have included nonsteroidal anti-inflammatory drugs, antibiotics, heparin, dimethyl sulfoxide, carboxymethylcellulose, and meticulous surgical technique; however, the ideal surgical technique and prevention therapy has not been determined. Further, treatment of abdominal adhesions has a poor prognosis, emphasizing the need for improvements in prevention methods.
Evaluation of a biofragmentable anastomosis ring for small intestinal anastomosis in ponies. Six ponies divided into two groups of three were used in a double crossover study design. Group 1 ponies had a small intestinal resection and anastomosis performed using a biofragmentable anastomosis ring (BAR); group 2 ponies had a hand-sewn small intestinal resection and anastomosis using a Gambee suture pattern. Approximately 30 days later, all ponies had a second celiotomy and anastomosed segments were removed. Group 1 ponies had a hand-sewn anastomosis performed and group 2 had a BAR. The anastomotic sites were collected at necropsy approximately 30 days later. Anastomosed intestinal segm...
Open peritoneal drainage in horses with experimentally induced peritonitis. Peritonitis was induced in 12 horses by median celiotomy and 1 hour of small intestinal ischemia. Six horses had primary closure of the incision, whereas six horses had a plastic mesh sutured to the ventral abdominal wall leaving the abdomen open for ventral drainage. The mesh was removed after 5 days and the abdominal wall was closed by apposition of the linea alba and subcutaneous tissues and approximation ef the skin edges. Peritoneal fluid was collected and analyzed for nucleated cell count and total protein concentration on days 0 and 5. Serum biochemical profiles, serum electrolyte conce...
Blood precipitate associated with intra-abdominal carboxymethylcellulose administration. A precipitate was observed on the blood films of horses (15 of 16) and one cow given a peritoneal infusion of 1 % sodium carboxymethylcellulose (SCMC) solution to prevent abdominal adhesions. The intensity of the precipitate seen 2 to 3 days post-infusion strongly correlated with the administered dose of SCMC (range 0.96 to 11.7 ml/kg). The dose given was inversely correlated with bodyweight and the most prominent precipitates were seen in foals. The precipitate was observed as early as 24 hours and persisted for as long as 9 days after SCMC administration. Fibrinogen was the only hematologica...
Infectious tenosynovitis. Infectious tenosynovitis is treated similarly to infectious arthritis. The principles of treatment include an early diagnosis and immediate therapy. Therapy should include use of systemic and local antimicrobials and sheath lavage and drainage. Fibrosis and adhesions can be minimized with passive range of motion exercises, intrathecal hyaluronate, and phenylbutazone therapy. Restrictive fibrosis may be treated successfully by annular ligament resection.
Intraperitoneal use of sodium carboxymethylcellulose in horses undergoing exploratory celiotomy. The effect of intraperitoneal sodium carboxymethylcellulose (SCMC) administration on clinical outcome and survival was evaluated in horses undergoing exploratory celiotomy for acute gastrointestinal disease. Comparison of variables was made retrospectively between 44 horses that had SCMC and 92 horses (controls) not treated with SCMC. Mean age, body weight, heart rate, packed cell volume and plasma total protein of horses at admission, and convalescent period were not significantly different between control and SCMC groups. No significant differences were noted between control horses and SCMC ...
GRASP: a novel heparin-binding serum glycoprotein that mediates oligodendrocyte-substratum adhesion. Cell-substratum adhesion plays a crucial part in the cascade of events that control growth or turn on and consummate a differentiation program. We are investigating the molecular basis of oligodendrocyte (OLG) cytodifferentiation, employing pure cultures of OLGs isolated from postmyelination brains. We have shown that such OLGs will regenerate in vitro and reenact the ontogenic development of myelin, but to do so they need a signal. Adherence to a polylysine surface in the presence of 20% horse serum generates such a signal. Among the events that are turned on upon OLG adhesion is the phosphor...
Successful pregnancy after partial hysterectomy in two mares. Infertility was associated with a uterine mass in 2 Thoroughbred mares. Both mares had produced live foals, but had been barren for 2 years, despite repeated breedings. Each mass was removed through a right ventral paramedian incision. Histologic examination of the masses revealed a leiomyoma and an ovarian abscess. In 1 mare, approximately 30% of 1 uterine horn was removed because of tumor attachment; in the other mare, approximately 50% of 1 uterine horn was removed because of adhesions to the ovarian abscess. Pregnancy information was available for both mares for the 3 years after surgery; ...
Stringhalt secondary to trauma to the dorsoproximal region of the metatarsus in horses: 10 cases (1986-1991). A review of medical records was used to identify 10 horses in which stringhalt developed subsequent to trauma to the dorsal metatarsus. Six horses developed stringhalt within 3 months after injury, 3 horses developed stringhalt > 3 months after injury, and time from injury to stringhalt was unknown for 1 horse. Horses were treated with exercise, including daily hand-walking with pasture turnout, followed by lunging; or surgically, using lateral digital extensor myotenectomy. Of the horses treated with exercise, 1 had resolution of stringhalt, 2 improved but had residual stringhalt, and 1 ha...
Heparin: a review of its pharmacology and therapeutic use in horses. Heparin is used clinically in horses to treat hemostatic abnormalities associated with severe gastrointestinal disease, septicemia, and endotoxemia. The primary anticoagulant effect of heparin is through the suppression of thrombin-dependent amplification of the coagulation cascade, and inhibition of thrombin-mediated conversion of fibrinogen to fibrin. Heparin may be of benefit in preventing the complications associated with hypercoagulable states such as jugular vein thrombosis, laminitis, and organ failure. Heparin may also be beneficial in the prevention of intraabdominal adhesions after g...
Failure of calcium channel blockade to prevent intra-abdominal adhesions in ponies. Intra-abdominal adhesions were created by localized serosal trauma in 11 adult ponies at three locations on the small intestine. Six ponies received verapamil hydrochloride (0.2 mg/kg) subcutaneously every eight hours for three days, and five ponies received an equal volume of saline solution at the same intervals. The investigators were not informed which treatments the ponies received. Systolic, diastolic, and mean carotid arterial pressures and heart rates were measured six hours before surgery, and then 0.5, 1, 1.5, and 8 hours after the first treatment on each day for three days. One pony...
Retrospective analysis of the results of 151 exploratory laparotomies in horses with gastrointestinal disease. Of 149 horses that underwent 151 exploratory laparotomies for gastrointestinal disorders from September 1987 to May 1991, 107 (72%) were discharged from the hospital: 100 (66%) survived for > 7 months, 94 of which returned to their intended use. Survival rate (64/80) for horses with caecum/large colon obstruction was significantly (P = 0.003) higher than for horses with small intestinal obstruction (33/64). Prolonged surgery was associated with significantly (P < 0.001) lower survival rates than short surgical time. In the large intestine, survival rate (15/29) for strangulated obstructions wa...
Left dorsal displacement of the colon with splenic adhesions in three horses. Three horses underwent exploratory celiotomy because of signs of acute abdominal pain. At surgery, all horses were diagnosed as having left dorsal displacement of the large colon. Each surgery was complicated by fibrous adhesions of the spleen to the body wall. All horses had previously undergone abdominal surgery for colic. In these cases, it appeared that the left large colon displaced cranially and then entered the renosplenic space from a cranial to caudal direction. Adhesions of the spleen to the body wall would prevent correction of left dorsal displacement of the large colon by the roll...