Intestinal surgery in horses involves surgical procedures performed on the horse's intestines to address conditions such as colic, obstructions, or strangulations. This type of surgery is a component of equine veterinary medicine focused on resolving gastrointestinal issues that cannot be managed through medical treatment alone. The surgical process may include resection, anastomosis, or bypass of affected intestinal segments. Post-operative care is critical, as horses are prone to complications such as adhesions and infections. This page compiles peer-reviewed research studies and scholarly articles that explore the techniques, outcomes, and post-operative management associated with intestinal surgery in horses.
Carvalho BVL, de Souza MCN, Avanza MFB, Teixeira RBC, Silva JRB, da Silva Cardoso T, Novais LGES, de Oliveira Monteiro FD, Viana RB, Monteiro BM....Access to the equine cecum is required for various therapeutic and experimental procedures, including decompression, fluid therapy, and transfaunation. Traditional approaches via laparotomy are highly invasive. This study aimed to describe a minimally invasive, laparoscopically assisted technique for cecal cannulation in standing horses. Unassigned: Seven horses underwent the procedure under sedation and paravertebral anesthesia. Two right flank accesses were created: a 10-mm laparoscopic port for visualization and a 2-cm minilaparotomy for cecal exteriorization. A Foley catheter was inserted ...
Freeman DE, Smith B, Bauck AG, Denagamage T, Moyer EK, Chanutin S.To develop a modified stapled (MS) jejunocecostomy (JC) in healthy horses. Methods: In vivo experimental study. Methods: Six healthy adult horses underwent ventral midline celiotomy, a jejunal resection, and an MS. Methods: Time to complete anastomosis and anastomotic length at necropsy were recorded. Horses were assessed by physical examination every 6 h for 5 days after surgery, then once daily until euthanasia at 7 days. A group of seven horses that had a stapled side-to-side JC and were euthanized 28 days postoperatively was used as an historical control (SS). Results: All MS horse...
Mudge M.Morbidity after equine abdominal surgery is common and post-operative complications can be costly to owners. The focus of this article is on intraoperative decision-making and current evidence, including surgical techniques and prognostic information that can prevent and predict complications. Emerging techniques for intra-operative monitoring and intestinal viability assessment, anastomotic techniques, body wall suturing, peritonitis treatment, and pain management are discussed.
Paganelli GC, Schott HC.Small intestinal (SI) distension and gastric reflux (GR) are common in horses with mechanical and functional ileus. Removal of GR results in fluid/ion losses. Objective: 1) Determine the capacity of healthy SI; 2) measure ion concentrations in normal SI fluid, GR, or fluid from SI undergoing resection. The authors hypothesized that Na and Cl concentrations would be lower and higher, respectively, in GR as compared to SI fluid from healthy horses, while there would be little difference in K concentration. Methods: Observational study: two to 15 meters of SI from 15 horses were distended with wa...
Migliorisi A, Nottle B, Smanik LE, Nout-Lomas YS, Hassel DM.To (1) compare total nucleated cell count (TNCC) and neutrophil-to-lymphocyte ratio (NLR) at admission between horses with medically managed, large intestinal (LI) and small intestinal (SI) surgical colic; (2) compare TNCC and NLR between survivors and nonsurvivors; and (3) investigate associations between TNCC, NLR, surgical intervention, and outcome. Methods: Case-control study. Methods: Single, academic institution. Methods: A total of 341 adult horses diagnosed with noninfectious medical or surgical colic. Results: Admission TNCC did not differ between the medical and combined surgical gro...
Willette J, Guinn A, Munsterman A.Impactions of the jejunum are rarely described in the literature. The current case series describes six cases of adult horses with jejunal impactions with feed material diagnosed by exploratory celiotomy. Horses underwent exploratory celiotomy based off of their degree of pain despite medical management and concerns for a primary strangulating small intestinal lesion. All jejunal impactions were relieved via manual decompression of the impaction into the cecum. None of the cases underwent a resection or anastomosis at the site of impaction. All horses were treated with gastroprotectants (omepr...
Chanutin SS, Elliott CRB, Fielding AS, Brown PM, McCreary CA, Bennet ED, Davis W.To provide performance data of warmblood jumping horses following colic surgery. Unassigned: This retrospective case series reviewed clinical records of 5 equine hospitals with the inclusion criteria of warmblood horses undergoing colic surgery between January 1, 2011, and December 31, 2021, surviving to discharge, and being registered as a hunter or jumper with the US Equestrian Federation. Clinical data included age, sex, and lesion type. Performance data included discipline, jump height, number of starts, number of wins, and number of placings. Pre- and postoperative data were analyzed sepa...
Baldwin CM, Gillen A.To evaluate three different jejunal transection angles for end-to-end jejunojejunostomies, comparing construction time, lumen size, and suture number. Methods: Ex vivo cadaver study. Methods: Eight euthanized horses each had three mid-jejunal specimens harvested. Methods: Jejunal segments were assigned to one of three groups (A30, A45, and A60) and transected at 30, 45, or 60°, respectively. Following transection, a standardized handsewn single-layer interrupted modified Lembert anastomosis was performed, and construction time and number of sutures placed were recorded. Anastomotic index (AI)...
Crabtree NE, Capper AM, McKinnon LH, Epstein KL.The objective was to compare perioperative factors that may influence clinician decisions regarding antimicrobial therapy duration and outcomes in horses undergoing exploratory celiotomy. Unassigned: Horses > 1 mo of age undergoing exploratory celiotomy for colic that survived without repeat celiotomy for ≥ 5 d. Unassigned: Retrospective cohort study. Cases were grouped by duration of antimicrobial therapy: G1, ≤ 24 h; G2, 1 to 3 d; G3, > 3 d. Admission, surgical, and postoperative data from the medical records and long-term outcome assessed telephone follow-up were compared among g...
Verhaar N, Geburek F.Clinical intestinal viability assessment is associated with significant limitations, and there is an undisputable need for ancillary diagnostics during colic surgery. Human and companion animal surgeons struggle with similar intraoperative issues, yet there is little exchange between specialists. Therefore, this narrative review aimed to create an overview of real-time ancillary diagnostics with the potential for intraoperative intestinal viability assessment in horses. Most real-time ancillary diagnostics can be classified as either tissue perfusion or oxygenation assessments. Intestinal perf...
Maire U, Genton M, Vitte-Rossignol A.A 16-year-old, French saddlebred horse was referred for examination because of colic signs, diagnosed with incarceration of the jejunum in a mesoduodenic rent, and subsequently treated surgically (with an end-to-end anastomosis of the jejunum and an enterotomy of the pelvic flexure). The horse initially recovered without complications; however, on the following day, it exhibited moderate signs of endotoxemia and severe serosanguineous discharge from the abdominal wound. Abdominal ultrasonography revealed substantial peritoneal effusion, necessitating the placement of an abdominal drain. The bl...
Chanutin S, Bauck AG, Roberts JF, Denagamage TN, Freeman DE.Jejunocaecostomy (JC) is frequently required to bypass diseased ileum as a side-to-side (SS) anastomosis with blind end closure of the small intestine. The effects of the blind end closure method on the performance of the anastomosis have not been studied. Objective: To compare handsewn and stapled blind end closures of the ileum and jejunum. Methods: In vivo experiments. Methods: JC was performed with either Parker-Kerr (PK; 6 horses) or oversewn stapled technique (OS; 6 horses) to close jejunum and ileum for an SS anastomosis. At surgery, peritoneal fluid was analysed and various anastomotic...
Moyer EK, Bauck AG, Denagamage T, Freeman DE.To compare end-to-side (ES) and side-to-side (SS) jejunocecostomy (JC) in healthy horses. Methods: Experimental study in vivo. Methods: A total of 14 healthy adult horses underwent ventral midline celiotomy, a resection, and either an ES (n = 7) or stapled SS (n = 7) JC. Methods: Surgical times and the external lengths of completed anastomoses were measured. Physical examinations and pain scoring were performed every 6 h for 5 days, then once daily until euthanasia and necropsy 28 days postoperatively. Results: The anastomosis was completed more rapidly (p < .002) with the SS...
Troillet A, Scharner D.Cecocolic intussusceptions are a rare condition of acute colic in horses requiring immediate surgical intervention due to persistent uncontrollable pain and ongoing ischemic cecal necrosis. Particularly in cases where reduction of the intussusception is surgically not feasible surgical interventions such as partial typhlectomy through colotomy (partial cecal amputation) combined with or without cecal bypass techniques are described. Alternatively, surgical interventions can also be performed without partial typhlectomy via incomplete bypass ileocolostomy. Information regarding applicable techn...
Barton CK, Hassel DM, Anders K, Weir TL.A major cause of morbidity and mortality in horses with large colon obstructive lesions is injury to the colonic mucosal barrier from ischemic injury. Since butyrate has been shown to play a critical role in the maintenance of a healthy mucosal barrier, it may play a role in the recovery process. This study's objective was to determine whether the differences in butyrate concentrations existed between horses with surgical large colon obstructive lesions and healthy horses both during and after surgery. Eleven horses presenting with surgical colic lesions were enrolled; colonic samples were acq...
Verhaar N, Hammer E, Reineking W, Hewicker-Trautwein M, Geburek F.To compare the practicability and tissue sample quality between different intestinal biopsy techniques. Methods: Experimental, randomized ex vivo study. Methods: Small intestine of nine horses. Methods: Four different biopsy techniques were evaluated in the aboral jejunum and the ileum within 1 h after euthanasia. One segment was used as control (C), and the applied techniques included an 8 mm biopsy punch (BP), transverse wedge resection (TW), longitudinal wedge resection with transverse closure (LW) and a longitudinal sample using Eppendorfer biopsy forceps (EF). Defects were closed using ...
Kopec EK, Stevens M, Crowe O, Wright C, Suthers J.The aim of the present study was to investigate the long-term survival and postoperative complications in horses that had undergone small intestinal resection and a modified anastomosis technique using a partially stapled, functional end-to-end anastomosis. Methods: Observational retrospective case series. Methods: A total of 25 horses underwent small intestinal resection and a partially stapled, functional end-to-end anastomosis. Methods: A modified technique to create a partially stapled, functional end-to-end anastomosis is described. The clinical case records of all horses that fulfilled t...
Bell J, Radial SL, Cuming RS, Trope G, Hughes KJ.Diarrhea in foals can be associated with disruption of the intestinal microbiota (dysbiosis). Effective management of intestinal dysbiosis in foals has not been demonstrated. Objective: Fecal microbiota transplantation (FMT) in foals with diarrhea influences the intestinal microbiota and improves clinical and clinicopathological outcomes. Methods: Twenty-five foals <6 months of age with diarrhea and systemic inflammatory response syndrome at 3 veterinary hospitals. Methods: A prospective randomized placebo-controlled cohort study. Foals in the FMT group (n = 19) or control group (n =â€...
St Blanc MP, Mirza MH, Riggs LM, Leise BS.The aim of the study was to evaluate time to closure, bursting pressures and luminal diameters of a single and double-layer end-to-end anastomoses in normal equine descending colon. Methods: Experimental study. Methods: Eight adult horses. Methods: Four segments of descending colon from each horse were randomly assigned to a control (n = 8, CON), one-layer (n = 12, group 1; continuous Lembert pattern), or two-layer group (n = 12, group 2; simple continuous oversewn with Cushing pattern). Anastomoses were performed, and time to closure and luminal diameter were measured. Bursting pr...
Verhaar N, Reineking W, Hewicker-Trautwein M, Grages AM, Kästner SBR, Geburek F.To evaluate the use of laser Doppler flowmetry and spectrophotometry (LDFS) for large intestinal viability assessment in horses with naturally occurring large intestinal strangulations. Methods: By use of LDFS, intestinal microperfusion was quantified as tissue oxygen saturation (tSo2), hemoglobin (tHB), and blood flow (tBF) in cases with large colon volvulus and small colon strangulations undergoing colic surgery (n = 17). Intestinal biopsies were taken from the pelvic flexure in all large colon cases and in small colon cases that underwent intraoperative euthanasia. Measurements were compare...
Azizi S, Mazaheri-Khameneh R, Davoodi F, Gooran MM, Ghoreishi SS, Mozaffari N, Dalir-Naghadeh B.In this case report, we present an unusual clockwise torsion of left colon around mesenteric root in a 10-month-old Arab filly, highlighting the clinical presentation, diagnostic approach and successful surgical intervention. A 10-month-old Arab filly weighing approximately 250Â kg was referred with signs of acute abdominal pain. The history revealed anorexia, restlessness and severe abdominal pain that had begun the previous day. The local practitioner had previously administered flunixin meglumine, an analgesic, but it proved ineffective in relieving the pain. Upon physical examination, the ...
Tallon RE, Allen SE, Bladon BM, McGovern KF.To determine the effect of a single intraoperative dose of dexamethasone on the risk of postoperative reflux (POR) in horses undergoing small intestinal surgery and to investigate its association with incisional complications and short-term survival. Methods: Retrospective cohort study over an 11-year period (2008-2019). Methods: UK-based private referral center. Methods: Two hundred and forty client-owned horses >6Â months of age undergoing exploratory laparotomy for treatment of a small intestinal lesion. Methods: Ninety-seven horses received a single intraoperative dose of dexamethasone ...
Watkins A, Engiles J, Long A, Brandly J, Hopster K.Large colon volvulus is a cause of colic in horses with high morbidity and mortality when not promptly treated. More treatment options are needed to improve the outcome of these cases by protecting against the damage caused by ischaemia and reperfusion injury. Objective: To determine the effect of preconditioning with dexmedetomidine prior to induction of ischaemia-reperfusion (IR) injury in a large colon volvulus model in the horse. Methods: Randomised blinded in vivo experiments. Methods: Horses received either a dexmedetomidine (DEX) or saline (CON) constant rate infusion (CRI) immediately ...
Verhaar N, Grages AM, Sauer FJ, Geiger T, Reineking W, Hewicker-Trautwein M, Geburek F, Kästner SBR.To assess the histological injury and intestinal microperfusion measured by laser Doppler flowmetry and spectrophotometry (LDFS) of the small intestine orad to a strangulation during colic surgery. Methods: Horses with naturally occurring small intestinal strangulations undergoing colic surgery were included. Methods: In this prospective clinical trial, intestinal tissue oxygen saturation (tSO2) and tissue blood flow (tBF) were measured by LDFS orad to the strangulation following release of the strangulation (n = 18). The number of horses with postoperative reflux (POR) and the cases that surv...
Munsterman AS, VanderBroek AR, Kottwitz JJ, Watson VE.To compare a novel suture loop method for intestinal biopsies (SLB) with a two-layer, hand-sutured biopsy (HSB) technique in equine small and large intestines. Methods: Experimental, randomized, ex vivo study. Methods: Eight healthy adult horses. Methods: The duodenum, aboral jejunum, and ventral and dorsal large colon were harvested after euthanasia and divided into three sections each. The sections were randomized to SLB, HSB, or control (C, no biopsy) groups. Tissue samples were excised after placement of a suture loop formed by a 4S Roeder knot and oversewn with a Cushing pattern using bar...
Ruff J, Zetterstrom S, Boone L, Hofmeister E, Smith C, Epstein K, Blikslager A, Fogle C, Burke M.The objective of this study was to compare the occurrence of post-operative complications and survival to discharge in horses with ileal impactions resolved by manual decompression compared with jejunal enterotomy. Unassigned: A total of 121 client-owned horses undergoing surgical correction of an ileal impaction at three teaching hospitals. Unassigned: Data from the medical records of horses undergoing surgical correction of an ileal impaction was retrospectively collected. Post-operative complications, survival to discharge, or post-operative reflux present were evaluated as dependent variab...
Southwood LL.Horses with colic caused by intestinal strangulation can have an excellent outcome with early surgical correction of the obstruction. The expense associated with surgery is typically less with early lesion correction. The challenge is making an early diagnosis of intestinal strangulation. Although for some horses with a strangulating obstruction, the need for surgery is made based on severe colic signs or lack of response to analgesia, in other horses, it is less obvious. Signalment, history, and meticulous physical examination, combined with some targeted diagnostic procedures can help with e...
Gandini M, Cerullo A, Gallo L, Iussich S, Minoli L, Giusto G.To describe a technique for a side-to-side jejunocecal anastomosis in horses using radiofrequency thermofusion (TF) of the intestines supported by a Cushing oversew and to compare this anastomosis to handsewn and stapled techniques. Methods: Ex vivo study. Methods: Intestinal tracts from 24 slaughtered horses. Methods: A radiofrequency device was used to perform a jejunocecal anastomosis (Group RFA). The construction time and bursting pressure of this construct were compared with those of a hand-sewn double layer (Group HS) and stapled anastomoses (Group ST) without oversew of the staple line....
Verhaar N, de Buhr N, von Köckritz-Blickwede M, Dümmer K, Hewicker-Trautwein M, Pfarrer C, Dengler F, Kästner S.Hypoxia inducible factors (HIF) are widely researched in human medicine for their role in different disease processes. The aim of this study was to investigate the expression and distribution of HIF in experimental small intestinal ischemia in the horse. Unassigned: In 14 horses under general anesthesia, segmental jejunal ischemia with 90% reduction in blood flow was induced. The horses were randomly divided into two groups of seven horses, one subjected to ischemic postconditioning (IPoC) by delayed reperfusion, and a control group (group C) undergoing undelayed reperfusion. Intestinal sample...
Veerasammy B, Gonzalez G, Báez-Ramos P, Schaaf CR, Stewart AS, Ludwig EK, McKinney-Aguirre C, Freund J, Robertson J, Gonzalez LM.Intestinal epithelial stem cells (ISC) are responsible for epithelial regeneration and are critical to the intestine's ability to regain barrier function following injury. Evaluating ISC biomarker expression in cases of small intestinal strangulation (SIS) may provide insight into clinical progression. Objective: Intestinal resection margins from cases of SIS were evaluated to determine if (1) evidence of injury could be identified using histomorphometry, (2) ISC biomarker expression was decreased in the proximal resection margin compared to control and distal resection margin, and (3) the ISC...
Pihl TH, Nielsen MK, Olsen SN, Leifsson PS, Jacobsen S.Strongylus vulgaris is re-emerging in horses kept under surveillance-based parasite control regimens. Information on nonstrangulating intestinal infarction associated with S. vulgaris is needed to improve recognition of the condition. Objective: To describe the typical clinical presentation, laboratory findings, gross pathology, treatment and outcome of horses with nonstrangulating intestinal infarction. Methods: Retrospective case series. Methods: Nonstrangluating intestinal infarction was diagnosed in 30 horses with a localised intestinal infarction with concurrent signs of S. vulgaris mig...
Phillips TJ, Walmsley JP.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...
Latson KM, Nieto JE, Beldomenico PM, Snyder JR.The most common cause of death as a direct result of colic is acute circulatory failure secondary to intestinal ischaemia. Early and accurate recognition of ischaemic bowel is essential to decrease complications and increase survival. Blood to peritoneal lactate values have been evaluated as a prognostic indicator, but lactate values characterised by type of lesion have not been reported. Objective: Plasma and peritoneal lactate values are higher in horses with intestinal ischaemia secondary to a strangulating obstruction (ISSO). Methods: Venous blood and peritoneal fluid were collected sequen...
Freeman DE, Hammock P, Baker GJ, Goetz T, Foreman JH, Schaeffer DJ, Richter RA, Inoue O, Magid JH.The records of 74 horses that recovered from anaesthesia after surgery for a small intestinal lesion from 1994 to 1999 were reviewed. Sixty-three horses (85%) had a strangulating lesion and 43 of these (68%) had a resection and anastomosis. Four of 11 horses (36%) without a strangulating lesion had a resection and anastomosis. Sixty-three horses (85%) survived to discharge, with a survival rate of 53/63 in horses with a strangulating lesion (84%) and 10/11 (91%) in others. For all lesions, short-term survival for all end-to-end anastomoses (91%; 21/23) and for no resection (92%; 23/25) were su...
Wilson DA, Baker GJ, Boero MJ.Complications of celiotomy incisions were evaluated retrospectively in 274 horses that survived at least 1 month after surgery, or died or were euthanatized within 1 month of surgery, as a direct result of these complications. Horses were divided into four groups; group A, a ventral median celiotomy for intestinal disease; group B, ventral median celiotomy for nonintestinal disease; group C, repair of an umbilical hernia; and group D, celiotomy in a region other than the midline. Specific incisional complications were peri-incisional edema, drainage, incisional abscess, suture sinus, and dehis...
Van Hoogmoed LM, Nieto JE, Snyder JR, Harmon FA.To report prokinetic strategies used to manage horses after gastrointestinal surgery. Methods: Electronic questionnaire. Methods: Diplomates of the American College of Veterinary Surgeons (ACVS) who perform equine intestinal surgery. Methods: A survey (21 questions) designed to determine use of prokinetic agents was sent electronically to 112 ACVS Diplomates known to perform equine intestinal surgery. Several clinical scenarios were also described to determine which, if any, prokinetic agent respondents would select. Results: Responses were obtained from 58 (52%) surgeons from 44 clinics. Sele...
Torfs S, Delesalle C, Dewulf J, Devisscher L, Deprez P.Postoperative ileus (POI) is a frequent and often fatal complication of colic surgery. Reliably effective treatments are not available. Objective: To determine risk factors and protective factors associated with POI, and to assess the effect of lidocaine IV on short-term survival. Methods: One hundred and twenty-six horses that underwent small intestinal colic surgery and that survived for at least 24 hours postoperatively. Methods: Retrospective cross-sectional study. The association of 31 pre-, intra-, and postoperative variables with POI and the association of lidocaine treatment with short...
Peloso JG, Cohen ND.To determine the value of serial measurements of peritoneal fluid lactate concentration (PFL) for detecting strangulating intestinal lesions (SLs) in referred horses with signs of colic. Methods: Retrospective cohort study. Methods: 94 horses with signs of colic. Methods: Medical records of horses evaluated between September 2006 and February 2010 because of signs of colic were reviewed. All included horses had ≥ 2 peritoneal fluid samples collected, including one at admission and another within 1 to 6 hours after admission. Of the 94 horses, 26 were assigned to the SL group on the basis of ...
White NA, Moore JN, Trim CM.Small intestinal strangulation obstruction (ISO) was produced in seven ponies (under pentobarbital-anesthesia) by arteriovenous ligation. Positive-pressure ventilation with room air was used to maintain arterial PCO2 at the initiation of the ISO. Biopsy materials obtained from affected intestines at various times were evaluated, using histopathologic examination and scanning electron microscopy. Mucosal and villus degeneration was graded 0 to V and compared with intestinal gross color, motility, and wall thickness. The mucosa at the tip of the villus was the first to be affected. Degeneration ...
Brianceau P, Chevalier H, Karas A, Court MH, Bassage L, Kirker-Head C, Provost P, Paradis MR.Twenty-eight horses with the diagnosis of an intestinal disorder requiring surgical intervention were randomly assigned to lidocaine (n = 13) or saline (control, n = 15) treatment groups. After induction of anesthesia, treated horses received a loading dose of 2% lidocaine (0.65 mg/kg) intravenously, followed by a continuous rate of infusion of 1% lidocaine (0.025 mg/kg/min) until the discontinuation of anesthesia. Upon recovery from anesthesia, a 2nd loading dose of 2% lidocaine (1.3 mg/kg) was administered, followed by an infusion of 1% lidocaine (0.05 mg/kg/min) for 24 hours postoperatively...
Kilcoyne I, Nieto JE, Dechant JE.To assess the diagnostic value of plasma and peritoneal fluid procalcitonin concentrations for identification of horses with strangulating intestinal lesions. Methods: 65 horses with signs of colic of intestinal origin and 10 healthy (control) horses. Methods: For each horse, plasma and peritoneal fluid samples were obtained for a CBC and determination of total protein, procalcitonin, and lactate concentrations. Signalment and clinicopathologic findings were compared among control horses and horses with strangulating and nonstrangulating intestinal lesions. Results: Mean ± SD plasma (274.9 ±...
van den Boom R, van der Velden MA.A retrospective study was carried out of 224 horses operated for strangulating small intestine obstructions. Fifty-four horses were euthanized and 5 horses died during surgery which means that 165 (73%) were allowed to recover. Of these, 53 horses were euthanized or died in the clinic and 112 (50%) were discharged from the hospital. Of 90 horses available for follow-up 1 year postoperatively, 76 (84%) were still alive. The most important causes of death or reasons for euthanasia in the direct post-operative period were post-operative paralytic ileus, (adhesive) peritonitis and intra-abdominal ...
Freeman DE.Although earlier reports describe a poor prognosis for small intestinal surgery in the horse, there is growing evidence that the short-term survival rate can exceed 80%. In addition to advancements in surgery and aftercare, early referral contributes considerably to the improved prognosis. Surgical procedures that restore anatomic and physiologic continuity to close to normal can minimize postoperative complications. Jejunojejunostomy carries a better prognosis than jejunocecostomy, probably because the latter involves anastomosis between two intestinal segments with dissimilar functions. Care...
Chaffin MK, Fuenteabla IC, Schumacher J, Welch RD, Edwards JF.The medical records of 11 horses with idiopathic muscular hypertrophy (MH) of the small intestine were reviewed to determine the clinical and pathological features of the disease. The median age of affected horses was 10.0 years (range 5-18 years). No breed or sex predisposition was apparent. Ten horses (91%) had chronic (23 days to 2.4 years) signs of mild, intermittent colic, and 1 horse had signs of severe colic of only 3 days' duration. Partial anorexia and chronic weight loss of variable duration (1-6 months) were prominent historical findings in 5 (45%) horses. Diagnostic tests, with the...
Proudman CJ, Edwards GB, Barnes J.Horses requiring different methods of intestinal anastomosis during equine colic surgery may have differences in mortality and morbidity. Objective: Horses requiring side-to-side jejunocaecal anastomosis have a higher mortality and morbidity rate than those requiring end-to-end jejunojejunal anastomosis. Morbidity and mortality of handsewn vs. stapled side-to-side jejunocaecal anastomoses are not significantly different. Methods: A prospective, nonrandomised, observational study was conducted. Clinical and surgical details were recorded during hospitalisation and survival data acquired by peri...
Parker JE, Fubini SL, Todhunter RJ.Fifty-three of 648 horses (8.2%) treated surgically for acute gastrointestinal obstruction were subjected to repeat celiotomy. Forty horses (75%) recovered from anesthesia after repeat celiotomy, and 26 horses (49%) were discharged from the clinic. Excluding two horses lost to follow-up, 10 of 51 horses (20%) survived long term. Horses subjected to repeat celiotomy had a significantly lower long-term survival rate than horses subjected to a single celiotomy. Twenty-eight horses had mechanical obstructions, and 22 had functional obstructions at the second surgery. Significantly more horses with...
Hawkins JF, Bowman KF, Roberts MC, Cowen P.Peritonitis was diagnosed in 67 horses between 1985 and 1990: 14 horses developed septic peritonitis after intestinal rupture, 25 horses developed peritonitis after abdominal surgery, and 28 horses had peritonitis not associated with intestinal rupture or abdominal surgery. Forty of 67 horses (59.7%) did not survive. Nonsurvivors had higher heart rates (P = 0.01), RBC count (P = 0.039), serum creatinine concentration (P = 0.036), PCV (P = 0.007), and anion gap (P = 0.005); lower venous blood pH (P = 0.002); and a greater number of bacterial species cultured from peritoneal fluid samples (P = 0...
Grulke S, Olle E, Detilleux J, Gangl M, Caudron I, Serteyn D.A retrospective study evaluated 200 surgical colic cases. A gravity score (GS) based on four clinical parameters estimating intestinal obstruction (rectal palpation, borborygmi, abdominal distension, pain) and classified into three categories was established and tested to determine if it could evaluate prognosis. A shock score (SS) based on six parameters was also attributed to each case. The overall survival rate was 54%. The statistical analysis showed a significant (P < 0.01) difference in the survival rate in the different categories of the GS, as well as in the categories of the SS. A ...
Owen RA, Jagger DW, Quan-Taylor R.A caecocaecal intussusception in a pony and a caecocolic intussusception in a horse, both infected with Anoplocephala perfoliata, are described and the relevance of tapeworms in such intestinal disease of horses is reviewed.
Edwards GB.During a 14 year period, 27 of 310 horses undergoing laparotomy because of abdominal pain were found to have an intussusception involving the small intestine (16 cases) or caecum (11 cases). The clinical signs, operative findings and techniques adopted to overcome the obstruction are described. An evaluation of possible predisposing factors provided further evidence of the important role of the tapeworm Anoplocephala perfoliata in initiating intussusception involving the ileum and caecum.
Reichert C, Kästner SB, Hopster K, Rohn K, Rötting AK.To evaluate the use of a micro-lightguide tissue spectrophotometer for measurement of tissue oxygenation and blood flow in the small and large intestines of horses under anesthesia. Methods: 13 adult horses without gastrointestinal disease. Methods: Horses were anesthetized and placed in dorsal recumbency. Ventral midline laparotomy was performed. Intestinal segments were exteriorized to obtain measurements. Spectrophotometric measurements of tissue oxygenation and regional blood flow of the jejunum and pelvic flexure were obtained under various conditions that were considered to have a potent...
Prichard M, Ducharme NG, Wilkins PA, Erb HN, Butt M.We hypothesized that xanthine oxidase plays a role in the postischemic reperfusion injury in the equine small intestine. Under anesthesia, four horses and two ponies underwent ischemic strangulating obstructions of segments of the proximal jejunum, mid-jejunum and ileum. Prior to vascular occlusion, and at 1 h and 2 h of ischemia, full-thickness intestinal biopsies were collected for histopathological evaluation and for determination of combined xanthine dehydrogenase (XDH) plus xanthine oxidase (XO) activity, and XO activity alone. The level of XO activity was expressed in percentage accordin...
Freeman DE, Gentile DG, Richardson DW, Fetrow JP, Tulleners EP, Orsini JA, Cimprich R.Strangulation obstruction was induced in anesthetized ponies for periods of 2 and 3 hours by clamping 45-cm segments of jejunum and associated veins (venous strangulation obstruction) and arteries and veins (arterial and venous strangulation obstruction). Four segments were studied in each of 7 ponies allowed to survive 12 hours, 2 segments in a pony that was allowed to survive 1 hour, and 1 segment in each of 10 ponies allowed to survive 42 days after the strangulation periods ended. Fifteen minutes after the periods of strangulation obstruction ended, the viability of test segments was asses...
MacDonald MH, Pascoe JR, Stover SM, Meagher DM.The authors examined factors influencing survival in 140 horses that recovered from anesthesia after small intestinal resection between 1968 and 1986, using Kaplan-Meier estimated survival curves and the Cox proportional hazards regression model. Seventy-two horses (51%) died during the initial postoperative period, 19 horses (14%) died after discharge from the hospital, 33 horses (24%) were alive, and 16 horses (11%) were classified as censored. Mean age at surgery was 8 years. Horses 15 years of age or older, Arabians and Stallions, were overrepresented in the hospital population. The most c...
van der Gaag I, Tibboel D.Intestinal atresia was found in 29 animals and stenosis in five. Atresia was found in the duodenum in one pup; in the jejunum in nine calves, two lambs and one piglet; in the ileum in one pup, one lamb and one piglet; and in the colon in one foal, seven calves, one lamb, one piglet and three kittens. Stenosis was found in the duodenum of a foal, in the jejunum in two calves and one pup, and in both the ileum and the colon of a kitten. One lamb showed ileal atresia as well as ileal stenosis. We classified the atresia as type 1, membrane atresia (four cases); type 2, cord atresia (six cases); an...
Verhaar N, Pfarrer C, Neudeck S, König K, Rohn K, Twele L, Kästner S.Pharmacological preconditioning of dexmedetomidine on small intestinal ischaemia/reperfusion injury has been reported in different animal models including horses. Objective: The objective was to assess if xylazine and lidocaine have a preconditioning effect in an experimental model of equine jejunal ischaemia. Methods: Terminal in vivo experiment. Methods: Ten horses under general anaesthesia were either preconditioned with xylazine (group X; n = 5) or lidocaine (group L; n = 5). A historical untreated control group (group C; n = 5) was used for comparison. An established experimental mo...
To document morphologic changes that occur in equine intestinal serosa after experimentally induced ischemia and subsequent reperfusion (jejunum, ascending colon) or after intraluminal distention and decompression (jejunum). Methods: Morphologic effects of ischemia-reperfusion or intraluminal distention-decompression determined on the serosal layer of the equine jejunum. The large colon serosa was evaluated after ischemia-reperfusion injury. Methods: Seven adult horses. Methods: After induction of general anesthesia and ventral median celiotomy, ischemia was created by arteriovenous (AVO) and ...
Radcliffe RM, Liu SY, Cook VL, Hurcombe SDA, Divers TJ.Interpreting changes in peritoneal fluid helps clinicians manage colic and other diseases in horses. During abdominal problems in the horse, abdominal fluid characteristics such as color, turbidity, total nucleated and red blood cell counts, cytology, total protein, and l-lactate change in predictable ways, helping the clinician characterize the disease. Methods: Normal abdominal fluid in horses is odorless, clear to light yellow in color, and transparent. Peritoneal fluid becomes more turbid with increasing levels of protein, number of WBCs or RBCs, or with gross contamination following intes...
Bauck AG, Grosche A, Morton AJ, Graham AS, Vickroy TW, Freeman DE.OBJECTIVE To examine effects of continuous rate infusion of lidocaine on transmural neutrophil infiltration in equine intestine subjected to manipulation only and remote to ischemic intestine. ANIMALS 14 healthy horses. PROCEDURES Ventral midline celiotomy was performed (time 0). Mild ischemia was induced in segments of jejunum and large colon. A 1-m segment of jejunum was manipulated by massaging the jejunal wall 10 times. Horses received lidocaine (n = 7) or saline (0.9% NaCl) solution (7) throughout anesthesia. Biopsy specimens were collected and used to assess tissue injury, neutrophil inf...
