FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Antibiotics (Basel) / A Pilot Randomised Clinical Trial Comparing a Short-Term Per...
Antibiotics (Basel, Switzerland)2021; 10(5); doi: 10.3390/antibiotics10050587

A Pilot Randomised Clinical Trial Comparing a Short-Term Perioperative Prophylaxis Regimen to a Long-Term Standard Protocol in Equine Colic Surgery.

Abstract: For surgical interventions classified as clean or clean-contaminated, including laparotomy, guidelines in human and veterinary medicine recommend a short-term perioperative antibiotic prophylaxis (PAP). In equine colic surgery, however, PAP commonly exceeds 24 h. Objective: The aim of this study was to compare a single-shot to a 5-day lasting PAP considering surgical site infections (SSI) and other adverse effects probably associated with the particular antimicrobial regimen. Methods: The study was designed as a randomised non-inferiority pilot study including horses subjected to colic surgery while receiving one of two distinct PAP regimens. Methods: All horses (n = 67) included in the study received the standard physical examination before and after surgery. Colic surgery was performed according to the current standard of the clinic. Horses were randomly assigned to two groups, receiving either the "single-shot" or the "5-day lasting" antibiotic prophylaxis. The "single-shot" group (n = 30) received penicillin and gentamicin only once before and, if needed, during surgery, whereas the "5-day lasting" group (n = 37) received antibiotics for five days. In addition to the standard laboratory examinations, serum amyloid A and fibrinogen were determined preoperatively and during five days after surgery. SSI, postoperative colitis and haemolytic anaemia were classified as postoperative complications potentially related to antibiotic use. Results: The outcome of this preliminary non-inferiority clinical trial showed that the occurrence of postoperative adverse events (i.e., SSI, postoperative colitis and haemolytic anaemia) lacked significant differences between the study groups. Main limitations: The main limitations of this study are the limited group sizes and our inability to blind the study. Conclusions: Single-shot PAP seems to be an alternative approach considering the 5-day lasting protocol commonly used in equine abdominal surgery. However, a proper hygiene management together with a close clinical and laboratory monitoring of the equine patient is indispensable.
Get Full Text
Publication Date: 2021-05-16 PubMed ID: 34065712PubMed Central: PMC8156649DOI: 10.3390/antibiotics10050587Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article is about a comparative study of short-term (single-shot) and long-term (5-day) perioperative antibiotic prophylaxis in equine colic surgery. The preliminary outcomes indicate that both approaches presented similar rates of postoperative adverse events, suggesting that the single-shot approach may be a viable alternative.

Objective and Methodology

  • The aim of this research was to determine if a single shot of antibiotic (short-term perioperative antibiotic prophylaxis – PAP) could be as effective as a 5-day long antibiotic regimen in preventing surgical site infections (SSIs) and other adverse effects related to the antibiotics.
  • The researchers designed a randomised non-inferiority pilot study, where they divided 67 horses undergoing colic surgery into two groups.
  • Physical examinations were performed on all the horses before and after the surgery.
  • In addition to the standard lab exams, levels of serum amyloid A and fibrinogen were measured preoperatively and up to five days post-surgery.
  • Postoperative complications, such as SSIs, postoperative colitis and haemolytic anaemia, were identified and classified as potential outcomes of antibiotic use.

Procedure

  • Horses were divided into two groups, with one group (30 horses) receiving a “single-shot” antibiotic prophylaxis, and the other (37 horses) undergoing a “5-day lasting” antibiotic treatment. These antibiotics consisted of penicillin and gentamicin.
  • The group receiving the short-term treatment were administered the antibiotics once before the operation and during the surgery if needed. The other group was given antibiotics for five consecutive days.

Results

  • The study found that the occurrence of postoperative adverse events (i.e., surgical site infection, postoperative colitis and haemolytic anaemia) showed no significant difference between the two study groups.

Limitations and Conclusions

  • The limitations of this study include the small sample size and the lack of blinding.
  • However, the results suggest that a single-shot antibiotic prophylaxis could be a viable alternative to the usual 5-day protocol in abdominal surgery for horses. Despite the findings, the authors emphasise the importance of proper hygiene management and the necessity of close clinical and laboratory monitoring of the horse patients.

Cite This Article

APA
Stöckle SD, Kannapin DA, Kauter AML, Lübke-Becker A, Walther B, Merle R, Gehlen H. (2021). A Pilot Randomised Clinical Trial Comparing a Short-Term Perioperative Prophylaxis Regimen to a Long-Term Standard Protocol in Equine Colic Surgery. Antibiotics (Basel), 10(5). https://doi.org/10.3390/antibiotics10050587

Publication

Antibiotics (Basel, Switzerland)
ISSN: 2079-6382
NlmUniqueID: 101637404
Country: Switzerland
Language: English
Volume: 10
Issue: 5

Researcher Affiliations

Stöckle, Sabita Diana
  • Equine Clinic: Surgery and Radiology, Freie Universität Berlin, 14163 Berlin, Germany.
Kannapin, Dania A
  • Equine Clinic: Surgery and Radiology, Freie Universität Berlin, 14163 Berlin, Germany.
Kauter, Anne M L
  • Robert Koch Institute, Advanced Light and Electron Microscopy, 13353 Berlin, Germany.
Lübke-Becker, Antina
  • Institute of Microbiology and Epizootics, Freie Universität Berlin, 14163 Berlin, Germany.
Walther, Birgit
  • Robert Koch Institute, Advanced Light and Electron Microscopy, 13353 Berlin, Germany.
Merle, Roswitha
  • Institute for Veterinary Epidemiology and Biostatistics, Freie Universität Berlin, 14163 Berlin, Germany.
Gehlen, Heidrun
  • Equine Clinic: Surgery and Radiology, Freie Universität Berlin, 14163 Berlin, Germany.

Grant Funding

  • 01KI1727F and 01KI1727D / Bundesministerium für Bildung und Forschung

Conflict of Interest Statement

The authors declare no competing interests. This study contains data of the so-far unpublished dissertation of D. A. Kannapin.

References

This article includes 71 references
  1. Traub-Dargatz JL, Kopral CA, Seitzinger AH, Garber LP, Forde K, White NA. Estimate of the national incidence of and operation-level risk factors for colic among horses in the United States, spring 1998 to spring 1999.. J. Am. Vet. Med. Assoc. 2001;219:67–71.
    doi: 10.2460/javma.2001.219.67pubmed: 11439773google scholar: lookup
  2. Cruse PJ, Foord R. The epidemiology of wound infection: A 10-year prospective study of 62,939 wounds.. Surg. Clin. N. Am. 1980;60:27–40.
    doi: 10.1016/S0039-6109(16)42031-1pubmed: 7361226google scholar: lookup
  3. Bartmann C, Bubeck K, Georgiadis S, Deegen E. Reduction of complications of the wound healing following ventral median celiotomy in horses.. Pferdeheilkunde 2003;19:351ff.
    doi: 10.21836/PEM20030403google scholar: lookup
  4. French N, Smith J, Edwards G, Proudman C. Equine surgical colic: Risk factors for postoperative complications.. Equine Vet. J. 2002;34:444–449.
    doi: 10.2746/042516402776117791pubmed: 12358045google scholar: lookup
  5. Mair T, Smith L. Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 2: Short-term complications.. Equine Vet. J. 2005;37:303–309.
    doi: 10.2746/0425164054529364pubmed: 16028617google scholar: lookup
  6. Torfs S, Levet T, Delesalle C, Dewulf J, Vlaminck L, Pille F, Lefere L, Martens A. Risk factors for incisional complications after exploratory celiotomy in horses: Do skin staples increase the risk?. Vet. Surg. 2010;39:616–620.
    doi: 10.1111/j.1532-950X.2009.00636.xpubmed: 20636556google scholar: lookup
  7. Davis W, Fogle C, Gerard M, Levine J, Blikslager A. Return to use and performance following exploratory celiotomy for colic in horses: 195 cases (2003–2010). Equine Vet. J. 2013;45:224–228.
    doi: 10.1111/j.2042-3306.2012.00615.xpubmed: 22853644google scholar: lookup
  8. Christophersen M, Tnibar A, Pihl T, Andersen P, Ekstrøm C. Sporting activity following colic surgery in horses: A retrospective study.. Equine Vet. J. 2011;43:3–6.
    doi: 10.1111/j.2042-3306.2011.00490.xpubmed: 22082438google scholar: lookup
  9. Walther B, Janßen T, Gehlen H, Vincze S, Borchers K, Wieler LH, Barton AK, Lübke-Becker A. Infektionsprävention und Hygiene management in Pferdekliniken.. Berliner und Münchener Tierärztliche Wochenschrift 2014;127:448–497.
    pubmed: 25872258
  10. Walther B, Tedin K, Lübke-Becker A. Multidrug-resistant opportunistic pathogens challenging veterinary infection control.. Vet. Microbiol. 2017;200:71–78.
    doi: 10.1016/j.vetmic.2016.05.017pubmed: 27291944google scholar: lookup
  11. Gehlen H. Umgang mit Antibiotikaresistenzen in Praxis und Klinik; Proceedings of the Leipziger Tierärztekongress; Leipzig, Germany. 16–18 January 2020.. Leipziger Blaue Hefte 174.
  12. Maddox TW, Clegg PD, Williams NJ, Pinchbeck GL. Antimicrobial resistance in bacteria from horses: Epidemiology of antimicrobial resistance.. Equine Vet. J. 2015;47:756–765.
    doi: 10.1111/evj.12471pubmed: 26084443google scholar: lookup
  13. Ahern BJ, Richardson DW. Chapter 7-Surgical Site Infection and the Use of Antimicrobials.. In: Auer JA, Richardson DW, editors. Equine Surgery. 4th ed. W.B. Saunders; Saint Louis, MO, USA: 2011. pp. 68–74.
  14. Maier S, Eckmann C, Kramer A. Perioperative Antibiotikaprophylaxe: Ein Update.. Krankenh.hyg. up2date 2015;10:e1-e1.
    doi: 10.1055/s-0034-1392967google scholar: lookup
  15. Ebenhoch M. Abdominaltrauma und Antibiotikaprophylaxe.. Trauma und Berufskrankheit 2017;19:109–111.
    doi: 10.1007/s10039-016-0228-4google scholar: lookup
  16. Teschner D, Barton AK, Klaus C, Gehlen H. Antibiotikaeinsatz bei operierten Kolikpferden in Deutschland.. Pferdeheilkunde 2015;31:235–240.
    doi: 10.21836/PEM20150305google scholar: lookup
  17. Durward-Akhurst SA, Mair TS, Boston R, Dunkel B. Comparison of two antimicrobial regimens on the prevalence of incisional infections after colic surgery.. Vet. Rec. 2013;172:287.
    doi: 10.1136/vr.101186pubmed: 23268187google scholar: lookup
  18. Bratzler DW, Houck PM. Antimicrobial prophylaxis for surgery: An advisory statement from the National Surgical Infection Prevention Project.. Am. J. Surg. 2005;189:395–404.
    doi: 10.1016/j.amjsurg.2005.01.015pubmed: 15820449google scholar: lookup
  19. Rovera F, Diurni M, Dionigi G, Boni L, Ferrari A, Carcano G, Dionigi R. Antibiotic prophylaxis in colorectal surgery.. Expert Rev. Anti-Infect. Ther. 2005;3:787–795.
    doi: 10.1586/14787210.3.5.787pubmed: 16207170google scholar: lookup
  20. Anderson SL, Devick I, Bracamonte JL, Hendrick S, Barber SM, Carmalt JL, Wilson DG. Occurrence of Incisional Complications After Closure of Equine Celiotomies With USP 7 Polydioxanone.. Vet. Surg. 2015;44:521–526.
    doi: 10.1111/j.1532-950X.2014.12275.xpubmed: 25230697google scholar: lookup
  21. Darnaud SJ, Southwood LL, Aceto HW, Stefanovski D, Tomassone L, Zarucco L. Are horse age and incision length associated with surgical site infection following equine colic surgery?. Vet. J. 2016;217:3–7.
    doi: 10.1016/j.tvjl.2016.09.004pubmed: 27810207google scholar: lookup
  22. Colbath AC, Patipa L, Berghaus RD, Parks AH. The influence of suture pattern on the incidence of incisional drainage following exploratory laparotomy.. Equine Vet. J. 2014;46:156–160.
    doi: 10.1111/evj.12091pubmed: 23663132google scholar: lookup
  23. Tnibar A, Grubbe Lin K, Thurøe Nielsen K, Christophersen MT, Lindegaard C, Martinussen T, Ekstrøm CT. Effect of a stent bandage on the likelihood of incisional infection following exploratory coeliotomy for colic in horses: A comparative retrospective study.. Equine Vet. J. 2013;45:564–569.
    doi: 10.1111/evj.12026pubmed: 23294287google scholar: lookup
  24. Dziubinski N, Mählmann K, Lübke-Becker A, Lischer C. Retrospective Identification of Bacterial Isolates from Emergency Laparotomy Surgical Site Infections in Horses.. J. Equine Vet. Sci. 2020;87:102927.
    doi: 10.1016/j.jevs.2020.102927pubmed: 32172917google scholar: lookup
  25. van Spijk JN, Schmitt S, Schoster A. Infections caused by multidrug-resistant bacteria in an equine hospital (2012–2015). Equine Vet. Educ. 2017:653–658.
    doi: 10.1111/eve.12837google scholar: lookup
  26. Walther B, Luebke-Becker A, Stamm I, Gehlen H, Barton AK, Janssen T, Wieler LH, Guenther S. Suspected nosocomial infections with multi-drug resistant E. coli, including extended-spectrum beta-lactamase (ESBL)-producing strains, in an equine clinic.. Berliner und Munchener tierarztliche Wochenschrift 2014;127:421–427.
    pubmed: 25872251
  27. Vincze S, Stamm I, Kopp PA, Hermes J, Adlhoch C, Semmler T, Wieler LH, Lübke-Becker A, Walther B. Alarming proportions of methicillin-resistant Staphylococcus aureus (MRSA) in wound samples from companion animals, Germany 2010–2012.. PLoS ONE 2014;9:e85656.
    doi: 10.1371/journal.pone.0085656pmc: PMC3896405pubmed: 24465637google scholar: lookup
  28. Walther B, Klein KS, Barton AK, Semmler T, Huber C, Merle R, Tedin K, Mitrach F, Lübke-Becker A, Gehlen H. Equine methicillin-resistant sequence type 398 Staphylococcus aureus (MRSA) harbor mobile genetic elements promoting host adaptation.. Front. Microbiol. 2018;9:2516.
    doi: 10.3389/fmicb.2018.02516pmc: PMC6207647pubmed: 30405574google scholar: lookup
  29. Walther B, Klein KS, Barton AK, Semmler T, Huber C, Wolf SA, Tedin K, Merle R, Mitrach F, Guenther S. Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Acinetobacter baumannii among horses entering a veterinary teaching hospital: The contemporary “Trojan Horse”.. PLoS ONE 2018;13:e0191873.
    doi: 10.1371/journal.pone.0191873pmc: PMC5790241pubmed: 29381714google scholar: lookup
  30. Klohnen A. New perspectives in postoperative complications after abdominal surgery.. Vet. Clin. Equine Pract. 2009;25:341–350.
    doi: 10.1016/j.cveq.2009.05.003pubmed: 19580944google scholar: lookup
  31. Galuppo LD, Pascoe J, Jang SS, Willits NH, Greenman SL. Evaluation of iodophor skin preparation techniques and factors influencing drainage from ventral midline incisions in horses.. J. Am. Vet. Med. Assoc. 1999;215:963–969.
    pubmed: 10511861
  32. Fürst A, Kummer M, Kümmerle J, Bettschart Wolfensberger R, Schwarzwald C. Mögliche Komplikationen in der Kolikchirurgie.. Pferdeheilkunde 2012;5:522–530.
    doi: 10.21836/PEM20120501google scholar: lookup
  33. Smith L, Mellor D, Marr C, Reid S, Mair T. Incisional complications following exploratory celiotomy: Does an abdominal bandage reduce the risk?. Equine Vet. J. 2007;39:277–283.
    doi: 10.2746/042516407X193963pubmed: 17520982google scholar: lookup
  34. Wilson DA, Baker GJ, Boero MJ. Complications of celiotomy incisions in horses.. Vet. Surg. 1995;24:506–514.
    doi: 10.1111/j.1532-950X.1995.tb01362.xpubmed: 8560746google scholar: lookup
  35. Ingle-Fehr JE, Baxter GM, Howard RD, Trotter GW, Stashak TS. Bacterial culturing of ventral median celiotomies for prediction of postoperative incisional complications in horses.. Vet. Surg. 1997;26:7–13.
    doi: 10.1111/j.1532-950X.1997.tb01456.xpubmed: 9123817google scholar: lookup
  36. Kobluk CN, Ducharme NG, Lumsden JH, Pascoe PJ, Livesey MA, Hurtig M, Horney FD, Arighi M. Factors affecting incisional complication rates associated with colic surgery in horses: 78 cases (1983–1985). J. Am. Vet. Med. Assoc. 1989;195:639–642.
    pubmed: 2777714
  37. Coomer R, Mair T, Edwards G, Proudman C. Do subcutaneous sutures increase risk of laparotomy wound suppuration?. Equine Vet. J. 2007;39:396–399.
    doi: 10.2746/042516407X195123pubmed: 17910262google scholar: lookup
  38. Honnas C, Cohen N. Risk factors for wound infection following celiotomy in horses.. J. Am. Vet. Med. Assoc. 1997;210:78–81.
    pubmed: 8977653
  39. Macdonald MH, Pascoe JR, Stover SM, Meagher DM. Survival after small intestine resection and anastomosis in horses.. Vet. Surg. 1990;18:415–423.
    doi: 10.1111/j.1532-950X.1990.tb01116.xpubmed: 2603371google scholar: lookup
  40. Phillips T, Walmsley J. Retrospective analysis of the results of 151 exploratory laparotomies in horses with gastrointestinal disease.. Equine Vet. J. 1993;25:427–431.
    doi: 10.1111/j.2042-3306.1993.tb02985.xpubmed: 8223375google scholar: lookup
  41. Gibson KT, Curtis CR, Turner AS, McIlwraith CW, Aanes WA, Stashak TS. Incisional hernias in the horse incidence and predisposing factors.. Vet. Surg. 1989;18:360–366.
    doi: 10.1111/j.1532-950X.1989.tb01100.xpubmed: 2530684google scholar: lookup
  42. Packer M, German A, Hunter L, Trayhurn P, Proudman C. Adipose tissue-derived adiponectin expression is significantly associated with increased post operative mortality in horses undergoing emergency abdominal surgery.. Equine Vet. J. 2011;43:26–33.
    doi: 10.1111/j.2042-3306.2011.00404.xpubmed: 21790751google scholar: lookup
  43. Wieler LH, Ewers C, Guenther S, Walther B, Lübke-Becker A. Methicillin-resistant staphylococci (MRS) and extended-spectrum beta-lactamases (ESBL)-producing Enterobacteriaceae in companion animals: Nosocomial infections as one reason for the rising prevalence of these potential zoonotic pathogens in clinical samples.. Int. J. Med. Microbiol. 2011;301:635–641.
    pubmed: 22000738
  44. Walther B, Lübke-Becker A, Brunnberg L, Kohn B, Wieler LH. Einsatz von Antibiotika in der Kleintiermedizin: Quo vadis?. Der praktische Tierarzt 2011;1:1047–1049.
  45. Weese JS, Rousseau J, Willey BM, Archambault M, McGeer A, Low DE. Methicillin-resistant Staphylococcus aureus in horses at a veterinary teaching hospital: Frequency, characterization, and association with clinical disease.. J. Vet. Intern. Med. 2006;20:182–186.
    doi: 10.1111/j.1939-1676.2006.tb02839.xpubmed: 16496939google scholar: lookup
  46. Weese JS. A review of post-operative infections in veterinary orthopaedic surgery.. Vet. Comp. Orthop. Traumatol. 2008;21:99–105.
    doi: 10.3415/VCOT-07-11-0105pubmed: 18545710google scholar: lookup
  47. Ewers C, Bethe A, Semmler T, Guenther S, Wieler L. Extended-spectrum β-lactamase-producing and AmpC-producing Escherichia coli from livestock and companion animals, and their putative impact on public health: A global perspective.. Clin. Microbiol. Infect. 2012;18:646–655.
    doi: 10.1111/j.1469-0691.2012.03850.xpubmed: 22519858google scholar: lookup
  48. Benz R, Selke S, Holländer R. Der Hygieneplan: Ein Wegweiser durch den Alltag der Krankenhaushygiene.. Kohlhammer; Stuttgart, Germany: 1998.
  49. Bergström K, Aspan A, Landén A, Johnston C, Grönlund-Andersson U. The first nosocomial outbreak of methicillin-resistant Staphylococcus aureus in horses in Sweden.. Acta Vet. Scand. 2012;54:1–9.
    doi: 10.1186/1751-0147-54-11pmc: PMC3348035pubmed: 22316072google scholar: lookup
  50. Dallap Schaer BL, Linton JK, Aceto H. Antimicrobial Use in Horses Undergoing Colic Surgery.. J. Vet. Intern. Med. 2012;26:1449–1456.
    doi: 10.1111/j.1939-1676.2012.01024.xpubmed: 23167747google scholar: lookup
  51. Ernst NS, Hernandez JA, MacKay RJ, Brown MP, Gaskin JM, Nguyen AD, Giguere S, Colahan PT, Troedsson MR, Haines GR. Risk factors associated with fecal Salmonella shedding among hospitalized horses with signs of gastrointestinal tract disease.. J. Am. Vet. Med. Assoc. 2004;225:275–281.
    doi: 10.2460/javma.2004.225.275pubmed: 15323386google scholar: lookup
  52. Hird D, Casebolt D, Carter J, Pappaioanou M, Hjerpe C. Risk factors for salmonellosis in hospitalized horses.. J. Am. Vet. Med. Assoc. 1986;188:173.
    pubmed: 3700214
  53. Costa MC, Stämpfli HR, Arroyo LG, Allen-Vercoe E, Gomes RG, Weese JS. Changes in the equine fecal microbiota associated with the use of systemic antimicrobial drugs.. BMC Vet. Res. 2015;11:19.
    doi: 10.1186/s12917-015-0335-7pmc: PMC4323147pubmed: 25644524google scholar: lookup
  54. Harlow BE, Lawrence LM, Flythe MD. Diarrhea-associated pathogens, lactobacilli and cellulolytic bacteria in equine feces: Responses to antibiotic challenge.. Vet. Microbiol. 2013;166:225–232.
    doi: 10.1016/j.vetmic.2013.05.003pubmed: 23769300google scholar: lookup
  55. Karcher LF, Dill SG, Anderson WI, King JM. Right dorsal colitis.. J. Vet. Intern. Med. 1990;4:247–253.
    doi: 10.1111/j.1939-1676.1990.tb03117.xpubmed: 2262926google scholar: lookup
  56. Marshall J, Blikslager A. The effect of nonsteroidal anti-inflammatory drugs on the equine intestine.. Equine Vet. J. 2011;43:140–144.
    doi: 10.1111/j.2042-3306.2011.00398.xpubmed: 21790769google scholar: lookup
  57. McConnico RS, Morgan TW, Williams CC, Hubert JD, Moore RM. Pathophysiologic effects of phenylbutazone on the right dorsal colon in horses.. Am. J. Vet. Res. 2008;69:1496–1505.
    doi: 10.2460/ajvr.69.11.1496pubmed: 18980433google scholar: lookup
  58. Morris D, Divers T, Whitlock R. Renal clearance and fractional excretion of electrolytes over a 24-hour period in horses.. Am. J. Vet. Res. 1984;45:2431–2435.
    pubmed: 6524740
  59. Galvin N, Dillon H, McGovern F. Right dorsal colitis in the horse: Minireview and reports on three cases in Ireland.. Ir. Vet. J. 2004;57:467.
    doi: 10.1186/2046-0481-57-8-467pmc: PMC3113814pubmed: 21851661google scholar: lookup
  60. Parraga ME, Spier SJ, Thurmond M, Hirsh D. A clinical trial of probiotic administration for prevention of Salmonella shedding in the postoperative period in horses with colic.. J. Vet. Intern. Med. 1997;11:36–41.
    doi: 10.1111/j.1939-1676.1997.tb00071.xpubmed: 9132482google scholar: lookup
  61. Prange T, Holcombe SJ, Brown JA, Dechant JE, Fubini SL, Embertson RM, Peroni J, Rakestraw PC, Hauptman JG. Resection and anastomosis of the descending colon in 43 horses.. Vet. Surg. 2010;39:748–753.
    doi: 10.1111/j.1532-950X.2010.00700.xpubmed: 20459485google scholar: lookup
  62. McConnico R, Roberts M, Tompkins M. Penicillin-induced immune-mediated hemolytic anemia in a horse.. J. Am. Vet. Med. Assoc. 1992;201:1402.
    pubmed: 1429188
  63. Blue JT, Dinsmore RP, Anderson KL. Immune-mediated hemolytic anemia induced by penicillin in horses.. Cornell Vet. 1987;77:263–276.
    pubmed: 3677710
  64. Step D, Blue J, Dill S. Penicillin-induced hemolytic anemia and acute hepatic failure following treatment of tetanus in a horse.. Cornell Vet. 1991;81:13–18.
    pubmed: 1993388
  65. Robbins R, Wallace S, Brunner C, Gardner T, DiFranco B, Speirs V. Immune-mediated haemolytic disease after penicillin therapy in a horse.. Equine Vet. J. 1993;25:462–465.
    doi: 10.1111/j.2042-3306.1993.tb02992.xpubmed: 8223382google scholar: lookup
  66. Moore BR, Hinchcliff KW. Heparin: A review of its pharmacology and therapeutic use in horses.. J. Vet. Intern. Med. 1994;8:26–35.
    doi: 10.1111/j.1939-1676.1994.tb03192.xpubmed: 8176660google scholar: lookup
  67. Duncan SG, Meyers KM, Reed SM. Reduction of the red blood cell mass of horses: Toxic effect of heparin anticoagulant therapy.. Am. J. Vet. Res. 1983;44:2271–2276.
    pubmed: 6660615
  68. Meyers K, Duncan S, Reed S. Research in anticoagulation in equine gastrointestinal disease; Proceedings of the Equine Colic Research Symposium; Athens, GA, USA. 15 September 1982; pp. 121–129.. .
  69. Moore J, Mahaffey E, Zboran M. Heparin-induced agglutination of erythrocytes in horses.. Am. J. Vet. Res. 1987;48:68–71.
    pubmed: 3826844
  70. Trowbridge AA, Caraveo J, Green JB III, Amaral B, Stone MJ. Heparin-related immune thrombocytopenia: Studies of antibody-heparin specificity.. Am. J. Med. 1978;65:277–283.
    doi: 10.1016/0002-9343(78)90820-3pubmed: 80131google scholar: lookup
  71. Gerhards H. Low dose calcium heparin in horses: Plasma heparin concentrations, effects on red blood cell mass and on coagulation variables.. Equine Vet. J. 1991;23:37–43.
    doi: 10.1111/j.2042-3306.1991.tb02711.xpubmed: 2015807google scholar: lookup
Subscribe to our newsletter
Join 99,344 horse owners like you who receive our email updates on horse health and nutrition.