Evaluation of phenylephrine and exercise with or without trocarization for treatment of suspected nephrosplenic entrapment in horses.

The research involves a retrospective observation of horses suspected with nephrosplenic entrapment (NSE) or trapped large colon problem, and their treatment using phenylephrine and exercise, with or without trocarization. The study indicates that although this medical treatment helps, there is a high chance of misdiagnosis, and timely surgical intervention is advised in the absence of a proper response from medical treatment.

Objective of the Research

• The research aims to analyze the treatment outcomes of horses affected with suspected nephrosplenic entrapment, a condition where the large colon of the animal gets trapped between the kidney and spleen. For this, intravenous phenylephrine administration and exercise were chosen as the medical intervention.

Methodology Employed

• The research utilized a retrospective observational study approach and took into account 134 horses between 1995 to 2014 from a veterinary teaching hospital.
• As part of the study, vital information such as demographical details, ultrasonographic and physical examination findings, treatment details, surgical findings if relevant, observed complications, and preemptive outcomes were recorded.

Key Findings

• Out of 134 patients, 72 horses had suspected nephrosplenic entrapment that was resolved with the chosen medical treatment.
• In scenarios where medical management failed, 59 of 62 horses underwent surgery, but 3 were euthanized without any surgical attempt.
• Among those operated, 25 had a confirmed diagnosis of NSE, and their condition was surgically corrected. The remaining 34 horses had lesions other than or in addition to NSE.
• All the horses that underwent surgical correction for NSE and 18 of 34 horses with other lesions survived and were discharged from the hospital.
• The study also found that the chances of resolving NSE with medical management were greater for horses that underwent 2 or fewer treatments.
• The research didn’t find any increased success rate in treatments involving trocarization procedure compared to those without.

Conclusions

• The chosen medical management was proven effective in treating most horses with suspected nephrosplenic entrapment.
• Despite this, the research indicated a high potential for misdiagnosis.
• The study finally recommends timely surgical intervention for horses failing to respond aptly to the chosen medical management.