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Home / Equine Research Bank / Equine Vet J / Flowmetry and spectrophotometry for the assessment of intest...
Equine veterinary journal2024; doi: 10.1111/evj.14118

Flowmetry and spectrophotometry for the assessment of intestinal viability in horses with naturally occurring strangulating small intestinal lesions.

Abstract: Ancillary diagnostic methods to enhance the accuracy of viability assessment have not been established for use in clinical practice. Objective: To assess intestinal microperfusion measured by Laser Doppler Flowmetry and Spectrophotometry (LDFS) in naturally occurring small intestinal strangulations of different origins and to compare this between viable and non-viable segments. Methods: Prospective clinical trial. Methods: Forty horses undergoing colic surgery for naturally occurring small intestinal strangulations were included. Tissue oxygen saturation (tSO), haemoglobin (tHB) and blood flow (tBF) were determined by LDFS before and after release of the strangulation. Intestinal biopsies were taken in cases that underwent intestinal resection or intraoperative euthanasia and assessed using a semi-quantitative mucosal injury score (MIS). The LDFS measurements were compared between the different categories of strangulation causes and histopathological injury using parametric and non-parametric tests (p  5 showed lower tBF during strangulation than segments with MIS < 4 (mean difference 61.1 AU; CI -1.119 to -0.07361; p = 0.03). This did not differ significantly following release of strangulation. Furthermore, there was a positive correlation between the inflammatory cell count and tBF during strangulation (r 0.34; CI 0.01 to 0.60; p = 0.04). The tSO and tHB did not differ between the different categories of lesions or injury. Conclusions: No biopsies could be taken from the intestinal segments that did not undergo resection. The duration of strangulation could not reliably be ascertained. Conclusions: Blood flow measurements in naturally occurring strangulating lesions show a varying degree of ischaemia in different causes of strangulation. Intestinal blood flow measurements prior to release of the strangulation could potentially contribute to the identification of mucosal injury, yet a high individual variability and other contributing factors need to be considered.
© 2024 The Author(s). Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2024-06-18 PubMed ID: 38888520DOI: 10.1111/evj.14118Google Scholar: Lookup
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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.

This research reports on assessing intestinal viability in horses with naturally occurring small intestinal strangulations using Laser Doppler Flowmetry and Spectrophotometry (LDFS). The authors found that blood flow measurements prior to releasing the strangulation can potentially help identify mucosal injuries.

Biopsy for Strangulated Intestine Study

  • The research began by focusing on forty horses that were to undergo surgery due to colic complications. These horses were all victims of naturally occurring small intestinal strangulations.
  • By using Laser Doppler Flowmetry and Spectrophotometry (LDFS), the researchers were able to measure tissue oxygen saturation (tSO), the quantity of oxygenated haemoglobin (tHB), and blood flow (tBF) in the affected areas of the intestine both before and after the strangulation was released.
  • They also took biopsies from those subjects that required intestinal resection or were euthanized during the operative procedure. These tissue samples were graded with a mucosal injury score (MIS).
  • The results gathered from the LDFS measuring were then compared among different categories of causes for the strangulation and the varying degrees of histopathological damage using both parametric and non-parametric tests.

Study Findings

  • Results indicated that strangulations caused by pedunculated lipomas resulted in lower blood flow than that of strangulations caused by epiploic foramen entrapments.
  • Segments with a higher mucosal injury score (MIS > 5) showed lower tBF during strangulation compared to segments with a lower mucosal injury score (MIS < 4).
  • There was a positive correlation found between the inflammatory cell count and blood flow during the strangulation.
  • However, the levels of tissue oxygen saturation and quantity of oxygenated haemoglobin did not significantly differ between the varying categories of strangulation causes or levels of injury.

Study Limitations and Conclusions

  • The study faced limitations in that no biopsies could be taken from those intestinal segments that did not require resection during the operation, and the exact duration of each strangulated intestine could not be accurately determined.
  • The researchers concluded that measurements of blood flow in naturally occurring strangulating lesions showed varying levels of lack of blood or oxygen (ischaemia) in the different causes of strangulation.
  • Crucially, intestinal blood flow measurements taken before the release of the strangulation could potentially contribute to the identification of mucosal injury.
  • However, the researchers highlight that individual variability and additional factors need to be taken into consideration.

Cite This Article

APA
Verhaar N, Grages AM, Bienert-Zeit A, Schwieder A, Reineking W, Hewicker-Trautwein M, Kästner S, Geburek F. (2024). Flowmetry and spectrophotometry for the assessment of intestinal viability in horses with naturally occurring strangulating small intestinal lesions. Equine Vet J. https://doi.org/10.1111/evj.14118

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Verhaar, Nicole
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hannover, Germany.
Grages, Anna Marei
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hannover, Germany.
Bienert-Zeit, Astrid
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hannover, Germany.
Schwieder, Alexander
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hannover, Germany.
Reineking, Wencke
  • Department of Pathology, University of Veterinary Medicine Hannover, Hannover, Germany.
Hewicker-Trautwein, Marion
  • Department of Pathology, University of Veterinary Medicine Hannover, Hannover, Germany.
Kästner, Sabine
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hannover, Germany.
  • Clinic for Small Animals, University of Veterinary Medicine Hannover, Hannover, Germany.
Geburek, Florian
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hannover, Germany.

Grant Funding

  • Clinic for Horses of the University of Veterinary Medicine Hannover

References

This article includes 43 references
  1. Auer JA, Stick JA, Kuemmerle JM, Prange T. Equine surgery. 5th ed. Philadelphia, PA: Elsevier Health Sciences; 2019.
  2. Freeman DE, Schaeffer DJ, Cleary OB. Long‐term survival in horses with strangulating obstruction of the small intestine managed without resection. Equine Vet J 2014;46:711–717.
  3. Freeman D, Gentile D, Richardson D, Fetrow JP, Tulleners EP, Orsini JA. Comparison of clinical judgment, Doppler ultrasound, and fluorescein fluorescence as methods for predicting intestinal viability in the pony. Am J Vet Res 1988;49:895–900.
  4. Snyder J, Pascoe J, Holland M, Kurpershoek C. Surface oximetry of healthy and ischemic equine intestine. Am J Vet Res 1986;47:2530–2535.
  5. Obeid A, Barnett N, Dougherty G, Ward G. A critical review of laser Doppler flowmetry. J Med Eng Technol 1990;14:178–181.
  6. Rotering RH Jr, Dixon JA, Holloway GA Jr, McCloskey DW. A comparison of the He Ne laser and ultrasound Doppler systems in the determination of viability of ischemic canine intestine. Ann Surg 1982;196:705–708.
  7. Lynch TG, Hobson RW 2nd, Kerr JC, Brousseau DA, Silverman DG, Reilly CA. Doppler ultrasound, laser Doppler, and perfusion fluorometry in bowel ischemia. Arch Surg 1988;123:483–486.
  8. Grages AM, Verhaar N, Pfarrer C, Breves G, Burmester M, Neudeck S. Low flow versus no flow: Ischaemia reperfusion injury following different experimental models in the equine small intestine. Animals 2022;12:2158.
  9. Verhaar N, Breves G, Hewicker‐Trautwein M, Pfarrer C, Rohn K, Burmester M. The effect of ischaemic postconditioning on mucosal integrity and function in equine jejunal ischaemia. Equine Vet J 2022;54:427–437.
  10. Mirle E, Wogatzki A, Kunzmann R, Schoenfelder AM, Litzke LF. Correlation between capillary oxygen saturation and small intestinal wall thickness in the equine colic patient. Vet Rec Open 2017;4:e000197.
  11. Krug A. Mikrozirkulation und sauerstoffversorgung des gewebes. Phlebologie 2006;35:300–312.
  12. Reichert C, Kästner SB, Hopster K, Rohn K, Rötting AK. Use of micro‐lightguide spectrophotometry for evaluation of microcirculation in the small and large intestines of horses without gastrointestinal disease. Am J Vet Res 2014;75:990–996.
  13. Chiu C‐J, McArdle AH, Brown R, Scott HJ, Gurd FN. Intestinal mucosal lesion in low‐flow states: I. A morphological, hemodynamic, and metabolic reappraisal. Arch Surg 1979;101:478–483.
  14. White N, Moore J, Trim C. Mucosal alterations in experimentally induced small intestinal strangulation obstruction in ponies. Am J Vet Res 1980;41:193–198.
  15. Park P, Haglund U, Bulkley G, Fält K. The sequence of development of intestinal tissue injury after strangulation ischemia and reperfusion. Surgery 1990;107:574–580.
  16. Gonzalez LM, Fogle CA, Baker WT, Hughes FE, Law JM, Motsinger‐Reif AA. Operative factors associated with short‐term outcome in horses with large colon volvulus: 47 cases from 2006 to 2013. Equine Vet J 2015;47:279–284.
  17. Wagner A, Junginger J, Lemensieck F, Hewicker‐Trautwein M. Immunohistochemical characterization of gastrointestinal macrophages/phagocytes in dogs with inflammatory bowel disease (IBD) and non‐IBD dogs. Vet Immunol Immunopathol 2018;197:49–57.
  18. Grosche A, Morton AJ, Polyak MM, Matyjaszek S, Freeman DE. Detection of calprotectin and its correlation to the accumulation of neutrophils within equine large colon during ischaemia and reperfusion. Equine Vet J 2008;40:393–399.
  19. Verhaar N, deBuhr N, vonKöckritz‐Blickwede M, Dümmer K, Hewicker‐Trautwein M, Pfarrer C. Hypoxia signaling in the equine small intestine: expression and distribution of hypoxia inducible factors during experimental ischemia. Front Vet Sci 2023;10:1110019.
  20. Snyder JR, Pascoe JR, Olander HJ, Hinds DM, Young R, Tyler WS. Vascular injury associated with naturally occurring strangulating obstructions of the equine large colon. Vet Surg 1990;19:446–455.
  21. Gerard M, Blikslager A, Roberts M, Tate JP Jr, Argenzio RA. The characteristics of intestinal injury peripheral to strangulating obstruction lesions in the equine small intestine. Equine Vet J 1999;31:331–335.
  22. Verhaar N, Grages AM, Sauer FS, Geiger T, Reineking W, Hewicker‐Trautwein M. Measuring tissue oxygen saturation in the orad intestinal segment during equine colic surgery may aid in predicting the occurrence of postoperative ileus. Am J Vet Res 2024;1–8.
    doi: 10.2460/ajvr.23.12.0286google scholar: lookup
  23. Dabareiner RM, Sullins KE, White NA, Snyder JR. Serosal injury in the equine jejunum and ascending colon after ischemia‐reperfusion or intraluminal distention and decompression. Vet Surg 2001;30:114–125.
  24. Dengler F, Sternberg F, Grages M, Kästner SB, Verhaar N. Adaptive mechanisms in no flow vs. low flow ischemia in equine jejunum epithelium: different paths to the same destination. Front Vet Sci 2022;9:947482.
  25. vanBergen T, Doom M, van denBroeck W, Wiemer P, Clegg PD, Cornillie P. A topographic anatomical study of the equine epiploic foramen and comparison with laparoscopic visualisation. Equine Vet J 2015;47:313–318.
  26. French NP, Smith J, Edwards GB, Proudman CJ. Equine surgical colic: risk factors for postoperative complications. Equine Vet J 2002;34:444–449.
  27. Proudman C, Smith J, Edwards G, French N. Long‐term survival of equine surgical colic cases. Part 2: modelling postoperative survival. Equine Vet J 2002;34:438–443.
  28. Freeman D, Schaeffer D. Short‐term survival after surgery for epiploic foramen entrapment compared with other strangulating diseases of the small intestine in horses. Equine Vet J 2005;37:292–295.
  29. Kilcoyne I, Dechant JE, Nieto JE. Comparison of clinical findings and short‐term survival between horses with intestinal entrapment in the gastrosplenic ligament and horses with intestinal entrapment in the epiploic foramen. J Am Vet Med Assoc 2016;249:660–667.
  30. vanBergen T, Haspeslagh M, Wiemer P, Swagemakers M, vanLoon G, Martens A. Surgical treatment of epiploic foramen entrapment in 142 horses (2008–2016). Vet Surg 2019;48:291–298.
  31. Horne MM, Pascoe PJ, Ducharme NG, Barker IK, Grovum WL. Attempts to modify reperfusion injury of equine jejunal mucosa using dimethylsulfoxide, allopurinol, and intraluminal oxygen. Vet Surg 1994;23:241–249.
  32. Dabareiner R, Snyder J, White N, Pascoe JR, Harmon FA, Gardner I. Microvascular permeability and endothelial cell morphology associated with low‐flow ischemia/reperfusion injury in the equine jejunum. Am J Vet Res 1995;56:639–648.
  33. Gonzalez LM, Moeser AJ, Blikslager AT. Animal models of ischemia‐reperfusion‐induced intestinal injury: progress and promise for translational research. Am J Physiol‐Gastrointest Liver Physiol 2014;308:G63–G75.
  34. Vatistas N, Snyder J, Nieto J, Hildebrand SV, Woliner MJ, Harmon FA. Morphologic changes and xanthine oxidase activity in the equine jejunum during low flow ischemia and reperfusion. Am J Vet Res 1998;59:772–776.
  35. Vatistas NJ, Snyder JR, Hildebrand S, Harmon FA, Woliner MJ, Barry SJ. Effects of U‐74389G, a novel 21‐aminosteroid, on small intestinal ischemia and reperfusion injury in horses. Am J Vet Res 1996;7:762–770.
  36. König KS, Verhaar N, Hopster K, Pfarrer C, Neudeck S, Rohn K. Ischaemic preconditioning and pharmacological preconditioning with dexmedetomidine in an equine model of small intestinal ischaemia‐reperfusion. PLoS One 2020;15:e0224720.
  37. Verhaar N, Pfarrer C, Neudeck S, König K, Rohn K, Twele L. Preconditioning with lidocaine and xylazine in experimental equine jejunal ischaemia. Equine Vet J 2021;53(1):125–133.
  38. Dart A, Snyder J, Julian D, Hinds D. Microvascular circulation of the small intestine in horses. Am J Vet Res 1992;53:995–1000.
  39. Karlsson MG, Hübbert L, Lönn U, Janerot‐Sjöberg B, Casimir‐Ahn H, Wårdell K. Myocardial tissue motion influence on laser Doppler perfusion monitoring using tissue Doppler imaging. Med Biol Eng Comput 2004;42:770–776.
  40. Cook VL, Meyer CT, Campbell NB, Blikslager AT. Effect of firocoxib or flunixin meglumine on recovery of ischemic‐injured equine jejunum. Am J Vet Res 2009;70:992–1000.
  41. Iwao T, Toyonaga A, Ikegami M, Oho K, Sumino M, Sakaki M. Observer agreement and variability in measuring gastric mucosal blood flow by laser Doppler flowmetry in humans. Endoscopy 1993;25:274–277.
  42. Adair HS 3rd, Goble DO, Shires GM, Sanders WL. Evaluation of laser Doppler flowmetry for measuring coronary band and laminar microcirculatory blood flow in clinically normal horses. Am J Vet Res 1994;55:445–449.
  43. Ghazanfari M, Vogt L, Banzer W, Rhodius U. Reproduzierbarkeit nicht‐invasiver durchblutungsmessung mit der laser‐doppler‐spektroskopie. Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2002;12:330–336.

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