Histological Evaluation of Resected Tissue as a Predictor of Survival in Horses with Strangulating Small Intestinal Disease.
Abstract: Strangulating small intestinal disease (SSID) in horses carries a poor prognosis for survival, especially following resection of ischaemic tissue. The margins of a resection are principally based on visual appraisal of the intestine during surgery. We hypothesized that histological evaluation of resected tissue may identify occult changes indicative of prognosis. Small intestinal samples from 18 horses undergoing resection for SSID and 9 horses euthanised for reasons unrelated to gastrointestinal pathology were utilised. Histological appearance was used to generate a 'total damage score' (TDS) for the control tissue, grossly normal tissue at oral and aboral extremities (sections OR1 and AB1) of the resected intestine, and oral and aboral extremities of visually abnormal tissue (sections OR2 and AB2) from SSID horses. The relationship between TDS and long-term post-operative survival was investigated. TDS was not different between control tissues and OR1 and AB1 sections. Five surgical cases were alive at follow-up, the longest follow-up time being 2561 days. Based on the median scores for SSID cases versus controls, cut-off values were generated to evaluate post-operative survival versus TDS. Only OR2 TDS was significantly associated with survival, with a higher (worse) score indicating longer survival. More severe tissue insult may expedite rapid progression to surgery, improving post-operative outcomes.
Publication Date: 2023-08-26 PubMed ID: 37684979PubMed Central: PMC10486948DOI: 10.3390/ani13172715Google Scholar: Lookup
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Summary
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This research looks into how the analysis of surgically removed tissue can forecast survival outcomes for horses struggling with strangulating small intestinal disease (SSID). It hints that higher damage scores at the extremities of the visually abnormal portion of the intestines are linked with longer survival following surgery.
Strangulating Small Intestinal Disease and Its Impact
- The study aims to investigate Strangulating Small Intestinal Disease (SSID), a condition in horses that often carries a grim prognosis. The disease often requires surgical resection of the affected intestinal tissue.
- The decision about where to cut during a resection is mostly based on visual inspection of the intestine during the surgery. There has been little investigation into whether the histological or microscopic evaluation of resected tissue could reveal indicators that predict prognosis.
Research Methodology and Findings
- For this study, the investigators collected samples from 18 horses that had undergone resection for SSID, and from 9 other horses that were euthanised for reasons unrelated to gastrointestinal pathology. These latter samples served as the control group.
- These samples underwent histological analysis and were assigned ‘total damage scores’ (TDS). The scores were assigned to these specimens – the control tissue, the normal tissue at the opposite ends of the resected part of the intestine, and the opposite ends of visually abnormal tissue from horses with SSID.
- An examination of the TDS scores and post-operative survival discovered a significant correlation. Notably, TDS was not different between controls and the normal tissues next to the resected portions. However, the TDS of the visually abnormal intestinal section related to survival – the higher the damage score, the longer the survival, contrary to the initial hypothesis.
Conclusions and Implications
- Ultimately, the study suggested that horses with severe tissue damage (resulting in higher TDS) might have faster disease progression, leading them to surgery sooner. It seems this expedited progression offers a greater chance of improved post-operative results and increased long-term survival.
- This research helps in redefining the prognosis of SSID in horses and offers a new perspective on how histological evaluations could guide surgical decisions and the planned course of treatment.
Cite This Article
APA
Bardell D, Rocchigiani G, Ressel L, Milner P.
(2023).
Histological Evaluation of Resected Tissue as a Predictor of Survival in Horses with Strangulating Small Intestinal Disease.
Animals (Basel), 13(17), 2715.
https://doi.org/10.3390/ani13172715 Publication
Researcher Affiliations
- Department of Equine Clinical Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston CH64 7TE, UK.
- Department of Veterinary Anatomy Physiology and Pathology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston CH64 7TE, UK.
- Department of Veterinary Anatomy Physiology and Pathology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston CH64 7TE, UK.
- Department of Equine Clinical Sciences, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Chester High Road, Neston CH64 7TE, UK.
Grant Funding
- VET002VSRP / University of Liverpool Veterinary Research Projects Support Fund
Conflict of Interest Statement
The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.
References
This article includes 33 references
- Phillips TJ, Walmsley JP. Retrospective analysis of the results of 151 exploratory laparotomies in horses with gastrointestinal disease.. Equine Vet. J. 1993;25:427–431.
- Christophersen MT, Dupont N, Berg-Sørensen KS, Konnerup C, Pihl TH, Andersen PH. Short-term survival and mortality rates in a retrospective study of colic in 1588 Danish horses.. Acta Vet. Scand. 2014;56:20.
- Allen D, White NA, Tyler DE. Factors for prognostic use in equine obstructive small intestinal disease.. J. Am. Vet. Med. Assoc. 1986;189:777–780.
- Mair TS, Smith LJ. Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 1: Short-term survival following a single laparotomy.. Equine Vet. J. 2005;37:296–302.
- Freeman DE, Hammock P, Baker GJ, Goetz T, Foreman JH, Schaeffer DJ, Richter RA, Inoue O, Magid JH. Short and long term survival and prevalence of postoperative ileus after small intestinal surgery in the horse.. Equine Vet. J. 2000;32:42–51.
- Proudman CJ, Smith JE, Edwards GB, French NP. Long term survival of equine surgical colic cases. Part 1: Patterns of mortality and morbidity.. Equine Vet. J. 2002;34:432–437.
- Morton AJ, Blikslager AT. Surgical and postoperative factors influencing short-term survival of horses following small intestinal resection: 92 cases (1994–2001). Equine Vet. J. 2002;34:450–454.
- Lane JS, Todd KE, Lewis MPN, Gloor B, Ashley SW, Reber HA, McFadden DW, Chandler CF. Interleukin-10 reduces the systemic inflammatory response in a murine model of intestinal ischemia/reperfusion.. Surgery 1997;122:288–294.
- Petrat F, Rönn T, de Groot H. Protection by pyruvate infusion in a rat model of severe intestinal ischemia-reperfusion injury.. J. Surg. Res. 2011;167:e93–e101.
- Chiu C-J, McArdle AH, Brown R, Scott HJ, Gurd FN. Intestinal mucosal lesion in low-flow states.. Arch. Surg. 1970;101:478–483.
- Blikslager AT, Roberts MC, Rhoads JM, Argenzio RA. Is reperfusion injury an important cause of mucosal damage after porcine intestinal ischemia?. Surgery 1997;121:526–534.
- Derikx JPM, Matthijsen RA, de Bruïne AP, van Dam RM, Buurman WA, Dejong CHC. A new model to study intestinal ischemia-reperfusion damage in man.. J. Surg. Res. 2011;166:222–226.
- White NA, Moore JN, Trim CM. Mucosal alterations in experimentally induced small intestinal strangulation obstruction in ponies.. Am. J. Vet. Res. 1980;41:193–198.
- Arden WA, Slocombe RF, Stick JA, Parks AH. Morphologic and ultrastructural evaluation of effect of ischemia and dimethyl sulfoxide on equine jejunum.. Am. J. Vet. Res. 1990;51:1784–1791.
- Horne MM, Pascoe PJ, Ducharme NG, Barker IK, Grovum WL. Attempt to modify reperfusion injury of equine jejunal mucosa using dimethylsulfoxide, allopurinol and intraluminal oxygen.. Vet. Surg. 1994;23:241–249.
- Tomlinson JE, Wilder O, Young KM, Blikslager AT. Effects of flunixin meglumine or etodolac treatment on mucosal recovery of equine jejunum after ischemia.. Am. J. Vet. Res. 2004;65:761–769.
- Dabareiner RM, White NA, Snyder JR, Feldman BF, Donaldson LL. Effects of Carolina rinse solution, dimethylsulfoxide, and the 21-aminosteroid, U-74389G, on microvascular permeability and morphology of the equine jejunum after low-flow ischemia and reperfusion.. Am. J. Vet. Res. 2005;66:525–536.
- Meschter CL, Tyler DE, White NA, Moore J. Histological findings in the gastrointestinal tract of horses with colic.. Am. J. Vet. Res. 1986;47:598–606.
- Gerard MP, Blikslager AT, Roberts MC, Tate LP 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.
- De Ceulaer K, Delesalle C, van Elzen R, van Brantegem L, Weyns A, van Ginneken C. Morphological changes in the small intestinal smooth muscle layers of horses suffering from small intestinal strangulation. Is there a basis for predisposition for reduced contractility?. Equine Vet. J. 2011;43:439–445.
- MacDonald MH, Pascoe JR, Stover SM, Maegher DM. Survival after small intestinal resection and anastomosis in horses.. Vet. Surg. 1989;18:415–423.
- Fogle CA, Gerard MP, Elce YA, Little D, Morton AJ, Correa MT, Blikslager AT. Analysis of sodium carboxymethylcellulose administration and related factors associated with postoperative colic and survival in horses with small intestinal disease.. Vet. Surg. 2008;37:558–563.
- Archer DC, Proudman CJ, Pinchbeck G, Smith JE, French NP, Edwards GB. Entrapment of the small intestine in the epiploic foramen in horses: A retrospective analysis of 71 cases recorded between 1991 and 2001.. Vet. Record. 2004;155:793–797.
- Wadman M, Syk I, Elmståhl S. Survival after operations for ischaemic bowel disease.. Eur. J. Surg. 2000;166:872–877.
- Fintl C, Hudson NPH, Mayhew IG, Edwards GB, Proudman CJ, Pearson GT. Interstitial cells of Cajal (ICC) in equine colic: An immunohistochemical study of horses with obstructive disorders of the small intestines.. Equine Vet. J. 2004;36:474–479.
- Hudson N, Mayhew I, Pearson G. A reduction in interstitial cells of Cajal in horses with equine dysautonomia (grass sickness). Autonom. Neurosci. Basic Clin. 2001;92:37–44.
- McAnulty JF, Stone WC, Darien BJ. The effects of ischemia and reperfusion on mucosal respiratory function, adenosine triphosphate, electrolyte, and water content in the ascending colon of ponies.. Vet. Surg. 1997;26:172–181.
- Marañón G, Manley W, Cayado P, García C, de la Muela MS, Vara E. Alterations in the glutathione metabolism could be implicated in the ischemia-induced small intestinal cell damage in horses.. BMC Vet. Res. 2009;5:10.
- Bauck AG, Grosche A, Morton AJ, Graham AS, Vickroy TW, Freeman DE. Effect of lidocaine on inflammation in equine jejunum subjected to manipulation only and remote to intestinal segments subjected to ischemia.. Am. J. Vet. Res. 2017;78:977–989.
- Brown RA, Chiu C-J, Scott HJ, Gurd FN. Ultrastructural changes in the canine ileal mucosal cell after mesenteric arterial occlusion.. Arch. Surg. 1970;101:290–297.
- Hostetter JM, Uzal FA. Gastrointestinal biopsy in the horse: Overview of collection, interpretation, and applications.. J. Vet. Diagn. Investig. 2022;34:376–388.
- Rocchigiani G, Ricci E, Navarro MA, Samol MA, Uzal FA. Leukocyte numbers and intestinal mucosal morphometrics in horses with no clinical intestinal disease.. J. Vet. Diagn. Investig. 2022;34:389–395.
- Dabareiner RM, Sullins KE, White NA, Snyder JR. Serosal injury in the equine jejunum and ascending colon after ischemia-reperfusion or intraluminal distension and decompression.. Vet. Surg. 2001;30:114–125.
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