Medical and surgical management of an intra-abdominal abscess of hepatic origin in a horse.
Abstract: A 4-year-old Arabian-cross mare was examined because of a 48-hour history of pyrexia, lethargy, and signs of abdominal discomfort. Results: On initial evaluation, the horse was in good body condition, but febrile, tachycardic, tachypneic, and icteric and had signs of colic. Findings on CBC and serum biochemical analysis indicated marked systemic inflammation and hepatocellular damage. Serial abdominal ultrasonographic examinations revealed progressive, localized hepatic parenchymal abnormalities in the left ventral aspect of the abdomen in proximity to the left liver lobes, and eventual identification of an irregularly marginated, hyperechoic walled region of heterogenous echogenicity consistent with an encapsulated hepatic abscess. Results: Medical treatment was initiated with administration of doxycycline and flunixin meglumine. After 7 days, the horse's clinical signs and hematologic values improved. After 14 days, the horse was discharged from the hospital and prescribed continuation of doxycycline treatment for 14 days. One week following hospital discharge, the horse was reevaluated for recurrent signs of colic and pyrexia. The horse was sedated, and the region overlying the caudal aspect of the seventh rib was desensitized with an inverted L nerve block by local infiltration with 2% lidocaine. While the horse was standing and sedated, drainage of an encapsulated intra-abdominal abscess was followed by rib resection and removal of a portion of necrotic left lateral liver lobe. The development of a pneumothorax following rib resection represented the only major surgical complication. Twelve months later, the horse was clinically normal and had returned to its previous level of performance. Conclusions: Rib resection in standing sedated horses, together with appropriate medical management, should be considered an option for removal of well-encapsulated cranially located intra-abdominal abscesses that are adherent to the ventrolateral aspect of the body wall in horses.
Publication Date: 2015-06-19 PubMed ID: 26086235DOI: 10.2460/javma.247.1.98Google 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.
- Case Reports
- 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.
This research article presents a case study of a 4-year-old horse that developed an intra-abdominal abscess of hepatic origin, treated successfully through a combination of medical treatment and surgical intervention, including removing a part of the damaged liver.
Summary of the Case
- The subject of the case was an Arabian-cross mare, presented with a two-day history of fever, lethargy, and abdominal discomfort, indicative of colic symptoms.
- Initial examination showed that the horse was febrile which means had a fever, as well as tachycardic (fast heart rate), tachypneic (rapid breathing), and icteric (jaundiced). A Complete Blood Count (CBC) and serum biochemical analysis further confirmed systemic inflammation and hepatocellular damage, indicating liver disease or disorder.
- Subsequent ultrasonographic examinations revealed progressive abnormalities in the left liver lobes, ultimately identifying an encapsulated, irregularly shaped hyperechoic hepatic abscess, an accumulation of pus in the liver.
Medical Treatment
- Medical treatment was initiated with the administration of doxycycline, an antibiotic, and flunixin meglumine, a nonsteroidal anti-inflammatory drug (NSAID).
- Within a week, the horse’s symptoms and hematologic values, which are blood test results, showed signs of improvement, and after 14 days, the horse was discharged with the direction to continue doxycycline treatment for another two weeks.
Surgical Management
- One week after discharge, the horse returned with recurrent colic and febrile symptoms. The area over the seventh rib was desensitized using lidocaine, a local anesthetic, and while sedated, the horse underwent surgery to drain the abscess. This was followed by rib resection, the removal of the seventh rib, and removal of a portion of the necrotic left lateral liver lobe.
- The surgery had one major complication: the development of a pneumothorax, an abnormal collection of air or gas in the chest or pleural space that causes part or all of a lung to collapse.
- Despite the complication, the horse was clinically normal and had returned to its previous performance level 12 months after the surgery.
Conclusions
- The successful treatment in this case suggests that a combination of medical management and surgical intervention, rib resection specifically, can be an effective approach for treating well-encapsulated intra-abdominal abscesses in horses.
- Such abscesses, especially when located near the body wall, may require surgical intervention if they fail to respond to medical management alone.
Cite This Article
APA
Cypher EE, Kendall AT, Panizzi L, Stewart AJ, Taylor SL, Bodaan CJ, Riley CB, Gordon SJ, Whitfield LK.
(2015).
Medical and surgical management of an intra-abdominal abscess of hepatic origin in a horse.
J Am Vet Med Assoc, 247(1), 98-105.
https://doi.org/10.2460/javma.247.1.98 Publication
Researcher Affiliations
MeSH Terms
- Abdominal Abscess / etiology
- Abdominal Abscess / therapy
- Abdominal Abscess / veterinary
- Animals
- Anti-Bacterial Agents / therapeutic use
- Drainage / veterinary
- Female
- Horse Diseases / therapy
- Horses
Citations
This article has been cited 1 times.- Chapuis RJJ, Smith JS, French HM, Toka FN, Peterson EW, Little EL. Nonlinear Mixed-Effect Pharmacokinetic Modeling and Distribution of Doxycycline in Healthy Female Donkeys after Multiple Intragastric Dosing-Preliminary Investigation. Animals (Basel) 2021 Jul 9;11(7).
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists
