Perianesthetic development of diaphragmatic hernia in a horse with equine pituitary pars intermedia dysfunction (PPID).
Abstract: A 21-year-old Thoroughbred gelding with a history of equine pituitary pars intermedia dysfunction (PPID) presented with priapism of 2 days' duration. The horse received a caudal morphine epidural and then underwent corpus cavernosum lavage and phallectomy under general anesthesia. The patient's recovery featured multiple unsuccessful attempts to stand and his respiratory distress persisted for several hours until he acutely developed severe colic and was euthanized. Necropsy findings revealed a pituitary adenoma of the pars intermedia, bilateral adrenal cortical hyperplasia, and diaphragmatic herniation. This report suggests that horses with PPID may present a greater risk for diaphragmatic hernia under general anesthesia or during procedures placing stress on the diaphragm, including anesthetic recovery. Développement périanesthésique d’une hernie diaphragmatique chez un cheval atteint d’une dysfonction de l’hypophyse pituitaire (DHP). Un hongre Thoroughbred âgé de 21 ans avec une anamnèse de dysfonction de l’hypophyse pituitaire (DHP) a été présenté avec un priapisme présent depuis 2 jours. Le cheval a reçu une épidurale caudale de morphine et a ensuite subi un lavement du corps caverneux et une phallectomie sous anesthésie générale. Le rétablissement du patient a comporté de nombreuses tentatives infructueuses de se tenir debout et sa détresse respiratoire a persisté pendant plusieurs heures jusqu’à ce qu’il développe de graves coliques et soit euthanasié. Les constatations à la nécropsie ont révélé un adénome pituitaire de l’hypophyse, de l’hyperplasie corticale bilatérale et une herniation diaphragmatique. Ce rapport suggère que les chevaux atteints de DHP peuvent présenter un plus grand risque d’hernie diaphragmatique sous anesthésie générale ou durant des interventions exerçant un stress sur le diaphragme, y compris le réveil après l’anesthésie.(Traduit par Isabelle Vallières).
Publication Date: 2015-01-08 PubMed ID: 25565714PubMed Central: PMC4266055
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Summary
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A study showed that horses with pituitary pars intermedia dysfunction (PPID) may be at a higher risk of developing diaphragmatic hernia when under general anesthesia or during procedures that stress the diaphragm.
Introduction and Methodology
- The case study presents a 21-year-old Thoroughbred gelding who had a known history of equine pituitary pars intermedia dysfunction (PPID).
- The horse had priapism, an abnormal erection, lasting for 2 days.
- To alleviate the horse’s condition, it was administered a caudal morphine epidural, then it underwent corpus cavernosum lavage and phallectomy under general anesthesia.
Post-Surgery Observations
- After the surgery, the horse tried to stand repeatedly but failed.
- The horse continued to show signs of respiratory distress for several hours post-operation.
- Shortly after, it developed severe colic and was ultimately euthanized due to the worsening of its condition.
Necropsy Findings
- A necropsy, conducted post-mortem, found a pituitary adenoma in the pars intermedia and bilateral adrenal cortical hyperplasia, which are both common in horses with PPID.
- Interestingly, a diaphragmatic hernia was also discovered. This is not commonly observed in horses and raised questions regarding the link between PPID and the occurrence of diaphragmatic hernia, particularly after anesthetic procedures that stress the diaphragm.
Conclusion and Implication
- The findings of this study suggest that horses with PPID may be at a higher risk of developing a diaphragmatic hernia under general anesthesia or during procedures that put stress on the diaphragm, including recovery from anesthesia.
- Thus, owners and veterinary practitioners should be aware of this potential complication, particularly during and after anesthetic procedures.
Cite This Article
APA
Shepard MK, Lee WL, Eggleston RB.
(2015).
Perianesthetic development of diaphragmatic hernia in a horse with equine pituitary pars intermedia dysfunction (PPID).
Can Vet J, 56(1), 48-52.
Publication
Researcher Affiliations
- Department of Large Animal Medicine, College of Veterinary Medicine, 501 DW Brooks Drive, University of Georgia, Athens, Georgia 30602, USA.
- Department of Large Animal Medicine, College of Veterinary Medicine, 501 DW Brooks Drive, University of Georgia, Athens, Georgia 30602, USA.
- Department of Large Animal Medicine, College of Veterinary Medicine, 501 DW Brooks Drive, University of Georgia, Athens, Georgia 30602, USA.
MeSH Terms
- Animals
- Hernia, Diaphragmatic / etiology
- Hernia, Diaphragmatic / veterinary
- Horse Diseases / etiology
- Horse Diseases / pathology
- Horses
- Male
- Pituitary Diseases / complications
- Pituitary Diseases / veterinary
- Pituitary Gland, Intermediate / pathology
References
This article includes 20 references
- Hart SK, Brown JA. Diaphragmatic hernia in horses: 44 cases (1986–2006). J Vet Emerg Crit Care 2009;19:357–362.
- Santschi EM, Juzwiak JS, Moll HD, Slone DE. Diaphragmatic hernia repair in three young horses. Vet Surg 1997;26:242–245.
- Kelmer G, Kramer J, Wilson DA. Diaphragmatic hernia: Etiology, clinical presentation, and diagnosis. Compend Equine 2008 Jan-Feb;:28–44.
- Bristol DG. Diaphragmatic hernias in horses and cattle. Compend Contin Educ Pract Vet 1986;8:S407–S412.
- Brosnahan MM, Paradis MR. Assessment of clinical characteristics, management practices, and activities of geriatric horses. J Am Vet Med Assoc 2003;223:99–103.
- Aleman M, Nieto JE. Gene expression of proteolytic systems and growth regulators of skeletal muscle in horses with myopathy associated with pituitary pars intermedia dysfunction. Am J Vet Res 2010;71:664–670.
- Skarda RT, Tranquilli WJ. Local and regional anesthetic and analgesic techniques: Horses. In: Tranquilli WJ, Thurmon JC, Grimm KA, editors. Lumb and Jones’ Veterinary Anesthesia and Analgesia. 4th ed. Ames, Iowa: Blackwell Publishing; 2007. p. 620.
- Starkey SR, Morrisey JK, Stewart JE, Buckles EL. Pituitary-dependent hyperadrenocorticism in a cockatoo. J Am Vet Med Assoc 2008;232:394–398.
- Smeak DD. Abdominal hernia. In: Slatter D, editor. Textbook of Small Animal Surgery. Philadelphia, Pennsylvania: WB Saunders; 1993. pp. 433–454.
- Capen CC. Endocrine glands. In: Maxie MG, editor. Jubb, Kennedy and Palmer’s Pathology of Domestic Animals. 3rd ed. Edinburgh, UK: Elsevier Saunders; 2007. pp. 415–418.
- La Perle KMD. Endocrine system. In: Zachary J, McGavin MD, editors. Pathologic Basis of Veterinary Disease. St. Louis, Missouri: Elsevier; 2012. pp. 675–676.
- Walmsley D, McIntyre R, Sawers HA. Laparoscopic transperitoneal adrenalectomy: A preliminary report of 14 adrenalectomies. Clin Endocrinol (Oxf) 1996;45:141–145.
- Lee CY, Wang WK, Lin YH, Wang CB, Tseng CJ. Transvaginal evisceration in a case with iatrogenic Cushing’s syndrome and no previous gynecologic surgery. Taiwan J Obstet Gynecol 2009;48:196–199.
- Jacoby RC, Owings JT, Ortega T, Gosselin R, Feldman EC. Biochemical basis for the hypercoagulable state seen in Cushing syndrome; discussion 1006–7. Arch Surg 2001;136:1003–1006.
- Olbrich VH, Mosing M. A comparison of the analgesic effects of caudal epidural methadone and lidocaine in the horse. Vet Anaesth Analg 2003;30:156–164.
- LeBlanc PH. Regional anesthesia. Vet Clin North Am Equine Pract 1990;6:693–704.
- LeBlanc PH, Caron JP, Patterson JS, Brown M, Matta MA. Epidural injection of xylazine for perineal analgesia in horses. J Am Vet Med Assoc 1988;193:1405–1408.
- Natalini CC, Robinson EP. Effects of epidural opioid analgesics on heart rate, arterial blood pressure, respiratory rate, body temperature, and behavior in horses. Vet Ther 2003;4:364–375.
- Valverde A, Gunkelt C, Doherty TJ, Giguere S, Pollak AS. Effect of a constant rate infusion of lidocaine on the quality of recovery from sevoflurane or isoflurane general anaesthesia in horses. Equine Vet J 2005;37:559–564.
- Feary DJ, Mama KR, Wagner AE, Thomasy S. Influence of general anesthesia on pharmacokinetics of intravenous lidocaine infusion in horses. Am J Vet Res 2005;66:574–580.
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