Prevention of ischaemia-induced small intestinal adhesions in foals.
Abstract: Treatments addressing variously theorised pathophysiological mechanisms of small intestinal adhesions have been reported. This study applied those classes of treatments to the most clinically relevant aetiology of post operative adhesions. Objective: Treatments addressing the pathophysiology of ischaemia-reperfusion induced adhesions would accordingly reduce the incidence of adhesions from this model. Methods: Four classes of treatments were administered for 72 h to 16 foals subjected to complete ischaemia followed by reperfusion to create peritoneal adhesions. These groups were: 1) FPG group--flunixin meglumine (1.1 mg/kg bwt i.v., divided q.i.d.), potassium penicillin G (22,000 iu/kg bwt i.v., q.i.d.) and gentamicin (2.2 mg/kg bwt i.v., t.i.d.); 2) HEP group--heparin (80 iu/kg bwt subcut., b.i.d.); 3) DMSO group--dimethylsulphoxide (DMSO) (20 mg/kg bwt [diluted in 500 ml normal saline] i.v., b.i.d.); and 4) SCMC group--sodium carboxymethylcellulose (500 ml 3% sterile solution intraperitoneally, administered only at the beginning of surgery). Results: Post operative intestinal obstruction did not occur in any foal. After 10 days, necropsy revealed bowel-to-bowel adhesions in none of the FPG or DMSO groups, in 2/4 of the SCMC group, in 3/4 of the HEP group and 5/6 foals subjected to the procedure without treatment (UIR group). Conclusions: Inhibition of the inflammation associated with ischaemia and reperfusion in foals treated with FPG or DMSO decreased small intestinal adhesions in foals. Conclusions: Although anti-inflammatory therapy was shown to eliminate bowel-bowel adhesions in this controlled study, it must be remembered that clinical cases are without control. These therapies are advised to improve the result but are unlikely to eliminate the problem.
Publication Date: 2004-07-16 PubMed ID: 15253075DOI: 10.2746/0425164044868431Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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This research investigates various treatments to prevent small intestinal adhesions in foals caused by ischaemia-reperfusion, with findings indicating that anti-inflammatory treatments FPG and DMSO effectively reduced adhesions.
Research Objective
In the study, the researchers aimed to test different treatments to address the pathophysiology of ischaemia-reperfusion induced adhesions in foals, with the hope to reduce the incidence of post operative adhesions from this procedure.
Research Methods
- Four different treatment classes were administered over 72 hours to 16 foals that were subjected to complete ischaemia followed by reperfusion to create peritoneal adhesions.
- The groups included FPG (flunixin meglumine, potassium penicillin G and gentamicin), HEP (heparin), DMSO (dimethylsulphoxide), and SCMC (sodium carboxymethylcellulose).
- The FPG group received these drugs intravenously at different time intervals.
- The HEP group received heparin subcutaneously twice a day.
- The DMSO group received DMSO (a substance often used as an anti-inflammatory and analgesic) intravenously twice a day.
- The SCMC group received sodium carboxymethylcellulose intraperitoneally, only at the beginning of surgery.
- A fifth group, UIR, didn’t receive any treatment and served as a control group.
Results of the Study
- No post-operative intestinal obstruction occurred in any of the foals. After 10 days, necropsy conducted revealed bowel-to-bowel adhesions in none of the FPG or DMSO groups.
- Adhesions occurred in 2 out of 4 of the SCMC group, in 3 out of 4 of the HEP group, and in 5 out of 6 foals belonging to the control group (UIR group).
Conclusion
- The conclusion of the research indicated that using FPG or DMSO to inhibit the inflammation associated with ischaemia and reperfusion in foals decreased small intestinal adhesions.
- Despite the significant results, the researchers emphasized that while these treatments have shown to clear bowel-bowel adhesions in a controlled study, real clinical cases may not repetitively result in the same outcome.
- Therefore, while these therapies are recommended to improve results, they are unlikely to completely remove the problem.
Cite This Article
APA
Sullins KE, White NA, Lundin CS, Dabareiner R, Gaulin G.
(2004).
Prevention of ischaemia-induced small intestinal adhesions in foals.
Equine Vet J, 36(5), 370-375.
https://doi.org/10.2746/0425164044868431 Publication
Researcher Affiliations
- The Marion duPont Scott Equine Medical Center, Virginia-Maryland Regional College of Veterinary Medicine, Virginia Polytechnic Institute and State University, PO Box 1938, Leesburg, Virginia 20177, USA.
MeSH Terms
- Animals
- Animals, Newborn
- Anti-Bacterial Agents / therapeutic use
- Carboxymethylcellulose Sodium / therapeutic use
- Dimethyl Sulfoxide / therapeutic use
- Heparin / therapeutic use
- Horse Diseases / etiology
- Horse Diseases / pathology
- Horse Diseases / prevention & control
- Horses
- Intestinal Diseases / etiology
- Intestinal Diseases / prevention & control
- Intestinal Diseases / veterinary
- Intestine, Small / blood supply
- Intestine, Small / pathology
- Ischemia / complications
- Ischemia / veterinary
- Peritoneal Diseases / etiology
- Peritoneal Diseases / prevention & control
- Peritoneal Diseases / veterinary
- Peritoneum / pathology
- Postoperative Complications / prevention & control
- Postoperative Complications / veterinary
- Random Allocation
- Reperfusion Injury / complications
- Reperfusion Injury / veterinary
- Tissue Adhesions / etiology
- Tissue Adhesions / prevention & control
- Tissue Adhesions / veterinary
Citations
This article has been cited 4 times.- Rockow M, Griffenhagen G, Landolt G, Hendrickson D, Pezzanite L. The Effects of Antimicrobial Protocols and Other Perioperative Factors on Postoperative Complications in Horses Undergoing Celiotomy: A Retrospective Analysis, 2008-2021. Animals (Basel) 2023 Nov 19;13(22).
- Rockow M, Griffenhagen G, Landolt G, Hendrickson D, Pezzanite L. Current Antimicrobial Use in Horses Undergoing Exploratory Celiotomy: A Survey of Board-Certified Equine Specialists. Animals (Basel) 2023 Apr 22;13(9).
- Erwin SJ, Clark ME, Dechant JE, Aitken MR, Hassel DM, Blikslager AT, Ziegler AL. Multi-Institutional Retrospective Case-Control Study Evaluating Clinical Outcomes of Foals with Small Intestinal Strangulating Obstruction: 2000-2020. Animals (Basel) 2022 May 27;12(11).
- Alonso Jde M, Alves AL, Watanabe MJ, Rodrigues CA, Hussni CA. Peritoneal response to abdominal surgery: the role of equine abdominal adhesions and current prophylactic strategies. Vet Med Int 2014;2014:279730.
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