Severe nasal hemorrhage in an anesthetized horse.
Abstract: An 8-year-old Thoroughbred gelding with colic was anesthetized for surgical correction of right dorsal displacement of the ascending colon. Removal of the nasogastric tube at the end of surgery resulted in hemorrhage from the nares and loss of 24 L of blood. Treatment included administration of acetated Ringer's solution, hypertonic saline solution, and dobutamine. A blood transfusion was started after hemorrhage was controlled, and arterial pressure was restored to the prehemorrhage value, but was stopped after infusion of 2.7 L of blood because of a suspected adverse reaction. This case indicates that infusion of balanced electrolyte solution, hypertonic saline solution, and dobutamine may maintain adequate arterial pressure after severe blood loss, and also supports the suggestion that administration of hypertonic saline solution potentiates blood loss in the absence of hemostasis.
Publication Date: 1997-05-01 PubMed ID: 9143539
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Summary
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The research article discusses a case where a racehorse experiencing severe nosebleeds following surgery, lost a large volume of blood. Various treatments were used to maintain arterial pressure, and an adverse reaction halted a blood transfusion after a small amount had been delivered.
Background and Objective
- This case study focuses on an 8-year-old Thoroughbred gelding that was put under anesthesia for surgery to correct right dorsal displacement of the ascending colon, a condition commonly known as colic in horses.
- The researchers aim to discuss the events that occurred after the surgery, particularly the severe nose bleed that led to significant blood loss in the horse after the nasogastric tube was removed.
The Case and Intervention
- Post-surgery, the horse suffered a severe hemorrhage from the nostrils resulting in the loss of 24 liters of blood.
- The treatment approach included administration of acetated Ringer’s solution, hypertonic saline solution, and dobutamine, all aimed at maintaining the arterial pressure of the horse after this significant blood loss.
- The medical team also started a blood transfusion to try to make up for the blood loss.
Observations and Learnings
- The blood transfusion had to be stopped after delivering only 2.7 liters of blood due to a suspected adverse reaction to the transfusion in the horse – an unforeseen complication.
- Notwithstanding the above, the interventions helped to restore the arterial pressure to pre-hemorrhage values, indicating that the treatment with balanced electrolyte solution, hypertonic saline solution, and dobutamine may help maintain adequate arterial pressure after severe blood loss.
- The case also indicated that administration of hypertonic saline solution could potentially enhance blood loss in the absence of hemostasis, which is the process that causes bleeding to stop, hence needs to be administered carefully.
Conclusion
- This research paper points to the potential risks and complications that can occur during recovery from anesthesia and surgery. It underscores the importance of careful monitoring and treatment for maintaining arterial pressure after significant blood loss.
- Moreover, it exposes a potential risk factor associated with the administration of hypertonic saline solution in the absence of hemostasis.
Cite This Article
APA
Trim CM, Eaton SA, Parks AH.
(1997).
Severe nasal hemorrhage in an anesthetized horse.
J Am Vet Med Assoc, 210(9), 1324-1327.
Publication
Researcher Affiliations
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens 30602, USA.
MeSH Terms
- Anesthesia / adverse effects
- Anesthesia / veterinary
- Animals
- Blood Transfusion / veterinary
- Cardiotonic Agents / therapeutic use
- Colic / surgery
- Colic / veterinary
- Dobutamine / therapeutic use
- Epistaxis / etiology
- Epistaxis / therapy
- Epistaxis / veterinary
- Fluid Therapy / veterinary
- Horse Diseases / etiology
- Horse Diseases / surgery
- Horse Diseases / therapy
- Horses
- Intubation, Gastrointestinal / adverse effects
- Intubation, Gastrointestinal / veterinary
- Male
- Shock, Hemorrhagic / etiology
- Shock, Hemorrhagic / therapy
- Shock, Hemorrhagic / veterinary
- Tracheostomy / veterinary
- Transfusion Reaction
Citations
This article has been cited 2 times.- Alvey E, Fielding L, Dennis D, Rhodes D, Deane E, Bouton J. A randomized clinical trial comparing intranasal lidocaine and saline prior to gastroscopy. Open Vet J 2025 Jun;15(6):2915-2918.
- Chesnel MA, Aprea F, Clutton RE. Anesthetic management of a horse with traumatic pneumothorax. Can Vet J 2012 Jun;53(6):648-52.
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