Successful Surgical and Medical Management of a Pararectal Abscess in a Horse.
Abstract: Pararectal abscesses are life-threatening conditions that can rupture and cause septic peritonitis. The objective of this case report is to describe aggressive treatment of a pararectal abscess to allow a quick return to competitions. A 14-year-old pony was admitted to the Veterinary Teaching Hospital (VTH) of the University of Perugia because of a suspected intra-abdominal mass. Two weeks earlier, it exhibited clinical signs compatible with colic which was treated medically; however, because of the persistence of a firm mass on the right side of the abdomen noted on rectal palpation, the pony was admitted to the VTH. Based on rectal palpation, rectal ultrasound, neutrophilic leukocytosis, hyperfibrinogenemia, and elevated alkaline phosphatase, the diagnosis of a pararectal abscess was made. The horse was treated with ceftiofur IM and MgSO4/paraffin oil via a nasogastric tube. Standing surgical drainage of the abscess with placement of an indwelling drain was performed, followed by daily lavages with rifampicin and acetylcysteine along with Ringer lactate solution with subsequent passive drainage. A bacterial culture revealed the presence of Streptococcus zooepidemicus that was treated with oral rifampicin. Standing laparoscopy revealed adhesions to the rectum. An epidural catheter was placed for repeated delivery of morphine sulfate. The pony was monitored daily by rectal examination, while complete blood count, fibrinogen, serum amyloid A, and abdominal ultrasound (to assess the size of the abscess) were repeated weekly. The pony progressively improved and was discharged one month later, shortly returning to competitions. This report emphasizes the importance of combining medical and surgical treatments for pararectal abscesses.
Copyright © 2021 Elsevier Inc. All rights reserved.
Publication Date: 2021-01-13 PubMed ID: 33781413DOI: 10.1016/j.jevs.2021.103387Google Scholar: Lookup
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Summary
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The study describes the diagnosis and management of a pararectal abscess in a pony, with successful outcomes which allowed a fast return to competitions.
Background
- The research focuses on a pararectal abscess on a 14-year-old pony, a life-threatening condition if left untreated.
- The pony showed signs of colic and had a firm mass on the right side of its abdomen. Despite receiving initial medical treatment, the persistence of the mass led to its admission to the Veterinary Teaching Hospital.
Diagnosis
- The indication of a pararectal abscess was identified through rectal palpation, rectal ultrasound, conditions of neutrophilic leukocytosis and hyperfibrinogenemia, and increased levels of alkaline phosphatase.
- Bacterial culture also shoed the presence of Streptococcus zooepidemicus.
Treatment
- Medications administered included ceftiofur through Intramuscular injection (IM) and MgSO/paraffin oil via a nasogastric tube.
- The horse received standing surgical drainage of the abscess, with the placement of an indwelling drain, and daily lavages with rifampicin and acetylcysteine along with a Ringer’s lactate solution.
- Due to the detection of Streptococcus zooepidemicus, rifampicin was given to the horse orally.
Post-Treatment Monitoring
- Observations included daily rectal examinations and weekly blood count checks. Fibrinogen, serum amyloid A, and abdominal ultrasound were also assessed weekly to monitor the size of the abscess.
- An epidural catheter was introduced for the repeated delivery of morphine sulfate.
Outcome
- The pony showed progressive improvements and was discharged from the hospital after one month.
- The horse was able to return to competitions shortly after being discharged which showed the efficacy of the treatment combination.
Conclusion
- From the case study results, the researchers presented a strong recommendation for the combination of medical and surgical treatments in managing pararectal abscesses in horses.
Cite This Article
APA
Ortolani F, Nannarone S, Scilimati N, Gialletti R.
(2021).
Successful Surgical and Medical Management of a Pararectal Abscess in a Horse.
J Equine Vet Sci, 99, 103387.
https://doi.org/10.1016/j.jevs.2021.103387 Publication
Researcher Affiliations
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy; Sport Horse Research Centre, University of Perugia, Perugia, Italy.
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy; Sport Horse Research Centre, University of Perugia, Perugia, Italy. Electronic address: sara.nannarone@unipg.it.
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy; Sport Horse Research Centre, University of Perugia, Perugia, Italy.
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy; Sport Horse Research Centre, University of Perugia, Perugia, Italy.
MeSH Terms
- Abscess / drug therapy
- Abscess / veterinary
- Animals
- Catheterization / veterinary
- Colic / veterinary
- Horse Diseases / diagnosis
- Horses
- Hospitals, Animal
- Hospitals, Teaching
Citations
This article has been cited 2 times.- Douglas H, Midon M, Shroff K, Floriano D, Driessen B, Hopster K. Caudal epidural catheterization for pain management in 48 hospitalized horses: A descriptive study of demographics, complications, and outcomes. Front Vet Sci 2022;9:995299.
- Soroko M, Górniak W, Zielińska P, Górniak A, Śniegucka K, Nawrot K, Korczyński M. Effect of Lentinula edodes on Morphological and Biochemical Blood Parameters of Horses. Animals (Basel) 2022 Apr 25;12(9).
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