No abstract

CASE DESCRIPTION A 17-year-old Friesian gelding was examined at a referral hospital because of a 1-month history of mild exercise intolerance and marked lymphocytosis. CLINICAL FINDINGS Physical examination revealed no peripheral lymphadenopathy or other abnormalities. Results of an abdominal palpation examination per rectum and thoracic and abdominal ultrasonographic examinations were unremarkable. B-cell chronic lymphocytic leukemia (CLL) was diagnosed on the basis of severe lymphocytosis and positive expression of the B-cell marker CD20 by lymphocytes in the bone marrow and peripheral blood. TREATMENT AND OUTCOME Treatment with prednisolone (2 mg/kg [0.9 mg/lb], PO, every other day) and chlorambucil (20 mg/m2, PO, every 3 weeks for 2 doses, then every 2 weeks) was initially associated with improvement in clinical signs and a decrease in the lymphocyte count. However, 3 weeks after administration of the first dose of chlorambucil, the lymphocyte count began to increase. One week later, the horse developed episodes of recurrent fever and the lymphocyte count continued to increase. Despite continued administration of the prednisolone-chlorambucil protocol, the horse's clinical condition deteriorated rapidly, and it was euthanized 6 weeks after initial examination at the referral hospital because of a poor prognosis. A necropsy was not performed. CLINICAL RELEVANCE B-cell CLL has been infrequently described in horses. This report was the first to describe the use of chemotherapy, albeit unsuccessful, for the treatment of B-cell CLL in a horse. This information should be useful for guiding expectations for prognosis and management of other horses affected with the disease.

Objectives: To determine the impact of age on survival in horses with colitis and to elucidate whether a lower type-1/type-2 cytokine ratio or an exaggerated inflammatory state contribute to reduced survival in aged horses.

A favourable outcome in cases of colic depends on early referral and prompt differentiation of strangulating and nonstrangulating obstructive lesions to allow for quick surgical intervention. While history and physical examination provide essential information for decision making, clinicopathological parameters using bodily fluids such as blood, peritoneal fluid, saliva or urine offer the appeal of being objective regardless of the observer. If parameters can be easily measured with

BackgroundEarly identification of strangulating obstruction (SO) in horses with colic improves outcomes, yet early diagnosis of horses requiring surgery for SO often remains challenging.ObjectivesTo compare blood and peritoneal fluid l‐lactate concentrations, peritoneal:blood l‐lactate ratio, peritoneal minus blood (peritoneal‐blood) l‐lactate concentration and other clinical variables for predicting SO and SO in horses with small intestinal lesions (SO‐SI) and then to develop a multivariable model to predict SO and SO‐SI.Study designRetrospective cohort.MethodsA total of 197 equids admitted to a referral institution for colic between 2016 and 2019 that had peritoneal fluid analysis performed at admission were included. Twenty‐three admission variables were evaluated individually for the prediction of a SO or SO‐SI and then using multivariable logistic regression. Odds ratios (ORs) with 95% confidence intervals (CI) and area under the curve of the receiver operator characteristic (AUC ROC) were calculated.ResultsAll variables performed better in the model than individually. The final multivariable model for predicting SO included marked abdominal pain (OR 5.31, CI 1.40–20.18), rectal temperature (OR 0.30, CI 0.14–0.64), serosanguineous peritoneal fluid (OR 35.34, CI 10.10–122.94), peritoneal‐blood l‐lactate (OR 1.77, CI 1.25–2.51), and peritoneal:blood l‐lactate ratio (OR 0.36, CI 0.18–0.72). The AUC ROC was 0.91. The final multivariable model for predicting SO‐SI included reflux volume (OR 0.69, CI 0.56–0.86), blood l‐lactate concentration (OR 0.43, CI 0.22–0.87), serosanguineous peritoneal fluid (OR 4.99, CI 1.26–19.74), and peritoneal l‐lactate concentration (OR 3.77, CI 1.82–7.81).Main limitationsRetrospective, single‐hospital study design.ConclusionsBlood and peritoneal fluid l‐lactate concentrations should be interpreted in conjunction with other clinical variables. The relationship between peritoneal and blood l‐lactate concentration for predicting SO or SO‐SI was complex when included in a multivariable model. Models to predict SO probably vary based on lesion location.