SummaryA male red deer (Cervus elaphus) of unknown age was admitted to Istanbul University, Faculty of Veterinary Medicine, Department of Surgery with an open fracture at the level of the right proximal third metacarpal bone. The leg was amputated and two months later he received an prosthetic leg and the clinical outcome was discussed. Keywords: Red deer, Cervus elaphus, Amputation, Prosthetic limb Yabani Bir Kızıl Geyikte (Cervus elaphus) Parsiyel Ön Bacak Amputasyonu ve Protez Bacak Uygulaması Özetİstanbul Üniversitsi Veteriner Fakültesi Cerrahi Anabilim Dalı'na sağ metakarpus III'ün proksimalinde açık kırık şikayetiyle getirilen, yaşı bilinmeyen erkek bir kızıl geyiğin (Cervus elaphus) sağaltımında bacağın amputasyonunu takiben 2 ay sonra protez bacak uygulanması ve klinik sonuçları değerlendirilmiştir.

Background: Recently, the role of inflammation triggered by handling of the intestine various gastrointestinal (GI) surgeries is generally accepted as the key event in postoperative ileus (POI). Because, prokinetics have been increased the smooth muscle contractions and may act by attenuating the inflammatory process in the GI tract, they have been used the treatment of POI in human and animals. There are many in vivo analysis techniques of GI motility. However, there have not yet been studied associated with the evaluation of the inflammatory response. Therefore, it was aimed to evaluate the efficiencies of 3 different prokinetics from inflammatory response during experimentally-induced POI.Materials, Methods & Results: Twenty healthy lambs (30-45 days old) were randomly assigned to four groups. In all groups, enterotomy was performed on the ileum. Erythromycin and metoclopramide were administered to the ERT and MET groups before the surgery, respectively, while lidocaine was administered to the LID group as bolus before and continuous rate infusion during the surgery. Physiological saline was administered to the lambs in control group as placebo before the surgery. Blood samples were collected before surgery (~30-45 min), at the end of surgery (0 h), and at the postoperative 1, 3, 5, 10, 48, 72 and 96 h. The concentrations of serum amyloid A (SAA), haptoglobin (HPT), fibrinogen (FIB) as acute phase proteins (APPs), thiobarbituric acide reactant substrate (TBARs), myeloperoxidase (MPO) as reactive oxygen species, and transforming growth factor-beta (TGF- β) as a cytokine were measured with ELISA reader. In terms of time points, it was found that FIB was statistically higher in ERT group at the 1st h, in MET and LID groups at the 10th h, and in LID group at the 48th and in MET group at the 72 h (P < 0.05). It was found that SAA was higher in MET group at the 1st, 3rd, 5th, 10th, 24th, 48th and 72nd h. HPT was higher in CNTR group until 72th h and MET group at 48th, 72nd and 96th h. TBARs concentrations were statistically higher in MET and LID groups at 0 hour, in ERT and MET groups at the 1st h, in MET group at the 3rd h, in MET and LID groups at the 5th and 10th h, in MET group at the 48th, 72nd and 96th h (P < 0.05). MPO concentrations was higher in LID group at the 3rd, 5th, 10th and 96th h, and in ERT group at the 72nd h (P < 0.05). TGF-β concentrations were particularly high in MET group at the 3rd, 5th, 48th and 72nd h, and in LID group at the 10th, 24th, and 96th h (P < 0.05).Discussion: APPs (HPT, SAA, FIB), which are important regulators of inflammation in cows and sheep, were higher generally in MET and LID groups and inflammation persists in these two groups and, therefore, metoclopramide and lidocaine are less effective in early postoperative POI treatment. Because, significant increase in serum TBARs and MPO concentrations was considered as an important indicator of oxidative stress and inflammatory response MPO concentrations was particularly high until 10th h in LID group, and TBARs concentrations was high both MET and LID groups throughout the study, this was correlated with higher neutrophil infiltration in the postoperative early period than the other groups. It is known that TGF-β, an inflammatory cytokine, is correlated with various smooth muscle disorders in humans. In this study, TGF-β concentration were higher in the MET and LID groups. High concentration of this cytokine might have led to decrease contractions in smooth muscles, thereby slowing down the intestinal transition. In conclusion, based on the presence of pro-inflammatory markers in this study, erythromycin seems to be the most suitable prokinetic drug in lambs. Moreover, lidocaine and metoclopramide are not as successful in small ruminants as reported in other species.

The aim of this study was to evaluate the effects of the three different prokinetic agents, namely erythromycin, lidocaine, and metoclopramide in lambs with postoperative ileus (POI) using motilin and ghrelin, which are known as motility markers. Twenty lambs were allocated to 4 groups of 5 lambs each. An enterotomy was performed on the ileum of each lamb. Erythromycin (8.8 mg/ kg), metoclopramide (0.2 mg/kg), and saline (2 mL) were administered as single dose IM before surgery in the ERT, MET, and CNTR groups, respectively. Lidocaine was administered to the LID group, both as a bolus before (1.3 mg/kg IV) and as a continuous rate infusion during surgery (0.05 mg/kg/h IV). Serum motilin and ghrelin concentrations as motility hormones were measured with ELISA. The serum motilin concentration was significantly higher at 0, 1, 3, 5, 10, 24, and 48 h in the ERT group and at 1 and 10 h in the LID group. The serum ghrelin concentration was significantly higher at 0, 1, and 48 h in the ERT group and at 3, 5, 10, 24, and 48 h in the LID group. As a result, erythromycin and lidocaine was thought to be useful in lambs with POI according to the stimulatory effects on the motility hormones.