Acute, moderate hyperglycemia in healthy adult horses does not have a detectable effect on coagulation based on evaluated parameters. Jugular catheter placement results in a transient increase in thrombin generation as determined by increased TAT concentrations.
Summary Gastric impaction associated with large colon volvulus (LCV) was identified in seven horses. Right dorsal displacement of the large colon and suspected nephrosplenic entrapment was identified in 2 of the 7 horses as well as LCV with concurrent gastric impaction. All horses underwent surgery for LCV and none survived. Five horses died or were subjected to euthanasia intraoperatively or in recovery. One horse was subjected to euthanasia post operatively due to persistent gastric reflux, following resolution of the gastric impaction. One horse was subjected to euthanasia post operatively due to a suspected gastric rupture, which was confirmed on post mortem examination. It is hypothesised that a large mass in the cranial abdomen, such as a gastric impaction may disrupt the normal anatomical large colon alignment or may cause colonic motility or microbiota alterations, and thus increase the risk of large colon displacement and volvulus.
A 13-year-old 480-kg mixed breed gelding was examined because of a 2-day history of anorexia, fever, mild colic, and icterus.Three days before the onset of clinical signs, the horse received vaccinations for rabies, tetanus, West Nile virus, Western equine encephalomyelitis, and Eastern equine encephalomyelitis.On examination the horse was quiet, alert, and responsive. Heart rate was 54 beats/min, respiration rate was 18 breaths/min, and temperature was 37.9°C. Mucous membranes and sclera of the eyes were markedly icteric and capillary refill time was 2 seconds. Heart, lung, and abdominal auscultation were within normal limits. Peripheral lymph nodes were not enlarged and no abnormalities were detected on the remainder of the physical examination.Naso-gastric intubation revealed no net gastric reflux. Abdominal ultrasonography revealed a small area of moderately thickened (0.8 cm) ventral colon. Thoracic ultrasound did not reveal abnormalities. Rectal examination revealed splenomegaly but was otherwise within normal limits. Abdominocentesis was attempted but peritoneal fluid was not obtained.Complete blood count (CBC) revealed anemia (PCV 16%; reference range 33-42%) and thrombocytopenia (26,000/lL [reference range 100,000-600,000/lL]). Total white blood cell count and differential were within normal limits. Cytological evaluation of peripheral blood revealed rare nucleated red blood cells but otherwise abnormalities were not detected. Serum biochemistry abnormalities were limited to hyperglycemia (135 mg/ dL; reference range 60-107 mg/dL) and hyperbilirubinemia (10.9 mg/dL; reference range 0.5-2.5 mg/ dL). Direct and indirect bilirubin values were not measured. Total protein (TP) was 6.1g/dL (reference range 5.5-7.5 g/dL). Hyperfibrinogenemia was detected (275 g/dL; reference range 125-262 g/dL). Venous blood gas analysis a identified hyperlactatemia (7.1 mmol/L; reference range <1 mmol/L) but was otherwise normal. Prothrombin time and partial thromboplastin time were normal. A direct Coombs test was negative.ELISA and agar gel immunodiffusion (Coggins test) for equine infectious anemia and ELISA for Anaplasma phagocytophilum were negative.Volume replacement included lactated Ringer's b (20 mL/kg bolus followed by 2 mL/kg/h IV maintenance). Urine specific gravity (USG) after the initial fluid bolus was 1.025 and dipstick analysis did not reveal any abnormalities. Following the fluid bolus, PCV was 13% and TP 5.6 g/dL. The horse was lethargic and tachycardic (66 beats/min). Commercial fresh frozen plasma c was administered (4 mL/kg IV). Cross matching was performed and 8 L whole blood was administered from a donor horse. Treatment included dexamethasone d (0.2 mg/kg, IV, q24h), trimethoprim sulfamethoxazole e (TMS) (30 mg/kg, PO, q12h), and sucralfate f (20 mg/kg, PO, q6h). Because of the history of colic, feed was withheld for the first 18 hours. No signs of colic or fever were noted. The day after initial examination the horse was brighter and vital parameters were within normal limits. PCV was 17% and blood l...
Background Intrasynovial corticosteroid injections are commonly used in the treatment of equine orthopaedic disease, but corticosteroid administration is widely considered a risk factor for the development of laminitis. Despite a list of putative mechanisms and a number of case reports of steroid‐induced laminitis, no case‐control or cohort studies investigating the association between use of intrasynovial corticosteroids and acute laminitis have been published. Objectives To quantify the risk of laminitis posed by intrasynovial triamcinolone acetonide (TA) administration in a mixed population of horses. Study design Retrospective observational cohort study. Methods Clinical records of horses registered with one large UK equine practice were reviewed retrospectively to identify all horses receiving intrasynovial TA treatment between 1 January 2007 and 31 December 2017. A total of 1510 horses were selected and records investigated for incidence of laminitis over a 4‐month period following treatment. For each TA‐treated horse, an untreated horse, individually matched by age, sex, date of treatment and client type, was selected from the clinical records. Untreated horses were then investigated for laminitis over the same 4‐month period. Data were analysed in a 2 × 2 contingency table using Fisher's exact test. Results A total of 489 horses were lost to follow‐up and 55 horses were excluded, leaving 966 treated and matched, untreated horses. The incidence of laminitis over the 4‐month study period in both groups was identical: 3/966 horses (0.31%) (95% C.I. [0.08%, 0.91%]), equivalent to 0.93 cases per 100 horses per year (P > .9). Main limitations Retrospective study; large proportion (489/1510) of horses lost to follow‐up; large proportion of study population were racehorses; selection method resulted in disproportionate selection of horses born before 2013; similar incidence between groups may reflect existing risk‐based selection by clinicians. Conclusions intrasynovial triamcinolone acetonide administration does not increase the risk of laminitis in this study population.
Horses with suspected RDD or LDD of the large colon may respond to medical management including exercise.
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