Summary Reasons for performing study: Wound healing proceeds faster in ponies than in horses and complications during healing, such as wound infection, occur less frequently in ponies. Earlier studies suggested that this difference might be related to differences in the initial post traumatic inflammatory response. Hypothesis: That polymorphonuclear leucocyte (PMN) function and profiles of humoral factors in local inflammatory processes are different in horses and ponies. Methods: PMNs were isolated from venous blood of horses and ponies. Chemotaxis and reactive oxygen species (ROS) production was determined. Tissue cages were implanted in limbs and necks of horses and ponies and injected with carrageenan and, 3 weeks later, with LPS. In sequential samples of inflammatory exudate, the numbers of macrophages and PMNs and the production of PGE2, TNFα, IL‐1, IL‐6 and chemoattractants were determined. Results: In vitro ROS production of PMNs was significantly higher in ponies than in horses, whereas in vitro PMN chemotaxis was significantly lower in ponies. In the tissue cages for both stimuli, the production of IL‐1 and chemoattractants was significantly higher in ponies than in horses and remained so towards the end of the observation period in ponies. Conclusions: This study demonstrated a higher production of various inflammatory mediators by pony leucocytes. Despite the lower in vitro chemotaxis of pony PMNs, this higher in vivo production resulted in a stronger initial inflammatory response in ponies, as has been reported in studies on wound healing, through the attraction of leucocytes and triggering of the production of other cytokines. A stronger initial inflammation may promote healing by more rapid elemination of contaminants and earlier transition to repair. Potential relevance: Modulation of the initial inflammatory response might therefore be a valid option for therapeutic intervention in cases of problematic wound healing. Further, the intraspecies differences in leucocyte function may have an impact on many fields in equine medicine.
SUMMARYA retrospective study was carried out of 224 horses operated for strangulating small intestine obstructions. Fiftyfour horses were euthanized and 5 horses died during surgery which means that 165 (73%) were allowed to recover. Of these, 53 horses were euthanized or died in the clinic and 112 (50%) were discharged from the hospital. Of 90 horses available for follow-up 1 year postoperatively, 76 (84%) were still alive. The most important causes of death or reasons for euthanasia in the direct post-operative period were post-operative paralytic ileus, (adhesive) peritonitis and intra-abdominal haemorrhage. After discharge from the hospital the reasons were (adhesive) peritonitis and (recurrent) colic. Of the horses which survived for at least 1 year, 16% sometimes suffered from colic, 12% experienced problems with incisional woundhealing and 4% suffered from jugular vein thrombosis. All were in good or reasonable condition and 88% performed at (approximately) the same level as before the operation. The type of surgical intervention (i.e. enterotomy, enterectomy) did not significantly influence the outcome of surgery, whereas the type of anastomosis did. End-to-end jejunojejunostomy had a better prognosis than side-toside jejunocaecostomy.It was concluded that strangulating obstructions of the small intestine still carry a poor to guarded prognosis.Mortality was highest in the direct peri-operative period.Once discharged from hospital, prognosis can be considered to be fair to good. Attempts to improve outcome should be directed at a better handling of the ileal stump during surgery and at the prevention of post-operative ileus and the formation of adhesions.
Wound healing in horses is often complicated by wound infection, exuberant granulation tissue, and hypertrophic scars, especially when wounds are located on the limbs. Wound healing in ponies is less problematic, characterized by a greater degree of wound contraction and a more intense initial inflammatory response. Because both processes are influenced by transforming growth factor-beta (TGF-beta), it was hypothesized that the better wound healing in ponies was associated with different TGF-beta profiles. A series of small wounds was created on the distal limbs and hindquarters of ponies and horses. Tissue samples were harvested on alternate days until day 13 postwounding, and levels of total and active TGF-beta were determined. Levels of TGF-beta were significantly higher in pony wounds than in those of horses. The TGF-beta profile differed between limb and body wounds, with levels in body wounds decreasing at the end of the experiment and persisting in limb wounds. In ponies, the higher TGF-beta levels can, to a large extent, explain the more intense inflammatory response and may explain the greater degree of wound contraction. Apparently adequate levels in the limbs fail to result in greater wound contraction, probably because of a stronger fixation of the skin. The persistence of elevated levels of TGF-beta may result in the production of exuberant granulation tissue. Further research on the temporal patterns of the different TGF-beta isoforms seems indicated, because manipulation of TGF-beta levels appears to be a promising option for intervention in problematic wound healing in horses.
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