Summary Reasons for performing study: Few studies have assessed short‐ and long‐term complication rates of horses following surgical treatment of colic, a potentially fatal condition. Complications can lead to patient discomfort and increased costs; knowledge of predisposing factors may help to reduce complication rates. Objectives: To document and analyse short‐term complications in 300 horses undergoing colic surgery, and to assess some of the possible predisposing factors. Methods: History, clinical findings, surgical findings and procedures, and post operative treatments of 300 consecutive surgical colic cases (1994–2001) were reviewed. Comparisons among groups of discrete data were made using chi‐squared or Student's t tests as appropriate. Results: Short‐term complications in 227 horses following a single laparotomy included colic/pain (28.2%), incisional drainage or infection (26.9%), post operative ileus (13.7%), severe endotoxaemic shock (12.3%), jugular thrombophlebitis (7.5%), septic peritonitis (3.1%) and colitis/diarrhoea (2.2%). Horses with small bowel obstruction had a higher rate of post operative ileus than those with large bowel obstruction. Rates of post operative pain and shock were higher in horses with small colon rather than large colon obstruction, and in those that had an ischaemic rather than a simple obstruction. The rate of wound complications increased with increasing total plasma protein concentration at admission. Horses that had a repeat laparotomy had a higher rate of wound complications compared to those that had a single laparotomy. Application of a stent bandage was associated with a higher rate of wound complications than if no stent was applied; however, application of an incise drape over the wound for recovery was associated with a lower rate of wound complications than for horses that had no protective covering of the wound. Conclusions: The most common short‐term post operative complications following colic surgery were pain, incisional drainage, ileus, endotoxaemiac shock and jugular thrombophlebitis. Some factors that appeared to predispose to these complications were identified. Although many of these factors related to the underlying disease process, a number of factors, including surgical techniques, were identified that might be amenable to modification. Potential relevance: Prospective studies to assess the effects of modifying these factors on survival rates should be performed.
Summary Reasons for performing study: Few studies have evaluated long‐term survival and complication rates in horses following surgical treatment of colic, making it difficult to offer realistic advice concerning long‐term prognosis. Objective: To review the complications occurring after discharge from hospital and survival to >12 months after surgery of 300 horses undergoing exploratory laparotomy for acute colic. Pre‐, intra‐ and post operative factors that affected long‐term complications and long‐term survival were assessed. Methods: History, clinical findings, surgical findings and procedures and post operative treatments of 300 consecutive surgical colic cases (1994–2001) were reviewed. Long‐term follow‐up information was retrieved from case records and telephone enquiries from owners. Results: The long‐term (>12 months) survival rate for 204 horses discharged after colic surgery and for which follow‐up information was available was 84%. The most common complication after discharge was colic, affecting 35.1% of horses following a single laparotomy. Colic was most common in horses that had had small intestinal obstructions, bowel resection or post operative ileus. Abdominal adhesions were most common in horses that presented with severe colic due to strangulation of small intestine. Ventral hernia formation occurred in 8% of horses, and was most common in horses that had had post operative wound drainage or infection. Conclusions: This study identified various factors that appear to predispose horses to long‐term complications after colic surgery. Potential relevance: Further evaluation of strategies that might reduce the incidence of such complications are needed; in particular, the value of intraperitoneal heparin should be evaluated, and procedures designed to reduce the rates of wound drainage and infection assessed.
Using an abdominal bandage following an exploratory laparotomy may help reduce the prevalence of post operative incisional complications, and prevent the development of potentially life-threatening complications.
Summary The medical records of 45 horses treated for suspected squamous cell carcinoma of the penis and/or prepuce were reviewed. The age of 40 horses was known, and these had a mean age of 17.4 years. The duration of neoplasia was known foronly 3 of the 45 horses. The results of histological evaluation of lesions, available for 35 horses, confirmed that the diseased tissue was squamous cell carcinoma. The location of gross neoplastic lesions was recorded for 43 horses; the glans penis was involved in 24 horses, the body of the penis or the inner lamina of the preputial fold in 27 horses, and the external fold of the prepuce in 10 horses. Surgical treatments of these horses included phallectomy (penile amputation) in 35 horses, segmental posthectomy in 4 horses, phallectomy plus segmental posthectomy in 2 horses, and en bloc resection of the penis, prepuce and superficial inguinal lymph nodes with penile retroversion in 4 cases. Short‐term complications in the immediate postoperative period included preputial oedema and haemorrhage at the end of urination. One horse developed acute urinary retention because of severe urethral oedema. Long‐term (>1 year) follow‐up information was obtained for 31 horses. Neoplasia of the penis and/or prepuce recurred in 6 of these 31 horses (19%), and in 5 of these the recurrence necessitated euthanasia of the horse.
This retrospective study was conducted in the UK and identifies the most frequent causes, diagnoses, treatment and prognoses for short- and long-term survival in 54 cases of horses with haemoperitoneum. Clinical signs of haemorrhagic shock and colic were common, and abdominal ultrasound was very useful for the identification of haemoperitoneum. Causes of haemoperitoneum included uterine injury (22 per cent), involvement of specific blood vessels (20 per cent), splenic injury (19 per cent), neoplasia (13 per cent) and other (4 per cent). No source was identified in 22 per cent of cases. Fifty-seven per cent of cases underwent exploratory laparotomy. Of the surgical cases, a diagnosis was made in 65 per cent, with 42 per cent surviving to discharge. It was felt that exploratory laparotomy had both diagnostic and therapeutic implications. Twenty-eight per cent of cases died, and 33 per cent were euthanased, whereas 39 per cent survived to be discharged from the hospital, with 35 per cent of these surviving in the long term. Idiopathic haemoperitoneum was associated with the best outcome for long-term survival.
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