Clinical and diagnostic findings, treatment, and short‐ and long‐term survival in horses with peritonitis: 72 cases (2007‐2017)

Abstract

To identify etiology, clinical findings, diagnostic results, treatment, and short-and long-term survival and to report factors associated with nonsurvival and survival in horses with peritonitis. Study design: Retrospective study. Animals: Horses (n = 72). Methods: Medical records at William R. Pritchard Veterinary Medical Teaching Hospital from 2007-2017 were reviewed for horses diagnosed with peritonitis. The essential inclusion criterion was a peritoneal nucleated cell count of ≥25 000 cells/μL. Gastrointestinal rupture and cases in which peritonitis occurred after abdominal surgery or castration were excluded. Information retrieved from medical records included signalment, history, clinicopathological and peritoneal fluid variables, diagnostic imaging findings, inciting cause, treatment, and short-and long-term survival. Data were analyzed by using Fisher's exact test, Wilcoxon rank sum test, and χ 2 test (P < .05). Results: Colic was the most common presenting complaint (34/72 [48%]). A definitive diagnosis could be made in 44 (44/72 [61%]) cases. The most common cause of peritonitis was infectious agents (31/72), followed by trauma (8/72), gastrointestinal thickening (3/72), and eosinophilic peritonitis (2/72). Idiopathic peritonitis was identified in 28 (28/72 [39%]) cases. Sixty (83%) horses survived to hospital discharge. Long-term follow-up was available for 49 horses, with 43 (88%) horses alive 1 year after discharge. Significant differences between nonsurvivors and survivors were history of colic, positive peritoneal fluid culture, and several hematological/peritoneal fluid variables. Conclusion: Peritoneal fluid analysis was essential for a definitive diagnosis of peritonitis, and certain variables were useful for predicting outcome.

Successful transabdominal treatment of a chronic splenic abscess caused byClostridium perfringensafter penetrating external trauma in a horse

“…In the current case, minimally invasive transabdominal drainage of an intrasplenic abscess caused by Clostridium perfringens after trauma from a sharp metallic object led to complete healing and return to the previous level of performance. results of abdominocentesis revealed severe non-septic peritonitis (Arndt et al, 2021). Although non-specific per se, all these findings are in accordance with previously described cases of intrasplenic abscess formation (Alsop et al, 2007;Coleman & Schmitz, 2019;Rosso et al, 2012;Thomson et al, 2020).…”

“…At the time of presentation, haematology revealed severe leucocytosis, neutrophilia, lymphopenia, hyperproteinaemia and hyperfibrinogenaemia, which is consistent with chronic inflammation. The results of abdominocentesis revealed severe non‐septic peritonitis (Arndt et al, 2021). Although non‐specific per se, all these findings are in accordance with previously described cases of intrasplenic abscess formation (Alsop et al, 2007; Coleman & Schmitz, 2019; Rosso et al, 2012; Thomson et al, 2020).…”

“…It may be caused by perforation of the gastrointestinal tract by metallic wire (Coleman & Schmitz, 2019; Rosso et al, 2012; Saulez et al, 2009; Thomson et al, 2020). A few reports also state the association with an external trauma (Coleman & Schmitz, 2019; Spier et al, 1986), the migration of Strongylus vulgaris (Coleman & Schmitz, 2019) and Streptococcus equi subspecies equi infection (Pusterla et al, 2007) or Corynebacterium pseudotuberculosis (Arndt et al, 2021). Clinical signs include anorexia, lethargy, fever, chronic weight loss, tachycardia, tachypnoea and potentially abdominal pain (Coleman & Schmitz, 2019; Thomson et al, 2020).…”

Differentiating Strongylus vulgaris‐associated, non‐strangulating intestinal infarctions from idiopathic peritonitis and acute colitis in horses

“…When the time from admission to surgery was decreased from a median of 1.2 to 0.3 days, the risk of intraoperative euthanasia decreased from 52% (11/21) to 17% (1/6), and the chance of survival in horses where resection was performed increased from 33% (3/9) to 100% (5/5) ( p = 0.030) 36 . As idiopathic peritonitis generally has a high survival rate to discharge without surgery, 8,37,38 decision making (to decide whether to perform surgery) in horses with peritonitis is difficult. A previous study identified no signs of abdominal pain, normal intestinal borborygmi, normal faeces, no nasogastric reflux, normal colour of PF and normal findings on palpation per rectum to be the most important variables indicating survival without surgery in horses with peritonitis 37 .…”

Highlights of recent clinically relevant papers

“…This retrospective study by Stefanie Arndt and co‐workers at the University of California‐Davis, USA, investigated clinical and diagnostic findings, treatment, and short‐ and long‐term survival in 72 horses with peritonitis .…”