Management of acute bleeding in a shetland pony during surgery for foreign body removal

Abstract

A 180-kg, male neutered 15-year-old shetland pony was referred to the authors’ clinic with a chronic purulent wound on the left flank and mild weight loss. Surgical treatment under sedation with local anaesthesia was already attempted twice, but each time within two months a new fistula was evident. Abdominal ultrasound exam revealed a possible abscess in the abdomen with no clear margins, indicative of extension of infected tissue or the presence of a foreign body. General anaesthesia for wound curettage surgery was scheduled. Complication during anaesthesia was a massive unexpected acute bleeding from adhesions of the abscess to the spleen, caused by a foreign body which had probably perforated the stomach.

Polymorphic tachycardia in an anaesthetised horse with an undiagnosed pheochromocytoma undergoing emergency coeliotomy

“…The consistent decrease of haematocrit throughout the anaesthesia was deemed not optimal for oxygen‐carrying capacity. However, with administration of FWB, haematocrit could be maintained above the critical value of 20 per cent 8…”

“…Based on the ASA physical classification status, a category V‐E8 was assigned. Before general anaesthesia, the horse was sedated with medetomidine (0.007 mg/kg intravenously).…”

“…Hypotension secondary to haemorrhage and severe pain from tumour rupture can also be present 7. In cases of acute haemorrhage, fast transfusions are essential for horses’ survival, especially when blood loss exceeds 30 per cent of blood volume, and tachycardia or hyperlactataemia is present 8. Also, the presence of excessive sweating, muscle fasciculations, hyperlactataemia (>4.9 mmol/l) and/or hyperglycaemia (>10.2 mmol/l) should raise suspicion for a pheochromocytoma 1.…”

Spontaneous pulmonary haemorrhage in a standing sedated horse

“…In case of emergency, a healthy gelding can be used as a donor 18 . Successful blood transfusion without previous cross‐matching for treatment of an acute haemorrhage has been previously reported in equine anaesthesia 20 . Possible side effects of blood transfusion reactions were weighted against the benefits of blood administration and the emergency of the situation, and the transfusion was considered necessary.…”

Blood Transfusion in Equids—A Practical Approach and Review

“…Certain surgeries are associated with an increased risk of both intra- and postoperative hemorrhage. As mentioned above, these include surgeries involving the head and paranasal sinuses, reproductive tract and spleen, as well as the foot, and various foreign-body and tumor removal surgeries [ 21 , 22 , 23 , 24 , 25 , 26 ]. Intraoperative hemorrhage is deemed to be a surgical complication if it is unexpected and/or severe enough to warrant blood transfusion [ 27 ].…”