Successful Surgical and Medical Management of a Pararectal Abscess in a Horse

Ortolani, Flaminia; Nannarone, Sara; Scilimati, Nicola; Gialletti, Rodolfo

doi:10.1016/j.jevs.2021.103387

Cited by 5 publications

(8 citation statements)

References 16 publications

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“…Cervical epidural catheter placement and analgesia has recently been described as an alternative neuraxial technique for thoracic limb conditions ( 35 – 37 ). It is important to consider, however, that caudal epidural analgesia can also be an effective strategy for non-orthopedic conditions including abdominal and urogenital conditions ( 18 , 20 , 25 ). The epidural catheters in this study were maintained for a median of 4 days, with a maximum duration of 33 days.…”

Section: Discussionmentioning

confidence: 99%

“…The placement of epidural catheters for continuous caudal epidural therapy in horses was first reported in 1983 and has become more frequently implemented clinically to employ multi-modal analgesic therapies ( 3 , 14 , 17 – 24 ). Caudal epidural catheters have been placed for continuous anesthesia and analgesia for surgical procedures as well as for pain management for orthopedic, rectal, and urogenital conditions ( 3 , 14 , 18 , 19 , 21 , 25 ). Continuous or repeated epidural administration of analgesics offers the advantages of effective analgesia with reportedly fewer side effects than systemic analgesics ( 26 , 27 ).…”

Section: Introductionmentioning

confidence: 99%

“…Continuous or repeated epidural administration of analgesics offers the advantages of effective analgesia with reportedly fewer side effects than systemic analgesics ( 26 , 27 ). Despite its more frequent application in experimental and clinical settings, there are limited reports on the use of caudal epidural catheterization for long-term administration of epidural analgesics ( 18 , 21 , 24 , 25 ). In an experimental, prospective study on ten horses, no catheter-related complications, such as dislocation, catheter obstruction, leakage, or discomfort during injection were observed during a 14-day experimental observation period ( 24 ).…”

Section: Introductionmentioning

confidence: 99%

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Caudal epidural catheterization for pain management in 48 hospitalized horses: A descriptive study of demographics, complications, and outcomes

et al. 2022

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The placement of caudal epidural catheters in horses has become more frequent as a multi-modal analgesic strategy. Despite its integration into clinical practice, there are limited reports describing the use of caudal epidural catheterization for prolonged use in horses. The purpose of this study was to characterize the hospitalized caseload undergoing epidural catheterization for long-term epidural analgesic administration, to report the response to epidural therapy and observed complications, and to describe patient outcomes. Medical records of hospitalized equine patients that underwent placement of a caudal epidural catheter for analgesic management between 2017 and 2021 were analyzed retrospectively. For the 62 catheters placed in the 48 cases, the most frequent diagnosis category prompting epidural analgesia was orthopedic (43/48, 89.6%). Synovial sepsis was the most frequent specific diagnosis prompting epidural catheter placement (11/48, 22.9%). The initial response to epidural therapy was characterized as positive for 37/62 (59.7%) catheters. Complications were documented for 46/62 (74.2%) catheters. However, most of these complications were classified as mild (51.6%) or moderate (14.5%), and exaggerated physiologic responses were observed most frequently. Of the horses studied, 52.1% survived to be discharged from the hospital. With awareness of potential complications and vigilant monitoring, caudal epidural catheters should be considered for equine patients as an analgesic strategy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Caudal epidural catheterization for pain management in 48 hospitalized horses: A descriptive study of demographics, complications, and outcomes

et al. 2022

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“…65,103 Two recent case reports have questioned this generalization, as increased serum SAA concentrations were detected in a horse with an abdominal abscess 104 and a horse with a pararectal abscess. 105 In foals with Rhodococcus equi pneumonia, SAA has been suggested to be of limited diagnostic value. Measurement of serum SAA weekly or every 2 weeks was not useful for screening foals at farms endemically affected by Rhodococcus equi infection as a means to achieve early recognition.…”

Section: Patient Assessment and Diagnosismentioning

confidence: 99%

“…In several older studies, SAA concentrations were found to be normal or low in horses with abscesses (i.e., walled‐off inflammation) 65,103 . Two recent case reports have questioned this generalization, as increased serum SAA concentrations were detected in a horse with an abdominal abscess 104 and a horse with a pararectal abscess 105 . In foals with Rhodococcus equi pneumonia, SAA has been suggested to be of limited diagnostic value.…”

Section: Use Of Saa In Equine Medicine and Surgerymentioning

confidence: 99%

Use of serum amyloid A in equine medicine and surgery

Jacobsen

2022

Veterinary Clinical Pathol

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Serum amyloid A (SAA) has become an indispensable part of the management of equine patients in general practice and specialized hospital settings. Although several proteins possess acute phase properties in horses, the usefulness of SAA exceeds that of other acute phase proteins. This is due to the highly desirable kinetics of the equine SAA response. SAA concentrations exhibit a rapid and pronounced increase in response to inflammation and a rapid decline after the resolution of inflammation. This facilitates the detection of inflammatory disease and real‐time monitoring of inflammatory activity. SAA may be used in all stages of patient management: (1) before diagnosis (to rule in/rule out inflammatory disease), (2) at the time of diagnosis (to assess the severity of inflammation and assist in prognostication), and (3) after diagnosis (to monitor changes in inflammatory activity in response to therapy, with relapse of disease, or with infectious/inflammatory complications). By assessing other acute phase reactants in addition to SAA, clinicians can succinctly stage inflammation. White blood cell counts and serum iron concentration change within hours of an inflammatory insult, SAA within a day, and fibrinogen within 2–3 days; the interrelationship of these markers thus indicates the duration and activity of the inflammatory condition. Much research on the equine SAA response and clinical use has been conducted in the last decade. This is the prerequisite for the evidence‐based use of this analyte. However, still today, most published studies involve a fairly low number of horses. To obtain solid evidence for use of SAA, future studies should be designed with larger sample sizes.

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Use of Thoracic Catheters to Drain Pelvic Abscesses in Horses: Two Cases

Albanese

Mereu

2023

Journal of Equine Veterinary Science

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Successful Surgical and Medical Management of a Pararectal Abscess in a Horse

Cited by 5 publications

References 16 publications

Caudal epidural catheterization for pain management in 48 hospitalized horses: A descriptive study of demographics, complications, and outcomes

Caudal epidural catheterization for pain management in 48 hospitalized horses: A descriptive study of demographics, complications, and outcomes

Use of serum amyloid A in equine medicine and surgery

Use of Thoracic Catheters to Drain Pelvic Abscesses in Horses: Two Cases

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