Suspected postoperative phenylephrine‐associated pulmonary haemorrhage in a horse with nephrosplenic entrapment of the large colon

Abstract

AbstractA 16‐year‐old, Irish sport horse was treated with intravenous fluid therapy and phenylephrine, followed by light exercise for a nephrosplenic entrapment of the left large colon. Medical treatment failed to return the colon to its normal position and an exploratory coeliotomy was performed. The surgical procedure and general anaesthesia were uneventfully completed; however, the horse developed haemoptysis, pulmonary oedema and epistaxis in the recovery box. The horse improved after administration of intravenous furosemide and hypertonic saline and was discharged from the hospital 4 days later. Phenylephrine is a sympathomimetic drug that causes splenic contraction and thereby decreases the size of the spleen, allowing the colon to return to its normal position. Fatal pulmonary and abdominal bleeding has been reported as a rare complication of phenylephrine treatment in horses. This case shows a delayed and completely unexpected presentation, which responded to supportive treatment.