Colic Cases Research Articles

Treatment of equine keratomycosis, part 2: reporting common systemic and ocular complications to enhance decision-making for equine clinicians and owners.

The primary aims were to provide descriptive data on systemic and ocular complications associated with the treatment of equine keratomycosis. The secondary aims were to determine if complication rates differ between treatment types or are related to surgical and anesthetic factors. The study was a retrospective evaluation of 126 cases between 2004 and 2020 with confirmed fungal infection and recorded incidence of complications during hospitalization and surgical intervention if pursued. Additional information recorded included the size of the donor graft if utilized, time under general anesthesia, and prescribed medications. Fisher exact and χ2 tests were used to evaluate complication frequency differences. Logistic regression models determined the effects of donor graft size, anesthesia time, and duration of hospitalization on complication rates. Hypercreatininemia followed by colic were the most frequent systemic complications in the medical treatment group. Colic and conjunctival graft dehiscence were the most frequent systemic and ocular complications in all surgery treatment groups, respectively. The frequency of systemic complications did not vary between treatment groups, although colic rates were significantly higher following general anesthesia. All colic cases were resolved with supportive care. Donor graft size, anesthesia time, and duration of hospitalization did not impact complication frequency. The mainstays of medical therapy included topical fluoroquinolones, topical voriconazole, topical atropine, oral NSAIDS, and oral gastroprotectants. Treatment of keratomycosis is associated with a range of complications. Colic remains a significant risk, with increased frequency reported following general anesthesia. Reporting common complications associated with treatment aids in decision-making for equine clinicians and owners.

Incidental finding of intramural splenic heterotopy in the colon mimicking subepithelial neoplasm: a case report

AimThe aim of this case report is describe an unprecedented case with histological and immunohistochemical diagnosis of splenic heterotopy in the colon using material obtained by endoscopic ultrasound-guided biopsy.BackgroundSplenic heterotopia is a benign condition characterized by the implantation of splenic tissue in areas distant from its usual anatomical site, such as the peritoneum, omentum, mesentery, liver, pancreas, and subcutaneous tissue and, more rarely, in locations such as the colon and brain. It is generally associated with a history of splenic trauma or splenectomy and typically does not cause specific symptoms.Case presentationA 35-year-old white male patient who was healthy, with no history of trauma or splenectomy, but had a family history of colorectal neoplasia underwent colonoscopy for screening. The examination revealed a large bulge in the proximal descending colon, covered by normal-appearing mucosa. Endoscopic ultrasound-guided puncture was performed with a 22 gauge fine needle biopsy, and the histopathological and immunohistochemical analysis results were consistent with a heterotopic spleen.ConclusionsThis is the first report of a primary intramural colic splenosis case with histological and immunohistochemical diagnosis of splenic heterotopia in the colon, using material obtained by endoscopic ultrasound and ultrasound-guided biopsy.

Clinical and Epidemiological Profile of Patients Presenting With Acute Abdomen to the Emergency Department of a Tertiary Care Hospital.

Acute abdomen is a common and urgent clinical condition requiring prompt diagnosis and treatment. This study determines the clinical and epidemiological profile of patients presenting with acute abdomen at a tertiary care hospital. To describe the demographic characteristics, provisional diagnoses, treatment modalities, and pain management effectiveness in patients with acute abdomen. This prospective observational study was conducted in the Emergency Medicine department at Dr. D. Y. Patil Medical College, Hospital & Research Center, Pimpri, Pune, over a specified period. The study included patients presenting with acute abdomen, aged above 14 years, excluding those with traumatic acute abdomen and pregnant patients. A sample size of 146 was calculated based on the proportion of ureteric colic cases, with a 95% confidence interval and a 6% margin of error; however, a total of 176 patients were included in the study. Data collection involved recording demographic details, clinical features, provisional diagnoses, and pain scores, as well as performing required blood investigations and ultrasonography. Pain scores were assessed before and after treatment. Patients will be given non-steroidal anti-inflammatory drugs(NSAIDs) or opioid analgesia, depending on the clinical severity. Emergency medicine residents, in consultation with the on-call consultant, determined the disposition of patients, deciding if they required surgical or conservative management. The study found that the majority of patients, n = 130 (73.86%), were aged 26-50 years, with cases n = 103 (58.52%) being males and cases n = 73 (41.48%) females. Acute appendicitis was the most common diagnosis, n = 41 (24.43%), followed by urolithiasis n = 33 (18.75%). Surgical interventions were required for n = 78 (45.08%) of patients, highlighting the urgent nature of these conditions. Pain management was effective, with significant reductions in pain scores post-treatment (mean visual analog score (VAS) decreased from 6.22 to 2.33, and mean numerical rating score (NRS) from 6.05 to 2.10; p < 0.001). The study underscores the high prevalence of gastrointestinal and renal conditions in patients with acute abdomen, particularly in middle-aged adults. The high rate of surgical interventions reflects the urgent nature of these conditions. Significant reductions in pain scores demonstrated effective pain management. Comprehensive care strategies are essential for optimizing patient outcomes. Future research with larger sample sizes and multi-center participation is recommended to validate these findings and enhance management protocols for acute abdomen.

Increased peritoneal fluid lactate in colic cases treated medically that survived to discharge

Increased peritoneal fluid lactate in colic cases treated medically that survived to discharge

UK horse owners and veterinary practitioners' experiences of decision-making for critical cases of colic.

The survival of horses diagnosed with critical colic (requiring referral or euthanasia) relies on rapid and effective decision-making by the owner and veterinary practitioner. To explore UK horse owners' and veterinary practitioners' experiences of decision-making for critical cases of equine colic. Qualitative study using a phenomenological approach. Individual, semi-structured telephone interviews were conducted with 14 horse owners and 13 veterinary practitioners (vets) who had experienced a critical decision (referral or euthanasia) for a horse with colic. A purposive, convenience sample of participants was recruited. Sessions explored participant's experience of colic, including recognition, help-seeking behaviour, and challenges. Thematic analysis was performed on collected data. Four over-arching themes were identified; 'head', 'heart', 'practicalities' and 'impact'. Owners acknowledged responsibility for their horse's welfare but had different perspectives than vets on the importance of finance ('head'). Both vets and owners described how the horse-human relationship ('heart') often led to conflict during decision-making. The vet-client relationship was influential on decision-making for both owners and vets; involving other people in decision-making was described both positively and negatively by participants ('heart'). 'Practicalities', such as lack of preparedness, transport issues and adverse weather conditions, were identified by both owners and vets as barriers. Owners described a 'rollercoaster' of emotions after a critical decision, with profound impacts on their mental wellbeing, feelings of guilt, and long-term changes in behaviour ('impact'), and a lack of support to manage these feelings. Small sample size. This study describes stakeholder decision-making during critical cases of equine colic. Factors that commonly influenced decisions included an owner's previous knowledge and beliefs, social pressures, logistics and the relationship between the owner and vet. The study highlighted long-term impacts on the owner, including their management and decisions for subsequent horses. These factors should be considered in shared decision-making.

Colic in horses: Effects of dietary factors

Studies on colic, an economically important metabolic disease in horses, have typically emphasized maintenance characteristics. However, recent research has demonstrated that nutrient content also contributes to the development of colic. Microbial fermentation of the diet begins in the stomach and continues through the hindgut. During this process, various substrates are produced, including acetate, propionate, butyrate, and methane. The gut contains bacteria such as Firmicutes and Bacteroidetes, but the dominance of one over the other is influenced by the type of substrate available in the gut, such as oat, barley, wheat, corn, etc. Microbial fermentation in the equine cecum is markedly influenced by the pH balance of the nutrient metabolism. This has varying impacts on the cecal microbiota. Investigations into the effects of different feeding methods and nutrients have yielded diverse outcomes for the etiology of colic and post-colic nutrition. The objective of this review is to assess the impact of nutrition and diet composition on the etiology of colic in horses, investigate the role of additives in preventing colic cases, and analyze the results of several studies.

Dexmedetomidine preconditioning reduces ischaemia-reperfusion injury in equine model of large colon volvulus.

Large colon volvulus is a cause of colic in horses with high morbidity and mortality when not promptly treated. More treatment options are needed to improve the outcome of these cases by protecting against the damage caused by ischaemia and reperfusion injury. To determine the effect of preconditioning with dexmedetomidine prior to induction of ischaemia-reperfusion (IR) injury in a large colon volvulus model in the horse. Randomised blinded in vivo experiments. Horses received either a dexmedetomidine (DEX) or saline (CON) constant rate infusion (CRI) immediately following induction of anaesthesia. Venous, arterial, and transmural occlusion of a section of the large colon was performed for 3 h, after which the ligatures and clamps were removed to allow for reperfusion for 3 h. Biopsies of the large colon were taken at baseline, 1 and 3 h of ischaemia, and at 1 and 3 h of reperfusion. The severity of crypt epithelial loss (DEX = 2.1 [0.8-2.8], CON = 3.1 [2.5-4], p = 0.03) and mucosal haemorrhage was decreased (DEX = 2.1 [1.3-3], CON = 3.5 [2.5-4], p = 0.03) in group DEX compared to group CON when graded on a scale of 0-4. Crypt length remained longer (DEX = 369.5 ± 91.7 μm, CON = 238.5 ± 72.6 μm, p = 0.02) and interstitium to crypt (I:C) ratio remained lower (DEX = 1.4 (1-1.7), CON = 2.6 [1.8-5.9], p = 0.03) in group DEX compared to group CON during reperfusion. Clinical applicability of pharmacologic preconditioning is limited. Preconditioning with a dexmedetomidine CRI prior to IR injury demonstrated a protective effect histologically on the large colon in the horse. Further investigation into postconditioning with dexmedetomidine is warranted as a possible intervention in colic cases suspected of being large colon volvulus.

The prognostic importance of physiological and biochemical parameters in horses afflicted with colic.

Colic, a primary cause of illness and death in horses, necessitates the development of improved prognostic tools. The aim of this study was to investigate the prognostic significance of physiological and biochemical parameters in horses suffering from colic. A comprehensive clinical evaluation of 117 horses included assessment of heart rate, mucous membranes, capillary refill time, rectal temperature, respiratory rate, gut motility, reflux, and limb pulse strength. Stomach reflux, absence of gut noises, and increased heart rate (mean increase of 12 bpm) strongly correlate with a poor prognosis. Prolonged capillary refill time (mean increase of 3 seconds), rectal temperature (over 38.5°C), elevated packed cell volume (mean increase of 4%), and blood lactate levels (mean increase of 5 mmol/l) underscore the significance of these markers. Notably, blood lactate (p < 0.001), gut noises (p < 0.05), and heart rate (p < 0.001) demonstrate the highest predictive significance based on statistical analysis. Future research should investigate the prognostic potential of additional parameters and assess the impact of recommended treatments on colic prognosis. This data-driven study emphasizes the critical role of early recognition and thorough assessment in colic cases, offering vital insights into improving equine healthcare and mitigating mortality rates.

Arterial Blood Gas, Electrolyte and Acid-Base Values as Diagnostic and Prognostic Indicators in Equine Colic.

The study aimed to investigate if arterial blood analysis in conscious horses presenting with signs of colic and breathing ambient air had diagnostic or prognostic value. Arterial blood samples from 352 horses presenting with colic at a university equine referral hospital were analysed for pH, partial pressure of carbon dioxide (PaCO2), partial pressure of oxygen (PaO2), concentrations of sodium (Na+), potassium (K+), ionised calcium (Ca2+) and chloride (Cl-), actual and standardised plasma bicarbonate concentration (HCO3- (P) and HCO3- (P, st)), blood and extracellular fluid base excess (Base (B) and Base (ecf)) and anion gap (AG). Results were compared to previously reported values for healthy horses, and comparisons were made between final diagnosis, treatment and survival to hospital discharge. Significant differences were found between colic cases and healthy reference values between some primary aetiologies. Overall, surgical and non-surgical colic cases differed in Ca2+ and Cl- concentrations and Ca2+ differed between cases that survived to discharge and those that did not. PaO2 differed between small intestinal surgical cases that survived and those that did not. From these results, we developed regression models that demonstrated excellent or good predictive value in identifying the likelihood of surgical versus medical management and survival to hospital discharge.

116 Incidence of colic and lunar phase

Equine colic is defined as pain in the abdominal cavity; the etiology is commonly gastrointestinal. There is no known definitive cause, but conditions such as poor forage, poor dentition, parasites, or reduced water intake increase the risk of colic. Previous research on a small scale showed there is a weak but significant increase in the incidence of colic with the waxing gibbous and full moon. The objective of this study was to determine if the association between the incidence of colic and lunar phase was repeatable on a larger scale. Data on yearly equine admissions from Marion duPont Scott Equine Medical Center (2133 admissions) and Cornell University College of Veterinary Medicine Equine Hospital (1429 admissions) was aggregated, and the number of daily colic diagnoses was standardized into the number of daily colic diagnoses per 1000 yearly hospital admissions. Referred colic cases were confirmed by attending veterinarians. The corresponding moon phases were distributed into 3 levels: new moon + 2 d (n = 480), full moon + 2 d (n = 470) and remaining normal days (n = 1,850) and for each phase, the mean number of daily colic diagnoses per 1000 yearly admissions was foundto be 0.294 (SD = 0.478), 0.290 (SD = 0.463) and 0.304 (SD = 0.486), respectively. A priori power analysis showed the sample size was adequate to test the hypothesis (Statistical Power = 80%, α = 0.05). The data were strongly right skewed with multiple outliers, driving the decision to use the median and interquartile range (IQR) to represent the measure of center and dispersion and a Kruskal-Wallis H test for statistical analysis. The distribution of the number of colic cases per day were similar across all moon phases, as assessed by visual inspection of comparative boxplots. For all 3 lunar phases, the median number of daily colic diagnoses per 1000 yearly hospital admissions was 0 (IQR = 0.47). At the 0.05 significance level, there were no significant differences found in the median number of daily diagnoses per 1000 yearly admissions among the 3 lunar phases (χ2(2) = 0.261, P = 0.878). In conclusion, this data does not find an association between the incidence of referred colic cases and lunar phase.

Prevalence of and risk factors associated with Salmonella shedding among equids presented to a veterinary teaching hospital for colic (2013-2018).

Gastrointestinal disease has been associated with shedding of Salmonella with previous studies demonstrating that horses with colic have a higher risk of acquiring and shedding Salmonella organisms. The purpose of this study was to determine the prevalence of and risk factors associated with Salmonella shedding in a colic population at a referral clinic. Retrospective case-control study. For each colic case that was positive for Salmonella (n=56), two colic cases (n=112) that tested negative for Salmonella, were enrolled as controls. Associations between variables and Salmonella shedding were identified using logistic regression. Univariate and multivariable models were developed pertaining to (1) presenting clinicopathological data and (2) clinical variables that developed during hospitalisation. Of the equids presenting with colic, 1585/1917 had a sample submitted for Salmonella testing. Of these, 56 were positive for Salmonella yielding a prevalence of 3.5%. Equids shedding Salmonella were more likely to present in July (odds ratio [OR]=7.2; 95% confidence interval [CI]=1.63-32.13; p=0.009) and present with a history of fever (OR=53.5; 95% CI=2.57-1113.03; p=0.01), increased lactate (OR=1.6; 95% CI=1.14-2.29; p=0.007) and/or neutropenia (OR=0.79; 95% CI=0.65-0.97; p=0.02). Hospitalised equids shedding Salmonella were more likely to be febrile (OR=4.8; 95% CI=1.47-15.8; p=0.01) and 10 times more likely to develop reflux (OR=10.1; 95% CI=1.67-61.43; p=0.01) compared to colic controls. Retrospective nature of the study and bias inherent to the retrieval of data from medical records cannot be discounted. Classifying Salmonella status based on a single sample may have resulted in misclassification bias. The prevalence of Salmonella shedding in this colic population was low compared to earlier reports. Certain predictors such as the development of a fever or reflux in hospitalised colic cases were associated with Salmonella shedding and may help the clinician to promptly identify horses likely to shed; thus, helping institute effective use of barrier nursing precautions.

Clinical and pathological examination of mycotoxicosis as an associated risk factor for colic in equine

A retrospective cohort study was conducted on two Egyptian horse farms with most of horses were suffered from abdominal pain to describe the associations between the occurrence of mycotoxicosis and equine colic. The farms owner complain was an unexpected increase in number of colic cases and deaths among horses. The association between colic and risk factors (sex, type of food either dry or mixed with roughages and hematobiochemical parameters) was compared using independent sample T-test. The associations between possible prognostic indicators for colic caused by mycotoxicosis was estimated using logistic regression analysis model. The cumulative incidence, incidence rates for colic attacks, survival rate among diseased horses were additionally estimated. Our results showed that a total of 24 out of the 132 horses suffered from colic due to feeding of ration contaminated with high percent of mycotoxin including Aflatoxins, Ochratoxins and or fusarium mycotoxins. The total cumulative incidence of colic due to mycotoxicosis was 19.7%. The horses fed on dry rations had more chance of developing colic than horses fed on mixed rations (P < 0.05). The overall incidence rate of colic due to mycotoxicosis was estimated at 18 colic attack/1000 horse/month. The mortality rate of horses suffered from colic due to mycotoxicosis was estimated at 5.9% (5/85), while the case fatality rate was estimated at 25% (n = 5/20). Inconclusion, our results showed that mycotoxicosis are considered an important risks factor for colic cases development in equine practice.

Age-Dependent Intestinal Repair: Implications for Foals with Severe Colic.

Simple SummaryEquine colic places a substantial financial burden on horse owners and the equine industry each year. Equine veterinary research is focused on preventing colic on the farm whenever possible and improving treatment options available to veterinarians in the field and referral hospitals. It is important for scientists to have a detailed understanding of the intestinal damage created by different types of colic in foals and adult horses so they can better target certain cell types or tissue systems when investigating new treatment options. This review article summarizes recent works in the field of intestinal injury research and describes the potential roles of various intestinal systems, such as the enteric nervous system (ENS), in repairing the intestine after colic injury and how these systems mature in early life.Colic is a leading cause of death in horses, with the most fatal form being strangulating obstruction which directly damages the intestinal barrier. Following surgical intervention, it is imperative that the intestinal barrier rapidly repairs to prevent translocation of gut bacteria and their products and ensure survival of the patient. Age-related disparities in survival have been noted in many species, including horses, humans, and pigs, with younger patients suffering poorer clinical outcomes. Maintenance and repair of the intestinal barrier is regulated by a complex mucosal microenvironment, of which the ENS, and particularly a developing network of subepithelial enteric glial cells, may be of particular importance in neonates with colic. Postnatal development of an immature enteric glial cell network is thought to be driven by the microbial colonization of the gut and therefore modulated by diet-influenced changes in bacterial populations early in life. Here, we review the current understanding of the roles of the gut microbiome, nutrition, stress, and the ENS in maturation of intestinal repair mechanisms after foaling and how this may influence age-dependent outcomes in equine colic cases.

Abstract 59 - The impact of COVID-19 on acute urinary stone presentations: A single centre experience

The COVID-19 pandemic has seen a change in the numbers of patients presenting to the emergency department (ED) with non-COVID symptoms, resulting in delayed presentations of many medical and surgical conditions. To examine the impact of COVID-19 on acute urolithiasis presentations to the ED. In this retrospective, single-centre, observational study, we reviewed all CT KUBs (and their corresponding cases) ordered in ED for possible acute urolithiasis in a 100-day period immediately prior to COVID-19 and in a 100-day period immediately afterwards. We sought to establish the number of CT KUBs performed and the number confirming urolithiasis. We recorded patients’ age, gender, stone size and location. We also analysed CRP, WCC and creatinine as well as the duration of patients’ pain and the management strategy adopted for each case. One hundred ninety-eight CT KUBs were performed, 94 pre-COVID and 104 intra-COVID. A total of 70.2% (n = 66) and 66.3% (n = 69) were positive for urolithiasis pre-COVID and intra-COVID respectively (p = 0.56). There was a significantly higher percentage of females pre-COVID compared with intra-COVID (54% vs 36%, p = 0.012). There was no difference in median ureteric stone size seen between the groups (4.7 mm pre-COVID vs 4.0 mm intra-COVID, p = 0.179). There were no significant differences in WCC, CRP or creatinine levels. One patient in the pre-COVID group and two in the intra-COVID groups required percutaneous nephrostomies. The COVID-19 pandemic did not result in fewer or sicker patients presenting with acute ureteric colic cases to the ED.

Therapeutic trial on clinical cases of impactive and spasmodic colic in donkeys in Gondar, northwest Ethiopia

The therapeutic trial was conducted from December 2018 to May 2019 to compare the therapeutic efficacy of different drug regimens in the treatment of impactive and spasmodic colic in donkeys in Gondar, Northwest Ethiopia. Twenty-five purposively selected donkeys were used in this study. Ten of them were showing suspected clinical signs of impactive colic and the remaining ten were with spasmodic colic. The rest five donkeys were kept as control group. For this trial, each disease category was again grouped into two subgroups. The first sub-group in group A with suspected spasmodic colic was treated with ivermectin and, the second sub-group was treated with fenbendazole. Similarly, the first subgroup in group B with suspected impactive colic was treated with meloxicam and the remaining sub-group was treated with hyoscine butyl bromide. Most vital parameters were recorded before and after treatment of colicky donkeys. Feces and blood samples were collected and examined pre and post-treatment from each donkey. Donkeys treated with ivermectin subcutaneously have 97.3% fecal egg count reduction percentage, whereas donkeys treated with fenbendazole orally have fecal egg count reduction percentage of 79.85%. Donkeys treated with meloxicam, most of the clinical signs disappear within 24 hours of time after treatment. Subcutaneous administration of ivermectin was effective for the treatment of spasmodic colic due to Strongyle infestation in donkeys. Therefore, field veterinarians should practice subcutaneous administration of ivermectin and intramuscular administration of meloxicam for effective treatment of spasmodic and impactive colic in donkeys, respectively.

Endoscopic management of biliary ascariasis: A case report

BACKGROUNDBiliary ascariasis is rare but remains the most common parasitic infection in remote areas and in people with poor medical conditions. Here, we reported a case of biliary ascariasis in order to raise awareness of possible parasitic infections. CASE SUMMARYA 68-year-old female was admitted to the emergency room of the Affiliated Hospital of Guizhou Medical University on 28 September 2017, with chief complaint of pain in the right upper abdomen. Ultrasonography of the abdomen showed that the upper segment of the common bile duct was slightly dilated with parallel tubular structures, indicative of biliary ascariasis. Endoscopic retrograde cholangiopancreatography was performed under general anesthesia on 29 September 2017, and an adult Ascaris lumbricoides worm was observed. After the worm was removed from the bile duct, the patient’s pain immediately subsided. The patient was successfully cured, without any complications. CONCLUSIONThis report emphasizes the need for physicians to consider biliary ascariasis as a possible cause when treating cases of biliary colic.

Use of quantitative real-time PCR to determine the local inflammatory response in the intestinal mucosa and muscularis of horses undergoing small intestinal resection.

Studies in rodents and humans have demonstrated that intestinal manipulation or surgical trauma initiates an inflammatory response in the intestine which results in leucocyte recruitment to the muscularis externa causing smooth muscle dysfunction. To examine the intestinal inflammatory response in horses undergoing colic surgery by measuring relative differential gene expression in intestinal tissues harvested from surgical colic cases and control horses. Prospective case-control study. Mucosa and muscularis externa were harvested from healthy margins of resected small intestine from horses undergoing colic surgery (n=12) and from intestine derived from control horses euthanised for reasons unrelated to the gastrointestinal tract (n=6). Tissue was analysed for genes encoding proteins involved in the inflammatory response: interleukin (IL) 6 and IL1β, C-C motif chemokine ligand 2 (CCL2), tumour necrosis factor (TNF), prostaglandin-endoperoxide synthase 2 (PTGS2) and indoleamine 2,3-dioxygenase (IDO1). Relative expression of these genes was compared between the two groups. Further analysis was applied to the colic cases to determine whether the magnitude of relative gene expression was associated with the subsequent development of post-operative reflux (POR). Samples obtained from colic cases had increased relative expression of IL1β, IL6, CCL2 and TNF in the mucosa and muscularis externa when compared with the control group. There was no difference in relative gene expression between proximal and distal resection margins and no association between duration of colic, age, resection length, short-term survival and the presence of pre-operative reflux and the relative expression of the genes of interest. Horses that developed POR had significantly greater relative gene expression of TNF in the mucosa compared with horses that did not develop POR. Small sample size per group and variation within the colic cases. These preliminary data support an upregulation of inflammatory genes in the intestine of horses undergoing colic surgery.

Evaluation of Diagnostic, Prognostic Indicators and Surgical Outcome in 20 Cases Treated for Equine Intestinal Colic

Background: Colic is one of the most common and challenging problem encountered by equine practitioners. In practise majority of horses suffering from colic can be treated with medical management but around 10% of horses with colic require surgical intervention in an effort to save the life of animal. In India, equine abdominal surgery is not popular because there is lack of infrastructure, manpower and expertise therefore, there is a need to conduct clinical studies to document outcome of equine colic cases managed surgically. The present report describes diagnostic, prognostic indicators and post-operative outcome of exploratory celiotomy performed to manage various cases of colic surgical outcome of colic surgery in Indian horse breeds.Methods: The present study was conducted on 20 horses having intestinal colic (n=20). The affected patients were selected for exploratory celiotomy on an emergency basis having moderate to severe persistent abdominal pain, lack of response to medicinal treatment with absence of intestinal borborygmi. Preoperative physical assessment, biochemical analysis and peritoneal fluid analysis were done in all the clinical cases. The preoperative physical assessment and various blood parameter estimation helped in decision making.Conclusion: The result of intestinal colic cases showed that mean heart rate and respiration rate (mean±SE) were significantly higher in non-survivors as compared to survivors. Blood lactate level was significantly higher in non survivors than survivors. Large colon affectation (n=8) were the primary cause of the colic, followed by small colon (n=6), cecum (n=3) and small intestine (n=3). Postoperative complications were peritonitis and ileus (n=6), subcutaneous seroma (n=7), pyrexia (n=4), diarrhoea (n=6). Short term survivability in intestinal colic patients was 55% and long term survivability was 50%.

The impact of COVID-19 on acute urinary stone presentations: a single-centre experience.

BackgroundThe COVID-19 pandemic has seen a change in the numbers of patients presenting to the emergency department (ED) with non-COVID symptoms, resulting in delayed presentations of many medical and surgical conditions.AimsTo examine the impact of COVID-19 on acute urolithiasis presentations to the ED.MethodsIn this retrospective, single-centre, observational study, we reviewed all CT KUBs (and their corresponding cases) ordered in ED for possible acute urolithiasis in a 100-day period immediately prior to COVID-19 and in a 100-day period immediately afterwards. We sought to establish the number of CT KUBs performed and the number confirming urolithiasis. We recorded patients’ age, gender, stone size and location. We also analysed CRP, WCC and creatinine as well as the duration of patients’ pain and the management strategy adopted for each case.ResultsOne hundred ninety-eight CT KUBs were performed, 94 pre-COVID and 104 intra-COVID. A total of 70.2% (n = 66) and 66.3% (n = 69) were positive for urolithiasis pre-COVID and intra-COVID respectively (p = 0.56). There was a significantly higher percentage of females pre-COVID compared with intra-COVID (54% vs 36%, p = 0.012). There was no difference in median ureteric stone size seen between the groups (4.7 mm pre-COVID vs 4.0 mm intra-COVID, p = 0.179). There were no significant differences in WCC, CRP or creatinine levels. One patient in the pre-COVID group and two in the intra-COVID groups required percutaneous nephrostomies.ConclusionThe COVID-19 pandemic did not result in fewer or sicker patients presenting with acute ureteric colic cases to the ED.

Disorders of forestomach in cattle and buffaloes of Haryana

The study was conducted on 5,689 animals (2,163 cattle; 3,526 buffaloes) during July 2016 to June 2017 to understand the epidemiological features of forestomach disorders in cattle and buffaloes. Diagnosis was made on the basis of history, clinical, haemato-biochemical and radiographic examinations. Overall annual incidence of forestomach disorders was 17.82%, significantly more in buffaloes (19.11%) compared to cattle (15.71%). Impaction was the major forestomach disorder with overall annual incidence of 11.37%, with significantly higher incidence in buffaloes (12.16%) than cattle (10.07%). Different forestomach disorders and their respective incidence were: simple indigestion (SI) (2.6% – 2.45% in cattle and 2.69% in buffaloes), colic (0.49% – 0.64% in cattle and 0.39% in buffaloes), tympany (0.79% – 0.87% in cattle and 0.73% in buffaloes), Lactic acidosis (0.38% – 0.55% in cattle and 0.28% in buffaloes), Traumatic pericarditis (1.12% – 0.69% in cattle, 1.38% in buffaloes), foreign body syndrome (FBS) (0.68% – 0.41% in cattle, 0.85% in buffaloes) and diaphragmatic hernia (DH) (0.59% – 0.0% in cattle and 0.59% in buffaloes). Forestomach disorders mainly occurred during summer and rainy season. Impaction, SI and colic cases were mainly observed in initial lactations whereas cases of tympany were higher in between 4th to 6th lactation. DH and FBS were significantly higher in buffaloes compared to cattle (particularly upto third lactation). The present study indicated that impaction, SI, FBS and DH are most prevalent forestomach disorders in Haryana leading to significant production losses. Hence, research on responsible etiological factors and preventive measures is warranted.