Equine Colic Research Articles

Adaptive mechanisms in no flow vs. low flow ischemia in equine jejunum epithelium: Different paths to the same destination.

Intestinal ischemia reperfusion injury (IRI) is a frequent complication of equine colic. Several mechanisms may be involved in adaptation of the intestinal epithelium to IRI and might infer therapeutic potential, including hypoxia-inducible factor (HIF) 1α, AMP-activated protein kinase (AMPK), nuclear factor-erythroid 2-related factor 2 (NRF2), and induction of autophagy. However, the mechanisms supporting adaptation and thus cellular survival are not completely understood yet. We investigated the activation of specific adaptation mechanisms in both no and low flow ischemia and reperfusion simulated in equine jejunum epithelium in vivo. We found an activation of HIF1α in no and low flow ischemia as indicated by increased levels of HIF1α target genes and phosphorylation of AMPKα tended to increase during ischemia. Furthermore, the protein expression of the autophagy marker LC3B in combination with decreased expression of nuclear-encoded mitochondrial genes indicates an increased rate of mitophagy in equine intestinal IRI, possibly preventing damage by mitochondria-derived reactive oxygen species (ROS). Interestingly, ROS levels were increased only shortly after the onset of low flow ischemia, which may be explained by an increased antioxidative defense, although NFR2 was not activated in this setup. In conclusion, we could demonstrate that a variety of adaptation mechanisms manipulating different aspects of cellular homeostasis are activated in IRI irrespective of the ischemia model, and that mitophagy might be an important factor for epithelial survival following small intestinal ischemia in horses that should be investigated further.

Numerical Simulation of Viscosity Effects on Carbon Steel 90° Elbow Erosion due to Sand-Liquid Flow

Elbow pipes are important pipeline components in hydrocarbon transportation systems, and they were prone to erosive wear by the impact of abrasive particles. A discrete phase modeling (DPM) and numerical simulation of the liquid-sand transportation process was carried out focused on the investigation into the influence of carrier fluid viscosity on erosion distribution of carbon steel 90° elbows. The accuracy of the predicted results was validated by comparison with experimental data. CFD simulations have been carried out by combining DPM to predict the erosion rate and particle impaction regions in carbon steel 90° elbow with a diameter of 50.8 mm. The fluid viscosity is set for 1cP, 5cP, and 15 cP with an inlet velocity of 8 m/s, and the size of sand particles is 200 μm. While the maximum erosion rates enhance with an increase in fluid viscosity, the location of maximum particle impaction has been specified to be adjacent to the outlet for 1 cP and 5 cP carrier fluid viscosity. It is also found that increasing the viscosity does not considerably alter the average erosion rate. Moreover, the increase in carrier fluid viscosity with the same flow velocity influences maximum erosion rate and yields 1.45 times higher erosion rates at 15 cP compared to 5cP and 1cP. This is mainly due to severe sand impaction at the side of the elbow wall.

Colic horse: A diagnostic challenge

No conflicts of interest have been declared.

Changes in Oxidative Status Biomarkers in Saliva and Serum in the Equine Gastric Ulcer Syndrome and Colic of Intestinal Aetiology: A Pilot Study.

Simple SummaryGastric ulcers and colic of intestinal aetiology (CIE) are highly prevalent diseases in domestic horses, with a negative impact on equine sport and breeding life. Therefore, the studies investigating possible biomarkers for their diagnosis or clarifying their pathophysiology are of high interest. Oxidative status changes have been reported in both diseases, but only in the blood. However, saliva may be a relevant source of oxidative status biomarkers not yet assessed in horses with interesting advantages, owing to its non-invasive collection. Hence, this study aimed to validate in both saliva and serum automated assays for the measurement of oxidative status biomarkers and assess them in horses suffering gastric ulcer diseases (squamous and/or glandular) and CIE, studying their possible relationship with their inflammatory and immunity status. It was found that horses with glandular mucosa ulcers showed higher levels of some antioxidant and oxidative biomarkers in saliva correlating with a marker of the immune system such as salivary adenosine deaminase. Horses suffering from CIE had increases in serum uric acid associated with their systemic inflammatory response and outcome of the disease. In conclusion, some oxidative status analytes can be automatically measured in horses’ saliva and serum and may potentially be assessed as biomarkers of gastric ulcers and CIE.Changes in the oxidative status of the blood of horses suffering from gastric ulcers and colic of intestinal aetiology (CIE) have been reported. However, saliva can also be a source of biomarkers of oxidative status. Therefore, this study aims to validate automated assays for the measurement of oxidative status biomarkers (ferric reducing ability of saliva/serum—FRAS/FRAP, cupric reducing antioxidant capacity—CUPRAC, the Trolox equivalent antioxidant capacity—TEAC, uric acid, and advanced oxidation protein products—AOPP) in the saliva and serum of horses, to assess their changes in the different ulcer gastric diseases (squamous—ESGD and glandular—EGGD) and CIE, and to evaluate their relationship with serum amyloid A (SAA), adenosine deaminase (ADA), and the systemic inflammatory response syndrome (SIRS) status. The assays showed a low imprecision and good linearity with enough sensitivity in both fluids. In EGGD, higher levels of FRAS, uric acid, and AOPP in saliva were observed compared to the healthy group, correlating with the salivary ADA levels. Horses with CIE showed increases in uric acid concentrations in serum associated with their SIRS status and outcome of the disease. In conclusion, analytes related to the oxidative status can be measured in the saliva and serum from horses by automated assays, and some of them can potentially be assessed as biomarkers in horses with gastric ulcers and CIE.

Investigation of plasma cell-free DNA as a potential biomarker in horses.

Plasma cell-free DNA (cfDNA) is a biomarker of ischemia, systemic inflammation, and mortality in humans with gastrointestinal disease. Cell-free DNA has not been investigated as a biomarker for equine colic, to our knowledge. We hypothesized that cfDNA could be measured accurately in neat equine plasma using a benchtop fluorometer and that plasma cfDNA would be elevated in emergency patients compared to healthy horses. Plasma was obtained from blood collected in Roche DNA stabilizing tubes. We used the Qubit 4 fluorometer and 1× dsDNA HS assay kit to measure cfDNA concentration in neat patient plasma and following DNA extraction of plasma with a commercial kit. Assay precision and linearity of dilution were satisfactory for neat plasma cfDNA, but DNA spike and recovery results were variable. Further, cfDNA concentrations in paired neat plasma and extracted-plasma samples (n = 66) were not correlated. Median extracted-plasma cfDNA was higher in emergency patients (n = 50) and a subgroup of colic patients (n = 36), compared to healthy horses (n = 19). Our results with extracted-plasma samples provide proof of concept for further investigation of plasma cfDNA as a biomarker in horses.

Interpreting abdominal fluid in colic horses: Understanding and applying peritoneal fluid evidence.

Interpreting changes in peritoneal fluid helps clinicians manage colic and other diseases in horses. During abdominal problems in the horse, abdominal fluid characteristics such as color, turbidity, total nucleated and red blood cell counts, cytology, total protein, and l-lactate change in predictable ways, helping the clinician characterize the disease. Normal abdominal fluid in horses is odorless, clear to light yellow in color, and transparent. Peritoneal fluid becomes more turbid with increasing levels of protein, number of WBCs or RBCs, or with gross contamination following intestinal rupture. The color of abdominal fluid will also change with the type and quantity of cells or other elements present. The transformation of peritoneal fluid color from golden to orange to red represents increasing levels of RBCs, common with strangulating intestinal lesions. Serosanguinous defines fluid that is both turbid and orange to bloody because of increased total protein, WBCs, and RBCs, and is considered classic for diseases characterized by intestinal ischemia. Peritoneal fluid may also be red or blood-colored because of a hemoperitoneum, or secondary to blood contamination during sample collection. l-Lactate measurement in the abdominal fluid has proven invaluable for the identification of strangulating intestinal injury. Cytology acts as an important supplement to cell counts in peritoneal fluid, and the normal ratio of non-degenerate neutrophils:mononuclear cells of 2:1 changes during various gastrointestinal diseases. Culture of peritoneal fluid samples should be performed when septic peritonitis is suspected. Abdominal fluid is a sensitive indicator of intestinal injury and a useful tool to direct treatment. Peritoneal fluid evaluation includes gross visual and olfactory examination, nucleated cell count, total protein, RBC count, lactate levels, cytology, and culture. The changes noted in such variables are related to the type and duration of the abdominal problem. Abdominal fluid interpretation has become central to the triage and management of challenging equine colic patients. The transformation of peritoneal fluid color from golden to orange to red represents increasing levels of RBCs, common with strangulating intestinal lesions. Contamination with RBCs at various concentrations may be secondary to vascular (eg, abdominal wall or mesenteric vessels) or splenic trauma during abdominal fluid collection; however, this must be distinguished from orange to red fluid associated with intestinal strangulating obstruction or hemoabdomen Peritoneal fluid analysis reveals abdominal pathology by recognizing specific changes that occur with disease processes affecting the tissues and organs within this cavity. Abdominal fluid examination should be used as a tool to direct treatment rather than the definitive test for diagnosis of the acute abdomen Septic peritonitis in horses most commonly originates secondary to intestinal compromise or accidents (vascular damage, perforation, or surgical manipulation), leading to bacterial translocation into the abdomen.

Survey on the recognition, attitudes, and experience of horse owners during episodes of equine colic in Rio Grande do Norte, Brazil

Horse owners are crucial in recognizing colic because they are responsible for identifying the signs of colic and deciding whether to seek veterinary intervention. Common reasons for delayed response to clinical issues include lack of understanding or knowledge of the subject and difficulty in recognizing subtle clinical signs of abdominal pain. Examining horse owners' basic knowledge of colic, their motivations, obstacles in seeking veterinary care, and their responses to the various clinical symptoms manifested during colic will identify current knowledge gaps and decision-making barriers. This study aimed to examine the experiences, recognition, and attitudes of horse owners during an episode of equine colic in Rio Grande do Norte, Brazil. A cross-sectional study was conducted using questionnaires in Rio Grande do Norte, Brazil. The sample consisted of horse owners, competitors of any equestrian modality (provided that they were responsible for a horse at the time of the application of the questionnaire), or individuals who had previously owned a horse. There were differences related to the recognition and attitudes adopted towards colic in horses compared to the studies performed in other countries. The overall results of this study highlight the need for educational campaigns for horse owners to fill knowledge gaps about colic and the need for a clearer picture of colic, including what it is, the predisposing factors, and the range of symptoms. Additionally, this knowledge will equip horse owners to appropriately respond to these symptoms.

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.

Small intestinal intussusception in horses: Multicentre retrospective report on 26 cases (2009‐2020)

SummaryBackgroundIntussusception is an infrequent cause of equine colic, most commonly encountered in young horses. This condition occurs due to abnormalities of motility and frequently includes the caecum.ObjectivesThe purpose of this study was to review the cases of equine small intestinal (SI) intussusception excluding those with caecal involvement.Study designCase series, analytical retrospective study.MethodsMedical records of all horses that had SI intussusception, not involving the caecum, from three equine clinics between 2009 and 2020 were reviewed. Information obtained included: clinical parameters, surgical or necropsy findings, complications and outcome. The Mann‐Whitney U test was used to compare the outcome and complications with various parameters. Fisher’s exact test was used to compare short‐term survival with categorical variables. Significance was set at p ≤ 0.05.ResultsTwenty‐six horses met the inclusion criteria. Median age of horses was 9 months (interquartile range 2.8 months–6.5 years). Relevant history included diarrhoea and general anaesthesia. Twenty‐two out of 26 horses were diagnosed during surgery and 4 at necropsy. During surgery, 5 horses were subjected to euthanasia, 9 underwent manual reduction and 8 underwent resection and anastomosis. The postoperative complication rate was high at 47% and included ileus, diarrhoea and colic. The prognosis decreased when the involved segment was longer (p = 0.032), lactate levels were higher (p = 0.024) and reflux was present before admission (p = 0.024). Of all horses, 53% survived to discharge and 92% of these survived for &gt;1 year post‐operatively (one case was lost to follow‐up).Main limitationThe retrospective nature of the study and the low number of cases included.ConclusionsSmall intestinal intussusception was diagnosed in horses of a variety of breeds and ages. Alterations of motility can predispose to intussusception, not only due to hypermotility (diarrhoea), but also due to hypomotility (anaesthesia). Prognosis for hospital discharge was fair; however, following hospital discharge, the long‐term survival rate is high and complications are rare.

Evaluierung prognostischer Indikatoren der klinischen Untersuchung sowie eines Scoringsystems für Kolikerkrankungen beim Pferd

In horses, colic is associated with relatively high mortality rates. Identification of parameters associated with poor outcome may aid in providing a more accurate prognosis. This study aimed to assess the early prognostic value towards survival of the horse based on parameters of the clinical examination. In a retrospective study (2013-2017), results of the clinical examination of horses with colic were analyzed. Obtained parameters were categorized from physiologic up to different pathophysiologic manifestations. The risk of death was calculated as odds ratios in comparison to normal values of these parameters. Individual score points were obtained and related to the respective outcome. Cut-off values for prognosis and treatment were calculated to distinguish between outcome and treatment group. A total of 492 colic horses were analyzed, presenting 433 survivors (88 %). Overall, medical treatment was selected in 346 (70.3 %) horses (with 96 % survivors) and surgical treatment (laparotomy) was performed in 146 (29.7 %) horses (69.2 % survivors). An increased likelihood of the outcome "death" was found in horses aged over 20 years (OR = 5.498, p < 0.0005), with colic signs of > 6 hours duration (OR = 3.590, p = 0.035) and, also, for breeds of draft horses (OR = 8.364, p < 0.0005). Horses with significant increases in heart and respiratory rates (OR = 24.294, p < 0.0005 and OR = 20.375, p < 0.0005, respectively) and increased blood lactate concentrations (> 90 mg/dl: OR = 26.390, p < 0.0005) were more likely to succumb to the disease. However, a scoring system failed to show an association between high score points and poor prognosis. Parameters of the clinical examination as well as the history of the patient may be indicative for the patient's outcome. However, no clear-cut distinction of the evaluated parameters towards survival and treatment options was obtained. A careful investigation of the patient remains mandatory for selection of treatment and a proper assessment of prognosis.

↵​Clinical and Haemato-biochemical Studies on Gastro-intestinal Colic in Horses

Background: Colic is an important disease of horses. It is a multifactorial and complex disorder. Colic remains one of the common causes of death in horses therefore in present investigation, clinical and haemato-biochemical changes associated with GI colic in horses were studied. Methods: Total 105 horses were examined to study the clinical and haemato-biochemical parameters in colicky horses in southern part of Rajasthan. Result: Mean respiration rate, pulse rate and capillary refill time was found to be significantly increased in horses affected with colic than healthy control animals (P less than 0.05). In haematological indices, mean packed cell volume was significantly increased in colic affected horses (P less than 0.05) whereas mean total platelet count and mean lymphocyte count was found to be significantly decreased (P less than 0.05). In serum biochemical indices, serum aspartate amino transferase, serum alanine amino transferase, blood urea nitrogen, serum creatinine, serum glucose, serum albumin, serum total protein, serum alkaline phosphate and blood lactate were found to be significantly increased in horses affected with colic than healthy control group (P less than 0.05).

Owners' Knowledge and Approaches to Colic in Working Equids in Honduras.

Simple SummaryThere are approximately 275,000 equids in Honduras, with many providing tractional assistance to human lives and livelihoods. The aim of this study was to define the role and improve the welfare of working equids through obtaining a baseline understanding of equine colic or ‘abdominal pain’ in the Choluteca region of Honduras. The objectives were: to explore owners’ current understanding of colic in Honduras through questionnaires and to identify knowledge gaps where educational materials could benefit owners and working equid welfare. Ninety-three verbal questionnaires were conducted with owners from eleven different communities in the Choluteca region on their use of working equids and knowledge and treatment of colic. Additional context was gained through observations and verbal questionnaires with three veterinary practitioners and eight agricultural pharmacy (agrovet) store owners. Equids played a role in firewood collection, the transportation of people, and carrying crops. Most owners with previous experience of colic had treated it themselves, typically using their own remedies. Owners with prior knowledge or experience of colic expressed concern about the condition. Across all stakeholders, knowledge and understanding of colic varied, and access to evidence-based treatments for owners was very limited. Areas for improving education on equine colic were highlighted in this study.In Honduras, many families are reliant on working equids in their daily life. The aim of this study was to evaluate knowledge about, and approaches to colic used by owners of working equids in Choluteca, Honduras using a phenomenological approach. Semi-structured, verbal questionnaires were conducted with ninety-three owners from eleven different communities in the Choluteca region on equid horse owners’ knowledge of colic and treatments. Additional context was gained through observations and verbal questionnaires with three veterinary practitioners and eight agricultural pharmacy (agrovet) store owners. Working equids were commonly used for firewood collection 31% (40/126), transportation 24% (30/126), and carrying crops 13% (17/126). Thirty-eight percent of owners (35/92) said they did not know what colic was, 27% (24/89) could not name any clinical signs, and 46% (42/92) could not name any causes. Most owners with previous experience of colic had treated it themselves 79% (53/67), typically using herbal remedies. Colic was a major concern for owners of working equids who had prior experience or knowledge of the condition. Knowledge and understanding of colic varied, and access to evidence-based treatments was very limited. The findings will be used to inform the development of educational resources on colic in working equids.

Evaluation of Plasmatic Procalcitonin in Healthy, and in Systemic Inflammatory Response Syndrome (SIRS) Negative or Positive Colic Horses.

Simple SummaryProcalcitonin (PCT) increased in the case of systemic inflammatory response syndrome (SIRS), especially due to bacterial infection. The correlation between SIRS score and plasma PCT levels in horses have not been evaluated, and no studies investigated plasma PCT concentration over time. In the present study, PCT and SIRS score were evaluated in colic horses at admission to the hospital and at 24, 48, 72 and 96 h. Statistically differences were detected between healthy vs. all colic horses and between healthy vs. SIRS positive or SIRS negative horses. No correlation was observed between SIRS score and PCT. This suggests a role of plasmatic PCT as good biomarker for colic.Colic horses show systemic inflammatory response syndrome (SIRS) clinical signs. Procalcitonin (PCT) showed increased circulating levels in sick horses. This study compares plasma PCT concentrations in healthy vs. SIRS negative/positive colic horses over time, and evaluates PCT and SIRS score potential correlation, to verify the usefulness of PCT for the evaluation of SIRS severity. Ninety-one horses were included; 43/91 were healthy, on basis of physical examination, blood work and SIRS score (score = 0), while 48/91 were sick colic horses, classified as SIRS-negative (score < 2) and positive (score ≥ 2). Moreover, a 0–6 point-scale SIRS score was calculated (assessing mucous membrane color and blood lactate concentration). PCT was evaluated at admission, and at 24, 48, 72 and 96 h, using a commercial kit for equine species. We verified by the ANOVA test PCT differences between healthy vs. colic horses, healthy vs. SIRS-negative or SIRS-positive colic horses, at all sampling times, and the correlation between the SIRS score at admission with the SIRS score. Statistically significant differences were detected between healthy vs. all colic horses and between healthy vs. SIRS-positive or negative horses at all sampling times. No correlation was observed between the SIRS score at admission and PCT values. PCT was statistically higher in colic horses compared to the healthy ones, suggesting a role as a biomarker for colic.

Performance of the Parasympathetic Tone Activity (PTA) index to predict changes in mean arterial pressure in anaesthetized horses with different health conditions

The parasympathetic tone activity (PTA) index is based on heart rate variability and has been developed recently in animals to assess their relative parasympathetic tone. This study aimed to evaluate PTA index in anaesthetized horses with different health conditions and the performance of PTA variations (∆PTA) to predict changes in mean arterial pressure (MAP).Thirty-nine client-horses were anaesthetized for elective or colic surgery and divided into “Elective” and “Colic” groups. During anaesthesia, dobutamine was administered as treatment of hypotension (MAP <60 mmHg).In both groups, no significant variation of PTA and MAP were detected immediately before and after cutaneous incision. The PTA index increased 5 min before each hypotension, whereas it decreased 1 min after dobutamine administration. Horses of the Colic group had lower PTA values than those of the Elective group, whereas MAP did not differ between groups. To predict a 10% decrease in MAP, ΔPTA performance was associated with: AUC ROC [95% CI] =0.80 [0.73 to 0.85] (p < 0.0001), with a sensitivity of 62.5% and a specificity of 94.6% for a threshold value of 25%.The PTA index in anaesthetized horses appears to be influenced by the health condition. The shift toward lower PTA values in colic horses may reflect a sympathetic predominance. An increase in PTA of >25% in 1 min showed an acceptable performance to predict MAP decrease of >10% within 5 min. Even though these results require further evaluation, this index may thus help to predict potential autonomic dysfunctions in sick animals.

Use of a polyethylene glycol solution for the management of sand impaction in three dogs

AbstractThree dogs were hospitalized for management of acute gastrointestinal signs secondary to sand impaction. Hospitalized care with administration of a polyethylene glycol (PEG) solution via nasogastric tube. Variable PEG solution doses were used in these dogs (range 72–109 ml/kg). All patients tolerated PEG administration without adverse effects. Two dogs had additional radiographs performed, consistent with radiographic improvement of impaction. Each dog had marked clinical improvement and was successfully discharged from the hospital.

Renal Resistive Index as A Potential Indicator of Acute Kidney Injury in Horses

Reliable and simple tests are constantly being sought to enable the quick detection of acute kidney injury in humans and animals. Diagnosis of subclinical AKI in horses, mainly in field practice, is difficult. An ultrasound scan is a routine test performed when kidney disease is suspected. The aim of the study was to establish the value of the renal resistive index (RRI) in intrarenal arteries in horses with clinical AKI and compare it to that of healthy horses. The second goal was to determine whether potentially nephrotoxic agents can influence RRI. The kidney ultrasonography examination was performed in 30 healthy horses, 11 horses with AKI and 30 horses at risk for AKI (10 colic horses, 10 horses receiving gentamicin and 10 horses receiving NSAIDs). RRI values were measured using pulsed-wave Doppler. Differences in RRI between groups were observed only in the right kidney. Horses with AKI had significantly higher RRI values compared to healthy horses. In the risk group, there was no effect of potentially nephrotoxic agents on the RRI value. RRI value in horses seem to be lower than in other species. The increase in this parameter in horses with AKI affected only one kidney and these values did not reach values obtained in other species. The clinical application of this method in non-cooperating animals remains questionable, and therefore RRI Doppler ultrasonography of blood flow in the intrarenal arteries may have poor clinical utility as a diagnostic tool in the diagnosis of AKI in horses.

A Pilot Randomised Clinical Trial Comparing a Short-Term Perioperative Prophylaxis Regimen to a Long-Term Standard Protocol in Equine Colic Surgery.

Background: For surgical interventions classified as clean or clean-contaminated, including laparotomy, guidelines in human and veterinary medicine recommend a short-term perioperative antibiotic prophylaxis (PAP). In equine colic surgery, however, PAP commonly exceeds 24 h. Objectives: The aim of this study was to compare a single-shot to a 5-day lasting PAP considering surgical site infections (SSI) and other adverse effects probably associated with the particular antimicrobial regimen. Study design: The study was designed as a randomised non-inferiority pilot study including horses subjected to colic surgery while receiving one of two distinct PAP regimens. Methods: All horses (n = 67) included in the study received the standard physical examination before and after surgery. Colic surgery was performed according to the current standard of the clinic. Horses were randomly assigned to two groups, receiving either the “single-shot” or the “5-day lasting” antibiotic prophylaxis. The “single-shot” group (n = 30) received penicillin and gentamicin only once before and, if needed, during surgery, whereas the “5-day lasting” group (n = 37) received antibiotics for five days. In addition to the standard laboratory examinations, serum amyloid A and fibrinogen were determined preoperatively and during five days after surgery. SSI, postoperative colitis and haemolytic anaemia were classified as postoperative complications potentially related to antibiotic use. Results: The outcome of this preliminary non-inferiority clinical trial showed that the occurrence of postoperative adverse events (i.e., SSI, postoperative colitis and haemolytic anaemia) lacked significant differences between the study groups. Main limitations: The main limitations of this study are the limited group sizes and our inability to blind the study. Conclusions: Single-shot PAP seems to be an alternative approach considering the 5-day lasting protocol commonly used in equine abdominal surgery. However, a proper hygiene management together with a close clinical and laboratory monitoring of the equine patient is indispensable.

Evaluation of Clinical, Laboratory and Ultrasonography Variables as Prognostic Indicators in Equine Colic Surgery

Background: Equine colic surgery is an expensive procedure and availability of reliable prognostic indicators aid in decision making process. This study aimed to evaluate clinical, hemato-biochemistry, ultrasonography, surgery and peritoneal cytology / intestinal histology as prognostic indicators (based on strangulating vs non-strangulating lesion) for equine colic surgery. Methods: Fifteen equines {13 females and 2 males; 5 Thoroughbred, 9 Marwari and one mule} operated for intestinal colic were investigated. The feeding history, pre and post-surgery clinical, hematological and biochemical findings were recorded. Pre and post-surgery ultrasonography, peritoneal cytology and intestinal histology were done. Three equine were euthanized intra-operatively and 12 were followed for short and long term outcome. Result: On surgery, three equine were diagnosed for strangulating (right dorsal displacement of large colon, large colon volvulus and small colon strangulation) and 12 for non-strangulating colic {impaction (3), fecalith (5), sand colic (2), foreign body (1) and small intestine ileus (1)}. Detection of polymorphonuclear cells alone or with lymphocytes on peritoneal fluid cytology was indicator of good prognosis. Feeding of wheat straw is major predisposing factor for non-strangulating colic in Marwari breed but had favorable surgical prognosis (7/9=77.78%). While Thoroughbreds, not on wheat straw, are susceptible to strangulating colic that require early referral for favorable surgical outcome. Prolonged capillary refill time, injected mucous membranes, absent borborygymi, high serum creatine kinase and glucose are poor prognostic indicators for colic surgery. Thoroughbred equine with severe pain, elevated levels of Hb, neutrophils, packed cell volume (PCV), serum glucose and low peritoneal total protein are indicators of strangulating lesion. The equine colic surgery bears a very good short term (10/12=83.33%) and excellent (10/10=100%) long term outcome.

MMP-9 Concentration in Peritoneal Fluid Is a Valuable Biomarker Associated with Endotoxemia in Equine Colic.

The purpose of the study was to compare the results of sepsis scoring (clinical examination and clinical pathology) to the concentrations of matrix-metalloproteinases (MMPs) -2, -8, and -9; tissue-inhibitor of metalloproteinases (TIMPs) -1 and -2; and inflammatory chemokines interleukin (IL) 1β and tumor-necrosis-factor-alpha (TNF-α) in plasma and peritoneal fluid of equine colic patients. A modified sepsis scoring including general condition, heart and respiratory rate, rectal temperature, mucous membranes, white blood cell count (WBC), and ionized calcium was applied in 47 horses presented with clinical signs of colic. Using this scoring system, horses were classified as negative (n = 32, ≤6/19 points), questionable (n = 9, 7-9/19 points), or positive (n = 6, ≥10/19 points) for sepsis. MMPs, TIMPs, IL-1β, and TNF-α concentrations were evaluated in plasma and peritoneal fluid using species-specific sandwich ELISA kits. In a linear discriminant analysis, all parameters of sepsis scoring apart from calcium separated well between sepsis severity groups (P < 0.05). MMP-9 was the only biomarker of high diagnostic value, while all others remained insignificant. A significant influence of overall sepsis scoring on MMP-9 was found for peritoneal fluid (P = 0.005) with a regression coefficient of 0.092, while no association was found for plasma (P = 0.085). Using a MMP-9 concentration of >113 ng/ml in the peritoneal fluid was found to be the ideal cutoff to identify positive sepsis scoring (≥10/19 points; sensitivity of 83.3% and specificity of 82.9%). In conclusion, MMP-9 was found to be a biomarker of high diagnostic value for sepsis and endotoxemia in equine colic. The evaluation of peritoneal fluid seems preferable in comparison to plasma. As abdominocentesis is commonly performed in the diagnostic work-up of equine colic, a pen-side assay would be useful and easy-to-perform diagnostic support in the decision for therapeutic intervention.

Clinical-diagnostic significance of the level of lactacidemia in horse colic

Clinical-diagnostic significance of the level of lactacidemia in horse colic