SUMMARYA retrospective study was carried out of 224 horses operated for strangulating small intestine obstructions. Fiftyfour horses were euthanized and 5 horses died during surgery which means that 165 (73%) were allowed to recover. Of these, 53 horses were euthanized or died in the clinic and 112 (50%) were discharged from the hospital. Of 90 horses available for follow-up 1 year postoperatively, 76 (84%) were still alive. The most important causes of death or reasons for euthanasia in the direct post-operative period were post-operative paralytic ileus, (adhesive) peritonitis and intra-abdominal haemorrhage. After discharge from the hospital the reasons were (adhesive) peritonitis and (recurrent) colic. Of the horses which survived for at least 1 year, 16% sometimes suffered from colic, 12% experienced problems with incisional woundhealing and 4% suffered from jugular vein thrombosis. All were in good or reasonable condition and 88% performed at (approximately) the same level as before the operation. The type of surgical intervention (i.e. enterotomy, enterectomy) did not significantly influence the outcome of surgery, whereas the type of anastomosis did. End-to-end jejunojejunostomy had a better prognosis than side-toside jejunocaecostomy.It was concluded that strangulating obstructions of the small intestine still carry a poor to guarded prognosis.Mortality was highest in the direct peri-operative period.Once discharged from hospital, prognosis can be considered to be fair to good. Attempts to improve outcome should be directed at a better handling of the ileal stump during surgery and at the prevention of post-operative ileus and the formation of adhesions.

Summary Reasons for performing study: Intra‐abdominal ligation/transection of the spermatic cord may result in necrosis of the testis; castration of abdominal cryptorchids via laparoscopy has therefore become common. Notwithstanding some adaptations of the technique, a small percentage of operations fail, prompting research into the anatomical background and clinical relevance of the procedure. Hypothesis: That an alternate blood supply may prevent complete necrosis of the testis after spermatic cord transection. Objective: To establish the prevalence of the problem in normal and cryptorchid stallions. Methods: In a preliminary study, the spermatic cords of 8 normal stallions were ligated and transected at different sites and in various manners. Five weeks later the testes were removed and the vitality of both the testes and epididymes was evaluated. In a prospective clinical trial, intra‐abdominal spermatic cord transection was performed in 241 cryptorchid and normal stallions. In cases of surgical failure, the testes were removed and histology performed. Results: Examination of the specimen removed from the 8 animals of the preliminary study revealed that all epididymes were completely or largely spared. All except one testis were completely necrotic. In the patients that underwent surgery all abdominally retained testes (n = 123) were necrotic, while 5 out of 88 inguinally retained and 8 out of 236 normally descended testes had partially survived. The pattern of survival differed between inguinally retained and normally descended testes. The epididymes of these 13 horses were (largely) vital. The (partial) survival of the epididymes and inguinally retained testes was ascribed to an alternate blood supply via anastomosing vessels derived from the cremasteric artery. A tributary from the external pudendal artery was considered responsible for the partial survival of normally descended testes. Conclusions and potential relevance: After intra‐abdominal transection of the entire spermatic cord, 5.6% of inguinally retained and 3.4% of normally descended testes failed to become completely necrotic, as a result of an alternate blood supply via the cremasteric and/or external pudendal artery. Therefore, laparoscopic castration without orchidectomy cannot be recommended as a trustworthy method for castration of inguinal cryptorchids and normal stallions.

Serial peri-operative plasma and serum samples from 55 horses suffering from acute abdominal disease and presented for surgical intervention were assayed for the presence of endotoxins (lipopolysaccharides; LPS), tumor necrosis factor (TNF) and interleukin-6 (IL-6). At study entry, venous blood was collected for blood cultures. Intra-operatively collected ascitic fluid samples were assayed for the presence of LPS. The clinical course of the disease was documented. Four horses were excluded from the study. At study entry, 21 of the 51 horses (41%) had increased platelet-rich plasma LPS concentrations, i.e. ≥ 5 ng/l (mean 35.5; range 7-197 ng/l), in 34 horses (67%) IL-6 concentrations were increased, i.e. exceeding 35 ng/l (mean 364; range 36—1762 ng/l). Detectable TNF was present in 5 horses (10%); 3 of them died spontaneously during surgery. In all TNF positive samples, markedly increased LPS and IL-6 concentrations were detected. Study entry IL-6 concentrations were significantly higher in non-surviving (mean 394; range < 20—1762 ng/l) than in surviving horses (mean 116; range < 20—894 ng/l; P < 0.0002). This was most evident when non-surviving horses with inflamed bowel disease were considered (mean 1096; range 650—1762 ng/l; P < 0.0001). Positive ascitic fluid LPS concentrations (≥ 3 ng/l) were encountered in 18 horses. There was no significant correlation between the LPS concentrations in ascites and plasma. Study entry concentrations of IL-6 were significantly correlated with LPS concentrations (r = 0.62; P < 0.001) and were inversely correlated with platelet counts (r = -0.46; P < 0.002). The magnitude of a calculated LPS-cytokine score strongly correlated with mortality (P < 0.001). Receiver operating characteristic (ROC) curve analysis showed that the IL-6 assay had reasonable accuracy for the prediction of unfavorable outcome (i.e. the area under the curve equalled 0.72), in contrast to the LPS assay. The results indicate that LPS, TNF and IL-6 are predominantly released in the systemic circulation of horses suffering from inflamed and ischemic bowel disease. IL-6 concentrations have predictive value for unfavorable outcome and the simultaneous presence of increased LPS, TNF and IL-6 concentrations is especially associated with a poor clinical condition and outcome.The clinical signs culminating in equine acute abdominal disease range widely, from mild symptoms to fulminant shock with profound metabolic and respiratory acidosis, hypotension, and hypovolemia with death ocat RYERSON UNIV on June 18, 2015 ini.sagepub.com Downloaded from

Summary During a seven year period, 51 cases of acquired inguinal herniation in 50 stallions were treated surgically. In 25 cases the herniated loop was ileal, in the other 26 it was jejunal. In cases of strangulation, the vaginal ring was enlarged by incising the peritoneum and transverse fascia. Closure of the superficial inguinal ring was advisable to prevent the hernia recurring. In all cases unilateral castration was performed. Laparotomy was carried out in 33 cases; 22 required intestinal resection and in four cases a bypass was made. Follow‐up at least six months postoperatively indicated that surgery had been successful in 76 per cent of the cases treated.

Summary During a 3-year period 21 horses were surgically treated because of large abdominal wall defects. In each case the defect was bridged with a polypropylene mesh, which was placed on the outside of the hernial ring. This was in contrast with the technique for mesh herniorrhaphy generally described in human and veterinary literature, in which the mesh is always implanted on the inside of the hernial ring. One horse was destroyed on the first postoperative day because of postanaesthetic myelomalacia. Surgical repair as described was successful in 18 patients. Recurrence of herniation occurred in two horses. On re-herniorrhaphy a second and larger mesh was successfully implanted.