Compared to the recent reports, the proportion of horses alive at hospital discharge was lower for both medically and surgically managed horses with cecal impaction. There was decreased survival for horses treated medically than those treated surgically; however, no significant difference was seen in survival between horses managed with typhlotomy alone versus jejunocolostomy.
Results suggested that coughing is a common complaint in mature nonracehorses with epiglottic abnormalities. Therefore, upper airway endoscopy is recommended in the evaluation of older horses with a cough. Surgical treatment can be beneficial in most horses, with some requiring further postoperative medical treatment.
Summary
Three Standardbred foals, a colt approximately one month old and 2 fillies approximately 4.5 months old, from the same farm, presented to University of Pennsylvania's New Bolton Centre over the course of 3 months for further evaluation due to acute onset of colic. All foals had a history of diarrhoea prior to presentation. On presentation, the foals had abdominal distension, dull demeanour and repeatedly lay down and rolled. Exploratory celiotomy revealed a segment of stenotic (lumen diameter 1–4 mm) small colon with marked distension of the colon proximal to the stenotic segment. Post mortem examination of the foals confirmed stenosis of the small colon with a segment of ulcerative colitis associated with the stenotic region. An aetiological agent was not identified.
Objective: To determine serum amyloid A (SAA) concentrations in the postoperative (PO) colic horse and its association with PO complications and infection. Study design: Prospective case series. Animals: Fifty-one horses after colic surgery. Methods: Blood samples from horses undergoing exploratory celiotomy were analyzed for quantitative SAA and fibrinogen concentrations and for neutrophil count at days 0, 1, 2, and 4-6 and at hospital discharge. Results: Complications developed in 35 (69%) horses and included PO colic (n = 13, 25%), PO reflux (n = 11, 22%), intravenous catheter (IVC) complications (n = 11, 22%), low-grade fever (n = 11, 22%); surgical site infection (SSI; n = 9, 18%), high-grade fever (n = 7, 14%), and diarrhea (n = 4, 8%). There was an association between day 2 SAA and PO colic (P = .004), diarrhea (P = .042), IVC complications (P = .008), and PO reflux (P = .008) as well as day 4-6 SAA and PO colic (P = .004) and diarrhea (P = .018). Discharge SAA concentration was associated with SSI (P = .001). Fibrinogen concentrations at days 4-6 and at discharge were associated with PO colic (P = .003), diarrhea (P = .004), IVC complications (P = .002), and PO reflux (P = .023). No differences were seen in SAA, fibrinogen, or neutrophils between horses with PO infection vs those with non-infection-associated complications. Conclusion: Serum amyloid A was markedly increased in the PO period in all horses but did not differ between PO infection and noninfection complications. The amount of inflammation associated with PO colic and colic surgery was high and may have affected the predictive value of SAA for early PO infection. Clinical significance: Although increases occurred earlier, measurement of SAA with a point-of-care analyzer may not be a more sensitive indicator of infection in the early PO colic horse than fibrinogen concentration. Serum amyloid A may help detect SSI in the late PO period.
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