A retrospective study was performed of 181 horses that underwent an exploratory celiotomy because of acute abdominal disease. Forty‐four horses died or were euthanized during surgery. Of the 137 horses that recovered from anesthesia, 72 died of associated diseases or complications, 86 were discharged from the hospital of which 60 survived at least 7 months. Horses with disorders affecting the small intestine had a significantly lower survival rate. Causes of death early in the postoperative period included long bone fracture, shock, ileus, gastric rupture, and peritonitis. After discharge from the hospital, deaths were attributed to colic of unknown cause, malabsorption syndrome, adhesive small bowel obstruction, small and large intestinal volvulus, perforated bowel, and laminitis. Of the 60 horses that were alive at the time of survey, 93.3% had returned to their previous use. A second occurrence of the initial acute abdominal disease was not documented in any horse.
This study compared the severity of ischemic injury to the equine jejunal mucosa caused by arteriovenous obstruction (AVO) or venous obstruction (VO) with that caused by reperfusion after ischemia. The degree of mucosal damage and regeneration was scored according to a modified version of an established light microscopic classification for ischemic injury. Biopsy specimens taken after 3 and 4 hours of obstruction, and after 3 hours of obstruction and 1 hour of reperfusion, were compared. There were no changes in the severity of mucosal injury (characterized by epithelial sloughing, loss of villus architecture, and necrosis of crypt cells) at 4 hours of ischemia when compared with 3 hours of ischemia. The mucosal injury score increased by one grade in three of six and five of eight segments during reperfusion for the VO and AVO models, respectively; however, only the scores for the AVO model were significantly different from the injury caused by ischemia alone. Modification of reperfusion injury was attempted by the administration of intravenous (IV) allopurinol, dimethyl sulfoxide (DMSO), or intraluminal oxygen insufflation at the time of release of the AVO and VO. Treatments did not significantly alter either the severity of injury noted after 1 hour of reperfusion or the degree of mucosal regeneration after 48 hours of reperfusion. In this group of ponies, the severity of mucosal damage was greater after 1 hour of reperfusion for both AVO and VO.
Future research investigating distal limb system function as a whole should help refine clinical diagnostic procedures and exercise training approaches that will lead to more effective prevention and treatment of digital flexor tendon injuries in equine athletes.
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