Objective To review the veterinary literature regarding healing and complications associated with equine celiotomy including anatomy and physiology, risk factors for incisional infection and hernia, and treatment. Etiology Celiotomy is the most common approach to treat horses with surgical colic. Incision through the linea alba provides exposure to most of the abdomen for exploration, exteriorization, and correction of surgical lesions. Incisional apposition relies on suture strength during anesthetic recovery and for the first 30 days postoperatively. Factors associated with the patient, surgical lesion and procedures, anesthesia, and recovery put the horse at risk for surgical site infection. Infection is the most important risk factor for incisional hernia formation. Diagnosis A presumptive diagnosis of surgical site infection is made based on the presence of fever and incisional swelling, pain, and discharge. Ultrasonography can be used to identify areas of fluid accumulation prior to the appearance of incisional drainage. Definitive diagnosis is based on positive bacteriologic culture of the incisional discharge. Incisional hernia is diagnosed by palpation of the incision, usually 30–60 days after surgery. Ultrasound of the incision may aide in early diagnosis of incisional hernia if gaps along the incision in the linea alba are apparent. Therapy No objective data exist to assess the efficacy of specific therapies for surgical site infections following celiotomy. Principles of treatment include the establishment of drainage, bandaging, antimicrobial therapy based on culture and sensitivity, and extended rest in an attempt to avoid incisional hernia or dehiscence. Treatment for incisional hernia includes prolonged circumferential bandaging, open or minimally invasive hernia repair, or no treatment. Prognosis Incisional complications are associated with prolonged convalescence and diminished prognosis for return to athleticism. Limiting risk factors for surgical site infections, prompt treatment, and incisional support may optimize celiotomy healing and timely return to function. Horses compete in many disciplines with incisional hernias.

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Summary This case report describes an unusual case of anaerobic peritonitis in a 2‐year‐old horse following castration. The horse was evaluated 2 weeks following castration for signs of acute, severe abdominal pain and swelling surrounding a previous castration site. Physical examination revealed marked scrotal and ventral abdominal oedema that was cool and crepitant upon palpation. Ultrasonographic evaluation was unrewarding because gas shadowing distributed throughout the subcutis prevented imaging of the abdominal cavity. Ventral midline celiotomy revealed a copious amount of malodorous, serosangious, cloudy peritoneal fluid that was submitted for culture. Abdominal exploration revealed the gastrointestinal tract to be in its anatomically correct position. There was diffuse petechiation of the small intestine and large intestine, oedema and crepitant swelling surrounding the left inguinal ring and body wall. The abdomen was lavaged with 10 l of sterile saline prior to closure of the celiotomy and the left castration incision was opened digitally, releasing a large volume of serosanguinous fluid and gas that flowed freely from the incision site and deeper inguinal tissues. The horse was placed in the recovery box where it suffered cardiac arrest. Culture of the peritoneal fluid revealed heavy growth of Clostridium septicum. This case of anaerobic peritonitis represents an unusual complication following castration not previously reported in the horse.

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Low motion joints have significantly higher concentrations of Dkk-1 compared to high motion joints. Further research is needed to establish the importance of this finding and whether potential diagnostic or therapeutic applications of Dkk-1 exist in the horse.