Prevention of ischaemia-induced small intestinal adhesions in foals.

REASONS FOR PERFORMING STUDY: Treatments addressing variously theorised pathophysiological mechanisms of small intestinal adhesions have been reported. This study applied those classes of treatments to the most clinically relevant aetiology of post operative adhesions. HYPOTHESIS: Treatments addressing the pathophysiology of ischaemia-reperfusion induced adhesions would accordingly reduce the incidence of adhesions from this model. METHODS: Four classes of treatments were administered for 72 h to 16 foals subjected to complete ischaemia followed by reperfusion to create peritoneal adhesions. These groups were: 1) FPG group--flunixin meglumine (1.1 mg/kg bwt i.v., divided q.i.d.), potassium penicillin G (22,000 iu/kg bwt i.v., q.i.d.) and gentamicin (2.2 mg/kg bwt i.v., t.i.d.); 2) HEP group--heparin (80 iu/kg bwt subcut., b.i.d.); 3) DMSO group--dimethylsulphoxide (DMSO) (20 mg/kg bwt [diluted in 500 ml normal saline] i.v., b.i.d.); and 4) SCMC group--sodium carboxymethylcellulose (500 ml 3% sterile solution intraperitoneally, administered only at the beginning of surgery). RESULTS: Post operative intestinal obstruction did not occur in any foal. After 10 days, necropsy revealed bowel-to-bowel adhesions in none of the FPG or DMSO groups, in 2/4 of the SCMC group, in 3/4 of the HEP group and 5/6 foals subjected to the procedure without treatment (UIR group). CONCLUSIONS: Inhibition of the inflammation associated with ischaemia and reperfusion in foals treated with FPG or DMSO decreased small intestinal adhesions in foals. POTENTIAL RELEVANCE: Although anti-inflammatory therapy was shown to eliminate bowel-bowel adhesions in this controlled study, it must be remembered that clinical cases are without control. These therapies are advised to improve the result but are unlikely to eliminate the problem.

The effects of corticosteroid administration on the migration, phagocytosis and bactericidal capacity of equine neutrophils.

Neutrophil function was evaluated in six clinically normal adult horses, immediately before and 3-6 hours after they were given one dose of hydrocortisone sodium succinate (1 mg/kg body weight). Random migration, stimulated migration to zymosan-activated serum, bacterial phagocytosis and bactericidal capacity of neutrophils were determined in vitro. The mean indices of stimulated migration (net migration and migration ratio) were significantly greater after CS administration (net migration = 62 +/- 23 micron; migration ratio = 11.5 +/- 6.7) than before CS administration (net migration = 44 +/- 10 micron; migration ratio = 6.0 +/- 3.1; P less than 0.05). Random migration, bacterial phagocytosis and bactericidal capacity of neutrophils were unchanged by CS therapy. Results from this study suggest that the migration of equine neutrophils is influenced, but not impaired, after one dose (1 mg/kg) of hydrocortisone sodium succinate and that the latter causes no change in the ability of equine neutrophils to phagocytize and kill Staphylococcus aureus.

Assessment of neutrophil migration, phagocytosis and bactericidal capacity in neonatal foals.

Comparison of neutrophil function was made between 8 clinically normal pony foals (3 to 7 days of age), and their dams. Random migration, stimulated migration to zymosan-activated serum, bacterial phagocytosis and bactericidal capacity of neutrophils were determined in vitro. Random migration was greater (P less than 0.01) and stimulated migration was less (P less than 0.01) in foals than in their dams. Bacterial phagocytosis and bactericidal capacity of neutrophils were not different (P greater than 0.05) between foals and mares. Results of this study suggested that neonatal foals have altered neutrophil locomotion, when compared to their dams.

Evaluation of granulocyte transfusion in healthy neonatal pony foals.

Granulocyte transfusions (GT), 0.98 X 10(9) neutrophils/kg of body weight, were performed on 7 healthy pony foals between 2 and 7 days old. The mean neutrophil count of the foals was significantly (P less than 0.05) greater than base line (4,830 +/- 1,260/microliter) 1 hour after GT (8,870 +/- 3,350/microliter) and was similar to base line by 15 to 18 hours after GT (6,550 +/- 2,310/microliter). Leukocyte concentrates (LC) used for GT were harvested from clinically normal adult horses by continuous-flow centrifugation leukapheresis (CL), 3 to 6 hours after hydrocortisone sodium succinate was administered to increase the blood neutrophil count. The mean neutrophil count of the LC used for GT was 68,050 +/- 13,990/microliter, and the mean LC volume was 377.4 +/- 79.2 ml (14.82 +/- 3.54 ml/kg). The mean time required to collect the LC used for GT was 232.1 +/- 73.4 minutes. Neutrophils from LC had significantly reduced in vitro stimulated migration to zymosan-activated serum, when compared with peripheral blood neutrophils of the donors (P less than 0.05). Neutrophil phagocytosis and bactericidal capacity were not significantly changed in LC. Mean neutrophil migration indices were not significantly different in foals after GT. Mild depression and transient diarrhea was noticed in 1 foal 30 minutes after the start of the GT. The donor of LC for this foal and 1 other donor experienced depression, piloerection, and muscle tremors during CL, indicating that complement had been activated. Problems were eliminated by the use of new disposable plastic materials for blood processing in each CL procedure.