Morphine synovial fluid concentrations after intravenous regional limb perfusion in horses during standing sedation.

BACKGROUND: Addition of morphine to the perfusate while performing intravenous regional limb perfusion (IVRLP) may be helpful in treating painful infectious orthopaedic conditions of the distal limb. OBJECTIVES: The main objective of this study was to determine synovial morphine concentrations following IVRLP with morphine alone or in combination with amikacin. STUDY DESIGN: Randomised cross-over in vivo experiment. METHODS: Six horses underwent IVRLP with 0.1 mg/kg morphine sulphate diluted to 60 mL using 0.9% NaCl (M group) or combined with 2 g amikacin and 0.9% NaCl (MA group) with a 2-week washout period between treatments. Synovial fluid was collected from the radiocarpal joint (RCJ) at 10, 20, 30, 120, 240, 480, 720 and 1440 min after IVRLP. The tourniquet was removed after the 30-min sample was collected. Synovial concentrations of morphine and major metabolites were measured using liquid chromatography-tandem mass spectrometry. Amikacin concentrations were quantified by a fluorescence polarisation immunoassay. RESULTS: Measurable concentrations of morphine were apparent in the RCJ of all horses. Median CMAX of morphine in the M group was 4753.1 (2115.7-14 934.5) ng/mL and 4477 (3434.3-7363) ng/mL in the MA group (p = 0.5). Median CMAX of synovial amikacin was 322.6 (157.5-1371.6 µg/mL). MAIN LIMITATIONS: Limitations include small sample size. Investigators were not blinded to the treatments and a third treatment group where amikacin alone was administered via IVRLP to the study population was not included. CONCLUSIONS: IVRLP using morphine is a feasible technique and synovial morphine concentrations were measurable following IVRLP and were not affected when used concurrently with amikacin. Administration of morphine via IVRLP may be beneficial as an analgesic technique for orthopaedic conditions of the distal limb while limiting potential serious systemic side-effects.

Faster perfusate instillation time results in more systemic leakage of amikacin sulfate when performing intravenous regional limb perfusion in horses.

OBJECTIVE: To evaluate if a difference in synovial amikacin concentrations exists in the radiocarpal joint (RCJ) following different durations of instillation of an IV regional limb perfusion (IVRLP) perfusate. ANIMALS: 7 healthy horses. METHODS: Horses received 2 IVRLPs with 2 g amikacin diluted to 60 mL with 0.9% NaCl via the cephalic vein in a crossover study design with a wash-out period between procedures. Instillation of the perfusate was administered over a 1-minute (technique 1) and 5-minute (technique 5) period. Concentrations of amikacin within the RCJ were measured at time (T) 5, 10, 15, 20, 25, and 30 minutes after instillation of the perfusate. Systemic concentrations of amikacin were measured at T0, 5, 10, 15, 20, 25, 29 minutes, and 1 minute after tourniquet removal (T31). Amikacin concentrations were determined by fluorescence polarization immunoassay. RESULTS: The median maximum concentration (CMAX) of amikacin within the RCJ for technique 1 was 338.4 µg/mL (range, 60 to 4,925 µg/mL), while the median CMAX for technique 5 was higher at 694.8 µg/mL (range, 169.2 to 3,410 µg/mL; P = .398). There was a higher amikacin blood concentration over time for technique 1 compared to technique 5 (P = .004). CLINICAL RELEVANCE: Administration of perfusate at different rates did not significantly affect synovial concentration of amikacin within the RCJ when performing IVRLP. However, increased systemic leakage was noted when the perfusate was administered over 1 minute, which might affect synovial concentrations in a larger group of horses.

Ponies, miniatures, and younger equids are at higher risk of fecalith obstruction compared to a general colic population.

OBJECTIVE: To determine breed, age, and sex predispositions for fecalith obstruction and to evaluate short-term survival and prognostic factors following surgical treatment of fecalith intestinal obstruction in equids. ANIMALS: 151 equids. METHODS: Medical records of equids undergoing surgery for fecalith obstruction from 2000 to 2020 were reviewed. Signalment, history, presenting clinicopathological data, surgical findings, complications, and short-term survival were recorded and compared between survivors and nonsurvivors. Signalment of the fecalith population was compared to a contemporaneous colic population. Clinical factors were assessed for association with outcome. RESULTS: 64 females, 53 castrated males, and 31 intact males were included. Three equids presented twice. Miniature horses, ponies, and miniature donkeys/mules represented 48% (71/148) of fecalith population and full-sized breeds represented 52% (77/148). Miniature horses and ponies were overrepresented and equids ≤ 1 year of age were overrepresented in the fecalith population compared to the colic population. One hundred thirty-nine equids (92%) survived to discharge, 6% (9/148) were euthanized intraoperatively, and 2% (3/148) were euthanized during hospitalization. Nonsurvivors showed more severe colic signs on admission, tachycardia on admission, and hyperlipemia. Equids with postoperative colic (P = .01) and complications (P = .002) were less likely to survive. CLINICAL RELEVANCE: Miniature horses and ponies were overrepresented compared to the colic population; however, full-sized breeds were also affected. Surgical treatment had an excellent short-term prognosis. Severe colic signs, tachycardia, hyperlipemia, postoperative colic, and surgical complications negatively affected short-term survival.

Treatment of lidocaine-refractory ventricular tachycardia using procainamide in an anesthetized horse.

OBJECTIVE: To highlight the use of procainamide as a potential alternative treatment modality in cases of ventricular tachycardia that are refractory to lidocaine and magnesium sulfate. ANIMAL: 1 adult horse weighing 380 kg. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES: A 25-year-old Arabian gelding presented with severe colic signs. Due to persistent pain, it was elected to carry out an exploratory laparotomy. During the procedure a diagnosis of severe, unstable ventricular tachycardia was made based on the ECG findings, with an initial heart rate of 195 beats per minute and severe hypotension. TREATMENT AND OUTCOME: Initial treatment consisted of discontinuing dobutamine and the administration of a 2 mg/kg IV lidocaine bolus followed by a continuous rate infusion at 50 µg/kg/min. Twenty grams magnesium sulfate (5 mg/kg) was administered IV in 1 L of lactated Ringer solution as a slow bolus over 30 minutes. Ventricular tachycardia persisted with poor peripheral pulses, a severely dampened arterial waveform, and a MAP of 30 to 45 mm Hg. Two milligrams/kg IV procainamide was administered over 3 minutes, 3 separate times, at 5-minute intervals. Immediately following the third dose sinus rhythm was detected on the ECG, the arterial waveform improved, and MAP increased to 85 mm Hg. CLINICAL RELEVANCE: Ventricular tachycardia is a rare but potentially life-threatening complication in horses undergoing general anesthesia. The potential of this arrhythmia to progress to ventricular fibrillation is of grave concern, as the option to attempt to externally defibrillate horses back to normal sinus rhythm does not exist. This case highlights procainamide as a potential option for cases of ventricular tachycardia that are refractory to more standard treatment modalities.

Effects of a 10% dimethyl sulfoxide solution on radiocarpal joint amikacin pharmacokinetics during intravenous regional limb perfusion in standing sedated horses.

OBJECTIVE: To determine the effect of a 10% dimethyl sulfoxide (DMSO) solution on the peak concentration (CMAX ) of amikacin in the radiocarpal joint (RCJ) during intravenous regional limb perfusion (IVRLP) compared with 0.9% NaCl. STUDY DESIGN: Randomized crossover study. ANIMALS: Seven healthy adult horses. METHODS: The horses underwent IVRLP with 2 g of amikacin sulfate diluted to 60 mL using a 10% DMSO or 0.9% NaCl solution. Synovial fluid was collected from the RCJ at 5, 10, 15, 20, 25, and 30 minutes after IVRLP. The wide rubber tourniquet placed on the antebrachium was removed after the 30 min sample. Amikacin concentrations were quantified by a fluorescence polarization immunoassay. The mean CMAX and time to peak concentration (TMAX ) of amikacin within the RCJ were determined. A one-sided paired t-test was used to determine the differences between treatments. The significance level was p < .05. RESULTS: The mean ± SD CMAX in the DMSO group was 1361.8 ± 593 µg/mL and in the 0.9% NaCl group it was 860 ± 481.6 µg/mL (p = .058). Mean TMAX using the 10% DMSO solution was 23 and 18 min using the 0.9% NaCl perfusate (p = .161). No adverse effects were associated with use of the 10% DMSO solution. CONCLUSION: Although there were higher mean peak synovial concentrations using the 10% DMSO solution no difference in synovial amikacin CMAX between perfusate type was detected (p = .058). CLINICAL SIGNIFICANCE: Use of a 10% DMSO solution in conjunction with amikacin during IVRLP is a feasible technique and does not negatively affect the synovial amikacin levels achieved. Further research is warranted to determine other effects of using DMSO during IVRLP.

Septic inflammation of the bicipital bursa: clinical, imaging, and surgical findings in nine horses.

OBJECTIVE: To describe the etiologies, clinicopathologic findings, diagnostic modalities employed, treatments, and outcome associated with cases of septic bicipital bursitis. ANIMALS: 9 horses. CLINICAL PRESENTATION AND PROCEDURES: Medical records of horses diagnosed with septic bicipital bursitis between 2000 and 2021 were reviewed. Horses were included if synoviocentesis of the bicipital bursa revealed a total nucleated cell count of ≥ 20,000 cells/µL with a neutrophil proportion of ≥ 80%, a total protein concentration of ≥ 4.0 g/dL, and/or the presence of bacteria on cytology, or positive culture of the synovial fluid. Information retrieved from medical records included signalment, history, clinicopathologic variables, diagnostic imaging findings, treatment, and outcome. RESULTS: Trauma was the most common inciting cause (n = 6). Synoviocentesis using ultrasonographic guidance was performed in all cases and showed alterations consistent with septic synovitis. Radiography identified pathology in 5 horses, whereas ultrasonography identified pathology in all horses. Treatment consisted of bursoscopy (n = 6) of the bicipital bursa of which 1 was performed under standing sedation, through-and-through needle lavage (3), bursotomy (2), or medical management alone (2). Five (55.6%) horses survived to discharge. Long-term follow-up was available for 3 horses and all were serviceably sound, with 2 in training as pleasure horses and 1 case continuing retirement. CLINICAL RELEVANCE: Ultrasonography was the most informative imaging modality and paramount in obtaining synovial fluid samples for definitive diagnosis of septic bicipital bursitis. Bursoscopy performed under standing sedation is a feasible treatment option. Horses treated for bicipital septic bursitis have a fair prognosis for survival and may return to some level of athletic performance.

Prevalence of and risk factors associated with Salmonella shedding among equids presented to a veterinary teaching hospital for colic (2013-2018).

BACKGROUND: Gastrointestinal disease has been associated with shedding of Salmonella with previous studies demonstrating that horses with colic have a higher risk of acquiring and shedding Salmonella organisms. OBJECTIVES: The purpose of this study was to determine the prevalence of and risk factors associated with Salmonella shedding in a colic population at a referral clinic. STUDY DESIGN: Retrospective case-control study. METHODS: For each colic case that was positive for Salmonella (n = 56), two colic cases (n = 112) that tested negative for Salmonella, were enrolled as controls. Associations between variables and Salmonella shedding were identified using logistic regression. Univariate and multivariable models were developed pertaining to (1) presenting clinicopathological data and (2) clinical variables that developed during hospitalisation. RESULTS: Of the equids presenting with colic, 1585/1917 had a sample submitted for Salmonella testing. Of these, 56 were positive for Salmonella yielding a prevalence of 3.5%. Equids shedding Salmonella were more likely to present in July (odds ratio [OR] = 7.2; 95% confidence interval [CI] = 1.63-32.13; p = 0.009) and present with a history of fever (OR = 53.5; 95% CI = 2.57-1113.03; p = 0.01), increased lactate (OR = 1.6; 95% CI = 1.14-2.29; p = 0.007) and/or neutropenia (OR = 0.79; 95% CI = 0.65-0.97; p = 0.02). Hospitalised equids shedding Salmonella were more likely to be febrile (OR = 4.8; 95% CI = 1.47-15.8; p = 0.01) and 10 times more likely to develop reflux (OR = 10.1; 95% CI = 1.67-61.43; p = 0.01) compared to colic controls. MAIN LIMITATIONS: Retrospective nature of the study and bias inherent to the retrieval of data from medical records cannot be discounted. Classifying Salmonella status based on a single sample may have resulted in misclassification bias. CONCLUSIONS: The prevalence of Salmonella shedding in this colic population was low compared to earlier reports. Certain predictors such as the development of a fever or reflux in hospitalised colic cases were associated with Salmonella shedding and may help the clinician to promptly identify horses likely to shed; thus, helping institute effective use of barrier nursing precautions.

Ultrasonographic diagnosis of femoral fractures in large animals.

OBJECTIVE: Femoral fractures are often catastrophic in large animals. Radiographic diagnosis is limited by patient size and feasibility, especially in ambulatory settings. Ultrasonography is widely available and may provide an alternative to radiography for definitive diagnosis. ANIMALS: 12 large animals (6 horses, 5 cattle, and 1 elephant). PROCEDURES: Retrospective analysis of large animal patients diagnosed with femoral fracture by use of femoropelvic ultrasonography (2000 to 2019). RESULTS: 5 of 12 cases were ≤ 1 year of age. The remaining 7 cases were 2 to 33 years of age (median, 13 years). All patients developed severe acute lameness after falling (n = 4), limb entrapment (2), dystocia (1), vehicular collision (1), ipsilateral full limb casting (1), or unknown events (3). All were non-weight-bearing or lame at the walk, including 2 recumbent cattle. Ten cases showed upper limb swelling that was variable in location, and 3 had nonspecific upper limb crepitus. Ultrasonography revealed evidence of diaphyseal (n = 6), greater trochanteric (2), capital physeal (2), and distal femoral (2) fractures. Fracture movement during limb manipulation or weight shifting was sonographically visualized in 5 animals. Radiography confirmed fractures in 3 of 8 animals: 2 bovines with distal femoral fractures detected on standing projections and 1 capital physeal fracture that required ventrodorsal projections under general anesthesia. All animals were euthanized (11) or slaughtered (1 bovine). Postmortem examination confirmed ultrasonographic findings in 10 of 10 necropsied animals. CLINICAL RELEVANCE: Femoral fractures were not localized nor confirmed in any case prior to ultrasonography. Study findings supported the use of ultrasonography for rapid patient-side diagnosis, prognostication, and decision-making in suspect cases.

Increasing tourniquet number has no effect on amikacin concentration within the radiocarpal joint in horses undergoing intravenous regional limb perfusion.

OBJECTIVE: To determine whether IV regional limb perfusion (IVRLP) performed in the cephalic vein with a wide rubber tourniquet (WRT) applied proximal and distal to the carpus results in a higher peak concentration (Cmax) of amikacin in the radiocarpal joint (RCJ), compared with the Cmax for IVRLP using a single WRT proximal to the carpus. ANIMALS: 7 healthy adult horses. PROCEDURES: Horses underwent IVRLP using standing sedation with 2 g of amikacin sulfate diluted to 60 mL by use of saline (0.9% NaCl) solution in the cephalic vein with 2 different tourniquet techniques; proximal WRT (P) and proximal and distal WRT (PD). Synovial fluid was collected from the RCJ at 5, 10, 15, 20, 25, and 30 minutes after IVRLP. Tourniquets were removed after the 30-minute sample was collected. Blood samples from the jugular vein were collected at 5, 10, 15, 20, 25, 29, and 31 minutes after IVRLP. Amikacin concentration was quantified by a fluorescence polarization immunoassay. Median peak concentration (Cmax) of amikacin and time to maximum drug concentration (Tmax) within the RCJ were determined. RESULTS: Median peak concentration in the RCJ was 1331.4 µg/mL with technique P and 683.1 µg/mL with technique PD. Median Tmax occurred at 30 minutes with technique P and 25 minutes with technique PD. No significant (Cmax, P = 0.18; Tmax, P = 0.6) difference in amikacin Cmax or Tmax between techniques was detected. CLINICAL RELEVANCE: Placement of 2 WRTs offers no advantage to a single proximal WRT when performing IVRLP to deliver maximal amikacin concentrations to the RCJ using IVRLP.

Orthopedic Infections-Clinical Applications of Intravenous Regional Limb Perfusion in the Field.

For the equine veterinarian, orthopedic emergencies are a common occurrence in clinical practice, with traumatic wounds of the distal limb and penetrating injuries of the hoof being some of the most common medical conditions to affect horses. Intravenous regional limb perfusion is a technique widely used for the treatment of orthopedic infections in horses. The objectives of this review are to discuss some of the clinical applications for this treatment modality in the field and to review the technique for the practitioner.

Castration Complications: A Review of Castration Techniques and How to Manage Complications.

Castration is one of the most common surgical procedures performed in equine practice. Open, closed, and semiclosed techniques are described for castration of horses, and the procedure may be performed in a standing, sedated animal or in a recumbent animal under general anesthesia. Although a relatively routine procedure, complications can occur, with reported complication rates ranging from 10.2% to 60%. Most complications are mild and resolve rapidly with appropriate treatment, but more serious or life-threatening complications can also occur. A thorough knowledge of male reproductive anatomy combined with good surgical technique is imperative to help reduce the rate of complications.

Bacterial meningitis after dental extraction in a 17-year-old horse.

Dental extractions in horses may result in bacteremia, which can lead to systemic complications. Bacterial meningitis following oral cheek tooth extractions in a 17-year-old Thoroughbred gelding is described in this report. The bacterial meningitis was confirmed by histopathology. The gelding was presented for evaluation of intermittent fever, loose feces, and mild colic signs which started 5 days after cheek tooth extraction. This case illustrates a rare complication associated with oral tooth extraction in a horse and highlights the unusual presenting features of meningitis. Key clinical message: Bacterial meningitis secondary to oral cheek tooth extraction should be considered as differential diagnosis; particularly in cases with the development of pyrexia a few days after the procedure.

Méningite bactérienne après extraction dentaire chez un cheval de 17 ans. Les extractions dentaires chez les chevaux peuvent entraîner une bactériémie, ce qui peut amener des complications systémiques. Un cas de méningite bactérienne à la suite d'extractions buccales de dents jugales chez un hongre pur-sang de 17 ans est décrite dans ce rapport. La méningite bactérienne a été confirmée par histopathologie. Le hongre a été présenté pour évaluation d'une fièvre intermittente, de selles molles et de signes de coliques légers qui ont commencé 5 jours après l'extraction de la dent jugale. Ce cas illustre une complication rare associée à l'extraction dentaire orale chez un cheval et met en évidence des caractéristiques inhabituelles de la méningite.Message clinique clé :La méningite bactérienne secondaire à l'extraction buccale des dents jugales doit être considérée comme un diagnostic différentiel, en particulier dans les cas de développement d'une pyrexie quelques jours après l'intervention.(Traduit par Dr Serge Messier).

In vitro efficacy of a 0.2% polyhexamethylene biguanide-impregnated gauze dressing against pathogenic bacterial isolates found in horses.

OBJECTIVE: To determine the ability of 0.2% polyhexamethylene biguanide (PHMB)-impregnated gauze to inhibit the growth of bacteria isolated from equine infected sites. STUDY DESIGN: In vitro study. METHODS: Nine bacterial isolates were obtained from cultures submitted from equine patients presenting with penetrating injuries of the hoof (n = 4), septic osteitis (n = 1), synovial sepsis (n = 1), wounds (n = 2), and incisional infection following laparotomy (n = 1). Two standardized strains were also included. A standard inoculum of each isolate was placed on 12 Muller-Hinton agar plates. Squares (2.5 cm × 2.5 cm) of 0.2% PHMB-impregnated (n = 6) and nonimpregnated control gauze (n = 6) were placed on inoculated agar plates. Bacterial growth under each gauze square was assessed after a 24-h incubation period and areas of inhibition were measured to a standardized scale, using image-processing software. Mean ± SD growth inhibition (%) using 0.2% PHMB-impregnated gauze was compared to the nonimpregnated gauze for each isolate using Student's t test (p < .05). RESULTS: The 0.2% PMHB-impregnated gauze inhibited the growth of Staphylococcus spp. (n = 4) by 33%-83.1% and that of Escherichia coli spp. (n = 4) by 6.5%-37%. There was no inhibition of growth of Pseudomonas aeruginosa or either Enterococcus spp. CONCLUSION: The 0.2% PHMB-impregnated dressing tested here inhibited the growth of staphylococcal and E. coli isolates, but the magnitude of inhibition varied between strains. CLINICAL RELEVANCE: These results justify in vivo studies to evaluate the ability of the dressing to reduce the bacterial growth of common equine bacterial pathogens in clinical practice.

Time required to achieve maximum amikacin concentration in the synovial fluid of the tarsocrural joint following administration of the drug by intravenous regional limb perfusion in horses.

OBJECTIVE: To determine the median time to maximum concentration (tmax) of amikacin in the synovial fluid of the tarsocrural joint following IV regional limb perfusion (IVRLP) of the drug in a saphenous vein of horses. ANIMALS: 7 healthy adult horses. PROCEDURES: With each horse sedated and restrained in a standing position, a 10-cm-wide Esmarch tourniquet was applied to a randomly selected hind limb 10 cm proximal to the point of the tarsus. Amikacin sulfate (2 g diluted with saline [0.9% NaCl] solution to a volume of 60 mL) was instilled in the saphenous vein over 3 minutes with a peristaltic pump. Tarsocrural synovial fluid samples were collected at 5, 10, 15, 20, 25, and 30 minutes after completion of IVRLP. The tourniquet was removed after collection of the last sample. Amikacin concentration was quantified by a fluorescence polarization immunoassay. Median maximum amikacin concentration and tmax were determined. RESULTS: 1 horse was excluded from analysis because an insufficient volume of synovial fluid for evaluation was obtained at multiple times. The median maximum synovial fluid amikacin concentration was 450.5 µg/mL (range, 304.7 to 930.7 µg/mL), and median tmax was 25 minutes (range, 20 to 30 minutes). All horses had synovial fluid amikacin concentrations ≥ 160 µg/mL (therapeutic concentration for common equine pathogens) at 20 minutes after IVRLP. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that, in healthy horses, maintaining the tourniquet for 20 minutes after IVRLP of amikacin in a saphenous vein was sufficient to achieve therapeutic concentrations of amikacin in the tarsocrural joint.

Clinical and diagnostic findings, treatment, and short- and long-term survival in horses with peritonitis: 72 cases (2007-2017).

OBJECTIVE: To identify etiology, clinical findings, diagnostic results, treatment, and short- and long-term survival and to report factors associated with nonsurvival and survival in horses with peritonitis. STUDY DESIGN: Retrospective study. ANIMALS: Horses (n = 72). METHODS: Medical records at William R. Pritchard Veterinary Medical Teaching Hospital from 2007-2017 were reviewed for horses diagnosed with peritonitis. The essential inclusion criterion was a peritoneal nucleated cell count of ≥25 000 cells/µL. Gastrointestinal rupture and cases in which peritonitis occurred after abdominal surgery or castration were excluded. Information retrieved from medical records included signalment, history, clinicopathological and peritoneal fluid variables, diagnostic imaging findings, inciting cause, treatment, and short- and long-term survival. Data were analyzed by using Fisher's exact test, Wilcoxon rank sum test, and χ2 test (P < .05). RESULTS: Colic was the most common presenting complaint (34/72 [48%]). A definitive diagnosis could be made in 44 (44/72 [61%]) cases. The most common cause of peritonitis was infectious agents (31/72), followed by trauma (8/72), gastrointestinal thickening (3/72), and eosinophilic peritonitis (2/72). Idiopathic peritonitis was identified in 28 (28/72 [39%]) cases. Sixty (83%) horses survived to hospital discharge. Long-term follow-up was available for 49 horses, with 43 (88%) horses alive 1 year after discharge. Significant differences between nonsurvivors and survivors were history of colic, positive peritoneal fluid culture, and several hematological/peritoneal fluid variables. CONCLUSION: Peritoneal fluid analysis was essential for a definitive diagnosis of peritonitis, and certain variables were useful for predicting outcome. CLINICAL SIGNIFICANCE: Results of this study provide evidence of the value of peritoneal fluid analysis for identification of peritonitis, prediction of outcome, and successful treatment.

Do allogeneic bone marrow derived mesenchymal stem cells diminish the inflammatory response to lipopolysaccharide infusion in horses? A pilot study.

Endotoxemia is a leading cause of morbidity and mortality in the equine industry, with colic being the most common cause of endotoxemia in horses. The objective of this study was to evaluate the safety and potential efficacy of a single dose of allogeneic equine bone marrow derived mesenchymal stem cells (BM-MSCs) in horses after the IV administration of lipopolysaccharide (LPS). Six horses were administered an IV infusion of 30 ng/kg LPS (O55:B5 Escherichia coli) in 500 ml saline over 30 min. Immediately after infusion test horses (n = 3) were administered 100 × 106 allogeneic BM-MSCs diluted in saline IV and control horses (n = 3) were administered saline. Clinicopathological data, pro-inflammatory cytokine measurements and sCD14 concentrations were compared between groups. No adverse reactions were observed in horses administered BM-MSCs intravenously. There were no significant differences between test and control horses with regard to clinicopathological values or pro-inflammatory cytokine production. At no time point did concentrations of sCD14 exceed the reference range in any horse. Results suggest that administration of a single IV dose of freshly cultured MSCs is safe and well-tolerated in horses with induced endotoxemia. Further study to evaluate their efficacy as a potential therapeutic in a larger number of horses with clinical disease is required.

Incidence of incisional complications after exploratory celiotomy in equids affected with enterolithiasis.

This study reports the prevalence of and risk factors for incisional complications in equids after ventral midline celiotomy for enterolithiasis. This study covered the years 2008 to 2015 and included 72 equids. Enteroliths were removed from the ascending or descending colon through 1 or more enterotomies. Complications were defined as surgical site infection and/or incisional hernia formation. Follow-up by telephone questionnaire or medical records determined that 10/72 (13.9%) equids experienced complications, with 6/72 (8.3%) developing a surgical site infection and 5/72 (6.9%) a hernia. Seven of ten were presented for chronic abdominal discomfort (> 24 hours), and 8/10 had right dorsal colon and pelvic flexure enterotomies. All equids that developed an incisional hernia and 4 with surgical site infection had enteroliths > 15 cm diameter removed from the right dorsal colon. Antimicrobial powder applied to the ventral midline incision during closure significantly reduced incisional complications. Removal of > 15 cm diameter enteroliths from the right dorsal colon may predispose to postoperative incisional complications.

Incidence des complications incisionnelles après une céliotomie exploratoire chez des équidés atteints d'entérolithiase. Cette étude rapporte la prévalence et les facteurs de risque des complications incisionnelles chez les équidés opérés pour l'entérolithiase en utilisant une celiotomie médiane ventrale de 2008 à 2015. Soixantedouze équidés ont été inclus. Les entérolithes ont été retirés du côlon ascendant ou descendant par ≥ 1 entérotomies. Les complications étaient définies comme une infection du site opératoire et/ou la formation d'une hernie incisionnelle. Le suivi a été obtenu par questionnaire téléphonique ou par dossiers médicaux. Dix des 72 (13,9 %) des équidés ont eu des complications, dont 6/72 (8,3 %) ont développé une infection du site opératoire et 5/72 (6,9 %) une hernie. Sept sur 10 ont été présentés pour un malaise abdominal chronique (> 24 heures) et 8/10 avaient des entérotomies du côlon dorsal droit et de la flexion pelvienne. Tous les équidés ayant développé une hernie incisionnelle et quatre avec une infection du site opératoire avaient des entérolithes > 15 cm de diamètre prélevés du côlon dorsal droit. La poudre antimicrobienne appliquée sur l'incision médiane ventrale lors de la fermeture réduisait significativement les complications incisionnelles. Le retrait d'entolithes de > 15 cm de diamètre du côlon dorsal droit peut prédisposer aux complications incisionnelles postopératoires.(Traduit par les auteurs).