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OBJECTIVE To assess incidence of incisional infection in horses following management with 1 of 3 protective dressings after exploratory celiotomy for treatment of acute signs of abdominal pain (ie, colic) and determine the risk of complications associated with each wound management approach. DESIGN Prospective, randomized, controlled study. ANIMALS 85 horses. PROCEDURES Horses were assigned to 3 groups. After standardized abdominal closure, a sterile cotton towel (group 1) or polyhexamethylene biguanide–impregnated dressing (group 2) was secured over the incision site with 4 or 5 cruciate sutures of nonabsorbable monofilament, or sterile gauze was placed over the site and secured with an iodine-impregnated adhesive drape (group 3). Demographic and clinicopathologic data, intraoperative and postoperative variables, and development of complications were recorded and compared among groups by statistical methods. Follow-up information was collected 30 and 90 days after surgery. Incidence and odds of incisional complications were calculated. RESULTS 75 horses completed the study. Group 3 typically had dressing displacement necessitating removal during anesthetic recovery; dressings were in place for a mean of 44 and 31 hours for groups 1 and 2, respectively. Purulent or persistent serosanguinous incisional discharge (ie, infection) was detected in 11 of 75 (15%) horses (2/24, 0/26, and 9/25 from groups 1, 2, and 3, respectively). Odds of incisional complications were significantly greater for group 3 than for groups 1 or 2. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that risk of infection after celiotomy for treatment of colic is lower for incisions covered with sterile towels or polyhexamethylene biguanide–impregnated dressings secured with sutures than for incisions covered with gauze secured with iodine-impregnated adhesive drapes.

Auditory loss has been reported in camelids using brainstem auditory evoked responses (BAER). Differentiation between conductive versus sensorineural dysfunction has not been investigated. Therefore, the objective of the study was to investigate auditory function using BAER and bone conduction (BC). Twenty-four alpacas: 15 females, 9 intact males (2–16 years of age) were included in a randomized clinical trial. BAER and BC were recorded using two derivations (vertex to mastoid and vertex to cranial aspect of second cervical vertebra). All alpacas underwent complete physical examinations and were sedated with xylazine hydrochloride at 0.6 mg/kg IM. Peaks, when present, were identified and latencies, amplitudes, and amplitude ratios were determined. Eleven alpacas had normal responses and 13 had auditory loss based on BAER. The latter consisted of complete absence of peaks bilaterally (n = 3), absence of peaks unilaterally (n = 1), delayed latencies bilaterally (n = 4), and delayed latencies unilaterally (n = 5). Distinct peaks on BC supported conductive auditory loss in 6 alpacas, difficult to interpret due to stimulus artifact and additional undefined peaks in 4, and absent peaks in 3 alpacas. The cause of auditory loss was presumed to be due to otitis in 6, aging in 4 (10–16 years old), and congenital sensorineural (absent peaks on BAER and BC) in 3 alpacas with unpigmented fiber and irises. BAER and BC are useful and non-invasive to perform techniques for the investigation of auditory loss in alpacas, and further characterization as conductive or sensorineural.

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 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.

OBJECTIVE To describe clinical features and outcome of horses with severe large intestinal thickening diagnosed with transabdominal ultrasonography. DESIGN: Retrospective case series. ANIMALS 25 horses. PROCEDURES Medical records of horses that underwent transabdominal ultrasonography between 2003 and 2010 were reviewed. Horses were included if the wall of the large intestine was ≥ 9 mm thick in any of 6 abdominal zones. RESULTS Median age was 13 years (range, 3 to 28 years). Horses were initially examined because of colic, diarrhea, inappetence, weight loss, lethargy, fever, or hematuria. Severe large intestinal thickening (range, 9 to 46.6 mm; mean ± SD, 18.8 ± 6.8 mm) was the primary ultrasonographic finding in all horses. Thickened large intestine was more likely to be detected in ventral versus upper (ie, combined paralumbar and intercostal) abdominal zones and in right versus left zones. Eleven horses survived and had resolution of clinical signs, including the l horse treated surgically for colon torsion. An additional horse survived but continued to have intermittent colic. Ten horses were euthanized or died, including 3 horses with neoplasia and 3 with colitis. Three horses were lost to follow-up, including 1 horse with a cecal mass and 1 with hepatosplenic lymphoma. Severity of thickening and number of zones affected were not significantly different between survivors and nonsurvivors. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that in horses undergoing transabdominal ultrasonography, large intestinal wall thickness ≥ 9 mm may be detected in patients with a variety of conditions. Ultrasonographic examination of all abdominal zones was helpful to determine the extent of thickening and identify additional findings that helped prioritize differential diagnoses.

Mental wellness is an important topic among practicing veterinarians. Peer reviewed studies focusing on veterinary house officers’ wellbeing are lacking in veterinary medicine. The aim of this study was to assess wellbeing of house officers using validated surveys for anxiety, burnout, depression, and quality of life. A cross-sectional survey of 103 house officers (residents, interns, and fellows) was performed. Respondents were invited to voluntarily complete the online surveys. Anxiety, burnout, depression, and quality of life were assessed using the Generalized Anxiety Disorder (GAD-7), Maslach Burnout Inventory (MBI), Patient Health Questionnaire (PHQ-9), and Short Form-8 (SF-8), respectively. Descriptive statistics were calculated. For qualitative analysis, respondents were requested to rate their perception of the level of stress regarding various work-related stressors. The first survey was completed in 2017 with 60 respondents of which 51 (85%) identified as females and nine (15%) identified as males. The second survey was completed in 2018 with 43 respondents of which 35 (81.4%) identified as females and 8 (18.6%) identified as males. Respondents reported high levels of burnout characterized by high levels of emotional exhaustion and lack of personal accomplishment but reported mild levels of anxiety and depression. The mental component of their quality of life score was lower than the general US population, whereas the physical component score was consistent with the general US population. Respondents indicated moderate scores of stress for concerns regarding patient management, research, teaching, work-life balance, relationships, organizational skills, time management, finances, and the mental and emotional impact of the work environment. The high levels of burnout, and low mental quality of life in house officers require specific intervention programs to improve wellbeing.

Regional limb perfusion (RLP) in horses has proven to be a simple and effective technique for the treatment of synovial and musculoskeletal infections in the distal portion of the limbs. The ideal tourniquet time needed to achieve therapeutic synovial concentrations remains unknown. The pharmacokinetic effects of general anesthesia (GA) versus standing sedation (SS) RLP on synovial amikacin concentrations are not completely understood. This study investigated the pharmacokinetic effects of RLP under general anesthesia (GA) versus standing sedation (SS) on synovial amikacin concentration following 20 or 30 min tourniquet time. Using 1 g of amikacin RLP was performed in two groups of six horses (GA and SS). A pneumatic tourniquet was applied proximal to the carpus and maintained for 20 or 30 min. Two weeks later, the opposite treatment (20 or 30 min) was randomly performed in the opposite limb of horses in each group (GA and SS). Synovial fluid samples were collected from the metacarpophalangeal (MCP) and radiocarpal (RC) joints. Amikacin was quantified by a fluorescence polarization immunoassay. Regardless of the group, no significant difference in the synovial amikacin concentrations was noted between 20 and 30 min RLP. Mean synovial concentrations of amikacin in the standing sedated horses were significantly higher in the MCP joint at 30 min (P = 0.003) compared to horses under general anesthesia. No significant difference was noted for the RC joint.

Objective To determine if preoperative and intraoperative clinical variables correlate with resection and anastomosis (RA) in horses presenting with strangulating small intestinal (SI) lesions. Study design Retrospective case series. Animals Horses undergoing exploratory celiotomy for a strangulating SI lesion (n = 243). Methods The records of horses undergoing surgical correction for strangulating SI lesions from January 1, 2000 to December 31, 2017 were reviewed. Horses were categorized as treated with RA or not treated with RA. Obtained information included history, signalment, clinical findings, diagnostic test results, intraoperative findings, and survival to discharge. Univariable and multivariable analyses were used to compare data between horses treated with RA vs those not treated with RA (P = .05). Results In total, 172 SI lesions were resected, and 71 were not resected. Horses that had gastric reflux at admission to the hospital (odds ratio [OR] 5.56; 95% CI 1.76, 17.59) and horses with amotile SI according to abdominal ultrasonography (OR 9.69; 95% CI 3.09, 30.37) were more likely to undergo RA. Increased difference between peritoneal fluid and blood lactate was higher in horses that underwent RA (OR 1.55; 95% CI 1.12, 2.13). Survival to hospital discharge was lower in the group of horses that underwent RA compared with horses that did not undergo RA. Conclusion Resection and anastomosis of strangulating SI lesions was associated with several preoperative variables. Clinical significance This study highlights the value of preoperative diagnostic procedures in aiding intraoperative decision making and prognostication in horses presenting with strangulating SI lesions.

OBJECTIVE: To determine the ability of plasma and peritoneal creatine kinase (CK) to predict the presence of a strangulating lesion in horses presented for colic. STUDY DESIGN: Prospective clinical study. ANIMALS: Ten healthy control horses and 61 clinical colic cases. METHODS: Creatine kinase activity was measured in peritoneal fluid and plasma of 10 healthy horses and 61 horses presenting for colic (40 horses with nonstrangulating lesions and 21 horses with strangulating lesions). Information on other blood and peritoneal fluid variables, signalment, results from the physical examination, outcome, requirement for surgery, and lesion location and type were retrieved from the medical records of horses presenting for colic. RESULTS: A peritoneal CK cutoff level of 16 IU/L yielded a sensitivity of 95.2% and a specificity of 84.6% (positive predictive value [PPV] = 76.9% and negative predictive value [NPV] = 97%, respectively) for predicting a strangulating lesion. A peritoneal lactate cutoff level of 3.75 mmol/L yielded a sensitivity of 81% and a specificity of 92% (PPV = 85% and NPV = 90%, respectively) for predicting a strangulating lesion. CONCLUSION: Peritoneal CK concentration was a sensitive indicator of the presence of a strangulating lesion in horses presenting with colic, whereas peritoneal lactate concentration was a more specific indicator. CLINICAL SIGNIFICANCE: Measuring CK in peritoneal fluid may be a useful adjunct to clinical case presentation to accelerate the diagnosis and definitive treatment of horses presenting with strangulating intestinal lesions, thereby improving their outcome.

Anti-idiotypic antibodies recognize the antigenic determinants of an antibody, thus they can be used as surrogate antigens. Single-domain antibodies from camlid heavy-chain antibodies with the benefit features of small size, thermostability, and ease in expression, are leading candidates to produce anti-idiotypic antibodies. In this work, we constructed an antibody phage library from the mRNA of an alpaca immunized with an antiaflatoxin monoclonal antibody (mAb) 1C11. Three anti-idiotypic VHH antibodies were isolated and applied to immunoassay toward aflatoxin as a coating antigen. The best immunoassay developed with one of these VHH antibodies shows an IC50 of 0.16 ng/mL toward aflatoxin B1 and cross-reactivity toward aflatoxin B2, G1, and G2 of 90.4%, 54.4%, and 37.7%, respectively. The VHH-based immunoassay was successfully applied to the analysis of peanuts, corn, and rice, which are the predominant commodities regularly contaminated by aflatoxins. A good correlation (r(2) = 0.89) was found between the data obtained from the conventional ELISA and the ELISA based on a VHH coating antigen for the analysis of aflatoxins in peanuts and feedstuff. The use of biotechnology in developing the surrogate, the absence of standard aflatoxin and organic solvents in the synthesis procedures, and the reproducibility of the VHH antibody makes it an ideal strategy for replacing conventional synthesized antigens.

OBJECTIVE To compare clinical findings and short-term outcome for horses with intestinal entrapment in the gastrosplenic ligament (GLE) with those of horses with intestinal entrapment in the epiploic foramen (EFE). DESIGN Retrospective case-control study. ANIMALS 43 horses with GLE (cases) and 73 horses with EFE (controls). PROCEDURES Medical records of horses examined because of colic at a veterinary teaching hospital between 1992 and 2012 were reviewed. Signalment was extracted from medical records for all horses with colic (colic population), and additional information regarding colic history, clinical findings, treatments, and outcome was extracted from the records of horses in which GLE or EFE was diagnosed during surgery or necropsy. Signalment was compared between the colic population and the case and control populations. Clinical findings and short-term outcome were compared between the cases and controls. RESULTS The proportions of middle-aged horses and geldings in both the case and control groups were greater than those in the colic population. Mean heart rate and blood and peritoneal fluid lactate concentrations in horses with EFE were significantly greater than those for horses with GLE. The proportion of horses that underwent surgery and were discharged from the hospital (short-term survival rate) did not differ between the GLE (22/25 [88%]) and EFE (29/34 [85%]) groups. CONCLUSIONS AND CLINICAL RELEVANCE Compared with the colic population, results suggested middle-aged geldings might be predisposed to GLE and EFE. The short-term survival rate was similar between the GLE and EFE groups even though horses with EFE had more severe systemic derangements than did horses with GLE.

To determine the influence of radiographic quantification of sand accumulation on the medical versus surgical management of large colon sand accumulations. To compare short- and long-term outcomes and complications associated with medical and surgical management of these horses.Retrospective.A total of 153 horses.Medical records and abdominal radiographs of horses presented for colic between 2004 and 2014 were reviewed. Severity of sand accumulation was quantified by tracing and measuring a region of interest with a commercial software program. Breed, weight, amount of sand, presence of diarrhea at presentation, treatment, and the development of complications were recorded.Records from 153 horses were reviewed. The mean cross-sectional area of sand accumulation was 692.9 cmIncreased accumulation of gas on radiographs and transrectal palpation of impaction or intestinal gas distension increase the likelihood of surgery. Both medical and surgical treatments carry a good prognosis.The sheer quantity of sand is not a factor when determining surgical intervention. Attention should be paid to the presence of increased gas accumulation on rectal or radiographic examination.

Objective—To determine the outcome of penetrating injuries to the central region of the foot in equids and identify factors that may affect treatment and outcome. Design—Retrospective case series. Animals—63 equids (61 horses, 1 pony, and 1 mule). Procedures—Records of equids incurring puncture wounds through the frog (cuneus ungulae) or collateral sulci of the foot between 1998 and 2008 were reviewed. Evaluated factors that were hypothesized to affect outcome included signalment, degree of lameness, foot affected, duration between injury and admission, and treatment. Injuries were graded from 1 (< 1 inch; involving superficial corium only) to 4 (involving a synovial structure) on the basis of severity of penetration as determined by radiographic evidence or findings on synoviocentesis at the time of admission. Results—Overall, 60% (38/63) of equids returned to soundness. Thirteen equids were euthanized on the basis of synovial structure involvement and financial constraints. Of 35 equids that were treated conservatively, which may have included undergoing a surgical procedure with the horse standing, 32 (91.4%) returned to their previous level of soundness. Fifteen equids underwent surgical treatment under general anesthesia, of which 6 (40%) became sound for intended use. Ten of 34 (29%) equids with synovial structure involvement regained soundness. Equids treated earlier after injury had a better prognosis. Equids with a hind foot injury had a more favorable outcome than those with a forefoot injury. Conclusions and Clinical Relevance—Results suggested that penetrating injuries located centrally in the foot of equids without involvement of a synovial structure have a favorable prognosis, especially if managed early. Penetration of a synovial structure provided a poor prognosis.

Summary Reasons for performing study: Osteoarthritis is a frequent sequela of joint disease, especially with severe injuries or if attempts at therapy are unsuccessful. Negative and positive effects of corticosteroid treatment of articular cartilage have been demonstrated by in vitro and in vivo studies. Objectives: To assess the metabolic effects of varying dosages of methylprednisolone acetate (MPA) and triamcinolone acetonide (TA) on interleukin-1α (IL-1) conditioned equine cartilage explants. Our hypothesis was that lower dosages of corticosteroids would be less detrimental to cartilage metabolism than higher dosages. TA would be less detrimental to cartilage metabolism than MPA. Methods: Treatment groups included articular cartilage explants with no IL-1 (control), IL-1 alone, and IL-1 plus 10, 5, 1 and 0.5 mg/ml MPA or 1.2, 0.6, 0.12 and 0.06 mg/ml TA. Explants were labelled with 35SO4 priorto the beginning and end of the experiment to assess glycosaminoglycan (GAG) degradation and synthesis, respectively. Total GAG content in media and explants and total cartilage DNA were also analysed. Results: MPA and TA reduced GAG synthesis compared to control and IL-1 alone. The highest dosage of MPA (10 mg/ml) reduced GAG synthesis less than lower dosages of MPA and all dosages of TA Compared to IL-1 alone, all dosages of TA and lower dosages of MPA increased GAG degradation. MPA at 10 mg/ml reduced GAG degradation. Both MPA and TA increased media GAG content compared to control and IL-1 explants. Total cartilage GAGs were unchanged with MPA, but reduced with TA, compared with IL-1 alone. Total cartilage DNA was decreased with MPA and increased with TA compared to IL-1 and control explants. Conclusions: MPA and TA did not counteract the negative effects of IL-1 and did not maintain cartilage metabolism at control levels. Lower dosages of MPA and TA were not less detrimental to cartilage metabolism than higher dosages. TA did not appear to be less harmful than MPA on cartilage metabolism. The results of this study differ from the findings of comparable in vivo studies. Potential relevance: The low numbers of horses used in this study limits extrapolation of these findings to the equine population; however, this study also questions the clinical relevance of this in vitro model.

A 6-year-old Quarter Horse stallion was referred to Oklahoma State University Veterinary Medical Teaching Hospital for evaluation of abdominal pain that developed after breeding activity earlier in the day. The horse developed diarrhea and progressively worsening neurologic signs (circling, ataxia, head pressing) within 22 hours of presentation and was subsequently euthanized due to severe self-destructive behavior. Antemortem biochemical and hematologic abnormalities included hypocalcemia but no evidence of hepatic disease. Idiopathic hyperammonemia and encephalopathy were suspected; cerebrospinal fluid (CSF) and aqueous humor were collected 10 hours postmortem for ammonia analysis using a colorimetric assay. Results were compared with those of 6 horses that also had been euthanized, for diseases unrelated to encephalopathy. Ammonia also was measured in plasma samples obtained antemortem. Ammonia concentrations in plasma (958 micromol/L), CSF (1566 micromol/L) and aqueous humor (1018 micromol/L) samples from the stallion were markedly increased compared to those in the 6 unaffected horses (plasma, 9-43 micromol/L; CSF, 370-532 micromol/L; aqueous humor, 70-483 micromol/L). Since the acute nature of hyperammonemic encephalopathy often does not provide sufficient time for an antemortem diagnosis, postmortem analysis of CSF and aqueous humor ammonia concentrations may be a useful alternative for documenting hyperammonemia in horses.

A 523 kg Quarter Horse was anesthetized for unilateral eye enucleation. The anesthetic period was unremarkable. During anesthetic recovery the cap on the jugular venous catheter became dislodged. Clinical signs of pulmonary edema associated with moderate arterial hypoxemia subsequently developed. Although pulmonary edema resolved with medical therapy, the day following anesthetic recovery, clinical signs of vestibular disease and blindness developed. Treatment included nasal oxygen insufflation, flunixin meglumine, furosemide, dexamethasone, thiamine, dimethylsulfoxide, antimicrobials, and phenylbutazone. The horse recovered and was discharged from the hospital after 7 days of treatment and was neurologically normal at 6 weeks. While venous air embolism was not confirmed in this case, the catheter cap complication followed by signs of pulmonary edema and neurologic sequelae support the presumptive pathogenesis of this horse's complications. Diagnostic confirmation of air embolism in horses with compatible acute clinical signs should be documented with echocardiography.

The purpose of this retrospective case-control study was to identify factors associated with primary gastric rupture and to investigate if there were differences between etiologies of primary gastric rupture. Compared to the general colic population, Quarter horses were under-represented and Friesians and draft breeds were over-represented in 47 cases of primary gastric ruptures. Horses with primary gastric rupture typically presented with severe clinical and clinicopathological derangements. There were 24 idiopathic gastric ruptures, 20 gastric impaction associated ruptures, and 3 perforating gastric ulcers. Thoroughbred horses were over-represented in the idiopathic gastric rupture group compared to other breeds and etiologies. This study suggests the presence of important breed predispositions for development of gastric rupture. Further study is necessary to identify if these predispositions are associated with management factors or breed-specific disorders.

To describe the successful management of a urethral stricture with an absorbable stent in a stallion.Clinical report.Stallion with a urethral stricture.A 12-year-old Thoroughbred breeding stallion was evaluated for acute onset of colic. Uroperitoneum because of presumptive urinary bladder rupture, with urethral obstruction by a urethrolith, was diagnosed. The uroperitoneum was treated conservatively. The urethrolith was removed through a perineal urethrotomy. Approximately 15 weeks after urethrolith removal, the stallion presented with a urethral stricture. The stricture was unsuccessfully treated with an indwelling urinary catheter and 4 attempts at balloon dilation. Eight weeks after diagnosis of stricture, an absorbable polydioxanone (20 mm × 80 mm) urethral stent was implanted under percutaneous, ultrasound guidance. Urethroscopy was performed at 70, 155, and 230 days after stent placement and the endoscope passed through the affected site without complication. Urethroscopy at 155 days showed the stent had been reabsorbed. Follow-up 20 months after stent placement reports the stallion was able to void a normal urine stream.Absorbable urethral stent placement was a feasible treatment for urethral stricture in this stallion.

Objective—To evaluate clinical findings, underlying causes, and short-term outcome associated with hemoperitoneum in horses. Design—Retrospective case series. Animals—67 horses with hemoperitoneum. Procedures—Medical records of horses with hemo-peritoneum (excluding postoperative abdominal hemorrhage) from 1989 through 2004 were analyzed. Information obtained included history, signalment, physical examination findings, diagnostic test results, and short-term outcome. Results—Breed distribution was 28 Thoroughbreds, 13 Arabians, 10 Quarter Horses, 5 Warmbloods, 3 Appaloosas, and 1 each of 8 other breeds. There were 40 mares, 23 geldings, and 4 stallions. Median age was 12 years (range, 1 month to 40 years). Signs of abdominal discomfort were the primary complaint in 79% of horses. Clinical findings included shock (60%) and pale mucous membranes (60%). Median heart rate was 76 beats/min (range, 30 to 216 beats/min), median respiratory rate was 30 breaths/min (range, 8 to 92 breaths/min), median Hct was 31% (range, 10.5% to 73.0%), and total protein concentration was 5.8 g/dL (range, 3.3 to 8.7 g/dL). Cause of hemoperitoneum was attributed to trauma (25.4%), neoplasia (17.9%), uterine artery rupture (13.4%), mesenteric injury (11.9%), disseminated intravascular coagulopathy (6.0%), other causes (3.0%), and idiopathic causes (22.4%). Fifty-one percent of horses survived to hospital discharge, 37% were euthanized, and 12% died. Poor short-term outcome was significantly associated with high respiratory rate and certain underlying causes. Conclusions and Clinical Relevance—Hemoperitoneum is an infrequent but important cause of abdominal discomfort in horses. Predominant underlying causes were trauma, neoplasia, and idiopathic causes. Identification of underlying cause is important because of its association with outcome.

Objective—To evaluate the outcome of horses with large fragments of the extensor process of the distal phalanx that were removed by use of arthrotomy. Design—Retrospective study. Animals—14 horses with large fragments of the extensor process of the distal phalanx. Procedure—Medical records for horses with large fragments of the extensor process that were removed by use of arthrotomy were reviewed. Data retrieved from medical records included signalment, use of horse, affected limb, lameness history, lameness examination findings, radiographic findings, surgical technique, and outcome. Follow-up evaluation was obtained by telephone interview. Results—Most affected horses were < 5 years old and had a history of chronic lameness. Lameness grade ranged from 1/5 to 4/5. Fragments involved 20 to 45% of the dorsopalmar articular surface of the distal phalanx. Eight of 14 horses had a successful outcome. Outcome was not associated with age, duration or severity of lameness, or fragment size. Conclusions and Clinical Relevance—Despite involvement of a large portion of the articular surface and use of arthrotomy, joint instability and permanent soft tissue injury was not a problem in most horses. Outcome may be improved by selection of horses with lameness of < 2 years' duration and careful management after surgery. A fair prognosis may be anticipated for removal of large fragments of the extensor process via arthrotomy. (J Am Vet Med Assoc 2000; 217:1351–1355)

To determine the effects of intratesticular and incisional injection of local anesthetics on response to castration, surgical ease, and recovery in alpacas.Prospective, blinded, randomized, and clinical trial.Intact male alpacas (n = 38).Alpacas were anesthetized with intramuscular butorphanol, ketamine, and xylazine (BKX). Once recumbent, alpacas were instrumented with electrocardiogram, pulse oximeter, oscillometric blood pressure, and capnography. Heart rate (HR), respiratory rate (RR), and blood pressure (BP) were recorded every minute. Treatment drug (lidocaine, bupivacaine, or saline) was infiltrated along the incision and into both testicles followed by a prescrotal closed castration. Timing of major events, presence of movement during the procedure, need for additional anesthesia, and ease of surgery were recorded. Alpacas were administered postoperative oral meloxicam and assessment was made 24 hours after recovery.Median RR and mean BP (MBP) were lower in the lidocaine compared with the saline treated group. Median RR, HR, and MBP were significantly lower in the bupivacaine group compared with the saline group. Fewer alpacas displayed physical response to surgical stimulus with bupivacaine. No significant differences were found between groups for timing of events, need for additional anesthesia, ease of surgery, or postoperative assessment.Intratesticular local anesthetic blunts autonomic response and facilitates castration in alpacas anesthetized with BKX with minimal negative effects. Bupivacaine may have some benefit for local anesthesia during castration compared with lidocaine.

To determine if application of silver sodium zirconium phosphate polyurethane semi-occlusive foam (SPF) dressing would improve measures of wound healing and decrease bacterial contamination compared with a non-adherent, absorbent dressing applied to wounds created on the distal aspect of the equine limb.Controlled randomized experimental study.Adult Quarter Horse and Thoroughbred horses (n = 5).One 6.25 cm(2) wound was created on the dorsomedial aspect of the proximal metacarpus on each forelimb. A SPF dressing was applied to 1 randomly assigned limb as a treatment and a non-adherent, absorbent dressing was applied to the opposite limb as control. Bandages were changed every 3 days for 60 days. Granulation tissue was scored every 3 days, wound area measured every 6 days, and wound bed was cultured every 12 days.SPF-treatment wounds had significantly decreased wound area and decreased granulation tissue scores when evaluated30 days and over the 60 day study, although complete wound healing times were not significantly different. Bacteria were cultured from all wounds at varying times throughout the study.The SPF wound dressing improved some measures of wound healing compared with the control dressing, most significantly during the first 30 days. This suggests that the SPF wound dressing may be useful in the early management of wounds on the equine lower limb. Further studies using the SPF dressing are needed to characterize the temporal and cellular effects on wound healing and evaluate this dressing in a clinical environment.

To investigate postoperative hemoperitoneum in a population of horses that had surgery for colic.Retrospective case series.Horses (n = 23).Preoperative, intraoperative, and postoperative information was obtained from medical records (1985-2012) of horses with postoperative hemoperitoneum after emergency exploratory celiotomy. Pre-existing hemoperitoneum during surgery and nonsurgical hemoperitoneum were excluded.Of 4520 horses that had emergency exploratory celiotomy for gastrointestinal disease, 23 horses met inclusion criteria; an incidence of 0.5%. Horse signalment approximated the colic population, although Thoroughbreds were significantly overrepresented. Hemoperitoneum was significantly associated with intestinal resection. Postoperative hemoperitoneum was recognized a mean (± SD) of 1.0 ± 0.7 days after surgery and associated with tachycardia, decreasing hematocrit, incisional drainage, or ultrasonographic identification of swirling, echogenic abdominal fluid. Primary treatments included intravenous fluid therapy (n = 23), colloid support (20), blood transfusion (13), and antifibrinolytic agents (11). Fifteen horses (65%) survived to discharge, which was associated with admission lactate and days of hospitalization.Postoperative hemoperitoneum is a rare complication of exploratory celiotomy in horses that should be considered when there are signs of abdominal discomfort and declining hematocrit in the early postoperative period. Prognosis is guarded because of potential sequelae of septic peritonitis and adhesion formation.

To report the clinical findings, incidence of complications, and outcome associated with perineal urethrotomy in equids.Retrospective case series.Equids (n = 27).Medical records (January 2000 to December 2010) of equids that had a perineal urethrotomy were reviewed. Data retrieved and evaluated were breed, age, surgical technique, use of general anesthesia, complications, time from surgery to development of complications and their management, and outcome.Perineal urethrotomy was performed for urolithiasis (n = 22), for treatment of urethral rents (3), severe balanoposthitis (1), and bladder atony caused by equine protozoal myeloencephalitis (1). The incidence of complications was 52%, including recurrence of urolithiasis in 5 (23%) equids. Horses that had postoperative cystoscopy and bladder lavage were significantly less like likely to have recurrence of urolithiasis (P = .039). Of equids that had postoperative indwelling urinary catheters, 75% developed complications.Perineal urethrotomy can be an effective for treatment of urolithiasis, hematuria, and urethral trauma. Postoperative cystoscopy and bladder lavage significantly reduced the incidence of postoperative recurrence of urolithiasis.

To evaluate the association between peritoneal fluid and plasma d-lactate concentration with variables used in the diagnosis and prognosis of horses with colic.Clinically healthy horses (n=6) and 90 horses with colic.Prospective cross-sectional study.D-lactate concentration was determined in peritoneal fluid and plasma of all horses. Information on other blood and peritoneal fluid variables, signalment, results from the physical examination, outcome, need for surgery, lesion location, and type was retrieved from medical records.Peritoneal D-lactate concentration was strongly correlated with plasma D-lactate concentration (r=0.71; P.001). Peritoneal and plasma D-lactate concentrations were positively correlated with peritoneal (r=0.8; P.001) and plasma L-lactate (r=0.33; P=.001) concentrations, respectively. Peritoneal D-lactate concentration was negatively correlated with survival to discharge (U=430.5; P.001). Median peritoneal D-lactate concentration of horses with septic peritonitis (455.2 μmol/L) and horses with gastrointestinal rupture (599.5 μmol/L) were higher compared with horses with nonstrangulating obstructions (77.7 μmol/L). A cut-off concentration of peritoneal D-lactate of 116.6 μmol/L had a sensitivity of 0.813 and a specificity of 0.651 to differentiate between nonstrangulating and strangulating obstructions.Peritoneal D-lactate concentration may be more useful for identifying horses with strangulating obstructions (high sensitivity, low probability of a false negative) than to ruling out strangulating obstruction (moderate specificity, high probability of a false positive).

To determine (1) the short- (to hospital discharge) and long- (6 months) term survival, (2) factors associated with short-term survival, and (3) the perioperative course for horses with resection and anastomosis of the descending colon.Multicentered case series.Horses (n=43) that had descending colon resection and anastomosis.Medical records (January 1995-June 2009) of 7 equine referral hospitals were reviewed for horses that had descending colon resection and anastomosis and were recovered from anesthesia. Retrieved data included history, results of clinical and clinicopathologic examinations, surgical findings, postsurgical treatment and complications, and short-term survival (hospital discharge). Long-term survival was defined as survivalor =6 months after hospital discharge.Of 43 horses, 36 (84%) were discharged from the hospital. Twenty-eight of 30 horses with follow-up information survivedor =6 months. No significant associations between perioperative factors and short-term survival were identified. Lesions included strangulating lipoma (n=27), postfoaling trauma (4), infarction (4), intraluminal obstruction (2), and other (6). Common postoperative complications included fever and diarrhea. During hospitalization 7 horses were euthanatized or died because of septic peritonitis (3), endotoxemia (3), and colic and ileus (1).Descending colon resection and anastomosis has a favorable prognosis for hospital discharge and survivalor =6 months. The most common cause of small colon incarceration was strangulating lipoma.Complications include postoperative fever and diarrhea but the prognosis is good after small colon resection and anastomosis.

Objective— To determine the effect of intrathecal amikacin administration and repeated tenovaginocentesis on the total nucleated cell count (TNCC), total protein (TP) concentration and cytologic characteristics of synovial fluid of the equine digital flexor tendon sheath (DFTS). Study Design— Randomized, cross-over experimental design. Animals— Adult horses (n=8). Methods— Synovial fluid was aseptically collected from the DFTS and either 1 mL amikacin sulfate (250 mg/mL) or lactated Ringer's solution (LRS) was injected into the DFTS. Serial synovial fluid samples were obtained at 0, 12, 24, 48, and 72 hours. The opposite treatment was administered to the contralateral DFTS after a washout period of 2 weeks. Results— Treatment increased TP concentration, TNCC, percentage of neutrophils, and neutrophil counts from baseline levels. There was no difference between treatment of the DFTS with amikacin or LRS. Values peaked at 12–24 hours after the initial centesis and then declined toward baseline levels. Conclusions— Injection and repeat centesis of the normal DFTS with 250 mg amikacin or an equivalent volume of LRS resulted in mild increases in synovial fluid analytes from baseline. Synovial inflammation in this study was not accompanied by lameness at the walk and measured analytes returned toward baseline levels within 12–24 hours of first injection. Clinical Relevance— The effect of tenovaginocentesis and intrathecal administration of amikacin or LRS on DFTS synovial fluid values are modest in most horses; however, some horses can develop marked increases in synovial fluid values that may be interpreted as sepsis.

Simple complete dorsal fractures of the proximal phalanx were repaired in 2 mature pleasure horses with cortical bone screws placed in lag fashion. Healing occurred within 12 weeks and both horses returned to their previous performance level of light pleasure riding within 6 months of injury.

Some unique subclasses of Camelidae antibodies are devoid of the light chain, and the antigen binding site is comprised exclusively of the variable domain of the heavy chain (VHH). Although conventional antibodies dominate current assay development, recombinant VHHs have a high potential as alternative reagents for the next generation of immunoassay. We expressed VHHs from an immunized alpaca and developed a VHH-based immunoassay using 3-phenoxybenzoic acid (3-PBA), a major metabolite of pyrethroid insecticides as a model system. A phage VHH library was constructed, and seven VHH clones were selected by competitive binding with 3-PBA. The best immunoassay developed with one of these VHHs showed an IC(50) of 1.4 ng/mL (limit of detection (LOD) = 0.1 ng/mL). These parameters were further improved by using the phage borne VHH, IC(50) = 0.1 ng/mL and LOD = 0.01 ng/mL. Both assays showed a similar tolerance to methanol and dimethylsulfoxide up to 50% in assay buffer. The assay was highly specific to 3-PBA and its 4-hydroxylated derivative, 4-hydroxy 3-PBA, (150% cross reactivity) with negligible cross reactivity with other tested structural analogues, and the recovery from spiked urine sample ranged from 80 to 112%. In conclusion, a highly specific and sensitive VHH for 3-PBA was developed using sequences from immunized alpaca and phage display technology for antibody selection.