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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.

In October 2008, a 15-year-old female alpaca ( Vicugna pacos) housed at a breeding farm in northern California died after a brief illness characterized by sudden onset of weakness, recumbency, and respiratory distress. Postmortem examination revealed severe hydrothorax and hydropericardium, marked pulmonary edema, and acute superficial myocardial hemorrhage affecting the left ventricle. Bluetongue virus (BTV) was detected in the spleen by quantitative real-time reverse transcription polymerase chain reaction and confirmed by sequence analysis. No antibodies against BTV were detected in the serum using a competitive enzyme-linked immunosorbent assay, confirming acute, fulminant BTV infection.

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 compare 3 portable handheld analyzers with a bench top blood gas analyzer for measurement of blood and peritoneal fluid L-lactate concentrations in horses admitted with signs of colic.Prospective clinical study.Blood and peritoneal fluid from horses with colic.L-lactate concentrations in heparinized blood and peritoneal fluid were measured serially on 10 occasions to evaluate repeatability of the portable analyzers. Blood and peritoneal fluid L-lactate concentrations were simultaneously evaluated by a bench top and 3 portable analyzers and the results compared by intraclass correlation coefficients and Bland Altman plots. L-Lactate concentrations in a subgroup of peritoneal fluid samples were evaluated by a chromogenic laboratory assay and compared with the bench top and the handheld analyzers.Portable lactate analyzers had good intra-analyzer reliability for peritoneal fluid. Two portable analyzers had poor intra-analyzer reliability for mid concentrations of L-lactate in blood. L-lactate measurements from portable analyzers were closer to the bench top analyzer at low concentrations of L-lactate than at higher concentrations. Compared with the bench top analyzer, the Lactate Pro and Lactate Plus have the highest intraclass correlation coefficient and the smallest bias for peritoneal fluid and blood L-lactate, respectively. The bench top analyzer and the Lactate Pro had the highest level of agreement for peritoneal fluid compared with the chromogenic assay.Although portable analyzers are alternatives for the measurement of L-lactate concentration in field situations, clinicians need to be aware of the variable results between analyzers, especially when extrapolating means or cutoff values from studies using different lactate analyzers.

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).

Objective To evaluate the association between peritoneal fluid and plasma d-lactate concentration with variables used in the diagnosis and prognosis of horses with colic. Animals Clinically healthy horses (n=6) and 90 horses with colic. Study Design Prospective cross-sectional study. Methods 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. Results Peritoneal d-lactate concentration was strongly correlated with plasma d-lactate concentration (r=0.71; P

To compare agreement between a portable clinical analyzer and laboratory-based bench-top analyzer for analysis of pH, lactate, and glucose concentrations in synovial fluid.Prospective experimental study.Clinically normal horses (n=8); 6 horses euthanatized for reasons unrelated to the study; 11 horses that had synoviocentesis for reasons other than sepsis; 7 horses that had synoviocentesis for evaluation of sepsis; and 2 horses without recorded clinical data. Median age of horses was 8 years (range, 1 day to 24 years).Supernatant from each synovial fluid sample was analyzed for pH, lactate, and glucose concentrations using an ABL 705 laboratory-based bench-top analyzer and i-STAT portable clinical analyzer. Bland-Altman plots were constructed and concordance analysis performed to determine bias and agreement between the 2 analyzers.There was acceptable agreement between analyzers for lactate and glucose concentrations, with biases of 0.198 mmol/L and 9 mg/dL and concordance correlation coefficients of 0.97 and 0.96 for lactate and glucose, respectively. The agreement between analyzers for pH was not acceptable, with a bias of -0.057 and concordance correlation coefficient of 0.89.This study found that the portable clinical analyzer performed similarly to the bench-top blood gas analyzer for evaluation of lactate and glucose concentrations, but not pH, in synovial fluid.

To determine whether in healthy horses and those with colic, exposure of peritoneal fluid to room air affects values obtained on biochemical analysis.Prospective study.Adult horses with a primary complaint of acute abdominal pain (n=29) and 12 healthy horses.Peritoneal fluid was aseptically collected under aerobic and anaerobic conditions. After collection, pH, PCO(2) , PO(2) , HCO(3) (-) , Na(+) , ionized Ca(2+) , K(+) , lactate, and glucose were immediately measured using a commercial blood gas analyzer. Biochemical variables were compared between aerobically and anaerobically obtained samples using a paired t-test.In healthy horses, peritoneal fluid samples collected under anaerobic conditions had higher PCO(2) and ionized Ca(2+) and lower PO(2) , HCO(3) (-) , and pH compared with samples exposed to air. No differences were observed for K(+) , Na(+) , glucose, and lactate. In horses with colic, samples collected anaerobically had higher PCO(2) , ionized Ca(2+) , Na(+) , and glucose and lower PO(2) , HCO(3) (-) , and pH value compared with samples exposed to air. No differences were observed for K(+) and lactate.Exposure of peritoneal fluid to room air had a significant effect on pH, PCO(2) , PO(2) , and variables associated or dependent on changes in pH such as HCO(3) (-) and ionized Ca(2+) . Interpretation of biochemical analysis of peritoneal fluid may be influenced by sample collection method.

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.

Objectives: 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. Study Design: Multicentered case series. Animals: Horses (n=43) that had descending colon resection and anastomosis. Methods: 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 survival ≥6 months after hospital discharge. Results: Of 43 horses, 36 (84%) were discharged from the hospital. Twenty-eight of 30 horses with follow-up information survived ≥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). Conclusions: Descending colon resection and anastomosis has a favorable prognosis for hospital discharge and survival ≥6 months. The most common cause of small colon incarceration was strangulating lipoma. Clinical Relevance: Complications include postoperative fever and diarrhea but the prognosis is good after small colon resection and anastomosis.

Gastroscopic examinations were performed in 62 Thoroughbred broodmares (33 pregnant, 29 non-pregnant) at one breeding farm to investigate the prevalence of gastric ulceration. Age, pregnancy status, race earnings, last race start, herd size, medical history, number of live foals, breeding years, feed type and number of feedings were recorded, plus coat condition and body condition score were determined. Twenty-one mares were re-evaluated after foaling, and the foaling date, foal weight at birth and placenta weight were recorded. The overall prevalence of gastric ulcers was 70.9%, with a median ulcer score of 3.0 (range: 2-5). Most ulcers were present on the squamous portion of the stomach, while two mares had glandular ulcers. There were no differences in the presence, location and severity of gastric ulcers between pregnant and non-pregnant mares. Furthermore, there were no significant associations between the variables measured and the presence of gastric ulceration. The prevalence of gastric ulceration in this specific population of horses was higher than expected and further investigation is warranted to determine the factors that contributed to this finding.

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.

Standing female urogenital endoscopic surgery is facilitated by the more dorsal location of the organs of the female reproduction tract. The most common reason for laparoscopic surgery on the female urogenital system is ovariectomy; however, the technique has been used to diagnose periparturient or reproductive diseases and to perform surgical embryo transfer. Standing surgical approaches avoid the risk and expense of general anesthesia, but these techniques are limited by the temperament and size of the patient and the availability of facilities for restraint. Owner acceptance of laparoscopic procedures is excellent. It is anticipated that standing endoscopic surgery may become the preferred technique for applicable procedures.

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.