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Objective: To determine changes in blood granulocyte counts and in plasma myeloperoxidase (MPO) and elastase (ELT) concentrations in surgical colic cases, and to determine the relationship between these changes and the surgical procedure performed, occurrence of postoperative ileus, and final outcome., Design: Prospective clinical study conducted over a 12-month period., Setting: University teaching hospital., Animals: Fifty-three horses undergoing emergency laparotomy and surviving at least 12 hours postoperatively., Interventions: Blood samples were taken before surgery, during surgery, at the recovery from anesthesia, and then serially until the 150th hour after the first blood sampling. Granulocyte counts were performed by an automated cell hematology analyzer. Specific ELISAs were performed for the MPO and ELT measurements. Mixed models were used to compare the time-trends of the 3 parameters., Measurements and Main Results: Taking all horses together, the time-trends of MPO and ELT were not significantly different from each other, but they were significantly different from the granulocyte time-trend. The type of surgical procedure did not influence the time-trends of the 3 parameters. Significant changes in the granulocyte time-trends were associated with postoperative ileus and outcome. Significant changes in the MPO time-trends were associated with outcome. The ELT time-trends were not influenced by ileus or outcome., Conclusions: Granulocyte counts and MPO change over time and are related to the severity of the inflammatory reaction in surgical colic cases. These time-trends may allow evaluation of treatment efficacy in an effort to modulate excessive granulocyte activation and degranulation., (© Veterinary Emergency and Critical Care Society 2016.)

Objective: To assess the prognostic value of echocardiographic parameters of left ventricular (LV) function in horses with systemic inflammatory response syndrome (SIRS)., Design: Prospective observational study., Setting: Veterinary teaching hospital., Animals: Forty-one horses admitted for colic with clinical evidence of SIRS., Interventions: All horses underwent Doppler echocardiographic examination on admission. LV echocardiographic parameters, including pulsed-wave tissue Doppler imaging parameters, were compared between nonsurvivors (n = 29) and horses that survived to discharge (n = 12)., Measurements and Main Results: With comparable heart rate and LV preload estimate, LV stroke volume index, the velocity time integral, deceleration time, ejection time of Doppler aortic flow, and peak early diastolic myocardial velocity were lower in the nonsurviving than in the surviving horses, while pre-ejection period to ejection time ratio (PEP/ET) of Doppler aortic flow and the peak early diastolic filling velocity to peak early diastolic myocardial velocity ratio (E/Em) were higher (P < 0.05). A cut-off value of 0.26 for PEP/ET predicted mortality with 100% sensitivity and 42% specificity (area under the receiver operating characteristic curve: 0.71), whereas a cut-off value of 2.67 for E/Em predicted mortality with 100% sensitivity and 83% specificity (area under the receiver operating characteristic curve: 0.89)., Conclusions: Echocardiography may provide prognostic information in colic horses with clinical evidence of SIRS. Especially, PEP/ET and E/Em could be useful markers of systolic and diastolic dysfunction, respectively, to detect horses with a high risk of death requiring more intensive cardiovascular monitoring as it has been reported in human patients with septic shock., (© Veterinary Emergency and Critical Care Society 2014.)

Recent studies have shown that hydro-alcoholic solutions are more efficient than traditional medicated soaps in the pre-surgical hand antisepsis of human surgeons but there is little veterinary literature on the subject. The aim of this study was to compare the efficiency of medicated soaps and a hydro-alcoholic solution prior to surgery using an in-use testing method in a veterinary setting. A preliminary trial was performed that compared the mean log(10) number of bacterial colony forming units (CFU) and the reduction factors (RF) between two 5-min hand-scrubbing sessions using different soaps, namely, povidone iodine (PVP) and chlorhexidine gluconate (CHX), and the 1.5-min application of a hydro-alcoholic rub. A clinical in-use trial was then used to compare the hydro-alcoholic rub and CHX in a surgical setting. Sampling was performed using finger printing on agar plates. The hydro-alcoholic rub and CHX had a similar immediate effect, although the sustained effect was significantly better for the hydro-alcoholic rub, while PVP had a significantly lower immediate and sustained effect. The hydro-alcoholic rub showed good efficiency in the clinical trial and could be considered as a useful alternative method for veterinary surgical hand antisepsis., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Objective: To assess current habits for surgical hand preparation among veterinary surgical specialists and to compare data with current guidelines for hand asepsis techniques., Study Design: Survey of veterinary surgical specialists., Sample Population: Diplomates of the American (ACVS) and European Colleges of Veterinary Surgeons (ECVS)., Methods: An internet-based survey of hand preparation methods before surgical procedures was conducted of 1300 listed ACVS and ECVS Diplomates., Results: A 42.6% response rate was obtained. Approximately, 80% of respondents use disinfecting soaps as a primary method for hand antisepsis. Of those, 81% use chlorhexidine-based scrubs and 7% use a neutral soap followed by a hydroalcoholic solution., Conclusions: Contrary to current recommendations of the World Health Organization and scientific evidence supporting use of hydro-alcoholic rubs for presurgical hand preparation, veterinary surgical specialists still use surgical scrub solutions containing disinfecting soaps., (© Copyright 2011 by The American College of Veterinary Surgeons.)

Equine neutrophil elastase (NE) is a protease released in inflammatory diseases and participating in tissue destruction. To measure NE in horse plasma to assess its role in pathological conditions, we purified elastase from equine neutrophils by a double step chromatography and obtained a pure protein of 27 kDa, 4 kDa smaller than the NE 2A previously purified (Scudamore et al., 1993; Dagleish et al., 1999), which was likely to be NE 2B. We developed an ELISA by using two specific polyclonal antibodies obtained from rabbit and guinea pig. The sandwich complex was detected using a secondary antibody conjugated to alkaline phosphatase. The ELISA showed good precision and accuracy, with intra- and inter-assay coefficients of variation below 10% for equine NE concentrations ranging from 1.875 to 60 ng/ml. A stable plasma NE value, unaffected by the delay of centrifugation (over 4h), was obtained with plasma from EDTA anticoagulated blood. The mean value (+/-SEM) measured in 37 healthy horses was 32.53+/-4.6 ng/ml. NE level in plasma of horses with colic at the time of admission was significantly higher than in healthy horses. Our results indicate that the ELISA technique we developed to measure plasmatic NE is a powerful tool for studying the role of elastase in equine inflammatory disease. In future, the application will be extended to other equine biological fluids., (Copyright 2009 Elsevier B.V. All rights reserved.)

Persistent Meckel's diverticulum is an uncommon embryonic developmental anomaly of the distal small intestine created by a portion of the vitelline duct adjacent to intestine that remains patent. This portion can form a diverticulum (Meckel's diverticulum) or a fibrous band, called vitelloumbilical band, and can be associated with colic after local impaction or strangulation of the small intestine around the remnant. This report describes two cases of Meckel's diverticulum with different morphological features in older horses. This congenital disorder should be considered as a reason for abdominal pain, even in the older horse, and should be included in the differential diagnosis of acute abdominal pain and recurrent moderate colic.

Establishing the osteoarticular status of the horse is often performed by means of radiological screening of the animals. Widespread blood sampling could reveal to be an interesting alternative to this procedure which is time consuming and sometimes technically difficult. The aim of this study was to investigate the relationship between the radiological status of the horses and the levels of biochemical markers of cartilage degradation and synovial inflammation. A specific radiological scoring and classification system was therefore developed and applied on 63 stallions presented for studbook admission. Additionally, groups of horses were established according to the occurrence of osteochondrosis, degenerative joint disease and distal interphalangeal joint effusion. Insulin growth factor-I, myeloperoxidases, Coll2-1 and Coll2-1NO(2) were used as blood markers. The combination of the blood parameters did not seem to correlate with the used scoring system. Coll2-1NO(2) levels however tended to increase with poorer radiological class and this could therefore potentially be a useful predictor of the osteoarticular status in the horse. Coll2-1 levels were significantly higher in the degenerative joint disease group. A high percentage of horses with distal interphalangeal joint effusion was present in this study and was associated with decreased IGF-I and increased Coll2-1 levels.

Objectives: The aim of this study is to describe the prevalence of postoperative laminitis in colic cases and to determine if low-molecular-weight heparin (LMWH) is effective in preventing this complication., Design: Retrospective clinical study., Animals: Client-owned horses. Interventions- SC administration of enoxaparin during the postoperative period., Measurements and Main Results: Medical records of 360 horses undergoing surgery for colic and surviving at least 3 days were evaluated. Fifty-six horses admitted before 1995 did not receive LMWH (control group) and 304 admitted after 1995 received LMWH as a prophylaxis for laminitis (treatment group). Three grades of severity were defined for laminitis. Prevalence and severity of laminitis were compared between the 2 groups. Several parameters recorded on admission (sex, age, breed, site and nature of the disease, heart rate, PCV, gravity score, and shock score) and the administration of LMWH were tested as risk factors in the development of laminitis in a logistic regression procedure. Prevalence and grade of laminitis were significantly lower in the treatment group. Only the absence of LMWH was recognized as a significant risk factor in the logistic regression model., Conclusions: The administration of LMWH appears to be effective in the prophylaxis of laminitis following colic surgery and may be useful in the postoperative management of these horses.

Objective: To describe a technique for, and outcome after, mandibular osteodistraction in the horse., Study Design: Clinical report., Animals: Warmblood horse., Methods: A half ring external fixator was applied on both sides of an osteotomy site performed on the mandible of a colt. A bite plate was placed on the upper incisors creating occlusion between lower and upper jaw. After a 5-day latency period, distraction was applied (1 mm/day) until the overjet was judged normal., Results: Mandibular elongation and correction of brachygnathia was obtained without major complications. Six months after the procedure the overjet reduction was considered stable., Conclusions: Mandibular osteodistraction can be considered for treatment of severe brachygnathia in yearlings., Clinical Relevance: Distraction osteogenesis has the advantage of progressive elongation of the mandible, allowing concurrent bone remodeling and soft tissue adaptation. Severe mandibular incisor malocclusion in horses outside the maximal growth phase can be corrected using this technique.

Background: Few studies exist about factors affecting the outcome of horses with tetanus., Animals: 31 equids (30 horses and 1 donkey) with a clinical diagnosis of tetanus admitted to the Equine Clinic of the University of Liege between 1991 and 2006. The cases were divided into two groups according to the outcome (survivors and non-survivors)., Methods: The clinical data of survivors and non-survivors were compared using an ANOVA (continuous data) or a Fisher's test (discrete data)., Results: The survival rate was 32%. Most animals were 5 years or younger, and none had been appropriately vaccinated. The non-survivors were significantly younger than the survivors. The development of dyspnoea, recumbency, and the combination of dysphagia, dyspnoea, and recumbency was observed significantly more in the non-survivors than in the survivors. The timing of tetanus antitoxin administration (either immediately after the onset of suggestive signs or after a delay) was not different between the two groups. The time between the occurrence of a wound and the first signs ranged from 2 days to 2 months and was not significantly different between groups. All non-survivors died within 8 days of the first signs., Conclusions & Clinical Importance: This study suggests that young animals are affected more often and more severely by tetanus than older animals. Dyspnoea, recumbency, and the combination of dysphagia, dyspnoea, and recumbency can be considered as indicators of a poor prognosis in equids suffering from tetanus.

Gastrointestinal disorders, especially strangulating intestinal obstructions, are still a major cause of illness and death in the horse. Circulating lipopolysaccharides may activate both neutrophils and monocytes. The activated neutrophils release myeloperoxidase (MPO), a specific enzyme with strong oxidative activity. The aim of this study was to evaluate MPO concentrations in the plasma and peritoneal fluid (PF) of horses with colic and to check the hypothesis that these concentrations would be higher in a case of strangulating obstruction than in cases of nonstrangulating disease. By using a specific enzyme-linked immunosorbent assay for equine MPO, we determined the MPO concentrations in horses admitted to a clinic for colic. Horses with nonstrangulating or strangulating obstruction of the large intestine (NSLI or SLI), strangulating obstruction of the small intestine (SSI), or inflammatory bowel disease (IBD) were compared with healthy horses. The horses with SLI, SSI, or IBD had significantly higher MPO levels in plasma and PF than did those in the other 2 groups. The mean plasma level was significantly higher in the horses with NSLI than in the healthy horses. High MPO values in PF indicated necrotic bowel. These results show that neutrophil activation occurs during nonstrangulating and strangulating intestinal obstruction in horses and that the plasma and PF MPO concentrations may be a marker of the severity of the disease.

Shock is accompanied by generalised splanchnic hypoperfusion, and splanchnic organs like the pancreas can be damaged, as shown in animal experimental models and in humans, by the presence of high plasma concentrations of trypsin and other pancreatic enzymes. In order to design a radioimmunoassay technique (RIA) for the measurement of equine trypsin-like immunoreactivity (TLI) in biological fluids, trypsin was purified (with purity > or = 96%) from the equine pancreas by extraction in an acid medium, ammonium sulfate precipitations, gel filtration chromatography and, after activation of trypsinogen into trypsin, affinity chromatography. Gel polyacrylamide electrophoresis showed a monomeric enzyme with a molecular weight of 27 kDa. The purified equine trypsin served for the immunisation of rabbits in order to obtain a specific antiserum, and the labelled antigen was prepared by iodination of equine trypsin with 125I. The RIA was based on the binding of the antigen to the antibody followed by the separation of the antigen-antibody complex by immunoprecipitation in the presence of sheep anti-rabbit gammaglobulins and the assay of the radioactivity in the precipitate. The RIA showed good sensitivity, specificity, precision, accuracy and reproducibility. The reference mean value of TLI in the plasma of healthy horses (n = 20) was 30.01+/-6.84 ng/mL (upper confidence limit 50.52 ng/mL; p < 0.01). Three horses with non strangulating intestinal obstruction without shock showed TLI values within normal limits whereas 5 of 7 horses with strangulation obstruction showed TLI levels above the upper confidence limit. Further studies using the RIA and the enzymatic assay should be performed in order to confirm the role of the pancreas in equine intestinal obstruction.

Forty-eight horses subjected to elective surgery were randomly assigned to three groups of 16 horses. After premedication with 0.1 mg/kg acepromazine intramuscularly and 0.6 mg/kg xylazine intravenously, anaesthesia was induced either with 2 g thiopentone in 500 ml of a 10 per cent guaifenesin solution, given intravenously at a dose of 1 ml/kg (group TG), or with 100 mg/kg guaifenesin and 2.2 mg/kg ketamine given intravenously (group KG), or with 0.06 mg/kg midazolam, and 2.2 mg/kg ketamine given intravenously (group KM). Anaesthesia was maintained with isoflurane. The mean (sd) end tidal isoflurane concentration (per cent) needed to maintain a light surgical anaesthesia (stage III, plane 2) was significantly lower in group KM (0.91 [0.03]) than in groups TG (1.11 [0.03]) and KG (1.14 [0.03]). The mean (sd) arterial pressure (mmHg) was significantly lower in group KG (67.4 [2.07]) than in groups TC (75.6 [2.23]) and KM (81.0 [2.16]). There were no significant differences in the logarithm of the heart rate, recovery time or quality of recovery between the three induction groups. However, pronounced ataxia was observed in the horses of group KM, especially after periods of anaesthesia lasting less than 75 minutes.

Myeloperoxidase (MPO) is a specific enzyme of neutrophil azurophilic granules with a strong oxidative activity. Thanks to a radioimmunoassay of equine myeloperoxidase, the authors have observed a significantly higher plasma level of MPO in horses operated for strangulation obstruction of the large intestine (n = 6) than in horses suffering from a non-strangulating displacement of the large intestine (n = 9). For the 2 groups, 3 phases were distinguished: reception (P1), intensive care (P2) and terminal phase (P3). The mean peak values of MPO for these phases were 121.6 ng/mL (P1), 168.6 ng/mL (P2), and 107.0 ng/mL (P3) for the non-strangulating group, and 242.6 ng/mL (P1); 426.0 ng/mL (P2), and 379.5 ng/mL (P3) for the strangulation group. The variations of the mean peak values of plasma MPO were significantly different between the 2 groups and between the different phases. A significant increase of the least square means of MPO was observed between P1 and P2. A significant decrease of the least square means of the number of circulating leukocytes was observed between P1 and P3. Polymorphonuclear neutrophil activation could play a major role in the pathogenesis of acute abdominal disease and endotoxic shock.