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Identifying therapies that mitigate ischemic colonic injury and improve mucosal healing and intestinal viability are crucial to improving survival in horses with ≥360° large colon volvulus (LCV). Ethyl pyruvate is the ethyl ester of pyruvate with diverse pharmacologic effects that limit ischemic injury and hasten intestinal mucosal repair in preclinical rodents, sheep and swine models. The objective of this study was to determine the effects of ethyl pyruvate on systemic indices of colon viability, expression of inflammatory genes in whole blood, morbidity and survival after surgical correction of LCV compared to controls. Horses received either 150 mg/kg ethyl pyruvate in 1 liter lactated Ringer's solution (LRS) or 1 liter LRS intravenously (IV) every 6 h for 24 h following surgical recovery for correction of LCV. Colic duration, perioperative heart rate (HR), packed cell volume (PCV), total solids (TS), blood L-lactate concentration, surgical time, intraoperative episodes of hypoxemia and hypotension, expression of inflammatory cytokine genes, fecal consistency and survival to hospital discharge were compared between ethyl pyruvate treated horses and controls. Twenty-two horses, 12 receiving ethyl pyruvate and 10 controls, were enrolled in the study. Ethyl pyruvate was safely administered to horses following surgical correction of LCV. No significant effects of ethyl pyruvate on post-operative variables, including survival, were found. Seven of 12 ethyl pyruvate treated horses and 5/10 controls survived to hospital discharge. Higher HR, PCV and blood L-lactate concentration at the time of hospital admission, P = 0.005, 0.01, 0.04, respectively, 24 h after surgery, P = 0.001, 0.03, 0.02, respectively, were associated with death. Heart rate, P = 0.005, 48 h after surgery was associated with death. Ethyl pyruvate was safely administered to horses following correction of LCV with no apparent adverse events but was not associated with improved post-operative outcomes including survival. A larger, randomized control trial is needed to fully evaluate the effectiveness of ethyl pyruvate. A major limitation of this investigation is the small sample size, making the study underpowered and creating a high possibility of type II error.

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OBJECTIVE: To review the veterinary literature regarding healing and complications associated with equine celiotomy including anatomy and physiology, risk factors for incisional infection and hernia, and treatment. ETIOLOGY: Celiotomy is the most common approach to treat horses with surgical colic. Incision through the linea alba provides exposure to most of the abdomen for exploration, exteriorization, and correction of surgical lesions. Incisional apposition relies on suture strength during anesthetic recovery and for the first 30 days postoperatively. Factors associated with the patient, surgical lesion and procedures, anesthesia, and recovery put the horse at risk for surgical site infection. Infection is the most important risk factor for incisional hernia formation. DIAGNOSIS: A presumptive diagnosis of surgical site infection is made based on the presence of fever and incisional swelling, pain, and discharge. Ultrasonography can be used to identify areas of fluid accumulation prior to the appearance of incisional drainage. Definitive diagnosis is based on positive bacteriologic culture of the incisional discharge. Incisional hernia is diagnosed by palpation of the incision, usually 30-60 days after surgery. Ultrasound of the incision may aide in early diagnosis of incisional hernia if gaps along the incision in the linea alba are apparent. THERAPY: No objective data exist to assess the efficacy of specific therapies for surgical site infections following celiotomy. Principles of treatment include the establishment of drainage, bandaging, antimicrobial therapy based on culture and sensitivity, and extended rest in an attempt to avoid incisional hernia or dehiscence. Treatment for incisional hernia includes prolonged circumferential bandaging, open or minimally invasive hernia repair, or no treatment. PROGNOSIS: Incisional complications are associated with prolonged convalescence and diminished prognosis for return to athleticism. Limiting risk factors for surgical site infections, prompt treatment, and incisional support may optimize celiotomy healing and timely return to function. Horses compete in many disciplines with incisional hernias.

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We conducted a retrospective cohort study to test the hypothesis that performing 4 weeks of core abdominal rehabilitation exercises (CARE) postoperatively would be safe and associated with faster return to training and improved performance after colic surgery. Performance horses that recovered from colic surgery performed by the same surgeon and survived ≥ 1 year from 2008 to 2017 were included. Data were obtained from a review of medical records. Information about the horses' rehabilitation and performance was obtained from owners/trainers. Data from horses that completed a 4-week CARE program after surgery were compared with control horses that did not do the exercises after colic surgery. Data were analyzed using univariate and multiple regression, P < .05. Eleven CARE horses and 51 controls between the ages of 3 and 18 years were included in the data analysis. All CARE horses completed the rehabilitation program with no reported complications, returned to work faster after surgery, P = .002, and to training faster, P = .0002. After colic surgery, 81% of CARE horses improved their performance level compared with 7.8% of controls, P < .001. Core abdominal rehabilitation exercises were safely performed by horses after colic surgery with no reported complications and may have facilitated faster convalescence and improved performance.

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The purpose of this study was to develop a minimally invasive approach to equine cervical articular facet joints for application of an ND:YAG LASER and to evaluate the effects of the laser fiber on the surrounding tissue. Under general anesthesia, an ND:YAG LASER was used to apply 2000 J of energy to 5 cervical articular facet joints in 3 horses (15 joints total). Horses were euthanized and the cervical facets and spinal cords were examined grossly and histologically. Gross pathology of the articular facets revealed evidence of articular cartilage charring and diffuse roughening of the surface. Histopathology confirmed coagulative necrosis. This novel technique allowed access to the cervical articular facet joints with the ND:YAG LASER and has the potential to allow performance of a minimally invasive facilitated ankylosis procedure. Further validation in sedated, standing horses is required to establish safety and efficacy of this technique.

Développement d'une approche minimalement invasive pour les facettes vertébrales lombaires équines pour le placement d'un LASER ND:YAG. Le but de cette étude était de développer une approche minimalement invasive pour l'application d'un LASER ND:YAG sur les facettes vertébrales lombaires équines et l'évaluation des effets de la fibre laser sur les tissus environnants. Sous anesthésie générale, un LASER ND:YAG a été utilisé pour appliquer 2000 J d'énergie à 5 facettes vertébrales lombaires chez 3 chevaux (total de 15 articulations). Les chevaux ont été euthanasiés et les facettes vertébrales et les colonnes vertébrales ont été examinées macroscopiquement et histologiquement. La pathologie macroscopique des facettes vertébrales lombaires a révélé des preuves de carbonisation du cartilage dens articulaires et un durcissement diffus de la surface. L'histopathologie a confirmé la nécrose decoagulatio. Cette technique nouvelle a permis l'accès aux facettes vertébrales lombaires avec le LASER ND:YAG et a le potentiel de permettre la réalisation d'interventions d'ankylose minimalement invasives. De nouvelles études de validation chez des chevaux debout sous sédation sont requises pour établir l'innocuité et l'efficacité de cette technique.(Traduit par Isabelle Vallières).

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OBJECTIVE: The purpose of this study was to determine whether there was a correlation between circulating and intra-synovial Dkk-1 and radiographic signs of equine osteoarthritis. METHODS: Circulating and intra-synovial Dkk-1 levels were measured in clinical cases using a commercially available human Dkk-1 ELISA. Radiographs were performed of the joints from which fluid was collected and these were assessed and scored by a boarded radiologist for joint narrowing, subchondral bone sclerosis, subchondral bone lysis, and periarticular modelling. Comparisons were made between radiographic scores and the concentrations of Dkk-1 using a Kruskal-Wallis one-way ANOVA. Correlations were calculated using Kendall's statistic. RESULTS: A total of 42 synovial fluid samples from 21 horses were collected and used in the analysis. No significant correlation was identified between Dkk-1 concentrations and radiographic signs of osteoarthritis. Intra-synovial Dkk-1 concentrations were significantly greater (p <0.001) in low motion joints (mean concentration, 232.68 pg/mL; range, 109.07-317.17) when compared to high-motion joints (28.78 pg/mL; 0.05-186.44 pg/mL) (p <0.001). CLINICAL SIGNIFICANCE: Low motion joints have significantly higher concentrations of Dkk-1 compared to high motion joints. Further research is needed to establish the importance of this finding and whether potential diagnostic or therapeutic applications of Dkk-1 exist in the horse.

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