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Management of gastrointestinal pain.

Choice of an analgesic for gastrointestinal pain requires consideration of the cause of the pain, desired duration of pain relief, need for sedation, and potential side effects and toxicity, particularly in light of other drugs being used and effects on the gastrointestinal tract. It is imperative that close monitoring be continued to ensure that surgical lesions or worsening conditions are detected. Recent research in the field may lead to new drugs, drug combinations, and avenues of treatment that minimize the side effects of these drugs while maximizing their efficacy.

Analgesia↗

Recurrent airway obstruction--heaves.

Heaves, or recurrent airway obstruction (RAO), is a chronic respiratory disease featuring lower airway inflammation, bronchoconstriction, and mucus accumulation. Inhaled organic dusts and T helper 2 type immunologic reactions are involved in the complex pathophysiology of RAO. Clinical signs vary and alternate with remission periods. The diagnosis is often based on history and clinical examination in severe cases, but bronchoalveolar lavage may be useful for the detection of early cases. The most important aspect of treatment is to avoid exposure to allergens. Corticosteroids may be administered systemically or by inhalation in combination with bronchodilators and environmental control.

Adrenal Cortex Hormones↗

Standing female equine urogenital endoscopic surgery.

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.

Animals↗

Thermographic diagnostics in equine back pain.

Infrared thermographic imaging (ITI) is the most sensitive objective imaging currently available for the detection of back disease in horses. It is, however, only a physiological study primarily of vasomotor tone overlying other superficial tissue factors. Interpretation requires extreme care in imaging protocol and in understanding the significance of altered sympathetic nervous tone and the sympathetic distribution. Most discussions on back pain have centered on nociception and inflammatory events. ITI provides information and localization for more significant than diagnosing areas of hot spots. Chronic back pain usually involves vasoconstriction at the affected sites and from ITI studies in man, we have an opportunity to appreciate chronic pain phenomena that involves non-inflammatory events. These occur commonly in horses, but are still seldom recognized and treated.

Animals↗

Diseases and surgery of the large colon.

Displacements and intraluminal obstructions of the large colon carry a good to excellent prognosis for long-term recovery, and surgery for these diseases is rarely followed by short-term or long-term complications. Entrapment of the large colon over the renosplenic ligament is amenable to medical therapies so that surgery can be avoided in many cases. However, preoperative diagnosis of all nonstrangulating diseases of the large colon can be difficult. Vascular diseases of the large colon, such as thromboembolic diseases and large colon volvulus, are more difficult to treat and carry a poorer prognosis for survival.

Animals↗

Abdominal surgery in foals.

Foals are good candidates for abdominal surgery because their smaller size permits a more complete abdominal exploration and frequently definitive procedures in many cases. The use of rectal examination is replaced with alternative diagnostic modalities such as barium contrast radiography and ultrasonography. With the advancements in these technologies they can distinguish common gastrointestinal lesions and, in most cases, provide sufficient information to guide surgical intervention. The unique aspects of diagnosis and surgical management of gastrointestinal disorders of the foal are discussed.

Abdomen↗

Equine ehrlichiosis.

Equine ehrlichiosis is a seasonal disease of horses first reported in 1969. Clinical signs in horses include high fever, depression, partial hypophagia, anorexia, limb edema, petechiation, icterus, ataxia, and reluctance to move. Hematologic changes include leukopenia, thrombocytopenia, icterus, anemia, and inclusion bodies, principally in neutrophils and occasionally in eosinophils. Diagnosis is made by clinical signs and observing characteristic morulae in a blood smear with standard Wright's stain. Mortality is low unless secondary infection develops or injury occurs as a result of incoordination. Treatment with tetracycline produces prompt defervescence of fever and gradual improvement of clinical signs.

Animals↗

Principles of therapeutics.

Topical administration of drugs is the treatment of choice for diseases of the anterior segment. Drug levels attained by this means are usually of short duration, however, necessitating frequent therapy or continuous perfusion if prolonged drug levels are required. A drug-delivery device (collagen shield or contact lens) or subconjunctival injections can be used to augment topical therapy if frequent treatment is not possible. Subconjunctival injections are recommended for drugs that have low solubility and, hence, low corneal penetration. Retrobulbar injections are seldom indicated, except for regional anesthesia. Systemic administration is useful for anti-inflammatory therapy but it may be difficult to establish therapeutic levels of antibiotic agents in the eye because of the blood-ocular barrier. In severe cases, intraocular injection may be required.

Administration, Topical↗

Clinical examination of the equine foot.

The foot is the most common source of limb pain. The problems vary from simple to quite complex. An accurate diagnosis is dependent upon a thorough and detailed knowledge of anatomy and of what is available in the way of ancillary examination techniques. The correction of most foot problems requires an appreciation of a multitude of factors and a thorough knowledge of farrier science.

Animals↗

Radiographic examination of the equine foot.

A complete radiographic examination of the equine foot consists of properly exposed, processed, and positioned radiographs. For radiographic interpretation, in addition to knowing radiographic signs of disease, a knowledge of normal radiographic anatomy and possible insignificant anatomic variations is necessary.

Animals↗

Alternative diagnoses in the colic patient.

Despite clinical signs compatible with obstruction or ischemia of the gastrointestinal tract, the clinician occasionally is unable to identify a gastrointestinal cause for colic. In this article, disorders not originating from obstruction or ischemia of the gastrointestinal tract but causing real or apparent abdominal pain are presented as alternative causes of colic. In addition, colic of gastrointestinal origin may be the primary inciting factor or a secondary complication of an alternative disorder, causing colic-like signs. Recognition of alternative diagnoses relies on a thorough and consistent approach to the clinical assessment of the equine colic patient and helps to ensure appropriate patient management.

Abdomen↗

Initial treatment of colic.

This article discusses some of the rationales for the medical management of colic during the initial treatment period. The issue of colic pain control and the masking of clinical signs that may indicate severe gastrointestinal disease is addressed. Therapeutic considerations related to dehydration, metabolic imbalances, hemostatic disorders, antimicrobial therapy, fecal consistency, gastrointestinal decompression, and regulation of intestinal motility are reviewed.

Animals↗

Equine degenerative myeloencephalopathy.

This article discusses the history and signalment, clinical signs, differential diagnosis, pathology, etiology and pathogenesis, and treatment and prevention of equine degenerative myeloencephalopathy.

Animals↗

Protozoal diseases.

The clinical and pathologic findings of and therapy for such protozoal diseases as equine protozoal myeloencephalitis, toxoplasmosis, sarcocystosis, pneumocytosis, cryptosporidiosis, giardiasis, besnoitiosis, and klossiellosis are discussed. Emphasis is placed on disorders that occur with greater frequency in North America and on emerging protozoal diseases affecting horses.

Animals↗

Articular chondrocyte apoptosis in equine osteoarthritis.

Osteoarthritis (OA) is the most common joint disease in horses. Chondrocyte apoptosis has been implicated as a major pathological OA change in humans and experimental animals but no studies have been performed on equine OA. Articular cartilage was collected from three normal and five OA horses. Histopathological changes were scored by a modified Mankin grading system. A terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay was performed to identify chondrocyte apoptosis. Nitric oxide (NO) production from chondrocytes was indirectly evaluated by immunohistochemistry with polyclonal antibody to nitrotyrosine. The histopathological score and percentage of chondrocyte apoptosis from the OA cartilages were significantly higher than from normal cartilages. There was a significant correlation between histopathological grade and the percentage of chondrocyte apoptosis. OA cartilages exhibited stronger immunoreactivity to nitrotyrosine than normal cartilage. Topographical distributions of chondrocyte apoptosis, cartilage matrix degeneration, and NO production overlapped in equine OA cartilages, suggesting that these pathological phenomena are closely interrelated.

Animals↗