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EQUINE VETERINARY EDUCATION / AE / MAY 2018


6.6 mg/kg bwt i.v.) and flunixin (Finadyne2, 0.25 mg/kg bwt i.v.). The horse also received brief polyionic crystalloid fluid therapy (Plasmavet9, bolus of 6 mL/kg bwt i.v.). Exploratory laparotomy revealed typhlocolitis and a nonreducible caecocaecal intussusception. The mare was subsequently subjected to intraoperative euthanasia. Necropsy revealed additional haemorrhagic ulcerative colitis and large numbers of adult G. aegyptiacus flukes in both the caecum and ascending colon. No cestodes were observed. Histological assessment demonstrated lymphoplasmacytic infiltration of the colon and caecum. Additionally an area of the caecum was necrotic, with loss of normal tissue architecture and concurrent neutrophilic and eosinophilic infiltration. No cyathostomins were identified during histological assessment.


Case 5 A 9-year-old crossbreed gelding was presented at the OVAH with a 3 day history of colic. Prior to referral the horse had received phenylbutazone and magnesium sulphate solution (trade names and doses unknown). On presentation the horse displayed mild colic signs with mild tachycardia and tachypnoea (Table 1). Total serum protein and albumin concentrations were decreased (Table 2). Abdominal ultrasonography revealed an abnormal structure with a thickened double walled appearance (total diameter 60 mm, wall thickness 15 mm) in the right caudoventral abdomen. Mildly distended small intestine was palpable on transrectal palpation. Faecal nematode egg count, trematode sedimentation, cestode flotation and culture were not performed. The horse was initially treated with butorphanol (Torbugesic6,


0.025 mg/kg bwt i.v.) and flunixin (Finadyne2,0.5 mg/kgbwt i.v.), signs of pain then resolved. Polyionic crystalloid fluid therapy was administered (Plasmavet8 bolus, 30 mL/kg bwt i.v. q. 4 h) and water withheld. The day after admission signs of abdominal pain recurred. Clinical parameters were within normal limits. On transrectal palpation an abnormal soft tissue structure was identified in the right caudodorsal abdomen. Subsequent haematology and serum biochemistry revealed a mild anaemia and a moderate hypoproteinaemia (Table 2). Peritoneal fluid was serosanguinous in appearance and had an increased nucleated cell count (23.4 9 109/L). These findings were considered consistent with caecocaecal or caecocolic intussusception. Exploratory laparotomy was declined and the horse was subjected to euthanasia. Necropsy revealed caecocolic intussusception with moderate typhlocolitis (Fig 4) and numerous adult G. aegyptiacus flukes in the ascending colon. No cestodeswere observed. Histologywas not performed.


Case 6 An 8-year-old Percheron gelding was presented at the OVAH with a 24 h history of colic. The horse had received flunixin (Finadyne2, 1.1 mg/kg bwt i.v), butylscopolamine bromide and metamizole (Buscopan Compositum7, 0.3 mg/kg bwt i.v.) and detomidine (Domosedan6, 0.004 mg/kg bwt i.v.) prior to referral. On admission, the horse showed mild intermittent signs of abdominal pain. Moderate tachycardia was present (Table 1) and borborygmi were reduced. Transrectal palpation revealed a firm mass in the mid-dorsal abdomen. Colon displacement with secondary impaction of the large colon was suspected. Abdominal ultrasonography was not


performed. Nasogastric intubation elicited 6 L of net gastric fluid reflux.


© 2017 EVJ Ltd Fig 4: Necropsy image of a caecocolic intussusception (Case 5).


Initial medical management consisted of polyionic


crystalloid fluid therapy (Plasmavet8 bolus, 20 mL/kg bwt i.v. over 1 h, followed by 1.6 mL/kg bwt/h i.v.) and xylazine (Chanazine,14 10% 0.7 mg/kg bwt i.v.). The gelding showed progressively severe signs of colic and abdominal distention despite further xylazine treatment, gastric decompression and walking. Exploratory laparotomy was declined and the horse was subjected to euthanasia. Necropsy revealed caecocolic intussusception with necrosis of the caecal wall and large numbers of adult G. aegypticus flukes in the ascending colon. No cestodes were observed. Histology was not performed.


Case 7 An 18-year-old Thoroughbred gelding was presented at the OVAH with acute colic signs. The horse also had a 2 month


history of weight loss. Prior to referral, the gelding received flunixin (Finadyne2, 1.1 mg/kg bwt i.v.) and butorphanol (Torbugesic6, 0.04 mg/kg bwt i.v.). On presentation the horse was showing mild signs of abdominal pain and had a BCS of 2.5/5 (Carroll and Huntington 1988). The horse was tachycardic (Table 1) and had reduced borborygmi. Despite a normal mature neutrophil count, circulating immature forms were increased and a moderate lymphopaenia was also observed (Table 2). Transabdominal ultrasonography demonstrated a thickened right dorsal colon wall (wall thickness not recorded) and fluid within the colon. Right dorsal colitis was suspected and initial medical management consisted of polyionic crystalloid fluid therapy (Plasmavet8, 4 mL/kg bwt/h i.v.), a lignocaine infusion (Lignocaine HCl9, bolus 1.3 mg/kg bwt i.v. followed by 0.05 mg/kg bwt/min i.v.) and metronidazole (Bio-Metronidazole1, 15 mg/kg bwt per os q. 8 h). Colic signs progressed and reassessment revealed the same clinical parameters. Transrectal palpation revealed moderate gas distension of the large colon and a tight caecal taenial band. Peritoneal fluid was serosanguinous and had an increased lactate level (7.6 mmol/L [<2 mmol/L]; Latson et al. 2005). Exploratory laparotomy was declined. Detomidine (Domosedan6, 0.006 mg/kg bwt i.v.) and


morphine (Morphine11, 0.1 mg/kg bwt i.v.) were administered and the horse walked regularly. Subsequently clinical parameters improved, but intermittent mild tachycardia remained. The horse showed mild intermittent colic signs including lying in sternal recumbency and occasional pawing.


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