[Show abstract][Hide abstract] ABSTRACT: Original title: Vergleich rektaler und sonographischer Untersuchungsbefunde bei der Kolik des Pferdes
The examination of patients suffering from an acute abdomen routinely comprises both clinical and rectal examinations, and is ever more frequently accompanied by an ultrasonographic abdominal examination. The aim of the study was to compare the findings as defined through rectal examination with the results of the ultrasonographic examination for different forms of colic.
Material and methods:
In a retrospective study, the patient records of the Large Animal Clinic of the University of Leipzig from 2012 and 2013 were analysed, and those of horses suffering from colic were included. Diagnoses made through rectal and ultrasonographic examination were grouped and compared with the diagnoses made during colic surgery or pathologic examination, which served as the gold standard. Horses that underwent conservative treatment had a definitive diagnosis assigned only in cases where a pathognostic rectal finding defined the diagnosis. Based on these data, sensitivity, specificity and positive and negative predictive values were calculated for both techniques.
Ultrasonography was more sensitive than rectal examination in cases of small intestinal occlusion (97.1% vs. 50.7%), torsion of the large colon in the long axis (63.2% vs. 26.3%) and dislocation of the large colon into the nephrosplenic space (90.9% vs. 72.7%). Rectal examination was more sensitive than ultrasonographic examination in cases of other types of dislocation of the large colon (96.5% vs. 8.8%) and of constipations of the large colon (93.6% vs. 29.8%).
Conclusion and clinical relevance:
In cases of severe diseases, including small intestinal occlusions and torsions of the large colon, ultrasonography helps to better identify and more precisely diagnose conditions that in most cases require abdominal surgery than rectal examination. Therefore, under hospital conditions, it is highly advisable to include ultrasonography in the routine examination of the equine acute abdomen. However, this technique does not replace the traditional rectal examination, which is superior in the diagnosis of dislocations and constipations of the large colon as well as diseases of the caecum.
Gegenstand und Ziel:
Neben der routinemäßigen Untersuchung des Kolikpatienten (klinische inklusive rektale Untersuchung), kommt zunehmend die Sonographie zur Anwendung. Ziel der Studie war, die Befunde der rektalen Untersuchung mit denen der sonographischen Untersuchung bei unterschiedlichen Kolikerkrankungen zu vergleichen.
Material und Methoden:
In einer retrospektiven Studie wurden die Patientendaten von Pferden mit Koliksymptomen der Jahre 2012 und 2013 der Chirurgischen Tierklinik Leipzig ausgewertet. Die anhand der
rektalen und sonographischen Untersuchung gestellten Verdachtsdia -gnosen wurden gruppiert und den Diagnosen (Goldstandard) der operativen Behandlung bzw. der pathologischen Untersuchung gegenübergestellt. Bei konservativ behandelten Tieren wurde nur bei eindeutigem rektalem Befund eine definitive Diagnose formuliert. Für beide diagnostische Verfahren erfolgte die Ermittlung von Sensitivität, Spezifität, positivem und negativem Vorhersagewert. Ergebnisse:Bezüglich der Diagnostik des Dünndarmverschlusses erwies sich die sonographische Untersuchung als deutlich sensitiver als die rektale Befunderhebung (97,1%; 50,7%). Eine bessere Sensitivität erzielte die sonographische Untersuchung auch bei der Längsachsendrehung des großen Kolons (63,2% vs. 26,3%) und bei der Verlagerung des großen
Kolons in den Milz-Nieren-Raum (90,9% vs. 72,7%). Im Fall von Kolonverlagerungen bzw. Verstopfungen des großen Kolons war die rektale Untersuchung weitaus sensitiver als die sonographische Untersuchung (96,5% vs. 8,8%) bzw. (93,6% vs. 29,8%). Schlussfolgerung
und klinische Relevanz: Besonders schwerwiegende Erkrankungen, wie der Dünndarmverschluss und die Längsachsendrehung des großen Kolons, werden mithilfe der Sonographie sicherer erkannt als durch die rektale Untersuchung. Deshalb sollte unter Klinikbedingungen auf die sonographische Untersuchung des Kolikpatienten nicht
verzichtet werden. Bei der Diagnostik von Verlagerungen und Verstopfungen des großen Kolons sowie von Blinddarmerkrankungen erweist sich hingegen die transrektale Palpation gegenüber der Ultraschall -untersuchung überlegen.
[Show abstract][Hide abstract] ABSTRACT: Aim of the study is the analysis of cases of laparotomy in foals with an anamnesis of intestinal or extraintestinal disease at the Large Animal Clinic for Surgery, University of Leipzig. Clinical files of the years 2001 until 2011 were screened for cases of foals up to one year of age, which had undergone laparotomy for intestinal disease, uroperitoneum or umbilical disease. Parameters for evaluation were signalement, season of admission, diagnosis, surgical therapy, surgical complications and success of surgical therapy. 98 foals had undergone laparotomy, of which over two thirds were colts. The predominant breed were Warmbloods (70,4%), while the predominant age was the neonate foal (59,2%). Suckling foals represented 32,7% of the patients, whereas weanling foals were the smallest fraction (8,2%). Predominant diagnoses were meconium impaction (20,4%), umbilical disease (19,4%) and ileus of the small intestine (17,3%). Surgical interventions were classified little invasive in 37,8% of the cases and invasive in 44,9%. Intro-operative death or euthanasia supra tabulam due to bad prognosis was recorded in 17,3% of the cases. Post-operative complications occurred in 28 foals. Re-laparotomy had to be performed in 9 foals. Of the 98 foals which underwent laparotomy, 70 could be discharged from the hospital. Survival rates were 71,4% on the basis of all cases and 86,4% on the basis of a completed laparotomy. Highest survival rates were recorded when conglobate or meconium impaction caused the indication for surgery, while small intestinal ileus and congenital malformation were the diagnoses yielding the worst outcome.
[Show abstract][Hide abstract] ABSTRACT: Tumours of the thyroid gland are rare in the equine species. In literature varying clinical signs and diagnostic findings are described in single reports and case series. Reported clinical signs are related to upper airway compression or thyroidal metabolic activity. A considerable risk of laryngeal hemiplegia is described when horses were treated with hemithyroidectomy . To review 11 horses referred with a unilateral thyroid neoplasia in order to describe clinical presentation, diagnostic findings, treatment and outcome. Histopathology was performed on all resected thyroid lobes. Retrospective case series. Records from horses with histologically confirmed thyroid tumours treated with unilateral thyroid lobe resection were reviewed (2003–2013). Short-term outcome was defined for 2 weeks after surgery. Owners’ questionnaire was performed for evaluation of long-term outcome defined as a minimum of 6 months. Affected horses were aged between 6 and 21 years. In contrast to literature the majority of tumours were adenocarcinomas (9/11), mainly found in mares (8/9). Histology revealed follicular and parafollicular (C-cell) mixed growth pattern of the carcinomas. Tumour size, growth rate and sonographic appearance did not correlate to histological characteristics. Ventral displacement of the thyroid lobe and close preparation along the thyroid capsule during surgical resection are inevitable to avoid damage to laryngeal nerves. Seroma formation was the only observed short-term complication. No long-term complications occurred. Hemithyroidectomy is regarded the treatment of choice in horses with a unilateral thyroid lobe neoplasia with excellent long-term prognosis. High incidence of malignant tumours particularly in mares has to be considered. Tumour characteristics can only be derived from histopathology and immunhistochemistry. Ethical animal research: Ethical committee oversight not currently required by this congress: retrospective study of clinical records. Explicit owner informed consent for participation in this study was not stated. Sources of funding: None. Competing interests: None.
[Show abstract][Hide abstract] ABSTRACT: To describe a surgical technique for thoracoscopy and report visible anatomy within the thoracic cavity of standing cattle.
Adult clinically healthy Holstein-Friesian cows (n = 15).
Each cow had four thoracoscopic examinations. Initially, the left hemithorax was examined after passive lung collapse, then again 24 hours later after CO2 insufflation. The right hemithorax was examined 24 hours later after passive lung collapse and again 24 hours later after CO2 insufflation.
CO2 insufflation did not significantly improve visibility within the pleural space. Collapsed lung, aorta, esophagus, diaphragm, and azygos vein were readily viewed; however, the pericardial region was not consistently visible. Minor laceration of the lung occurred in 1 cow with adhesions, otherwise there were no intra- or postoperative complications. All cows recovered without signs of discomfort. No local swelling or emphysema occurred at the portals.
Thoracoscopy can be safely performed on healthy standing cattle.
Veterinary Surgery 12/2013; 43(1). DOI:10.1111/j.1532-950X.2013.12086.x · 1.04 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The tarsal sheath is a relatively large structure and has an exposed position on the medial aspect of the hock in horses. Because of that, it may be affected by various diseases. The precise knowledge of anatomical location, extend and relationship to surrounding structures and diagnostic modalities is an important prerequisite to diagnose those conditions. The goal of the present study was to illustrate and document the anatomical details in cadaver limbs. Furthermore, a retrospective analysis of all cases with tarsal sheath involvement pre- sented to the Large Animal Clinic for Surgery, Faculty of Veterinary Medicine, University of Leipzig in a seven year period (2005-2011) was performed. A detailed anatomical description of the tarsal sheath based on our own evaluation as well as literature findings is presented. It was noted that the description of the anatomical situation in the present literature is neither consistent, nor precise and partly outdated. Among patients presented to our hospital, diseases of the tarsal sheath have a low incidence (0.3 %). Based on the clinical findings, most cases could be allocated to one of four groups: 1) acute to chronic, subclinical aseptic tenosynovitis, 2) chronic, clinical apparent, asep- tic tenosynovitis, 3) acute, septic tenosynovitis due to laceration, and 4) acute tenosynovitis secondary due to cellulitis. Some conditions warrant immediate and comprehensive treatment whereas other conditions have a low clinical relevance and may heal on their own. Prognoses for life, for full athletic function as well as cosmetic appearance of the hock vary considerably among the diseases affecting the tarsal sheath.
[Show abstract][Hide abstract] ABSTRACT: To report successful use of stent repair for a chronically injured parotid duct in a thoroughbred colt.
A 2-year-old thoroughbred colt.
Chronic injury to the parotid duct was identified 4-cm caudal to the facial vessel notch on the ventral border of the right mandible. After careful surgical dissection of the surrounding firm fibrous tissue, the defect was temporarily stented using an 8-Fr human ureteral catheter (223600 ERU(®) SOFT URETERAL(®) , Laboratoires pharmaceutique, Betschdorf, France) to bridge the tissue loss. The rostral end of the catheter exited the oral cavity through a buccotomy stab incision at the level of the second premolar tooth of the maxilla.
Primary wound healing occurred and the stent was maintained for 5 weeks with saliva drainage visible when the colt was fed. After stent removal, function was restored with good cosmesis.
A tissue defect in the parotid duct can be repaired successfully by temporary use of a stent until wound healing occurs.
Veterinary Surgery 04/2012; 41(4):536-9. DOI:10.1111/j.1532-950X.2012.00960.x · 1.04 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A male foal with an age of eight month was presented to the Clinic for Large Animal Surgery in December 2006. The owner had noticed an increased tissue growth at medial side of the left hock, since its third week of life. The region of the tarsus was examined radiologically, sonographically and with MRI. The suspected diagnosis of a haemangiosarcoma was proved histopathologically after total surgical resection. After a partial secondary wound closure, the foal went home six weeks later. Despite the poor prognosis, no indication of metastatic spread or local reccurence had been reported until 18 months after discharge from the clinic.