The Horse:Your Guide To Equine Health Care provides monthly equine health care information to horse owners, breeders, veterinarians, barn/farm managers, trainer/riding instructors, and others involved in the hands-on care of the horse.
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26 TheHorse.com THE HORSE December 2017 secured a sterile towel stent (24 horses) or a PHMB-impregnated stent (26 horses) over the incision using the same type of suture material and method, or they placed sterile gauze over the incision (25 horses) and covered it with a protective iodine-impregnated adhesive drape. They considered incisional drainage continuing 24 hours after surgery an in- cisional infection. Eleven horses (14.7%) developed infections—none in the PHMB group, two in the sterile towel group, and nine in the adhesive drape group. "The mean time to developing incision- al drainage was 14 days," she said, "and only two horses developed this at the hos- pital." None of the horses that developed an incisional infection developed a hernia. "We believe that the use of the PHMB- impregnated dressing can help reduce the incidence of incisional infections," Kilcoyne said. "Also, the use of any type of stent is beneficial to protect the incision." In closing, Kilcoyne emphasized the importance of follow-up with the refer- ring veterinarian and communication with owners in identifying incisional in- fections because of the tendency for them to develop after horses go home. Proteins Can Predict Colic Surgery Survival Scientists in Denmark recently exam- ined whether certain acute phase proteins (APPs), which the liver produces in the wake of infection or inflammation, could help predict whether a colicking horse would survive to hospital discharge after surgery or medical treatment. Tina Holberg Pihl, DVM, PhD, associate professor of medicine and surgery in the University of Copenhagen's Department of Large Animal Sciences, collaborated on the study with practitioners from the University of Pretoria, in South Africa. Pihl explained that APPs are elevated in horses with severe colic, and research- ers already know there's an association between blood APP concentrations and survival. "Larger studies evaluating the prognostic value of APPs are, however, lacking," she said. "I wanted to see if se- rum amyloid A (SAA) and haptoglobin in blood and peritoneal (abdominal cavity) fluid and fibrinogen (in blood) could give a prognosis in these horses." First, here's a quick primer on these liver-produced proteins: Haptoglobin binds with hemoglobin, a protein in red blood cells released when the cells are destroyed (as part of their life cycle). If red blood cell destruction outpaces production, haptoglobin levels drop because the liver can't keep up. Hap- toglobin production in the liver increases slowly in response to acute inflammation. Serum amyloid A helps the immune system fight infection early in the course of disease. Levels are either undetectable or very low in normal, healthy horses, but they can rise 100 to 1,000 times higher than baseline in horses fighting an inflammatory condition. Fibrinogen plays a major role in blood clotting and functions in the inflammatory process by converting to fibrin, which serves to localize an invasive disease pro- cess. Levels generally rise in sick horses. Pihl and her team included 551 horses admitted with acute colic signs to either university. Veterinarians collected blood samples and/or peritoneal fluid from the horses, freezing the samples and sending them for automated testing. They did not include horses with inflammation unrelated to the abdomen, and, ultimately, they excluded 87 horses that didn't meet study criteria. Thirty- nine percent required surgery, and 20% of those horses did not survive to discharge. It turned out that SAA in serum and peritoneal fluid and haptoglobin in peritoneal fluid were the only test results significantly associated with nonsurvival. Ultimately, the researchers optimized a predictive model for nonsurvival that includes a combination of serum SAA, plasma fibrinogen, mucous membrane color, body temperature, gastric reflux greater than 5 L, plasma lactate, hemato- crit, and peritoneal fluid hemolysis (red blood cell destruction). "Measuring acute phase proteins at admission can improve the ability to classify the horses as survivors and nonsurvivors," she said. "Serum amyloid COLIC: An Ever-Evolving Issue Veterinarians can monitor SAA trends to potentially pick up on postoperative complications. COURTESY STABLELAB Come to our AAEP Booth #6034 for a free Ultra Wizard 2.0 DEMONSTRATION or CALL US TODAY 1-800-346-9729 • 10"x12" Wireless DR Flat Panel • CSI - Pixel Pitch – 76 μm • 5 yr hardware & software warranty offer ends Dec. 31, 2017 $1,000 OFF ULTRA 9030Hf Portable X-Ray Unit w/ panel purchase QUALIT Y | INTEGRIT Y | VALUE...DIS privately owned since 1983