Surgical correction of large colon volvulus and colopexy in a postpartum mare

A 17-year old Thoroughbred broodmare presented to the Cornell University Large Animal Emergency Service on 6/12/13 for colic five weeks post-partum. The patient was observed to be thrashing in the paddock three hours prior to presentation, at which time oral Flunixin meglumine was administered. Diagnostic efforts by the referring veterinarian included nasogastric tubing, rectal palpation, and abdominal ultrasound; the mare continued to break through sedation and was ultimately referred for a suspected large colon volvulus. The patient had a history of large colon volvulus that was surgically corrected at Cornell in October of 2012. On presentation, the mare was quiet, alert, responsive, and moderately painful. Vital signs were within normal parameters, mucous membranes were dark pink and slightly tacky, and the patient’s abdomen appeared distended with minimal gastrointestinal sounds. Point-of-care blood work was relatively unremarkable. Rectal examination revealed a gas distended viscous in the caudal right abdomen and tight bands coursing transversely. Abdominal ultrasound revealed diffusely thickened colon walls and colonic mesenteric vessels positioned against the right body wall. No net reflux was obtained upon nasogastric intubation. Abdominocentesis yielded slightly serosanguinous peritoneal fluid with a mildly elevated lactate. An exploratory celiotomy was performed and a 360° large colon volvulus entrapping the cecum was identified. The large colon was diffusely edematous but relatively non-compromised based on bowel color and mesenteric pulse quality. The colon was decompressed and replaced in the abdomen. Careful examination of the remaining gastrointestinal tract revealed no abnormalities. A colopexy was performed from the ventral band of the left ventral colon to the body wall. The patient recovered from anesthesia without incident and was treated post-operatively with intravenous fluids, plasma, Lidocaine, antibiotics, anti-inflammatories, anti-endotoxic agents, and precautions were taken to prevent laminitis. The patient’s foal was re-introduced the following day. The patient recovered well and was discharged from the hospital 6 days following surgery, but later returned due to an incisional infection and substantial weight loss. This presentation will focus on colic diagnostics, surgical treatment options for large colon volvulus, and specific aspects of post-operative management for the colic patient

ALVAC‐fIL2, a feline interleukin‐2 immunomodulator, as a treatment for sarcoids in horses: A pilot study

Abstract Background Sarcoid tumors are common in horses and may negatively impact the performance and value of the horse. No known treatment is reliably successful. Hypotheses/Objectives To determine tolerability, overall response rate, time to response, and progression‐free survival of horses with biopsy‐confirmed or suspected sarcoids treated with ALVAC‐fIL2. Animals Client‐owned horses with measurable, presumed‐ or biopsy‐confirmed sarcoid tumors. Methods Prospective pilot study. One milliliter of ALVAC‐fIL2 was injected into 4 to 5 areas of the sarcoid(s) in each horse (week 0); this treatment was repeated in weeks 1, 3, and 7. Sarcoids were measured at each visit, and response to treatment was determined according to the Response Evaluation Criteria in Solid Tumors for dogs (v1.0). After the final treatment, horses were reassessed and sarcoids remeasured every 3 months until tumor progression or for a minimum of 1 year if progression was not documented. Results Fourteen horses were included. Tumor size decreased in 86% of the horses, and the median time to first response was 89 days (range, 34‐406 days). Median time to best response was 211 days (range, 56‐406 days), but 3 of the sarcoids still were decreasing in size at the time of final evaluation. The median progression‐free interval was not reached. Adverse events were minimal and included transient focal inflammation in 2 horses. Conclusions and Clinical Importance Intratumoral injection of ALVAC‐fIL2 has promise as a well‐tolerated and effective, tissue‐sparing treatment for horses with sarcoid tumors