Department of Biomedical Science and Veterinary Public Health, Parasitology Unit, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Equine Clinic, University Animal Hospital, Swedish University of Agricultural Sciences, Uppsala, Sweden.
BMC Vet Res. 2022 Apr 23;18(1):149. doi: 10.1186/s12917-022-03248-x.
Peritonitis in horses secondary to non-strangulating infarction (NSII) has a guarded prognosis, even after intestinal resection. In contrast, horses with idiopathic peritonitis respond well to medical treatment. Affected horses in both cases often show signs of both colic and systemic inflammation, but early diagnosis is crucial for optimal treatment and an accurate prognosis. One cause of NSII is thrombus formation secondary to Strongylus vulgaris larval migration. There has been a documented increase in S. vulgaris prevalence in Sweden since the implementation of selective anthelmintic treatment in 2007, which subsequently could result in a rise in NSII cases. In a retrospective clinical study, medical records from cases diagnosed with NSII of the pelvic flexure or idiopathic peritonitis from three equine referral hospitals in Sweden during 2017-2020 were reviewed. Information including demographic data, relevant medical history, and clinical- and laboratory parameters were obtained from patient records. To facilitate the differentiation between cases of idiopathic peritonitis and cases with confirmed NSII of the pelvic flexure, the aim of the study was to compare clinical and laboratory parameters, clinical progression and initial response to antimicrobial treatment. A secondary aim was to compare survival-rates.
Horses with NSII (n = 20) were significantly more likely to present during the winter months with a poorer response to medical treatment within 48 h. Cases of idiopathic peritonitis (n = 107) had a 100% survival rate with medical treatment, although one case required surgical correction of a colon displacement. In comparison, all confirmed NSII cases were non-responsive to antimicrobial treatment, with a survival rate to discharge of 50% after colon resection. Specific rectal findings and peripheral blood neutropenia were strongly associated with NSII.
In Sweden, idiopathic peritonitis cases still predominate over S. vulgaris associated NSII cases and have an excellent survival rate with antimicrobial treatment. However, horses presenting with septic peritonitis during the winter months with a palpable rectal mass and displaying fever and colic signs beyond 48 h of medical treatment are likely to suffer from NSII of the pelvic flexure and should be considered for abdominal surgery.
马的非绞窄性梗死（NSII）继发腹膜炎的预后较差，即使进行肠切除术也是如此。相比之下，特发性腹膜炎的马对药物治疗反应良好。这两种情况下的受影响的马通常都表现出疝痛和全身炎症的迹象，但早期诊断对于最佳治疗和准确预后至关重要。NSII 的一个原因是马副蛔虫幼虫迁移引起的血栓形成。自 2007 年实施选择性驱虫治疗以来，瑞典已记录到马副蛔虫的流行率有所增加，这可能导致 NSII 病例的增加。在一项回顾性临床研究中，对瑞典三家马转诊医院 2017-2020 年期间诊断为骨盆弯曲 NSII 或特发性腹膜炎的病例的医疗记录进行了回顾。从患者记录中获得了包括人口统计学数据、相关病史以及临床和实验室参数在内的信息。为了促进特发性腹膜炎病例和经证实的骨盆弯曲 NSII 病例之间的区分，本研究的目的是比较临床和实验室参数、临床进展和对抗菌治疗的初始反应。次要目标是比较存活率。
NSII 马（n=20）在冬季更有可能出现，对 48 小时内的药物治疗反应较差。特发性腹膜炎病例（n=107）经药物治疗的存活率为 100%，尽管有一例需要手术纠正结肠移位。相比之下，所有经证实的 NSII 病例对抗菌治疗均无反应，结肠切除术后的存活率为 50%。直肠的特定发现和外周血中性粒细胞减少与 NSII 密切相关。
在瑞典，特发性腹膜炎病例仍多于马副蛔虫相关 NSII 病例，并且经抗菌治疗后具有极佳的存活率。然而，在冬季出现败血症性腹膜炎、直肠可触及肿块、发热和疝痛症状超过 48 小时的马很可能患有骨盆弯曲 NSII，应考虑进行腹部手术。
