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Evaluation of phenylephrine and exercise with or without trocarization for treatment of suspected nephrosplenic entrapment in horses
- Gillen, Alex M., Munsterman, Amelia S., Hanson, R. Reid
- Journal of the American Veterinary Medical Association 2019 v.254 no.12 pp. 1448-1453
- colon, descriptive statistics, exercise, horses, hospitals, laparotomy, medical records, medical treatment, observational studies, patients, phenylephrine, ultrasonography
- OBJECTIVE To report the outcomes of horses with suspected nephrosplenic entrapment (NSE) of the large colon treated by IV phenylephrine administration and exercise with and without trocarization (ie, medical management). DESIGN Retrospective, observational study. ANIMALS 134 horses. PROCEDURES Electronic medical records were searched to identify horses that underwent medical management for suspected NSE at a veterinary teaching hospital between 1995 and 2014. Demographic information, physical and ultrasonographic examination findings, treatment information (including the number of times the treatment was performed and patient response), surgical findings if applicable, complications, and patient outcome were recorded. Descriptive statistics were reported. RESULTS 72 horses had suspected NSE that resolved with medical treatment; 59 of 62 horses underwent laparotomy when medical management failed, and 3 were euthanized without surgery. Twenty-five of the 59 horses had confirmed NSE that was surgically corrected, and 34 had lesions other than or in addition to NSE. All horses that had surgically corrected NSE and 18 of 34 horses that had other lesions survived to hospital discharge. The odds of resolution of NSE with medical management were greater for horses that underwent ≤ 2 (vs > 2) treatments. The treatment success rate for horses that underwent trocarization was not greater than that for horses that did not have the procedure. CONCLUSIONS AND CLINICAL RELEVANCE Suspected NSE resolved with the described medical management for most horses. However, results indicated the potential for misdiagnosis was high. Timely surgical intervention is recommended for horses that fail to respond to medical treatment.