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Evaluation of Intra-Abdominal Pressure in Horses That Exhibit Cribbing Behavior

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Evaluation of Intra-Abdominal Pressure in Horses That Exhibit Cribbing Behavior Evaluation Of Intra-Abdominal Pressure In Horses That Exhibit Cribbing Behavior by Valeria Albanese A thesis submitted to the Graduate Faculty of Auburn University in partial fulfillment of the requirements for the Degree of Master of Science Auburn, Alabama August 2, 2014 Keywords: cribbing, intra-abdominal pressure, intra-abdominal hypertension, epiploic foramen entrapment, colic Approved by Amelia Munsterman, Chair, Clinical Instructor, Department of Clinical Sciences Reid Hanson, Professor, Department of Clinical Sciences Cynthia McCall, Professor, Department of Animal Sciences Abstract Cribbing behavior in horses is associated with an increased incidence of small intestinal strangulation through the epiploic foramen. The suggested mechanism for this association is through changes in intra-abdominal pressure (IAP); however, the effect of cribbing behavior on IAP has not been previously researched. This study used 16 healthy horses to investigate the effect of cribbing on IAP. Eight healthy cribbing horses (cribbing cohort) and 8 healthy non-cribbing horses (non-cribbing cohort) were selected and a microsensor catheter was introduced into the peritoneal cavity through the right paralumbar fossa, using local anesthesia, for measurement of IAP. These pressures were recorded in one minute intervals for 2 hours, while the horses were standing tied in a stall. Upon data analysis, baseline IAPs were not significantly different between cribbing and non- cribbing cohorts (P=0.08). However, IAPs in the cribbing cohort were significantly increased when compared to the non-cribbing cohort, during the period of active cribbing behavior (P=0.002). The frequency of cribbing was not associated with increased IAP (P=0.3). IAPs in the cribbing cohort remained significantly elevated compared to the non-cribbing cohort, even for the 30 minutes measurement taken after the behavior had ceased (P=0.0002). We concluded that cribbing is significantly associated with increased IAP in the horse, both during and after the behavior. ii Acknowledgments There are many people who made this project possible. Few people made it pleasant. Fewer people made it worth it. If you see your name in this list, you know you belong to one of the three groups: you probably know which one, too. In any case, thank you. Dr. Amelia Munsterman, Dr. Reid Hanson, Dr. Fred DeGraves, Dr. Cynthia McCall, Dr. Jennifer Taintor, Dr. Teresa Fenn, Ms. Susan Pecci, Ms. Sam Thrower, my wonderful resident mates Liz, Mattie and Alex, my fantastic roommate Wesley, our dogs Rossa and Jake, and, most of all, my beloved family. I apologize if I forgot somebody. If you feel you should be in this list, you are probably right. iii Table of Contents Abstract ......................................................................................................................................... ii Acknowledgments ....................................................................................................................... iii Table of Contents ........................................................................................................................ iv List of Tables ............................................................................................................................ viii List of Figures .............................................................................................................................. ix List of Abbreviations .................................................................................................................... x I. Introduction and Literature Review ......................................................................................... 1 a. Cribbing Behavior In Horses .................................................................................................... 1 Definitions ....................................................................................................................... 1 Prevalence ....................................................................................................................... 2 Risk Factors .................................................................................................................... 3 Prevention ....................................................................................................................... 4 Consequences .................................................................................................................. 7 b. Intra-Abdominal Pressure In Human Medicine ...................................................................... 12 Historical Background .................................................................................................. 12 Definitions ..................................................................................................................... 12 Etiology ......................................................................................................................... 14 Diagnosis......................................................................................................................... 14 1.Bladder ............................................................................................................... 15 iv 1.1 Original Open Single Measurement Technique .......................................... 16 1.2 Closed System Single Measurement Technique ......................................... 17 1.3 Closed System Repeated Measurement Technique .................................... 17 1.4 Revised Closed System Repeated Measurement Technique ...................... 18 1.5 Classic Technique ....................................................................................... 20 1.6 U-tube Technique........................................................................................ 20 1.7 Foley Manometer Technique ...................................................................... 21 2. Stomach............................................................................................................. 22 2.1 Classic Intermittent Technique ................................................................... 22 2.2 Semi-Continuous Technique ....................................................................... 23 2.3 Revised Semi-Continuous Technique ........................................................ 24 2.4 Continuous Fully Automated Technique ................................................... 25 3. Rectum ............................................................................................................. 26 4. Uterus ............................................................................................................... 27 5. Inferior Vena Cava ............................................................................................ 27 6. Microchip Transducer-Tipped Catheters .......................................................... 29 Pathophysiologic Implications ........................................................................................ 30 1. Neurologic Function ......................................................................................... 30 2. Cardiovascular Function ................................................................................... 31 3. Pulmonary Function .......................................................................................... 31 4. Hepatic Function ............................................................................................... 32 5. Renal Function .................................................................................................. 33 6. Gastrointestinal Function .................................................................................. 34 v 7. Abdominal Wall and Endocrine Function ........................................................ 34 Clinical Management ...................................................................................................... 35 1. Medical Treatment ............................................................................................ 35 1.1 Improvement of Abdominal Wall Compliance........................................... 35 1.2 Evacuation of Intra-Luminal Contents........................................................ 37 1.3 Evacuation of Abdominal Fluid Collections............................................... 37 1.4 Correction of Capillary Leakage, Blood Pressure Management and Positive Fluid Balance ................................................................................ 37 1.5 Specific Treatments .................................................................................... 38 2. Surgical Decompression ................................................................................... 39 c. Intra-Abdominal Pressure In Equine Medicine....................................................................... 40 Potential relevance .......................................................................................................... 40 Definitions....................................................................................................................... 40 Diagnosis......................................................................................................................... 41 1.Bladder ............................................................................................................... 42 1.1 Water Manometry ....................................................................................... 42 1.2 Air Filled
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