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Peer-reviewed veterinary case report

Perianesthetic development of diaphragmatic hernia in a horse with equine pituitary pars intermedia dysfunction (PPID).

Journal:
The Canadian veterinary journal = La revue veterinaire canadienne
Year:
2015
Authors:
Shepard, Molly K et al.
Affiliation:
Department of Large Animal Medicine · United States
Species:
horse

Plain-English summary

A 21-year-old male Thoroughbred horse with a condition called equine pituitary pars intermedia dysfunction (PPID), which affects hormone levels, was brought in because he had an unusual and painful erection that lasted for two days. He was given pain relief through an epidural and underwent surgery to treat the issue while under general anesthesia. After the surgery, he struggled to stand and had trouble breathing for several hours, and then suddenly developed severe abdominal pain, leading to the decision to euthanize him. An examination after his death showed that he had a tumor in his pituitary gland, enlarged adrenal glands, and a tear in his diaphragm. This case suggests that horses with PPID may be at a higher risk for developing a diaphragmatic hernia during anesthesia or recovery from surgery.

Abstract

A 21-year-old Thoroughbred gelding with a history of equine pituitary pars intermedia dysfunction (PPID) presented with priapism of 2 days' duration. The horse received a caudal morphine epidural and then underwent corpus cavernosum lavage and phallectomy under general anesthesia. The patient's recovery featured multiple unsuccessful attempts to stand and his respiratory distress persisted for several hours until he acutely developed severe colic and was euthanized. Necropsy findings revealed a pituitary adenoma of the pars intermedia, bilateral adrenal cortical hyperplasia, and diaphragmatic herniation. This report suggests that horses with PPID may present a greater risk for diaphragmatic hernia under general anesthesia or during procedures placing stress on the diaphragm, including anesthetic recovery.

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Original publication: https://pubmed.ncbi.nlm.nih.gov/25565714/