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

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.

[1]  J. Nieto,et al.  Gene expression of proteolytic systems and growth regulators of skeletal muscle in horses with myopathy associated with pituitary pars intermedia dysfunction. , 2010, American journal of veterinary research.

[2]  T. Doherty,et al.  Effect of a constant rate infusion of lidocaine on the quality of recovery from sevoflurane or isoflurane general anaesthesia in horses. , 2010, Equine veterinary journal.

[3]  J. Brown,et al.  Diaphragmatic hernia in horses: 44 cases (1986-2006). , 2009, Journal of veterinary emergency and critical care.

[4]  Yu-Hsiang Lin,et al.  Transvaginal evisceration in a case with iatrogenic Cushing's syndrome and no previous gynecologic surgery. , 2009, Taiwanese journal of obstetrics & gynecology.

[5]  E. Buckles,et al.  Pituitary-dependent hyperadrenocorticism in a cockatoo. , 2008, Journal of the American Veterinary Medical Association.

[6]  K. Mama,et al.  Influence of general anesthesia on pharmacokinetics of intravenous lidocaine infusion in horses. , 2005, American journal of veterinary research.

[7]  M. Brosnahan,et al.  Assessment of clinical characteristics, management practices, and activities of geriatric horses. , 2003, Journal of the American Veterinary Medical Association.

[8]  M. Mosing,et al.  A comparison of the analgesic effects of caudal epidural methadone and lidocaine in the horse. , 2003, Veterinary anaesthesia and analgesia.

[9]  J. T. Owings,et al.  Biochemical basis for the hypercoagulable state seen in Cushing syndrome; discussion 1006-7. , 2001, Archives of surgery.

[10]  R. Johnson,et al.  Regional anesthesia , 1997 .

[11]  Elizabeth M. Santschi,et al.  Diaphragmatic hernia repair in three young horses. , 1997, Veterinary surgery : VS.

[12]  D. Walmsley,et al.  Laparoscopic trans‐peritoneal adrenalectomy: a preliminary report of 14 adrenalectomies , 1996, Clinical endocrinology.

[13]  J. Caron,et al.  Epidural injection of xylazine for perineal analgesia in horses. , 1988, Journal of the American Veterinary Medical Association.

[14]  J. Hutton The Endocrine Glands , 1940 .

[15]  N. Talley,et al.  Endocrine System , 2020, Definitions.

[16]  J. Kramer,et al.  Diaphragmatic Hernia : Etiology , Clinical Presentation , and Diagnosis , 2008 .

[17]  J. Zachary,et al.  Pathologic basis of veterinary disease , 2007 .

[18]  C. Natalini,et al.  Effects of epidural opioid analgesics on heart rate, arterial blood pressure, respiratory rate, body temperature, and behavior in horses. , 2003, Veterinary therapeutics : research in applied veterinary medicine.

[19]  D. Slatter Textbook of small animal surgery , 1985 .