Scientific Articles
Abdominal Crisis in the Horse:
A Comparison of Pre-Surgical Evaluation
With Surgical Findings and Results
STEPHEN 6. ADAMS, D.V.M. AND C. WAYNE MclLWRAITH, B.V.Sc., M.S., M.R.C.V.S.
The results of preoperative examination, surgical inter-
vention and the outcome of 50 cases of acute abdomi-
nal crisis in the horse are presented. Pre-surgical
parameters discussed in this correlative study include
duration of the condition prior to sergery, pulse rate,
packed cell volume (PCV), abdominal distention, intes-
tinal motility and tympany, rectal findings, reflux of fluid
after passage of a nasogastric tube, and abdominal
paracentesis. A retrospective study was performed to
evaluate the usefulness of each clinical parameter in
deciding that a case was surgical, arriving at a specific
pre-surgical diagnosis, and in giving a prognosis. Rec-
tal examination was the single most useful diagnostic
tool. Reflux of gastric fluid through the nasogastric tube
usually indicated obstruction of the small intestine.
HE diagnosis and management of acute abdominal
T disorders in t h e horse requiring surgical interven-
tion, have been discussed in recent iiterature.’-I’ The
value of diagnostic parameters used in evaluation of
these disorders h a s also been This re-
port presents a series of 50 consecutive cases undergo-
ing surgical intervention for abdominal crisis, with
primary emphasis on the correlation of the preopera-
tive clinical examination and diagnostic work-up with
the surgical findings and outcome.
Materials and Methods
Fifty incidents of abdominal crisis requiring surgical inter-
vention are reported. The animals involved were presented
to the Large Animal Clinic, School of Veterinary Medicine,
Purdue University from September 1975 to October 1977.
The fifty laparotomies were performed on 48 different pa-
tients. These laparotomies were performed for separate
episodes of abdominal crisis.
0161-3499/78/0700/0063/$00.85
@ American College of Veterinary Surgery
63
From the Department of Large Animal Clinics
School of Veterinary Medicine,
Purdue University,
West Lafayette, Indiana
A thorough history was obtained on each animal at the
time of entry, with specific attention to the duration of the
disorder. In cases where the exact time of onset was un-
known, an estimate of onset was made between the time the
animal was last observed to be normal and first observed to
be in pain, and an average between these two times was
used. The duration of the disorder was defined as the time
interval between the estimate of onset and surgical inter-
vent ion.
A routine evaluation of each patient followed presentation
to the Large Animal Clinic. Parameters evaluated for each
case at the time of admission included the pulse rate and
character, packed cell volume, degree of abdominal disten-
tion, presence of intestinal motility upon auscultation, and
results of rectal examination and passage of a nasogastric
tube. An abdominal paracentesis was performed on selected
cases. Other parameters which were observed are not
evaluated in this paper.
The assessment of abdominal distention was made subjec-
tively. All cases that were not distended or were borderline
were recorded as negative. Auscultation was performed on
both sides of the abdomen. Positive findings were considered
to be the presence of intestinal motility on the left side, right
side or both sides of the abdomen.
Positive findings upon rectal examination included dis-
tended loops of small intestine, distended large intestine,
displaced cecum or large colon and tight mesenteric bands in
abnormal locations.
The results of passage of a nasogastric tube into the
stomach were recorded as positive or negative findings. A
positive finding was recorded if more than 1 liter of fluid was
64 VETERINARY SURGERY
removed from the stomach. It was difficult to quantitate and
evaluate the significance of gas reflux through the tube.
The fluid obtained from abdominal paracentesis was
evaluated for color, turbidity, nucleated cell count and pro-
tein levels. A positive finding, as indicated by a plus in Table
2 , was recorded if one or more of the parameters evaluated
were outside the normal range. Normal values for nucleated
cell counts were considered to be anything less than 3,000
cells/mm3. This figure is consistent with previously pub-
lished value^.'^^^^ Protein levels were considered normal if
less than 1.5 gm/lOO ml.13318Normal color and turbidity
ranged from clear white to a light straw color with slight
turbidity.13-'*
Anesthesia was induced in all animals with sodium
thiamylal and glycerol guiacolate and maintained under
closed circuit halothane inhalation anesthesia with intermit-
tant positive pressure ventilation. Each laparotomy was per-
formed through a ventral midline incision with the animal in
dorsal recumbancy. In all cases appropriate supportive
therapy was administered during and after the operative pe-
riod. This therapy included volume replacement, acid-base
and electrolyte correction, and cortico-steroids in selected
cases.
Lesions were located by systematic exploration of
the abdomen. Surgical correction of lesions was accom-
plished by a combination of one or more of the following
procedures: enterotomy of small or large intestine, correc-
tion of rnalposition and/or resection and anastomosis of a
portion of the intestinal tract. In all patients except those
euthanatized during surgery at least one enterotomy was per-
formed to evacuate the intestinal tract. An end-to-end anas-
tomosis of jejunum-to-jejunum was used in the small
intestine unless the ileum was resected, in which case an
end-to-side anastomosis of jejunum-tocecum was performed.*
Euthanasia at the time of surgery, if performed, was done
after visual appraisal of the abdominal viscera. Factors in the
decision to euthanatize a patient included quantitative esti-
mate of bowel necrosis and evaluation of the potential gut
viability. The latter evaluation was based o n serosal color,
mucosal appearance after enterotomy, mesenteric integrity,
thrombosis of mesenteric vessels, and bowel motility after
correction of the problem. The presence of ruptured bowel
was also grounds for euthanasia. The final decision to per-
form euthanasia was made after consultation with the owner.
In 39 cases, the patients were allowed to recover from
anesthesia. Twenty cases were successful, 17 died post-
operatively and two were euthanatized due to post-operative
complications. The 20 successful cases consisted of 11 cases
with a large intestine abnormality, six cases with a small
intestine abnormality, two cases with both large and small
intestine involved and one uterine torsion. Eleven patients
died postoperatively from septic shock related to the abdom-
inal crisis, four patients from Salmonellosis, one from gastric
rupture, and one from a second incarceration. One patient
fractured a femur during recovery from anesthesia, and
another had bilateral, deep digital flexor tendon rupture of
the hind legs seven days postoperatively. These two pa-
tients were euthanatized at the time the complications
occurred.
Results
The age, breed, sex, laparotomy findings, method of
surgical correction and outcome of each case are
shown in Table 1. The age of the patients ranged from
July-September 1978 VOl. 7
two months to 16 years with a mean of 6.4 years.
Twenty-five of the patients were female, 13 were intact
males and 10 were geldings.
Nine of the 39 cases in which the patients were re-
covered from the operating table required resection of
devitalized intestine and anastomosis. Correction of
the malpositioned intestines after decompression of
distended segments was performed in the remaining 30
cases.
Eleven patients were euthanatized during surgery
based on laparotomy findings. In three cases, the
owner did not grant permission despite a grave prog-
nosis.
Several parameters used in the diagnosis and evalua-
tion of this series of surgically treated colics are sum-
marized in Table 2. The values were recorded at the
time of initial examination. In most cases, however,
some form of therapy had been given bv the primary
veterinarian prior to referral.
The duration ranged from one to 120 hours, with a
mean duration for all cases of 18 hours. Disease proc-
esses of the small intestine had a mean duration of 21
hours and disease processes of the large colon and
cecum had a mean of 17 hours. The duration of cases
involving both small and large intestine had a mean of
20 hours. The mean duration for the successful cases
was 19 hours, for the cases that died, 16 hours, and for
those cases euthanatized on the table, 20 hours.
The pulse rate ranged from 42/minute to 180/minute.
The mean pulse rate of those horses that were termed
successful was 72 with a range of 42-100, and the
mean pulse rate of the horses that died or were
euthanatized on the table was 86 with a range of 40-
180.
The PCV ranged from 37% to 69% for all cases. The
mean PCV of cases with small intestine involvement in
the disorder was 47%; with large intestine involve-
ment, 48%; and with a combination involvement, 48%.
The mean PCV of successful cases was 46%; the high-
est PCV of this group was 52%.
Of the 50 cases reported 18 had abdominal disten-
tion. Fifteen of these had large intestine involvement,
two had diseased small intestine, and one a small colon
volvulus. The two animals with abdominal distention
associated with small intestine involvement were two
months and six months of age respectively. The former
case had a ruptured jejunum, severe bacterial
peritonitis and pneumoperitoneum. One of the cases
involving the large intestine had a ruptured viscus
prior to surgery and large amounts of gas within the
peritoneal cavity.
The results of auscultation were recorded for 46
cases and 29 of these cases had no intestinal motility at
the time of presentation. Of the 20 cases termed suc-
cessful, eight had intestinal motility, 10 lacked motility
No. 3 ABDOMINAL CRISIS AND SURGERY Adams and Mcllwraith 65

TABLE 1. Age, Breed, Sex, Diagnosis, Method of Surgical Correction

and Outcome of 50 Surgical Colics
~~~~ ~~

Case Surgical
Number Age Breed Sex Findings Upon Laparotomy Correction Outcome

1 8 Y. Quarter Horse M Incarceration of large colon over nephrosplenic ligament EL, CM D

2 12 y. Arabian F Torsion of large colon EL, CM D
3 2 Y. Standard bred M Torsion of large colon EL, CM S
4 6 Y. Appaloosa G Ileum incarcerated in epiploic foramen ES, RA S
5 6 Y. Arabian G Incarceration of large colon over nephrosplenic ligament EL, CM S
6 8 Y. Appaloosa F Impaction of transverse colon E
7 6 Y. Belgian M Torsion of large colon, jejunum incarcerated in EL, ES, CM D
mesenteric rent
8 2 Y. Quarter Horse M Volvulus of jejunum ES, CM D
9 4 Y. Thoroughbred F Incarceration of large colon by mesentery of small EL, ES, CM D
intestine
10 7 Quarter Horse
Y. F Torsion of large colon and cecum E
11 7 Quarter Horse
Y. F Torsion of large colon EL, CM S
12 4 Quarter Horse
Y. G Torsion of large colon and cecum EL, CM S
13 4 Quarter Horse
Y. F Torsion of large colon EL, CM S
14 2 Quarter Horse
Y. G Volvulus of jejunum ES, RA D
15 8 Y. Grade G Jejunum incarcerated around base of cecum ES, CM D
16 2 Y. Quarter Horse F Jejunal mass, impaction of right dorsal colon ES, EL, RA S
17 8 Y. Quarter Horse F Torsion of large colon and cecum EL, CM S
18 6 Y. Quarter Horse F Torsion of large colon EL, CM S
19 7 Y. Quarter Horse F Jejunum incarcerated in mesenteric rent ES, CM D
20 7 m. Quarter Horse F Jejunum incarcerated in mesenteric rent ES, RA D
21 7 Y. Standardbred F Volvulus of jejunum E
22 10 y. Arabian F Uterine torsion CM S
23 10 m. Belgian F Thromboembolic ES D
24 3 Y. Quarter Horse M Sand impaction of ileum ES, EL D
25 11 y. Appaloosa F Torsion of large colon and cecum EL, CM S
26 9 Y. Palomino G Torsion of large colon, cecal impaction EL, CM D
27 6 Y. Quarter Horse F Small colon prolapse through vaginal tear RA D
28 8 Y. Arabian F Volvulus of jejunum ES, CM S
29 3 Y. Morgan M Torsion of large colon EL, CM D
30 3 Y. Arabian F Torsion of large colon EL, CM S
31 7 Y. Paint F Torsion of large colon and cecum E
32 2 m. Quarter Horse F Ileum incarcerated in mesenteric rent ES, RA D
33 3 Y. Standard bred M Ileum incarcerated in inguinal canal ES, RA D
34 10 y. Arabian M Torsion of large colon, jejunum behind base of cecum ES, EL, CM D
35 10 y. Quarter Horse M Jejunum incarcerated in inguinal canal E
36 8 Y. Arabian G Torsion of large colon, 2" incarceration of jejunum ES, EL, CM S
37 2 m. Appaloosa F Jejunal intersussception ES, RA D
38 6 Y. Thoroughbred F Torsion of large colon EL, CM S
39 16 y. Standard bred F Torsion of large colon and cecum E
40 12 y. Thoroughbred F Jejunum incarcerated around base of cecum ES, CM S
41 14 y. Appaloosa G Jejunum incarcerated through rent in gastrosplenic RA D
ligament
42 4 Y. Thoroughbred M Volvulus of jejunum ES, CM D
43 7 Y. Quarter Horse F Volvulus of jejunum ES, CM S
44 13 y. Quarter Horse M Volvulus of small colon E
45 8 m. Quarter Horse M Volvulus of jejunum & ileum E
46 6 m. Quarter Horse M Rupture of jejunum secondary to ascarid impaction E
47 11 y. Arabian G Torsion of large colon EL, CM S
48 11 y. Arabian G Jejunum incarcerated by fibrous adhesions ES, CM S
49 7 Y. Quarter Horse G Impaction of transverse colon and rupture E
50 8 Y. Thoroughbred F Torsion of large colon and cecum E
~~~

Key:
D =died CM = correction of malposition
S =successful RA = resection and anastomosis
E = euthanatized on table EL = enterotomy or cecum andlor large colon
ES = enterotomy of the small intestine
66 VETERINARY SURGERY July-September 1978 VOI. 7

TABLE 2. Clinical Parameters at Initial Examination of 50 Surglical Cases

~~ ~

Duration Pulse Abdominal Stomach Para-

Case (Hours) Rate PCV (Yo) Distension Auscultation Rectal Tube centesis

1 7 48 43 + ND
2 8 89 59 + ND
3 16 42 NR + ND
4 96 80 45 - +
5 16 64 43 + -
6 120 50 48 + -
7 16 80 45 + +
8 4 88 40 + +
9 6 100 47 + ND
10 6 100 NR + ND
11 6 80 NR + ND
12 12 80 52 + ND
13 16 66 43 + ND
14 12 104 50 + -
15 36 88 59 - +
16 54 100 53 + +
17 1 90 ND + ND
18 6 NR NR + ND
19 10 90 56 - +
20 12 112 61 + +
21 12 84 60 + ND
22 10 52 39 + -

23 48 80 40 + ND
24 36 60 50 + -

25 22 88 45 + -

26 24 80 50 + -
27 2 100 ND ND ND
28 8 56 52 - -

29 8 54 40 + ND
30 12 76 NR + ND
60 NU - ND
31 6
32 14 180 44 MID +
33 20 96 69 - +
34 5 40 49 t ND
35 12 90 NA - ND
36 18 80 45 - ND
37 12 68 47 ND ND
38 9 48 44 t ND
NR 58 - ND
39 6
40 6 80 42 - -
41 24 92 47 + ND
NR 59 - ND
42 16
43 12 88 45 + -
44 12 88 49 + NR
45 22 96 37 ND -
46 6 120 46 ND ND,
47 22 84 46 + -
40 24 44 45 + AID
49 6 54 NR + ND
50 10 84 59 + -

Key:
+ = positive findings ND = Not done
- = negative findings NR = not recorded

and t w o were not recorded. Eleven c a s e s were A rectal examination was performed on 45 of the 50
euthanatized on the table and only two of these had cases reviewed. Four patients not subjected to rectal
intestinal motility preoperatively . palpation were too small to pass a hand through the
No. 3 ABDOMINAL CRISIS AND SURGERY
pelvic inlet; the fifth patient had a prolapse of the small
colon through a rent in the vagina. Thirty-four patients
revealed t h e presence of an abnormality and 11
showed no changes from the normal. Of the 26 cases
with large intestine involvement, 23 had one or more
positive findings. Of the 21 cases with small intestine
involvement, nine had one or more positive findings,
eight had negative findings, and four were not done.
The passage of a nasogastric tube was performed on
48 of the 50 cases reported (Table 2). Seventeen cases
had positive findings and 29 had negative findings. The
17 positive cases consisted of 14 with a disorder that
involved the small intestine and three cases with the
large intestine involved.
An abdominal paracentesis was not performed
routinely. Twenty-two cases had a paracentesis per-
formed. Of the 22 cases, 13 involved a small intestine
disorder; six, a large intestine disorder; two, a com-
bined large and small intestine disorder; and one, a
uterine torsion.
The 22 abdominal paracenteses revealed peritoneal
fluid that was normal in 13 cases. Paracentesis was
performed on seven cases that were found to have a
segment of necrotic intestinal tract, and two of these
had abdominal fluid that fell within the normal range.
Surgery was performed in both cases within one hour
of the abdominal paracentesis. Both cases had vascu-
lar occlusion of a jejunal segment without luminal
obstruction.
Discussion
The results of preoperative examination, surgical in-
tervention, and outcome of 50 cases of surgical colic
have been presented. A statistical analysis of age and
age related lesions has been discussed previously in
the 1iterat~re.l~Of the 50 cases reported here, six were
less than one year of age and all had disorders of the
small intestine.
The various intestinal disorders associated with the
need for surgical intervention have been previously
~ -24 ~All
d i s c ~ s s e d . 23, ~~ of ~the
~~cases
~ reported in this
paper fall within categories previously described ex-
cept case 41. This patient had approximately 40 feet of
ischemic jejunum incarceration through a rent in the
gastrosplenic ligament.
The breed incidence, although heavily weighed to-
wards the Quarter Horse, reflects the general horse
population of the referral area for our practice. Of
2,433 equine in-patients hospitalized during a two year
period, 948 or 39% were Quarter Horses. This com-
pares with the figure of 41.7% for Quarter Horses with
acute abdominal crises requiring surgery. The sex in-
Adams and Mcllwraith 67
cidence was also comparable to the overall hospital
population.
Fifty-one per cent of the 39 cases allowed to recover
from anesthesia were discharged as functioning ani-
mals. Some interesting observations can be made on
some of the cases that were not successful. Case
number 33 died of a ruptured stomach 72 hours after an
ileal resection and jejunocecal anastomosis. This rup-
ture occurred even though the stomach was decom-
pressed by a nasogastric tube. Since these 50 cases
were tabulated, another post-surgical stomach rupture
has occurred. This patient had an indwelling nasogas-
tric tube sewn to the nostril. Movement of the end of
the tube in the stomach with the application of nega-
tive pressure was carried out every hour. In both in-
stances the tube used for decompression had only one
opening in the end placed within the stomach. These
cases point out the possible technical weakness of
using this type of nasogastric tube for gastric decom-
pression of post-surgical cases. A tube fenestrated in
several places at the indwelling end would be less
likely to plug with stomach contents or by contact with
the mucosa of the stomach.
Case number 14 was euthanatized 13 days after
surgery following bilateral rupture of the deep digital
flexor tendons of the rear legs. The ruptures were sec-
ondary to septic tenosynovitis and self-mutilation. A
bacteremia originating from the diseased gastrointesti-
nal tract was possibly responsible for the septic
tenosynovitis.
Gastroenteritis due to Salmonella has been recog-
nized as a major enteric disease in the horse.25 The
acute abdominal crisis and stress of surgery in each of
these cases may have predisposed them to this prob-
lem. Case numbers 23, 26, 29 and 34 died 14 days, 14
days, 15 days and 7 days respectively after surgery
was performed. The four cases of Salmonella were
confirmed at necropsy and by isolation of the organism
from the gastrointestinal tract. These cases exhibited a
satisfactory recovery until three to four days prior to
death and all occurred within a four month span. Al-
lmonella organisms were not typed, all
though
four ““a,
isolates
the sh ed identical sensitivities. Intensive
medical care, including antibiotic and fluid therapy,
was used without success.
Finally, case numbers 20 and 32 point out the value
of assessing the integrity of the mesentery upon
laparotorny. Both cases had small intestine incarcer-
ated through a mesenteric rent and required resection
and anastomosis. The remaining mesentery was ex-
tremely friable and ruptured upon routine manipula-
tion. These cases both died from subsequent necrosis
of remaining small intestine that Was associated with
the friable mesentery.
 VETERINARY SURGERY
In general, disease involving the small intestine is
more acute, more rapid in onset, more severe and
more fulminant than colic involving the large intestine.
It has been reported that complete torsions of the large
intestine tend to be the exception to this rule.26 The
duration prior to surgery of small intestine, large intes-
tine, and combination of small and large intestine
colics reported averaged 21, 17, and 20 hours respec-
tively. Five of the 21 cases with large intestine in-
volvement had a complete torsion with vascular com-
promise and were acute in onset and progression of the
disease. All but two of the 50 cases were referred to
the Large Animal Clinic after examination by a re-
gional veterinarian. In most cases the referring vet-
erinarians treated the animals for various periods of
time prior to transfer of them to the Large Animal
Clinic. Thus the nature of onset, degree of progression
and true estimate of pain were often masked at the
time of our examination.
Until surgical intervention, the mean duration of the
successful cases was greater than the mean duration
for those cases that died. Many abdominal crisis pa-
tients requiring surgical intervention are in some phase
of septic shock. Early surgical intervention is rightly
believed to be associated with a higher chance for suc-
cess. However, the less intense the abdominal crisis,
the longer the presurgical duration may be. This is
particularly true in a referral practice. The less intense
abdominal disease has a more favorable outcome over
extended durations.
The duration of an individual case does not always
correlate with the prognosis. Case number 4 had an
ileal incarceration in the epiploic foramen with a 96
hour duration and was successful. The use of duration
prognostically in evaluating potential surgical candi-
dates without regard for the specific problem, systemic
condition, and intensity of the case is not reliable.
A single pulse rate was not 'helpful in the diagnosis of
the specific problem, or in determining the prognosis
for the patient. A consistently elevated pulse rate not
responsive to medical therapy was one of the criteria
used as an indication for surgical intervention.
The average PCV of successful cases was lower than
the average of the nonsuccessful patients. The range in
each category was wide. Evans has stated that an
acute abdominal crisis with a PCV above 60 has a poor
prognosis.27In general, our experience supports this
premise. The highest PCV of a successful case in this
report was 52%. However, it is our experience that in
some cases, a successful outcome can be attained even
when the presenting PCV is greater than 60%.
The presence of bowel motility may indicate the in-
tensity of the abdominal disease present. In this report
July-September 1978 VOI. 7
the presence of motility was of no diagnostic value and
of little prognostic value.
A definitive diagnosis in acute abdominal crisis is
often difficult to achieve. However, when examining
any case of abdominal crisis certain symptoms must be
recognized which indicate the need for surgery.2RIn 34
cases, positive rectal findings indicated the need for
surgical intervention. The authors tend to agree with
Kalsbeek that a rectal examination may be the single
most important diagnostic tool available.29 In two
cases there appeared to be a lack of normal intestinal
mass upon rectal examination. This finding, coupled
with reflux gastric fluid upon passage of a nasogastric
tube, supported a diagnosis of a high small intestinal
obstruction. This was confirmed in both cases at
surgery.
The reflux of gastric fluid, especially if it occurs
more than one time, is an excellent indicator that
surgery should be considered. In most cases gastric
reflux indicates an obstruction of the small intestine.
Primary gastric dilatation, ileus, and disorders of the
large intestine of long duration will also cause reflux of
gastric fluids.
An abdominal paracentesis was done when a defini-
tive preoperative diagnosis could not be reached or
when the decision to do a laparotomy based on all
previously discussed parameters was still unclear. Er-
rors may result from relying heavily on the use of an
abdominal paracentesis as a guide for the need for
surgery. Of the seven patients with necrotic intestine,
two had normal peritoneal fluid parameters. These
two, cases 14 and 45, had 16 feet and 50 feet respec-
tively of necrotic jejunum at laparotomy. It has been
hypothesized that false negatives may be due to the
tap being performed in an area where normal peri-
toneal fluid has been sequestered by omentum and
loops of bowel. However, at laparotomy visual inspec-
tion of the peritoneal fluid was unremarkable. Al-
though abdominal paracentesis was formerly our
routine practice when handling acute abdomens, we
now believe that the paracentesis can be used selec-
tively. If properly interpreted it is most useful in dis-
tinguishing between lesions with or without vascular
impairment.
Although a definitive diagnosis may not be deter-
mined, it is often possible to distinguish between small
and large intestine disorders prior to surgery. The re-
sults of the rectal examination, passage of the nasogas-
tric tube and the presence or absence of abdominal
distention appear to be most helpful in this regard.
Fourteen of the 17 positive findings upon passage of
the nasogastric tube were from cases involving the
small intestine. Abdominal distension visible exter-
No. 3 ABDOMINAL CRISIS AND SURGERY Adams and Mcllwraith 69

nally is associated primarily with large intestinal dis-
t e n t i ~ n . ' However,
~,~~ any time abdominal distention
is encountered, a ruptured viscus must also be consid-
ered. An exception was case 32, which had distention
due to an ileal incarceration without rupture. In this
case the small intestinal distention manifest itself as
external abdominal distention likely due to the rela-
tively thin abdominal wall in this very young horse.
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salmonellosis in hospitalized horses. J Am Vet Med Assoc
166: 65, 1975.
26. Meagher DM: Surgery of the Large Intestine in the Horse. Arch
Am Coll Vet Surg 3: 9, 1974.
27. Evans L: Personal communication, 1973.
28. Limont AG: Observations on colic and abdominal surgery in the
horse. Equine Vet J 2: 59, 1970.
29. Kalsbeek HC: The State University of Utrecht, Utrecht, The
Netherlands: Unpublished data, 1969.

American College of Veterinary Surgeons College Calendar

July 17-20, 1978. Board of Regents meeting, Dallas, Texas.
October 24-25, 1978. Board of Regents meeting, Chicago, Illinois.
October 25-27, 1978. Veterinary Surgical Forum VI, Chicago, Illinois.
January 30-February 2, 1979. 14th Annual Meeting, Reno, Nevada.

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