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Brandon AM, Williams JM, Davis JL, Martin EG, Capper AM, Crabtree NE. Evaluation of pharmacokinetics of metoclopramide administered via subcutaneous bolus and intravenous constant rate infusion to adult horses. Vet Surg 2024. [PMID: 38925540 DOI: 10.1111/vsu.14128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 04/26/2024] [Accepted: 06/08/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE To determine the pharmacokinetics (PK) of metoclopramide administered via intravenous continuous rate infusion (IV CRI) and subcutaneous (SC) bolus and evaluate for gastrointestinal motility and adverse side effects. STUDY DESIGN Experimental study; randomized, crossover design. ANIMALS Six healthy adult horses. METHODS Each horse received metoclopramide via IV CRI (0.04 mg/kg/h for 24 h) and SC bolus (0.08 mg/kg once), with ≥1 week washout period between. Plasma was analyzed by UPLC-MS/MS. Compartmental modeling was used to determine PK parameters for each treatment; nonparametric superposition was used to simulate multiple SC bolus regimens. Gastrointestinal motility and evidence of adverse effects were monitored. RESULTS Tmax (h) for SC bolus was 0.583 ± 0.204 versus 17.3 ± 6.41 for IV CRI, while Cmax (ng/mL) was 27.7 ± 6.38 versus 43.6 ± 9.97, respectively. AUC (h × ng/mL) was calculated as 902 ± 189 for 24 h IV CRI versus 244 ± 37.4 simulated for 0.08 mg/kg SC bolus every 8 h. Simulations revealed similar exposure between groups with administration of 0.96 mg/kg/day SC bolus, divided into three, four, or six doses. SC bolus bioavailability was estimated as 110 ± 11.5%. No clear trends in motility alteration were identified. No adverse effects were noted. CONCLUSION Repeated SC boluses of metoclopramide at 0.08 mg/kg would result in lower total drug exposure and Tmax than IV CRI administration but would be highly bioavailable. CLINICAL SIGNIFICANCE Higher and/or more frequent SC bolus doses are needed to achieve a similar AUC to IV CRI. No adverse effects were noted; however, evaluation of alternative dosing strategies is warranted.
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Affiliation(s)
- Amy M Brandon
- Department of Large Animal Medicine, University of Georgia, Athens, Georgia, USA
| | - Jarred M Williams
- Department of Large Animal Medicine, University of Georgia, Athens, Georgia, USA
| | - Jen L Davis
- Department of Biomedical Sciences and Pathobiology, Virginia Tech, Blacksburg, Virginia, USA
| | - Emily G Martin
- Department of Clinical Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Ava M Capper
- Department of Large Animal Medicine, University of Georgia, Athens, Georgia, USA
| | - Naomi E Crabtree
- Department of Large Animal Medicine, University of Georgia, Athens, Georgia, USA
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Vitale V, Bindi F, Velloso Alvarez A, de la Cuesta-Torrado M, Sala G, Sgorbini M. Transcutaneous Auricular Vagal Nerve Stimulation in Healthy Non-Sedated Horses: A Feasibility Study. Vet Sci 2024; 11:241. [PMID: 38921988 PMCID: PMC11209208 DOI: 10.3390/vetsci11060241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/21/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
This study aimed to evaluate the feasibility of transcutaneous auricular vagal nerve stimulation (tAVNS) in healthy horses and its effect on heart rate variability (HRV). The study comprised three phases: the selection of mares, their acclimatization to the tAVNS, and the stimulation phase. Stimulation was performed with two electrodes positioned on the right pinna. The settings were 0.5 mA, 250 μs, and 25 Hz for pulse amplitude, pulse width, and pulse frequency, respectively. HRV was analysed before (B1), during (T), and after (B2) the tAVNS. From the 44 mares initially included, only 7 completed the three phases. In these mares, the heart rate (HR) was significantly lower, and frequency domain parameters showed an increased parasympathetic tone in B2 compared with B1. However, in 3/7 mares, the HR was significantly higher during T compared with B1 and B2, compatible with a decreased parasympathetic tone, while in 4/7 mares, the HR was significantly lower and the parasympathetic nervous system index was significantly higher during T and B2 compared with B1. The tAVNS is an economical and easy procedure to perform and has the potential to stimulate vagal activity; however, it was poorly tolerated in the mares included in this study.
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Affiliation(s)
- Valentina Vitale
- Department of Animal Medicine and Surgery, Institute of Biomedical Sciences, Cardenal Herrera-CEU University, CEU Universities, 46115 Alfara del Patriarca, Spain; (A.V.A.); (M.d.l.C.-T.)
| | - Francesca Bindi
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, 56122 Pisa, Italy; (F.B.); (G.S.); (M.S.)
| | - Ana Velloso Alvarez
- Department of Animal Medicine and Surgery, Institute of Biomedical Sciences, Cardenal Herrera-CEU University, CEU Universities, 46115 Alfara del Patriarca, Spain; (A.V.A.); (M.d.l.C.-T.)
| | - María de la Cuesta-Torrado
- Department of Animal Medicine and Surgery, Institute of Biomedical Sciences, Cardenal Herrera-CEU University, CEU Universities, 46115 Alfara del Patriarca, Spain; (A.V.A.); (M.d.l.C.-T.)
| | - Giulia Sala
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, 56122 Pisa, Italy; (F.B.); (G.S.); (M.S.)
| | - Micaela Sgorbini
- Department of Veterinary Sciences, University of Pisa, Viale delle Piagge 2, 56122 Pisa, Italy; (F.B.); (G.S.); (M.S.)
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Rockow M, Griffenhagen G, Landolt G, Hendrickson D, Pezzanite L. The Effects of Antimicrobial Protocols and Other Perioperative Factors on Postoperative Complications in Horses Undergoing Celiotomy: A Retrospective Analysis, 2008-2021. Animals (Basel) 2023; 13:3573. [PMID: 38003189 PMCID: PMC10668654 DOI: 10.3390/ani13223573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 11/13/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023] Open
Abstract
Recognition of antimicrobial resistance in equine practice has increased over the past decade. The objective of this study was to provide an updated retrospective review of antimicrobial regimens in one tertiary referral hospital and to evaluate the association with postoperative complications. A secondary objective was to evaluate other perioperative factors including surgical procedure, anesthetic and recovery parameters, and the effect of perioperative medications on complications and outcomes. A computerized search of medical records was performed to identify horses undergoing exploratory celiotomy from 1 January 2008 to 31 December 2021. A total of 742 celiotomies were performed (608 completed, 134 terminated intraoperatively). Factors recorded were evaluated using logistic regression for the presence of either incisional infection, postoperative ileus, or other complications postoperatively. Antimicrobial type or timing (pre-, intra-, or postoperative) were not associated with decreased risk of incisional infection or postoperative ileus; however, the duration of NSAID use was positively associated with incisional infection (OR 1.14 per day). Lidocaine and alpha-2-agonist administration postoperatively were also associated with increased incidence of postoperative ileus (OR 21.5 and 1.56, respectively). Poor recovery quality (OR 4.69), the addition of other antimicrobials besides penicillin/gentamicin postoperatively (OR 3.63), and an increased number of different NSAID classes used (OR 1.46 per additional) were associated with other complications. Implementation of enterotomy was associated with decreased risk of other complications (OR 0.64). These findings provide an updated summary of factors associated with postoperative complications in horses undergoing celiotomy.
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Affiliation(s)
| | - Gregg Griffenhagen
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA; (M.R.); (G.L.); (D.H.)
| | | | | | - Lynn Pezzanite
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA; (M.R.); (G.L.); (D.H.)
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Bonomelli N, Bonilla AG. Standing surgery among equine board certified surgeons: Survey regarding current use and trends. Equine Vet J 2023; 55:1045-1057. [PMID: 36586731 DOI: 10.1111/evj.13920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 12/07/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND Publications about equine standing surgery are flourishing, however, information regarding its use and prevalence among surgeons is still limited. OBJECTIVES To determine the current use and recent trends for equine standing surgery among board certified surgeons and to identify the main reasons and limitations for performing a procedure standing. STUDY DESIGN Cross-sectional survey. METHODS A 139-item questionnaire was sent by email to 733 large animal surgery Diplomates (ACVS and ECVS) from November 2020 to February 2021. The survey collected demographic information and general data regarding standing surgery before being divided into seven identical sections for each body system, involving 36 standing procedures. RESULTS The survey response rate was 29.7% (218/733). Most respondents (58.9%, 126/214) had performed standing surgery for <10 years regardless of length of time they were board certified (48.2% board certified <10 years and 51.8% >10 years). Most respondents (range: 50.0%-92.9%, mean 69.5%) changed from performing 14/36 surgeries under general anaesthesia (GA) to standing within the previous 10 years and had always performed 8/36 surgeries standing (51.6%-73.9%, mean 61.4%) regardless of board certification time. Surgeons board certified <10 years ago performed more often 3/36 listed procedures standing than those board certified >10 years ago (p < 0.05). Avoiding GA (179/218) and/or reducing procedure cost (111/218) were the two main reasons to perform standing surgeries whereas the horse's behaviour (183/218) and/or the patient size/age (94/218) were the two main limiting factors. MAIN LIMITATIONS Low response rate. Results biased towards the opinion of a subgroup of surgeons, those performing standing surgery. Some standing procedures were not included in the survey. CONCLUSIONS The use of standing surgery is well established among board certified surgeons and progressively increasing, especially in the last 10 years and among recent Diplomates. With increased training and awareness, more Diplomates may be encouraged towards performing standing surgeries.
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Affiliation(s)
- Natacha Bonomelli
- Department of Clinical Sciences, College of Veterinary Medicine, University of Montreal, Saint Hyacinthe, Quebec, Canada
| | - Alvaro G Bonilla
- Department of Clinical Sciences, College of Veterinary Medicine, University of Montreal, Saint Hyacinthe, Quebec, Canada
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Bauck AG. Basic Postoperative Care of the Equine Colic Patient. Vet Clin North Am Equine Pract 2023:S0749-0739(23)00022-6. [PMID: 37120332 DOI: 10.1016/j.cveq.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
The 3 time periods around colic surgery (preoperative, operative, and postoperative) are all critical to successful outcomes. Although much focus is often paid to the first 2 time periods, the importance of sound clinical judgment and rational decision-making in the postoperative period cannot be overstated. This article will outline the basic principles of monitoring, fluid therapy, antimicrobial therapy, analgesia, nutrition, and other therapeutics routinely used in patients following colic surgery. Discussions of the economics of colic surgery and expectations for normal return to function will also be included.
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Affiliation(s)
- Anje G Bauck
- Large Animal Surgery, Department of Large Animal Clinical Sciences, University of Florida College of Veterinary Medicine, University of Florida, 2015 Southwest 16th Avenue, Gainesville, FL 32608, USA.
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6
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Byrne CA, Hotchkiss JW, Barakzai SZ. Variations in the application of equine prosthetic laryngoplasty: A survey of 128 equine surgeons. Vet Surg 2023; 52:209-220. [PMID: 36420588 PMCID: PMC10100511 DOI: 10.1111/vsu.13913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/01/2022] [Accepted: 10/31/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To document variations in the application of equine prosthetic laryngoplasty among equine surgeons. STUDY DESIGN Cross-sectional survey. SAMPLE POPULATION Six hundred and seventy-eight equine surgeons performing prosthetic laryngoplasty. METHODS An online questionnaire was sent to equine surgeons, including diplomates of the American College of Veterinary Surgeons and European College of Veterinary Surgeons. Questions focused on participant profile, surgical technique, antimicrobial therapy, and concurrent procedures. Descriptive statistical analysis was performed on the survey output. RESULTS Complete responses were received from 128/678 individuals, mostly from experienced surgeons. Most participants used 2 prostheses (106/128, 82.8%) and a single loop was the most common method used to anchor the prosthesis in the cricoid (95/128, 74.2%) and arytenoid (125/128, 97.7%) cartilages. Use of general anesthesia was common, although 46/128 (35.9%) participants now performed most laryngoplasty surgery with standing sedation. The material used as a prosthesis varied among surgeons, although participants typically aimed to achieve grade 2 intraoperative arytenoid abduction. Participants most commonly administered perioperative systemic antimicrobial therapy for 1-3 days (57/128, 44.5%) and 48/128 (37.5%) used local antimicrobial therapy. CONCLUSION Most surgeons performed laryngoplasty with 2 prostheses, a single loop construct at the muscular process of the arytenoid cartilage and systemic antimicrobial therapy. There was variation in the preferred method of surgical restraint, prosthesis material selection, and use of local antimicrobial therapy. CLINICAL SIGNIFICANCE Long-established techniques remain popular in clinical practice despite evidence that variations offer advantages, particularly in relation to biomechanics. Other factors are also likely to influence technique selection in a clinical context.
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Orr H, Rabea H, Amos TJ, Ori B, Gal K. Intramural jejunal haematoma in an Arabian mare as a cause of colic: Clinical presentation, diagnosis and treatment. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Haion Orr
- Department of Large Animal Medicine and Surgery, Koret School of Veterinary Medicine ‐ Veterinary Teaching Hospital The Hebrew University of Jerusalem Rehovot Israel
| | - Haddad Rabea
- Department of Large Animal Medicine and Surgery, Koret School of Veterinary Medicine ‐ Veterinary Teaching Hospital The Hebrew University of Jerusalem Rehovot Israel
| | - Tatz J. Amos
- Department of Large Animal Medicine and Surgery, Koret School of Veterinary Medicine ‐ Veterinary Teaching Hospital The Hebrew University of Jerusalem Rehovot Israel
| | - Brenner Ori
- Department of Large Animal Medicine and Surgery, Koret School of Veterinary Medicine ‐ Veterinary Teaching Hospital The Hebrew University of Jerusalem Rehovot Israel
| | - Kelmer Gal
- Department of Large Animal Medicine and Surgery, Koret School of Veterinary Medicine ‐ Veterinary Teaching Hospital The Hebrew University of Jerusalem Rehovot Israel
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8
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Freeman DE. Fluid therapy in horses: how much is too much? Vet Rec 2021; 188:103-105. [PMID: 34651870 DOI: 10.1002/vetr.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- David E Freeman
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
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Hellstrom EA, Ziegler AL, Blikslager AT. Postoperative Ileus: Comparative Pathophysiology and Future Therapies. Front Vet Sci 2021; 8:714800. [PMID: 34589533 PMCID: PMC8473635 DOI: 10.3389/fvets.2021.714800] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/19/2021] [Indexed: 12/11/2022] Open
Abstract
Postoperative ileus (POI), a decrease in gastrointestinal motility after surgery, is an important problem facing human and veterinary patients. 37.5% of horses that develop POI following small intestinal (SI) resection will not survive to discharge. The two major components of POI pathophysiology are a neurogenic phase which is then propagated by an inflammatory phase. Perioperative care has been implicated, namely the use of opioid therapy, inappropriate fluid therapy and electrolyte imbalances. Current therapy for POI variably includes an early return to feeding to induce physiological motility, reducing the inflammatory response with agents such as non-steroidal anti-inflammatory drugs (NSAIDs), and use of prokinetic therapy such as lidocaine. However, optimal management of POI remains controversial. Further understanding of the roles of the gastrointestinal microbiota, intestinal barrier function, the post-surgical inflammatory response, as well as enteric glial cells, a component of the enteric nervous system, in modulating postoperative gastrointestinal motility and the pathogenesis of POI may provide future targets for prevention and/or therapy of POI.
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Affiliation(s)
| | | | - Anthony T. Blikslager
- Department of Clinical Sciences, North Carolina State University, Raleigh, NC, United States
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10
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Freeman DE. Effect of Feed Intake on Water Consumption in Horses: Relevance to Maintenance Fluid Therapy. Front Vet Sci 2021; 8:626081. [PMID: 33732739 PMCID: PMC7956953 DOI: 10.3389/fvets.2021.626081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/19/2021] [Indexed: 11/13/2022] Open
Abstract
Maintenance fluid therapy is challenging in horses that cannot drink or are denied feed and water because of concerns about gastrointestinal tract function and patency. Intravenous fluid delivery to meet water needs based on current recommendations for maintenance requirements were obtained in fed horses and therefore might not apply to horses that are not being fed. This is a critical flaw because of the interdependence between intestinal tract water and extracellular water to support digestion while preserving water balance, a concept explained by the enterosystemic cycle. Because horses drink less when they are not eating and hence have lower water needs than fed horses, maintenance water requirements need to be adjusted accordingly. This article reviews this topic and identifies benefits of adjusting maintenance fluid therapy to meet lower demands from gastrointestinal function, such as reduced volumes, lower cost, avoidance of overhydration.
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Affiliation(s)
- David E. Freeman
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
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Aitken MR. Clinical insights: Update on colic. Equine Vet J 2021; 53:6-8. [PMID: 33345359 DOI: 10.1111/evj.13347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 08/27/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Maia R Aitken
- University of Pennsylvania New Bolton Center - Clinical Studies, Pennsylvania, USA
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12
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Lawson AL, Sherlock CE, Ireland JL, Mair TS. Equine nutrition in the post-operative colic: Survey of Diplomates of the American Colleges of Veterinary Internal Medicine and Veterinary Surgeons, and European Colleges of Equine Internal Medicine and Veterinary Surgeons. Equine Vet J 2021; 53:1015-1024. [PMID: 33174212 PMCID: PMC8451781 DOI: 10.1111/evj.13381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 09/30/2020] [Accepted: 10/29/2020] [Indexed: 11/30/2022]
Abstract
Background Evidence is lacking concerning re‐introduction of feed and water following colic surgery. Objectives To describe current approaches of European and American specialists to re‐introduction of feed and water in adult horses following surgical treatment of common intestinal lesions, assuming an uncomplicated recovery. Study design Cross‐sectional survey. Methods Electronic invitations, with a link to the online survey, were sent to 1,430 large animal specialists, including Diplomates of the ECVS, ACVS, ECEIM and ACVIM colleges. Results The response rate was 12.6% including partial respondent data. Responses for each multiple‐choice question were between 123 and 178. Results are expressed as the percentage of the total number of responses and as a range where specific lesions are grouped together. Respondents reported that horses with large intestinal displacements were offered free choice water (63%‐65%) within 3 hours (55%‐63%), whereas horses with a small intestinal strangulating lesion were offered < 2 L water (64%‐74%) 12‐24 hours (28%‐34%) post‐operatively. Horses with a large colon displacement were offered feed within 3 hours of surgery (16%) with the majority offered feed 6‐12 hours (35%‐36%) post‐operatively. Horses with small intestinal strangulating lesions and small colon lesions were offered feed 24‐48 hours (34%‐42%) after surgery. Following small intestinal, small colon or caecal lesions, horses were re‐introduced feed in handfuls (79%‐93%) and initially with grass (41%‐54%). Horses with large colon displacements were mostly fed handfuls (49%‐50%) of forage initially, but a number of respondents would offer larger quantities such as a small bucket (35%‐37%) and predominantly of hay (50%‐51%). Main limitations Low response rate. This study did not take into account common post‐operative complications that may alter the clinical approach. Conclusions This post‐operative colic nutrition survey is the first to describe current clinical practice. Further research is required to investigate nutritional strategies in post‐operative colic cases.
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Affiliation(s)
- April L Lawson
- Institute of Veterinary Science, University of Liverpool, Neston, UK
| | | | - Jo L Ireland
- Institute of Veterinary Science, University of Liverpool, Neston, UK
| | - Tim S Mair
- Bell Equine Veterinary Clinic, Mereworth, UK
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Beder NA, Mourad AA, Aly MA. Ultrasonographic evaluation of the effects of the administration of neostigmine and metoclopramide on duodenal, cecal, and colonic contractility in Arabian horses: A comparative study. Vet World 2020; 13:2447-2451. [PMID: 33363340 PMCID: PMC7750228 DOI: 10.14202/vetworld.2020.2447-2451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 10/06/2020] [Indexed: 11/16/2022] Open
Abstract
Background and Aim As means for enhancing gastrointestinal (GI) motility, prokinetics have previously been evaluated in different breeds of horses with varying success. No previous studies were conducted to evaluate the effect of prokinetics on the intestinal tract of Arabian horses breed. Using B-mode ultrasound in the quantification of intestinal contractility, this study aimed to compare the impact of neostigmine and metoclopramide on the intestinal motility of healthy Arabian horses. Materials and Methods Twenty-one clinically healthy Arabian horses were equally distributed into three groups. The control group was administered with 5 mL normal saline intramuscularly (IM). The second group was administered with neostigmine (0.044 mg/kg body weight [BW], IM), and the third group was administered with metoclopramide (0.25 mg/kg BW, IM). Duodenal, cecal, and colonic contractions were counted through ultrasonography for 3 min (pre-administration and 15, 30, 60, 120, and 180 min post-administration). Results In the neostigmine group, a significant (p<0.05) increase in duodenal, cecal, and colonic contractions was observed 15 min post-administration compared with that in the control group (15±1.0, 11.33±1.53, and 12.33±2.31 vs. 11.0±2.0, 6.33±0.58, and 5.33±0.58 contractions per 3 min, respectively), continuing to 60 min post-administration for the duodenum and cecum and 120 min for colon and then returning to the normal; however, the metoclopramide group showed a significant (p<0.05) increase only in cecal and colonic contractions 60 min post-administration compared with the control group (11.0±1.0 and 12.33±0.58 vs. 6±1.0 and 5.67±0.58 contractions per 3 min, respectively), continuing until the end of the experiment. Excessive sweating, excitation, and straining were recorded following the administration of neostigmine, whereas no side effects were observed in the metoclopramide group. Conclusion Neostigmine improves duodenal, cecal, and colonic contractions in healthy adult Arabian horses, whereas metoclopramide only improves cecal and colonic contractions. Metoclopramide appears to be safer and longer acting than neostigmine in the Arabian horse breed. Ultrasonography is a valuable noninvasive tool for the quantification of intestinal contractility. Future studies should consider the use of various dosages of metoclopramide and administration routes and investigate its impact on horses with GI transit disorders and inclusion in colic post-operative care.
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Affiliation(s)
- Noha Abdallah Beder
- Department of Animal Medicine, Faculty of Veterinary Medicine, Damanhour University, Egypt
| | - Ahmed Atef Mourad
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, University of Sadat City, Egypt
| | - Mahmoud Allam Aly
- Department of Animal Medicine and Infectious Diseases, Faculty of Veterinary Medicine, University of Sadat City, Egypt
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15
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Steinmann M, Bezugley RJ, Bond SL, Pomrantz JS, Léguillette R. A wireless endoscopy capsule suitable for imaging of the equine stomach and small intestine. J Vet Intern Med 2020; 34:1622-1630. [PMID: 32511848 PMCID: PMC7379013 DOI: 10.1111/jvim.15825] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 05/19/2020] [Accepted: 05/20/2020] [Indexed: 12/22/2022] Open
Abstract
Background Capsule endoscopy offers a new method for visualization of the gastrointestinal mucosa in horses where other imaging technologies have diagnostic limitations. Objectives To (1) test the feasibility of using this novel endoscopy capsule to visualize intestinal mucosa in horses, including an objective assessment of image quality, (2) assess how changes in preadministration preparation affect the transit time and the amount of gastrointestinal mucosa visualized, and (3) describe intestinal mucosa lesions in healthy horses. Animals Five healthy adult horses. Methods Three protocols were used in a crossover study design. Protocols varied in time fasted, amount of oral fluid administered, and exercise. Manure was radiographically inspected for capsule recovery. Percentage of visible gastrointestinal mucosa was objectively assessed. Results Detailed images of the gastrointestinal mucosa were recorded with all 3 protocols, including images of the pylorus, major duodenal papilla, individual villi, and ileocecal junction. Visualization of large intestinal mucosa was poor. Interobserver agreement on image quality was excellent. Capsule administration after feed withholding for 24 hours provided the greatest percentage of visible mucosa in the stomach and small intestine. Total transit time to capsule excretion was 6.5 (3‐8.75) days. Of 15 capsules administered, 3 were not recovered. Lesions visualized included mucosal erosion, ulceration and hemorrhage, areas of thickened mucosa, and evidence of parasitism. Conclusions This novel endoscopic capsule appears safe, practical, and noninvasive in horses; however, variability in capsule excretion time must be taken into account for clinical application.
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Affiliation(s)
- Mei Steinmann
- Faculty of Veterinary Medicine, Department of Veterinary Clinical and Diagnostic Services, University of Calgary, Calgary, Alberta, Canada
| | | | - Stephanie L Bond
- Faculty of Veterinary Medicine, Department of Veterinary Clinical and Diagnostic Services, University of Calgary, Calgary, Alberta, Canada
| | | | - Renaud Léguillette
- Faculty of Veterinary Medicine, Department of Veterinary Clinical and Diagnostic Services, University of Calgary, Calgary, Alberta, Canada.,Moore Equine Veterinary Centre, Rocky View County, Alberta, Canada
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16
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Verhaar N, Pfarrer C, Neudeck S, König K, Rohn K, Twele L, Kästner S. Preconditioning with lidocaine and xylazine in experimental equine jejunal ischaemia. Equine Vet J 2020; 53:125-133. [PMID: 32119148 DOI: 10.1111/evj.13251] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 12/17/2019] [Accepted: 02/20/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Pharmacological preconditioning of dexmedetomidine on small intestinal ischaemia/reperfusion injury has been reported in different animal models including horses. OBJECTIVES The objective was to assess if xylazine and lidocaine have a preconditioning effect in an experimental model of equine jejunal ischaemia. STUDY DESIGN Terminal in vivo experiment. METHODS Ten horses under general anaesthesia were either preconditioned with xylazine (group X; n = 5) or lidocaine (group L; n = 5). A historical untreated control group (group C; n = 5) was used for comparison. An established experimental model of equine jejunal ischaemia was applied, and intestinal samples were taken pre-ischaemia, after ischaemia and following reperfusion. Histomorphological examination was performed based on a modified Chiu score. Immunohistochemical staining for cleaved caspase-3, TUNEL and calprotectin was performed, and positive cell counts were expressed in cells/mm2 . RESULTS There was no progression of histomorphological mucosal injury from ischaemia to reperfusion, and there were no differences in histomorphology between the groups. After ischaemia, group X had significantly less caspase-positive cells compared to the control group with a median difference of 227% (P = .01). After reperfusion, group X exhibited significantly lower calprotectin-positive cell counts compared to the control group, with a median difference of 6.8 cells/mm2 in the mucosa and 44 cells in the serosa (P = .02 and .05 respectively). All groups showed an increase in caspase- and calprotectin-positive cells during reperfusion (P < .05). TUNEL-positive cells increased during ischaemia, followed by a decrease after reperfusion (P < .05). MAIN LIMITATIONS The small sample size and the use of a historical control group. Preconditioning effects of the tested drugs may be masked by the protective effects of isoflurane in the anaesthetic protocol. CONCLUSIONS Preconditioning with lidocaine did not have any effect on the tested variables. The lower cell counts of caspase- and calprotectin-positive cells in group X may indicate a beneficial effect of xylazine on ischaemia/reperfusion injury. Due to the absence of a concurrent reduction of histomorphological injury, the clinical significance remains uncertain.
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Affiliation(s)
- Nicole Verhaar
- Clinic for Horses, University of Veterinary Medicine, Hannover, Germany
| | - Christiane Pfarrer
- Institute for Anatomy, University of Veterinary Medicine, Hannover, Germany
| | - Stephan Neudeck
- Clinic for Horses, University of Veterinary Medicine, Hannover, Germany
| | - Kathrin König
- Clinic for Horses, University of Veterinary Medicine, Hannover, Germany
| | - Karl Rohn
- Department of Biometry, University of Veterinary Medicine, Hannover, Germany
| | - Lara Twele
- Clinic for Horses, University of Veterinary Medicine, Hannover, Germany
| | - Sabine Kästner
- Clinic for Horses, University of Veterinary Medicine, Hannover, Germany
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17
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Lawson AL, Sherlock CE, Mair TS. Equine duodenal motility, assessed by ultrasonography, as a predictor of reflux and survival following colic surgery. EQUINE VET EDUC 2019. [DOI: 10.1111/eve.13202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - T. S. Mair
- Bell Equine Veterinary Clinic Maidstone Kent UK
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18
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Grauw J, Loon T. Successful treatment of prolonged postoperative ileus following resection of a small intestinal spindle cell sarcoma in a horse. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2019-000899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Janny Grauw
- Department of Equine SciencesUtrecht University Faculty of Veterinary MedicineUtrechtthe Netherlands
| | - Thijs Loon
- Department of Equine SciencesUtrecht University Faculty of Veterinary MedicineUtrechtthe Netherlands
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19
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Durket E, Gillen A, Kottwitz J, Munsterman A. Meta‐analysis of the effects of lidocaine on postoperative reflux in the horse. Vet Surg 2019; 49:44-52. [DOI: 10.1111/vsu.13286] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 05/29/2019] [Accepted: 06/20/2019] [Indexed: 01/31/2023]
Affiliation(s)
- Elyse Durket
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University Ames Iowa
| | - Alexandra Gillen
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University Ames Iowa
| | - Jack Kottwitz
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University Auburn Alabama
| | - Amelia Munsterman
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin Madison Wisconsin
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20
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Freeman DE. Is There Still a Place for Lidocaine in the (Postoperative) Management of Colics? Vet Clin North Am Equine Pract 2019; 35:275-288. [PMID: 31076222 DOI: 10.1016/j.cveq.2019.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Intravenous lidocaine is widely used to prevent or treat postoperative ileus in horses. Clinical studies that support this approach are flawed and contradicted by others. Also, physical obstruction could be more important in causing postoperative reflux than postoperative ileus in the horse. The antiinflammatory properties of lidocaine and the role of inflammation from intestinal handling in the genesis of postoperative reflux are questionable. Because of cost and questionable efficacy of lidocaine, a well-designed clinical trial is required to support its continued use. However, lidocaine could be given to provide or enhance analgesia in selected cases with postoperative colic.
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Affiliation(s)
- David E Freeman
- Equine Surgery, University of Florida, College of Veterinary Medicine, Large Animal Clinical Sciences, PO Box 100136, Gainesville, FL 32610, USA.
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21
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Boorman S, Stefanovski D, Southwood LL. Clinical findings associated with development of postoperative reflux and short-term survival after small intestinal surgery in geriatric and mature nongeriatric horses. Vet Surg 2019; 48:795-802. [PMID: 31002397 DOI: 10.1111/vsu.13217] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 02/26/2019] [Accepted: 04/03/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine risk factors, especially age, associated with postoperative reflux (POR; >2 L of reflux present upon intubation), high-volume POR (≥20 L in 24 hours), and short-term outcome after small intestinal (SI) surgery. STUDY DESIGN Retrospective case-control study. SAMPLE POPULATION Horses aged ≥16 years (geriatric; range, 16-30; n = 44) and <16 years (mature; range, 2-15; n = 39) with an SI surgical lesion that survived general anesthesia and did not have a second exploratory celiotomy during the same visit. METHODS Medical records (2009-2015) were reviewed; perioperative variables were evaluated for associations with outcomes by using multivariable logistic regression. RESULTS Postoperative reflux was associated with an increasing packed cell volume at admission (odds ratio [OR], 1.08; 95% CI, 1.00-1.16; P = .042) and presence of nasogastric reflux at admission (OR, 4.61; 95% CI, 1.3-15.69; P = .014). High-volume POR was associated with an increasing glycemia at admission (OR, 1.19; 95% CI, 1.01-1.40; P = .041), presence of nasogastric reflux at admission (OR, 10.05; 95% CI, 2.21-45.74; P = .003), and SI resection (OR, 10.52; 95% CI, 1.81-61.25; P = .009). Increasing surgical time (OR, 2.50; 95% CI, 1.16-5.29; P = .019) and high-volume POR (OR, 6.37; 95% CI, 2.12-19.12; P = .001) were associated with nonsurvival. CONCLUSION Age, considered as both a continuous variable and a categorical variable, was not associated with the development of POR, high-volume POR, or nonsurvival. CLINICAL SIGNIFICANCE Age does not influence the occurrence of POR and should not negatively impact an owner's decision to pursue surgery in aged horses.
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Affiliation(s)
- Sophie Boorman
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania
| | - Darko Stefanovski
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania
| | - Louise L Southwood
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania
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22
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Freeman DE. Fifty years of colic surgery. Equine Vet J 2018; 50:423-435. [DOI: 10.1111/evj.12817] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 12/05/2017] [Accepted: 01/10/2018] [Indexed: 12/21/2022]
Affiliation(s)
- D. E. Freeman
- Department of Large Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville Florida USA
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23
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Lisowski ZM, Pirie RS, Blikslager AT, Lefebvre D, Hume DA, Hudson NPH. An update on equine post-operative ileus: Definitions, pathophysiology and management. Equine Vet J 2018; 50:292-303. [DOI: 10.1111/evj.12801] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 11/24/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Z. M. Lisowski
- The Roslin Institute and Royal (Dick) School of Veterinary Studies; University of Edinburgh, Easter Bush; Midlothian UK
| | - R. S. Pirie
- The Roslin Institute and Royal (Dick) School of Veterinary Studies; University of Edinburgh, Easter Bush; Midlothian UK
| | - A. T. Blikslager
- Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh North Carolina USA
| | - D. Lefebvre
- The Roslin Institute and Royal (Dick) School of Veterinary Studies; University of Edinburgh, Easter Bush; Midlothian UK
| | - D. A. Hume
- The Roslin Institute and Royal (Dick) School of Veterinary Studies; University of Edinburgh, Easter Bush; Midlothian UK
- Mater Research; The University of Queensland; Woolloongabba Queensland Australia
| | - N. P. H. Hudson
- The Roslin Institute and Royal (Dick) School of Veterinary Studies; University of Edinburgh, Easter Bush; Midlothian UK
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24
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25
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Di Salvo A, Giorgi M, Nannarone S, Lee HK, Corsalini J, della Rocca G. Postoperative pharmacokinetics of meloxicam in horses after surgery for colic syndrome. J Vet Pharmacol Ther 2017; 41:369-373. [DOI: 10.1111/jvp.12461] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 09/06/2017] [Indexed: 11/28/2022]
Affiliation(s)
- A. Di Salvo
- Department of Veterinary Medicine; University of Perugia; Perugia Italy
| | - M. Giorgi
- Department of Veterinary Sciences; University of Pisa; SanPiero a Grado, Pisa Italy
| | - S. Nannarone
- Department of Veterinary Medicine; University of Perugia; Perugia Italy
- CeSDA - Centro di Studio sul Dolore Animale; University of Perugia; Perugia Italy
| | - H. K. Lee
- Pharmacology and Toxicology; College of Veterinary Medicine; Chungnam University; Daejon South Korea
| | - J. Corsalini
- Department of Veterinary Medicine; University of Perugia; Perugia Italy
| | - G. della Rocca
- Department of Veterinary Medicine; University of Perugia; Perugia Italy
- CeSDA - Centro di Studio sul Dolore Animale; University of Perugia; Perugia Italy
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26
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Agass RF, Brennan M, Rendle DI. Extrapyramidal side effects following subcutaneous metoclopramide injection for the treatment of post operative ileus. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12586] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- R. F. Agass
- Rainbow Equine Hospital; Old Malton Malton North Yorkshire UK
| | - M. Brennan
- Rainbow Equine Hospital; Old Malton Malton North Yorkshire UK
| | - D. I. Rendle
- Rainbow Equine Hospital; Old Malton Malton North Yorkshire UK
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27
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Bauck AG, Grosche A, Morton AJ, Graham AS, Vickroy TW, Freeman DE. Effect of lidocaine on inflammation in equine jejunum subjected to manipulation only and remote to intestinal segments subjected to ischemia. Am J Vet Res 2017; 78:977-989. [DOI: 10.2460/ajvr.78.8.977] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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28
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Affiliation(s)
- D. Freeman
- College of Veterinary Medicine; University of Florida; Gainesville Florida USA
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29
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Salem SE, Proudman CJ, Archer DC. Has intravenous lidocaine improved the outcome in horses following surgical management of small intestinal lesions in a UK hospital population? BMC Vet Res 2016; 12:157. [PMID: 27459996 PMCID: PMC4962447 DOI: 10.1186/s12917-016-0784-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 07/20/2016] [Indexed: 12/14/2022] Open
Abstract
Background Perioperative lidocaine treatment is commonly used in horses that undergo surgical treatment of colic, to prevent or treat postoperative ileus and reduce the effects of intestinal ischaemia-reperfusion injury. However, its clinical efficacy has not been evaluated in a large population of horses undergoing small intestinal surgery. The aim of the current study was to evaluate whether systemic lidocaine administration reduced the prevalence, volume and duration of postoperative reflux and improved rates of survival following surgical treatment of small intestinal lesions. Data were collected as a part of two prospective studies investigating postoperative survival of surgical colic patients admitted to a UK equine referral hospital during the periods 2004–2006 and 2012–2014. Kaplan-Meier plots of cumulative probability of survival and the log-rank test were used to compare survival between horses that did or did not receive lidocaine. The Wilcoxon rank-sum test was used to compare the total reflux volume and duration of reflux between the groups. A multivariable Cox proportional hazards model was used to identify pre- and intraoperative risk factors for non-survival. Results Data from 318 horses were included in the final analysis. The overall prevalence of postoperative reflux was 24.5 %. This was significantly higher (34.8 %) in horses admitted in 2012–2014 compared to the 2004–2006 cohort (16.7). Perioperative lidocaine treatment had no effect on total reflux volume, duration of reflux or rates of postoperative survival nor was it a risk factor associated with altered postoperative survival. Variables identified to be associated with increased risk of postoperative mortality included packed cell volume on admission (hazard ratio [HR] 1.03 95 %, 95 % confidence interval [CI] 1.004–1.06, p = 0.024), heart rate on admission (HR 1.014, 95 % CI 1.004–1.024, p =0.008) and duration of surgery (HR 1.007, 95 % CI 1.002–1.01, p = 0.008). Conclusions Lidocaine therapy had no effect on the prevalence of postoperative reflux, total reflux volume and duration of reflux nor did it have any effect on postoperative survival in horses undergoing surgical management of small intestinal disease for treatment of colic. There is a need for a well-designed multicentre, prospective randomised controlled trial to fully investigate the efficacy of lidocaine across different hospital populations. Electronic supplementary material The online version of this article (doi:10.1186/s12917-016-0784-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shebl E Salem
- Institute of Infection and Global Health, Department of Epidemiology and Population Health, University of Liverpool, Wirral, CH64 7TE, UK.,Department of Surgery, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Chris J Proudman
- School of Veterinary Medicine, University of Surrey, Guildford, GU2 7TE, UK
| | - Debra C Archer
- Institute of Infection and Global Health, Department of Epidemiology and Population Health, University of Liverpool, Wirral, CH64 7TE, UK. .,Philip Leverhulme Equine Hospital, School of Veterinary Science, University of Liverpool, Wirral, CH64 7TE, UK.
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30
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McConachie E, Giguère S, Barton MH. Scoring System for Multiple Organ Dysfunction in Adult Horses with Acute Surgical Gastrointestinal Disease. J Vet Intern Med 2016; 30:1276-83. [PMID: 27296454 PMCID: PMC5094519 DOI: 10.1111/jvim.14321] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Revised: 03/04/2016] [Accepted: 05/09/2016] [Indexed: 01/28/2023] Open
Abstract
Background The prevalence of multiple organ dysfunction syndrome (MODS) in horses with acute surgical gastrointestinal (GI) disease is unknown. Currently, there are no validated criteria to confirm MODS in adult horses. Objectives To develop criteria for a MODS score for horses with acute surgical colic (MODS SGI) and evaluate the association with 6‐month survival. To compare the MODS SGI score with a MODS score extrapolated from criteria used in people (MODS EQ). Animals Adult horses that required exploratory laparotomy (n = 62) for colic. Healthy adult horses undergoing elective surgical procedures (n = 12) established the reference range of some variables. Methods Prospectively, a MODS SGI score was developed based on organ‐specific criteria established from a literature review, data collection, and clinical judgment. Data for scoring each horse were collected on Days 1 and 2 postoperatively. Horses were scored retrospectively using both scoring criteria. The prognostic performance of the MODS SGI score and its overall performance compared with the MODS EQ score were assessed with receiver operating characteristic (ROC) curve analysis. Results The MODS SGI score had excellent performance for predicting 6‐month survival with an area under the ROC curve (AUC) of 0.95 (95% CI: 0.87–0.99). The AUC for the MODS SGI score was significantly higher than the MODS EQ (AUC: 0.76; 0.63–0.86). Conclusions and Clinical Importance The MODS SGI score predicts 6‐month survival from discharge in horses with acute surgical colic. The MODS SGI score performed better than a score extrapolated from human scoring systems.
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Affiliation(s)
- E McConachie
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA
| | - S Giguère
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA
| | - M H Barton
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA
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31
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Affiliation(s)
- R. M. Christley
- School of Veterinary Science and Institute of Infection and Global Health; University of Liverpool; Neston UK
- NIHR Health Protection Research Unit in Emerging and Zoonotic Infections; Liverpool UK
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32
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Lefebvre D, Hudson NPH, Elce YA, Blikslager A, Divers TJ, Handel IG, Tremaine WH, Pirie RS. Clinical features and management of equine post operative ileus (POI): Survey of Diplomates of the American Colleges of Veterinary Internal Medicine (ACVIM), Veterinary Surgeons (ACVS) and Veterinary Emergency and Critical Care (ACVECC). Equine Vet J 2015; 48:714-719. [PMID: 26502215 DOI: 10.1111/evj.12520] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 10/09/2015] [Indexed: 11/30/2022]
Abstract
REASONS FOR PERFORMING STUDY A recent survey of European Colleges (European College of Equine Internal Medicine [ECEIM] and European College of Veterinary Surgeons [ECVS]) revealed the different strategies implemented by, and some of the challenges facing, European clinicians presented with cases of post operative ileus (POI). It was concluded that further comparative analysis of opinions, canvassed from additional colleges of equine veterinary specialism worldwide, would provide valuable additional insight into current POI knowledge on a more global scale. OBJECTIVES To report and compare the current strategies favoured by American veterinary specialists when managing POI in horses that underwent emergency colic surgery. STUDY DESIGN Cross-sectional survey. METHODS Electronic invitations were sent to 814 Large Animal specialists, including 3 colleges: the American College of Veterinary Internal Medicine (ACVIM), American College of Veterinary Surgeons (ACVS) and the American College of Veterinary Emergency and Critical Care (ACVECC). RESULTS The response rate was 14% (115/814). The majority of respondents (68%) reported an estimated prevalence range of POI of 0-20%. The presence of reflux on nasogastric intubation was the main criterion used to define POI. A lesion involving the small intestine was considered the main risk factor for POI. Anti-inflammatory drugs, intravenous (i.v.) fluids and antimicrobial drugs were the primary strategies used when managing POI. Flunixin meglumine and i.v. lidocaine were the drugs most commonly used in the treatment of horses with POI. Supplementary management strategies targeted mainly the prevention of post operative adhesions, infection and inflammation. CONCLUSIONS There is a lack of consensus on the clinical definition of POI. Prospective and objective clinical assessment of the effectiveness of the different strategies contained within this and the European survey is necessary in order to identify a standardised approach to the management of equine POI.
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Affiliation(s)
- D Lefebvre
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Roslin, Midlothian, UK
| | - N P H Hudson
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Roslin, Midlothian, UK
| | - Y A Elce
- Centre Hospitalier Universitaire Vétérinaire de l'Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - A Blikslager
- College of Veterinary Medicine, North Carolina State University, Raleigh, USA
| | - T J Divers
- College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - I G Handel
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Roslin, Midlothian, UK
| | - W H Tremaine
- Department of Clinical Veterinary Science, University of Bristol, Langford, Bristol, UK
| | - R S Pirie
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, University of Edinburgh, Roslin, Midlothian, UK.
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33
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Salem SE, Proudman CJ, Archer DC. Prevention of post operative complications following surgical treatment of equine colic: Current evidence. Equine Vet J 2015; 48:143-51. [PMID: 26440916 DOI: 10.1111/evj.12517] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 09/29/2015] [Indexed: 11/28/2022]
Abstract
Changes in management of the surgical colic patient over the last 30 years have resulted in considerable improvement in post operative survival rates. However, post operative complications remain common and these impact negatively on horse welfare, probability of survival, return to previous use and the costs of treatment. Multiple studies have investigated risk factors for post operative complications following surgical management of colic and interventions that might be effective in reducing the likelihood of these occurring. The findings from these studies are frequently contradictory and the evidence for many interventions is lacking or inconclusive. This review discusses the current available evidence and identifies areas where further studies are necessary and factors that should be taken into consideration in study design.
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Affiliation(s)
- S E Salem
- Department of Surgery, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - C J Proudman
- Faculty of Health and Medical Sciences, School of Veterinary Medicine, Guildford, Surrey, UK
| | - D C Archer
- Institute of Infection and Global Health and School of Veterinary Sciences, University of Liverpool, Leahurst, Neston, UK
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