Duodenojejunal mesenteric rents: Survival and complications after surgical correction in 38 broodmares (2006-2014)

Colic Surgery: Recent Updates

The following article provides an overview of the last 5 years of research and innovation within the field of equine colic surgery, focusing on new techniques, new or recently described lesions, prevention of lesion recurrence or postoperative complications, and updates in prognoses. Early surgical intervention is an important factor in horse survival.

Outcomes of pregnant broodmares treated for colic at a tertiary care facility

OBJECTIVE

To evaluate, following colic admission during pregnancy, (1) broodmare survival; (2) the frequency of recurrent colic in broodmares and its associated variables, and (3) pregnancy outcome and the variables associated with a negative pregnancy outcome.

STUDY DESIGN

Ambidirectional observational cohort study.

ANIMALS

One hundred and four client-owned broodmare admissions.

METHODS

Admissions of pregnant mares from June 2010 until October 2016 were included. Data were collected until November 2017. Cox proportional hazards regression analysis was performed to evaluate variables associated with broodmare survival. Logistic regression analysis was used to examine the variables associated with recurrent colic and pregnancy outcome.

RESULTS

Broodmares from 73/104 (70.2%) admissions were discharged alive. Lesion category, admission hyperlactatemia (hazard ratio (HR) 3.24, 95%, CI 1.28-8.22, P = .013), and admission high packed cell volume (HR 2.89, 95% CI 1.29-6.47, P = .010) were associated with reduced survival. Recurrent colic was observed in broodmares from 33/70 admissions (47.1%). The final multivariable model for recurrent colic included Thoroughbred breed (OR 5.09, 95% CI 1.58-16.4, P = .006) and age (OR .876, 95% CI .747-1.03, P = .105). Overall, negative pregnancy outcome was 14/65 (21.5%). Lesion category, evidence of systemic inflammatory response syndrome (SIRS) in hospital (OR 31.2, 95% CI 2.09-466.5, P = .013), and diarrhea in hospital (OR 379.3, 95% CI 97.1-1482.0, P < .001) were associated with increased negative pregnancy outcome. Altrenogest administration was inversely associated with negative pregnancy outcome (OR 0.029, 95% CI .004-.222, P = .001).

CONCLUSION

Pregnant broodmares admitted for colic had lower survival than anticipated and were at risk of recurrent colic. Markers of broodmare disease severity were associated with pregnancy outcome.

CLINICAL SIGNIFICANCE

Lesion category, hematologic variables (packed cell volume and l-lactate concentration), evidence of SIRS, and diarrhea were useful for predicting broodmare and pregnancy outcomes.

Prevalence of Electrolyte Disturbances and Perianesthetic Death Risk Factors in 120 Horses Undergoing Colic Surgery

The objective of this study was to determine the prevalence of intraoperative electrolyte disturbances and risk factors associated with perianesthetic death in horses undergoing colic surgery. The files of 120 horses meeting the inclusion criteria were reviewed. Data retrieved from the medical records, including demographic data and the occurrence of electrolyte disturbances and other intraoperative complications, were analyzed with a two step-approach by univariate and multivariate logistic regression models. Hypocalcemia was the most represented electrolyte disturbance (52.5%), followed by hypokalemia (30.0%) that was associated with intraoperative administration of salbutamol (P = .045). Perianesthetic death occurred in 46 horses, accounting for an overall mortality rate of 38.3%. Risk factors associated with death were anesthetic duration (P = .001), body weight (P = .020), presence of gastric reflux before anesthesia (P = .021), and intraoperative tachycardia (P = .043) and acidosis (P = .025). The mortality in the study population was comparable to previously reported findings. Based on the study findings, it is advisable to optimize hemodynamics prior to anesthesia, in order to prevent intraoperative tachycardia that is associated with increased risk of death. Heavier horses and those with gastric reflux may have a higher risk of fatalities, and intraoperative salbutamol administration may contribute to hypokalemia.