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Barton C, Hassel DM. Critical Care of the Colic Patient: Monitoring, Fluid Therapy, and More. Vet Clin North Am Equine Pract 2023:S0749-0739(23)00023-8. [PMID: 37169620 DOI: 10.1016/j.cveq.2023.03.011] [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: 05/13/2023] Open
Abstract
A successful outcome to management of the critical colic patient is highly dependent on how the patient is monitored and treated, particularly, in the perioperative period. In this article, we will provide an update on monitoring techniques, advances in fluid therapy, nutrition management and pharmacotherapeutic agents, inclusive of pain monitoring and management, prokinetics, and management of systemic inflammatory response syndrome and the hypercoagulable state.
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Affiliation(s)
- Charlie Barton
- Department of Clinical Sciences, Colorado State University, College of Veterinary Medicine & Biological Sciences, 300 West Drake Road, Fort Collins, CO 80523, USA
| | - Diana M Hassel
- Department of Clinical Sciences, Colorado State University, College of Veterinary Medicine & Biological Sciences, 300 West Drake Road, Fort Collins, CO 80523, USA.
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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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Filippo PAD, Duarte BR, Albernaz AP, Quirino CR. Effects of feed deprivation on physical and blood parameters of horses. BRAZILIAN JOURNAL OF VETERINARY MEDICINE 2021; 43:e000321. [PMID: 35749104 PMCID: PMC9179197 DOI: 10.29374/2527-2179.bjvm000321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 06/29/2021] [Indexed: 12/04/2022] Open
Abstract
The objective of this study was to evaluate the effect of feed restriction on some physical and blood parameters in horses kept outdoors under natural conditions. Twenty horses were deprived of food for 48 h. They were closely monitored and examined, and blood samples were taken at the beginning (0) of the experiment and 6, 12, 18, 24, 30, 36, 42 and 48 hours afterward. During the experimental period, the control group (12 animals) had free access to water and hay, while the restricted group had free access to water only. Data were submitted to two-way analysis of variance with repeated measures, and statistical significance was P ≤ 0.05. The horses tolerated feed restriction without complications. Feed restriction had no effect on body mass and body condition score, heart rate, respiratory rate, capillary filling time and body temperature. However, feed restriction decreased the intensity of gastrointestinal sounds (P<0.05) compared to the control horses. Feed restriction did not cause any changes in erythrocyte variables and gamma glutamyl transferase, creatinine, total protein, and albumin concentrations. During fasting, there was a reduction in the leukocyte response (P<0.05). Feed restriction significantly raised the levels of blood urea nitrogen (24 to 48 hours), aspartate aminotransferase (36 to 48 hours) and total cholesterol (42 to 48 hours). During 48 hours of fasting, there was a continuous increase in triglyceride concentration. Feed restriction for 48 h had a marked effect on the intensity of gastrointestinal sounds and was responsible for important metabolic changes in the healthy horses of our sample.
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Affiliation(s)
- Paula Alessandra Di Filippo
- Veterinarian, DSc., Laboratório de Clínicas e Cirurgia Animal (LCCA), Universidade Estadual do Norte Fluminense Darcy Ribeiro (UENF), Campos dos Goytacazes, RJ, Brasil.
- Correspondence Paula Alessandra Di Filippo Laboratório de Clínica e Cirurgia Animal, Universidade Estadual do Norte Fluminense Darcy Ribeiro - UENF Av. Alberto Lamego, 2000, Parque Califórnia, CEP 28013-602 - Campos dos Goytacazes (RJ), Brasil E-mail:
| | - Barbara Ribeiro Duarte
- Veterinarian, MSc., Programa de Pós-Graduação em Ciência Animal (PPGCA), UENF, Campos dos Goytacazes, RJ, Brasil.
| | - Antônio Peixoto Albernaz
- Veterinarian, DSc., Laboratório de Clínicas e Cirurgia Animal (LCCA), Universidade Estadual do Norte Fluminense Darcy Ribeiro (UENF), Campos dos Goytacazes, RJ, Brasil.
| | - Célia Raquel Quirino
- Veterinarian, DSc., Laboratório de Reprodução e Melhoramento Genético Animal (LRMGA), UENF, Campos dos Goytacazes, RJ, Brasil.
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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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Enteral/Parenteral Nutrition in Foals and Adult Horses Practical Guidelines for the Practitioner. Vet Clin North Am Equine Pract 2018; 34:169-180. [PMID: 29426711 DOI: 10.1016/j.cveq.2017.11.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Nutritional support is an important adjunct to medical therapy in the sick, injured, or debilitated equine patient. What is not clear is the optimal route, composition, or amounts of support. The enteral route should be chosen whenever possible to maximize the benefits to the gastrointestinal tract and the patient as a whole. Complete or partial parenteral nutrition is most useful as a bridge during recovery and transition to enteral feeding in the horse. The reader is encouraged to consider nutritional support whether enteral or parenteral in any anorexic, chronically debilitated, or sick equine patient.
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Tóth B, Auth A, Rompos L, Bakos Z. Effect of feed deprivation on selected parameters of lipid mobilisation and hepatic function in healthy Akhal Teke horses. Equine Vet J 2017; 50:98-103. [DOI: 10.1111/evj.12730] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 07/31/2017] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - Z. Bakos
- Department and Clinic of Equine Medicine; University of Veterinary Medicine; Üllő Hungary
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Magdesian KG, Bozorgmanesh R. Nutritional considerations for horses with colitis. Part 2: Parenteral nutrition, new nutritional considerations and specific dietary recommendations. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | - R. Bozorgmanesh
- Veterinary Medical Teaching Hospital; School of Veterinary Medicine; University of California; Davis USA
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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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Affiliation(s)
- R. S. Pirie
- Royal (Dick) School of Veterinary Studies and Roslin Institute; University of Edinburgh; UK
| | - R. C. Jago
- Royal (Dick) School of Veterinary Studies and Roslin Institute; University of Edinburgh; UK
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Lefebvre D, Pirie RS, Handel IG, Tremaine WH, Hudson NPH. Clinical features and management of equine post operative ileus: Survey of diplomates of the European Colleges of Equine Internal Medicine (ECEIM) and Veterinary Surgeons (ECVS). Equine Vet J 2015; 48:182-7. [PMID: 25256601 DOI: 10.1111/evj.12355] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 09/03/2014] [Indexed: 11/30/2022]
Abstract
REASONS FOR PERFORMING STUDY There is a need for an improved understanding of equine post operative ileus (POI), in terms of both clinical definition and optimal management. Although the pharmacological strategies that are used to treat POI continue to evolve, little is known about the supplementary strategies used to prevent and manage this condition. OBJECTIVES To report the current strategies used to diagnose, prevent and manage POI following emergency abdominal surgeries. STUDY DESIGN Cross-sectional survey. METHODS An electronic survey invitation was sent by email to 306 European college diplomates (European Colleges of Equine Internal Medicine, ECEIM n = 120, and Veterinary Surgeons, ECVS n = 186). RESULTS The response rate was 33% (100 of 306). The median reported estimated incidence of POI was 10-20%. The presence of reflux on nasogastric intubation was the main criterion used to define POI. Lesions involving the small intestine were thought to be the leading risk factors for developing POI. Anti-inflammatory drugs, antimicrobial drugs and i.v. fluids were the primary preventative strategies when managing cases at high risk for POI. Flunixin meglumine and lidocaine were the drugs most commonly used to treat horses with POI. Supplementary preventative and treatment strategies for POI included control of endotoxaemia, fluid therapy, early ambulation and judicious timing of post operative feeding. CONCLUSIONS Appreciation of the potential risk factors associated with the development of POI appeared to have an impact on the choice of management strategies that are implemented. The majority of ECEIM and ECVS Diplomates in the survey used flunixin meglumine and lidocaine, often in combination, to treat horses with POI, which is likely to reflect the contributory role of inflammation in its pathophysiology. Various supplementary strategies were used to prevent and manage POI risk factors intraoperatively and post operatively.
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Affiliation(s)
- D Lefebvre
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, Easter Bush Veterinary Centre, University of Edinburgh, UK
| | - R S Pirie
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, Easter Bush Veterinary Centre, University of Edinburgh, UK
| | - I G Handel
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, Easter Bush Veterinary Centre, University of Edinburgh, UK
| | - W H Tremaine
- Department of Clinical Veterinary Science, University of Bristol, UK
| | - N P H Hudson
- The Royal (Dick) School of Veterinary Studies and Roslin Institute, Easter Bush Veterinary Centre, University of Edinburgh, UK
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van Galen G, Votion DM. Management of cases suffering from atypical myopathy: Interpretations of descriptive, epidemiological and pathophysiological findings. Part 1: First aid, cardiovascular, nutritional and digestive care. EQUINE VET EDUC 2012. [DOI: 10.1111/j.2042-3292.2012.00439.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Williams A, Peachey LE, Christley RM. Assessment of a point-of-care test for measurement of blood triglyceride levels for rapid detection of equid hypertriglyceridaemia. EQUINE VET EDUC 2012. [DOI: 10.1111/j.2042-3292.2011.00379.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Myers CJ, Magdesian KG, Kass PH, Madigan JE, Rhodes DM, Marks SL. Parenteral nutrition in neonatal foals: Clinical description, complications and outcome in 53 foals (1995–2005). Vet J 2009; 181:137-44. [DOI: 10.1016/j.tvjl.2008.02.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2007] [Revised: 02/24/2008] [Accepted: 02/28/2008] [Indexed: 10/22/2022]
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Coelho CS, Fantoni DT, Torres LN, Hendrickson DA, Silva LC. Short-Term Effects of Duodenocecostomy on Body Weight, Glucose Absorption, Serum Components, and Intestinal Histopathology in Four Normal Horses. J Equine Vet Sci 2009. [DOI: 10.1016/j.jevs.2009.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Edner AH, Nyman GC, Essén-Gustavsson B. Metabolism before, during and after anaesthesia in colic and healthy horses. Acta Vet Scand 2007; 49:34. [PMID: 18001483 PMCID: PMC2206032 DOI: 10.1186/1751-0147-49-34] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2007] [Accepted: 11/15/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many colic horses are compromised due to the disease state and from hours of starvation and sometimes long trailer rides. This could influence their muscle energy reserves and affect the horses' ability to recover. The principal aim was to follow metabolic parameter before, during, and up to 7 days after anaesthesia in healthy horses and in horses undergoing abdominal surgery due to colic. METHODS 20 healthy horses given anaesthesia alone and 20 colic horses subjected to emergency abdominal surgery were anaesthetised for a mean of 228 minutes and 183 minutes respectively. Blood for analysis of haematology, electrolytes, cortisol, creatine kinase (CK), free fatty acids (FFA), glycerol, glucose and lactate was sampled before, during, and up to 7 days after anaesthesia. Arterial and venous blood gases were obtained before, during and up to 8 hours after recovery. Gluteal muscle biopsy specimens for biochemical analysis of muscle metabolites were obtained at start and end of anaesthesia and 1 h and 1 day after recovery. RESULTS Plasma cortisol, FFA, glycerol, glucose, lactate and CK were elevated and serum phosphate and potassium were lower in colic horses before anaesthesia. Muscle adenosine triphosphate (ATP) content was low in several colic horses. Anaesthesia and surgery resulted in a decrease in plasma FFA and glycerol in colic horses whereas levels increased in healthy horses. During anaesthesia muscle and plasma lactate and plasma phosphate increased in both groups. In the colic horses plasma lactate increased further after recovery. Plasma FFA and glycerol increased 8 h after standing in the colic horses. In both groups, plasma concentrations of CK increased and serum phosphate decreased post-anaesthesia. On Day 7 most parameters were not different between groups. Colic horses lost on average 8% of their initial weight. Eleven colic horses completed the study. CONCLUSION Colic horses entered anaesthesia with altered metabolism and in a negative oxygen balance. Muscle oxygenation was insufficient during anaesthesia in both groups, although to a lesser extent in the healthy horses. The post-anaesthetic period was associated with increased lipolysis and weight loss in the colic horses, indicating a negative energy balance during the first week post-operatively.
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