Factors associated with mortality and morbidity in small intestinal volvulus in horses.
Authors: Stephen Jennifer O, Corley Kevin T T, Johnston Janet K, Pfeiffer Dirk
Journal: Veterinary surgery : VS
Summary
# Small intestinal volvulus: prognostic indicators for equine practitioners Researchers examined 115 horses presenting with primary small intestinal volvulus to identify clinical and pathological factors predicting surgical outcome and post-operative survival. Through retrospective analysis of medical records, they compared physical examination findings, laboratory values, and surgical decisions between horses that survived to discharge and non-survivors, using statistical modelling to account for confounding variables. Eighty percent of surgical cases survived to hospital discharge; however, demographic factors such as age, breed and sex had no bearing on outcome, whereas pre-operative cardiovascular compromise—characterised by elevated heart rate, prolonged capillary refill time and poor mucous membrane colour—significantly predicted non-survival, as did worsening haemoconcentration and peritoneal exudation of cells and protein. Post-operatively, colic recurrence and requirement for a second celiotomy carried substantially worse prognoses, with both complications occurring significantly more often following jejunocecostomy procedures during the initial surgery. These findings provide evidence-based prognostic indicators that enable veterinary surgeons to counsel clients realistically at each stage of management, and suggest that operative technique selection may influence post-operative morbidity and ultimate survival in this challenging condition.
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Practical Takeaways
- •Pre-operative cardiovascular parameters (heart rate, mucous membrane color, capillary refill time) are reliable prognostic indicators for survival in small intestinal volvulus cases and should guide decision-making
- •Jejunocecostomy procedures increase risk of post-operative complications including colic and need for re-surgery; monitor these cases intensively post-operatively
- •Peritoneal fluid analysis showing exudation of cells and protein indicates worse prognosis independent of initial surgical success
Key Findings
- •80% of horses that underwent surgery for small intestinal volvulus survived to hospital discharge
- •Survivors had significantly lower heart rate, shorter capillary refill time, and better mucous membrane color compared to non-survivors
- •Post-operative colic and requirement for second celiotomy were significantly associated with non-survival (P=0.028 and P<0.01 respectively)
- •Age, breed, and sex were not related to mortality; adverse cardiovascular status and peritoneal fluid changes were significant mortality predictors