Surgical and postoperative factors influencing short-term survival of horses following small intestinal resection: 92 cases (1994-2001).
Authors: Morton A J, Blikslager A T
Journal: Equine veterinary journal
Summary
# Small intestinal resection in horses: identifying at-risk patients Whilst survival rates following small intestinal resection in horses range from 48–88%, Morton and Blikslager's retrospective analysis of 92 cases identified specific postoperative indicators that substantially worsen prognosis and should guide clinical decision-making. The researchers used logistic regression to evaluate clinical and surgical variables in horses that survived anaesthesia, determining odds ratios for non-survival to hospital discharge across jejunal-to-jejunal (JJ) and jejunal-to-caecal (JC) anastomosis procedures. Four factors emerged as critical predictors: postoperative ileus carried a 30-fold increased odds of non-survival, requirement for repeat celiotomy an 18-fold increase, elevated resting heart rate (≥60 bpm) a 5.6-fold increase, and low total plasma protein (<55 g/l) an 1.8-fold increase. For practitioners managing post-resection cases, these markers—particularly the development of ileus, the need for second surgery, and persistent tachycardia—should trigger intensified therapeutic intervention and inform realistic prognostic conversations with owners, whilst recognition of hypoproteinaemia as a contributing factor highlights the importance of aggressive nutritional and fluid support during recovery.
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Practical Takeaways
- •Monitor postoperative horses closely for ileus development and heart rate elevation—these are the strongest indicators of poor prognosis and should trigger aggressive intervention
- •Horses requiring repeat celiotomy have substantially worse outcomes; optimize initial surgical planning and technique to minimize need for reoperation
- •Serial assessment of plasma protein and maintenance of cardiovascular stability in the immediate postoperative period are key prognostic markers to communicate realistic survival expectations to owners
Key Findings
- •Overall survival to discharge was 81.8% for jejunojejunostomy and 70.8% for jejunocaecostomy procedures
- •Postoperative ileus was the strongest predictor of nonsurvival (OR=29.7), increasing risk nearly 30-fold
- •Repeat celiotomy was associated with 18-fold increased risk of nonsurvival (OR=18)
- •Elevated postoperative heart rate ≥60 beats/min increased nonsurvival risk 5.6-fold, and low plasma protein <55 g/l increased risk 1.8-fold