Investigation of perioperative and anesthetic variables affecting short-term survival of horses with small intestinal strangulating lesions.
Authors: Espinosa Pablo, Le Jeune Sarah S, Cenani Alessia, Kass Philip H, Brosnan Robert J
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Strangulating lesions of the small intestine represent an acute surgical emergency in horses with notoriously poor prognosis, yet limited evidence exists regarding which perioperative factors genuinely predict survival. This retrospective analysis examined 274 horses undergoing celiotomy for small intestinal strangulation to identify specific physiologic variables and anaesthetic parameters associated with survival to recovery, hospital discharge, the need for repeat surgery, and postoperative nasogastric intubation. Preoperative metabolic acidosis, elevated serum lactate, prolonged capillary refill time, and hypotension emerged as significant negative prognostic indicators, whilst certain intraoperative factors—including anaesthetic drug selection and duration of surgery—influenced short-term outcomes; notably, horses managed with postoperative NGT drainage showed improved survival despite indicating more severe initial disease. These findings provide evidence-based guidance for practitioners to refine prognostic counselling with owners and inform targeted perioperative management decisions, such as aggressive fluid resuscitation, careful drug selection, and consideration of extended postoperative decompression protocols in cases where physiologic parameters suggest severe intestinal compromise.
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Practical Takeaways
- •Understanding which preoperative vital signs and blood parameters predict poor outcomes helps identify high-risk colic cases requiring aggressive resuscitation or alternative management strategies
- •Intraoperative monitoring parameters may guide surgical decision-making and help predict which horses will need repeat procedures
- •Knowledge of postoperative complications like ileus requiring NGT support aids in client communication about recovery expectations and aftercare planning
Key Findings
- •Preoperative and intraoperative physiologic variables were evaluated to identify predictors of survival to anesthetic recovery and hospital discharge
- •Surgical factors and anesthetic variables were assessed for correlation with need for repeat celiotomy
- •Postoperative nasogastric intubation requirements were analyzed as an outcome variable in small intestinal strangulation cases