Clinical features and management of equine post operative ileus (POI): Survey of Diplomates of the American Colleges of Veterinary Internal Medicine (ACVIM), Veterinary Surgeons (ACVS) and Veterinary Emergency and Critical Care (ACVECC).
Authors: Lefebvre D, Hudson N P H, Elce Y A, Blikslager A, Divers T J, Handel I G, Tremaine W H, Pirie R S
Journal: Equine veterinary journal
Summary
# Editorial Summary Post-operative ileus remains a significant complication following equine abdominal surgery, yet clinical management approaches vary considerably amongst practitioners. To establish current global practice standards, researchers surveyed diplomates across three major American veterinary colleges (ACVIM, ACVS, and ACVECC) regarding their diagnosis, clinical assessment, and treatment strategies for POI, building upon earlier European survey data to provide international perspective on this condition. The findings revealed substantial variation in diagnostic criteria, therapeutic protocols, and monitoring practices amongst North American specialists, with particular divergence in the use of prokinetic agents, nutritional support methods, and decision-making thresholds for surgical re-exploration. These inconsistencies highlight both the multifactorial nature of POI and gaps in evidence-based consensus, suggesting that clinicians must remain flexible in their approach whilst advocating for standardised protocols based on pathophysiological principles rather than empirical preference. For equine practitioners involved in post-operative care—whether managing cases directly or liaising with referral hospitals—understanding these professional variations underscores the importance of clear communication regarding treatment goals, realistic timelines for functional recovery, and the evidence supporting different management modalities, particularly regarding antimotility agents and early mobilisation strategies.
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Practical Takeaways
- •POI management approaches vary significantly among equine specialists; awareness of alternative strategies from diplomates worldwide may improve clinical decision-making
- •Consult with colleagues from ACVIM, ACVS, and ACVECC specialties when managing POI cases, as different expertise informs management approaches
- •This survey-based evidence suggests ongoing need for standardized POI protocols given the diversity of current clinical practices
Key Findings
- •Survey of American College diplomates reveals varied clinical strategies for managing equine POI across different specialties
- •Previous European College survey demonstrated different approaches and challenges in POI management among European clinicians
- •Global comparison of POI management opinions from multiple veterinary colleges provides broader insight into current clinical practices