Nutritional and clinicopathological effects of post operative parenteral nutrition following small intestinal resection and anastomosis in the mature horse.
Authors: Durham A E, Phillips T J, Walmsley J P, Newton J R
Journal: Equine veterinary journal
Summary
Following surgical resection and anastomosis of the small intestine for colic, horses face a critical period of negative energy balance with limited data to guide nutritional management; Durham and colleagues addressed this gap by comparing post-operative outcomes in horses receiving parenteral nutrition (PN) against conventionally starved controls. Fifteen horses in each group were monitored for clinicopathological markers of nutritional status during the post-operative period, with the PN formulation designed to offset the metabolic demands of recovery. The parenteral nutrition protocol produced striking biochemical differences: treated horses showed significantly lower triglycerides, total bilirubin, albumin and urea, alongside elevated glucose and insulin concentrations, whilst control animals exhibited clear clinicopathological evidence of starvation. These results demonstrate that targeted PN can measurably improve nutritional status in post-operative colic cases, potentially mitigating the muscle wasting and immunosuppression associated with prolonged fasting following intestinal surgery. Despite these promising biochemical findings, the authors appropriately call for further investigation into clinical outcomes and potential complications before PN becomes routine practice—a reminder that improved laboratory parameters alone do not necessarily translate to better survival rates or reduced post-operative morbidity.
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Practical Takeaways
- •Post-operative colic patients receiving parenteral nutrition show measurably improved metabolic markers and nutritional status compared to fasting alone
- •PN administration appears to mitigate the starvation response seen in conventionally managed post-colic cases, though clinical benefits and safety require further investigation before routine recommendation
- •Consider that post-operative colic cases suffer significant negative energy balance—parenteral nutrition protocols may help, but more evidence is needed on long-term outcomes and complications
Key Findings
- •Parenteral nutrition group had significantly lower serum triglycerides, total bilirubin, albumin and urea compared to control group post-operatively
- •Parenteral nutrition group demonstrated significantly higher serum glucose and insulin concentrations compared to starved control group
- •Control group showed clinicopathological evidence of starvation while treated group demonstrated improved nutritional status
- •PN formulation resulted in detectable improvements in nutritional markers in post-operative colic surgery patients