Use of physiologic and arterial blood gas variables to predict short-term survival in horses with large colon volvulus.
Authors: Kelleher Maureen E, Brosnan Robert J, Kass Philip H, le Jeune Sarah S
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Predictive Indicators in Large Colon Volvulus Surgery Large colon volvulus remains one of the most challenging surgical emergencies in equine practice, with highly variable outcomes that are difficult to predict preoperatively. Kelleher and colleagues retrospectively analysed physiologic parameters, blood gas values, and intraoperative findings in horses undergoing exploratory celiotomy for LCV, stratifying outcomes by whether colon resection was required and whether horses survived to anesthetic recovery and discharge. Several preoperative and intraoperative variables emerged as significant predictors of survival, though specific thresholds and odds ratios varied depending on resection status—a critical finding given that resection necessity cannot always be determined until surgical exploration. The research underscores that no single parameter reliably predicts outcome in isolation; rather, a combination of clinical assessment and laboratory findings (particularly arterial blood gas variables reflecting tissue hypoperfusion and metabolic derangement) provides the most informative prognostic picture. For practitioners advising owners on case prognosis or triaging referrals, this evidence supports obtaining comprehensive preoperative bloodwork and considering multiple variables simultaneously rather than relying on any one value to justify euthanasia decisions—though the authors' stratification by resection status also highlights how intraoperative findings ultimately drive prognostic accuracy in these cases.
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Practical Takeaways
- •Preoperative assessment including arterial blood gas analysis helps prognosticate survival likelihood before surgery in large colon volvulus cases
- •Monitor specific intraoperative physiologic parameters as indicators of outcome; adjust management strategy accordingly
- •Decision-making regarding colon resection versus conservative management should incorporate physiologic assessment data
Key Findings
- •Preoperative physical examination and blood gas variables can predict survival to anesthetic recovery in horses with large colon volvulus
- •Intraoperative physiologic variables and treatments correlate with short-term survival outcomes
- •Horses requiring colon resection versus those managed with decompression alone show differential survival patterns