Use of ultrasound to evaluate outcome following colic surgery for equine large colon volvulus.
Authors: Sheats M K, Cook V L, Jones S L, Blikslager A T, Pease A P
Journal: Equine veterinary journal
Summary
# Editorial Summary: Ultrasound Assessment of Post-operative Colon Wall Recovery Following Large Colon Volvulus Surgery Large colon volvulus (LCV) represents a serious surgical emergency in equine practice, yet little was known about how the colon wall recovers following surgical correction. Sheats and colleagues conducted a prospective ultrasound study at North Carolina State University's veterinary teaching hospital between 2006–2008, measuring large colon wall thickness at anaesthetic recovery and every 6–8 hours thereafter in horses that had undergone surgical correction of LCV (rotation ≥360°) without resection, tracking the time until wall thickness normalised (≤5 mm). The critical finding was that horses developing multiple organ dysfunction syndrome (MODS) during the post-operative period took significantly longer for colon wall involution—a mean of 39.7 hours compared to 19.6 hours in horses that recovered uneventfully (P = 0.006)—suggesting that prolonged oedema and inflammation correlates with increased morbidity. Whilst time to colon wall normalisation did not significantly differ between survivors and non-survivors overall, the marked association between delayed involution and MODS development indicates that serial ultrasound monitoring could identify high-risk cases early, potentially allowing for more aggressive intervention strategies. For practitioners managing post-operative LCV cases, transabdominal ultrasound assessment of colon wall thickness warrants consideration as a practical prognostic tool, particularly to flag patients at elevated risk of systemic complications.
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Practical Takeaways
- •Use transabdominal ultrasound to monitor large colon wall thickness (target ≤5 mm) as a prognostic indicator after LCV surgery; delayed involution suggests increased MODS risk
- •Horses with slower colon wall involution (taking >39 hours) warrant more intensive post-operative monitoring and intervention for potential complications
- •Colon wall involution rate appears more predictive of morbidity complications than ultimate survival outcome in LCV cases
Key Findings
- •Horses without MODS had significantly shorter colon wall involution time (19.6 ± 2.5 hours) compared to those with MODS (39.7 ± 6.7 hours, P = 0.006)
- •Colon wall involution time did not significantly differ between survivors and non-survivors (26.2 ± 4.9 hours vs 33.2 ± 7.8 hours, respectively)
- •Shorter time to colon wall involution (≤5 mm thickness) was associated with decreased post-operative morbidity
- •Ultrasonographic monitoring of colon wall thickness post-operatively may help identify horses at risk for developing MODS