Clinical findings associated with development of postoperative reflux and short‐term survival after small intestinal surgery in geriatric and mature nongeriatric horses

Abstract

Objective To determine risk factors, especially age, associated with postoperative reflux (POR; >2 L of reflux present upon intubation), high‐volume POR (≥20 L in 24 hours), and short‐term outcome after small intestinal (SI) surgery. Study design Retrospective case‐control study. Sample population Horses aged ≥16 years (geriatric; range, 16–30; n = 44) and <16 years (mature; range, 2–15; n = 39) with an SI surgical lesion that survived general anesthesia and did not have a second exploratory celiotomy during the same visit. Methods Medical records (2009–2015) were reviewed; perioperative variables were evaluated for associations with outcomes by using multivariable logistic regression. Results Postoperative reflux was associated with an increasing packed cell volume at admission (odds ratio [OR], 1.08; 95% CI, 1.00–1.16; P = .042) and presence of nasogastric reflux at admission (OR, 4.61; 95% CI, 1.3–15.69; P = .014). High‐volume POR was associated with an increasing glycemia at admission (OR, 1.19; 95% CI, 1.01–1.40; P = .041), presence of nasogastric reflux at admission (OR, 10.05; 95% CI, 2.21–45.74; P = .003), and SI resection (OR, 10.52; 95% CI, 1.81–61.25; P = .009). Increasing surgical time (OR, 2.50; 95% CI, 1.16–5.29; P = .019) and high‐volume POR (OR, 6.37; 95% CI, 2.12–19.12; P = .001) were associated with nonsurvival. Conclusion Age, considered as both a continuous variable and a categorical variable, was not associated with the development of POR, high‐volume POR, or nonsurvival. Clinical significance Age does not influence the occurrence of POR and should not negatively impact an owner's decision to pursue surgery in aged horses.

Facial nerve paralysis in 64 equids: Clinical variables, diagnosis, and outcome

“…Median rectal temperature was 38.0°C (IQR, 37.2‐38.3); fever (≥38.6°C) was identified in 5 cases. Median heart rate was 44 beats per minute (IQR, 39‐53 beats per minute); tachycardia (≥45 beats per minute) was recorded in 30% (19/52) of cases; and median respiratory rate was 20 breaths per minute (IQR, 14‐24 breaths per minute) …”

Standing jejunal enterotomy for resolution of an ileal impaction

“…The development of an incisional abscess is not unique to standing surgery and is also reported following ventral midline celiotomy (Rubio Martínez et al., 2012). The gelding also experienced postoperative ileus in the immediate period following the first surgery, but this was considered mild due to the short volume and duration and was successfully treated medically (Boorman et al., 2019). Despite this, the total treatment cost of the two standing procedures was less than that of a typical surgical small intestinal colic case performed under general anaesthesia at our institution.…”

Immunosenescence and inflammaging in the aged horse

“…One study of horses with naturally-occurring colitis found the likelihood of non-survival increased by 11.8% for every year the horse aged, and that horses ≥ 20 years of age were 15.2 times more likely to die than young adults, independent of financial considerations, comorbidities, and duration of hospitalization [76]. In contrast, a study examining post-operative recovery from colic surgery in aged and adult horses found no differences in the severity of post-operative reflux or likelihood of survival [111]. Clearly much remains to be elucidated regarding the effect of age on disease in horses.…”