Risk factors for enterolithiasis among horses in Texas

OBJECTIVE: To identify risk factors for enterolithiasis in horses. DESIGN: Matched case-control study. ANIMALS: 26 horses with enteroliths, 104 horses with other causes of colic that underwent surgery (52 horses, surgical control group) or were treated medically (52 horses, nonsurgical control group). PROCEDURE: Medical records were reviewed for horses with enteroliths and control horses. Information collected included signalment, anamnesis, and findings on physical examination and clinicopathologic testing at admission. Horses with enteroliths and control horses were compared by means of conditional logistic regression to identify factors associated with enterolithiasis. RESULTS: Horses that were fed alfalfa hay, spent < or = 50% of time outdoors, or were Arabian or miniature breeds had an increased risk of developing enteroliths. Horses with enteroliths were more likely to have been hyperbilirubinemic and to have had clinical signs > 12 hours prior to admission. CONCLUSIONS AND CLINICAL RELEVANCE: Breed and diet appear to influence the risk of enterolithiasis; other management factors also may influence development of enteroliths. Duration of clinical signs may be longer and signs may be less severe among horses with enteroliths, compared with horses with other causes of colic.     

Occurrence of Anoplocephala perfoliata infection in horses in Ontario, Canada and associations with colic and management practices

Infection with the tapeworm Anoplocephala perfoliata has been found to be associated with equine colic in horses in the United Kingdom. Using a matched case-control study design, data collected from 117 pairs of horses in Ontario were examined for evidence of associations between risk of colic and A. perfoliata infection, and between seropositivity to infection and management practices. Cases were horses in southern Ontario diagnosed with colic by local veterinarians, and control horses were from the same stables as cases and were matched by age, breed and gender where possible. Infection status was defined on the basis of positive results upon coprological examination, and/or seropositivity to a 12/13 kDa A. perfoliata secretory protein. Fifty-six percent of the 234 horses were seropositive for A. perfoliata, but eggs were found in samples from only 6% of horses. Horses dependent on pasture for a large part of their diet were significantly more likely to have ELISA optical density levels above 0.600 compared to other horses (odds ratio [OR]=6.38; p=0.029). This finding identified exposure to pasture as an important source of A. perfoliata infection in the horses used in the study. In a subset of 46 pairs of horses for which control horses had no known history of colic, a statistically significant negative association was found between the risk of colic and optical density (OD) levels >0.200-0.600, relative to OD levels < or = 0.090 (OR=0.08; p=0.017). There was no other statistical evidence of an association between the risk of colic and A. perfoliata infection.     

Detection of endotoxin in cases of equine colic

The Limulus amoebocyte lysate assay was used to test for the presence of endotoxin in 37 clinical cases of equine colic. Positive plasma titres were detected in 10 cases and the presence of endotoxin was significantly correlated with a high heart rate, a high packed cell volume and a poor prognosis. High levels of endotoxin were detected in gut contents taken from several sites in the gastrointestinal tract of normal horses.     

Evaluation of activated neutrophils in the blood of horses with colic

OBJECTIVE: To evaluate the activation status of neutrophils in blood samples obtained from horses with naturally occurring colic associated with strangulating obstruction, nonstrangulating obstruction, or inflammatory bowel disease. ANIMALS: 30 horses with naturally occurring colic and 30 healthy control horses. PROCEDURE: Activation status of neutrophils was determined by assessing the number of neutrophils that could pass through filters with 5-microm pores, cell-surface CD11-CD18 expression, and alterations in size and granularity of neutrophils. RESULTS: Horses with impaction or gas colic did not have evidence of activated neutrophils. Horses with inflammatory bowel disease consistently had evidence of activated neutrophils, including decreased leukocyte deformability, increased CD11-CD18 expression, increased neutrophil size, and decreased neutrophil granularity. Horses with strangulating colic had variable results. Of horses with strangulating colic, 7 of 14 had marked changes in filtration pressures, 5 of 14 had increased CD11-CD18 expression, 6 of 14 had changes in neutrophil size, and 5 of 14 had changes in neutrophil granularity. Among horses with strangulating colic, changes in deformability, size, and granularity of neutrophils correlated with an adverse outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Activated neutrophils were detected in all horses with inflammatory bowel disease and a few horses with strangulating colic. Correlation of activated neutrophils with horses that had strangulating colic that died or were euthanatized indicates that activated neutrophils are a negative prognostic indicator. Additional studies are needed to determine whether activated neutrophils contribute directly to the adverse outcome in horses with strangulating colic.     

A comparison of traditional and quantitative analysis of acid-base and electrolyte imbalances in horses with gastrointestinal disorders

The purpose of this study was to compare traditional and quantitative approaches in analysis of the acid-base and electrolyte imbalances in horses with acute gastrointestinal disorders. Venous blood samples were collected from 115 colic horses, and from 45 control animals. Horses with colic were grouped according to the clinical diagnosis into 4 categories: obstructive, ischemic, inflammatory, and diarrheic problems. Plasma electrolytes, total protein, albumin, pH, pCO2, tCO2, HCO3-, base excess, anion gap, measured strong ion difference (SIDm), nonvolatile weak buffers (A(tot)), and strong ion gap were determined in all samples. All colic horses revealed a mild but statistically significant decrease in iCa2+ concentration. Potassium levels were mildly but significantly decreased in horses with colic, except in those within the inflammatory group. Additionally, the diarrheic group revealed a mild but significant decrease in Na+, tCa, tMg, total protein, albumin, SIDm, and A(tot). Although pH was not severely altered in any colic group, 26% of the horses in the obstructive group, 74% in the ischemic group, 87% in the inflammatory group, and 22% in the diarrheic group had a metabolic imbalance. In contrast, when using the quantitative approach, 78% of the diarrheic horses revealed a metabolic imbalance consisting mainly of a strong ion acidosis and nonvolatile buffer ion alkalosis. In conclusion, mild acid-base and electrolyte disturbances were observed in horses with gastrointestinal disorders. However, the quantitative approach should be used in these animals, especially when strong ion imbalances and hypoproteinemia are detected, so that abnormalities in acid-base status are evident.     

Colic in geriatric compared to mature nongeriatric horses. Part 1: Retrospective review of clinical and laboratory data

Reason for performing study: It is the impression of some surgeons that geriatric horses have a lower survival rate compared to mature nongeriatric horses following colic surgery. One possible reason for this is that geriatric horses may be more critically ill at admission and have more severe disease than mature nongeriatric horses. Objective: To compare admission historical, physical examination and laboratory data for geriatric and mature nongeriatric horses referred for signs of colic. Methods: Medical records of horses admitted with a presenting complaint of colic between 2000 and 2006 were reviewed. Geriatric horses ≥16 years (n = 300) and mature nongeriatric horses 4–15 years (n = 300). Information obtained included duration of colic prior to admission, admission level of pain, heart rate, intestinal borborygmi, packed cell volume (PCV), plasma creatinine and blood lactate concentrations and peritoneal fluid total protein. Data were analysed using a Chi‐squared test or an analysis of variance. Level of significance was P<0.05. Results: There was no difference between geriatric and mature horses in the duration of colic prior to admission or in admission heart rate, PCV, or plasma creatinine or blood lactate concentrations. However, geriatric horses were more likely to be moderately painful and less likely to be bright and alert than mature horses; and less likely to have normal intestinal borborygmi than mature horses. Peritoneal fluid total protein concentration was higher in geriatric than mature horses. Conclusions and potential relevance: Geriatric horses presenting with signs of colic had a similar admission cardiovascular status based on heart rate, PCV, and plasma creatinine and blood lactate concentration to mature horses. Geriatric horses, however, may have different causes of colic, which may be more serious than mature horses based on pain, lack of intestinal borborygmi and peritoneal fluid total protein concentration.     

Cortisol Circadian Rhythm Ratio: A Simple Method to Detect Stressed Horses at Higher Risk of Colic?

With the hypothesis that police horses with abnormal cortisol circadian rhythm (CCR) had more chance to develop colic, the aim of this study was to determine the CCR ratio in horses subjected to different housing and work conditions and to associate abnormal CCR ratio with incidence of colic. A total of 116 police horses belonging to four different groups were studied. In all, 31 were full-time stabled and performed urban patrolling activity, 27 were full-time stabled and performed equine therapy and sports activities, 25 were part-time stabled and performed urban patrolling, and 33 animals were kept full-time on pasture and did not perform any kind of work activity. Venous blood samples were collected between 6 and 7 am and also 8 hours later, and cortisol concentrations were determined by radioimmunoassay to calculate the CCR ratio. Annual colic incidences (6 months before and after the day on which CCR ratio was determined) were assessed by examining individual medical files. The overall incidence of abnormal CCR ratio (<0.30) was 63.3%, and 107 cases of colic were reported for this population with a mean incidence of 0.92 colic/horse/yr. Horses with abnormal CCR had 2.3 times more chance to have colic (95% CI: 1.07 to 5.28, P = .03) when compared with those with normal CCR. In conclusion, high incidence of abnormal CCR ratio indicates that police horses were under stressful conditions. Horses with abnormal CCR ratios were more prone to suffer colic episodes, indicating that CCR ratio determination could perhaps be useful in detecting horses at risk of colic.     

Effects of oral powder electrolyte administration on packed cell volume,plasma chemistry parameters,and incidence of colic in horses participating in a 6-day 162-km trail ride

This study evaluated the effects of administering oral powder electrolytes on packed cell volume (PCV), plasma chemistry parameters, and incidence of colic in horses participating on a 6-day 162-km trail ride in which water was not offered ad libitum. Twenty-three horses received grain with powder electrolytes daily while 19 control horses received grain only. Horses were ridden approximately 32 km a day at a walk or trot. Packed cell volume and plasma chemistry parameters were analyzed daily. Episodes of colic were diagnosed and treated by a veterinarian unaware of treatment group allocation. Blood parameters and incidence of colic were compared between treatment groups. Electrolyte administration did not alter PCV or plasma chemistry parameters compared to controls. The incidence of colic was significantly higher in treated horses (P = 0.05). Oral powder electrolytes did not enhance hydration status or electrolyte homeostasis and may be associated with colic in horses participating on long distance trail rides similar to this model.     

Prevalence of Clostridium perfringens enterotoxin and Clostridium difficile toxin A in feces of horses with diarrhea and colic.

OBJECTIVE: To determine prevalence of clostridial enterotoxins in feces of horses with diarrhea and colic, and to determine whether an association exists between detection of clostridial enterotoxins in feces and development of diarrhea as a complication of colic. DESIGN: Prospective case series and case-control study. ANIMALS: 174 horses with diarrhea, colic, or problems not related to the gastrointestinal tract. PROCEDURE: Horses were assigned to 1 of 4 groups: colic with diarrhea (group 1; n = 30); colic without diarrhea (group 2; 30); diarrhea without colic (group 3; 57); and control (group 4; 57). Feces were evaluated by use of ELISA to detect Clostridium perfringens enterotoxin (CPE) and C difficile toxin A (TOXA). Frequency of detection of CPE or TOXA in groups 1 and 3 was compared with that in groups 2 and 4, respectively. RESULTS: Prevalence of enteric clostridiosis in horses in group 3 was 25%. Clostridium perfringens enterotoxin was detected in 9 of 57 (16%), TOXA in 8 of 57 (14%), and both toxins in 3 of 57 (5%) fecal samples collected from these horses. Neither toxin was detected in feces of the age-matched horses in group 4. Clostridial enterotoxins were detected in feces of 7 of 60 (12%) horses with colic (groups 1 and 2), however, a significant association was not found between detection of enterotoxins in feces and development of diarrhea as a complication of colic. CONCLUSIONS AND CLINICAL RELEVANCE: Clostridia are important etiologic agents of diarrhea in horses. Additionally, changes in intestinal flora of horses with colic may allow for proliferation of clostridia and elaboration of enterotoxins regardless of whether diarrhea develops.     

Association of admission plasma D-dimer concentration with diagnosis and outcome in horses with colic

Background: Coagulopathies detected in horses with gastrointestinal problems seem to be associated with poor outcome. Plasma D‐Dimer concentration is a sensitive test for assessing coagulopathies. Hypothesis: Plasma D‐Dimer concentration tested on admission is related to diagnosis and outcome in horses with colic. Animals: Four hundred and ninety three horses referred for evaluation of abdominal pain. Methods: Prospective observational clinical study. Horses were grouped according to diagnosis (medical and surgical intestinal obstructions, ischemic disorders with and without intestinal resection, enteritis, peritonitis), outcome (survivors, nonsurvivors), and number of coagulopathies (normal profile, 1 or 2 coagulopathies, subclinical disseminated intravascular coagulation [DIC]). Blood samples were collected on admission and plasma D‐Dimer concentration, clotting times (PT and aPTT), and antithrombin activity were determined. Positive likelihood ratios (LR+) were calculated for evaluation of D‐Dimer cut‐off values, which were later tested in a logistic regression model. Results: Horses with enteritis or peritonitis had significantly (P < .001) higher plasma D‐Dimer concentrations and more severe coagulopathies on admission than horses with other diagnoses. Nonsurvivors also had significantly (P < .001) higher plasma D‐Dimer concentrations at presentation than did survivors, and those horses with subclinical DIC on presentation had an odds ratio (OR) 8.6 (95% confidence interval [CI], 3.3–22.5, P < .001) for nonsurvival. Finally, D‐Dimer concentrations >4,000 ng/mL had a LR+ of 5.9 and an OR 8.8 (95% CI, 4.5–17.1, P < .001) for nonsurvival. Conclusion and Clinical Importance: Plasma D‐Dimer concentration measured on admission can be used to facilitate diagnosis and outcome prediction in horses with colic. A potential cut‐off value for nonsurvival was found at approximately 4,000 ng/mL.     

Analysis of Sodium Carboxymethylcellulose Administration and Related Factors Associated with Postoperative Colic and Survival in Horses with Small Intestinal Disease

Objective— To analyze the effect of the intraoperative use of sodium carboxymethylcellulose (CBMC) and related perioperative factors on postoperative colic and survival in horses that had abdominal surgery for colic.
Study Design— Retrospective study.
Animals— Horses (n=203) that had surgery for small intestinal disease; 33 horses had intraoperative administration of CBMC.
Methods— Information was obtained from medical records for 170 horses that had surgery for colic before use of CBMC and 33 horses that had intraoperative CBMC. Kaplan–Meier survival curves were used to estimate median survival time and a Cox proportional hazards model was used to estimate the hazard ratio for the effect of CBMC and other perioperative variables on survival.
Results— Seventy-five percent of horses administered CBMC survived to 180 days, whereas 75% of untreated horses survived 8 days (median survival time=18 days). Horses not administered CBMC were twice as likely to die compared with horses administered CBMC. Horses that had postoperative ileus (POI) were 1.4 times more likely to die than horses without ileus. Similarly, horses with signs of colic after surgery were 1.3 times more likely to die than horses without postoperative signs of colic.
Conclusions— CBMC administration is seemingly protective against death and prolongs survival when used intraoperatively in horses with small intestine disease, particularly horses with postoperative colic or POI. Both POI and colic increased risk of death after surgery.
Clinical Relevance— Intraoperative administration of CBMC in horses that have surgery for small intestinal disease may improve survival, possibly by reducing early adhesion formation.     

Ethyl pyruvate diminishes the inflammatory response to lipopolysaccharide infusion in horses

Reasons for performing the study: Endotoxaemia contributes to morbidity and mortality in horses with colic due to inflammatory cascade activation. Effective therapeutic interventions are limited for these horses. Ethyl pyruvate (EP), an anti‐inflammatory agent that alters the expression of proinflammatory cytokines, improved survival and organ function in sepsis and gastrointestinal injury in rodents and swine. Therapeutic efficacy of EP is unknown in endotoxaemic horses. Objectives: Determine the effects of EP on signs of endotoxaemia and expression of proinflammatory cytokines following administration of lipopolysaccharide (LPS) in horses. Methods: Horses received 30 ng/kg bwt LPS in saline to induce signs of endotoxaemia. Next, horses received lactated Ringer's solution (LRS), (n = 6), 150 mg/kg bwt EP in LRS, (n = 6), or 1.1 mg/kg bwt flunixin meglumine (FM), (n = 6). Controls received saline followed by LRS (n = 6). Physical examinations, behaviour pain scores and blood for clinical pathological testing and gene expression were obtained at predetermined intervals for 24 h. Results: Lipopolysaccharide infusion produced clinical and clinicopathological signs of endotoxaemia and increased expression of tumour necrosis factor alpha (TNFα), interleukin 6 (IL‐6) and IL‐8 (P<0.001) compared with controls. Leucopenia and neutropenia occurred in all horses that received LPS. Horses treated with EP and FM had significantly (P<0.0001) reduced pain scores compared with horses receiving LPS followed by LRS. Flunixin meglumine was significantly more effective at ameliorating fever compared with EP. Both EP and FM significantly diminished TNFα expression. Ethyl pyruvate significantly decreased, but FM significantly increased, IL‐6 expression. Neither EP nor FM altered IL‐8 expression. Conclusions and potential relevance: Ethyl pyruvate administered following LPS diminished the clinical effects of endotoxaemia and decreased proinflammatory gene expression in horses. Ethyl pyruvate suppressed expression of proinflammatory cytokines better than FM. However, FM was a superior anti‐pyretic compared with EP. Ethyl pyruvate may have therapeutic applications in endotoxaemic horses.     

Estimate of the national incidence of and operation-level risk factors for colic among horses in the United States, spring 1998 to spring 1999.

OBJECTIVE: To estimate the national incidence of, operation-level risk factors for, and annual economic impact of colic among horses in the United States during 1998 and 1999. DESIGN: Epidemiologic survey. ANIMALS: 21,820 horses on 1,026 horse operations in 28 states. PROCEDURES: Horses were monitored for colic for 1 year, and results were recorded in a log that was collected quarterly. Operation-level data were collected via 4 on-site personal interviews. Associations between colic and independent variables adjusted for size of operation were determined. RESULTS: Annual national incidence of colic in the US horse population was estimated to be 4.2 colic events/100 horses per year. Case fatality rate was 11%, and 1.4% of colic events resulted in surgery. Annual cost of colic in the United States was estimated to be $115,300,000. CONCLUSIONS AND CLINICAL RELEVANCE: The national impact of equine colic is substantial because of the high case fatality rate.     

Evaluation of peritoneal fluid lactate as a marker of intestinal ischaemia in equine colic

REASONS FOR PERFORMING STUDY: The most common cause of death as a direct result of colic is acute circulatory failure secondary to intestinal ischaemia. Early and accurate recognition of ischaemic bowel is essential to decrease complications and increase survival. Blood to peritoneal lactate values have been evaluated as a prognostic indicator, but lactate values characterised by type of lesion have not been reported. HYPOTHESIS: Plasma and peritoneal lactate values are higher in horses with intestinal ischaemia secondary to a strangulating obstruction (ISSO). METHODS: Venous blood and peritoneal fluid were collected sequentially from 20 clinically healthy horses and 189 horses admitted for colic during a one-year period. Blood gas, pH, electrolyte (K+, Na+, Ca++, Cl-), glucose and lactate values were determined for blood and peritoneal fluid samples; other values recorded for peritoneal fluid included gross appearance, total protein and nucleated cell count. Information regarding diagnosis, treatment and outcome was retrieved from the medical records. RESULTS: Peritoneal and plasma levels of lactate were lower in control compared to clinical cases. Horses with ISSO had a higher peritoneal lactate value (8.45 mmol/l) than those with nonstrangulating obstruction (2.09 mmo/l). Factors with the strongest correlations with the presence of ISSO were changes in the gross appearance of the peritoneal fluid and values of peritoneal fluid chloride, pH and log10 lactate. CONCLUSIONS: Analysis of peritoneal fluid gross appearance, pH, lactate and chloride can be used for diagnosis of ISSO. POTENTIAL RELEVANCE: Peritoneal fluid lactate is a better predictor of ISSO than blood lactate and may aid in early detection of catastrophic peritoneal lesions such as intestinal strangulation and rupture.     

Plasma arginine vasopressin concentration in horses undergoing surgery for colic

Objective – To determine if horses before undergoing anesthesia for surgical correction of colic would have lower plasma arginine vasopressin (AVP) concentrations than healthy horses undergoing anesthesia for arthroscopic surgery, and would not increase their plasma AVP concentrations in response to anesthesia and surgery. Design – Prospective clinical study. Setting – University teaching hospital. Animals – Fourteen horses with colic and 8 healthy horses. Interventions – Horses with colic underwent anesthesia and surgery for alleviation of colic, and healthy horses underwent anesthesia and surgery for arthroscopy. Measurements and Main Results – Plasma AVP was measured perioperatively in horses with colic and in healthy horses. Before anesthesia, and 30 and 60 minutes after induction, horses with colic had greater median plasma AVP concentrations than control horses (P≤0.001); thereafter during anesthesia differences in AVP concentrations between the 2 groups were not significant. In the control group, plasma AVP concentration increased during 120 minutes of anesthesia; no such increase occurred in colic horses. Conclusions – Compared with healthy horses, horses with colic had higher preanesthesia plasma AVP concentrations that did not increase further in response to anesthesia and surgery. Exogenous AVP is associated with decreased splanchnic perfusion in a variety of animal species and, therefore, could be detrimental to horses with colic. Thus, it may be inappropriate to use exogenous AVP in support of blood pressure in anesthetized horses with colic. Further studies are warranted to define appropriate indications for the use of AVP in horses with colic.     

Whole blood re-calcification time in equine colic

Whole blood re-calcification times were evaluated as a measure of endotoxin-associated coagulopathy in horses. First, the effects of endotoxin concentration and duration of in vitro incubation of citrated whole blood with endotoxin on the whole blood re-calcification time of blood collected from healthy horses were determined. Increasing concentrations or incubation times of endotoxin accelerated the whole blood re-calcification time. This effect was attributed mainly to increased monocyte thromboplastin activity. Second, whole blood re-calcification time, a clotting profile, plasma factor VII activity and plasma endotoxin concentration on blood samples obtained from 35 equine colic patients and 10 healthy horses were determined. Compared with healthy horses, colic patients had a longer mean whole blood re-calcification and prothrombin time, lower per cent factor VII activity and higher mean fibrin degradation products concentration. Within the colic patient group, horses that did not survive had detectable endotoxin in plasma, longer whole blood re-calcification and prothrombin times, and lower plasma factor VII activity, compared with colic patients that survived. These data indicate that colic patients with endotoxaemia experience hypercoagulable states, followed by consumptive coagulopathy. Although the cause of endotoxin-associated coagulopathy is likely multi-factorial, increased expression of monocyte thromboplastin activity may be involved in the pathogenesis of coagulopathy. The whole blood recalcification time is a simple, fast and inexpensive way to detect coagulopathy during endotoxaemia and determine the prognosis for survival.     

Peritoneal d-Dimer Concentration for Assessing Peritoneal Fibrinolytic Activity in Horses with Colic

Background: Plasma d -dimer concentration is a useful marker to assess systemic coagulation and fibrinolytic activities in humans, dogs, and horses. Peritoneal fibrinolytic activity increases in horses with colic, especially in horses with endotoxin in the peritoneal fluid.
Hypothesis/Objectives: Peritoneal d -dimer concentration can be used to assess peritoneal fibrinolytic activity in horses with severe gastrointestinal (GI) disorders and altered peritoneal fluid.
Animals: Two hundred and twenty-one colic horses and 15 control horses.
Methods: Prospective observational clinical study. Blood and peritoneal fluid were collected on admission. Horses were grouped according to diagnosis, peritoneal fluid analysis, and outcome. Peritoneal d -dimer concentration was determined, together with peritoneal tissue-plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI-1) activities. Plasma d -dimer concentration also was measured.
Results: Peritoneal d -dimer concentration was significantly higher in all colic groups compared with controls, and in horses with enteritis, peritonitis, and ischemic disorders compared with horses with large intestinal obstructions. Peritoneal d -dimer concentration was significantly higher in horses with altered peritoneal fluid (modified transudate and exudate) compared with horses with normal peritoneal fluid analysis. Plasma d -dimer concentration also was significantly higher in the peritonitis group, and in horses with altered peritoneal fluid analysis. Peritoneal and plasma d -dimer concentrations also were significantly higher in nonsurvivors. Peritoneal d -dimer concentration was significantly correlated with decreased peritoneal t-PA activity and increased peritoneal PAI-1 activity.
Conclusions and Clinical Importance: Peritoneal d -dimer concentration is markedly higher in severe GI disorders, and it can be used to assess peritoneal fibrinolytic activity in horses with colic.     

Serial venous lactate measurement following gastrointestinal surgery in horses

BackgroundProspective clinical study of blood lactate concentration in horses undergoing colic surgery is needed to determine utility in outcome prediction.ObjectivesTo evaluate venous lactate measurements in horses following colic surgery, including immediately after anesthetic recovery and daily throughout hospitalization, as well as to determine if lactate concentrations were significantly higher in horses that developed postoperative complications or did not survive to hospital discharge.MethodsHorses > 1 year of age undergoing surgery for colic and recovered from general anesthesia were sampled. A portable lactate meter was used to measure venous samples collected immediately following anesthetic recovery and daily throughout hospitalization. Complications arising during hospitalization and survival to hospital discharge were recorded.ResultsFifty one horses were enrolled, ranging in age from 2 to 29 years. Lactate concentration immediately following anesthetic recovery was higher in horses that developed complications during hospitalization (p = 0.046). The odds of developing complications postoperatively were doubled for horses with a venous lactate concentration > 5 mmol/L. Lactate measurements in non-survivors were significantly higher compared to survivors by 96 h postoperatively (p < 0.006).ConclusionsHigher venous lactate concentrations in the postoperative colic period were associated with an increased risk of complications and death. Results suggest horses with higher venous lactate measurements in recovery are more likely to have postoperative complications, with the odds of developing complications doubled for horses with a venous lactate > 5 mmol/L. Evaluation of venous lactate could provide information on prognosis in the postoperative period for horses with surgical colic.     

Prevalence of Gastric Ulcerations in Horses with Colic

The goal of this study was to determine the prevalence of gastric ulcers in horses with acute abdominal crisis (colic) and to examine the temporal effect of hospitalization on ulcer development in equine patients treated for colic. In addition, other factors that may be associated with gastric ulceration were also explored. The study design was a prospective original study incorporating 169 horses that presented to the George D. Widener Hospital for examination. One hundred and twelve horses presenting with the chief complaint of colic were included in the study group, and 57 horses that presented for non-colic or nonemergency complaints were evaluated and included as case controls. Gastroscopy was performed on equine patients presenting with the chief complaint of colic or horses presenting for reasons other than colic (control); mucosal changes were scored 0 to 3. Additionally, horses presenting for colic were gastroscopically evaluated twice during a 5-day period. Medical records were reviewed for history, clinical findings, laboratory results, and treatment. Seventy-six of 112 horses presenting with the chief complaint of colic had gastric ulceration compared with 41 of 57 horses in the control group. There was a significant association between age of the patient and chief complaint (ie, colic vs control) and between breed and chief complaint. There was no association between gastric ulcer score and chief complaint (colic vs control). Thirty-eight of the 112 horses presenting with colic deteriorated in ulcer score while hospitalized. Using a Pearson chi-squared test, there was no statistically significant association between gastric ulceration with age, breed, or sex. Horses with gastric ulceration in the colic group had lower packed cell volumes compared with horses presenting with colic without gastric ulcers, and this was statistically significant (P < .001). The high incidence of gastric ulceration in the study and control groups supports the reports of other investigators that gastric ulcers in horses, no matter the presenting complaint, are widespread. There was a significant association between breed and chief complaint (P = .005); however, breed and outcome of gastric ulceration were not related (Thoroughbreds were the least likely breed to present for colic). Although a trend in increasing gastric ulceration was seen in hospitalized colic patients, it was not statistically significant. This suggests that horses that are hospitalized may be at increased risk for developing gastric ulcers because of stress, feed deprivation, and administration of treatment. Thus, horses that present for colic should be gastroscopically evaluated if clinical signs raise the index of suspicion for gastric ulceration.