Survey of prokinetic use in horses with gastrointestinal injury

OBJECTIVE: To report prokinetic strategies used to manage horses after gastrointestinal surgery. DESIGN: Electronic questionnaire. SAMPLE POPULATION: Diplomates of the American College of Veterinary Surgeons (ACVS) who perform equine intestinal surgery. PROCEDURE: A survey (21 questions) designed to determine use of prokinetic agents was sent electronically to 112 ACVS Diplomates known to perform equine intestinal surgery. Several clinical scenarios were also described to determine which, if any, prokinetic agent respondents would select. RESULTS: Responses were obtained from 58 (52%) surgeons from 44 clinics. Selection of prokinetic agent for specific gastrointestinal conditions was relatively uniform whereas there was considerable variation in dose administered. For postoperative ileus (POI) associated with most intestinal lesions, 2% lidocaine was most commonly selected. Other prokinetics in decreasing frequency of use were erythromycin lactobionate, metoclopramide, and cisapride. Prokinetic agents were more commonly administered after small intestine strangulating obstructions and less commonly for large intestinal lesions. No novel agents were identified by respondents. CONCLUSIONS: Prokinetic drugs are commonly used for the management and/or attenuation of POI in horses, but dosages and routes of administration are variable. CLINICAL RELEVANCE: Although prokinetics are commonly used for management of POI in horses there is clearly a need for more controlled studies to define efficacious dosing and a need to develop new prokinetic drugs.