Colonic Luminal Pressure in Horses With Strangulating and Nonstrangulating Obstruction of the Large Colon |
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| Authors: | RUSTIN M. MOORE DVM PhD Diplomate ACVS STEPHEN R. HANCE DVM Diplomate ACVS Diplomate ABVP JOANNE HARDY DVM MS Diplomate ACVS BONNIE RUSH MOORE DVM MS Diplomate ACVIM ROLF M. EMBERTSON DVM Diplomate ACVS PETER D. CONSTABLE BVSc PhD Diplomate ACVIM |
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| Affiliation: | Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH;and Rood &Riddle Equine Hospital, Lexington, KY |
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| Abstract: | Colonic luminal pressure (median, range) measured during ventral midline celiotomy in 69 horses with strangulating obstruction (SO) of the large colon (SO; ≥ 270° large colon volvulus; 27 cm H2O: 2 to 80 cm H2O) was greater ( P =.0023) than that measured in 37 horses with nonstrangulating obstruction (NSO) of the large colon (NSO; ≤ 180° volvulus or a nonstrangulating displacement; 18 cm H2O; 6 to 46 cm H2O). Sixty-five percent (45 of 69) of horses with SO and all horses with NSO survived. Survival analysis was restricted to 59 horses with large-colon SO that survived to hospital discharge or met the criteria specified for classification as nonsurvivors. Colonic luminal pressure in nonsurvivors (48.5 cm H2O; 34 to 80 cm H2O) was higher ( P =.0001) than that measured in survivors (18 cm H2O; 2 to 50 cm H2O) of SO. From response operating characteristic curves, a luminal pressure of 38 cm H2O optimized the distribution of horses with SO into survivor and nonsurvivor groups. Sensitivity, specificity, and positive and negative predictive values for a colonic luminal pressure greater than 38 cm H2O in predicting nonsurvival were 0.89, 0.91, 0.72 and 0.97, respectively. Measurement of colonic luminal pressure may be useful for predicting survival in horses with colonic volvulus. |
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