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L J Smith - One of the best experts on this subject based on the ideXlab platform.
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survival and complication rates in 300 horses undergoing surgical treatment of Colic part 1 short term survival following a single laparotomy
Equine Veterinary Journal, 2010Co-Authors: T S Mair, L J SmithAbstract:Summary Reasons for performing study: A minority of Equine Colic cases prove fatal unless treated surgically; however, few studies have considered long-term survival and complication rates, and few have attempted to identify factors that might affect outcomes. Such information is required for owners and veterinary surgeons to make informed decisions about the most appropriate treatment for individual cases. Objectives: To document short-term survival rates of 300 horses undergoing Colic surgery and analyse factors that might have predisposed to short-term death. Methods: History, clinical and surgical findings, treatments and outcomes of 300 surgical Colic cases (1994–2001) were reviewed. Comparisons among groups of discrete data were made using chi-squared or Student's t tests as appropriate. Significance was set at P<0.05, and 95% confidence intervals were calculated for percentages. Results: The short-term survival rate (to discharge) was 70.3% for all horses and 83.1% for those recovering from anaesthesia; for horses that had a single laparotomy it was 87.2%. The most common reasons for death/euthanasia in the post operative period after a single laparotomy were persistent pain/Colic, post operative ileus and grass sickness. Horses with lesions involving the small intestine and caecum had lower survival rates (75.2 and 66.7%, respectively) than those with large colon or small colon lesions (89.9 and 100%, respectively). The survival rate for ischaemic/strangulating lesions (68.9%) was lower than for simple obstructions (90.5%). Conclusions: Short-term survival of horses undergoing exploratory laparotomy for acute Colic is dependent on many factors, including the nature of the underlying disease, cardiovascular status and post operative complications. Potential relevance: These retrospective studies may be used as a basis for prospective studies assessing treatments that could ultimately improve survival and decrease complication rates.
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survival and complication rates in 300 horses undergoing surgical treatment of Colic part 4 early acute relaparotomy
Equine Veterinary Journal, 2010Co-Authors: T S Mair, L J SmithAbstract:Summary Reasons for performing study: Early (acute) relaparotomy after surgery for Equine Colic is widely considered to be an acceptable treatment option for management of certain post operative complications. However, there is relatively little published information about resulting complication rates and short- and long-term outcomes. Objectives: To document the proportions, indications, complication rates and survival rates of horses undergoing acute relaparatomy following Colic surgery. Methods: History, clinical findings, surgical findings and procedures, post operative treatments and outcome of 300 consecutive surgical Colic cases (1994–2001) were reviewed. Long-term follow-up information was retrieved from case records and telephone enquiries from owners. Results: Acute relaparotomy was performed in 27/254 horses (10.6%) that recovered from initial general anaesthesia. The indications for relaparotomy included persistent pain, persistent ileus, peritonitis and wound breakdown. Of these 27 horses, 21 (77.8%) recovered from the second surgery, of which 8 (29.6%) died during the immediate post operative period. Thirteen of the 27 horses (48.2%) were discharged. Of these 13 horses, 5 (38.5%) were re-admitted to the hospital for surgical treatment of a subsequent bout of Colic. The long-term survival rate for the 27 horses that underwent relaparotomy was 22.2%. Colic following discharge after relaparotomy was recorded in 69.2% of cases. Conclusions: Relaparotomy is necessary in approximately 10% of horses undergoing surgery for acute Colic. Persistent pain and post operative ileus were the most common indications. The short-term survival rate for horses requiring relaparotomy was approximately 50% and the long-term survival rate 22%. Nearly 40% of horses surviving relaparotomy developed episodes of acute Colic that necessitated further surgery. Potential relevance: Owners of horses requiring early (acute) relaparotomy should be advised of the high complication rates for this procedure.
T S Mair - One of the best experts on this subject based on the ideXlab platform.
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survival and complication rates in 300 horses undergoing surgical treatment of Colic part 1 short term survival following a single laparotomy
Equine Veterinary Journal, 2010Co-Authors: T S Mair, L J SmithAbstract:Summary Reasons for performing study: A minority of Equine Colic cases prove fatal unless treated surgically; however, few studies have considered long-term survival and complication rates, and few have attempted to identify factors that might affect outcomes. Such information is required for owners and veterinary surgeons to make informed decisions about the most appropriate treatment for individual cases. Objectives: To document short-term survival rates of 300 horses undergoing Colic surgery and analyse factors that might have predisposed to short-term death. Methods: History, clinical and surgical findings, treatments and outcomes of 300 surgical Colic cases (1994–2001) were reviewed. Comparisons among groups of discrete data were made using chi-squared or Student's t tests as appropriate. Significance was set at P<0.05, and 95% confidence intervals were calculated for percentages. Results: The short-term survival rate (to discharge) was 70.3% for all horses and 83.1% for those recovering from anaesthesia; for horses that had a single laparotomy it was 87.2%. The most common reasons for death/euthanasia in the post operative period after a single laparotomy were persistent pain/Colic, post operative ileus and grass sickness. Horses with lesions involving the small intestine and caecum had lower survival rates (75.2 and 66.7%, respectively) than those with large colon or small colon lesions (89.9 and 100%, respectively). The survival rate for ischaemic/strangulating lesions (68.9%) was lower than for simple obstructions (90.5%). Conclusions: Short-term survival of horses undergoing exploratory laparotomy for acute Colic is dependent on many factors, including the nature of the underlying disease, cardiovascular status and post operative complications. Potential relevance: These retrospective studies may be used as a basis for prospective studies assessing treatments that could ultimately improve survival and decrease complication rates.
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survival and complication rates in 300 horses undergoing surgical treatment of Colic part 4 early acute relaparotomy
Equine Veterinary Journal, 2010Co-Authors: T S Mair, L J SmithAbstract:Summary Reasons for performing study: Early (acute) relaparotomy after surgery for Equine Colic is widely considered to be an acceptable treatment option for management of certain post operative complications. However, there is relatively little published information about resulting complication rates and short- and long-term outcomes. Objectives: To document the proportions, indications, complication rates and survival rates of horses undergoing acute relaparatomy following Colic surgery. Methods: History, clinical findings, surgical findings and procedures, post operative treatments and outcome of 300 consecutive surgical Colic cases (1994–2001) were reviewed. Long-term follow-up information was retrieved from case records and telephone enquiries from owners. Results: Acute relaparotomy was performed in 27/254 horses (10.6%) that recovered from initial general anaesthesia. The indications for relaparotomy included persistent pain, persistent ileus, peritonitis and wound breakdown. Of these 27 horses, 21 (77.8%) recovered from the second surgery, of which 8 (29.6%) died during the immediate post operative period. Thirteen of the 27 horses (48.2%) were discharged. Of these 13 horses, 5 (38.5%) were re-admitted to the hospital for surgical treatment of a subsequent bout of Colic. The long-term survival rate for the 27 horses that underwent relaparotomy was 22.2%. Colic following discharge after relaparotomy was recorded in 69.2% of cases. Conclusions: Relaparotomy is necessary in approximately 10% of horses undergoing surgery for acute Colic. Persistent pain and post operative ileus were the most common indications. The short-term survival rate for horses requiring relaparotomy was approximately 50% and the long-term survival rate 22%. Nearly 40% of horses surviving relaparotomy developed episodes of acute Colic that necessitated further surgery. Potential relevance: Owners of horses requiring early (acute) relaparotomy should be advised of the high complication rates for this procedure.
Gehlen Heidrun - One of the best experts on this subject based on the ideXlab platform.
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MMP-9 Concentration in Peritoneal Fluid Is a Valuable Biomarker Associated with Endotoxemia in Equine Colic
2021Co-Authors: Barton, Ann Kristin, Richter Ina-gabriele, Ahrens Tanja, Merle Roswitha, Alalwani Abdollah, Lilge Svenja, Purschke Katrin, Barnewitz Dirk, Gehlen HeidrunAbstract:The purpose of the study was to compare the results of sepsis scoring (clinical examination and clinical pathology) to the concentrations of matrix-metalloproteinases (MMPs) -2, -8, and -9; tissue-inhibitor of metalloproteinases (TIMPs) -1 and -2; and inflammatory chemokines interleukin (IL) 1 beta and tumor-necrosis-factor-alpha (TNF-alpha) in plasma and peritoneal fluid of Equine Colic patients. A modified sepsis scoring including general condition, heart and respiratory rate, rectal temperature, mucous membranes, white blood cell count (WBC), and ionized calcium was applied in 47 horses presented with clinical signs of Colic. Using this scoring system, horses were classified as negative (n=32, = 10/19 points) for sepsis. MMPs, TIMPs, IL-1 beta, and TNF-alpha concentrations were evaluated in plasma and peritoneal fluid using species-specific sandwich ELISA kits. In a linear discriminant analysis, all parameters of sepsis scoring apart from calcium separated well between sepsis severity groups (P113 ng/ml in the peritoneal fluid was found to be the ideal cutoff to identify positive sepsis scoring (>= 10/19 points; sensitivity of 83.3% and specificity of 82.9%). In conclusion, MMP-9 was found to be a biomarker of high diagnostic value for sepsis and endotoxemia in Equine Colic. The evaluation of peritoneal fluid seems preferable in comparison to plasma. As abdominocentesis is commonly performed in the diagnostic work-up of Equine Colic, a pen-side assay would be useful and easy-to-perform diagnostic support in the decision for therapeutic intervention
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A Pilot Randomised Clinical Trial Comparing a Short-Term Perioperative Prophylaxis Regimen to a Long-Term Standard Protocol in Equine Colic Surgery
2021Co-Authors: Stöckle, Sabita Diana, Merle Roswitha, Kannapin, Dania A., Kauter, Anne M. L., Lübke-becker Antina, Walther Birgit, Gehlen HeidrunAbstract:Background: For surgical interventions classified as clean or clean-contaminated, including laparotomy, guidelines in human and veterinary medicine recommend a short-term perioperative antibiotic prophylaxis (PAP). In Equine Colic surgery, however, PAP commonly exceeds 24 h. Objectives: The aim of this study was to compare a single-shot to a 5-day lasting PAP considering surgical site infections (SSI) and other adverse effects probably associated with the particular antimicrobial regimen. Study design: The study was designed as a randomised non-inferiority pilot study including horses subjected to Colic surgery while receiving one of two distinct PAP regimens. Methods: All horses (n = 67) included in the study received the standard physical examination before and after surgery. Colic surgery was performed according to the current standard of the clinic. Horses were randomly assigned to two groups, receiving either the “single-shot” or the “5-day lasting” antibiotic prophylaxis. The “single-shot” group (n = 30) received penicillin and gentamicin only once before and, if needed, during surgery, whereas the “5-day lasting” group (n = 37) received antibiotics for five days. In addition to the standard laboratory examinations, serum amyloid A and fibrinogen were determined preoperatively and during five days after surgery. SSI, postoperative colitis and haemolytic anaemia were classified as postoperative complications potentially related to antibiotic use. Results: The outcome of this preliminary non-inferiority clinical trial showed that the occurrence of postoperative adverse events (i.e., SSI, postoperative colitis and haemolytic anaemia) lacked significant differences between the study groups. Main limitations: The main limitations of this study are the limited group sizes and our inability to blind the study. Conclusions: Single-shot PAP seems to be an alternative approach considering the 5-day lasting protocol commonly used in Equine abdominal surgery. However, a proper hygiene management together with a close clinical and laboratory monitoring of the Equine patient is indispensable
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A Pilot Randomised Clinical Trial Comparing a Short-Term Perioperative Prophylaxis Regimen to a Long-Term Standard Protocol in Equine Colic Surgery
'MDPI AG', 2021Co-Authors: Stöckle, Sabita Diana, Merle Roswitha, Kannapin, Dania A., Kauter, Anne M. L., Lübke-becker Antina, Walther Birgit, Gehlen HeidrunAbstract:For surgical interventions classified as clean or clean-contaminated, including laparotomy, guidelines in human and veterinary medicine recommend a short-term perioperative antibiotic prophylaxis (PAP). In Equine Colic surgery, however, PAP commonly exceeds 24 h. Objectives: The aim of this study was to compare a single-shot to a 5-day lasting PAP considering surgical site infections (SSI) and other adverse effects probably associated with the particular antimicrobial regimen. Study design: The study was designed as a randomised non-inferiority pilot study including horses subjected to Colic surgery while receiving one of two distinct PAP regimens. Methods:All horses (n= 67) included in the study received the standard physical examination before and after surgery. Colic surgery was performed according to the current standard of the clinic. Horses were randomly assigned to two groups, receiving either the “single-shot” or the “5-day lasting”antibiotic prophylaxis. The “single-shot” group (n= 30) received penicillin and gentamicin onlyonce before and, if needed, during surgery, whereas the “5-day lasting” group (n= 37) received antibiotics for five days. In addition to the standard laboratory examinations, serum amyloid A and fibrinogen were determined preoperatively and during five days after surgery. SSI, postoperative colitis and haemolytic anaemia were classified as postoperative complications potentially related toantibiotic use. Results: The outcome of this preliminary non-inferiority clinical trial showed that the occurrence of postoperative adverse events (i.e., SSI, postoperative colitis and haemolytic anaemia)lacked significant differences between the study groups. Main limitations: The main limitations of this study are the limited group sizes and our inability to blind the study. Conclusions: Single-shot PAP seems to be an alternative approach considering the 5-day lasting protocol commonly used in Equine abdominal surgery. However, a proper hygiene management together with a close clinical and laboratory monitoring of the Equine patient is indispensable.Peer Reviewe
C J Proudman - One of the best experts on this subject based on the ideXlab platform.
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prevention of post operative complications following surgical treatment of Equine Colic current evidence
Equine Veterinary Journal, 2016Co-Authors: Shebl E Salem, C J Proudman, D C ArcherAbstract:Changes in management of the surgical Colic patient over the last 30 years have resulted in considerable improvement in post operative survival rates. However, post operative complications remain common and these impact negatively on horse welfare, probability of survival, return to previous use and the costs of treatment. Multiple studies have investigated risk factors for post operative complications following surgical management of Colic and interventions that might be effective in reducing the likelihood of these occurring. The findings from these studies are frequently contradictory and the evidence for many interventions is lacking or inconclusive. This review discusses the current available evidence and identifies areas where further studies are necessary and factors that should be taken into consideration in study design.
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factors affecting long term survival of horses recovering from surgery of the small intestine
Equine Veterinary Journal, 2010Co-Authors: C J Proudman, G. B. Edwards, J Barnes, N P FrenchAbstract:REASONS FOR PERFORMING STUDY: Epiploic foramen entrapment (EFE) has been associated with a particularly poor post operative prognosis for Equine Colic cases, but the reasons for this are unknown. OBJECTIVES: To identify variables associated with post operative survival following surgery for small intestinal disease; develop a model describing long-term post operative survival; and identify reasons for the poor prognosis associated with EFE. METHODS: Data from 382 horses undergoing surgery were used to identify variables associated with survival. A multivariable Cox proportional hazards model for post operative survival was developed and model fit evaluated. RESULTS: The final model included the variables total plasma protein (TP) and packed cell volume (PCV) at admission, duration of surgery and the dichotomous variable relaparotomy (yes/no). Risk of death was positively associated with increasing PCV, but negatively associated with increasing TP (which decreased the probability of death). In a univariable model, EFE cases had a significantly higher death rate than other types of small intestinal disease (hazard ratio = 1.7, P = 0.035). Multivariable modelling indicated that some of the increased risk associated with EFE cases was due to lower TP values and longer duration of surgery. CONCLUSIONS: Preoperative TP is associated negatively with the risk of post operative death in horses recovering from small intestinal surgery. Other variables associated with the probability of survival are preoperative PCV, duration of surgery and relaparotomy. The increased post operative death rate of EFE cases can be explained in part by lower TP and longer surgery times of these cases. POTENTIAL RELEVANCE: Total plasma protein may be not simply a measure of hydration status in small intestinal Colic cases, but an important determinant of survival. Further investigation of this relationship is warranted. Our model for post operative survival highlights the importance of preoperative TP, PCV and duration of surgery as prognostic indicators. This information should allow a more accurate post operative prognosis following small intestinal surgery.
G. B. Edwards - One of the best experts on this subject based on the ideXlab platform.
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factors affecting long term survival of horses recovering from surgery of the small intestine
Equine Veterinary Journal, 2010Co-Authors: C J Proudman, G. B. Edwards, J Barnes, N P FrenchAbstract:REASONS FOR PERFORMING STUDY: Epiploic foramen entrapment (EFE) has been associated with a particularly poor post operative prognosis for Equine Colic cases, but the reasons for this are unknown. OBJECTIVES: To identify variables associated with post operative survival following surgery for small intestinal disease; develop a model describing long-term post operative survival; and identify reasons for the poor prognosis associated with EFE. METHODS: Data from 382 horses undergoing surgery were used to identify variables associated with survival. A multivariable Cox proportional hazards model for post operative survival was developed and model fit evaluated. RESULTS: The final model included the variables total plasma protein (TP) and packed cell volume (PCV) at admission, duration of surgery and the dichotomous variable relaparotomy (yes/no). Risk of death was positively associated with increasing PCV, but negatively associated with increasing TP (which decreased the probability of death). In a univariable model, EFE cases had a significantly higher death rate than other types of small intestinal disease (hazard ratio = 1.7, P = 0.035). Multivariable modelling indicated that some of the increased risk associated with EFE cases was due to lower TP values and longer duration of surgery. CONCLUSIONS: Preoperative TP is associated negatively with the risk of post operative death in horses recovering from small intestinal surgery. Other variables associated with the probability of survival are preoperative PCV, duration of surgery and relaparotomy. The increased post operative death rate of EFE cases can be explained in part by lower TP and longer surgery times of these cases. POTENTIAL RELEVANCE: Total plasma protein may be not simply a measure of hydration status in small intestinal Colic cases, but an important determinant of survival. Further investigation of this relationship is warranted. Our model for post operative survival highlights the importance of preoperative TP, PCV and duration of surgery as prognostic indicators. This information should allow a more accurate post operative prognosis following small intestinal surgery.
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are tapeworms associated with Equine Colic a case control study
Equine Veterinary Journal, 1993Co-Authors: G. B. EdwardsAbstract:Summary Faeces samples from 116 horses with Colic and 115 non-Colic cases were assayed by a centrifugation/floatation method for the presence of tapeworm eggs. Analysis of these data failed to demonstrate an association between tapeworm infection and Colic of all types. The data were further analysed according to anatomical site of the lesion causing Colic. The risk of ileocaecal Colic was increased in the presence of tapeworms. Age, breed and sex were evaluated as possible confounding factors but had no association with the incidence of Colic. This study suggests an association between tapeworms and Colic of ileocaecal origin.