Risk factors associated with development of postoperative ileus in horses

Allen J. Roussel Jr Department of Large Animal Medicine and Surgery, Texas A&M University, College Station, TX 77843.

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 DVM, MS, DACVIM
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Noah D. Cohen Department of Large Animal Medicine and Surgery, Texas A&M University, College Station, TX 77843.

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 VMD, PhD, DACVIM
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R. Neil Hooper Department of Large Animal Medicine and Surgery, Texas A&M University, College Station, TX 77843.

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Peter C. Rakestraw Department of Large Animal Medicine and Surgery, Texas A&M University, College Station, TX 77843.

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 VMD, DACVS

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Abstract

Objective—To determine risk factors associated with development of postoperative ileus in horses undergoing surgery for colic.

Design—Case-control study

Animals—69 horses that developed ileus after surgery for colic and 307 horses that did not develop postoperative ileus.

Procedure—Signalment, history, clinicopathologic data, treatment, lesions, and outcome were obtained from medical records.

Results—Variables associated with increased risk of postoperative ileus included age > 10 years, Arabian breed, PCV ≥ 45%, high serum concentrations of protein and albumin, anesthesia > 2.5 hours' duration, surgery > 2 hours' duration, resection and anastomosis, and lesions in the small intestine. Enterotomy reduced the risk of postoperative ileus. After multivariate logistic regression, the final model included the variables Arabian breed, PCV ≥ 45%, lesion type, duration of surgery (> 2 hours vs ≤ 2 hours), and pelvic flexure enterotomy.

Conclusions and Clinical Relevance—Results suggest that by evaluating certain factors, horses at increased risk of postoperative ileus may be recognized before the condition develops. Preventative treatment and early intervention may be instituted in these horses. Shortening surgery time and performing an enterotomy may decrease the probability of horses developing postoperative ileus. (J Am Vet Med Assoc 2001;219:72–78)

Abstract

Objective—To determine risk factors associated with development of postoperative ileus in horses undergoing surgery for colic.

Design—Case-control study

Animals—69 horses that developed ileus after surgery for colic and 307 horses that did not develop postoperative ileus.

Procedure—Signalment, history, clinicopathologic data, treatment, lesions, and outcome were obtained from medical records.

Results—Variables associated with increased risk of postoperative ileus included age > 10 years, Arabian breed, PCV ≥ 45%, high serum concentrations of protein and albumin, anesthesia > 2.5 hours' duration, surgery > 2 hours' duration, resection and anastomosis, and lesions in the small intestine. Enterotomy reduced the risk of postoperative ileus. After multivariate logistic regression, the final model included the variables Arabian breed, PCV ≥ 45%, lesion type, duration of surgery (> 2 hours vs ≤ 2 hours), and pelvic flexure enterotomy.

Conclusions and Clinical Relevance—Results suggest that by evaluating certain factors, horses at increased risk of postoperative ileus may be recognized before the condition develops. Preventative treatment and early intervention may be instituted in these horses. Shortening surgery time and performing an enterotomy may decrease the probability of horses developing postoperative ileus. (J Am Vet Med Assoc 2001;219:72–78)

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