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Equine veterinary journal2024; 56(6); 1170-1182; doi: 10.1111/evj.14082

A retrospective comparison of postoperative outcomes in ovariectomised jennies (Equus asinus) treated with phenylbutazone or flunixin meglumine.

Abstract: Clinically, flunixin meglumine (FM) and phenylbutazone (PBZ) are preferentially selected for the treatment of visceral and musculoskeletal pain, respectively, in horses. In donkeys, there is no information to support or refute this conventional conjecture. Objective: To compare postoperative outcomes in a group of jennies treated with intravenous FM or oral PBZ. Methods: Fourteen jennies unilaterally ovariectomised by standing left flank laparotomy. Methods: Retrospective cohort study. Methods: Data from medical records of ovariectomised jennies (case details, weight, non-steroidal anti-inflammatory drug [NSAID] protocol, surgery duration, operative sequence, anaesthesia protocol, physical examination findings and outcomes) were collected. From collated data, postoperative adverse events were defined as fever, tachycardia, tachypnea, inappetence, altered mentation, abnormal oral mucous membranes, bruxism, colic, incisional complications (i.e., drainage, oedema, peri-incisional emphysema and pain) and non-survival, then further divided into occurrence during the early (≤24 h) or late (>24 h) postoperative period for data analysis using R software. Chi-squared test was used to compare individual adverse events between groups (PBZ vs. FM) and moments (early vs. late). Significance was set at p ≤ 0.05. Results: PBZ treatment (8/14) was associated with (odds ratio, 95% confidence interval) more total (2.93, 1.97-4.36), early (3.01, 1.87-4.84) and late (2.69, 1.28-5.63) adverse events than FM treatment (6/14). Tachycardia (37.83, 2.21-646.66), tachypnoea (0.29, 0.13-0.66), altered mentation (2.78, 1.01-7.67), altered mucous membranes (18.38, 1.04-325.23), incisional oedema (44.33, 2.60-754.5) and incisional pain (47.78, 2.81-811.61) were significantly different between groups. Early adverse events significantly different between groups included tachycardia (50.2, 2.9-877.0), altered mentation (3.33, 1.08-10.29) and incisional pain (21.0, 1.2-374.5), with late adverse events being tachypnea (0.07, 0.01-0.62), incisional oedema (32.92, 1.85-584.28) and incisional pain (28.92, 1.62-515.68). Colic (2/8) and non-survival (1/8) were rare events that only occurred in the PBZ cohort and could not be further evaluated for differences. Conclusions: Small sample size; retrospective study; treatment bias; varied administration routes. Conclusions: Oral PBZ may be inappropriate to use following abdominal surgery in donkeys. Conclusions: More prospective and case-controlled studies are needed to evaluate the clinical efficacy of these two NSAIDs in donkeys. Unassigned: Klinisch werden Flunixin‐Meglumin (FM) und Phenylbutazon (PBZ) bevorzugt zur Behandlung von viszeralen bzw. muskuloskelettalen Schmerzen bei Pferden eingesetzt. Bei Eseln gibt es keine Informationen, die diese herkömmliche Annahme bestätigen oder widerlegen. Unassigned: Vergleich der postoperativen Ergebnisse in einer Gruppe von Eselstuten, die mit intravenösem FM oder oralem PBZ behandelt wurden. Unassigned: Vierzehn einseitig, durch stehende Laparotomie über der linken Flanke ovarektomierte Eselstuten. Methods: Retrospektive Kohortenstudie. Methods: Es wurden Daten aus den medizinischen Aufzeichnungen ovarektomierter Eselstuten (Signalement, Gewicht, Protokoll für nichtsteroidale entzündungshemmende Medikamente [NSAID], Operationsdauer, Operationsablauf, Anästhesieprotokoll, Ergebnisse der klinischen Allgemeinuntersuchung und Ausgang) gesammelt. Aus den gesammelten Daten wurden postoperative unerwünschte Ereignisse definiert als Fieber, Tachykardie, Tachypnoe, Inappetenz, verändertes Bewusstsein, abnorme Maulschleimhäute, Bruxismus, Kolik, Komplikationen im Bereich der Inzision (d. h. Ausfluss, Ödem, Emphysem im Bereich der Inzision und Schmerzen) und Nichtüberleben. Anschließend wurden die Daten mit Hilfe der Software R nach Auftreten in der frühen (≤24 h) oder späten (>24 h) postoperativen Phase analysiert. Der Chi‐Quadrat‐Test wurde zum Vergleich einzelner unerwünschter Ereignisse zwischen den Gruppen (PBZ vs. FM) und den Zeitpunkten (früh vs. spät) verwendet. Die Signifikanz wurde auf P≤0,05 festgelegt. Unassigned: Die Behandlung mit PBZ (8/14) war mit (odds ratio, 95%CI) mehr insgesamten (2,93; 1,97–4,36), frühen (3,01; 1,87–4,84) und späten (2,69; 1,28–5,63) Komplikationen verbunden als die Behandlung mit FM (6/14). Tachykardie (37,83; 2,21–646,66), Tachypnoe (0,29; 0,13–0,66), verändertes Bewusstsein (2,78; 1,01–7,67), veränderte Maulschleimhaut (18,38; 1,04–325,23), Ödem im Bereich der Inzisionsstelle (44,33; 2,60–754,5) and Schmerz im Bereich der Inzisionsstelle (47,78; 2,81–811,61) unterschieden sich signifikant zwischen den Gruppen. Zu den frühen unerwünschten Ereignissen, die sich zwischen den Gruppen signifikant unterschieden, gehörten Tachykardie (50,2; 2,9‐877,0), Bewusstseinsstörungen (3,33; 1,08‐10,29) und Schmerzen im Inzisionsbereich (21,0; 1,2‐374,5), wobei die späten unerwünschten Ereignisse Tachypnoe (0,07; 0,01‐0,62), Ödeme im Inzisionsbereich (32,92; 1,85‐584,28) und Schmerzen im Inzisionsbereich (28,92; 1,62‐515,68) waren. Koliken (2/8) und Nichtüberleben (1/8) waren seltene Ereignisse, die nur in der PBZ‐Kohorte auftraten und nicht weiter auf Unterschiede untersucht werden konnten. Unassigned: Geringe Stichprobengröße; retrospektive Studie; Behandlungsbias; unterschiedliche Verabreichungswege. Unassigned: Die orale Verabreichung von PBZ ist bei Eseln nach abdominalen Eingriffen möglicherweise nicht geeignet. Es sind weitere prospektive und fallkontrollierte Studien erforderlich, um die klinische Wirksamkeit dieser beiden NSAIDs bei Eseln zu bewerten.
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Publication Date: 2024-03-18 PubMed ID: 38500306DOI: 10.1111/evj.14082Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research article compares the postoperative outcomes of female donkeys treated with phenylbutazone (PBZ) and flunixin meglumine (FM), medications commonly used for pain management. The results indicate that PBZ treatment resulted in a higher number of adverse events than FM, implying that PBZ may not be appropriate for use following abdominal surgery in donkeys.

Objective and Methods

  • The main objective of the study was to compare the impact of PBZ and FM on the postoperative outcomes in a group of female donkeys undergoing a surgical procedure known as unilateral ovariectomy via standing left flank laparotomy.
  • This is a retrospective cohort study that involved the analysis of medical records for 14 female donkeys that underwent the said operation.
  • Specific parameters were investigated, including case details, weight, the NSAID treatment protocol, the duration of the surgery, the sequence of the operation, the anaesthesia protocol, physical examination findings, and outcomes.

Data Analysis

  • The study defined postoperative adverse events as fever, tachycardia (rapid heart rate), tachypnea (abnormally rapid breathing), inappetence (lack of appetite), altered mental state, abnormal oral mucous membranes, bruxism (teeth grinding), colic, incisional complications (such as drainage, swelling, peri-incisional emphysema, and pain), and non-survival.
  • Postoperative adverse events were further divided into those that occurred during the early (≤24 hours) or late (>24 hours) postoperative period.
  • The statistical program R was used to compare occurrences between the PBZ and FM treatment groups and between early and late moments using the chi-squared test.

Results and Conclusion

  • PBZ treatment was associated with more total, early, and late adverse events compared to FM treatment.
  • Specifically, significant differences were observed between the groups in terms of tachycardia, tachypnea, altered mentation, incisional oedema, and incisional pain.
  • A noteworthy insight from the study is that colic and non-survival only occurred in the PBZ group.
  • Due to these findings, the authors concluded that PBZ may not be appropriate to use after abdominal surgery in donkeys.
  • However, the authors also recognize the limitations of this study, including its small sample size, retrospective nature, treatment bias, and varied administration routes.
  • More prospective and case-controlled studies are suggested for a comprehensive evaluation of the clinical efficacy of these two NSAIDs in donkeys.

Cite This Article

APA
Xue C, Segabinazzi L, Hall A, Dzikiti TB, French H, Gilbert R. (2024). A retrospective comparison of postoperative outcomes in ovariectomised jennies (Equus asinus) treated with phenylbutazone or flunixin meglumine. Equine Vet J, 56(6), 1170-1182. https://doi.org/10.1111/evj.14082

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 56
Issue: 6
Pages: 1170-1182

Researcher Affiliations

Xue, Cynthia
  • Department of Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies.
Segabinazzi, Lorenzo
  • Department of Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies.
Hall, Alexis
  • Department of Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies.
Dzikiti, Tarisai Brighton
  • Department of Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies.
French, Hilari
  • Department of Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies.
Gilbert, Robert
  • Department of Clinical Sciences, Ross University School of Veterinary Medicine, Basseterre, St. Kitts, West Indies.

MeSH Terms

  • Animals
  • Clonixin / analogs & derivatives
  • Clonixin / therapeutic use
  • Clonixin / administration & dosage
  • Female
  • Retrospective Studies
  • Equidae
  • Ovariectomy / veterinary
  • Ovariectomy / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Phenylbutazone / therapeutic use
  • Phenylbutazone / administration & dosage
  • Pain, Postoperative / veterinary
  • Pain, Postoperative / drug therapy
  • Cohort Studies
  • Postoperative Complications / veterinary
  • Treatment Outcome

Grant Funding

  • Ross University Center for Conservation Medicine and Ecosystem Health

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