Complications and survival associated with surgical compared with medical management of horses with duodenitis-proximal jejunitis.
Abstract: Based on clinical observation, it is hypothesised that horses with duodenitis-proximal jejunitis (DPJ) that are treated surgically have a shorter duration, smaller volume, and slower rate of nasogastric reflux (NGR) compared to horses treated medically, are more likely to develop diarrhoea than medically managed cases, and have a higher incisional infection rate than a sample population of horses undergoing abdominal exploration for gastrointestinal disease other than DPJ. Objective: To compare: 1) duration, volume and rate of NGR and the percentage of horses with diarrhoea between medically and surgically treated DPJ cases; and 2) incisional infection rate in horses with DPJ undergoing abdominal exploration to a sample population of horses undergoing abdominal exploration for gastrointestinal disease other than DPJ. Methods: Medical records of cases with DPJ diagnosed 1995-2006 were reviewed. Information obtained included subject details, presenting clinical findings, treatment category (medical/surgical), complications (diarrhoea, incisional infection), and outcome (survival/nonsurvival). Data were analysed using a Chi-squared test and a mixed model analysis of variance. Level of significance was P<0.05. Results: Compared to medical cases, surgical cases had significantly decreased survival, a longer duration and larger total volume of NGR, and were more likely to develop diarrhoea. The incisional infection rate for horses with DPJ undergoing abdominal exploration was 16% compared to 7% for the sample population of horses. Conclusions: Surgical treatment of horses with DPJ did not lead to resolution of NGR faster than medical treatment. Surgical cases were more likely to develop diarrhoea and did not have a significantly higher incisional infection rate than the sample population.
Publication Date: 2008-08-02 PubMed ID: 18672437DOI: 10.2746/042516408X302492Google Scholar: Lookup
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- Journal Article
Summary
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The research article investigates the survival and complications associated with surgical and medical management of horses suffering from duodenitis-proximal jejunitis (DPJ), a digestive disease. The study reveals that surgical intervention is related to extended symptoms, increased probability of diarrhea, and a slightly higher infection rate, compared to medical treatment.
Objective and Hypothesis
- The research primarily aimed to compare the duration, volume, and rate of nasogastric reflux (NGR), and the percentage of horses with diarrhea between those treated surgically and medically for DPJ. It also sought to weigh the infection rate during abdominal examination in horses with DPJ against a similar cohort undergoing the procedure for other gastrointestinal diseases.
- Based on clinical observations, the researchers hypothesized that surgically treated horses have increased symptoms, higher likelihood of developing diarrhea, and greater infection rates than the ones treated medically.
Methodology
- The researchers undertook a review of medical records for cases diagnosed with DPJ between 1995 and 2006.
- Capture of data included subject details, initial clinical findings, treatment category (surgical or medical), complications such as diarrhea and incisional infection, and the final outcome, whether survival or nonsurvival.
- The team then subjected the data to a Chi-squared statistical test and a mixed model analysis of variance, considering a P value of less than 0.05 as statistically significant.
Results
- Results suggested that surgical cases exhibited significantly lower survival rates, longer duration, and larger total volume of NGR, and were more prone to develop diarrhea compared to the medical cases.
- The infection rate for horses with DPJ undergoing abdominal examination was found to be 16%, slightly higher than the 7% infection rate for the cohort of horses undergoing a similar procedure for other gastrointestinal diseases.
Conclusions
- The outcomes of the study revealed that surgical treatment did not resolve NGR symptoms faster than medical management. Surgery also increased the probability of diarrhea.
- However, contrary to the hypothesis, the surgical cases did not have a significantly higher infection rate than the comparable sample population.
Cite This Article
APA
Underwood C, Southwood LL, McKeown LP, Knight D.
(2008).
Complications and survival associated with surgical compared with medical management of horses with duodenitis-proximal jejunitis.
Equine Vet J, 40(4), 373-378.
https://doi.org/10.2746/042516408X302492 Publication
Researcher Affiliations
- University of Pennsylvania, Department of Clinical Studies, 382 W. Street Road, Kennett Square, PA 19348, USA.
MeSH Terms
- Analysis of Variance
- Animals
- Chi-Square Distribution
- Diarrhea / epidemiology
- Diarrhea / mortality
- Diarrhea / veterinary
- Duodenitis / drug therapy
- Duodenitis / mortality
- Duodenitis / surgery
- Duodenitis / veterinary
- Female
- Gastroesophageal Reflux / epidemiology
- Gastroesophageal Reflux / mortality
- Gastroesophageal Reflux / veterinary
- Horse Diseases / drug therapy
- Horse Diseases / mortality
- Horse Diseases / surgery
- Horses
- Jejunal Diseases / drug therapy
- Jejunal Diseases / mortality
- Jejunal Diseases / surgery
- Jejunal Diseases / veterinary
- Male
- Odds Ratio
- Postoperative Complications / epidemiology
- Postoperative Complications / mortality
- Postoperative Complications / veterinary
- Prognosis
- Retrospective Studies
- Risk Factors
- Surgical Wound Infection / epidemiology
- Surgical Wound Infection / mortality
- Surgical Wound Infection / veterinary
- Survival Analysis
- Treatment Outcome
Citations
This article has been cited 3 times.- Arroyo LG, Gomez DE, Martins C. Equine duodenitis-proximal jejunitis: A review. Can Vet J 2018 May;59(5):510-517.
- Gitari A, Nguhiu J, Varma V, Mogoa E. Occurrence, treatment protocols, and outcomes of colic in horses within Nairobi County, Kenya. Vet World 2017 Oct;10(10):1255-1263.
- Pihl TH, Scheepers E, Sanz M, Goddard A, Page P, Toft N, Andersen PH, Jacobsen S. Influence of disease process and duration on acute phase proteins in serum and peritoneal fluid of horses with colic. J Vet Intern Med 2015 Mar-Apr;29(2):651-8.
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