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Equine veterinary journal2022; 54(6); 1031-1038; doi: 10.1111/evj.13558

Effects of age, disease and anastomosis on short- and long-term survival after surgical correction of small intestinal strangulating diseases in 89 horses.

Abstract: Although survival rates have been reported after small intestinal surgery for strangulating diseases in horses, none have followed survival for periods relevant to the long lifespan of horses and none have described effect of age, disease and surgical treatments over such long survival periods. Objective: To examine effects of age, disease and type of surgery on long-term survival in horses after surgical treatment of small intestinal strangulating diseases over periods relevant to the expected lifespan of a horse. Methods: Retrospective clinical study. Methods: Post-operative data were gathered from medical records and owner contact for 89 horses with small intestinal strangulation. Survival times from surgery to the date of death or the date of last follow-up were analysed by Kaplan-Meier statistics. Variables of interest were age, type of strangulating disease and surgical correction. Cox proportional hazards regression was used to evaluate these variables. Results: Short-term survival was not affected by any of the variables measured. For long-term survival with Kaplan-Meier statistics, horses ≥16 years old had significantly shorter (P = .002) median survival times (72 months; 95% CI 32.0-96.0) than younger horses (121.7 months; 95% CI 90.0-162), horses without resection had significantly longer (P = .02) survival times (120 months; 95% CI 86-212) than horses that had jejunocecostomy (76.8 months; 95% CI 24-125), and horses with miscellaneous diseases had significantly longer (P = .02) median survival times (161.9 months; 95% CI 72.0-M) than horses with strangulating lipoma (79.8 months; 95% CI 32.0-120.0). In the multivariable Cox Proportional Hazard model, age (HR = 2.67; 1.49-4.75, P < .001) and anastomosis (HR = 0.65; 0.46-0.92, P = .02) had the most significant effect on median survival time. Conclusions: Limitations were small numbers in some categories, loss of cases to follow-up, owner recall failures and lack of a control group. Conclusions: The remaining lifespan of older horses at the time of surgery had the greatest effect on survival. Age could influence long-term survival studies after colic surgery, and therefore needs to be considered for survival analyses. Horses that did not require resection and anastomosis had favourable outcomes, underscoring the potential importance of early intervention to reduce the need for resection.
Publication Date: 2022-01-21 PubMed ID: 35023209DOI: 10.1111/evj.13558Google Scholar: Lookup
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  • Journal Article

Summary

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The research article is an examination of how age, disease, and type of surgery affect long-term survival in horses after surgical treatment for small intestinal strangulating diseases. The findings showed that older horses had significantly shorter median survival times, horses without resection had longer survival times, and age and the anastomosing surgical procedure had the most significant effect on the median survival time.

Study Methodology

  • The study was a retrospective clinical analysis examining 89 horses that had undergone surgical correction for small intestinal strangulation.
  • Post-operative data was collected from the horses’ medical records and through owner communication.
  • The researchers analysed survival times from the date of the surgery to the horse’s death or last follow-up date.
  • Variables considered in the study were the horse’s age, the type of strangulating disease, and the surgical correction technique employed.
  • The effects of these variables on the horses’ survival were evaluated using Kaplan-Meier statistics and Cox proportional hazards regression.

Major Findings

  • The study found no measurable effects of any of the variables on short-term survival.
  • However, for long-term survival, age was found to affect prognosis significantly – horses older than 16 years had a median survival time of 72 months, compared to younger horses who had a median survival time of 121.7 months.
  • The type of surgery also affected long-term survival. Horses that did not require resection had longer survival times of 120 months, compared to horses that underwent a jejunocecostomy who had a median survival time of 76.8 months.
  • Disease type also played a role, horses with miscellaneous diseases had a longer median survival time of 161.9 months, compared to horses with a strangulating lipoma, who had a median survival time of 79.8 months.
  • The multivariable Cox Proportional Hazard model identified age and the anastomosis surgical procedure as the most significant factors affecting median survival time.

Study Limitations and Conclusions

  • The study acknowledged limitations such as a small sample size in some categories, loss of cases due to a lack of follow-up, owner recall failures, and a lack of a control group.
  • Despite these limitations, the study concluded that the age of the horse at the time of surgery was the most significant factor affecting survival.
  • For future studies involving long-term survival after colic surgery, the impact of age should be considered in the analysis.
  • The study also emphasized the potential importance of early intervention to reduce the need for resection, as horses that did not require this procedure had favourable outcomes.

Cite This Article

APA
Rudnick MJ, Denagamage TN, Freeman DE. (2022). Effects of age, disease and anastomosis on short- and long-term survival after surgical correction of small intestinal strangulating diseases in 89 horses. Equine Vet J, 54(6), 1031-1038. https://doi.org/10.1111/evj.13558

Publication

ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 54
Issue: 6
Pages: 1031-1038

Researcher Affiliations

Rudnick, Meredith J
  • Department of Large Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, Florida, USA.
Denagamage, Thomas N
  • Department of Large Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, Florida, USA.
Freeman, David E
  • Department of Large Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, Florida, USA.

MeSH Terms

  • Anastomosis, Surgical / veterinary
  • Animals
  • Colic / veterinary
  • Horse Diseases / surgery
  • Horses
  • Intestinal Obstruction / surgery
  • Intestinal Obstruction / veterinary
  • Postoperative Complications / veterinary
  • Retrospective Studies

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Citations

This article has been cited 4 times.
  1. Erwin SJ, Clark ME, Dechant JE, Aitken MR, Hassel DM, Blikslager AT, Ziegler AL. Multi-Institutional Retrospective Case-Control Study Evaluating Clinical Outcomes of Foals with Small Intestinal Strangulating Obstruction: 2000-2020. Animals (Basel) 2022 May 27;12(11).
    doi: 10.3390/ani12111374pubmed: 35681837google scholar: lookup
  2. Crosby CE, O'Connor A, Munsterman AS. Alactic base excess is not a sensitive or specific diagnostic tool for outcome in horses with colic. Front Vet Sci 2025;12:1618304.
    doi: 10.3389/fvets.2025.1618304pubmed: 40895787google scholar: lookup
  3. Elane GL, Blikslager AT, Mair TS. Trends in the management of horses referred for colic evaluation preceding and during the COVID-19 pandemic (2013-2023). Equine Vet Educ 2025 Jun;37(6):308-315.
    doi: 10.1111/eve.14038pubmed: 40599687google scholar: lookup
  4. Giusto G, Gandini M. Return of showjumping horses to sporting activity after colic surgery. Equine Vet J 2025 May;57(3):629-635.
    doi: 10.1111/evj.14407pubmed: 39205448google scholar: lookup