Evaluation of a protocol for fast localised abdominal sonography of horses (FLASH) admitted for colic.
Abstract: The aim of this prospective study was to establish a protocol for fast localised abdominal sonography of horses (FLASH) admitted for colic. The FLASH protocol was then presented to clinicians without extensive ultrasound (US) experience to determine whether they could learn to use it in less than 15 min. The clinical subjects comprised 36 horses that had been referred for colic over a 2 month period. Each horse was examined at admission and FLASH findings at seven topographical locations were compared to serial clinical examinations, surgical and non-surgical outcomes, or with post-mortem reports. FLASH was able to show free abdominal fluid and abnormal intestinal loops, with a mean time of 10.7 min required to complete the protocol. The positive and negative predictive values of requirement for surgery of dilated turgid small intestinal loops using FLASH were 88.89% and 81.48%, respectively. The results suggested that FLASH is a technique that can be used in an emergency setting by veterinarians without extensive US experience to detect major intra-abdominal abnormalities in horses with colic.
Copyright © 2010 Elsevier Ltd. All rights reserved.
Publication Date: 2010-03-26 PubMed ID: 20347357DOI: 10.1016/j.tvjl.2010.02.017Google Scholar: Lookup
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- Evaluation Study
- Journal Article
Summary
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The research article discusses a new rapid diagnostic technique called FLASH (Fast Localised Abdominal Sonography of Horses), developed for horses suffering from colic, which could help detect major intra-abdominal abnormalities. According to the study, clinicians with limited ultrasound experience can adopt the protocol within 15 minutes and use it to identify conditions that may necessitate surgery.
Development and Evaluation of the FLASH Protocol
- The initial objective of the study was to design a protocol for FLASH, which could help quickly assess horses with colic, an abdominal pain predominantly dangerous and common in horses.
- The developed FLASH protocol was then subjected to evaluation for its efficiency, usability, and time consumption for diagnosis.
- The time consideration was significant, aiming for a less than 15-minute usage window as the FLASH protocol was meant for emergency situations where quick judgement and decision-making abilities are crucial.
Study Design and Participants
- To check the viability of the protocol, it was field-tested by clinicians who did not have advanced ultrasound experience.
- The subjects of the study were 36 horses who were reported for colic over a span of two months.
- Each horse was evaluated using the FLASH protocol upon arrival, and the findings across seven topographical locations were cross-verified with clinical examinations, surgical results, non-surgical results, or post-mortem reports.
Key Findings
- The FLASH protocol, during the study, was able to detect the presence of free abdominal fluid and abnormal intestinal loops.
- The mean time required to complete the protocol was 10.7 minutes, which was within the intended time frame.
- In determining the requirement for surgery based on the presence of dilated turgid small intestinal loops, the positive predictive value of FLASH was 88.89%, and the negative predictive value was 81.48%.
- This indicates the high accuracy, reliability, and usability of FLASH as a rapid diagnostic tool in emergency settings for horses admitted for colic.
Implications
- The results of the study implied that the FLASH protocol could be a valuable diagnostic tool for use in emergency settings with horses suffering from colic.
- Even veterinarians without extensive ultrasound diagnosis experience could utilize this method to detect significant intra-abdominal abnormalities quickly and efficiently.
Cite This Article
APA
Busoni V, De Busscher V, Lopez D, Verwilghen D, Cassart D.
(2010).
Evaluation of a protocol for fast localised abdominal sonography of horses (FLASH) admitted for colic.
Vet J, 188(1), 77-82.
https://doi.org/10.1016/j.tvjl.2010.02.017 Publication
Researcher Affiliations
- Imaging Section, Department of Clinical Sciences of Companion Animals and Equids, Faculty of Veterinary Medicine, University of Liège, Sart-Tilman, 4000 Liège, Belgium. vbusoni@ulg.ac.be
MeSH Terms
- Abdomen / diagnostic imaging
- Animals
- Ascitic Fluid / diagnostic imaging
- Colic / diagnostic imaging
- Colic / veterinary
- Female
- Horse Diseases / diagnostic imaging
- Horses
- Intestine, Small / diagnostic imaging
- Male
- Predictive Value of Tests
- Prospective Studies
- Ultrasonography
Citations
This article has been cited 16 times.- Vitale V, Nocera I, van Galen G, Sgorbini M, Conte G, Aliboni B, Verwilghen D. Breath Alcohol Test Results in Equine Veterinarians after Performing an Abdominal Ultrasound with Ethanol. Vet Sci 2023 Mar 14;10(3).
- Bevevino KE, Cohen ND, Gordon SG, Navas de Solis C. Feasibility of a point-of-care ultrasound protocol for cardiorespiratory evaluation of horses in different clinical settings. J Vet Intern Med 2023 May-Jun;37(3):1223-1232.
- Epstein KL, Hall MD. Effect of Nasogastric Tube Placement, Manipulation, and Fluid Administration on Transcutaneous Ultrasound Visualization and Assessment of Stomach Position in Healthy Unfed and Fed Horses. Animals (Basel) 2022 Dec 6;12(23).
- Eberhardt C, Schwarzwald CC. Focused cardiac ultrasound examination in the emergency and critical care horse: Training for non-specialist veterinarians and evaluation of proficiency. J Vet Intern Med 2022 Jul;36(4):1471-1480.
- Dybkjær E, Steffensen KF, Honoré ML, Dinesen MA, Christophersen MT, Pihl TH. Short-term survival rates of 1397 horses referred for colic from 2010 to 2018. Acta Vet Scand 2022 May 7;64(1):11.
- Kos VK, Kramaric P, Brloznik M. Packed cell volume and heart rate to predict medical and surgical cases and their short-term survival in horses with gastrointestinal-induced colic. Can Vet J 2022 Apr;63(4):365-372.
- Cuevas-Ramos G, Domenech L, Prades M. Small Intestine Ultrasound Findings on Horses Following Exploratory Laparotomy, Can We Predict Postoperative Reflux?. Animals (Basel) 2019 Dec 9;9(12).
- Arroyo LG, Gomez DE, Martins C. Equine duodenitis-proximal jejunitis: A review. Can Vet J 2018 May;59(5):510-517.
- Siwinska N, Zak A, Baron M, Cylna M, Borowicz H. Right dorsal colon ultrasonography in normal adult ponies and miniature horses. PLoS One 2017;12(10):e0186825.
- Sprayberry KA. Ultrasonographic Examination of the Equine Neonate: Thorax and Abdomen. Vet Clin North Am Equine Pract 2015 Dec;31(3):515-43.
- Williams S, Cooper J, Freeman S. Evaluation of normal findings using a detailed and focused technique for transcutaneous abdominal ultrasonography in the horse. BMC Vet Res 2014;10 Suppl 1(Suppl 1):S5.
- Abraham M, Reef VB, Sweeney RW, Navas de Solís C. Gastrointestinal ultrasonography of normal Standardbred neonates and frequency of asymptomatic intussusceptions. J Vet Intern Med 2014 Sep-Oct;28(5):1580-6.
- Ness SL, Bain FT, Zantingh AJ, Gaughan EM, Story MR, Nydam DV, Divers TJ. Ultrasonographic visualization of colonic mesenteric vasculature as an indicator of large colon right dorsal displacement or 180° volvulus (or both) in horses. Can Vet J 2012 Apr;53(4):378-82.
- Accorroni L, Bazzano M, Marchegiani A, Spaterna A, Laus F. Abdominal Ultrasonography in Healthy Female Standard Donkeys. Animals (Basel) 2025 Jan 8;15(2).
- Ramsay L, Eberhardt C, Schoster A. Acute leptospirosis in horses: A retrospective study of 11 cases (2015-2023). J Vet Intern Med 2024 Sep-Oct;38(5):2729-2738.
- Haardt H, Romero AE, Boysen SR, Tan JY. Comparison of transrectal and transabdominal transducers for use in fast localized abdominal sonography of horses presenting with colic. Front Vet Sci 2023;10:1307938.
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