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Frontiers in veterinary science2020; 7; 204; doi: 10.3389/fvets.2020.00204

Multicenter Placebo-Controlled Randomized Study of Ethyl Pyruvate in Horses Following Surgical Treatment for ≥ 360° Large Colon Volvulus.

Abstract: Identifying therapies that mitigate ischemic colonic injury and improve mucosal healing and intestinal viability are crucial to improving survival in horses with ≥360° large colon volvulus (LCV). Ethyl pyruvate is the ethyl ester of pyruvate with diverse pharmacologic effects that limit ischemic injury and hasten intestinal mucosal repair in preclinical rodents, sheep and swine models. The objective of this study was to determine the effects of ethyl pyruvate on systemic indices of colon viability, expression of inflammatory genes in whole blood, morbidity and survival after surgical correction of LCV compared to controls. Horses received either 150 mg/kg ethyl pyruvate in 1 liter lactated Ringer's solution (LRS) or 1 liter LRS intravenously (IV) every 6 h for 24 h following surgical recovery for correction of LCV. Colic duration, perioperative heart rate (HR), packed cell volume (PCV), total solids (TS), blood L-lactate concentration, surgical time, intraoperative episodes of hypoxemia and hypotension, expression of inflammatory cytokine genes, fecal consistency and survival to hospital discharge were compared between ethyl pyruvate treated horses and controls. Twenty-two horses, 12 receiving ethyl pyruvate and 10 controls, were enrolled in the study. Ethyl pyruvate was safely administered to horses following surgical correction of LCV. No significant effects of ethyl pyruvate on post-operative variables, including survival, were found. Seven of 12 ethyl pyruvate treated horses and 5/10 controls survived to hospital discharge. Higher HR, PCV and blood L-lactate concentration at the time of hospital admission, P = 0.005, 0.01, 0.04, respectively, 24 h after surgery, P = 0.001, 0.03, 0.02, respectively, were associated with death. Heart rate, P = 0.005, 48 h after surgery was associated with death. Ethyl pyruvate was safely administered to horses following correction of LCV with no apparent adverse events but was not associated with improved post-operative outcomes including survival. A larger, randomized control trial is needed to fully evaluate the effectiveness of ethyl pyruvate. A major limitation of this investigation is the small sample size, making the study underpowered and creating a high possibility of type II error.
Copyright © 2020 Johnson, Holcombe, Shearer, Watson, Gandy, Southwood, Lynch, Schroeder, Fogle and Sordillo.
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Publication Date: 2020-04-21 PubMed ID: 32373640PubMed Central: PMC7187886DOI: 10.3389/fvets.2020.00204Google 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 study evaluates the effects of ethyl pyruvate on horses after surgical treatment for large colon volvulus. Results found that the treatment was safe but did not significantly improve post-operative outcomes or survival.

Objective of the Study

The study aimed to determine the effects of ethyl pyruvate on horses undergoing surgical treatment for ≥360° large colon volvulus (LCV), a severe intestinal condition. The focus was on

  • The systemic effects of ethyl pyruvate on colon viability
  • Its influence on the expression of inflammatory genes in the blood
  • The morbidity and survival rates after surgery compared to control groups.

Methodology

Horses received either a treatment of 150 mg/kg ethyl pyruvate in 1 liter lactated Ringer’s solution (LRS) or 1 liter LRS as a control, both administered intravenously every 6 hours for 24 hours after surgery to correct LCV. Researchers then compared:

  • Colic duration
  • Perioperative heart rate
  • Packed cell volume
  • Total solids
  • Blood lactate concentration
  • Surgical time
  • Intraoperative episodes of hypoxemia and hypotension
  • Expression of inflammatory cytokines
  • Fecal consistency, and
  • Survival plot to hospital discharge

Sample Size and Outcomes

The study involved 22 horses, 12 in the treatment group and 10 as controls. All horses safely received the ethyl pyruvate treatment, but there were no significant effects on post-operative variables or survival rates.

Key Results

Seven out of 12 horses in the treatment group and 5 out of 10 in the control group survived until hospital discharge. Higher heart rate, packed cell volume, and blood lactate concentration were associated with death in both the initial hospital admission and 24 hours after surgery. Similarly, a high heart rate 48 hours post-surgery indicated potential mortality.

Limitations and Recommendations

The authors noted limitations to the research including its small sample size. Consequently, there is a high probability of a type II error, where a false negative does not reject a false null hypothesis. They recommend a larger, randomized control trial to more accurately evaluate the effectiveness of ethyl pyruvate.

Cite This Article

APA
Johnson LM, Holcombe SJ, Shearer TR, Watson V, Gandy J, Southwood LL, Lynch TM, Schroeder EL, Fogle CA, Sordillo LM. (2020). Multicenter Placebo-Controlled Randomized Study of Ethyl Pyruvate in Horses Following Surgical Treatment for ≥ 360° Large Colon Volvulus. Front Vet Sci, 7, 204. https://doi.org/10.3389/fvets.2020.00204

Publication

Frontiers in veterinary science
ISSN: 2297-1769
NlmUniqueID: 101666658
Country: Switzerland
Language: English
Volume: 7
Pages: 204

Researcher Affiliations

Johnson, Lindsey M
  • Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, MI, United States.
Holcombe, Susan J
  • Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, MI, United States.
Shearer, Tara R
  • Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, MI, United States.
Watson, Victoria
  • Department of Pathobiology and Diagnostic Investigation, Michigan State University, East Lansing, MI, United States.
Gandy, Jeffery
  • Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, MI, United States.
Southwood, Louise L
  • Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA, United States.
Lynch, Tymothy M
  • Peterson and Smith Equine Hospital, Ocala, FL, United States.
Schroeder, Eric L
  • The Ohio State University, Department of Veterinary Clinical Sciences, Columbus, OH, United States.
Fogle, Callie A
  • Department of Clinical Sciences, North Carolina State University, Raleigh, NC, United States.
Sordillo, Lorraine M
  • Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, MI, United States.

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Citations

This article has been cited 3 times.
  1. Tharwat M, Al-Sobayil F. Equine colic: A comprehensive overview of the sonographic evaluation, diagnostic criteria, and management of different categories. Open Vet J 2025 Mar;15(3):1116-1139.
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  2. Kwak YB, Seo SA, Kim M, Yoon J. Identification of altered blood metabolic pathways in equines following ethyl pyruvate administration using non-targeted metabolomics. Sci Rep 2024 Nov 12;14(1):27684.
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  3. Koprivica I, Djedovic N, Stojanović I, Miljković Đ. Ethyl pyruvate, a versatile protector in inflammation and autoimmunity. Inflamm Res 2022 Feb;71(2):169-182.
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