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Home / Equine Research Bank / Equine Vet J / Operative factors associated with short-term outcome in hors...
Equine veterinary journal2014; 47(3); 279-284; doi: 10.1111/evj.12273

Operative factors associated with short-term outcome in horses with large colon volvulus: 47 cases from 2006 to 2013.

Abstract: There is an important need for objective parameters that accurately predict the outcome of horses with large colon volvulus. Objective: To evaluate the predictive value of a series of histomorphometric parameters on short-term outcome, as well as the impact of colonic resection on horses with large colon volvulus. Methods: Retrospective cohort study. Methods: Adult horses admitted to the Equine and Farm Animal Veterinary Center at North Carolina State University, Peterson and Smith and Chino Valley Equine Hospitals between 2006 and 2013 that underwent an exploratory coeliotomy, diagnosed with large colon volvulus of ≥360 degrees, where a pelvic flexure biopsy was obtained, and that recovered from general anaesthesia, were selected for inclusion in the study. Logistic regression was used to determine associations between signalment, histomorphometric measurements of interstitium-to-crypt ratio, degree of haemorrhage, percentage loss of luminal and glandular epithelium, as well as colonic resection with short-term outcome (discharge from the hospital). Results: Pelvic flexure biopsies from 47 horses with large colon volvulus were evaluated. Factors that were significantly associated with short-term outcome on univariate logistic regression were Thoroughbred breed (P = 0.04), interstitium-to-crypt ratio >1 (P = 0.02) and haemorrhage score ≥3 (P = 0.005). Resection (P = 0.92) was not found to be associated significantly with short-term outcome. No combined factors increased the likelihood of death in forward stepwise logistic regression modelling. A digitally quantified measurement of haemorrhage area strengthened the association of haemorrhage with nonsurvival in cases of large colon volvulus. Conclusions: Histomorphometric measurements of interstitium-to-crypt ratio and degree of haemorrhage predict short-term outcome in cases of large colon volvulus. Resection was not associated with short-term outcome in horses selected for this study. Accurate quantification of mucosal haemorrhage at the time of surgery may improve veterinary surgeons' prognostic capabilities in horses with large colon volvulus.
© 2014 EVJ Ltd.
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Publication Date: 2014-05-29 PubMed ID: 24735170PubMed Central: PMC4198525DOI: 10.1111/evj.12273Google 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 use of histomorphometric parameters to predict short-term outcomes in horses suffering from large colon volvulus, a twisting of the colon. The study found that the relative size of the interstices and crypts in biopsy samples, and the level of bleeding were significant factors in predicting outcomes. However, colonic resection, or the surgical removal of part of the colon, was not found to be significantly associated with short-term outcomes.

Objective of the Research

  • This study was conducted to find objective parameters that can accurately predict the short-term outcome of horses suffering from large colon volvulus, a condition where the large colon gets twisted by 360 degrees or more. The parameters investigated were based on histomorphometric measurements, which involve the study of the form and structure of animal tissues.

Research Methods

  • The research was a retrospective cohort study, using historic data for horses that were admitted to various veterinary hospitals.
  • The horses included in the study underwent an exploratory coeliotomy (surgical incision into the abdominal cavity), were diagnosed with large colon volvulus, provided a pelvic flexure biopsy, and survived general anaesthesia.
  • Objective factors like breed, measurements of the interstitium to crypt ratio, degree of bleeding, loss of epithelium and the effect of colonic resection were studied.
  • A statistical method called logistic regression was applied to determine the associations between these factors and the short-term outcome, which was defined as discharge from the hospital.

Findings

  • The variables that were found to be significantly associated with short-term outcome were the breed of the horse (Thoroughbred specifically), the relative size of interstitial spaces and crypts in the biopsy samples (>1), and the severity of bleeding (score >=3).
  • The study found that colectomy (surgical removal of part of the colon) was not significantly associated with short-term outcomes, meaning this surgery didn’t improve or damage chances of short-term survival.
  • The study also found that there were no combinations of factors that significantly increased the chance of death in horses diagnosed with the large colon volvulus.
  • The use of digital quantification improved the predictive power of bleeding severity for non-survival cases.

Conclusion

  • In conclusion, this research suggested that in cases of large colon volvulus in horses, histomorphometric measurements of the ratio of interstitium to crypts, and the severity of bleeding, were significant predictors of short-term outcomes.
  • Colectomy was not associated with short-term outcomes in this study.
  • A quantified, accurate measurement of mucosal blood loss at the time of surgery could enable veterinary surgeons to produce a better prognosis for horses with large colon volvulus.

Cite This Article

APA
Gonzalez LM, Fogle CA, Baker WT, Hughes FE, Law JM, Motsinger-Reif AA, Blikslager AT. (2014). Operative factors associated with short-term outcome in horses with large colon volvulus: 47 cases from 2006 to 2013. Equine Vet J, 47(3), 279-284. https://doi.org/10.1111/evj.12273

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 47
Issue: 3
Pages: 279-284

Researcher Affiliations

Gonzalez, L M
  • College of Veterinary Medicine, North Carolina State University, Raleigh, USA.
Fogle, C A
    Baker, W T
      Hughes, F E
        Law, J M
          Motsinger-Reif, A A
            Blikslager, A T

              MeSH Terms

              • Animals
              • Biopsy
              • Colon / pathology
              • Hemorrhage / pathology
              • Hemorrhage / veterinary
              • Horse Diseases / surgery
              • Horses
              • Intestinal Volvulus / pathology
              • Intestinal Volvulus / surgery
              • Intestinal Volvulus / veterinary
              • Logistic Models
              • Retrospective Studies

              Grant Funding

              • P30 DK034987 / NIDDK NIH HHS
              • T32 OD011130 / NIH HHS
              • T32 RR024394 / NCRR NIH HHS
              • T32OD011130 / NIH HHS

              Conflict of Interest Statement

              Authors’ declaration of interests. No competing interests have been declared

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              Citations

              This article has been cited 7 times.
              1. Cummings CO, Krucik DDR, Price E. Clinical predictive models in equine medicine: A systematic review. Equine Vet J 2023 Jul;55(4):573-583.
                doi: 10.1111/evj.13880pubmed: 36199162google scholar: lookup
              2. Lambertini C, Zannoni A, Romagnoli N, Bombardi C, Morini M, Dondi F, Bernardini C, Forni M, Rinnovati R, Spadari A. Expression of Proteinase-Activated Receptor 2 During Colon Volvulus in the Horse. Front Vet Sci 2020;7:589367.
                doi: 10.3389/fvets.2020.589367pubmed: 33330716google scholar: lookup
              3. Gonzalez LM, Baker WT, Hughes FE, Blikslager AT, Fogle CA. Comparison of histomorphometric characteristics of dorsal colon and pelvic flexure biopsy specimens obtained from horses with large colon volvulus that underwent resection. Am J Vet Res 2020 Nov;81(11):899-903.
                doi: 10.2460/ajvr.81.11.899pubmed: 33107753google scholar: lookup
              4. Johnson LM, Holcombe SJ, Shearer TR, Watson V, Gandy J, Southwood LL, Lynch TM, Schroeder EL, Fogle CA, Sordillo LM. Multicenter Placebo-Controlled Randomized Study of Ethyl Pyruvate in Horses Following Surgical Treatment for ≥ 360° Large Colon Volvulus. Front Vet Sci 2020;7:204.
                doi: 10.3389/fvets.2020.00204pubmed: 32373640google scholar: lookup
              5. Orr KE, Baker WT, Lynch TM, Hughes FE, Clark CK, Slone DE Jr, Fogle CA, Gonzalez LM. Prognostic value of colonic and peripheral venous lactate measurements in horses with large colon volvulus. Vet Surg 2020 Apr;49(3):472-479.
                doi: 10.1111/vsu.13361pubmed: 31916608google scholar: lookup
              6. Blikslager A, Gonzalez L. Equine Intestinal Mucosal Pathobiology. Annu Rev Anim Biosci 2018 Feb 15;6:157-175.
                doi: 10.1146/annurev-animal-030117-014748pubmed: 29144770google scholar: lookup
              7. Kucera CR, Stranahan LW, Hughes F, Blikslager AT, Gonzalez LM. Protein biomarker of cell proliferation determines survival to discharge in cases of equine large colon volvulus. Equine Vet J 2018 Jul;50(4):452-456.
                doi: 10.1111/evj.12767pubmed: 29032573google scholar: lookup
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