Outcome of Surgical and Medical Management of Cecal Impaction in 150 Horses (1991-2011).
Abstract: To evaluate short- and long-term outcome after medical and surgical management of horses with cecal impaction and to determine reasons for death or euthanasia. Methods: Retrospective case series. Methods: Horses (n = 150). Methods: Data collected from medical records (1991-2011) of horses with a diagnosis of cecal impaction, included signalment, history of recent disease/surgical procedure, admission data, management (medical, typhlotomy alone, jejunocolostomy), complications, and outcome. Short-term outcome (alive or dead at discharge) and long-term outcome (alive or dead at ≥1 year) were determined by telephone interview. Data were analyzed using a χ(2) or Fisher's exact test. Level of significance was P < .05. Results: Of 150 horses hospitalized with a diagnosis of cecal impaction, 102 (68%) had a history of recent disease or a surgical procedure. Thirty-eight horses (25%) had cecal perforation at admission and 3 horses (2%) were euthanatized without treatment. Of 109 horses treated, 59 (54%) were managed medically and 50 (46%) surgically (typhlotomy [26]; jejunocolostomy [24]). The proportion of horses alive at hospital discharge was significantly lower for horses managed medically (61%) compared with surgically (82%; P = .02) but there was no difference between horses managed with typhlotomy alone (77%) or with jejunocolostomy (88%; P = .47). There were 57% of horses managed medically alive at 1 year. There was a similar proportion of horses alive at 1 year after typhlotomy alone (73%) and jejunocolostomy (70%; P = .86). Conclusions: Compared to the recent reports, the proportion of horses alive at hospital discharge was lower for both medically and surgically managed horses with cecal impaction. There was decreased survival for horses treated medically than those treated surgically; however, no significant difference was seen in survival between horses managed with typhlotomy alone versus jejunocolostomy.
© Copyright 2014 by The American College of Veterinary Surgeons.
Publication Date: 2014-10-09 PubMed ID: 25302715DOI: 10.1111/j.1532-950X.2014.12286.xGoogle Scholar: Lookup
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Summary
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The research article discusses a retrospective case study comparing the short and long-term outcomes of horses with cecal impaction, treated through either surgical or medical management. The study finds that while horses managed surgically had better survival chances at hospital discharge, there wasn’t much difference observed in the one-year survival rates between two surgical treatment forms: typhlotomy and jejunocolostomy.
Study Background and Methods
- The study relied upon data collected from the medical records of 150 horses diagnosed with cecal impaction from 1991-2011.
- Information pulled from these records included signalement, recent disease history or surgical procedure, admission data, and treatment methods (whether medical or surgical).
- The two primary outcome measures were short-term survival, denoted by whether horses were alive or dead at the time of discharge, and long-term survival, i.e., alive or dead one year after treatment.
- To attain these outcomes, researchers conducted telephone interviews.
- All the collected data was then analyzed using a χ(2) or Fisher’s exact test, with a level of significance set at p < .05.
Study Findings
- Of the total horses, 68% had a history of recent disease or surgical procedure.
- 25% of the horses had cecal perforation at the time of admission.
- Out of 109 treated horses, 54% were managed medically while 46% were managed surgically.
- The survival rate at hospital discharge was lower for medically managed horses (61%) compared to surgically managed horses (82%). This difference was statistically significant.
- However, there was no significant survival difference at discharge or one year thereafter between horses treated with typhlotomy alone and those who underwent jejunocolostomy.
Conclusions
- In comparison to previous studies, this investigation demonstrated lower survival rates for horses with cecal impaction at hospital discharge, regardless of the management method used.
- However, medically treated horses showed decreased survival rates than their surgically treated counterparts.
- Interestingly, there was no substantial distinction in survival rates between the two surgical management methods studied – typhlotomy and jejunocolostomy – either at discharge or one year post-treatment.
Cite This Article
APA
Aitken MR, Southwood LL, Ross BM, Ross MW.
(2014).
Outcome of Surgical and Medical Management of Cecal Impaction in 150 Horses (1991-2011).
Vet Surg, 44(5), 540-546.
https://doi.org/10.1111/j.1532-950X.2014.12286.x Publication
Researcher Affiliations
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania.
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania.
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania.
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania School of Veterinary Medicine, Kennett Square, Pennsylvania.
MeSH Terms
- Anastomosis, Surgical / veterinary
- Animals
- Cecal Diseases / surgery
- Cecal Diseases / therapy
- Cecal Diseases / veterinary
- Fecal Impaction / mortality
- Fecal Impaction / surgery
- Fecal Impaction / therapy
- Fecal Impaction / veterinary
- Female
- Horse Diseases / surgery
- Horse Diseases / therapy
- Horses
- Intestine, Small / surgery
- Male
- Pennsylvania / epidemiology
- Retrospective Studies
- Survival Analysis
- Treatment Outcome
Citations
This article has been cited 2 times.- Gough RL, McGovern KF, Bladon BM, Carmichael LA. Caecal dysfunction following standing surgical procedures.. Vet Med Sci 2022 Sep;8(5):1930-1935.
- Lawson AL, Sherlock CE, Ireland JL, Mair TS. Equine nutrition in the post-operative colic: Survey of Diplomates of the American Colleges of Veterinary Internal Medicine and Veterinary Surgeons, and European Colleges of Equine Internal Medicine and Veterinary Surgeons.. Equine Vet J 2021 Sep;53(5):1015-1024.
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