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Postoperative management of the large colon volvulus patient.
Abstract: Horses with large colon volvulus (LCV) often require intensive postoperative medical management. Although early referral and surgical intervention are critical for minimal postoperative complications and a successful outcome, this is often not possible for many reasons. Endotoxemia, extensive mucosal damage with subsequent severe hypoproteinemia, and focal ischemic necrosis are the major causes of postoperative morbidity and mortality. Although fluid therapy, flunixin meglumine, and antimicrobials are still the mainstay of perioperative management, synthetic colloids are being used to maintain plasma oncotic pressure, hyperimmune antiendotoxic plasma and polymixin B are being used for management of endotoxemia, and lidocaine and constant rate infusion of butorphanol can be used for postoperative analgesia. The use of heparin, dimethyl sulfoxide, and corticosteroids for management of LCV are still controversial. Future studies are required to investigate nutritional improvement and methods to manage cases after surgery to prevent recurrence.
Publication Date: 2004-04-06 PubMed ID: 15062464DOI: 10.1016/j.cveq.2003.12.004Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
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Summary
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This research presents an evaluation of postoperative measures for horses suffering large colon volvulus (LCV), a serious equine medical condition. It summarizes current practices, such as fluid therapy and the use of flunixin meglumine, and discusses the use of other treatments like synthetic colloids, hyperimmune antiendotoxic plasma, and polymixin B.
Objective of the Research
- The study aims to explore the various effective methods of postoperative care on horses with large colon volvulus, as these medical cases are subject to major risks that can lead to morbidity and mortality.
Postoperative Complications
- Horses with large colon volvulus often suffer from postoperative complications such as endotoxemia, severe hypoproteinemia (resulting from extensive mucosal damage), and focal ischemic necrosis. These complications arise due to the complex nature of the condition and the bodies’ reaction to the surgical intervention.
Current Perioperative Management
- Currently, treatment routines include fluid therapy, use of flunixin meglumine (a nonsteroidal anti-inflammatory drug), and antimicrobials. These are key in averting potential risks and minimizing the impact of postoperative complications.
Additional Postoperative Measures
- Emerging management strategies, like the use of synthetic colloids to maintain plasma oncotic pressure, are being tested. Maintenance of plasma oncotic pressure helps in fluid balance in the body.
- Hyperimmune antiendotoxic plasma and polymixin B are being used for the management of endotoxemia, a potentially life-threatening condition.
- Lidocaine and a constant infusion of butorphanol are being used to alleviate postoperative pain.
Controversial Management Methods
- The research also points to the controversial use of heparin, dimethyl sulfoxide, and corticosteroids in the management of large colon volvulus. The effectiveness and impact of these substances on horses in relation to this condition are not definitively established.
Future Research Directions
- The study acknowledges the need for further research and improvement in the methods of managing large colon volvulus, specifically, enhancing nutritional regimens and prevention of recurrence after surgical intervention.
Cite This Article
APA
Southwood LL.
(2004).
Postoperative management of the large colon volvulus patient.
Vet Clin North Am Equine Pract, 20(1), 167-197.
https://doi.org/10.1016/j.cveq.2003.12.004 Publication
Researcher Affiliations
- University of Pennsylvania, New Bolton Center, 382 West Street Road, Kennett Square, PA 19348, USA. southwoo@vet.upenn.edu
MeSH Terms
- Animals
- Colon / surgery
- Colonic Diseases / surgery
- Colonic Diseases / veterinary
- Horse Diseases / surgery
- Horses
- Intestinal Volvulus / surgery
- Intestinal Volvulus / veterinary
- Postoperative Care / methods
- Postoperative Care / veterinary
- Postoperative Complications / prevention & control
- Postoperative Complications / therapy
- Postoperative Complications / veterinary
- Treatment Outcome
References
This article includes 82 references
Citations
This article has been cited 3 times.- Straticò P, Guerri G, Bandera L, Celani G, Di Nunzio L, Petrizzi L, Varasano V. Comparison of Xylazine and Lidocaine Infusion versus Medetomidine Continuous Rate Infusion during General Anesthesia with Isoflurane in Horses Undergoing Emergency Laparotomy. Vet Sci 2024 Apr 29;11(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.
- Gonzalez LM, Fogle CA, Baker WT, Hughes FE, Law JM, Motsinger-Reif AA, Blikslager AT. Operative factors associated with short-term outcome in horses with large colon volvulus: 47 cases from 2006 to 2013. Equine Vet J 2015 May;47(3):279-84.
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