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Veterinary surgery : VS2025; doi: 10.1111/vsu.14248

Real-time ancillary diagnostics for intraoperative assessment of intestinal viability in horses-looking for answers across species.

Abstract: Clinical intestinal viability assessment is associated with significant limitations, and there is an undisputable need for ancillary diagnostics during colic surgery. Human and companion animal surgeons struggle with similar intraoperative issues, yet there is little exchange between specialists. Therefore, this narrative review aimed to create an overview of real-time ancillary diagnostics with the potential for intraoperative intestinal viability assessment in horses. Most real-time ancillary diagnostics can be classified as either tissue perfusion or oxygenation assessments. Intestinal perfusion may be quantified using dark field microscopy, laser Doppler flowmetry, or fluorescence angiography (FA). In particular, indocyanine green FA has gained popularity in human medicine and is increasingly employed to predict intestinal injury. Intestinal oxygen saturation can be measured by pulse oximetry or mixed tissue oximetry. The latter can be conducted using visible light or near-infrared spectrophotometry, and these measurements correlate with clinical outcomes in various species. Other real-time diagnostics include thermography and techniques currently under development, such as laser speckle flowgraphy or photoacoustic imaging. The modalities discussed are minimally invasive and may be used for intraoperative assessments of the intestine. However, limitations include the occurrence of artifacts and the subjective nature of some modalities. Techniques such as indocyanine green FA and tissue oximetry are already available in veterinary practice and have the potential for use during colic surgery. However, blinded clinical trials are lacking in all species, and more research is needed to determine the accuracy and cutoff values in equine-specific intestinal lesions.
© 2025 The Author(s). Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
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Publication Date: 2025-03-20 PubMed ID: 40114354DOI: 10.1111/vsu.14248Google 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.

The research article reviews real-time ancillary diagnostics used for intraoperative assessment of intestinal viability in horses, highlighting their potential use across various species. The research focuses on perfusion and oxygenation assessments, examining existing methods and exploring emerging techniques.

Overview of Real-time Ancillary Diagnostics

  • The article explains that real-time ancillary diagnostics offer a rapid and dynamic assessment of intestinal viability during surgery. These diagnostics fall primarily into two categories: measurements of tissue perfusion and tissue oxygenation.
  • To measure intestinal perfusion, techniques such as dark field microscopy, laser Doppler flowmetry and fluorescence angiography (FA) are used. Indocyanine green FA is specifically highlighted as a popular technique in human medicine for predicting intestinal injury.
  • For oxygen saturation in the intestine, pulse oximetry and mixed tissue oximetry are used. Measurements in the latter method can be conducted with visible light or near-infrared spectrophotometry, and there’s evidence that these measurements correlate with clinical outcomes in different species.

Emerging Real-time Diagnostics

  • The article also notes the development of other real-time diagnostic tools such as thermography. Additionally, the authors mention laser speckle flowgraphy and photoacoustic imaging as techniques currently under development. These methods are characterized by minimal invasiveness and can be utilized during operative procedures on the intestine.

Limits and Challenges of Real-time Ancillary Diagnostics

  • Despite their utility, these diagnostics have certain limitations including susceptibility to artifacts and the subjective interpretation of some methods.

Application in Veterinary Practice

  • Methods like indocyanine green FA and tissue oximetry are already used in veterinary practices and show promise for use during colic surgery in horses.
  • However, more research is needed to validate these methods further. Blind clinical trials are particularly lacking across all species, and further exploration is required to define accuracy and cutoff values specifically for equine intestinal lesions. Therefore, the article calls for more interspecies dialogue and research on real-time ancillary diagnostics.

Cite This Article

APA
Verhaar N, Geburek F. (2025). Real-time ancillary diagnostics for intraoperative assessment of intestinal viability in horses-looking for answers across species. Vet Surg. https://doi.org/10.1111/vsu.14248

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English

Researcher Affiliations

Verhaar, Nicole
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hannover, Germany.
Geburek, Florian
  • Clinic for Horses, University of Veterinary Medicine Hannover, Hannover, Germany.

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