FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / J Vet Emerg Crit Care (San Antonio) / Retrospective evaluation of the effects of a single intraope...
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)2024; doi: 10.1111/vec.13374

Retrospective evaluation of the effects of a single intraoperative dose of dexamethasone in horses undergoing exploratory laparotomy for small intestinal lesions (2008-2019): 240 cases.

Abstract: To determine the effect of a single intraoperative dose of dexamethasone on the risk of postoperative reflux (POR) in horses undergoing small intestinal surgery and to investigate its association with incisional complications and short-term survival. Methods: Retrospective cohort study over an 11-year period (2008-2019). Methods: UK-based private referral center. Methods: Two hundred and forty client-owned horses >6 months of age undergoing exploratory laparotomy for treatment of a small intestinal lesion. Methods: Ninety-seven horses received a single intraoperative dose of dexamethasone (0.1 mg/kg, IV). Results: Of 97 horses that received dexamethasone, 52 (53.6%) required small intestinal resection. Of 143 horses that did not receive dexamethasone, small intestinal resection was performed in 78 (54.5%). A total of 70 horses (29%) developed POR. There was no difference in the risk of POR between horses that received dexamethasone (25/97; 26%) and those that did not (45/143; 31%, P = 0.34). Risk factors associated with the development of POR included small intestinal resection (odds ratio [OR]: 4.55, 95% confidence interval [CI]: 2.27-9.11, P 40% 24 hours postoperatively (OR: 4.11, 95% CI: 2-8.45, P 10 × 10/L on admission (OR: 3.29, 95% CI: 1.47-7.41, P = 0.004). Dexamethasone was not associated with the odds of POR. Horses undergoing repeat laparotomy had a higher risk of incisional infection (OR: 8.07, 95% CI: 1.98-32.81, P = 0.004). Dexamethasone administration was not associated with incisional infection. The development of POR was negatively associated with short-term survival (OR: 0.07, 95% CI: 0.03-0.17, P ≤ 0.001). Dexamethasone administration was not retained in the final multivariable model for survival. Conclusions: Intraoperative dexamethasone was not associated with the development of POR in this study population, nor did it have an effect on postoperative survival or incisional infection in horses undergoing surgical management of small intestinal disease.
© Veterinary Emergency and Critical Care Society 2024.
Get Full Text
Publication Date: 2024-05-29 PubMed ID: 38809185DOI: 10.1111/vec.13374Google 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.
LinkedInCopy
  • Journal Article

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 investigates the impact of a single intraoperative dose of dexamethasone on horses undergoing small intestinal surgery and its association with post-surgery complications and survival. The study finds that the use of intraoperative dexamethasone does not affect the occurrence of postoperative reflux (POR), the risk of infection, or the short-term survival of horses after the surgery.

Study Design

  • The study is a retrospective evaluation, meaning researchers analyzed data related to surgeries performed in the past to gather their results.
  • The research spans over an 11-year period from 2008 to 2019.
  • The study was conducted at a private referral center in the UK.
  • The subjects of study were 240 client-owned horses that were more than six months old and had undergone laparotomy (a surgical incision into the abdominal cavity) for small intestinal lesions.

Intraoperative Dexamethasone Administration

  • Out of the total, 97 horses received a single intraoperative dose of dexamethasone (0.1 mg/kg, IV).
  • Small intestinal resection (removal of a piece of small intestine) was performed on 52 out of these 97 horses (53.6%), and 25 of them (26%) developed postoperative reflux (POR).

Results

  • Comparatively, out of 143 horses that did not receive dexamethasone, a small intestinal resection was performed on 78 horses (54.5%), and 45 of these horses (31%) developed POR.
  • In total, 70 horses (29%) out of the entire sample developed POR, indicating no significant difference between the horses administered with dexamethasone and those without the drug.
  • Additionally, the study found that factors like small intestinal resection, high postoperative PCV (Packed Cell Volume) levels, and high WBC (White Blood Cell) count on admission were associated with the risk of developing POR, whereas dexamethasone administration was not.

Postoperative Complications and Survival

  • Horses who underwent repeat laparotomy had a higher risk of incisional infection, but dexamethasone administration did not affect this risk.
  • The occurrence of POR was negatively associated with short-term survival, meaning, horses that developed POR had a lesser chance of survival.
  • However, the administration of dexamethasone had no impact on the short-term survival of the horses, as per the final multivariable model for survival.

Conclusions

  • The research concluded that the intraoperative administration of dexamethasone does not affect the development of POR, likelihood of post-surgery infection, or short-term post-surgery survival in horses undergoing small intestine surgery.

Cite This Article

APA
Tallon RE, Allen SE, Bladon BM, McGovern KF. (2024). Retrospective evaluation of the effects of a single intraoperative dose of dexamethasone in horses undergoing exploratory laparotomy for small intestinal lesions (2008-2019): 240 cases. J Vet Emerg Crit Care (San Antonio). https://doi.org/10.1111/vec.13374

Publication

Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)
ISSN: 1476-4431
NlmUniqueID: 101152804
Country: United States
Language: English

Researcher Affiliations

Tallon, Rose E
  • Donnington Grove Veterinary Group, Newbury, UK.
Allen, Sarah E
  • Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, UK.
Bladon, Bruce M
  • Donnington Grove Veterinary Group, Newbury, UK.
McGovern, Kate F
  • Donnington Grove Veterinary Group, Newbury, UK.

References

This article includes 36 references
  1. Lisowski ZM, Pirie RS, Blikslager AT, Lefebvre D, Hume DA, Hudson NPH. An update on equine post‐operative ileus: definitions, pathophysiology and management.. Equine Vet J 2018;50(3):292‐303.
    doi: 10.1111/evj.12801google scholar: lookup
  2. Dunkel B, Mair T, Marr CM, Carnwath J, Bolt DM. Indications, complications, and outcome of horses undergoing repeated celiotomy within 14 days after the first colic surgery: 95 cases (2005‐2013).. J Am Vet Med Assoc 2015;246(5):540‐546.
    doi: 10.2460/javma.246.5.540google scholar: lookup
  3. Torfs S, Delesalle C, Dewulf J, Devisscher L, Deprez P. Risk factors for equine postoperative ileus and effectiveness of prophylactic lidocaine.. J Vet Intern Med 2009;23(3):606‐611.
  4. Morton AJ, Blikslager AT. Surgical and postoperative factors influencing short‐term survival of horses following small intestinal resection: 92 cases (1994‐2001).. Equine Vet J 2002;34(5):450‐454.
  5. Rychter J, Clavé P. Intestinal inflammation in postoperative ileus: pathogenesis and therapeutic targets.. Gut 2013;62(11):1534‐1535.
  6. De Winter BY, De Man JG. Interplay between inflammation, immune system and neuronal pathways: effect on gastrointestinal motility.. World J Gastroenterol 2010;16(44):5523‐5535.
  7. De Ceulaer K, Delesalle C, Van Elzen R, Van Brantegem L, Weyns A, Van Ginneken C. Morphological changes in the small intestinal smooth muscle layers of horses suffering from small intestinal strangulation. Is there a basis for predisposition for reduced contractility?. Equine Vet J 2011;43(4):439‐445.
  8. Wehner S, Straesser S, Vilz TO. Inhibition of p38 mitogen‐activated protein kinase pathway as prophylaxis of postoperative ileus in mice.. Gastroenterology 2009;136(2):619‐629.
  9. van Bree SHW, Gomez-Pinilla PJ, van de Bovenkamp FS. Inhibition of spleen tyrosine kinase as treatment of postoperative ileus.. Gut 2013;62(11):1581‐1590.
    doi: 10.1136/gutjnl-2012-302615google scholar: lookup
  10. Becker DE. Basic and Clinical Pharmacology of Glucocorticosteroids.. Anesth Prog 2013;60(1):25‐32.
  11. Collaborative DTC and WMR. Dexamethasone versus standard treatment for postoperative nausea and vomiting in gastrointestinal surgery: randomised controlled trial (DREAMS Trial).. BMJ 2017, 357.
  12. Schäcke H, Döcke WD, Asadullah K. Mechanisms involved in the side effects of glucocorticoids.. Pharmacol Ther 2002;96(1):23‐43.
  13. Shearer TR, Holcombe SJ, Valberg SJ. Incisional infections associated with ventral midline celiotomy in horses.. J Vet Emerg Crit Care 2020;30(2):136‐148.
  14. Polderman JA, Farhang-Razi V, Van Dieren S. Adverse side effects of dexamethasone in surgical patients.. Cochrane Database Syst Rev 2018;2018(11):CD011940.
  15. Belz J, Stroth C, Tessman L, Willman C. Transabdominal ultrasonography of the duodenum in the early diagnosis of paralytic ileus in postoperative horses.. Proceedings of the 11th International Equine Colic Research Symposium 2014, Dublin, Ireland.
  16. Archer DC, Pinchbeck GL, Proudman CJ. Factors associated with survival of epiploic foramen entrapment colic: a multicentre, international study.. Equine Vet J 2011;43(s39):56‐62.
  17. Naylor RJ, Taylor AH, Knowles EJ. Comparison of flunixin meglumine and meloxicam for post operative management of horses with strangulating small intestinal lesions.. Equine Vet J 2014;46(4):427‐434.
  18. Hoaglund EL, Hess AM, Hassel DM. Retrospective evaluation of the effect of intravenous fluid administration on development of postoperative reflux in horses with colic (2004–2012): 194 horses.. J Vet Emerg Crit Care 2018;28(6):566‐572.
  19. Proudman CJ, Edwards GB, Barnes J. Differential survival in horses requiring end‐to‐end jejunojejunal anastomosis compared to those requiring side‐to‐side jejunocaecal anastomosis.. Equine Vet J 2007;39(2):181‐185.
  20. Karagianni AE, Kapetanovic R, McGorum BC, Hume DA, Pirie SR. The equine alveolar macrophage: functional and phenotypic comparisons with peritoneal macrophages.. Vet Immunol Immunopathol 2013;155(4):219‐228.
  21. Anderson MJ, Ibrahim AS, Cooper BR, Woolcock AD, Moore GE, Taylor SD. Effects of administration of ascorbic acid and low‐dose hydrocortisone after infusion of sublethal doses of lipopolysaccharide to horses.. J Vet Intern Med 2020;34(6):2710‐2718.
  22. Templeton CB, Bottoms GD, Fessler JF. Endotoxin‐induced hemodynamic and prostaglandin changes in ponies: effects of flunixin meglumine, dexamethasone, and prednisolone.. Circ Shock 1987;23(4):231‐240.
  23. Ewert KM, Fessler JF, Templeton CB, Bottoms GD, Latshaw HS, Johnson MA. Endotoxin‐induced hematologic and blood chemical changes in ponies: effects of flunixin meglumine, dexamethasone, and prednisolone.. Am J Vet Res 1985;46(1):24‐30.
  24. Frauenfelder HC, Fessler JF, Moore AB, Bottoms GD, Boon GD. Effects of dexamethasone on endotoxin shock in the anesthetized pony: hematologic, blood gas, and coagulation changes.. Am J Vet Res 1982;43(3):405‐411.
  25. Tnibar A, Grubbe LK, Thurøe NK. Effect of a stent bandage on the likelihood of incisional infection following exploratory coeliotomy for colic in horses: a comparative retrospective study.. Equine Vet J 2013;45(5):564‐569.
  26. Smith LJ, Mellor DJ, Marr CM, Reid SWJ, Mair TS. Incisional complications following exploratory celiotomy: does an abdominal bandage reduce the risk?. Equine Vet J 2007;39(3):277‐283.
  27. Durward-Akhurst SA, Mair TS, Boston R, Dunkel B. Comparison of two antimicrobial regimens on the prevalence of incisional infections after colic surgery.. Vet Rec 2013;172(11):287‐287.
  28. Durmus M, Karaaslan E, Ozturk E. The effects of single‐dose dexamethasone on wound healing in rats.. Anesth Analg 2003;97(5):1377‐1380.
  29. Schulze S, Andersen J, Overgaard H. Effect of prednisolone on the systemic response and wound healing after colonic surgery.. Arch Surg Chic Ill 1960 1997;132(2):129‐135.
  30. Srinivasa S, Kahokehr AA, Yu TC, Hill AG. Preoperative glucocorticoid use in major abdominal surgery: systematic review and meta‐analysis of randomized trials.. Ann Surg 2011;254(2):183‐191.
  31. Assante J, Collins S, Hewer I. Infection associated with single‐dose dexamethasone for prevention of postoperative nausea and vomiting: a literature review.. AANA J 2015;83(4):281‐288.
  32. Wang AS, Armstrong EJ, Armstrong AW. Corticosteroids and wound healing: clinical considerations in the perioperative period.. Am J Surg 2013;206(3):410‐417.
  33. Mair TS, Smith LJ. Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 2: short‐term complications.. Equine Vet J 2005;37(4):303‐309.
  34. Freeman D. Post‐operative reflux—a surgeon's perspective.. Equine Vet Educ 2018;30(12):671‐680.
  35. Malone E, Ensink J, Turner T. Intravenous continuous infusion of lidocaine for treatment of equine ileus.. Vet Surg 2006;35:60‐66.
  36. Salem SE, Proudman CJ, Archer DC. Has intravenous lidocaine improved the outcome in horses following surgical management of small intestinal lesions in a UK hospital population?. BMC Vet Res 2016;12(1):157.

Citations

This article has been cited 0 times.
Subscribe to our newsletter
Join 99,357 horse owners like you who receive our email updates on horse health and nutrition.