Risk factors associated with development of diarrhea in horses after celiotomy for colic: 190 cases (1990-1994).

This research paper explores the risk factors that contribute to the development of diarrhea in horses after they have undergone celiotomy, a surgical procedure for colic. The study found a high incidence of diarrhea among post-celiotomy horses, with those having large intestine disorders, undergoing enterotomy, and fed with certain types of food being particularly prone.

Study Context and Methodology

The study examined 357 adult horses that had celiotomy for colic at a teaching hospital between the years 1990 and 1994. The researchers reviewed the medical records of the horses to research and collect information related to:

• Development of diarrhea post-surgery,
• Signalment (description of the horse including age, breed, gender etc.),
• Pre-surgery medical history of horse,
• Treatment given to horses.

This approach allowed them to design a thorough retrospective cohort study which can provide insights into the incidence of various risk factors related to post-celiotomy diarrhea in horses.

Main Findings of the Study

The results of the study were quite revealing:

• The study found that the incidence of diarrhea in horses after celiotomy for colic was 53.2% (190 out of 357 horses developed diarrhea).
• Horses with a disorder of the large intestine were found to be twice as likely to develop diarrhea post-celiotomy as compared to horses who had surgery for other types of intestinal defects, indicating a strong link between large intestine disorders and post-operative diarrhea.
• Even after adjusting for the effects of large intestinal surgery, if the horses also underwent a procedure called an enterotomy, they were found to be about 1.5 times as likely to develop diarrhea, pointing to another risk factor.
• The study also studied what they referred to as “severe diarrhea”–diarrhea that lasted longer than 2 days, or was associated with a positive test for Salmonella in feces, or leukopenia, a reduction in white blood cells. This severe diarrhea was found in 27.5% of the subjects, showing that a significant number of horses suffer from severe post-surgical complications.
• The likelihood of developing this severe diarrhea increased by 2.5 times if the horses underwent surgery of the large intestine.
• An interesting mitigating factor was also identified–horses that were fed grass hay were approximately half as likely to develop severe diarrhea as opposed to horses that were not given grass hay, suggesting dietary interventions can alleviate some of the risk.

Conclusions and Clinical Implications

While risk factors identified such as the presence of large intestine disorder and the necessity of other operations are not alterable, the knowledge of them can equip clinicians to better advise clients and prepare for medical management of horses post-surgery. This is particularly important considering the high incidence of both diarrhea and severe diarrhea found among post-operative horses in the study, and the marked impact these complications can have on the health and recovery trajectories of the animals. Consequently, dietary interventions like the use of grass hay feed may be incorporated as part of the post-surgical care regime, to minimize the risk of severe diarrhea.