Australian veterinary journal1998; 76(1); 25-31;

Role of prokinetic drugs for treatment of postoperative ileus in the horse.

Dart, AJ
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Hodgson, DR

Abstract: All horses undergoing coeliotomy for an acute abdominal crisis are at risk of developing ileus and should receive therapy aimed at promoting gastrointestinal function by restoring fluid and electrolyte balance. Adequate analgesia and prevention against peritonitis, bacteraemia and endotoxaemia should be provided. Horses that at the time of surgery have a strangulating or non-strangulating small intestinal obstruction should be considered to be at greater risk of developing a persistent ileus that is refractory to treatment than those horses with lesions involving the large intestine. In horses considered to be at greater risk of developing a persistent ileus, the use of prokinetic agents should be considered. Agents that may be used to improve gastrointestinal motility include adrenergic receptor antagonists, cholinergic agonists, benzamides, dopamine antagonists, macrolide antimicrobials, opiate receptor agonists and antagonists, somatostatin analogues and local anaesthetics. There are limited studies into the use of these agents in the horse. Until further research provides more information on motility disorders following intestinal surgery and the efficacy of prokinetic agents in this species, only selective use of some of these drugs can be recommended.

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Publication Date: 1998-05-14 PubMed ID: 9578763

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This study explores the role of prokinetic drugs in treating postoperative ileus (delayed gastric emptying) in horses. Investigations are based on a variety of agents that could potentially improve gastrointestinal motility but emphasizes the need for more research before solid recommendations can be made.

Postoperative Ileus and Associated Risks

Postoperative ileus, a condition where the intestine doesn’t push food through as it should, is a risk for all horses undergoing coeliotomy, the incision into the abdominal cavity, due to an acute abdominal crisis.
While administering therapy to promote gastrointestinal function, attention should also be given to restoring fluid and electrolyte balance in horses.
Furthermore, proper analgesia (pain relief) measures should be in place and prevention against peritonitis (inflammation of the abdominal lining), bacteraemia (bacteria in the bloodstream), and endotoxaemia (presence of endotoxins in the blood) should be ensured.
Particular caution should be exercised with horses having a strangulating or non-strangulating small intestinal obstruction at the time of the surgery, as they may be at a higher risk of developing a persistent ileus which can resist treatment.