Survey of prokinetic use in horses with gastrointestinal injury.

The research article presents a survey on the use of medications known as prokinetics, which enhance gastrointestinal mobility, to manage horses after gastrointestinal surgery. The article highlights the selections, dosages, and routes of administration, and concludes there’s a need for further studies and new prokinetic drug development.

Survey Methodology

• The researchers used an electronic questionnaire as their method of data collection.
• The target group for the survey were Diplomates of the American College of Veterinary Surgeons, specifically those who perform equine intestinal surgery.
• The survey, comprising of 21 questions, aimed to determine the use of prokinetic agents in which a total of 112 known ACVS Diplomates were invited.
• Several clinical scenarios were also provided to determine the preferred prokinetic agent in each case.

Survey Results

• A total of 58 surgeons from 44 clinics responded to the survey, representing a response rate of approximately 52%.
• The selection of prokinetic agent for specific gastrointestinal conditions was rather uniform, but there was a significant variation in the doses administered among surgeons.
• For postoperative ileus (a condition where part of the bowel stops functioning after surgery), the most commonly selected prokinetic agent was 2% lidocaine. Other decreasingly used agents included erythromycin lactobionate, metoclopramide, and cisapride.
• The use of prokinetic agents was reported to be more common after surgeries for small intestine strangulating obstructions, and less frequent for large intestinal injuries.
• Importantly, the respondents did not identify any novel agents in their current medical practice.

Conclusions

• Prokinetic drugs are regularly used to manage and/or mitigate postoperative ileus in horses, but their dosages and modes of administration vary among surgeons.
• Despite the widespread use of prokinetics for managing this condition in horses, the authors point out a clear need for more controlled studies to establish effective dosing patterns.
• Furthermore, the authors recommend the development of new prokinetic drugs to diversify the options and potentially improve the management of postoperative ileus in horses.