Approaches to Managing Equine Postoperative Ileus Studied

Approaches to Managing Equine Postoperative Ileus Studied

Horses coming out of abdominal surgery are at risk of reduced gastrointestinal tract motility.

Photo: Rebecca McConnico, DVM, PhD, Dipl. ACVIM

In human medicine, doctors must follow specific guidelines before recommending a procedure or treatment. Though not without controversy, this at least provides clear-cut standards for proceeding.

“In veterinary medicine, veterinarians can basically do whatever they deem necessary to increase the chances of survival and/or recovery,” said Anthony Blikslager, DVM, PhD, Dipl. ACVS, a professor of equine surgery and gastroenterology at North Carolina State University, in Raleigh.

This can be problematic in treating syndromes such as equine postoperative ileus (POI); Blicklslager recently researched clinical features and management techniques for this ailment. Horses coming out of abdominal surgery are at risk of reduced gastrointestinal tract motility. This is most challenging in the small intestine. When the small intestine doesn’t work properly, fluid backs up into the horse’s stomach. Because horses can’t vomit, they can experience a painful, distended stomach.

The challenge is defining POI. Most commonly, a veterinarian will pass a nasal tube when a horse shows signs of pain or an increased heart rate after surgery. The volume of fluid present determines whether a horse has POI. However, veterinarians don’t always agree on the amount of fluid that correlates with a POI diagnosis.

“Some veterinarians begin treatment if any fluid or a small volume (about 2 liters) is present,” Blikslager explained. “Others monitor the horse until the fluid reaches a specific volume, such as 8 liters, before beginning treatment.”

Once diagnosed, horses are most often treated with lidocaine (a local anesthetic that can help manage pain and inflammation and improve intestinal motility), which has a short half-life and must be administered continuously with an intravenous (IV) pump. The drug itself is not necessarily expensive, but the time it takes a technician to mix, set up, and administer lidocaine is costly.

“There is a lot of concern over the escalating bills for colic patients,” he explained.

Blikslager believes that a definition of POI, reached by a panel of experts from diverse backgrounds, would be particularly helpful.

“This would make it easier as veterinarians to explain the situation to clients and to help justify the expense,” he said. “It would also be hugely beneficial to be able to say that a group of horses has ileus and these specific drugs, particularly lidocaine, have an effect on that.”

The study, “Clinical features and management of equine post operative ileus (POI): Survey of Diplomates of the American Colleges of Veterinary Internal Medicine (ACVIM), Veterinary Surgeons (ACVS) and Veterinary Emergency and Clinical Care (ACVECC),” was published in the Equine Veterinary Journal

About the Author

Katie Navarra

Katie Navarra has worked as a freelance writer since 2001. A lifelong horse lover, she owns and enjoys competing a dun Quarter Horse mare.

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