title: Operative factors associated with short-term outcome in horses with large colon volvulus: 47 cases from 2006 to 2013.
abstract: BACKGROUND
  There is an important need for objective parameters that accurately predict the outcome of horses with large colon volvulus.
  
  
  OBJECTIVE
  To evaluate the predictive value of a series of histomorphometric parameters on short-term outcome, as well as the impact of colonic resection on horses with large colon volvulus.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Adult horses admitted to the Equine and Farm Animal Veterinary Center at North Carolina State University, Peterson and Smith and Chino Valley Equine Hospitals between 2006 and 2013 that underwent an exploratory coeliotomy, diagnosed with large colon volvulus of ≥360 degrees, where a pelvic flexure biopsy was obtained, and that recovered from general anaesthesia, were selected for inclusion in the study. Logistic regression was used to determine associations between signalment, histomorphometric measurements of interstitium-to-crypt ratio, degree of haemorrhage, percentage loss of luminal and glandular epithelium, as well as colonic resection with short-term outcome (discharge from the hospital).
  
  
  RESULTS
  Pelvic flexure biopsies from 47 horses with large colon volvulus were evaluated. Factors that were significantly associated with short-term outcome on univariate logistic regression were Thoroughbred breed (P = 0.04), interstitium-to-crypt ratio >1 (P = 0.02) and haemorrhage score ≥3 (P = 0.005). Resection (P = 0.92) was not found to be associated significantly with short-term outcome. No combined factors increased the likelihood of death in forward stepwise logistic regression modelling. A digitally quantified measurement of haemorrhage area strengthened the association of haemorrhage with nonsurvival in cases of large colon volvulus.
  
  
  CONCLUSIONS
  Histomorphometric measurements of interstitium-to-crypt ratio and degree of haemorrhage predict short-term outcome in cases of large colon volvulus. Resection was not associated with short-term outcome in horses selected for this study. Accurate quantification of mucosal haemorrhage at the time of surgery may improve veterinary surgeons' prognostic capabilities in horses with large colon volvulus.
authors.affiliation: College of Veterinary Medicine, North Carolina State University, Raleigh, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Gonzalez
authors.forename: C A
authors.initials: CA
authors.lastname: Fogle
authors.forename: W T
authors.initials: WT
authors.lastname: Baker
authors.forename: F E
authors.initials: FE
authors.lastname: Hughes
authors.forename: J M
authors.initials: JM
authors.lastname: Law
authors.forename: A A
authors.initials: AA
authors.lastname: Motsinger-Reif
authors.forename: A T
authors.initials: AT
authors.lastname: Blikslager
mesh_terms: D000818:Animals; D001706:Biopsy; D003106:Colon / Q000473:pathology; D006470:Hemorrhage / Q000473:pathology / Q000662:veterinary; D006734:Horse Diseases / Q000601:surgery*; D006736:Horses; D045822:Intestinal Volvulus / Q000473:pathology / Q000601:surgery / Q000662:veterinary*; D016015:Logistic Models; D012189:Retrospective Studies
keywords: horse; large colon volvulus; pelvic flexure; strangulation; surgery
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