Investigation of perioperative and anesthetic variables affecting short-term survival of horses with small intestinal strangulating lesions.
OBJECTIVE
To determine if preoperative and intraoperative physiologic variables, and surgical factors correlate with survival to anesthetic recovery or hospital discharge, repeat celiotomy, and postoperative nasogastric intubation (NGT) in horses undergoing exploratory celiotomy for small intestinal (SI) strangulating lesions.


METHODS
Retrospective case series.


METHODS
Horses that had surgical correction of SI strangulating lesions (n = 258).


METHODS
Medical records (January 2000-December 2014) of horses that had surgical correction of SI strangulating lesions were reviewed. Data collection included signalment, preoperative physical examination variables, hematologic values, presence of gastric reflux, peritoneal fluid analysis, intraoperative physiologic variables, intraoperative findings/treatments, and arterial blood gas values. Risk factors for survival to anesthetic recovery and hospital discharge were determined using exact logistic regression.


RESULTS
Survival to anesthetic recovery was 76% and survival to discharge after anesthetic recovery was 79%. The difference between abdominal and peripheral lactate concentrations and intraoperative tachycardia were associated with not surviving to anesthetic recovery or hospital discharge. Intraoperative hypotension, hypocapnia, and low intraoperative packed cell volume (PCV) were negative predictors of survival to anesthetic recovery. Low intraoperative PCV was also associated with NGT postoperatively. Performing resection-anastomosis and jejunocecostomy were associated with repeat celiotomy and with not surviving to hospital discharge.


CONCLUSIONS
Several hematological and cardiorespiratory variables show good correlation with short-term survival in horses undergoing surgery for SI strangulating lesions. These variables are easily measured and could be useful for prognosticating survival in horses presenting with SI strangulating lesions.
William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, California.
Pablo
P
Espinosa
Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California.
Sarah S
SS
Le Jeune
William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, California.
Alessia
A
Cenani
Department of Population Health and Reproduction, School of Veterinary Medicine, University of California-Davis, Davis, California.
Philip H
PH
Kass
Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California.
Robert J
RJ
Brosnan
D000758:Anesthesia / Q000662:veterinary*; D000818:Animals; D001784:Blood Gas Analysis / Q000662:veterinary; D002140:California; D005260:Female; D006734:Horse Diseases / Q000401:mortality / Q000601:surgery*; D006736:Horses; D045822:Intestinal Volvulus / Q000601:surgery / Q000662:veterinary*; D007421:Intestine, Small / Q000601:surgery*; D007813:Laparotomy / Q000662:veterinary; D008297:Male; D059035:Perioperative Period; D011379:Prognosis; D012086:Reoperation; D012189:Retrospective Studies; D016019:Survival Analysis