In areas where S. vulgaris is prevalent, nonstrangulating intestinal infarction should be considered as a differential diagnosis in horses presenting with mild colic and peritonitis. Survival of nonstrangulating intestinal infarction is possible in cases where surgical intervention with resection of the infarcted intestine is feasible. The summary is available in Spanish - see Supporting Information.
With the apparent difference between healthy horses and horses with colic and the presently established RIs, serum SAA and PF Hp concentrations represent potential valuable diagnostic markers for inflammatory abdominal conditions in that species.
BackgroundOutcomes of colic treatment are of great interest to clinicians, horse owners and insurers. One commonly used criterion of success is the overall short-term survival rate. This is used as to compare treatments and to measure quality of veterinary care, but may be biased by demographic or social factors such as attitudes towards animal suffering and euthanasia. The aims of this study were to 1) describe and analyse characteristics in horses with signs of colic referred to the University Hospital for Large Animals (UHLA), University of Copenhagen, Denmark over a 10-year period and 2) to compare these rates with those published in other comparable studies.ResultsThe overall survival rate for colic horses over the 10-year study period was 68% (confidence intervals (CI): 66–71%; 1087/1588). In the medical group, 1093 horses, short-term survival was 87% (CI: 85–89%). Thirty one % of referred horses were given diagnoses requiring surgical intervention (CI: 29–33%). In this group 32% of the horses were euthanized before surgery (CI: 28–36%; 159/495). Of the surgical cases 27% (CI: 23-31%) were euthanized or died during surgery. Of the horses that recovered from surgery 25% died or were euthanized (CI: 19–32%; 48/189), while 75% survived to discharge (CI: 68–81%).ConclusionsThe short term survival rates of Danish horses with colic were similar or lower to those reported from other countries. Apart from variability of veterinary care, attitudes towards euthanasia vary among the countries, which may bias the outcomes. This study indicates that qualitative interview studies on owners’ attitudes towards animal suffering and euthanasia need to be conducted. Our opinion is that survival rates are not valid as sole indicators of quality of care in colic treatment due to selection bias. If the survival rates are to be compared between hospitals, techniques or surgeons, prospective studies including mutually agreed-on disease severity scores and a predefined set of reasons for euthanasia are needed.
Background: The acute phase proteins (APP) serum amyloid A (SAA), haptoglobin, and fibrinogen are valuable blood biomarkers in equine inflammatory diseases, but knowledge of factors influencing their concentrations in blood and peritoneal fluid (PF) of horses with colic is needed.Objectives: The objective of this study was to investigate the influence of demographics (age, sex, breed), disease process (simple obstruction, strangulating obstruction, inflammatory), disease location, disease duration, hypovolemia, and admission hospital on concentrations of APP, lactate and white blood cell counts (WBC) in horses with colic admitted to 2 referral hospitals.Animals: The study included 367 horses with colic admitted at 2 referral hospitals. Methods: Prospective multicenter observational study of clinical data, as well as blood and PF biomarkers. Associations between biomarker concentrations and clinical variables were analyzed using multivariate linear regression analysis.Results: Increasing pre-admission duration of colic was associated with increased concentrations of APP in blood and PF. Blood concentrations of SAA and fibrinogen were associated with disease process (inflammatory, strangulations, simple obstructions) in more colic duration groups (5-12 and >24 hours) than any of the other biomarkers. No relevant associations between demographic factors, hospital, or hydration status and the measured biomarkers were found.Conclusions and Clinical Importance: In horses with colic, concentrations of APP are associated mainly with disease process and duration of colic and may thus be used for assessment of disease independently of demographic or geographic factors. Serum amyloid A may be a diagnostic marker for use in colic differential diagnosis, but further evaluation is needed.
Evaluation of SAA in serum improved the ability to differentiate horses with acute inflammatory colic requiring medical treatment from horses with colic requiring surgery, as it allowed an additional 4% of horses to be correctly classified into medical and surgical cases. Improved differentiation of these 2 groups of horses with colic may minimize the risk of unnecessary or delayed surgery.
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