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Multiple Abdominal Surgies w/in 2 Weeks Indicate Poor Prognosis

A study published in the Journal of the American Veterinary Medical Association (JAVMA) looked back on 95 cases of horses that underwent repeated abdominal surgeries from the years of 2005-2013. The goal of the study was to examine factors associated with short-term and long-term prognosis in these horses that underwent 2 abdominal surgeries within a 14-day period. Historical, clinical, and laboratory data were compared between those horses that survived to discharge from the hospital and those that did not (short-term survival) and to greater than 3 months, and 6 months after hospital discharge (long-term survival). The results of the study showed that colics involving the small intestine were most commonly responsible for the first surgery and persistent gastric reflux (fluid coming up the esophagus from the stomach, often through a placed nasogastric tube) the most common reason for the second surgery. Intestinal resection (removal of a portion of affected intestine) was shown to be a negative indicator for survival. The researchers concluded that the prognosis for horses undergoing two successive colic surgeries is guarded (only 24% of the horses in this study survived to greater than 6 months) and that resection of a portion of intestine negatively affects the long-term survival rates. They also pointed out that there are still many questions that need to be answered such that survival rates can improve.

Relevance: While this study seems, in some ways, to “point out the obvious”, there was only one other study prior to this one that looked at the issue of two abdominal surgeries within 14 days of each other. The researchers recognized that “the financial and emotional impact encountered by the client is substantial” and that “an accurate estimation of short- and long-term survival rates appears important but larger-scale studies investigating outcome are lacking”. Data from studies such as this one will help a veterinarian give a horse owner a fact based, clearer picture of what they are facing should they find their horse needing that second abdominal surgery so very close to the first one.

Scientific Article: Dunkel, BD et. al. “Indications, complications, and outcome of horses undergoing repeated celiotomy within 14 days after the first colic surgery: 95 cases (2005-2013). JAVMA, March 1, 2015, Vol. 246, Number 5, pp. 540-546.

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