Clinical Features and Management of Equine Postoperative Ileus (POI): Survey of Diplomates of the American Colleges of Veterinary Internal Medicine (ACVIM), Veterinary Surgeons (ACVS) and Veterinary Emergency and Critical Care (ACVECC)

Summary:
Reasons for performing the study: A recent survey of European Colleges (ECEIM and ECVS) revealed the different strategies implemented by, and some of the challenges facing, European clinicians presented with cases of POI. It was concluded that further comparative analysis of opinions, canvassed from additional colleges of equine veterinary specialism worldwide, would provide valuable additional insight into current POI knowledge on a more global scale.
Objectives: To report and compare the current strategies favoured by American veterinary specialists when managing postoperative ileus (POI) in horses that underwent emergency colic surgery.
Methods: Electronic invitations were sent to 814 Large Animal specialists, including 3 colleges: the ACVIM, the ACVS and the ACVECC.
Results: The response rate was 14% (115/814). The most common prevalence range of POI reported was 11 to 20%. The presence of reflux on nasogastric intubation was the main criterion used to define POI. A lesion involving the small intestine was considered the main risk factor for POI. Anti-inflammatory drugs, intravenous fluids and antimicrobial drugs were the primary strategies used when managing POI. Flunixin meglumine and intravenous (IV) lidocaine were the drugs most commonly used in the treatment of horses with POI. Supplementary management strategies targeted mainly the prevention of postoperative adhesions, infection and inflammation.
Conclusions: There is a lack of consensus on the clinical definition of POI. Prospective and objective clinical assessment of the effectiveness of the different strategies contained within this and the European survey is necessary in order to identify a standardized approach to the management of equine POI.