Equine Duodenal Motility, Assessed By Ultrasonography, As A Predictor Of Reflux And Survival Following Colic Surgery

Intestinal dysmotility following equine colic surgery contributes negatively to financial and prognostic outcomes. This study assessed duodenal contractility as a predictor of post-operative reflux and survival to discharge in horses following colic surgery. Duodenal contractility was assessed using daily transabdominal ultrasound examinations in 49 horses for up to 7 days (Day 1 scan performed between 6 and 36 h post-surgery and sequential daily scans performed between 08.00 and 20.00 h) following colic surgery (September 2014-April 2017). The duodenum was visualised ventral to the right kidney, and duodenal contractions were measured over 2 min. The signalment of each horse and surgical findings were noted. Outcomes were defined as horses that refluxed (>5 L/24 h beyond 24 h) or did not reflux post-operatively and those that were survivors or were nonsurvivors. A significant difference in duodenal contractions at Day 1 post-operatively was identified between horses that refluxed (n = 8) and those who did not reflux (n = 32; P = 0.013) but not between those who were nonsurvivors (n = 7) and survivors (n = 32; P = 0.113). Horses in the reflux group had reduced duodenal contractility comparatively. There were no significant differences in duodenal contractions in the sequential days after the Day 1 scan or between duodenal contractions and surgical findings. A significant association was identified between duodenal contractions and survivors (P = 0.039; odds ratio 1.88). The main study limitations were the single centre design with consequent small numbers of horses included. The study did not account for other factors that may contribute to alterations in motility such as drug administration or stages of re-feeding. This preliminary study indicates that Day 1 (6-36 h post-operatively) duodenal contractions may predict reflux (>5 L/24 h beyond 24 h) and that increased duodenal contractions are associated with survival. However, there was no clear distinction or cut-off between groups. Future studies with greater numbers of horses yielding better statistical power are required.