ABSTRACT
BACKGROUND: The prevalence of multiple organ dysfunction syndrome (MODS) in horses with acute surgical gastrointestinal (GI) disease is unknown. Currently, there are no validated criteria to confirm MODS in adult horses. OBJECTIVES: To develop criteria for a MODS score for horses with acute surgical colic (MODS SGI) and evaluate the association with 6-month survival. To compare the MODS SGI score with a MODS score extrapolated from criteria used in people (MODS EQ). ANIMALS: Adult horses that required exploratory laparotomy (n = 62) for colic. Healthy adult horses undergoing elective surgical procedures (n = 12) established the reference range of some variables. METHODS: Prospectively, a MODS SGI score was developed based on organ-specific criteria established from a literature review, data collection, and clinical judgment. Data for scoring each horse were collected on Days 1 and 2 postoperatively. Horses were scored retrospectively using both scoring criteria. The prognostic performance of the MODS SGI score and its overall performance compared with the MODS EQ score were assessed with receiver operating characteristic (ROC) curve analysis. RESULTS: The MODS SGI score had excellent performance for predicting 6-month survival with an area under the ROC curve (AUC) of 0.95 (95% CI: 0.87-0.99). The AUC for the MODS SGI score was significantly higher than the MODS EQ (AUC: 0.76; 0.63-0.86). CONCLUSIONS AND CLINICAL IMPORTANCE: The MODS SGI score predicts 6-month survival from discharge in horses with acute surgical colic. The MODS SGI score performed better than a score extrapolated from human scoring systems.
Subject(s)
Colic/veterinary , Horse Diseases/classification , Organ Dysfunction Scores , Systemic Inflammatory Response Syndrome/veterinary , Animals , Area Under Curve , Colic/surgery , Horse Diseases/pathology , Horse Diseases/surgery , Horses , Systemic Inflammatory Response Syndrome/pathologySubject(s)
Horse Diseases/diagnosis , Pasteurellaceae Infections/veterinary , Pasteurellaceae , Pneumonia, Bacterial/veterinary , Animals , Anti-Bacterial Agents/therapeutic use , Cough/etiology , Cough/veterinary , Female , Horse Diseases/drug therapy , Horse Diseases/microbiology , Horses , Male , Pasteurellaceae/pathogenicity , Pasteurellaceae Infections/diagnosis , Pasteurellaceae Infections/drug therapy , Pneumonia, Bacterial/diagnosis , Pneumonia, Bacterial/drug therapy , Pneumonia, Bacterial/microbiologyABSTRACT
BACKGROUND: Cardiac output (CO) is not routinely measured in critically ill adult horses because of invasiveness of currently validated methods. Noninvasive CO monitoring would complement clinical assessment of hemodynamic status in adult horses. HYPOTHESIS: Volumetric methods for measuring CO will have better agreement with lithium dilution than Doppler-based methods. ANIMALS: Eight healthy adult horses. METHODS: Prospective study. CO was manipulated with continuous rate infusions of dobutamine and romifidine to achieve high and low CO states, respectively. At each level, CO was measured by lithium dilution and various echocardiographic methods. Images stored as video loops were reviewed by an individual blinded to the lithium dilution results. RESULTS: Lithium dilution determinations of CO ranged between 16.6 and 63.0 L/min. There was a significant effect of method of CO measurement (P < .001), but no significant effect of CO level (P = .089) or interaction between level and method (P = .607) on the absolute value of the bias. The absolute values of the bias of the right ventricular outflow tract (RVOT) Doppler, Simpson, 4-chamber area-length, and bullet methods [5.5, 6.1, 6.5, 8.8 L/min, respectively] were significantly lower than that of the left ventricular outflow tract (LVOT) Doppler or cubic methods [14.8, 24.3 L/min, respectively]. CONCLUSIONS AND CLINICAL IMPORTANCE: The 4-chamber area-length, Simpson, bullet, and RVOT Doppler provided better agreement with lithium dilution than the other methods evaluated. These methods warrant further investigation for use in critically ill adult horses.
