Prevalence of and Risk Factors for Postoperative Ileus after Small Intestinal Surgery in Two Hundred and Thirty-Three Horses

Objectives-To determine the incidence of postoperative ileus (POI) in a population of horses after small intestinal surgery and the effect of multiple variables on development of POI. Study Design-Case series. Animals-Horses (n = 233) aged >= 1 year that had exploratory celiotomy for small intestinal disease that recovered from surgery from 1995 to 2005. Methods-Sixty-eight variables were collected from medical records (1995-2005) for each horse. POI was defined as nasogastric reflux volume >20L over 24 hours or >8L at any single time after surgery. Results-Twenty-seven percent (64/233) of horses developed POI; 29 of 64 (46%) horses with POI had duodenitis proximal jejunitis (DPJ). When no intestinal resection was required at surgery, excluding horses with DPJ, 15% of horses had POI; 30% horses had POI after intestinal resection. Ten percent of horses had POI for >24 hours. When horses with DPJ were excluded, factors associated with increased risk of POI included high packed cell volume at hospital admission (P = .024), increasing age (P = .0004), and length of intestinal resection (P = .05). Conclusions-Risk factors for POI in this study were nonspecific although horses with intestinal resection are at higher risk compared with horses without intestinal resection. Clinical Relevance-Predicting with certainty which cases will develop POI remains elusive. (C) Copyright 2009 by The American College of Veterinary Surgeons