Retrospective evaluation of the effects of a single intraoperative dose of dexamethasone in horses undergoing exploratory laparotomy for small intestinal lesions (2008–2019): 240 cases

• Published in: Journal of veterinary emergency and critical care (San Antonio, Tex. : 2000) Vol. 34; no. 3; pp. 245 - 251
• Main Authors: Tallon, Rose E., Allen, Sarah E., Bladon, Bruce M., McGovern, Kate F.
• Format: Journal Article
• Language: English
• Published: United States 01-05-2024
• Subjects: Animals; Anti-Inflammatory Agents - administration & dosage; Anti-Inflammatory Agents - therapeutic use; Cohort Studies; colic; corticosteroid; Dexamethasone - administration & dosage; Dexamethasone - therapeutic use; equine; Female; Horse Diseases - surgery; Horses; Intestinal Diseases - surgery; Intestinal Diseases - veterinary; Intestine, Small - surgery; Laparotomy - adverse effects; Laparotomy - veterinary; Male; Postoperative Complications - veterinary; postoperative ileus; reflux; Retrospective Studies; corticosteroid; reflux; colic; postoperative ileus; equine
• DOI: 10.1111/vec.13374
• EISSN: 1476-4431
• ISSN: 1479-3261

Objective
To determine the effect of a single intraoperative dose of dexamethasone on the risk of postoperative reflux (POR) in horses undergoing small intestinal surgery and to investigate its association with incisional complications and short‐term survival.
Design
Retrospective cohort study over an 11‐year period (2008–2019).
Setting
UK‐based private referral center.
Animals
Two hundred and forty client‐owned horses >6 months of age undergoing exploratory laparotomy for treatment of a small intestinal lesion.
Interventions
Ninety‐seven horses received a single intraoperative dose of dexamethasone (0.1 mg/kg, IV).
Measurements and Main Results
Of 97 horses that received dexamethasone, 52 (53.6%) required small intestinal resection. Of 143 horses that did not receive dexamethasone, small intestinal resection was performed in 78 (54.5%). A total of 70 horses (29%) developed POR. There was no difference in the risk of POR between horses that received dexamethasone (25/97; 26%) and those that did not (45/143; 31%, P = 0.34). Risk factors associated with the development of POR included small intestinal resection (odds ratio [OR]: 4.55, 95% confidence interval [CI]: 2.27–9.11, P < 0.001), a PCV >40% 24 hours postoperatively (OR: 4.11, 95% CI: 2–8.45, P < 0.001), and a WBC count >10 × 109/L on admission (OR: 3.29, 95% CI: 1.47–7.41, P = 0.004). Dexamethasone was not associated with the odds of POR. Horses undergoing repeat laparotomy had a higher risk of incisional infection (OR: 8.07, 95% CI: 1.98–32.81, P = 0.004). Dexamethasone administration was not associated with incisional infection. The development of POR was negatively associated with short‐term survival (OR: 0.07, 95% CI: 0.03–0.17, P ≤ 0.001). Dexamethasone administration was not retained in the final multivariable model for survival.
Conclusions
Intraoperative dexamethasone was not associated with the development of POR in this study population, nor did it have an effect on postoperative survival or incisional infection in horses undergoing surgical management of small intestinal disease.