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assistance with ropes result in better recoveries when compared to no assistance (‘free’ recovery)?’ Only three studies were found to address the PICO
question directly by comparing rope-assisted and unassisted recoveries in horses. One was a randomised, non-blinded controlled trial and two were retrospective cohort studies. These three studies arrive at different conclusions
regarding the utility of rope assistance in recovery from general anaesthesia in horses but examine very different populations. The randomised controlled trial provides weak evidence that rope assistance can shorten recovery and improve recovery quality in healthy (American Society of Anesthesiologists (ASA) I–II) horses. One retrospective cohort study provides weak evidence that rope assistance confers a reduction in fatality in both healthy and sick horses. The other retrospective cohort study provides weak evidence that rope assistance confers no benefit to horses undergoing emergency colic surgery. Both assisted and unassisted groups in each study had fatalities and all studies reported complications related to the rope recovery system. Insufficient evidence is available to permit a full recommendation regarding rope assistance during recovery from general anaesthesia in horses. Rope assistance may improve recovery time and quality in some horses. The decision to perform a rope-assisted recovery must be made considering individual patient, team and clinic factors. Rope assistance cannot prevent fatalities in recovery.
Faecal microbiota transplantation
The aim of this study by Marco Costa and co-workers in Canada and Brazil was to characterise the faecal microbiota of horses with acute and chronic diarrhoea before and after faecal microbiota transplantation (FMT). Six client-owned horses with acute and chronic diarrhoea
received FMT from two healthy donor horses. Microbiota analysis using next-generation sequencing was performed on faecal samples collected before and 2 and 7 days after FMT. Signs of diarrhoea improved in four horses, whereas the remaining two horses did not survive. There was a significant difference in the number of bacterial species between donors and recipients. The Order Lactobacillales and the genera Lactobacillus,
Intestinimonas,
and Streptococcus were increased in the microbiota of diarrhoeic horses, and Saccharofermentans genus increased in healthy donors. The results suggest that FMT from the healthy donors was not effective over a 7-day period as it did not change the faecal microbiota of the diarrhoeic horses. Further research to improve the efficacy of FMT in horses is needed.
Recovery quality
The objective of this retrospective case study by Isabel Santiago-Llorente and co-workers in Spain was to determine demographic, preoperative and anaesthesia-related variables that may be associated with unsatisfactory recovery quality in horses undergoing emergency abdominal surgery (colic) in an equine teaching hospital.
The anaesthetic records of 313 horses admitted for surgical
treatment of colic over a 14-year period were examined. Overall quality of recovery was assessed as dangerous, poor, fair, good or excellent. The following categories were constructed as a dichotomic variable: unsatisfactory recovery (poor and dangerous recoveries) and satisfactory recovery (excellent, good and fair recoveries). Univariable and multivariable analyses were performed to evaluate the association between all studied variables and recovery. All recoveries were unassisted. Unsatisfactory recovery
quality totalled 17.2% (3.5% dangerous and 13.7% poor), whereas satisfactory recoveries totalled 82.8% (26.2% fair, 40.9% good and 15.7% excellent). Univariable analysis showed that unsatisfactory recoveries were associated with high preoperative packed cell volume, pain behaviour, poor premedication and induction quality, high intraoperative mean heart rate, low mean arterial blood pressure, dobutamine dose ≥1.5 lg/kg bwt/min, non-administration of romifidine, long anaesthesia time and prolonged time to stand. The multivariable model showed that factors strongly associated with unsatisfactory recovery quality were dobutamine dose ≥1.5 lg/kg bwt/min (adjusted odds ratio (AOR) = 6.60; 95% CI: 2.91–14.96), poor premedication quality (AOR = 4.60; 95% CI: 1.73–12.23) and a time to stand >70 min (AOR = 2.59; 95% CI: 1.13–5.91). This study shows that high dobutamine requirements, poor
premedication quality and a prolonged time to stand are risk factors for unsatisfactory recovery quality in horses undergoing anaesthesia for colic surgery. Addressing these factors may enable clinicians to improve the quality of the recovery phase.
S. WRIGHT EVE Editorial Office References
Broyles, A.H., Embertson, R.M., Woodie, J.B. & Machado, V. (2021) The impact of grade of laryngeal function immediately prior to laryngoplasty and ipsilateral ventriculocordectomy on postoperative performance: 623 Thoroughbred racehorses (1998- 2013). Equine Veterinary Journal,
https://beva.onlinelibrary.wiley. com/doi/10.1111/evj.13523. Epub ahead of print.
Costa, M., Di Pietro, R., Bessegatto, J.A., Pereira, P.F.V., Stievani, F.C., Gomes, R.G. et al. (2021) Evaluation of changes in microbiota after fecal microbiota transplantation in 6 diarrheic horses. Canadian Veterinary Journal, 62, 1123–1130.
Douglas, H.F., Stefanovski, D. & Southwood, L.L. (2021) Outcomes of pregnant broodmares treated for colic at a tertiary care facility. Veterinary Surgery, 50(8), 1579–1591.
Lloyd, F. & Murison, P. (2021) For horses undergoing general anaesthesia, are rope recoveries or free recoveries better? Veterinary Evidence, 6,3.
Meyer, J.C., Hunyadi, L.M. & Ordnez-Mena, J.M. (2021) The accuracy o~
of ACTH as a biomarker for pituitary pars intermedia dysfunction in horses: A systematic review and meta-analysis. Equine Veterinary Journal.
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Santiago-Llorente, I., Lopez-San Rom an, F.J. & Villalba-Orero, M. (2021)
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© 2021 EVJ Ltd
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