Horses with acute diarrhea: survival and laminitis

Survival rates and factors associated with survival and laminitis of horses with acute diarrhoea admitted to referral institutions

Equine Vet J. 2023 Dec 11. doi: 10.1111/evj.14032. Online ahead of print.
Authors
Diego E Gomez 1 , Bettina Dunkel 2 , David L Renaud 3 , Luis G Arroyo 1 , Angelika Schoster 4 5 , Jamie J Kopper 6 , David Byrne 7 ; MEDS group; Ramiro E Toribio 8
Affiliations

1 Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
2 Department of Clinical Science and Services, The Royal Veterinary College, Hertfordshire, UK.
3 Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
4 Vetsuisse Faculty, Equine Department University of Zurich, Zurich, Switzerland.
5 Ludwig-Maximilians-University Munich, Equine Clinic, Oberschleissheim, Germany.
6 Department of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, Iowa, USA.
7 College of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia.
8 College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.

PMID: 38083907
DOI: 10.1111/evj.14032

Abstract
in English, Portuguese

Background: Clinicopathological findings and their association with the outcome and development of laminitis in horses with acute diarrhoea has not been investigated in a multicentre study across different geographic regions.

Objectives: Describe and compare clinicopathologic findings of diarrhoeic horses between different geographic regions, survival rates and factors associated with non-survival and laminitis.

Study design: Multicentre retrospective case series.

Methods: Information from horses with acute diarrhoea presenting to participating institutions between 2016 and 2020 was collected, and clinicopathological data were compared between surviving and non-surviving horses and horses that did and did not develop laminitis. Survival rates and seasonal and geographic differences were also investigated.

Results: One thousand four hundred thirty-eight horses from 26 participating institutions from 4 continents were included; 76% survived to discharge with no differences identified between geographic regions. The survival proportion of horses with SIRS (Systemic Inflammatory Response Syndrome) and creatinine concentrations > 159 μmol/L was 55% (154/279) compared with 81% (358/437) for those with SIRS and creatinine concentrations < 159 μmol/L (p < 0.001). The survival proportion of horses with SIRS that had an L-lactate concentration > 2.8 mmol/L was 59% (175/298) compared with 81% (240/296) in horses with SIRS and L-lactate concentration < 2.8 mmol/L (p < 0.001). The proportion of horses that developed laminitis was lower in Europe (4%, 19/479) compared with North America (8%, 52/619), Australia (8%, 12/138) and Latin America (11%, 16/146) (p < 0.05). More horses developed laminitis in the summer (46%, 39/85) compared with winter (18%, 15/85), spring (18%, 15/85) and fall (19%, 16/85) (p < 0.01). Horses with laminitis had greater odds of non-survival than those without laminitis (OR: 3.73, 95% CI: 2.47-5.65). Main limitations: Not all variables were available for all horses due to the retrospective nature. Conclusions: Clinicopathological findings in horses with acute diarrhoea and their association with survival are similar across geographic regions. However, developing laminitis secondary to diarrhoea is less common in Europe. In addition, factors associated with non-survival were indicative of disease severity and subsequent cardiovascular compromise.