An update on equine post-operative ileus: Definitions, pathophysiology and management

Area of Science:

• Veterinary Surgery
• Equine Medicine
• Gastroenterology

Background:

• Post-operative ileus (POI) significantly impacts horses after abdominal surgery, increasing recovery time and costs.
• Current understanding of equine POI relies heavily on human and rodent models, identifying manipulation-induced inflammation and macrophage activation as key factors.

Purpose of the Study:

• To review the current understanding of equine post-operative ileus pathophysiology.
• To highlight the role of inflammation and macrophage activation in POI development.
• To emphasize the need for multimodal treatment strategies.

Main Methods:

• Literature review of equine, human, and rodent studies on post-operative ileus.
• Analysis of inflammatory pathways and cellular mechanisms involved in POI.
• Evaluation of current and potential therapeutic approaches.

Main Results:

• Inflammation, particularly involving muscularis externa macrophages, is a critical component in POI development.
• Existing pharmacological treatments for POI have shown limited success across species.
• POI is recognized as a complex, multifactorial condition.

Conclusions:

• Effective management of equine POI requires a comprehensive, multimodal approach.
• Further research into equine-specific inflammatory mechanisms is needed.
• Minimizing POI incidence necessitates addressing its diverse contributing factors.