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Outcomes of pregnant broodmares treated for colic at a tertiary care facility
Hope F Douglas1, Darko Stefanovski1, Louise L Southwood1
1Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, Pennsylvania, USA.
Objective:
To evaluate, following colic admission during pregnancy, (1) broodmare survival; (2) the frequency of recurrent colic in broodmares and its associated variables, and (3) pregnancy outcome and the variables associated with a negative pregnancy outcome.
Study Design:
Ambidirectional observational cohort study.
Animals:
One hundred and four client-owned broodmare admissions.
Methods:
Admissions of pregnant mares from June 2010 until October 2016 were included. Data were collected until November 2017. Cox proportional hazards regression analysis was performed to evaluate variables associated with broodmare survival. Logistic regression analysis was used to examine the variables associated with recurrent colic and pregnancy outcome.
Results:
Broodmares from 73/104 (70.2%) admissions were discharged alive. Lesion category, admission hyperlactatemia (hazard ratio (HR) 3.24, 95%, CI 1.28-8.22, P = .013), and admission high packed cell volume (HR 2.89, 95% CI 1.29-6.47, P = .010) were associated with reduced survival. Recurrent colic was observed in broodmares from 33/70 admissions (47.1%). The final multivariable model for recurrent colic included Thoroughbred breed (OR 5.09, 95% CI 1.58-16.4, P = .006) and age (OR .876, 95% CI .747-1.03, P = .105). Overall, negative pregnancy outcome was 14/65 (21.5%). Lesion category, evidence of systemic inflammatory response syndrome (SIRS) in hospital (OR 31.2, 95% CI 2.09-466.5, P = .013), and diarrhea in hospital (OR 379.3, 95% CI 97.1-1482.0, P < .001) were associated with increased negative pregnancy outcome. Altrenogest administration was inversely associated with negative pregnancy outcome (OR 0.029, 95% CI .004-.222, P = .001).
Conclusion:
Pregnant broodmares admitted for colic had lower survival than anticipated and were at risk of recurrent colic. Markers of broodmare disease severity were associated with pregnancy outcome.
Clinical Significance:
Lesion category, hematologic variables (packed cell volume and l-lactate concentration), evidence of SIRS, and diarrhea were useful for predicting broodmare and pregnancy outcomes.
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