Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) · 2025
Retrospective Evaluation of Synchronous Diaphragmatic Flutter in Horses: 37 Cases (2004-2022).
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Faircloth Joanna, Fielding Langdon, Epstein Kira, Crabtree Naomi, Mochal Cathleen, Magdesian K Gary, Major Dustin
Аннотация
OBJECTIVE: To describe the clinical presentation of horses with synchronous diaphragmatic flutter (SDF) and identify clinical and laboratory variables associated with survival.
DESIGN: Retrospective study from January 2004 to September 2022.
SETTING: Five large animal referral hospitals in the United States.
ANIMALS: Thirty-seven horses of various breeds and ages presenting with clinical signs of SDF, excluding animals participating in an endurance competition. All horses were >1 year of age.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Variables recorded and analyzed included signalment, clinical and laboratory data, treatments, and outcome. SDF was seen with gastrointestinal disease in 35% (13/37) of horses. The survival for horses with SDF was 78.4% (29/37). Nonsurvivors had a higher heart rate (78 ± 15/min) than survivors (58 ± 17/min; p = 0.01). Nonsurviving horses were more likely than surviving horses to have had nasogastric reflux (odds ratio: 16.8; 95% confidence interval: 1.9-222.8). Compared with survivors, nonsurvivors had a lower sodium concentration (131 ± 7 mmol/L [131 ± 7 mEq/L]) and bicarbonate concentration (22.7 ± 2.8 mmol/L [22.7 ± 2.8 mEq/L]). Nonsurvivors had higher lactate concentration (7.1 ± 3.9 mmol/L [64 ± 35.1 mg/dL]), glucose concentration (20 [13.3-29] mmol/L; 378 [239-522] mg/dL), and gamma-glutamyltransferase activity (51 [27-687] U/L). In horses that had ionized calcium concentration measured, 13 of 18 (72%) had a concentration <1.3 mmol/L (5.2 mg/dL).
CONCLUSIONS: SDF in horses is seen concurrently with gastrointestinal and other diseases, and not all horses present with hypocalcemia. The survival for nonendurance horses with SDF was 78%. Nonsurvival was associated with increased heart rate, the presence of nasogastric reflux, and a variety of laboratory abnormalities.
DESIGN: Retrospective study from January 2004 to September 2022.
SETTING: Five large animal referral hospitals in the United States.
ANIMALS: Thirty-seven horses of various breeds and ages presenting with clinical signs of SDF, excluding animals participating in an endurance competition. All horses were >1 year of age.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Variables recorded and analyzed included signalment, clinical and laboratory data, treatments, and outcome. SDF was seen with gastrointestinal disease in 35% (13/37) of horses. The survival for horses with SDF was 78.4% (29/37). Nonsurvivors had a higher heart rate (78 ± 15/min) than survivors (58 ± 17/min; p = 0.01). Nonsurviving horses were more likely than surviving horses to have had nasogastric reflux (odds ratio: 16.8; 95% confidence interval: 1.9-222.8). Compared with survivors, nonsurvivors had a lower sodium concentration (131 ± 7 mmol/L [131 ± 7 mEq/L]) and bicarbonate concentration (22.7 ± 2.8 mmol/L [22.7 ± 2.8 mEq/L]). Nonsurvivors had higher lactate concentration (7.1 ± 3.9 mmol/L [64 ± 35.1 mg/dL]), glucose concentration (20 [13.3-29] mmol/L; 378 [239-522] mg/dL), and gamma-glutamyltransferase activity (51 [27-687] U/L). In horses that had ionized calcium concentration measured, 13 of 18 (72%) had a concentration <1.3 mmol/L (5.2 mg/dL).
CONCLUSIONS: SDF in horses is seen concurrently with gastrointestinal and other diseases, and not all horses present with hypocalcemia. The survival for nonendurance horses with SDF was 78%. Nonsurvival was associated with increased heart rate, the presence of nasogastric reflux, and a variety of laboratory abnormalities.