Risk factors for laminitis and nonsurvival in acute colitis: Retrospective study of 85 hospitalized horses (2011-2019).

ABSTRACT

BACKGROUND: Acute colitis is a serious cause of morbidity and death in horses. Recent studies have compared clinical features of coronavirus and salmonellosis, but no study has compared clinical features of enteric salmonellosis, coronavirus, and neorickettsiosis. HYPOTHESIS/OBJECTIVES: To identify risk factors for laminitis and nonsurvival to discharge in horses with enteric salmonellosis, coronavirus, or neorickettsiosis. ANIMALS Eighty-five horses hospitalized for acute colitis from 2011 to 2019. METHODS: Retrospective case series. Medical record review (2011-2019) of adult (≥2 years) horses with colitis. Primary outcomes were laminitis and survival to discharge. Multivariable logistic regression was performed to assess association between variables and the development of laminitis. Stepwise Cox regression was performed to assess association between variables and survival. RESULTS: Seventeen of 85 (20%) horses developed laminitis during hospitalization. Neorickettsiosis cases (11/26, 42%) were more likely to develop laminitis than coronavirus (0/16, 0%) cases (odds ratio [OR] 24.48; 95% confidence interval [CI] 1.33-451.74, P = .03). There was no significant difference in laminitis between salmonellosis and neorickettsiosis cases (OR 0.27; 95% CI 0.07-1.07, P = .06). Admission heart rate (OR 1.08; 95% CI 1.02-1.15, P = .01), total solids (OR 0.17; 95% CI 0.06-0.54, P = .003), band neutrophils (OR 1248.47; 95% CI 6.62-235 540, P = .008), and bicarbonate concentration (OR 0.68; 95% CI 0.5-0.92, P = .01) were predictive of development of laminitis during hospitalization. Sixty-three of 85 (74%) horses survived to discharge 16/16 (100%) coronavirus cases, 17/26 (65%) neorickettsiosis cases, 14/20 (70%) salmonellosis cases, and 16/23 (70%) unknown cases. Packed cell volume (hazard ratio [HR] 1.17; 95% CI 1.09-1.26, P < .001), L-lactate concentration (HR 1.33; 95% CI 1.14-1.55, P < .001), and development of laminitis (HR 7.07; 95% CI 1.67-29.95, P = .008) were retained in the final multivariable model for prediction of nonsurvival to discharge. CONCLUSION AND CLINICAL IMPORTANCE Nonsurvival and laminitis rates were high, likely related to the presence of neorickettsiosis in the region.