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Use of Pelvic Flexure Biopsy Scores to Predict Short-Term Survival after Large Colon Volvulus


  • Ohad Levi DVM,

  • Verena K. Affolter DVM, PhD, Diplomate ECVP,

  • Jaromir Benak DVM, Diplomate ACVP,

  • Philip H. Kass DVM, PhD, Diplomate ACVPM,

  • Sarah S. Le Jeune DVM, Diplomate ACVS & ECVS & CVA

    Corresponding author
    • Department of Surgical & Radiological Sciences, School of Veterinary Medicine, William R. Pritchard Veterinary Medical Teaching Hospital, University of California-Davis, Davis, CA
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  • Presented in part at the 10th Equine Colic Research Symposium in Indianapolis, IN, July 2011.

Corresponding Author

Sarah Le Jeune, DVM, Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, One Shields Avenue, Davis, CA 95616




To (1) determine if histologic scores of pelvic flexure biopsies can predict short-term survival in horses with large colon volvulus (LCV) and (2) identify clinical variables predictive of short-term survival.

Study Design

Case series.


Horses (n = 28) with LCV (≥360°).


Medical records (January 2000–February 2008) of 28 horses were reviewed and clinical data recorded. Pelvic flexure biopsies were reviewed by 2 board-certified veterinary pathologists, unaware of clinical history and outcome, using 2 scoring systems. Exact logistic regression analysis was used to determine the relationship between histopathology scores (tissue viability), clinical data, and short-term survival (hospital discharge).


Twenty-four horses (86%) survived to hospital discharge. Using a similar cutoff, neither scoring system was capable of predicting short-term survival. One scoring system failed to correctly predict clinical outcome in 5/25 horses (20%) and the other failed in 6/28 horses (22.4%). Heart rate (at admission and 24 hours after surgery) and packed cell volume 24 hours after surgery were significantly associated with short-term survival.


Histopathologic evaluation of pelvic flexure biopsies did not accurately predict short-term survival in a significant proportion of horses with LCV in this study.