Prokinetic drugs for postoperative ileus in horses: do non-lidocaine prokinetics vs standard care improve gastrointestinal recovery after colic surgery? — POSSIBLE

POSSIBLE: For the non-lidocaine prokinetic class, the clinical evidence rests on one randomised blind trial, and it is positive but unquantified in its record. In van der Velden 1993 (PMID: 8122356; 70 horses surgically treated for colic caused by disorders of the small intestine, in a randomized blind trial), cisapride 0.1 mg/kg intramuscularly at 8-hour intervals appeared to reduce the incidence of post-operative ileus, accelerated the restoration of bowel motility and reduced the period of post-operative intensive care; the abstract reports no group rates, no group sizes per arm and no P values, so the size of the effect cannot be stated, and what the control group received is not described in the record. The only clinical-outcome dataset for the class as actually used, Smith 2005 (PMID: 15908242; 55 horses with post-operative ileus following pedunculated lipoma obstruction at two hospitals, treated with four prokinetic agents), found prokinetic use was NOT associated with short-term survival in multivariable models (P = 0.15), in an analysis the authors themselves show was underpowered and describe as suggestive of limited efficacy — a null on survival in a retrospective dataset, not a test of ileus resolution. For the two drugs named in the mined question, erythromycin and metoclopramide, no clinical trial in horses with post-operative ileus was found at drafting: their equine evidence is motility surrogates in healthy or experimental animals (erythromycin increased ileal and pelvic-flexure myoelectric activity after electrode-implantation surgery in 8 healthy horses, Roussel 2000, PMID: 10772107; metoclopramide and cisapride improved jejunal motility indices against a water control in 7 healthy Thoroughbreds, Okamura 2009, PMID: 18723200), which cannot carry a clinical ileus claim. Design class (a): randomisation and blinding are established by the carded van der Velden 1993 record (record wording 'randomized blind trial'; MeSH includes Double-Blind Method; indexed as a Randomized Controlled Trial) answering this shelf's own comparison — a non-lidocaine prokinetic versus control in horses after colic surgery. The stamp is POSSIBLE, not LIKELY, because that trial is single, from 1993, and reports no figures in its record, the only other clinical dataset is a null retrospective survival analysis, and erythromycin/metoclopramide specifically have no clinical-outcome evidence. Boundary: intravenous lidocaine evidence is NOT re-carded here — it homes on Shelf #179 (IV lidocaine CRI for post-operative ileus) and Shelf #835 (intraoperative lidocaine); the one carded record whose dataset includes lidocaine-treated horses (Smith 2005) is carded for its prokinetic-class analysis, in which the agents were not separated, and that limitation is disclosed on its card. Drafted Nov 10, 2026 (VetMed build, topic #797); all figures from the abstracts fetched and verified at drafting.