Bouts of colic can be very serious and sometimes life threatening. There are a few tests that are generally used to determine whether or not a patient requires colic surgery.
- A rectal exam can be performed to evaluate the bowel that is within arms length and this can be helpful in determining the cause of the problem and the prognosis. If the exam reveals abnormal positioning of the bowel, the next step would be to pass a naso-gastric tube.
- A nasogastric tube allows the veterinarian to know if there is fluid accumulating in the stomach.This fluid, which is called reflux, can be a sign of a small intestinal obstruction or ileus. Ileus is a condition wherein the bowel is not moving as if it’s paralyzed. If there is no reflux, then mineral oil or some other laxative is given using a stomach pump. If the symptoms persist after naso-gastric tubing and analgesics, the patient will need an abdominal tap.
- An abdominal tap is performed to obtain a sample of peritoneal or abdominal fluid for testing.A clear, yellow fluid with little protein content is relatively normal while a reddish, cloudy fluid is evidence of a very sick horse. If the abdominal tap is normal, fluid therapy might resolve the problem but if the pain persists, an abdominal ultrasound may be warranted.
- An abdominal ultrasound is an evaluation of the intestines to determine motility or movement, called peristalsis, as well as relative location with the abdomen and in relation to other organs. In some cases, an intestinal stone is found, in which case surgery will be necessary to remove the enterolith, which is the medical term for stones that form inside the bowel.
For cases where the root cause is difficult to identify, we typically start the patient on fluids, manage their pain giving them time and essentially we let them tell us what the next step will need to be.
The horse is anesthetized and placed on the surgery table. The horse’s vital signs are continually monitored with an EKG, a pulse oximeter, and an arterial catheter is placed for blood pressure assessment and blood gas sample collection.The procedure begins with an evaluation of the location of the different segments of the bowel and any abnormalities are corrected. If there are any sections of compromised or dying bowel, a resection of those segments may be required. If an enterolith is found it is removed. An enterotomy is performed and the contents of the large colon are evacuated. This procedure allows the bowel to rest during the post-op period and improves patient recovery times.
After the abnormality has been corrected, the tissues of the abdomen are closed in 3-4 layers and the patient is moved to recovery. The nature of horses being what it is, some patients get panicky on recovery, as they emerge disoriented from the anesthesia. In an effort to insure their safety, we typically use head and tail ropes to assist them to standing. As soon as they are stable, a full body bandage is applied to relieve pressure on the abdominal incision and they are moved back to their stall to resume fluid therapy.
Patients are on antibiotics for 5-7 days and are typically re-introduced to feed on day two or three. The average colic surgery patient is discharged in 7 days and their recovery usually takes about 90-120 days.
Contact Mid-Rivers today for more information on colic surgery, a well-equipped facility with highly trained staff available 24/7 to assist your horse.