There is no easy answer when it comes to deciding to go through with colic surgery or not. Horse owners usually have to make this decision quickly in the dead of the night to prevent their horse from suffering further. Even if the owner decides to go through with the surgery there is no certainty as to what the outcome will be, whether the horse will survive and return home or be alive in a year. Will he be able to perform at the level that he did before, or will he live a quality life after surgery?
In the midst of this crisis, there is rarely enough time for owners to research all they need to know. I feel it important to describe colic surgery and answer some of the more frequently asked questions. The goal is for horse owners to go into the process better informed.
Why Do Some Colics Require Surgery?
Colic is a phrase that’s used to describe all manner of equine abdominal pain. Causes of colic range from a build up of gas, impactions to enteroliths (“stones” that form blockages in the large intestine) and various twists in the large or small intestine.
The cause of colic is the main question but research has shown that some colics can not be treated medically i.e gastric tubing, walking, lunging, drugs and other non-invasive methods. Torsions or twisted intestines need to be manually untied and in some cases dead or damaged intestine is removed. Enteroliths usually always require surgical removal from the large intestine.
Here are some points to consider when faced with colic surgery:
- Diagnosis & Prognosis. What is the vet think is wrong with your horse? Is it a complicated surgery? What is the prognosis? Is this a recurring problem? What are the risks? Worst case scenario?
- Relative risk. Colic surgery requires general anesthesia and even though modern techniques are used there is still a risk of injury during recovery.
- Cost. Can you afford the colic surgery? Do you have insurance for your horse’s vet bills? Does the coverage include colic surgery?
- Temperament. Is your horse a good colic surgery candidate from a temperament standpoint? Temperament of a potential surgical candidate is important. Some of the worst candidates are intense performance horses that simply cannot tolerate being locked in a stall for the weeks following surgery.
- Age and other conditions. Older horses and horses with other underlying diseases tend also not to be the best candidates for colic surgery.
- Distance & Travel to Clinic: How far is the Equine hospital from the horse’s location? Will your horse survive the trip?
- Stress: Intense colic surgery cases are stressful experiences for horse owners, especially if there are complications in the recovery room or post-operative infections. It can be a be of a rollercoaster of emotions for the owner during this time.
Arriving at the Hospital
Experienced handlers will be on hand to help unload your horse and take him to an examining area when you arrive. The attending veterinarian will complete a thorough examination to confirm that surgery is needed. If your horse is insured now might be a good time to call your insurance company to let them know what is going on.
Some owners prefer to stay with their horse during the surgery; however HorseUAE’s Editor, who has experienced a colic surgery, only managed to stay for the administrating of the anaesthetic and found watching the horse go down very stressful. If you watch bare in mind you will see your horse suspended belly-up with tubes coming out of him or her
The question uppermost on your mind, naturally; Will my horse live? Will he recover okay?
As with any human surgical procedure, colic surgery has its share of risks and complications. No surgery is 100% guaranteed to be successful, and no surgery is guaranteed not to have post-operative complications.
Survival rates for many types of colic operations are high, but things can go wrong at any time during this process. Very ill horses may have trouble surviving anesthesia. Horses can be injured during recovery. For horses with more severe conditions, the five days following surgery are a critical time and require intense medical treatment and monitoring as well as large volumes of intravenous fluids and other medications
Endotoxic shock: Colic is a disorder of the digestive system, and in some cases, part of the intestine suffers damage or dies. The affected bowel can release bacteria, which in turn release endotoxin (a lethal toxin) into the system. The endotoxin can depress the heart and inhibit circulation to the entire body and affected bowel, thereby starving it for oxygen and nutrients. In short, it can kill the horse.Endotoxic shock is not associated with surgery per se; it can occur even before a colicky horse gets to the operating room. A heart rate of 80 beats per minute or more is a telltale indicator of severe shock.Endotoxic shock isn’t always treatable, and that’s why it’s such a dangerous complication. The existing treatment methods aren’t effective in all cases. Seeking treatment early is your best defense against your horse’s developing endotoxic shock.
Peritonitis: The risk of infection is present with all surgeries. Colic surgery, which often entails removing fecal material out of opened bowel, can be especially risky. Veterinary surgeons are ultra-careful when they clean out the bowel and administer appropriate doses of antibiotics to reduce the risk of infection, but peritonitis still can develop. A raging infection can prove fatal.
Adhesions: As the injured bowel heals, it can form scar tissue, particularly at an incision site. This scar tissue can adhere (thus the name) to something it shouldn’t—even itself. Adhesions can obstruct blood flow or the intestines themselves, and cause chronic colic and pain. A second surgery might be needed to break down the scar tissue. In some cases, the surgeon will opt to bypass the adhesion entirely by rerouting the affected section of bowel.
Ileus: Endotoxic shock, infection, or bowel distention can cause ileus, a condition in which the bowel ceases its normal motility (natural movement). Veterinary surgeons can’t predict with certainty which cases will develop ileus, but several measures exist for attempting to jump-start the bowel and to prevent additional complications.
Incisional hernia: Contamination at the incision site can impede the healing process and lead to the development of an incisional hernia, a painless bulge in the abdominal wall that’s visible externally. Incisional hernias can be of varying sizes; if it’s just a small “bubble,” your veterinarian might advise that it be left alone. A large hernia, however, eventually could trap a portion of bowel and cause another surgical colic episode; such hernias usually require surgical repair.
Laminitis: Veterinary experts believe that the release of proteins and endotoxins, which can be released during intestinal disease, could be associated with colic and laminitis. Unfortunately, the incidence is erratic. It’s impossible to predict a colicking horse’s chances of developing laminitis. Some horses in severe shock don’t founder, and others in relatively good shape do.
The horse world is full of misconceptions about colic surgery. It is true that 30 years ago, successful outcomes were rare. Since then, though, there have been great strides made in equine surgical and anesthetic technique. Today many conditions carry a very good prognosis.
As with humans, the better shape the horse is in before the surgery, the better his chances of coming through the anesthesia with no problems and bouncing back in a relatively short period of time.
The best idea we have come across to help the decision process is to have a plan for each of your horses with respect to colic surgery, before being faced with having to make the decision. Learn as much as you can about the costs, risks and benefits of the colic surgery. It may be a good idea to research equine insurance options available from companies like Debuyl Insurance.