Surviving colic: Standing keyhole surgery saves dressage horse

Beatrix ready to return to work.
Beatrix ready to return to work. © Jody Stoudenmier

Fear of colic is in the back of many horse owners’ minds, but whatever the cause may be, the most important step any owner can take is to recognize the symptoms as early as possible and immediately call their veterinarian.

Characterized by abdominal pain or problems with the gastrointestinal tract, colic is something that often arises unexpectedly and from many different origins. Spoiled feed, abrupt changes in feed, parasite infestation, sand ingestion, lack of water consumption, and even excess stress or changes in the weather are among the numerous causes generally related to colic.

Pawing, rolling, looking at abdomen, sweating, loss of interest in food and water, and absence of gut sounds in any of the four quadrants are some of the telltale signs of colic development. Unfortunately, colic can be fatal.

Stall rest when recovering from injury can also be a catalyst for colic, as Florida dressage rider Jody Stoudenmier knows only too well.

Stoudenmier owns an 11-year-old American-bred Dutch Warmblood mare who joined her string at the end of 2016 and has competed through the Intermediate II level. Sidelined by a suspensory injury last year, Beatrix was prescribed stall rest to aid in her recovery but suffered from six bouts of colic that were resolved without surgery before she was referred to Palm Beach Equine Clinic (PBEC).

“When she was recovering from her injury we tried everything to prevent her from colicking – diet, medications, hand walking – but, nothing seemed to be working,” Stoudenmier said.

PBEC’s surgical team leader Dr. Robert Brusie in action.
PBEC’s surgical team leader Dr Robert Brusie: “In the last ten years, colic surgery has come a long, remarkable way.”

It was then that PBEC’s board-certified surgeon Dr Weston Davis, suggested a laparoscopic surgical approach.

“Her colic had never progressed so far that we needed to do surgery before,” Stoudenmier said. “But, at that point, I was open to anything!”

The procedure that Davis suggested was an endoscopic ablation of nephrosplenic space. In layman’s terms, as a result of Beatrix’s colic, her colon was essentially getting caught or entrapped over the nephrosplenic ligament, which connects the left kidney to the spleen. When the colon is entrapped in this position, its contents cannot move through it and the colon becomes distended, causing the horse considerable pain, and the inevitable colic.

The solution was to close or perform an ablation of the nephrosplenic space to prevent further entrapment. The procedure can be conducted endoscopically where the horse does not have to be anesthetized, but undergoes a standing surgery with sedation and local anesthesia. A small incision is made in the left flank and the laparoscope is inserted through a smaller incision close by. The nephrosplenic space is then sutured closed so that the trough that forms the space between the kidney and spleen is obliterated and can no longer entrap the colon.

On October 9, Beatrix underwent a successful ablation of the nephrosplenic space at the hands of Dr Davis.

“In the past, I have had several horses undergo surgery where they had to be anesthetized and it was very difficult to get them standing again after surgery,” Stoudenmier said. “We did not have that worry with Beatrix and the approach absolutely made a difference in her recovery.”

Beatrix remained at PBEC for a week and a half after surgery to jump-start her recovery before returning home to Stoudenmier.

Davis paid a visit to Beatrix in mid-November to perform an ultrasound, together with Beatrix’s own veterinarian Dr Robert Scott of Scott Equine Services in Ft. Lauderdale. Scott approved the mare to return to work, and Stoudenmier has begun to introduce trot work into Beatrix’s routine. She is optimistically expecting a full recovery: “She looks super and everything looks good for the next two months. My goal by the end of the season is to get her back in the show ring.”

Palm Beach Equine Clinic’s surgical team leader is Dr Robert Brusie, is a nationally renowned, Board-Certified surgeon. Brusie’s surgical specialties include orthopedic, arthroscopic, and emergency cases. Brusie has been the head surgeon with PBEC for the past 20 years.

“In the last ten years, colic surgery has come a long, remarkable way,” Brusie said. “With our clients, if the horse needs to go to surgery, we get an approximately 95% success rate. We attribute that to the client’s excellent care of their horses, as well as their knowledge to contact us immediately. That being said, colic surgery is always the last resort. We try to help all horses improve medically first.”

Palm Beach Equine Clinic


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