Speedy diagnosis and care key to colic survival

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A colic surgery under way with the large colon exteriorized by Dr Weston Davis. 
A colic surgery under way with the large colon exteriorized by Dr Weston Davis. © PBEC

One of the most dreaded words in horse care is “colic.” Fortunately for horses and their owners, colic surgery has come “a long, remarkable way” in the past 10 years, a leading US surgeon says.

Fear of colic is in the back of any horse owner’s mind. 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 stress or changes in the weather are among the numerous causes generally associated with colic.

Whatever the cause may be, the most imperative tip for successful treatment is the immediate identification of symptoms and veterinary involvement. Unfortunately, colic can be fatal, but early and appropriate treatment significantly improves outcomes and chances of survival.

Dr Robert Brusie, a surgeon with the Palm Beach Equine Clinic, said their vets try to help horses improve medically first, with colic surgery always the last resort. “With our clients, if the horse needs to go to surgery, we get an approximately 95% success rate.”

“In the last 10 years, colic surgery has come a long, remarkable way,” said Brusie. whose surgical specialties include orthopedic, arthroscopic, and emergency cases. He has been the head surgeon with PBEC in Florida for the past 20 years.

The biggest challenge in the treatment of colic is determining surgical versus non-surgical cases, says colleague Dr Weston Davis.

“We do not want to put a non-surgical case through the risk of anesthesia and the months of healing time, so we try to spare that at all costs and determine the surgical cases as accurately as we can,” Davis said.

“On the split side of that, we try to operate as quickly as possible on any horse that needs surgery and not miss any surgical lesion types.”

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.”
Surgery or not?

There are several methods for differentiating surgical cases. Beginning with a simple physical exam, the color of the gums, heart rate, gut sounds, and level of pain can all be supportive of surgical necessity. Additionally, a variety of tests may also include abdominal ultrasounds and rectal exams.

An abdominocentesis (or belly tap) is performed on every questionable colic case, where fluid is collected from around the intestines and analyzed for color and character. A variety of other laboratory tests are also run on the fluid with the purpose of quickly determining if the horse’s bowel is compromised.

If surgery is indeed a necessary step, horses with long-standing and intermittent colic will undergo an abdominal exploratory procedure that may be done with laparoscopy. This option can be done while the horse is standing as a minimally invasive way to examine the full abdomen.

In most acute cases, further steps must be taken and the horse will go under general anesthesia so the surgeon can make as small an incision as they can to perform the needed surgical correction. Surgery approaches a strangulating or compromised lesion – one that most people understand as a twist – and corrects it. In more severe or long-standing cases, the surgery can require a resection and an anastomosis procedure to excise a compromised or devitalized segment of the intestine.

After any surgery, there is a process of recovery. In traditional recovery, most horses will remain in the hospital to receive fluids until they are ready to eat and drink, along with receiving three to five days of antibiotics and five to seven days of anti-inflammatories.

After leaving the hospital, the horse is usually placed on a month of stall rest, followed by another month of turn-out in a small paddock. In between eight to 12 weeks, the horse will usually be fully recovered and ready to return to work.

Common colic signs:
  • Pawing
  • Rolling
  • Looking at abdomen
  • Sweating
  • Loss of interest in food and water
  • Absence of gut sounds in any of the four quadrants
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