Last Updated on March 15, 2022 by Allison Price
Would you be able to quickly make a decision if your horse required emergency colic surgery? This article will walk you through the entire process, from start to finish. We’ll explain the differences between “medical” and “surgical” colic, how veterinarians distinguish them, share survival rates and complications, how long it takes, and help you understand your role and make the right decisions for your horse.
According to the latest estimates, 5-10% of American horse population suffer from colic each year. The vast majority (990-95%), however, are mild cases that can be managed on the farm with minimal medical intervention. This leaves about 5-10% of colicky horses in need of being referred to a medical facility to undergo surgery. What is the difference between horses who respond well to standard pain-killers, sedatives and fluids?
Medical vs. Surgical Colic
Colic is not all the same. There are many things that could go wrong in horses’ abdomens. Remembering that “colic” refers to abdominal pain, and not to a particular section or problem, it is understandable that a horse experiencing belly pain could be suffering from:
- Medical colic (or ulcers in the stomach) can occur.
- A strangulating obstruction of the small intestine (a surgery colic) or
- Impaction of the large colon (a medical OR surgical colic) or another problem
How can your vet tell if a colic is medical? You can treat it at home, or if it is surgical? Your vet will perform a thorough examination, ask questions, and begin treatment. This gives clues about the nature of the episode.
If your horse has had colic surgery in the past year, it is possible that he may have “adhesions”. This refers to a condition where parts of the bowel stick to other parts of the bowel or to other organs. It might require another surgery to fix. Exemple 2: If your horse’s stomach is filled with a lot of liquid or gas, it could be a sign that there is a blockage. (Rectal palpation can also be used to detect blockages such as twists, displacements, impactions, and displacements. If your vet gives you pain medication, but your horse continues to feel the pain or returns to its original state, this is another example. This could indicate that surgery may be necessary.
However, if your horse has been seen out on grassy fields in recent times, the vet may suggest simple gas colic. Your horse’s heart rate should be between 28 and 42 beats per hour. If his gums are pink and moist during examination, then your horse’s cardiovascular condition is likely to be good. If he is asking for food or passing manure and wants to play with his friends, he may have taken enough painkillers.
If your vet feels the need to refer you immediately to an equine clinic for additional medical support or emergency abdominal surgery,
- If there is evidence of obstruction, consult your doctor immediately.
- If you are experiencing persistent or severe abdominal pain, consult your doctor immediately.
- If your horse seems to be in circulatory shock, you should immediately call the vet.
- If there is no response to medical treatment,
Colic Surgery Survival Rates & Post-Op Performance
In the past 20 years, there have been great advances in the technique of colic surgery and safety. Horses are now more likely to survive and thrive after this procedure than ever before. The current survival rates of horses undergoing colic surgery are between 80 and 95%, according to Practical guide to Equine Colic published by Louise Southwood in 2013. The type of lesion, the location, the severity, and the method of treatment will all affect the survival rate. It also depends on the surgeon and the region in which the surgery was performed. The most important factor in determining whether a horse who has had colic surgery is alive or dead is its owner’s early recognition and prompt referral by the veterinarian for a full-service equine hospital.
Many horse owners believe older horses shouldn’t or can’t have colic surgery. However, many horses without health issues are able to tolerate it. Dr. David Freeman presented at the American Association of Equine Physicians (AAEP) Annual Convention 2014. He shared that older horses, even those who are in their 20s or 30s, can handle general anesthesia and colic surgery with ease. Their postoperative survival rates are comparable to younger horses.
Dr. Freeman stated that most horses recover from colic surgery at their highest level of performance, regardless of whether they are competing in Grand Prix dressage, show jumping, racing, eventing or Grand Prix dressage. Even for older horses, survival rates are high and it is very likely that a horse who has undergone colic surgery will recover well enough to resume his performance career. Now it is time to look at other factors that may impact the decision to consent or deny colic surgery.
Colic Surgery Costs
Cost of colic surgery depends on the type of colic, severity, location, and other factors. Dr. Southwood explains that the cost of surgical management in the United States, which included emergency admission and basic postoperative care, ranged between $5,000 and $10,000 in 2012. In most cases, the facility will require a 50% deposit at the time of admission. SmartPak’s ColiCare ™ Program in 2016 revealed that the average cost for colic surgery, including post-op care and pre-op, was $7,800.
No matter if your horse is part of a colic reimbursement program such as ColiCare, or has colic insurance, all owners and those responsible for the care and management of horses must be aware of the policies and terms. Before you make a potentially life-threatening decision, here are some questions to consider:
- Do I need to obtain prior approval from the company before consenting to colic surgery
- Do I have to pay the bill, or does the company pay the vet/hospital directly?
- What is the deductible and co-pay?
- What could make the agreement invalid, such as the failure to disclose previous colics?
- How can I file a claim?
- How can I file a claim? (That is, do I have to submit paperwork and bills by a specific date?
- Is there a maximum payout? Or is it per event?
It is difficult to answer “yes” when a vet asks you if surgery is possible. This is especially true if your horse is insured or enrolled in a reimbursement program. You can save time and anxiety by understanding all the details and adhering to all requirements.
Complications and the Surgical Procedure
You can expect your horse to arrive at the facility quickly after you have unloaded him, checked-in, and arrived. Expect some of the same tests, such as rectal palpation and nasogastric inflation, to be repeated. This is because a change in the horse’s condition helps new vets determine whether your horse needs surgery.
Horses that are stable and seem unaffected upon arrival may be subject to additional diagnostic tests, including bloodwork, abdominocentesis, aka “belly tap”, and abdominal radiography (Xrays or ultrasound). If surgery is necessary, an intravenous catheter can be placed in either one or both of the jugular veins to allow for IV fluids to be administered.
Surgery can be used for diagnosis and treatment. Horses with a specific lesion that has not been identified may be brought to surgery to determine why they are not responding to medical treatment. Some hospitals offer a view window that allows owners to see the entire procedure, even after the horse is under general anesthesia. There may be “booties” covering the horse’s hooves or covering them, an endotracheal tube in his nose, EKG wires, blood pressure monitors, and either a cut and scrubbed abdomen, or one that is already draped.
An incision is made into the ventral (underside of the abdomen) via a small incision, which is usually made between the sheath/udder and navel. Each surgeon has a unique method for exploring the abdomen and intestinale. This ensures that no section is missed or lesion is overlooked. As necessary, corrections are made, including removing impactions, untwisting gas, untwisting stool, returning a section back to its original location, and resecting (removing) any other bowel section. After the procedure is complete, the horse is taken to a special, padded recovery area to wake up from anesthesia. He is then taken to his stall. Colic surgery can take anywhere from one to four hours depending on the time it takes to locate and fix the lesion.
Another episode of colic is the most common colic complication after colic surgery. This happens in 25 to 35% percent of horses who have had colic surgery. Other complications include adhesions and ileus, which is the absence of peristalsis (the normal wave-like movement in the intestine that propels food forward), problems at the incision site or where the IV catheter was inserted, peritonitis (inflammation of the abdomen cavity), diarrhea, laminitis, pneumonia, and others. Some complications can occur while your horse is still in hospital. Others occur after your horse has returned home. A member of the surgical team will meet with you to review your discharge instructions. They will also send you a copy home and ensure that your regular vet has it. These instructions will help you care for your horse, as well as what to do if something is not right.
Colic Surgery Recovery and Care
General monitoring, care for the incisions, feeding, exercise and any medication are some of the most common discharge instructions. General monitoring involves observing your horse for signs such as EDUD (Eating, Drinking and Urinating), as well as checking that he is BAR (bright and alert), that he has regained any weight lost, and that colic is not present. You should inspect the incision daily for any signs of infection, such as redness, discharge, excess swelling, or excessive swelling. Also, you should check for “dehiscence,” which is when the edges of the sutures split or become open.
Your horse will be gradually reintroduced to his normal diet by the surgical facility. They will also provide clear instructions as to how often and what you should feed him, while you restore him to full nutrition. Your horse’s regular diet may be changed depending on the cause of colic and the results of surgery. If a horse has an ileal obstruction and is currently on coastal Bermuda hay, his veterinarians might suggest that he switch to a different type of hay with less tendency to cause obstructions.
The typical exercise schedule begins with four weeks of stall relaxation, during which your horse can be handwalked or handgrazed. Then, four more weeks of turnout are required in an unattached stall. If all goes well, horses can be allowed to turnout in full with other horses after the 60-day, or two-month, period. This is a time when light longeing and riding are allowed. Full training will resume at the 90-day mark.
Answering the most frequently asked questions about colic surgery, such as when a horse requires surgery and medical care, what factors are involved in making the decision for each horse and what to expect during and afterwards, will help to remove some of the mystery surrounding this procedure, which can lead to better outcomes for both horse and owner.
