Colic Surgery - Would you do it?

[Michen]

Nope and I'm a vet and have been the one running anesthesia and scrubbed in to assist. If it's a possibility for your horse the refer them immediately and cut them early, don't hang on waiting to see if fluids and NSAIDS/sedation will solve it. The prognosis is much better if the abdominal lactate is low and there is no ischemia of the intestines.

Well yes but most people would rather run the risk of waiting to try and avoid surgery. I took my horse in fairly quickly so he could be operated on fast if needed, and I'm sure I remember the vet saying the peritoneal tap was key to indicate if and when it was necessary, of which I think he had about 3 over the day.

 

[druid]

Well yes but most people would rather run the risk of waiting to try and avoid surgery. I took my horse in fairly quickly so he could be operated on fast if needed, and I'm sure I remember the vet saying the peritoneal tap was key to indicate if and when it was necessary, of which I think he had about 3 over the day.

That's why I say refer immediately, then if things go south they're in the right place to under go surgery right away. If they come home as a medical colic, fantastic. By cut early I meant the first time it is recommended, so many times we PTS on the table due to poor prognosis when surgery had been offered 2-3 times over the course of the colic but only become an option for the owners when it came down to PTS or surgery and by then it was too late for a good outcome

 

[Michen]

That's why I say refer immediately, then if things go south they're in the right place to under go surgery right away. If they come home as a medical colic, fantastic. By cut early I meant the first time it is recommended, so many times we PTS on the table due to poor prognosis when surgery had been offered 2-3 times over the course of the colic but only become an option for the owners when it came down to PTS or surgery and by then it was too late for a good outcome

Ah yes I see what you mean. That's exactly why I took mine in even though vet at home said it wasn't essential at that point.

 

[Lurfy]

Thank you Druid that is very useful information.

 

[GoldenWillow]

Not with current horse as he has equine asthma and also it's 2.5+ hours travel from where we are. I'm doubtful if I would another horse with closer facilities as have seen a few recovering colic op horses none of which were successful long term and know of of few who either didn't survive the journey or operation.

 

[jenniehodges2001]

I was told once by a vet that came to see my horse that survival rates for colic are not that good. Here is a published paper on the subject, a five year study. https://beva.onlinelibrary.wiley.com/doi/10.1111/evj.12817

In particular the section entitle 'median survival times in long‐term studies on small intestinal surgery' is very though provoking. And early referral plays a huge part in the success rates also.

If I had a horse under say 12 that was fit and in work and had no huge health complications, and if that animal was insured then I'd probably go with surgery.

An older horse no way.

 

[eggs]

Had two home breds operated on for colic over the years. One was 3 years old and in hindsight I would have pts him at home but the attending vet thought it was worth taking him to the RVC. We found him colicking in the morning so don't know when it started. He came through surgery having had 3 meters of twisted intestine removed but was pts a few hours later as he deteriorated very rapidly with organ failure.

His brother was 6 when we was operated on. We took him straight to Newmarket as a precaution and were rather embarrassed when he strode off the lorry as happy as larry but decided to wait a while as he had got him there. About 45 minutes later he started to colic again and they operated to clear a blockage. He had a text book recovery and 9 years later has not had another episode and is out competing.

For me it would depend on the age of the horse and the severity of the episode.

 

[Murphy88]

That's why I say refer immediately, then if things go south they're in the right place to under go surgery right away. If they come home as a medical colic, fantastic. By cut early I meant the first time it is recommended, so many times we PTS on the table due to poor prognosis when surgery had been offered 2-3 times over the course of the colic but only become an option for the owners when it came down to PTS or surgery and by then it was too late for a good outcome

This. Nothing more frustrating than an owner changing their mind when you reach the point of PTS.

The main thing with colic surgery is that the outcome is determined by the type of colic - which part of intestine is affected, and is the blood supply cut off. Simple large intestine problems (e.g. colon in the wrong place) have >90% success and long-term survival. Most of those horses are home in 5-7 days, and back in work in 3 months. Small intestinal problems where the blood supply has been cut off (e.g. lipomas) short-term survival is closer to 60-70%, especially if intestine has to be removed, but some of those will go on to have intermittent colic episodes in the future and those tend to be the ones that might end up euthanized for colic weeks or months down the line. In most cases I know whether it's small or large intestine at the point I hand my colics to a surgeon, but it's not always clear. In cases where surgery is needed and owners aren't sure, I offer the chance to take the horse to surgery and look - makes no difference to the horse and allows us to give a much more accurate idea of the horse's chances. If it looks bad, the horse can be euthanized on the table, and if not the surgery continues.

In my experience horses cope remarkably well with the post-op period, even ones that normally live out 24/7. Certainly the racehorse colts are usually naughty enough by 24 hours post op that it suggests they aren't too bothered, and I have been run away with while hand-walking many a post op colic. But again depends on the type of colic - I've sent home colics at 3 days post-op and had others in the hospital for weeks. It is technically one month box rest but I encourage owners to hand walk and graze the horses as much as possible, and in sensible horses I'm happy for them to be turned out in a tiny paddock as long as they graze and don't run around. Studies show racehorses that have had colic surgery are as good as their cohorts, and plenty of my ex-patients are back either racing or at their previous level of performance.

My own horses are ancient now, but I would do surgery on my own if they were younger. But at the end of the day it's a lot of money without a guaranteed outcome, so I would always support an owner who decided against it.