Colic surgery

silu

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A friend has asked me if I think it is right to probably have to put her horse through colic surgery.

I have had horses a long time but by no means an expert. Frankly I don't personally know of any horses which have returned to exactly how they were pre the need for surgery certainly from a competiton point of view. Most horses I've known have either returned eventually to competition but at greatly reduced standard or more common been retired from competing, maybe managed light hacking and sadly more often than not continued to have digestive problems.

Personally I am for quality not quantity of life and am loathed to encourage my freind to put her horse through serious surgery without a good % positive outcome. Perhaps those on here have knowledge that horses can really be as good as new post surgery and be able to enjoy their lives/compete at high levels.
 
My horse was not a high level performer, he competed at RC level, hunted and showed successfully in workers before and after surgery with no ill effects once he regained full fitness. He lived a completely normal life until he suffered another catastrophic colic, probably due to the breakdown of scar tissue, 11/12 years later he was then 22, until then he had a few minor colics usually feed related and had to be managed a little more carefully than the others.

His surgery was complicated and he actually underwent a second op 2 days after the first, he did then not improve as expected and was just about to be pts when they took him out for some grass en route to the injection, he ate that, his guts started and he was given a reprieve, coming home about 10 days later.

Whether I would put another through it I have no idea, until you are in the position to make that choice it is hard to say and the vets will be guiding you, age would come into it, mine was a fit 10 year old I would not consider it for an old horse myself but some have undergone surgery in their 20s.

There are some top horses that came back after surgery, SJs and eventers but off the top of my head I cannot name them. If you search on here there are a few recent success stories, paint me proud being one about 12 months ago, there is also one very recent who is doing well.
 
The stats I have seen lately are that 50% where no gut was removed and 70% of ones where gut was removed are dead of surgery or continuing colic within one year. I would not put a horse of mine through it.
 
cptrayes, please would you quote your reference for those statistics.

My understanding (from what the referral vets said to me when one of my ponies had colic surgery) is that the prognosis varies greatly from one type of colic to another. Also that once a horse has had colic (whether surgical or not), they are at greater risk of colicking again.

Apart from the prognosis for the individual animal, for me I think it's really important to weigh up the age of the animal, as well as knowing that the owner/carer goes through a huge amount of emotional turmoil each day during the recovery period and thereafter, hoping that the horse is going to be ok when they go to see them. Every time the horse rolls, the heart sinks wondering whether it's a normal roll or a sign of colic. Nothing is ever the same.

Then there are the financial implications and uncertainties. Vets can give an idea of price for if things go ok, but if things aren't straight forward the costs can soon add up in terms of extra antibiotics if infection sets in, repeat surgery etc. Can soon reach insurance limit, and go beyond.

And then there's the physical stuff like how much time an owner can spend leading a horse out for inhand grazing, how long the horse has to be stabled for (and any associated costs) and the gradual rehab. And also how well the horse adapts to being restricted to a stable or yard while the wound is too weak for them to be allowed to move freely.

I'm a happy hacker and my pony has come back into pretty much the same level of work she was in before (we're 2 years on now). However, instead of a basic £3K surgery, it was £5K because of an incisional infection. She then went on to develop laminitis which I believe was probably caused by being on antibiotics for so long, and it took near enough a year after that for her to become her new normal, and so now I have the worry of colics and laminitis.

One local horse had colic surgery (not sure what type) and was then sold and went on to be shown successfully by a professional producer.

It's a tough decision, but I definitely wouldn't put an old horse through it. Beyond that I'm not sure.

Sarah
 
cptrayes, please would you quote your reference for those statistics.

My understanding (from what the referral vets said to me when one of my ponies had colic surgery) is that the prognosis varies greatly from one type of colic to another. Also that once a horse has had colic (whether surgical or not), they are at greater risk of colicking again.

Apart from the prognosis for the individual animal, for me I think it's really important to weigh up the age of the animal, as well as knowing that the owner/carer goes through a huge amount of emotional turmoil each day during the recovery period and thereafter, hoping that the horse is going to be ok when they go to see them. Every time the horse rolls, the heart sinks wondering whether it's a normal roll or a sign of colic. Nothing is ever the same.

Then there are the financial implications and uncertainties. Vets can give an idea of price for if things go ok, but if things aren't straight forward the costs can soon add up in terms of extra antibiotics if infection sets in, repeat surgery etc. Can soon reach insurance limit, and go beyond.

And then there's the physical stuff like how much time an owner can spend leading a horse out for inhand grazing, how long the horse has to be stabled for (and any associated costs) and the gradual rehab. And also how well the horse adapts to being restricted to a stable or yard while the wound is too weak for them to be allowed to move freely.

I'm a happy hacker and my pony has come back into pretty much the same level of work she was in before (we're 2 years on now). However, instead of a basic £3K surgery, it was £5K because of an incisional infection. She then went on to develop laminitis which I believe was probably caused by being on antibiotics for so long, and it took near enough a year after that for her to become her new normal, and so now I have the worry of colics and laminitis.

One local horse had colic surgery (not sure what type) and was then sold and went on to be shown successfully by a professional producer.

It's a tough decision, but I definitely wouldn't put an old horse through it. Beyond that I'm not sure.

Sarah

I was nodding as I read so much of this because a lot of it mirrors my experiences. It's easy to underestimate the emotional strain on the owner, but it can be a very big issue & I know that, 4 years later, I only need to see Jim do certain things or look a particular way & I feel sick. "Nothing is ever the same" is an understatement :( . He was never a competition horse to begin with, though he did school well & it was something we both enjoyed. I don't think he's worked at the same level since, but to be honest that may be as much because I will no longer push him at all - every day is so precious that I don't want to risk asking more than he can comfortably give.

I don't think there's a right or wrong decision. You have to way up all the factors in each individual case & do what you believe is right & even then I think you'll have times when you question your decision.
 
cptrayes, please would you quote your reference for those statistics.
Sarah

Those stats are freely available online if you use Google.

If you want a quicker ref, search on this forum under 'Zeus' and you will find that 50/70 is the prognosis that Zeus's owner was given prior to surgery. Thankfully, at the moment, Zeus is in the right 50%.
 
This is something i have always considered if i happened to be unfortunate enough for one of mine to suffer surgical colic.All the cases i have known of have not been greatly positive which is why i have in advance decided against future colic surgery,and i have discussed it with my vet who is aware of my view while in a rational frame of mind (may not be the case in an emergency where heart could rule head). Of the cases i know of who did pull through surgery,they never completely recovered,or they suffered a fatal relapse.However,i am sure there are many positive experiences on this forum which counteracts the negative.
 
the stats I saw were 80% survival to discharge and just slightly lower to continued survival, not including grass sickness. Seems good odds to me. Problem is they can't tell what is in there before they go and that's going to affect prognosis.
 
Thanks Cptrayes,

what I was really trying to ask you for was either the authors' names and/or the title of whatever scientific paper or review article you have seen giving those statistics. I'd be very interested to look it up.

Thanks again,

Sarah
 
This is quite an old paper but gives a few percentage survival figures looking retrospectively at 649 horses (Utrecht, Netherlands) so a reasonable sized study:

http://www.ncbi.nlm.nih.gov/pubmed/12774977

I'd hope (but don't know) that survival would have increased even more since then with advances in vet surgery. Will be interested to hear any more recent references.

Sarah
 
Personally I would never go down the surgery route for colic as so far of the ones I have known the stresses have far out weighed the benefits most lived less than a week post operatively and the few that did survive were seriously compromised either dying a few months later from colic or unable to work again one was a true survivor and made old bones but that isnt a very good outcome for the pain and suffering inflict necessarily by putting them through surgery. I have had major abdomenal surgery and I wouldnt like to put any animal through that pain when it wouldnt understand it would be relatively short lived weeks rather than months but still distressing for the horse
The owner of the surviving horse agrees with me she says if she knew then what she knows now she would never have done it
 
My HoL (Grade A SJ) has had 2 colic surgeries.

The first aged 19, pendunculated lipoma, displace caeceum, 3 metres small intestine removed, resection. In hospital 10 days. Returned to full competion. Never colicked again until...

Second surgery last October aged 25, pendunculated lipoma had grown back, less complicated surgery this time as no intestine needed removing. Ready to come home after just 4 days.
Then developed massive life threatening hock infection on the day we were to collect him, strange aeromonas bacteria never found in a horse before. Ended up having 2 further general anaesthetics within a few days, arthroscopy, numerous standing hock flushes.
Amazingly resilient horse came through all this and returned home after 3 weeks. Was allowed out in tiny field pretty much straight away, wearing belly band, to keep hock moving. Jumped out of field and did a tendon cahooning around, the idiot. Am hopeful that he'll be able to do some hacking when tendon fully mended - but that's all he'd be doing at his age anyway.

When the vet came out for the second colic and we were debating what to do, he encouraged us to take him for surgery and give him the chance. Horse practically dragged us up lorry ramp as if he knew where he wanted to go.

He is a unique pesonality - what was right for him may not necessarily be right for all our other horses.

Here's mine out in the field earlier this year - a few months after surgery - not looking too shabby for a 26 year old who's had 2 colic surgeries.

551537_10151533004647521_503344539_n.jpg
 
I don't think it's anyone's place but the owners to make a decision over colic surgery.

There's a lot of factors that affect such a decision, and when you're faced with it, there is usually a timer ticking. I went through with surgery, mainly because I idolised that horse enough to warrant the recovery, and I knew I would never forgive myself if I didn't give him every last chance. As it was, he was a prime candidate for surgery (young, relatively fit, no other health issues), so the surgeon agreed they could go ahead. He did say that had there been any other factors involved, they wouldn't have touched it.

Having looked into colic since, and spoken to someone who used to be a veterinary nurse, the prognosis for more severe cases isn't great. It's also a long, and rather nasty recovery period for the ones that do pull through. As it is though, regardless of statistics, if your horse of a lifetime comes down with life-threatening colic right in front of you, it's hard not to be swayed.

Bottom line, I guess, is that both the surgery and the recovery aren't great. However you can't just put these things into black and white. Maybe it will work, maybe it won't (I still don't think I'd have done it any other way to be honest, despite the outcome), but that's her place to decide.
 
My HoL (Grade A SJ) has had 2 colic surgeries.

The first aged 19, pendunculated lipoma, displace caeceum, 3 metres small intestine removed, resection. In hospital 10 days. Returned to full competion. Never colicked again until...

Second surgery last October aged 25, pendunculated lipoma had grown back, less complicated surgery this time as no intestine needed removing. Ready to come home after just 4 days.
Then developed massive life threatening hock infection on the day we were to collect him, strange aeromonas bacteria never found in a horse before. Ended up having 2 further general anaesthetics within a few days, arthroscopy, numerous standing hock flushes.
Amazingly resilient horse came through all this and returned home after 3 weeks. Was allowed out in tiny field pretty much straight away, wearing belly band, to keep hock moving. Jumped out of field and did a tendon cahooning around, the idiot. Am hopeful that he'll be able to do some hacking when tendon fully mended - but that's all he'd be doing at his age anyway.

When the vet came out for the second colic and we were debating what to do, he encouraged us to take him for surgery and give him the chance. Horse practically dragged us up lorry ramp as if he knew where he wanted to go.

He is a unique pesonality - what was right for him may not necessarily be right for all our other horses.

Here's mine out in the field earlier this year - a few months after surgery - not looking too shabby for a 26 year old who's had 2 colic surgeries.

551537_10151533004647521_503344539_n.jpg

Incidentally,how is your old boy bred as he looks very like my WB/
 
You might be interested to see this paper "Sporting activity following colic surgery in horses: A retrospective study" (Equine vet. J. (2011) 43 (Suppl. 40) 3-6) , I think the most recently published on the subject, whose results were:
"The survival rates (%) at 6, 12, 24, 36, 48 and 60 months were 95.3, 86.6, 80.9, 76.9, 62.1 and 57.6, respectively. A large majority of horses (86.1%) resumed or started
sporting activities after colic surgery. The proportion of horses that the owners believed to achieve the same or better performance after surgery was 83.5%. In 89.9% of the cases, owners stated that they would recommend colic surgery.

I personally think that there's no right or wrong answer and agree that it's down to each individual case- I've seen a lot of older horses come through surgery and live for many years more, but equally young and fit horses have too much gut compromised, or get all the post-op complications and have to be PTS. I would almost always try, as long as I was in a position to put the after care in when the horse returned home.
 
I am of the no surgery route but then I think of the horses that have made it.

A racehorse that had not run before had colic surgery as a 3yo. Came back to us for further recovery. I think it was 2009, maybe 2008. At any rate she went on to win and runs flat and hurdles. Was 3rd on Friday in England. So she seems to be doing well. I also know 2 mares that had major surgery, one a c section and one for a uterine torsion. While no not colic surgery, still has the chance for damage of scar tissue. They both went on to produce more foals and have had no issues. Then I'm reminded of the 3 others that went in for colic surgery and were misreable in recovery and didn't make 3 months. So while I'd say I'd never do it, who knows what I'll do if the time comes.

Terri
 
You might be interested to see this paper "Sporting activity following colic surgery in horses: A retrospective study" (Equine vet. J. (2011) 43 (Suppl. 40) 3-6) , I think the most recently published on the subject, whose results were:
"The survival rates (%) at 6, 12, 24, 36, 48 and 60 months were 95.3, 86.6, 80.9, 76.9, 62.1 and 57.6, respectively. A large majority of horses (86.1%) resumed or started
sporting activities after colic surgery. The proportion of horses that the owners believed to achieve the same or better performance after surgery was 83.5%. In 89.9% of the cases, owners stated that they would recommend colic surgery.

I personally think that there's no right or wrong answer and agree that it's down to each individual case- I've seen a lot of older horses come through surgery and live for many years more, but equally young and fit horses have too much gut compromised, or get all the post-op complications and have to be PTS. I would almost always try, as long as I was in a position to put the after care in when the horse returned home.



Interesting stats, thankyou. I see LIverpool University are advertising that they now get 80% through to going home, so presumably the statistics of those alive at certain time periods are a percentage of the 80% that lived to go home. If my sums are right, then that would mean that only about 60% are still alive two years after surgery, and many of those alive, as well as those that died in that time, will have gone through even more pain and unhappiness.

I don't believe horses know or care about time that they 'could' have lived. I wouldn't put one of mine through it and every time I go on holiday I leave my vets with that as a written instruction.

A horse that I had to give away but still loved was operated on a month ago. No gut was removed. He recovered and was home for two weeks, too uncomfortable from the wound to lie down. At two weeks he began to lie down again. Then he colicked again and was put down. He lived the last two weeks of his life in pain and misery. I am still struggling to come to terms with that, but I no longer owned him and it was not my decision to make.
 
Interesting stats, thankyou. I see LIverpool University are advertising that they now get 80% through to going home, so presumably the statistics of those alive at certain time periods are a percentage of the 80% that lived to go home. If my sums are right, then that would mean that only about 60% are still alive two years after surgery, and many of those alive, as well as those that died in that time, will have gone through even more pain and unhappiness.

I don't believe horses know or care about time that they 'could' have lived. I wouldn't put one of mine through it and every time I go on holiday I leave my vets with that as a written instruction.

A horse that I had to give away but still loved was operated on a month ago. No gut was removed. He recovered and was home for two weeks, too uncomfortable from the wound to lie down. At two weeks he began to lie down again. Then he colicked again and was put down. He lived the last two weeks of his life in pain and misery. I am still struggling to come to terms with that, but I no longer owned him and it was not my decision to make.

But do they not potentially suffer pain any time they go for surgery/ treatment one of mine went in for what should have been a fairly minor standing surgery. He suffered numerous injuries while there, including a very serious mouth injury caused, probably, by the rough use of a chiffney, his nose was very sore for over a week caused by twitching , his uninjured leg was cut numerous times by clippers when clipped for scanning.
The injury to his mouth was so bad he could not drink for 10 weeks, he did eat but not always comfortably, he was mentally so distressed by the workup he was given, which I had been told would not happen so I did not stay, that he still, 5 months later, gets upset by anyone he does not know going near his hind legs.
The one that had colic surgery bounced back far more quickly, had no lasting mental trauma and did live a good life, I know the recent experience is, hopefully, very rare and I am still in contact trying to get to the bottom of how badly he was treated, it may go further if I do not get a satisfactory response.
 
i have a now 22 year old who had a lypoma round his small intestine. he went down with colic exactly a week after i lost my dad to cancer so i was in a very vunerable state. i bred him so knew his history, he was 17 when he had the surgery and had never had colic in his life so when he was sent to liverpool i agreed to surgery, he was very uncomfortable after, and was given pain killers accordingly, but was happy eating within 24 hours post op and sent home within 1 week. he had a little niggle about a week later and we made the 30 mile trip back to liverpool where he stayed for 2-3 days under watch but sent back home a lot happier. he had time to recover and restricted turnout in a very small area for some time after untill he was ok to go back out with the other horses. he's fine now, he's had a couple of days when i thought he looked a little grumbly with his tummy and i have to watch the quantity he gets per feed but he's fine, happy and i'm pleased to say he's had another 5 years of very very good quality life. yes he's retired but thats more down to the fact he was a very quirky horse to ride before and he was suposed to be rested for 6 months post surgery, and to be honest i chickened out of getting back on board (i'm fully of arthritis from falls over the years as it is) i feel that had it not happed so soon after loosing dad i might have viewed things differently but glad i did go through with it now. hopefully my old man had many years left in retirement, his dam is 30 this year and only just looking her age. i feel he's given me many years of enjoyment and its only right i look after them in their old age (i do appreciate im lucky to have my own place so that helps considerably)
 
No I wouldn't after seeing two horses at my yard die after op with in a year.

One kept colicing when being brought back into work so was retired, coliced if stabled too long and in the end got lami and couldn't be stabled because if the colic so was pts


The other got an infection and didn't recover form it.

Both owners said they would never put another horse through it.
 
Thanks to all who responded to my post, some very interesting and thought provoking replies, certainly not a black or white issue.
 
My 10 year old warm blood had colic surgery, suffering a hernia which required another GA operation a year later. I'd had him since a yearling, so I was happy to proceed. He recovered well, although recovery was 6 months and he did look very poor. However, he did then lead another 13 years of happy life, with no further colic, before being PTS following a serious tendon injury. I'm very happy I agreed to the colic op! :)
 
I lost my boy in January to a suspected lipoma strangulation. He was 25 and I'd owned him for 23 of those years so knew his history. He'd never had colic before.
Everything happened so suddenly that day that I didn't have much time to make a decision on whether to operate or pts, but after weighing up the pros and cons I decided not to put him through surgery.

My main reason was that he had been living a happy retirement at grass for the past year but had been diagnosed with Cushings/Insulin Resistance last September and had already experienced one mild attack of laminitis as well as other mild attacks periodically over the years. I was highly confident that he would come through the surgery, but he would of hated the confinement following it, and the Cushings meant that even if he recovered fully from the surgery he was destined to a life of controlled feeding and starvation paddocks. He'd been my horse of a lifetime for 23 years and didn't deserve to be put through any more pain. Would I operate on a younger horse? I don't know is the honest answer. I think that every case is different and each horse has to be measured on its own merits. Looking at the statistics on post op complications though, I'm not sure that I'd put a horse of any age through such extensive surgery.
 
I've owned my ex racer for 16 years(from a 4yr old).He'd never had colic until he was 11(had been on box rest for a week with a foot injury and colicked after eating some grass when he was let out).The build up of gas caused his gut to twist and the vet reckoned that if we could get him to Liphook in time(some 45 miles away)they would probably be able to save him.We got there OK after the most stressful drive of my life and the brilliant vets there saved him.I watched the operation and they had to get his bowel out and ,by hand,squeeze all the food in it out through an incision at the end of the bowel nearest to the anus. None of the intestine had to be removed.
He recovered very well,but as mentioned by other posters,looking after him on 3 months box rest while having a stressful full time job was draining to say the least. I don't regret a second of it and he has never had colick since and it made no difference to his physical abililties whatsoever.
However,my previous horse also had colic surgery after having bouts of colic at the age of 21.He had every test the vets could think of,but they couldn't diagnose the problemHe was in the veterinary hospital when he colicked badly and was oprated on.Sadly he had quite advanced bowel cancer and was PTS under anaesthetic.He was my world and it broke my heart,but despite the fact that I had to pay for the operation as he was not insured and had no horse, I still don't regret trying to save him . So from my experiences I think that it depends a lot on how long the horse has had symptoms as to how likely a good recovery may be. I wish the OP's friend well and hope things tyrn out well for her and the horse.
 
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