Colic Surgery

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007Equestrian

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I've read quite a few comments on here about owners who say they would not put their horse through colic surgery. I'd love to hear both sides, those who would never do it and those who have successfully had their horses recover from it. All opinions welcome, I'm trying to best educate myself should the terrible situation ever arise.
 
I've had two horses have colic surgery. One was a three year old who had a serious twist just before the caecum which had resulted in some tissue death. He had to have a resection and whilst he got through the surgery he was PTS a couple of hours later as he went into organ failure as a result of the toxins that had flooded his system on the tissue death.

I also had a six year old operated on for impacted colic due to eating something he picked up in the field. He didn't need a resection as the blockage was broken up manually. He absolutely bounced back and was in amazing condition when I picked him up a week later. He has had no reoccurrence of any colic and was back out eventing a few months after the operation.

I've always said I wouldn't put an old horse through surgery be that for colic or anything else that would require prolonged box rest.
 
I'll never do it. Survival rates that are published are going home from hospital. Survival rates at a year are much lower, and many of those horses have been in pain and suffered additional colic episodes. Prognosis is good for some types of colic but they often don't knew until they've got the horse open what type it is.

A horse I had to gift to someone was operated on within two hours of it starting (early is good in terms of survival) but he colicked again two weeks later and was put to sleep. I'll never quite be able to forget the awful last two weeks of life he had. He was a horse who loathed being stuck in a box, never mind all that pain.

It's a complete no for me, no matter the age or health of the horse.
 
A complete no from me too. I think it's unfair to put such a large animal with a pendulous abdomen through such major surgery, can't even begin to imagine how painful it must be. Even if all goes well there is the risk of adhesions,complications and repeated colics.
So many seem to have the op only to be PTS afterwards....I'd be devastated if one of mine colicked badly but I'd rather make the final decision quickly so that suffering was minimised.
 
Not all colic surgery is the same, impactions, displacements and twists, and where they occur all carry different risk levels and chances of survival. I had a 4-year old die less than 2 weeks after colic surgery, but faced with the same situation again I would still go through with the surgery. He was in a bad way before the surgery and probably wouldn't have survived more than a couple of hours without it. He had pretty much the worst kind (a bad twist in the large intestine) and it was a massive operation with a very guarded prognosis, although he didn't make it, he was well supported after surgery and I don't believe he suffered. Survival rates are a lot higher than they used to be (again it varies with the type of colic/surgery) and if he had made it he would have had many good years ahead of him. Of the horses that were in hospital with him, I believe he was the only one who didn't make it home. Having said that, if he had been an older horse, my decision to have the surgery would probably be different.
 
if he had made it he would have had many good years ahead of him.
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Do you mean if he had made it home from hospital? Because if so, then I'm afraid that's not necessarily true. I can't find really up to date figures, but a lot of horses don't survive the first year after they go home, and some of those who do are never the same again.

And some of the survivors bankrupt their owners, because once you've gone through all that and exhausted your insurance, there can still be thousands more to pay on complications. And who could possibly bear to give up at that stage, after all the horse has gone through already?

I really don't get that the horse is not in pain after this operation. Everyone I know who has had such major abdominal surgery has been in pain in spite of morphine, and a lot of pain when they move.
 
I'm sorry of it reads as if i am trying to make anyone feel guilty about choosing colic surgery. I'm trying to do what the OP asked, and give the full story. I don't think choosing surgery is wrong. There are many horses around who have lived on for years because of it. But on balance, because of the uncertainty of the outcome, it's not something I will ever do.
 
A friend of mine put her pony through surgery and had another 12 happy years together. I personally wouldn't put mine through it due to possible complications and potential heartache. Far rather they were PTS and didn't suffer the pain of recovery.
 
We don't insure and one reason for that is because in the cold light of day, we have decided that we do not want to put any horse through surgery and prolonged boxrest. A friend had a 2 yr old with colic, transported it to horsepital about 10 miles away late one Sunday night. Vet said she only had a 1% chance of recovery, insurance company insisted that she be given the chance. She died in theatre. If that had been my horse, I would have pts at home, rather than putting everyone concerned through all the trauma, for the same end result.
 
I did it, pony had a cecal impaction and had just 15% of survival. We didn't know this when he went for surgery. Scans showed a mass in his abdomen and we assumed it was a tumour and that on finding it he would be destroyed on the table. Turns out it was a whopping cecal impaction that the surgeon cleared.

Pony had a rocky recovery- I won't go into the details but the first 9 months were stressful. We then had an amazing nearly 4 years before I found him one evening colicking and decided to call it a day.

I probably wouldn't do surgery again. But I dont regret that I did it for that pony at the time.
 
Pearlsasinger said:
We don't insure and one reason for that is because in the cold light of day, we have decided that we do not want to put any horse through surgery and prolonged boxrest. A friend had a 2 yr old with colic, transported it to horsepital about 10 miles away late one Sunday night. Vet said she only had a 1% chance of recovery, insurance company insisted that she be given the chance. She died in theatre. If that had been my horse, I would have pts at home, rather than putting everyone concerned through all the trauma, for the same end result.
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So the insurance company had the final say on the horse's fate? I find that wrong....were they hoping the owner wouldn't go through with the surgery because of the poor prognosis so they wouldn't have to pay out?
 
cobgoblin said:
So the insurance company had the final say on the horse's fate? I find that wrong....were they hoping the owner wouldn't go through with the surgery because of the poor prognosis so they wouldn't have to pay out?
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I know the same person and that has always been my suspicion :( If it had been one of ours we would have forgone the insurance payout, I also think that the vet should have refused to treat, as they were aware that the chances were minimal. No one came out of that episode with any credit IMO.
 
I would never do it to my horses, I think that the chances of a full recovery are limited. A friend had it done on her mare and she has never been quite right again and often has episodes of "light colic" and is pretty much a pasture ornament. I think it takes a tough horse to come through. I'm sure that some do pull though and do well but knowing my lads, sensitive cobs and an ultra sensitive Clyde, it would be better to let them go.
OP you know your horses, you will know what's best for them. In the end it's your decision. Let's hope none of us have to make it.....
 
I did have my horse operated on and as a result, I know I personally would never put another horse through the process. If I'm honest, I feel guilty every time I think about what he went through. He was my first horse; he was everything I'd dreamed of, only 6yrs old and I'd had him 18mths. The vets told me surgery was his only chance. I told myself he was young and strong and I couldn't let him go without trying. He lasted 2 1/2 months after the surgery; then he started colicking again; 2 or three 'minor' colics which resolved without the vet, then a worse colic episode which saw the vet coming out late at night and my lovely boy was pts; I couldn't see him suffer anymore. I wish with all my heart I knew then what I know now and I could have saved him those months of trauma; the end result was I still lost him.
 
I've known one with 'simple' twist that vets described as the easiest surgical procedure who survived surgery and as far as I know is still going strong. Recovery wasn't nice due to various wound infections but over all a good outcome. A second horse had a major blockage which was removed with minimal resection. Surgery and recovery was text book and horse lived for just under 2 years before colic struck again and he was PTS. A third horse had a major blockage and an 18 inch resection. Horse never came round properly from surgery and was PTS in recovery. Horse 3 was the horse I had on loan at the time. His owner, rightly for her, wanted to give him a chance.

All colics and situations are different. My horse will not cope well with prolonged box rest so I would choose to not put him through any kind of surgery that involves this as recovery. I don't need to put him through misery just so I might get a year or 2 longer with him. No one can really tell you what is right or not but you will know what is right for you.
 
If I'm honest, I feel guilty every time I think about what he went through.
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Please please don't. You did what you honestly believed was the right thing at the time with the advice you were given by professionals.
 
cobgoblin said:
So the insurance company had the final say on the horse's fate? I find that wrong....were they hoping the owner wouldn't go through with the surgery because of the poor prognosis so they wouldn't have to pay out?
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I imagine so!.

I think it is really difficult to make decision with a vet talking about the possibility of surgery with a poorly horse in the stable, late at night (it nearly always is, isn't it?). Of course you take the opportunity to 'give him a chance' and the insurance company saying they won't pay without surgery. That is why our decision has been taken before disaster is staring us in the face.
 
One of mine has had colic surgery. It was successful, simple manual breakdown of an impaction. It really does depend a lot on the type of colic. Recovery was not exactly straightforward but that was due to his allergy to the stitches and he managed to grow proud flesh on the wound so it took weeks longer than expected. Fortunately, once he started healing it was incredibly quick with the noticeable changes between morning and night. He made a full recovery, surgery at 16 and he's 20 now.

I have some horses I would chose surgery for, and others I would not, based on their temperament and previous surgical history.
 
I have posted about mine previously, he was referred as he was atypical and the vets thought it may be grass sickness, stomach tube sent back an incredible amount of stomach contents, so he went off to hospital where we were expecting him to be put onto fluids and supported medically, on returning home I had a call with the diagnosis it was an unusual form of colic, an intussusception where one part of the intestine had collapsed back onto another, he was insured but it was a bank holiday so the insurance company were not involved, the decision was pretty much out of my hands as a consent form had been signed and the vets wanted to go ahead with surgery immediately, there was no time to "think" or consider whether pts was a better option and no internet to look up anything.

He came through the op, after 48 hours his guts had not started working, they were nil by mouth until guts started, he had a build up of fluid so went back into surgery for that to be drained, then after a further 48 hours, still having had no food since the Sunday, this was Friday, they made contact to say he would be pts, on the way he was allowed a pick of grass as by then there was no reason to withhold food and being a horse he munched away happily and his guts started moving, he had a reprieve and to this day I still cannot fathom out why they were so against giving something to eat, I don't think there was anything in his system for the guts to work on, everything had come out one way or the other in the 5 days he was undergoing treatment.

He came home looking fairly poor but otherwise bright, had a textbook recovery helped by the fact that I was there all day, it was my small yard so I was in full control of what was best for him, he had a very long rest/ recovery/ rehab and came back to full work with no real problems other than a couple of minor colics, he lived about 12 years post surgery and was pts when we assume the scar tissue broke down causing a catastrophic colic which was not going to have a good outcome.

Would I do it again, I have no idea, he was a tough little horse and did come through it very well and in some ways was better than ever, he was only 10 so had a future, of the ones I have now only one is young enough to consider it for but he went through a very traumatic experience in a vet hospital several years ago and I promised him he would never be out of my control again, so I have stopped his insurance so I can do exactly as I want, the others are older, uninsured and I am not prepared to spend £5k + just to give them a few extra years if it even gave them that, I am happy to medicate/ patch up the older ones but not to operate.
 
I did it on a mare i had.

No history of colic before this incident and never since.

Colon 360 degree twist. Recovered well and died 7 years later from another disease entirely.

Would i do it again? No idea until im presented with the problem i wouldn't rule it out.
 
I will give my perspective from a different angle...

I worked in a specialist surgical hospital and watched MANY MANY horses have colic surgery and how they recovered.
I wholeheartedly feel I could never put my horse through such a traumatic surgery even if the prognosis is good.

It is easy to say "my horse was happy and pain free when I visited him after colic surgery" but the reality is that at some point during the day (usually not during visiting hours) the pain meds wear off and your horse is in pain, miserable and hasn't been allowed to eat for days.

Having had to soothe dying horses and hold them when they are frightened, in agony and alone in the middle of the night while the vet on call won't answer their phones near broke my heart.
 
Fawaz - it is interesting how perspectives differ isn't it. I have also worked in a specialist equine hospital, in the USA, we probably cut either the most or second most colics of any hospital in the world (multiple a day during foaling season, the most I think we did in one day was 14 colic surgeries). I am now doing my specialty training in another large hospital in the US where we see a lot of colics. My current 3 horses are all mid-20's or older, and two have cushings; in my head I have come to terms with the fact that they are probably too old to have colic surgery, however I would have no hesitation in taking an otherwise healthy horse to surgery and at least exploring; a lot of colics are fairly simple fixes. I'm not sure I would put a horse through an extensive resection of small intestine but I have seen plenty of horses have that surgery and do well.

I would like to think that I manage my post-op colics' pain to the best of my ability; the 26 year old that had surgery this morning was kicking his stable door for food when I left this evening, so he's clearly not feeling too bad. My plan is to start feeding him tomorrow, so less than 24 hours without food. Good post-operative management should include a comprehensive pain management regime so that the horse is maintained in a comfortable state. When I worked in Kentucky, most of our broodmares with large colon torsions were home on full feed within 3-5 days.

It is an individual choice, and I would never judge someone who chose not to do colic surgery - there is no doubt it is a huge thing to go through, and also a financial commitment that many people (myself included) would struggle with. That said, I think if someone chooses to do colic surgery with their horse, we shouldn't be judging them for that either or implying that their horse is going to be miserable and suffering horribly in the post-op period. I tell owners if I think their horse is suffering, and I can honestly say that of the hundreds of horses I have looked after post colic surgery, I can think of very few that I felt really suffered in the post-op period, and they were either extensive resections or bad large colon torsions where the mare developed colitis afterwards. In Kentucky, where people don't faff about and just refer the horse for surgery if it needs it, I would say we have >80% survival long-term. There is a recent paper out of Liverpool that had I think 80% long term survival for some types of colic surgery(ileal impactions and IFEE lesions); we are limited on long-term survival studies by the difficulty in keeping track of colics past around 2 years. If owners can afford it, I will always recommend doing an ex lap and then you always have the option of euthanizing the horse on the table if what you find gives a poor prognosis. Being induced for anesthesia is the same for the horse as being euthanized, so it makes no difference to the horse.
 
Murphy88 said:
Fawaz - it is interesting how perspectives differ isn't it. I have also worked in a specialist equine hospital, in the USA, we probably cut either the most or second most colics of any hospital in the world (multiple a day during foaling season, the most I think we did in one day was 14 colic surgeries). I am now doing my specialty training in another large hospital in the US where we see a lot of colics. My current 3 horses are all mid-20's or older, and two have cushings; in my head I have come to terms with the fact that they are probably too old to have colic surgery, however I would have no hesitation in taking an otherwise healthy horse to surgery and at least exploring; a lot of colics are fairly simple fixes. I'm not sure I would put a horse through an extensive resection of small intestine but I have seen plenty of horses have that surgery and do well.

I would like to think that I manage my post-op colics' pain to the best of my ability; the 26 year old that had surgery this morning was kicking his stable door for food when I left this evening, so he's clearly not feeling too bad. My plan is to start feeding him tomorrow, so less than 24 hours without food. Good post-operative management should include a comprehensive pain management regime so that the horse is maintained in a comfortable state. When I worked in Kentucky, most of our broodmares with large colon torsions were home on full feed within 3-5 days.

It is an individual choice, and I would never judge someone who chose not to do colic surgery - there is no doubt it is a huge thing to go through, and also a financial commitment that many people (myself included) would struggle with. That said, I think if someone chooses to do colic surgery with their horse, we shouldn't be judging them for that either or implying that their horse is going to be miserable and suffering horribly in the post-op period. I tell owners if I think their horse is suffering, and I can honestly say that of the hundreds of horses I have looked after post colic surgery, I can think of very few that I felt really suffered in the post-op period, and they were either extensive resections or bad large colon torsions where the mare developed colitis afterwards. In Kentucky, where people don't faff about and just refer the horse for surgery if it needs it, I would say we have >80% survival long-term. There is a recent paper out of Liverpool that had I think 80% long term survival for some types of colic surgery(ileal impactions and IFEE lesions); we are limited on long-term survival studies by the difficulty in keeping track of colics past around 2 years. If owners can afford it, I will always recommend doing an ex lap and then you always have the option of euthanizing the horse on the table if what you find gives a poor prognosis. Being induced for anesthesia is the same for the horse as being euthanized, so it makes no difference to the horse.
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I think the main problem with where I was working was it was a referral hospital in the middle of the city.

So basically the local vet would come out to treat a colic at a property, leave it too long before referring due to pride/lack of knowledge/owners unwilling to accept the horse will need surgery or euth and then the vets here had to deal with the extent of the damage.

I'm in Australia and the majority of horse owners have a wait and see approach to getting a vet for their horse regardless of the of the seriousness of injury/situation. There were so many things which had horrific complications which could have been a non event if the horse had received specialist care in the first instance.

There was multiple colic surgeries daily and I think 3/4 had complications with 1/4 resulting in death or euth. The straight forward ones were very rewarding but I think the length of time a horse has had colic had a profound effect on results.
 
A friend put a horse with 720 twist in gut through surgery, vet said last horse died on the table, she made it through surgery, lost a lot of gut as it had died, she recovered well, it was a long road with infection etc but she went back to full work, she was sold a year later so do not know her fate,

I was very involved with the horse and wanted to buy her myself I'm a bit gutted I didn't, but I didn't want the risk of it happening again etc

Would I put my horse through it? No, after watching her recovery etc.
 
Good post-operative management should include a comprehensive pain management regime so that the horse is maintained in a comfortable state.
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I am pretty sure that most patients who have had major abdominal surgery who can actually speak would tell you that you are wrong about this, especially if they move. My friends who have had caesareans and hysterectomy ops have certainly not been comfortable, especially when moving.
 
My boy had surgery in July, he had a twist caused by a growth wrapping itself around his gut. 20 foot of intestine was removed. The vets kept him gong for 2 1/2 days, it was clear he was not going to recover so he was pts. In hindsight I would not have done it, but having never had experience of this before I went with the vets advice which was to go ahead. Fortunately for me the insurance covered it all eventually, but I had to include the "loss of horse" part to to pay the full fees. I try not to feel guilty as I thought it was the best thing at the time, and selfishly I did have a little time to psych myself up to saying good bye, which I would not have had if we had pts immediately. If I am faced with it again I will not put another through it.
 
Personally it is not something I would put any of mine through. I love them dearly but I just couldn't put them through it. I chose to pts my cob rather than put him through surgery. He was in agony and I just couldn't do it to him.
A friend's stallion colicked very badly resulting in being pts. On post mortem it was found the cause of the colic was caused by disintegration of scar tissue from a previous surgery prior to them owning him. He didn't own him very long. 18mnths at most.

I've known two others while waiting for the vet to come with post surgery complications. One had managed to open the wound almost completely and the other colicked every day after he came home. I sat with both waiting for the vet. The first one was calling but then went quiet. The silence was worse
 
my first horse I owned for 13 years when she was 22 she went down with colic vet said the only option was surgery and I chose to pts, I didn't think it was fair at her age she was semi retired anyway and she had a bout of laminitis that year so I thought it was the best thing to do.

I am not sure I would consider it for the 2 I have now it's very hard to know what you would do until your faced with it.
 
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