neprosplenic entrapment

[Birker2020]

Bailey had nephrosplenic entrapment/left dorsal displacement over the weekend. He had this about four years ago at a previous yard. It’s when the colon gets stuck between the spleen and the gut wall and the vets say there is no obvious cause or why some horses are more predisposed. It can be caused by dehydration or excessive gas. The vet thought he may have been dehydrated although his hay nets are well wetted and he has an automatic waterer, so this wasn’t really certain to have been the cause. I think from now on I will leave a tub of water in his stable – the trouble with automatic waterers are that they don’t refill quick enough for a thirsty horse and Bailey gets impatient and then leaves it. Nobody knows how these colics happen, which is always the problem with colic, sometimes there is no obvious cause. 6% – 8% of colics are caused by nephrosplenic entrapment and 21% of horses will suffer a re-occurrence.

Bailey went down with colic immediately after a hack on Sunday afternoon although he didn’t get particularly hot or sweaty considering the weather conditions. When I put him in his stable to untack him he stood in the corner and started pawing the ground and I thought ‘here we go again’. I put him in the sandpit whilst I hurriedly skipped out his stable and took his net out. My friend who was watching him said that he was lying down in the sun so I went over and he stood up, his respiration was 58 per minute, his pulse 48 and he was obviously in a lot of pain. I knew it was splenic entrapment as he’d had it before and the symptoms he was displaying were much greater than his normal gassy colic which is treated with a quick lunging session.

I called the vet and hand walked him in the menage until he arrived, he kept trying to go down and roll and was curling his top lip back, moaning and swishing his tail. He did a rectal examination and confirmed it was left dorsal displacement. He said the caecum was a little impacted which was worrying. He tubed him and said no hay for rest of day or tomorrow (to allow the colon to drop) and to lunge him and give him a ‘bumpy’ trailer ride to try and shift the colon.

So poor Bailey, after being put under a local anaesthetic, having a hand shoved up his bottom, a tube shoved down his throat then gets lunged and taken out in a trailer (SHOCK – no hay to eat inside trailer) and taken on a ride from hell! It must be a strange experience being a horse!

Yesterday I had to ring in sick to work, was down the yard by half six checking on him. He was a little peeved he’d not been allowed breakfast or a haynet but took it in his stride. Only one pooh overnight, a little hard so the vet came out again and tubed and gave a rectal examination, confirmed the colon had gone back down again and the caecum was fine! Said he could go out for an hour at grass and lots of handwalking followed by another hour at grass. I handwalked him our favourite hack a five mile round trip (hopefully I will have lost some weight!) and then he went out for his second hour in the paddock. He hadn’t done a pooh when the vet rang me so another vet arrived, check his gut sounds and heart rate and retubed him. He was allowed two very small and very wet nets last night.

The Y.O rang me this morning as I am at work and he has passed at least one pooh this morning possibly more, bed is a bit of a mess, but she says he is bright and alert so has had breakfast and gone out in paddock for two hours. I’ve rung the vet, they are happy with this on the proviso that the Y.O rings me if he looks poorly again (which she will) and that he has passed pooh when I get there after work. Fingers xsed.

 

[only_me]

That's quite scary, glad he's ok now! Do you think it's linked with his change in routine ie. Out on grass now after being in all winter? Maybe grass gass colic?
I've never heard of entrapment before, is it common?

Trailer ride is a common technique used here for colic, but somebody is usually in trailer with horse in case tries to go down.
Walking is normal too - can I ask why you put him in the sandpit to muck out instead of immediately walking him & leaving stable for later? I would have thought walking was the priority, I would have left the stable till later.

Very glad he's ok, as I'm sure you are too!

 

[JenJ]

Sorry to read this but really glad he seems to be recovering well. My darling girl had this 6 months ago, but sadly less than 10 hours after discovering her I had to let her go. Was very scary and unexpected

 

[varkie]

Hope he continues to be well.

Some years ago (20?) a horse on a yard I worked on had this - it was the most painful colic I ever saw in a horse, he was flinging himself at walls, the lot. He went to the vets, and we were all worried about his prognosis, but he came home after three days spent on a drip, totally back to normal. He stayed at that yard another couple of years, and never had it again there - he moved after that.

 

[Birker2020]

That's quite scary, glad he's ok now! Do you think it's linked with his change in routine ie. Out on grass now after being in all winter? Maybe grass gass colic?
I've never heard of entrapment before, is it common?

Trailer ride is a common technique used here for colic, but somebody is usually in trailer with horse in case tries to go down.
Walking is normal too - can I ask why you put him in the sandpit to muck out instead of immediately walking him & leaving stable for later? I would have thought walking was the priority, I would have left the stable till later.

Very glad he's ok, as I'm sure you are too!

Hi only_me, as I said in my OP it is fairly common with 6-8% of all colic cases being due to this. The horse was stabilized with pain killer before trailering otherwise such a technique would not be attempted. There is nothing more dangerous than being in a trailer with a colicky horse - I would call that pure stupidity myself and to be honest there is very little a person can do to stop a horse going down anyway, especially in a trailer!

The vet says he doubts there is any link between him being out at grass as it was nearly a week later and he would have thought he would have shown a reaction before now. He is only going out for two hours a day at grass and is ridden nearly everyday. Besides I was letting him have a pick at grass on hacks prior to turning out for the first time and he was on pink powder treble maintenance dose three days prior to turnout on grass and double whilst on grass.

The reason I turned him out in the sandpit was for three reasons. Firstly to study him from a distance (which I would have done had he not gone down whilst doing his stable). I walked him after that point and shouted for a friend if she would kindly finish his stable off for me. From a diagnostic point of view its better not to fly into a mad panic. The horse was not thrashing about, and a lot can be gained by taking respiration rate, pulse and temperature and is very helpful for the vet. Vets these days don't seem to think there is any correlation between horses rolling and a twisted gut and so long as they can't damage themselves (rolling against something or someone) then if they want to roll let them seems to be the latest advice, its only like us moving about to make ourselves comfortable if we have stomach ache. The rolling does not cause colic. Colic causes rolling.

Secondly because his bed had not been mucked out since the morning before I needed to see what he has passed. Again I was not unduly concerned at this point because he had done plenty of poos, so I knew it was not an impaction but it was helpful to the vet when she asked me on the phone the amount and consistency of his poo, the fact I described it as doughy meant that and he had colicked during or shortly after a hack meant that there was a good chance the horse was dehydrated.

Thirdly because the horse always has the same colic (gassy colic) I was not overly concerned as its usually rectified by a quick lunge. He blows up easily when on grass (always has done). When I went back to the sandpit he got up and it was then that I could see his respiration was very fast and he was clearly in pain which is why I called the vet.

JenJ I am sorry for your story. That is so sad. I knew with Bailey if he needed surgery I would have to say goodbye to him not so much due to the G.A but the box rest afterwards. At the age of 19 with arthritis it would have been a no brainer.

Varkie it can be very painful which makes is stand out from a typical colic.

 

[vetsbestfriend]

My ID x TB has had an entrapment 3 times, each time he was near enough collapsing with the pain. Same treatment as yours received except the vet also administered adrenaline to shrink the spleen to allow the colon to become free. Lots of lunging, no food or hay overnight etc. Vet said that big roomy horses can be more likely to get a neprosplenic entrapment. Hope your horse is continuing to recover ok.

 

[Birker2020]

My ID x TB has had an entrapment 3 times, each time he was near enough collapsing with the pain. Same treatment as yours received except the vet also administered adrenaline to shrink the spleen to allow the colon to become free. Lots of lunging, no food or hay overnight etc. Vet said that big roomy horses can be more likely to get a neprosplenic entrapment. Hope your horse is continuing to recover ok.

Hi vetsbestfriend.

Gosh three times your horse had it! Blimey. Poor you, its horrible.Mind you there is a 21% chance of reoccurence with horses that have had it previously. This was my horses second time, the last time was in about Sept 2013 from what I can remember. The vet thought it was caused by dry hay and a large amount of grass - I'd swapped him from wet to dry hay some 8 days before I went on holiday to help my friend out and save her wetting his nets as she was looking after him for the week. When I came back of holiday he went down with it.

He couldn't have the phenylephrine injection because he suffers from second degree heartblock and it can bring on a fatal arythmia in horses that have this condition. Whilst the 2DHB doesn't effect him day to day as its a very common heart complaint with horses, I have to be careful what drugs he can have. He can't have Triamedazine for this very reason either.

Interesting what you say about big roomy horses. The vet is of the opinion that his colon always sits a little higher than it should (again of no consequence) until you get a gas build up which pushes it over the edge!

I am still not convinced he is out of the woods yet, I am VERY worried about him and I am watching him like a hawk. You know what its like though, every movement they make, every kick or lift of the tail and you think COLIC!!!