In following with his passion for continuing equine education, Dr. Grant Myhre has agreed to answer one to two questions a month to be published in the Yankee Pedlar. Maybe your question (and answer) will be published in next month’s Yankee Pedlar! We will be publishing questions and answers here monthly, be sure to check back often. *Questions submitted for consideration become the property of Myhre Equine Clinic and are submitted with the understanding that questions may be circulated for publication.
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I have an 11 yo, 14.2 h, QH mare. She colicked the other day and our vet examined and treated her. He said that she needs surgery. Could you please explain this procedure to me? How does this work? How long is the surgery, how long would her stay be? What is the success rate of colic surgery? Who would be a good candidate? Who would not be a good candidate? What is the average cost of this entire endeavor?
I want to start off by saying that if a horse is colicking and is in need of surgery then that procedure should happen immediately. Waiting will likely make the horse's condition more severe. Acute colic is indeed an emergency. Colic is defined as abdominal pain caused by any abdominal organ.
Colic is first recognized by the owner.You may notice signs such as kicking at the abdomen, looking at the flank region, pawing at the ground, rolling, laying down and getting up, stretching, sweating, reduced or lack of bowel movements, irritability, tacky gums, slow capillary refill time (>2seconds), elevated heart (>48 bpm) and elevated respiratory rate (>24 bpm).
Now that you have established that your horse is colicking you should call your veterinarian immediately. Have your veterinarian come to you or you go to your veterinarian. You should not let your horse consume any feed. Small frequent amounts of water is usually okay and most of the times helpful because most horses that are colicking are dehydrated. Do not attempt to 'cure' the colic on your own. Many medications or treatments that owners perform are detrimental to the horses condition. Your veterinarian will perform a physical examination which will give him/her a quick idea of the severity of the colic and discuss with you what further treatment is needed and what you can do to help. Shortly thereafter a sedative and pain killer may be administered to calm the horse. Blood work will likely be performed. A veterinarian is able to assess the severity of dehydration, bowel inflammation, electrolyte status and much more by this analysis. Next, a nasogastric tube will be passed. Spontaneous foul smelling reflux is sign of small intestinal obstruction(ie – small intestinal twist, etc.). Rectal examination (gloved arm into the horses rectum) enables the veterinarian to detect changes within the back 1/3 of the abdomen such as a large colon impaction or edema, small intestinal dilation or edema, splenic displacement, etc.
Abdominocentesis (abdominal tap to obtain fluid from the abdominal cavity) can be analyzed for color, turbidity, total protein and white blood cell count. Serosanguinous fluid (blood-tinged), turbidity, elevated total protein and elevated white blood cell count may indicate bowel leakage or decreased bowel integrity. Surgery is likely needed in these cases. Transabdominal ultrasound is a great tool to 'see' the inside of the abdomen. A veterinarian is able to diagnose dilated small intestine, motility and other conditions that may cause colic. After a thorough work-up has been performed, the veterinarian and you can put all the pieces of the puzzle together. Depending on the condition, the horse may be medically managed.
If surgery is required, the patient should be prepared for general anesthesia (intravenous catheter, clipping, intravenous fluids, etc.). Colic surgery, as with all general anesthetic procedures, has risks associated with it. This should be taken into account prior to surgery. Once the horse is on the surgery table and the abdomen has been opened by the surgeon, the veterinarian is able to diagnose the type of colic. The problem is corrected (such as being de-torsed), the bowel replaced into the abdomen and the abdominal wall sutured. Depending on the severity, the bowel may have to be incised to allow the impacted contents to be removed from the colon or small intestine may have to be resected (devitalized small intestine removed due to blood flow restriction). If the bowel is too devitalized or necrotic and causing secondary shock, the difficult decision to euthanize the horse may be indicated.
As far as time in surgery, this depends on the patient's condition. The more complex the colic, the more time is spent in surgery. Generally we keep a typical surgical colic at the clinic 7-10 days and medical colic 3-10 days. This depends on how the patient is recovering and responding to treatment. The success rate of colic surgery again depends on the severity of the colic, the type of colic (ie – large colon impaction), the duration of colic, condition of the horse (hydrated vs. severely dehydrated), etc. A good candidate for surgery would be a horse that has no other medical problems that would interfere with surgery. Most horses with colic have electrolyte imbalance and are dehydrated (shock) making these patients not ideal candidates for surgery, however, surgery can be performed on these patients after treatment and stabilization.
After the horse has recovered from anesthesia and surgery, close monitoring of the patient is crucial. Intravenous fluids, anti-inflammatory drugs and intense care will be crucial in the horse's recovery. After a few days, water and feed can be re-introduced to the horse, slowly. All other medications will be adjusted depending on how the horse is responding. In terms of cost, this again depends upon the type of colic the horse is presenting with. Medical management of colic (non-surgical) may cost anywhere from $2,000 - $5,000 while surgical colic may cost anywhere from $4,000 - $10,000. The prognosis for return to performance of all medically treated colics is approximately 95% at Myhre Equine Clinic and surgical cases approximately 85% of horses that we recover.
My 8 year old Tennessee Walker has developed the irritating habit of cribbing. Can you tell me why this occurs and if there are any long-term negative side effects I should be concerned about?
Cribbing or Crib Biting is
Cribbing or Crib Biting is considered a behavioral stable vice. The horse will take hold of an animate object with their incisor teeth (front teeth) and by pressing down hard will arch their head and neck. They do this by contracting sternocephalicous and sternohyoideus muscles (ventral neck muscles). This occurs in varying frequencies depending on the individual horse’s need and desire to crib. Some horses are easily distracted and some horses seem to avoid all means instituted to prevent the cribbing. Some horses will also "wind suck“, or swallow air during this cribbing. This air can accumulate in the intestine and can cause abdominal pain or colic. It is important to ascertain whether the horse is swallowing air and take needed precautions to stop the cribbing. Usually a cribbing collar placed around the throat latch, and occasionally over the poll, will put pressure on the affected muscles thus making it uncomfortable for the horse to crib. These collars vary in form from a leather strap, to straps with metal projections to increase the severity of the prevention. Surgical intervention should be reserved for those horses that do not respond to the cribbing collars. In 1929 Dr. Forssell described a technique in which the muscles that attached to the hyoid bone were excised, thus preventing air swallowing. Since that time modifications of Dr. Forssell’s technique have been described where less muscle has been excised, thus preventing any cosmetic damage. A neurectomy of the accessory spinal nerve has also been described and proven to be beneficial, however these modified techniques are not as efficacious as Forssell's technique.