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Standing Surgery A Non-Traditional Option For Severe Colic Cases

Colic is a very real concern to horse owners. An overarching term applied to any abdominal pain, over 80 percent of colic cases can be resolved without surgical intervention.

The standard colic surgery needed for horses which do require medical intervention involves putting the horse under general anesthesia, laying him down and opening the horse along his ventral midline. This type of surgery carries additional risk to the horse and adds significantly to the cost of treatment.

A new study has found that a flank incision, made while the horse is standing, may be a good option for specific types of colic. This type of surgery is less risky to the horse and less of a financial strain for the owner.

Dr. Marco Lopes and a study team reviewed records of 26 horses and ponies and one donkey which underwent a standing flank laparotomy between 2003 and 2020. The main reason for the decision to utilize this particular surgery was financial.

Though seven animals were euthanized due to an untreatable condition or a poor chance of survival, 20 of the 30 horses with treatable conditions survived. The surviving horses suffered from small intestine impaction or inflammation, large colon displacement (specifically nephrosplenic ligament entrapment), and sand impaction.

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Small colon impaction has already been found to respond well to the standing-flank incision method of treatment.

Study authors found that there are limitations to the surgery. These include:

The horse must remain still during the operation; one in intense pain from severe colic may not be able to have his pain controlled well enough to complete the surgery
Peritoneal cavity and abdominal organ access is not as good as with a typical ventral midline incision
A second incision on the opposite flank may be necessary

The team concluded that a standing flank laparotomy may be a viable approach for abdominopelvic exploration in horses with colic related to the small intestine, cecum, large colon, and peritoneum.

Common Colic Myths Debunked

The signs of colic are well-known to many horse owners: abdominal discomfort shown by pawing, kicking at the belly, repeatedly rolling, sweating and increased heart and respiration rate. Though colic is unfortunately common in horses, only about 10 percent of colic cases require surgical intervention to resolve.

Colic surgery can seem scary, but improvements in the past few decades have lessened the chance of a negative outcome, reports The Horse. Yet, myths regarding colic surgery remain. Dr. Jacqueline Hill, who practices at Littleton Equine Medical Center in Colorado, dispels some of the most common colic surgery myths.

Myth 1: A horse will never return to pre-surgery performance levels. Though colic surgery is a major surgery with a long recover period, horses can go back to their pre-surgery performance levels. A study that used over 200 horses of different breeds found that 84 percent of the horses returned to their discipline after colic surgery and that 79 percent were performing at or above the level they were at before the surgery.

Myth 2: A horse can be “too old” for colic surgery. The life expectancy for horses, like humans, has lengthened in the last few decades, with many horses ridden well into their 20s. A recent study from the University of Pennsylvania compared horses between 4 and 15 years old that had colic surgery with horses that were over 20 that had colic surgery. They found that both categories had similar post-operative complications and survival rates.

Myth 3: A horse is never the same after having a resection. Horses tend to fare differently depending on the section of intestine that has been resected: horses that have had their small intestine resected tend to fare better than those that have had the end of the intestine resected. It was recently reported that horses that have had their large colon resected have 65 to 75 percent long-term survival rates; small-intestine only resections see up to 75 percent of patients with long-term success.

More evidence is needed to resolve the myth that horses that have had colic surgery are more prone to colicking again. Studies have reported that between 0 to 35 percent of post-surgical horses have another colic episode within 12 months of a colic surgery. Factors that appear to affect this include what portion of the bowel was affected and what surgical procedure was used. Generally, if a horse doesn't colic in the first year after surgery, his risk of colicking again is similar to a horse that didn't have surgery.

Busted: Hand Walking A Colicky Horse Not Always Necessary

Nearly every equine enthusiast has been told that to allow a colicky horse to lay down is a possible death sentence: They may roll around and “twist” their gut, leading to a potentially more-serious colic outcome. Instead of leaving the horse to his own devices to find a comfortable position, horse owners often walk a colicky horse, not allowing him a chance to stop and breathe or stand quietly.

However, hand walking is only helpful for some types of colic—in others, it may make the situation worse. When deciding if a horse should be hand walked, it's important to consider the following:

Many minor colic episodes resolve on their own. If the horse is quiet, remove all hay and water and let him stand or rest quietly while consulting with a veterinarian.
Walking a horse can help impactions or a trapped gas bubbles move through the intestinal tract. However, if a horse has been walked (briskly) for 30 minutes and his condition has not changed, more hand walking will not help him. Never force a horse to walk and call the veterinarian immediately.
Even a normally docile horse in intense pain may become aggressive and unpredictable; walking him may endanger both the horse and he people around him. Additionally, if a horse is violent, he most likely has a colic that can only be remedied with surgery. Instead of focusing on walking, focus on how to get him in front of a vet as rapidly as possible.

It's important to note that other conditions can present like colic, including low-grade laminitis or an abscess. To help rule out other possible conditions, take the horse's temperature. Colic is not usually associated with any fever.

Tips To Prevent Winter-Weather Colic

Winter weather is rolling across many areas of the country and the vast temperature drops that tend to come with it make most horse owners anxious—and rightfully so. Certain types of colic are more prevalent when colder weather comes—specifically those that are impaction related.

An impaction colic is where ingested grain and hay ceases to move through the horse's digestive system. This blockage causes the intestines to distend and become painful. Impactions are often found in the pelvic flexure, where the large colon loops back on itself, but they can occur almost anywhere.

There are some management strategies can help keep impaction colic at bay:

Keep horses hydrated. It's imperative that horses always have access to unfrozen water. A bucket can freeze in six to 12 hours, if not sooner, so it's fair to say that a horse will be without water for part of the day or night in between when his buckets are refilled. The most important time a horse need access to ice-free water is the three hours after he has eaten.
Horses tend to drink more during cold weather when the water is warm; filling a bucket with warm water will also slow down the freezing process. Adding warm water to a horse's daily meals can also make sure he gets more water in his system.

Turn out horses as much as possible. The ability to move keeps a horse's gut going, as does continual grazing. Important to note, a horse that is moved from pasture to a stall is at an even higher risk of colic than those that are used to being stalled because of the dramatic change in management. A horse with a thick winter coat or a blanket, and access to shelter, can live outside comfortably even in single-digit temperatures.
Feed lots of forage. Though hay is much drier than pasture grasses, feeding hay constantly is easier on a horse than feeding hay just twice a day. Hay digestion also assists in keeping a horse warm.
Stay vigilant when temperatures tank. Though the correlation between plummeting temperatures and colic haven't been scientifically proven, vets report rashes of colic calls when temperatures drop. Try to keep horses in their normal routine and watch them closely for signs of colic.