small intestine | Horse Racing Free Tips

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.

[Story Continues Below]

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.

The Lowdown On Lipomas And Surgery Survival

Colic is a broad term that is often used to indicate any type of abdominal pain, but veterinarians can often determine — or at least narrow down — what is causing the abdominal issue. One common cause of colic, particularly in older equines, is a strangulating lipoma.

A strangulating lipoma is a benign, fatty tumor on a stalk that can wrap around and strangulate a section of small intestine. There are no good markers to denote a horse that may be at risk of a lipoma other than advancing age. The only repair for this type of colic is surgery.

When the veterinarian has the horse on the table, he or she will prophylactically remove all of the lipomas found in the small intestine and small colon to prevent strangulation in the future. Older horses tend to be more stoic so may not show the intense pain they are in. For this reason, some strangulating lipomas are missed during vet exams.

It's imperative that if a horse is suspected to have a strangulating lipoma that he is sent directly to an equine hospital equipped to handle surgery. The idea that older horses don't handle colic surgery and anesthesia well is a myth, according to EQUUS magazine. Older horses have as good of a chance of survival after colic surgery as younger horses.

Strangulating Lipoma: Surgery The Only Option

Strangulating lipomas are a common cause of colic in horses older than 10. These fatty tumors take years to develop; they eventually wrap around the small intestine or small colon and block ingested feed and hay from moving. If left long enough, they will eventually cut off blood flow to the tissues as well.

Why these tumors occur isn't known, but they don't only occur in overweight equines. Colic from a strangulating lypoma cannot be managed with on-farm treatments like hand walking or medicating—surgical removal is the only remedy for this type of colic.

A horse with a strangulating lipoma may have only mild abdominal pain as the tumor grows. His pain will escalate as the tumor increases in weight, which causes the loop to tighten and block more ingested material. Eventually the blood supply to the tissue may be cut off, causing it to die.

The horse may initially appear restless, he may roll, paw or bite at his sides. Stretching out to ease the pull and sweating is not uncommon, nor is an elevated heart rate and depression. A horse with a strangulating lipoma most likely will not eat or pass manure. This form of colic may cause the horse to have a distended abdomen from the buildup of fluids.

This type of colic is diagnosed through observation of behavior, as well as through palpation of the small intestine, presence of abdominal distention and an increase in proteins and white blood cells in the peritoneal fluid.

The only treatment for a horse with a diagnosed strangulating lipoma is surgery, which will remove the tumor as well as any damaged intestine.