Analysis of therapeutic results and complications after colic surgery in 434 horses

Abstract

Out of the total number of 434 horses that underwent colic surgery, small intestine was operated in 195 (44.9%) patients, caecum in 10 (2.3%) horses, large colon surgery was performed in 196 (45.2%) cases and small colon surgery in 14 (3.2%) horses. In 12 patients (2.8%) two different parts of the gastrointestinal tract were affected simultaneously, one horse suffered from peritonitis, torsion of the uterus developed in two mares and three animals had negative surgical findings. Of 434 horses, 371 (85.5%) survived. After small intestinal surgery, 159 patients (81.5%) recovered from anaesthesia and were discharged home as well as seven horses (70%) after caecal surgery, 175 horses (89.3%) after large colon surgery and 14 horses (100%) following small colon surgery. 75 out of 103 horses (72.8%) were discharged home after the small intestinal resection and 89 of 98 horses (90.8%) with small intestinal problems where no resection was needed. In total, 43 of the patients that underwent one surgery did not survive the immediate postoperative period. The most frequent lethal complications in horses following the small intestinal surgery included peritonitis (five horses) and paralytic ileus (four horses) and in horses with large colon problems it was typhlocolitis (six cases). Relaparotomy was indicated in 41 of 434 horses (9.4%) that recovered from colic surgery. 21 out of the 41 (51.2%) relaparotomised colic patients were released from the clinic. All successfully repeated surgeries were carried out to overcome primary small intestine ileus problems, and in 14 of these cases (66.7%) resection and anastomosis were performed. The most common finding, diagnosed in 9 of 21 reoperated horses, was paralytic ileus. Of 20 relaparotomised horses that did not survive, three animals were lost after the introduction of anaesthesia, nine horses were euthanised after the abdominal cavity revision, one horse did not recover after the surgical procedure and seven horses did not survive the postoperative period. In 15 of 20 dead horses, the cause of the first surgical intervention was small intestinal ileus, in other four horses there was a large colon problem and in the last patient, it was a stomach disease. In 13 of 15 (86.7%) horses with small intestinal problems and in three of four (75%) patients with large colon disease, either resection or bypass was performed. In the remaining four non-surviving horses of 20 relaparotomised ones, peritonitis and/or adhesion formation was diagnosed at the second surgery, in three horses anastomosis complications were the main problem. Peritonitis or paralytic ileus led to death or euthanasia in four of seven horses that recovered after relaparotomy.

Response to early repeat celiotomy in horses after a surgical treatment of jejunal strangulation

“…The inclusion of a single intestinal segment (jejunum) in our study contrasts with previous literature aimed at establishing general principles of repeat celiotomy, regardless of the diseased intestinal segment . Such general information is of little value to the management of individual horses, as most candidates for repeat celiotomy can be readily categorized by location of disease (small intestine vs large intestine) and initial surgical treatment (type of resection, no resection).…”

“…Repeat celiotomy after colic surgery is reported in 4.7%‐14.6% of horses, most involving small intestinal procedures (57%‐88% of repeat celiotomies) . When horses treated with small intestinal surgery only are considered, 12%‐27% of horses required a repeat celiotomy .…”

“…When horses treated with small intestinal surgery only are considered, 12%‐27% of horses required a repeat celiotomy . Short‐term survival in horses recovered from anesthesia after a repeat celiotomy range from 27% to 80%, with long‐term survival from 12% to 40% . The probability of survival to 100 days after repeat celiotomy dropped to approximately 50% in one study considering all horses who underwent small intestinal surgery .…”

“…No specific guidelines regarding the indications and prognostic factors associated with repeat celiotomy have been established . Although small intestinal surgery is most commonly associated with repeat celiotomy, clinical indicators for a second surgery in that segment are difficult to determine from the literature because most studies group small and large intestine together . Some of the largest studies also include horses with incisional complications and those with repeat surgery after hospital discharge, even up to 9 years from the date of initial surgery .…”

Inguinal-scrotal herniation and torsion of the large colon in an adult Andalusian stallion: a case report

“…In most of the cases the jejunum and ileum are the incarcerated segments, with a good prognosis and high rate of survival at discharge following the surgery (Mezerova et al, 2008a). Rarely, the large colon is the part of the bowel introduced into the inguinal canal or scrotal bag; foals are more likely to develop this herniation due to the fact that the inguinal canal is shorter and wider than in the mature horse (Robinson and Carmalt, 2009).…”