Colic Surgery

                                                           by Laura Crum

            I have had a few friends lately (both on the internet and in real life) who have either lost a horse to colic or had a serious colic, and the subject of colic surgery has come up. Since I have actually gone through colic surgery with a loved horse I thought I’d write a post on what I learned, in the hope that it might help someone else make a decision.

            First off, I have always been someone who said I wouldn’t do colic surgery. Too much risk, too hard on the horse, too expensive, the rehab is long and hard, many horses are never 100 percent…etc. I knew people who had done colic surgery, with varying results, and I felt pretty sure this was not a path I wanted to take.

            But…five years ago, when my son’s horse, Henry, colicked, I did, in the end, choose colic surgery. I had some pretty specific reasons for this. 1) My son had lost his beloved pony to cancer a year previously, and I was desperate not to lose Henry at this point, 2) Henry was sound and strong and in perfect health otherwise, 3) ultrasound showed a mass in his intestine that the surgeon thought was a pile of sand or small stones that needed to be removed and they felt this was a relatively straight forward surgery, and 4) Henry was in excellent shape for surgery…all his vital signs were very good. The vets at the equine center convinced me that surgery was Henry’s best chance.

            I was told the surgery would probably cost $7500, and though I had to put it on my credit card (I do not have that kind of extra money lying around), it was not an impossible amount for us as a family, and my husband was in agreement that we should try it. I would not have done the surgery if it would have been a serious financial problem for our family. (By the way, when all was said and done, with rechecks, post op problems…etc, it was more like $10,000, and people have told me that it is $12,000 today at that same equine center.)

            I was also told that Henry had a very good chance of going back to full work, which for him was walk, trot, lope trail horse. I forget the actual statistics now, but they were pretty good. The down side was that Henry had just turned twenty, and one in five rehabs had some sort of problems. Anyway, I made the choice to try the surgery.

            Those who have read this blog know that it did work out and Henry has been 100% fine for five years post surgery. Given the exact same set of circumstances, I would make the same choice. I do know the surgery was needed—I have the cantalope-sized stone they took out of Henry’s intestine on my living room shelf. However, if another one of my horses colicked tomorrow and I was faced with surgery, I think I probably would not choose this option (though again, it might depend on circumstances).

            Why? Well, having been through it, I really understand what it entails, which I certainly did not before. So let me see if I can describe the process well enough that others can understand my thinking.

            First of all, I would only consider colic surgery if the horse was, as Henry was at the time, vital and pretty much irreplaceable and completely sound and in full use. The horse would have to have an excellent prognosis going in, as Henry did. A horse that was already in distress with poor vital signs is just not a good bet. And finally (though I didn’t think much about this at the time) the horse would need to be the sort to be a good patient.

            Because the rehab was just as difficult as I had feared. First off, the horse has to be confined in a 15 by 15 stall for the first month and, guess what? They would prefer he didn’t roll. (You can easily see why.) I have no box stalls, so I built a 15 by 15 stall out of panels, under a pasture shed roof. Oh, and this just happened to be in February—it rained pretty much non-stop during the first part of Henry’s rehab. The stall had to be kept immaculate, because it was vital to keep the incision clean. So I bedded this stall VERY lightly, so Henry wouldn’t want to roll, and I cleaned it three times a day.

            The horse must be hand walked three times a day as well, and hand grazed on green grass three times a day. The horse must be fed four small meals of hay a day. Then there’s antibiotics and pain meds as needed. Taking care of Henry was almost a full time job. Fortunately, I had the time to do this.

            Henry had to go back to the equine center once a week for rechecks during the first month (and the equine center was an hour away). During these rechecks they changed his bandage (which was a huge thing that wrapped around his barrel and supported the incision). But after the first month, they had me buy a “hernia belt” (very expensive) and from then on I changed Henry’s wound dressing every two or three days myself. I learned to do it competently, but it would have been a dangerous business with a flighty horse inclined to spooking or kicking.

            Henry ended up with a couple of (very common) post surgical problems. First he got an infection (he was on antibiotics for a couple of months) and then he developed a hernia. Neither of these problems was a big deal in the grand scheme of things (though, of course I didn’t know that at the time), but they caused me a lot of worry and some expense and certainly many extra rechecks with the equine center.

            After six weeks of confinement in a stall, even the docile Henry was very full of himself and a pain to handle—I cannot imagine what this would be like with any sort of hot horse. I was worn down with worry and the constant care giving. I had been told that we could go back to riding Henry in three months, but it wasn’t until the end of four full months of rehab that we got cleared to actually ride the horse. And it wasn’t until we were six months out from surgery that we were taking him on trail rides and picking up the lope. It was a long haul.

            Six months is not a long time if you simply turn a horse out in pasture and let him heal. But this was four months of constant, every day, three and four times a day, hand walking…etc. It was a lot of work. I worried constantly that Henry would get adhesions, or a serious hernia that would require more surgery, or mean the end of him. In retrospect, since I know the horse is fine, this worry was pointless. And, of course, since I did my very best to take good care of Henry, and this was all that I COULD do, the worry was pointless in any case. But I couldn’t help worrying. It was very stressful.

Eventually rehab progressed to the point where my son could ride Henry—bareback at the walk. And this was the one and only point in all the time we’ve owned him when (the now feeling way too full of it) Henry ever dumped my kid. (My son wasn’t hurt, but it wasn’t our best moment, that’s for sure.) And then came two months of slow, careful under saddle exercise, while the horse lived in a small (20 by 20) pen. Lots of stall cleaning and pen cleaning involved, too. Again, a lot of work.

            Yes, it was worth it to me. Under the circumstances in which I made that choice, I would do it again. But I probably would not choose it today for any horse on my property. None of them have the disposition to be the excellent patient that Henry has/had, and Henry himself is 25 years old. All of my horses are in their late teens or older. Bearing in mind that we all must die sometime, I don’t think I would put myself or any of my horses through that ordeal just to extend their lives. The one exception might be Sunny—but I am not sure how he would deal with the rehab. He hates taking meds and will kick if he feels the need. I think it might be an unworkable combination.

            So yes, even though I had a successful result with colic surgery and I am very grateful that I spent the money and the time and the blood, sweat and tears to keep Henry with us, this hasn’t made me feel that I would want to do colic surgery in the future. I can’t, of course, make any recommendation on what others might want to do, because every situation is different, but I hope my story may help someone else to at least have a little more understanding than I had going into the process.

            And please, if anyone else has insights to offer, feel free to give them in the comments. 

           

Colic

By Laura Crum


All of us who own horses have dealt with colic. At least, all of us who’ve owned more than a few horses and for more than a few years. Colic is relatively common in horses, and by far the likeliest cause of death. And yet some of us skate through many years of happy horse ownership without ever facing that dreaded situation—the horse who is about to die of colic. I was one of those someones until five years ago. At that time I lost my great horse, Flanigan, to colic. Surgery was out of the question for Flanigan, because he had the pre-existing condition of a diaphragmatic hernia, diagnosed a year previously. So the decision to euthanize him came fairly easily, though it caused me much grief.

The next five years passed without another serious colic. My son’s horse, Henry, a reliable, bomb-proof mount, much loved by us all, had a couple of mild colics that resolved easily with a little banamine. And then…

Several weeks ago Henry had another mild colic. I treated him, but the symptoms returned. I had the vet out. We oiled Henry up, gave him fluids, more painkillers. But the symptoms returned. Henry was never very painful. His heart rate stayed normal. His breathing wasn’t much elevated. He wasn’t ever sweaty or distressed. He was merely uncomfortable. He looked at his sides. He stood camped out. He wouldn’t eat his hay. He wanted to lie down.

We spent thirty-six hours (and two sleepless nights) treating Henry. We walked him, we kept him from rolling, we gave him banamine and fluids. Every time the drugs wore off the symptoms came back. I cannot describe how helpless and depressed I felt. Henry is my son’s beloved horse. I desperately wanted him to get better. But he didn’t.

Early Friday morning, Jan 30th, we hauled Henry to the closest equine center, convinced that despite the apparent mildness of his symptoms, something was seriously wrong. At the equine center, X-rays showed what they said was a large pocket of “gravel” in Henry’s large intestine. Surgery was recommended. I stared at Henry, who still looked calm and relatively normal. Was this really a horse who needed surgery? The surgery is both expensive and also a danger in itself. 20% of horses that go through it have serious complications. I had no idea what the right choice was. In the end I asked the surgeon to look me in the eye and tell me what I should do.

He took off his sunglasses, met my eyes (pretty tear-filled by now, I will admit), and said “If he was my kid’s horse I’d operate on him right now. I wouldn’t wait.”

“Okay,” I said. And I left Henry there for colic surgery.

Do any of you know exactly what colic surgery entails? I didn’t. I do now. The vets at the surgery center explained the process to me very carefully. After lying the horse down, they open his belly, making an incision from belly button to near the sheath (in a gelding). Man, it’s a long cut.. Then they take the large intestine out of the horse’s body, drag it several feet away and open it up (This is to avoid contaminating the body cavity and the subsequent risk of peritonitis). In Henry’s case they found a section full of one gallon of black sand and small enteroliths (these are stones the horse makes in his gut—they looked like river rocks) ranging from two inches to one quarter inch in diameter. This is what they expected to find. But in the course of cleaning Henry’s large intestine out, they found another stone, in a place they hadn’t expected it, much further up the colon. They had to make a second incision to take this stone out. It was bigger than the biggest grapefruit you ever saw and weighs over fifteen pounds. I kid you not. It is on my desk as I type this.

While all this was going on, I was at home, alternately biting my fingernails, leaking tears, and trying to appear relatively normal for my son’s sake. Four hours later I got the call that Henry was coming out of the anesthetic, shaky, but okay…for now.

Henry stayed at the equine center for five days. The young vet who took care of him called me every day to let me know how he was doing. Henry, as she said, was a “rockstar of a patient”. He recovered smoothly, had a good attitude, was easy for them to handle. Our family visited him several times at the equine center and took him for walks. It cheered us all up to see how normal he looked, even just one day after his very major surgery. They showed us the bucket of sand and stones that came out of him and gave us the big stone to take home. It cheered me up to realize that I’d made the right decision. Henry would never have survived without surgery. It was his only chance.

I examined the bucket of “gravel” that was removed from our horse. The black sand never came from our property. There is no sand that looks like that here. We have owned Henry for a year and a half and my son has taken him on over one hundred rides. Three hour trail rides over many hills. Twenty minute loping sessions in the arena. Henry has always been sound. He had plenty of strength and air. He never showed the slightest sign of weakness. And yet Henry was packing that load of sand and stones, not to mention the big stone, on every single one of those rides. It boggles my mind.

After five days we were allowed to bring Henry home. He had a big “belly band” around his middle, supporting his incision and keeping it clean. He had to be fed four small meals a day. He had to be kept in a stall. He had to be hand walked for ten minutes two to three times a day and allowed to graze on green grass. I’ve been keeping quite busy with his care, especially since it has chosen to rain pretty much non-stop since I brought him home.

But I’m getting it done. Henry’s bandage stayed clean, he got his walks and meals and grazing. At his first re-check he was said to be healing well. He is still not out of the woods. He will have three months of rehab before he can return to normal use. We still have the risk of potential hernias and future colics to get through. But I am grateful we have come this far. We’ve given Henry a chance.

For any of you who ever face the same choice, I can only say that I’m glad I listened to the surgeon. I had Henry operated on before he was too far gone to save. I will be eternally thankful I made that decision.

Here’s to Henry…
Laura Crum