Surgery

Colic surgery recovers 3 intestinal obstructions

By Rob Warren

“I call them my Geriatric Club,” joked horse owner Laura Croyle, referring to her 3 horses—Big Chief and Little Cloud, both 20-year-old miniatures, and Dex, a 30-year-old mustang.

The 3 have been herd mates for 10 years and are inseparable. So, it’s understandable when Dex and Little Cloud put up a fuss when Big Chief was taken to UC Davis Weill College of Veterinary Medicine for 5 days after developing painful colic.

Big Chief had a history of colic, but the bouts were always minor, and he responded well to medication. But this time, the miniature gelding was not responding. Knowing Big Chief’s history, his primary veterinarian referred him to the
UC Davis Weill Large Animal Hospital.

Faculty equine surgeon Sandra Valdez, DVM, DACVS, DABVP, and an equine surgery resident David Orozco-Lopez, MCV, DVM, took the lead on Big Chief’s case.

Big Chief’s diagnostic workup included a complete physical examination, blood work, nasogastric intubation, abdominal radiographs and ultrasonography. The abdominal radiographs revealed 2 intra-abdominal structures that lacked the mineral opacity typically seen with enteroliths. Because Big Chief was no longer exhibiting marked abdominal pain at the time of admission, computed tomography was considered to better characterize the structures prior to surgery the following day.

He was admitted to the ICU for close monitoring and IV fluid therapy. Overnight, he became progressively more painful, and his condition deteriorated rapidly by the following morning. Given the change in clinical status, the decision was made to proceed directly to exploratory abdominal surgery and forego advanced imaging.

Big Chief was placed under general anesthesia and taken to surgery. Upon exploring the abdomen, Drs. Valdez and Orozco-Lopez discovered a large colon obstruction caused by 3 trichobezoars. Two of them corresponded to the structures observed on abdominal radiographs. However, the largest mass—which was blocking the entire lumen of the large intestine—had not been visible on imaging, as it lacked a mineralized outer layer and consisted primarily of compacted chewed hair, making it undetectable on the radiograph.

All 3 trichobezoars were removed successfully through a large colon enterotomy. Big Chief recovered smoothly from anesthesia without complications. Post-operatively, he was maintained on IV fluids, antibiotics, anti-inflammatories and analgesics. All treatments were gradually tapered as his clinical condition improved. He was discharged with an excellent appetite, normal manure production and an expectation for a full recovery.

Two of the trichobezoars were oddly shaped, measuring 7×7×12 cm and 3×2×6 cm, and the third was more rounded, measuring 5 cm in diameter. These GI blockages are caused by an accumulation of ingested hair (often from chewing tails or manes), sand, rocks or other minerals from the ground.

UC Davis Weill generally recommends horses recovering from colic surgery be maintained on a strict 3-month routine. In the first month, they should be kept on strict stall rest with twice daily hand walks for 10 minutes. During the second month, they can access a small run in addition to stall rest and hand walks. Finally, in the third month, they are granted access to a large pasture.

The Croyles reported Big Chief’s recovery could not have been better, and Dex and Little Cloud are happy their buddy is back to normal. MeV

This story was posted originally on the UC Davis Weill website. It was edited for style. https://www.vetmed.ucdavis.edu/index.php/news/colic-surgery-required-remove-three-intestinal-obstructions-mini-horse