What to Expect After Colic Surgery

Colic surgeries are common procedures in equine veterinary medicine, but do you know what to expect after your horse recovers from anesthesia? Equally as important as knowing whether you should send a horse to surgery is understanding what to prepare for once he’s back in his own stall.

Louise Southwood, BVSc, MS, PhD, Dipl. ACVS, ACVECC, reviewed what to expect following colic surgery at the 2015 World Equine Veterinary Association Congress, held Oct. 8-10 in Guadalajara, Mexico. Southwood is an Associate Professor of Emergency Medicine and Critical Care at the University of Pennsylvania School of Veterinary Medicine’s New Bolton Center, in Kennett Square.

After a horse makes it through surgery, the recovery process begins. Southwood said she generally administers antimicrobials for 24 hours after surgery and non-steroidal anti-inflammatory drugs for three to five days to help prevent infections and keep the horse comfortable, respectively.

Once the horse has recovered enough to be discharged, the owner assumes a lot of responsibility for observing the healing process and monitoring the horse, along with communicating his or her observations to the veterinarian. As the gastrointestinal tract resumes proper function and the body wall heals from the surgical incision, Southwood said it’s crucial to watch for:

• Incisional infections and other issues, such as hernia formation;
• Additional colic episodes (in up to 20-50% of horses), which tend to be mild and usually do not require additional hospitalization; if the horse has had surgery for a small intestinal problem, recurrent colic episodes could indicate that internal adhesions have formed, Southwood said);
• Laminitis development (in less than 1 to 2% of cases, she said);
• A consistent body weight (or weight gain, if the horse lost weight in connection with the surgery);
• A normal demeanor (an unusually quiet or depressed attitude could indicate complications that should be evaluated by the veterinarian); and
• Adequate water and food consumption and manure production.

Southwood recommended keeping the horse stalled, with hand walks and grazing, for the first four weeks following surgery to allow the body wall to heal. After that, she said, the horse can move to a small paddock or a stall with a run-in for another four weeks before resuming his regular turnout routine. Exercise or training can begin after 10-12 weeks, assuming the incision has healed without complication.

Many surgeons use absorbable sutures that do not need to be removed; however, if the surgeon used staples to close the incision, he or she should remove those after 10 to 14 days, she said. Before and after staple removal, Southwood said, she generally doesn’t recommend owners clean the incision unless it becomes infected and starts draining. At that point, she recommended the veterinarian gently open the wound to allow it to drain. She also encouraged practitioners to take a bacterial culture in these scenarios to determine what’s causing the infection. If an incision becomes infected, Southwood said she doesn’t generally administer additional antimicrobials. Rather, she focuses on keeping the wound clean and dry and monitoring it closely for hernia formation. “If the infection is severe or it is strongly desired to prevention hernia formation, an equine hernia belt may be used,” she said.

When it comes to nutrition, Southwood said most patients can resume eating a normal diet. In some cases, she noted, the attending surgeon might recommend modifying the horse’s diet, perhaps transitioning to a complete feed or adding oil if the horse is losing weight. In any case, it’s important to follow the surgeon’s and veterinarian’s advice when it comes to the horse’s diet following surgery.

Several researchers have evaluated horses’ return to work following colic surgery, Southwood said. After six months, she said, 68% of horses in one study had returned to work, with 56% of horses returning to their previous level; after 12 months, 76% of horses had returned to work. She noted, however, that other factors—including additional hospitalization, laminitis development, and other complications—delayed a horse returning to work following surgery.

Southwood noted that many racehorse trainers don’t believe that horses can return to having a successful racing career after colic surgery, so the group at New Bolton Center evaluated racehorses’ performance following colic surgery and compared it to horses (from the race prior to surgery) that had not had colic surgery. Key findings included:

• 76% of the study horses—all of which were 2 to 5 years old and had raced prior to surgery—returned to racing after surgery;
• Horses with strangulating obstructions were more likely to return to racing than those with nonstrangulating obstructions; and
• There were no differences between case and age-matched control horses in performance (including number of starts and earnings) except for in the first two quarters of the year following surgery (so, the first six months after surgery); in those quarters, control horses performed more and earned more because case horses were still recovering from surgery. Another study out of California had similar findings, she noted.

Southwood also touched on broodmares that undergo colic surgery. She said studies have shown that 66.7% of mares that undergo surgery while pregnant deliver a live foal, but live foaling rates decrease when the mare undergoes colic surgery early in gestation, when the surgery lasts for more than five hours, or when the mare is a senior. Finally, Southwood gave attendees tips on how to reduce the likelihood of horses developing colic. Her suggestions included:

• Increasing pasture time;
• Decreasing the amount of grain in the horse’s diet;
• Ensuring the horse has adequate quantities of water and good-quality hay;
• Scheduling regular dental exams;
• Employing strategic deworming;
• Increasing exercise; and
• Making dietary changes slowly.

She also noted that horses that crib and those that live in certain geographic areas could be at higher risk of developing colic, so owners should take extra steps to reduce the chance of their animals developing colic.

Take-Home Message

No owner wants to send his or her horse under the knife. But knowing what to expect ahead of time can help ensure the horse comes through surgery and recovery in the best shape possible.