b'2019 AAEP CONVENTION WRAP-UPintestine strangulations are more likely to2019 Havemeyer Workshop Panelists develop postoperative reflux. Therefore,Focus on Colicthe perception that older horses are moreEach year the Dorothy Russell Have-likely to reflux might relate to them be- meyer Foundation hosts a handful of ing more likely to have a small intestineworkshops on important horse health lesion, rather than any physiological ortopics; in August 2019 researchers tackled anatomical predisposition.equine colic. A panel of four experts Several studies have attempted toanswered audience questions about determine whether or not older horsescolic-related issues at a table topic session suffer postoperative reflux more com- reviewing this workshop.monly than younger animals followingThe panel included Frank Andrews, colic surgery, said Boorman. To date, noDVM, MS, Dipl. ACVIM, of LSU; Bar-clear answer has presented itself. bara Dallap-Schaer, VMD, Dipl. ACVS, Looking to finally put this question toACVECC, of Penn Vet; Michelle Barton, rest, Boorman and colleagues from PennDVM, PhD, Dipl. ACVIM, of the Univer-Vets New Bolton Center reviewed medicalsity of Georgia; and workshop organizer records of horses that underwent surgeryDiana Hassel, DVM, PhD, Dipl. ACVS, at the University of Londons RoyalACVECC, of CSU.Veterinary College for correction of smallOral and rectal fluids Sometimes ISTOCK.COMintestine lesions from December 2009 topractitioners administer oral fluids to June 2015. They divided horses into twohorses with impaction colic, especially if groups based on age: those 16 years (44)they suspect dehydration as a contribut- In cases of impaction due to ingesting sand, and mature horses 2-15 years of age (39).ing factor. Attendees expressed interestveterinarians should administer psyllium, but After scouring those patients records,in what the panelists add to these fluids.only after the colic has subsided.Boormans team found that horses mostWhile vets often give mineral oil, the likely to develop postoperative reflux hadpanel agreed that its greatest benefit is asduodenitis/proximal jejunitis, the panel-a resection of the small intestine duringa marker for liquid passage through theists said.surgery, longer surgery times, and gastricGI tract. Some panelists mentioned ad- Gut motility When a patient needs reflux upon arrival to the hospital. ministering 5 liters of balanced electrolyteincreased gut motilitysuch as during Age was not associated with eitherfluids once an hour for five hours. If theimpactions, after colic surgery, or when postoperative reflux or survival, butimpaction is due to sand, and the sand isin painAndrews said he places an horses with postoperative reflux hadmoving, they recommended administer- apple-flavored bit in the horses mouth. decreased survival, said Boorman.ing Epsom salts and psyllium.Having the horse chew on a bit stimulates There are many reasons to de- Discussion then turned to administer- GI motility and has resulted in shorter cide against pursing surgery during aing fluids rectally. The panelists agreedreflux durations in some postoperative colic episode: finances, emotional stress,this can be beneficial in some cases,colic cases. He has horses chew on the bit perceived prognosis of the horse, etc.,especially if clients cant afford for thefor 15 to 30 minutes every six hours. Re-she added. Older horses with a smallveterinarian to administer intravenoussearchers are currently evaluating the ef-intestinal lesion that survive colic surgeryfluids. Anecdotally, some panelists havefect of bit chewing on horses gut sounds are just as likely as younger horses tofound continuous rectal infusion of tap(indicative of normal motility). Bit use develop postoperative reflux or to survivewater more beneficial in some cases thanand chewing might stimulate motility in to hospital discharge. Therefore, the ageoral electrolytes. Partially used 5-literhorses with small intestine ileus after ab-of the horse should not be considered afluid bags are particularly useful as adominal surgery, he said. Doctors take a prognostic factor. fluid source for rectal administration.similar approach in human patients with Stacey Oke, DVM, MScTake caution, the panelists said, whenpostoperative ileus using chewing gum. administering rectal fluids, as there is theThe audience also discussed whether ARTICLE SPONSORED BY potential for rectal tears.psyllium is appropriate for impaction cas-NSAIDs Next the veterinarians dis- es with reduced small intestine motility. cussed NSAID use and whether its nega- The panelists said veterinarians should tive impacts on mucosal healing weregive nothing if thats the case. Again, with worth the risk. Panelists agreed that whilesand impactions, veterinarians should NSAIDs can compromise mucosal healthadminister psyllium, but only after the and repair, the benefits of controlling paincolic has subsided. At this point the vet outweigh the risks, because pain reducescan administer it daily via nasogastric GI motility. COX-2-specific inhibitorstube until the sand is seen clearly moving such as firocoxib can be particularlyout the digestive tract. beneficial in small intestine inflammationFecal water Chronic fecal water, in cases such as postoperative resections orwhich horses pass water either with 46March 2020The Horse|TheHorse.comAAEPWrapUp.indd 46 2/5/20 2:54 PM'