Wednesday, March 16, 2011

Colic continued

Well the good news is Kylie made it through surgery. BUT she has a long, winding, very difficult road ahead of her. She got up after an hour, which the doc said was pretty normal after being in surgery for so long. He removed 95% of her colon (large intestine), which they can live without if they survive all the potential complications from surgery. I feel so awful seeing Kylie this way. Her eyes are swollen from being on her back for so long during surgery. She is still out of it, and has IVs hanging from the ceiling attached to her, huge bandages around her belly, she has a Hannible Lechter leather muzzle on so she doesn't eat her staw bedding, and she stinks almost unbearably of DMSO (smells like rotting garlic and onion). It is overwhelming to see her like this. Just a day ago I was riding and jumping her happy and free. The vet told me that heart rate (HR) at 24 hours after surgery was significantly associated with survival. Thankfully, Kylie's is in the range for survival.

The term "colic" means only "pain in the abdomen" or "pain in the belly". There are many causes for such pain, ranging from the mild and inconsequential to the life-threatening or fatal. One of the problems with equine colic is that it can be very difficult in the early stages to distinguish the mild from the potentially fatal. This is why all cases of abdominal pain should be taken seriously right from the onset. Some horses are so painful on presentation at the hospital that there is no question surgery is needed, this was our case.

Kylie had the most severe form of colic - a twisted bowel, these types of colic cause a total blockage of the intestine and require immediate surgery if the horse is to survive. Not only is gas and food material trapped inside the twisted gut, but blood supply is cut off, causing damage or death to the intestine. As the gut dies, toxins are released into the body, causing severe illness or even death. For some horses, pain medication helps keep them quiet for approximately an hour. But some horses are so painful that the drugs seem to help very little. Horses can die from this type of colic within a few hours. So thankfully my friend noticed there was a problem!!! The cause for this type of colic is poorly understood, so I have no idea why this happened to her.

The large intestine fills a significant part of the abdomen. The total length of the large intestine is about 25 feet, but it holds approximately 30 gallons of material - twice as much as the small intestine. Surprisingly, this large unwieldy structure is tethered to the body wall at only two points: at its beginning (where it joins the small intestine and caecum) and at its end (where it joins the short, narrow small colon which leads to the anus). With only two immobile points, the large intestine lies in the abdomen in a neatly-arranged double-U formation, one "U" stacked on top of the other. This arrangement entails the food making it round a number of 180 bends (known as "flexures") in the intestine. In addition to these problems the only thing that holds the colon in place is bulk. So a hungry horse without access to forage and an empty colon is a prime candidate for a twisted gut.

So many challenges lie ahead...

The first 72 hours after surgery are the most critical. This is when the intestines are trying to reorganize themselves from being manipulated, cut open, et cetera. As a result the intestines sometimes stop moving, which is very painful for the horse. Also, if the circulation to the intestines was cut off for too long, the lining of the intestines sometimes reacts by becoming inflamed, or dies, resulting in severe diarrhea. If the horse had intestine cut out, the site of reattachment may fail, causing either another blockage or rupture at the site. After surgery the horse’s immune system is compromised from stress, and infection is a concern. Laminitis, may also occur.


Paint Girl said...

So happy to hear Kylie is doing better. My heart goes out to you and Kylie!! Sending lots of good thoughts your way for a speedy recovery!

Anonymous said...

Glad she's made it this far and keeping fingers crossed for continued progress.

Sarah said...

Awww, sweetie, I'm so sorry your sweet mare is going through this. It's absolutely terrifying to me, especially the part where you really don't know WHY. I hope hope hope she comes through all this with flying colors. Thank you for being the best horse mom and doing everything you can for her.

fernvalley01 said...

My prayers for an uncomplicated recovery

Marissa said...

Oh my gosh... My eyes are welling up with tears reading this. So sorry for what you and your mare are going through. Saying my prayers for her.

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