Colic Surgery

“Making The Decision”

Although the majority of cases of acute abdominal pain in horses can be treated and resolved conservatively with medical management in the field, some gastrointestinal disorders occur or progress into lesions that require surgical intervention. When basic therapy fails to correct your horse's problem, you generally have three therapeutic options in which you may pursue. Unless finances are the primary concern from the beginning, option number one is pain control combined with fluid therapy.  Initially we attempt medical correction unless it is obvious from the start that surgery or euthanasia is our only option. We give the horse every opportunity to respond to treatment before considering surgery. The greatest majority of medical therapy involves fluid administration and pain control. You must understand that fluid therapy itself can become quite costly because of the large volume of fluid typically required and the professional time devoted to their administration and care of your horse.
Frequently horses are monitored for several hours before clinical parameters such as pain response, heart rate, abdominal distention, or rectal examination findings begin to reflect an unresolving or deteriorating condition.  At this point, you basically have two choices left. These are either surgery or euthanasia. It is unfortunate that more times than not, finances are the determining factor.  You have to ask yourself some tough questions when making a decision.  Is your horse insured? What is the replacement value? What are the emotional ties? Will this be a financial hardship? What is the prognosis?  What will the cost of the surgery be and how will I pay for it?  e.t.c….

The prognosis of surgery will differ based on a number of factors. One such factor is the type and location of the problem. The prognosis of a large intestinal problem generally is better than that of a small intestinal problem. The prognosis of an impaction is better than a twist. Typically, small bowel problems involve a twist or some strangulation of the bowel and it's blood supply, requiring resection (removal of a dead section) of the bowel. Typically, large bowel problems involve impactions or if they involve torsion's (a twist along the long axis) frequently they don’t require resection. Other factors affecting prognosis are age of the horse, the duration of the problem, dehydration, and how long it takes to reach a surgical facility… just to name a few.

There are a number of hurdles a horse must clear if it is to survive: we first have to stabilize their condition so they hopefully can undergo the stress of anesthesia; they must have a correctable lesion, some do not; they have to survive the surgery (probably the most critical time); they have to get back on their feet in our recovery stall, some make it through the surgery only to die in recovery. Now, if the animal makes it this far they still are only about "half way home".

The postoperative phase of the horses recovery can be as difficult and as costly (or even more so) than the surgery itself. Many of our patients require large volumes of I.V. fluids daily (40 liters/day is not uncommon), antibiotics, pro-kinetics, anti-endotoxic therapy, gastric decompression and obviously a lot of intensive care. Just because an animal makes it through surgery does not guarantee its survival. When horses do not survive this phase, it is generally because of severe complications such as endotoxemia or peritonitis to name a few.  Endotoxins are poisons formed during the colic. These poisons are typically in greatest quantity when dead or devitalized bowel is present.  In spite of therapy specifically designed to combat their effect, these endotoxins can overwhelm the animal resulting in multiple systems shutting down and death. Peritonitis is an overwhelming infection of their peritoneal cavity due to leakage of fluids and bacteria through the diseased bowel.

If this seems like a "long row to hoe", you are correct. Hopefully all will work out for the best. However, whether we are successful or not with your animal, we are providing to you a service for which we must be paid. It's interesting to note that a certain segment of the horse owning population are extremely supportive of what we are providing until either the animal dies or when we ask for payment of our services.  At this point, the excuses fly (and money does not). We cannot continue to provide a highly specialized service and deal with individuals whom are less than honorable. We try to estimate the prognosis and surgical cost before surgery based on the information we have at that point in time. The fact is however, we frequently do not know how bad (or good) things are until we open the horse up. Even then, some animals I would not give you a nickel for during surgery turn out perfectly. Other horses that look great during surgery die 10 days and eight thousand dollars later. We are not dealing with automobiles in which an exact estimate can be given. When they have few complications the bill is less; when they have more problems the cost are higher.    

Since we are not in the banking business, your options for payment are:
   (1). Cash
   (2). Credit Card: Master Card, Visa e.t.c.
   (3). Care Credit Program: see the front desk regarding.
   (4). A Good Insurance Company.

If it is deemed that surgery is necessary and if you are paying by cash or credit card, one half of the estimate will be required at that time. When the animal is discharged to go home or unfortunately dies, you will need to settle the remaining balance.