Advanced surgical treatment at UF helps horse with colic

By Kate Valdovinos

Ruby Hudson with her owner, Adrienne Hudson, and her local veterinarian, Dr. Natalie Lamneck.

Ruby Hudson with her owner, Adrienne Hudson, and her local veterinarian, Dr. Natalie Lamneck.

Adrienne Hudson first encountered colic in 1990 when her 23-year-old pony died from sand colic, which occurs when sand builds up in the intestine. Colic is the leading cause of premature death in horses and Hudson decided to learn everything she could to prevent the condition in any other horses she owned.

“Maximum turn-out, the least possible amount of grain, semi-annual dental care, and electrolytes when there are big temperature variations were some of the things I gave importance to,” Hudson said. “I generally feed flakes of hay, or if I have to feed off of a round roll, I feed it in portions — never in a big round bale left out for them to gorge on.”

Hudson continued to learn about colic prevention, preventive veterinary care and dietary maintenance and her horses stayed healthy. A few years later, Hudson purchased Rubiyat Kharma, or Ruby, when she was a weanling. Over the years, Ruby had bouts of very mild colic when she traveled, but always recovered quickly following veterinary care.

In April, however, Hudson found Ruby down in her stall. Hudson got her up, but Ruby continued to roll violently, even while being walked. After an examination revealed severe colic signs, Ruby’s veterinarian, Dr. Natalie Lamneck, advised Hudson to take Ruby to the University of Florida Large Animal Hospital for further care.

After Ruby arrived at UF, Dr. Chris Sanchez, an associate professor of large animal medicine, and Dr. Martha Mallicote, a large animal medicine resident, performed an emergency work-up. After finding blood in the abdominal fluid — an indicator of a damaged intestine — the veterinarians began to suspect a strangulating lesion of the small intestine. They recommended Ruby go to surgery immediately.

Ruby was taken to UF’s specialized colic surgery operating suite, where surgeon Dr. Sarah Graham and surgical resident Dr. David Dymock found that a small fatty tumor had cut off the blood supply to a large section Ruby’s bowel. The veterinarians surgically removed 25 feet of the middle section of the small intestine. Called a “resection and anastomosis,” the procedure involves removing the damaged intestine followed by reconnecting the ends.

Through the use of a subjective system to decide when strangulated small intestine can be removed or left in the horse, Graham was able to determine how much of Ruby’s intestine needed to be removed. This system, pioneered by Dr. David Freeman, chief of large animal surgery and interim chair of UF’s department of large animal clinical sciences, has led to higher long-term survival and lower complication rates in horses.

Although the surgery was a success, Ruby showed signs of colic again the next morning. A tube was passed into Ruby’s stomach and excessive fluid was obtained — an indication that the small intestine was not working properly. The surgeons were concerned that the anastomosis was not working, which would explain the fluid that accumulated in the stomach. Graham recommended that Ruby be taken back to surgery that day so that the anastomosis could be evaluated and repeated if necessary.

This approach is consistent with the UF philosophy that emphasizes the importance of surgical treatment over aggressive or long-term medical management because it reduces postoperative complications, increases short and long-term survival, and improves the long-term quality of life for horses after colic surgery.

Ruby’s second surgical procedure revealed a large blood clot had caused a kink at the site where the intestines were reconnected. The section of intestine affected by the blood clot, about 1.5 feet, was removed and the anastomosis was performed again. While two colic surgeries in two days is uncommon, the second surgical procedure was just as important as the first, Graham said.

“I don’t think that Ruby would have recovered or done as well in the long-term without it,” Graham said, adding that Hudson’s confidence in the UF team and her belief in Ruby’s recovery made a big difference. “Taking Ruby back to surgery so quickly enabled us to save her owner money that might have been wasted on additional medications or a more prolonged hospital stay,” Graham said.

Freeman emphasized the importance of the steps that contributed to Ruby’s successful outcome.

“Prompt referral is critical,” Freeman said. “Delays caused by continued therapy at home or at a hospital where the surgery cannot be performed might be well-intentioned, but can lead to a high failure rate.”

Luckily for Ruby, Hudson and her veterinarian acted quickly when the colic was noticed and the emergency colic surgery was performed at UF, a facility with a designated space for colic surgery and board-certified veterinary surgeons and anesthesiologists.

A week after she came to UF, Ruby went home. She has shown no signs of colic since her second surgery. Veterinarians told Hudson that Ruby needed stall rest with hand grazing for two months before she could be released to a small paddock. Ruby’s diet increased gradually in the first week following surgery and after that she was allowed to eat her usual diet.

“As far as the future goes for Ruby and us, I figure she’s good for another 15 or 20 years,” Hudson said. “Though I was trying my best to be clinical and unemotional at UF, the cocoon of understanding, caring and grace that surrounded Ruby and me was, for want of a better term, transcendent. I think that Ruby understands and appreciates everyone’s efforts to save her life.”


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