Hi all, this is my first time posting though I have “lurked” for some time. I apologize for the long history, I will try to stick to relevant details.
I have a Clyde cross mare who I bought as an 8 year old from a family who was told by the horse trader they bought her from that she was a former PMU mare. This fits as she has a large brand on her shoulder and came to the trader with a rectal-vaginal fistula from an obviously bad foaling. While surgically repaired with good vulva closure, this resulted in about a 40% loss of anal sphincter and she has a pneumorectum now. At this point you are probably wondering why anyone would buy a horse with an issue like this (and I sometimes question myself) but she is a wonderful packer with a sweet, kind heart. She had obviously been through a lot, and long story short, I fell in love with her.
So I knew I would need to monitor her for discomfort with any air sucking, and she has remained relatively comfortable until about the past year. Inititally this began with two minor colics about 6 months apart, lasting less than 12 hours, that were resolved with Banamine iv and some bran mashing and that was that. Her colic symptoms are basically not eating, and some parking out. Her heart rate is the most tell-tale sign we have besides appetite. Her HR for these episodes was around 50. The first one was right after a cold snap and the second one was in the spring 2013. I should add at this point that she is usually on turn-out.
Flash-forward to March 2014, when she began another colic although this time she was telling us a lot more, parking very frequently and HR around 65. Upon tubing at home she didn’t reflux but upon palpation small intestine loops could be felt. She had gotten Banamine and Gentocin, and Buscopan for the ride to Hagyard Davidson. Ultrasound showed several small intestine loops with an edematous wall but good motility. She was monitored on fluids overnight, started to produce normal manure and was released the next afternoon as her scan looked normal. They recommended bran mashes and reintroducing hay and turn-out slowly, which we did. She did really well for a time. Then on Mother’s Day she started acting uncomfortable again. Her HR was 30 and I was hearing gut sounds so I gave Banamine and monitored her. She appeared to have loose stool on her rear, so our vet was thinking a mild enteritis so he suggested a dose of Pepto too. She seemed to relax and remained comfortable for a couple hours. Then she suddenly started to violently colic, trying to lay down, etc. and her HR was 86. We immediately took her Hagyard. When we got her there she was calm again though uncomfortable to my eye. They put the scan on her and couldn’t see anything b/c of how distended her stomach was. After immediately tubing her, she refluxed 8 gallons of thick fluid :eek: Again the rectal revealed distended small intestine as did the ultrasound. The distention of small intestine was wide-spread with very little motility. She remained somewhat calm for a couple hours but suddenly became uncomfortable again. They had been refluxing her every 2 hours but with her increasing discomfort and the increasing distention a repeat u/s showed in the small intestine, surgery became the top option. At this point the small intestine wall was measuring about 8 cm. :eek:
Surgery revealed diffuse distension of the small intestine consistent with anterior enteritis and a large colon impaction that I was told was secondary to the enteritis. The small intestine was stripped into the cecum and the colon was lavaged and she was closed up. She woke up well and stayed comfortable, however continued to reflux for 3 days post-surgery. She finally stopped refluxing and they pulled the NG tube and began small hay feedings. The day after the NG tube was pulled they turned her out for an hour, and started giving her Reglan. This whole time she had been on fluids with Lidocaine CRI, Carafate, Banamine, Ca Gluconate, Gentamicin, KPen, Magnesium Sulfate, Flagyl, and Pentoxifylline. She developed some diarrhea around this time so we opted to keep her there for a couple more days on fluids. She was given some Pepto-Bismuth paste along with her other meds and the diarrhea resolved at the hospital after about 36 hours. She was slowly weaned from the fluids and Lidocaine and after a total of 11 days in the hospital, we brought her back to the farm. She was still on stall rest with restricted hay feedings and short hand-grazing sessions. The other meds we were instructed by Hagyard to continue was the Flagyl BID w/ some yogurt. She showed signs of discomfort shortly after arriving, possibly due to transport stress, and we were instructed to continue Banamine doses q 12 hours. She also began to have diarrhea again. Our vet here came to follow-up the next day and left us with 5 days of Gastro-gard. The diarrhea and discomfort seemed to get better within hours of the Gastro-gard (whether this is due to the drugs or time idk) and when we finished the Gastro-gard doses we began using Succeed. We are about a week into Succeed and she is beginning short turn-out sessions and thus far is doing really well. My vet wants to add Ranitidine daily and we are waiting for it to come in.
So the reasons for this enormous post are:
a) Have any of you experienced anterior enteritis and what was your experience like (causes, history, etc.)
b) If so, how did you treat at the time and how do you manage your horse now (i.e. feed, supplements, etc.)
c) Any advice going forward
Thank you so much in advance, and again I am sorry that this is so lengthy but I wanted to give all the info I had.