Anterior Enteritis and colic surgery in a 12 year old Clyde cross mare

[Mohawk]

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.

[cloudyandcallie]

No advice, as the couple of friends of mine whose horses have had colic surgery have had their horses recover well (our vet John Malark is wonderful), but I do want to say that your mare is so lucky to have you for her owner. I hope she recovers well and lives a long life. That’s one very expensive mare that you have.

[Mohawk]

[QUOTE=cloudyandcallie;7606821]
No advice, as the couple of friends of mine whose horses have had colic surgery have had their horses recover well (our vet John Malark is wonderful), but I do want to say that your mare is so lucky to have you for her owner. I hope she recovers well and lives a long life. That’s one very expensive mare that you have.[/QUOTE]

Thank you very much! We are lucky to have her as well.

[Zuri]

Prebiotics and probiotics really helped my colicker. Post op he had dengie hay that was soaked and Ultium feed as it has omega 3s and other supplements in it. He is fed 4 times a day and has access to free choice Timothy hay and orchard grass.

I really hope your mare improves. The love you have for her is palpable through your post.

[Mohawk]

[QUOTE=Zuri;7606961]
Prebiotics and probiotics really helped my colicker. Post op he had dengie hay that was soaked and Ultium feed as it has omega 3s and other supplements in it. He is fed 4 times a day and has access to free choice Timothy hay and orchard grass.

I really hope your mare improves. The love you have for her is palpable through your post.[/QUOTE]

Thank you! Do you like any prebiotics and probiotics in particular? She had been on Fast-Track prior to the surgery.

[Peggy]

My horse Star had thickening of the intestinal walls in the ileum area. Before we got it diagnosed he’d had a couple small colic episodes over the year prior and had been diagnosed with and treated for ulcers about six months before. I don’t know if he had the thickening all along, but it wasn’t present when he went to the hospital with the colic that led to the ulcer diagnosis. (The clinic is literally a five minute walk so it is sometimes easier after hours just to go to the clinic as opposed to getting a vet out.)

Since the vets said he would have malabsorption issues from the thickening and that he shouldn’t have much in the way of concentrates and that we should keep food in front of him as much as possible, I started to free feed him timothy with a slow feeder. The routine was that he’d get his regular alfalfa breakfast and dinner from the barn but at lunch and some time around 8-10 pm he’d get a giant bag of timothy (1-2 flakes). I also had acupuncture done at the advice of my vet. Not cheap or easy, but it seemed to work as we had no more issues and the thickening was less with a follow-up ultrasound a few months later.

In the end, his neck arthritis caught up with up about six months after this started and I ended up retiring him. Lo and behold, the hard to keep weight on horse is now almost fat and has had (knock on wood) no issues. Although he isn’t retired on green pasture, the horses do have hay in front of them almost 24/7.

As far as what caused it, the vets (and I had three of them standing there with me one day–two from the hospital and mine) said he could have been susceptible to it for some reason. I did find out that the amount of hay that the horses were getting for breakfast and lunch was, um, variable and I don’t know if getting less roughage while maintaining the same concentrates somehow exacerbated things.

[khall]

Years ago I had a mare that at around 6 yrs old suddenly developed anterior enteritis. Refluxed gallons after the 2nd trip to the farm by my vet and was shipped to UGA where they opened her up to run the gut checking for dead intestine. She was fine, though she kept refluxing for several days and it took awhile for her SI to start back up again. (was very concerned with laminitis, but she made it through ok) Roughly 3 months later she coliced again, this time it was a colon impaction with a partial twist, was resolved surgically without opening the gut, came back home. She did develop some intestinal adhesions that caused her some issues and came close to ending her life when she tore one loose one day during hand walking and it took major drugs to get her comfortable.

She was on alfalfa mix hay for years and I used beet pulp to keep her well hydrated. She would colic usually about once a year, but never had to go back to surgery. Best thing I found was good grass, she got very little grain due to her air plant status. She gradually quit colicing yearly and what ended up getting her was not colic but her severe DJD in her knees.

Good luck with your mare.