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"Elective" Exploratory Colic Surgery - Trying to Diagnose Recurrent Colic - Massive Doubt and Guilt

I asked about that. NBC vet flat shot that down–apparently that particular section would have to be stitched to the abdominal wall–way too risky, as she could tear it lose “just being silly out in the field” and the result would be fatal.

Admittedly I am quite pressured by the insurance deadline. I got this horse her own 11k credit card when I got her along with the insurance, so that’s been…yeah, permissive. My credit was already pretty good; thanks to my horse it’s now PHENOMENAL, as I’ve been spending big on the card and then immediately paying it off when the insurance caught up. Paying out of pocket wouldn’t be impossible, but it would be hella more painful and leave her without a financial cushion for a window of time–something that feels VERY dangerous given her circumstances. I’m covering rehab out of pocket purely because as sweet as my sweetums is, trying to keep her in a stall is about as effective as the opening scene from Jurassic park and I definitely don’t have the facilities I feel she needs…big stall, big windows, small personal paddock for her to walk out into, that kind of thing. If I do this, she’s gonna rehab like a celebrity and I’m gonna be eating a lot of noodles.

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Mostly insurance is only holding sway over the “when.” If we’re gonna do exploratory surgery, it basically has to be before her policy renews if I want it covered. I shared my policy with my super star vet at NBC and what terms the renewal was proposing; she re-scheduled some commitments on her end to get my horse on the books for surgery with enough time before her current policy runs out.

As far as insurance in the future–I will probably still try to have her insured with the inevitable exclusions, because you just never know. My insurance company recently ditched medical assistance for any horse under 20K in declared value, though, so a change is certainly in order. I don’t think they’re gonna let me add all of her vet bills to her declared value lol.

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Would a Care Credit Card be helpful?

In the future, probably. Looking into it. NOT jazzed about the interest rates on these types of plans though–ghoulish. My strategy has always been to have a credit card that is, best I can manage, EXCLUSIVELY for one animal. My cat had one too lol. I used it only to pay for gas and re-paid it every week to keep it active, and when he needed it and payment was due up front, he had it.

I did request that during my horse’s surgery, they let me know what they found so we could make the decision to proceed or to euthanize. The surgeon had no issue with that. It was a very brief update and I just hung around the lobby until he called me back to discuss.

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I had a horse like this. But it was impactions. He would get impacted after a night out on wet grass. Definitely stress induced. Can’t tell you how many times I had to run iv fluids at shows. He went for a work up at new bolton after many years, many hospitalizations and many medically managed colics. He came home and ruptured his cecum within 24 hours of leaving there. On his discharge they noted his colon wasn’t in the correct spot but no doctor bothered to tell me. I read it. Freaked me out. Because he had just been to NBC they did a free necropsy. THEY FOUND ABSOLUTELY NOTHING. I think the stress of the tests induced another bout of colic. The only deduction they could come up with is low motility.

Personally I would not do an exploratory surgery. And I really understand how much it interrupts your life and the worry. And my horse with these issues was the horse of a lifetime. I loved him with every ounce of my being. I slept in the barn more times than I can count watching him round the clock alternating sedative with banamine to get him through a night until the vet came back at 8 am.

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I think Care Credit gives something like 6 months before you have to pay it.

I’ll have to float that by the surgeon. I think this would be relevant if I was entertaining taking the colon out–unfortunately we won’t know if we really “found” anything until the biopsy comes back. But I’ll certainly ask if there’s a point where they’d want my input.

She hasn’t impacted. We looked for that after the first colic–ultrasounds, x-rays, etc. Very sorry to hear that happened. I found their communication somewhat lacking after the first visit. One of the only bright sides to so many follow-up visits has been really getting to know 1-2 of the vets and having a lot of phone calls and email conversations rather than the more typical discharge papers. Not mentioning such a thing to you seems like an extreme oversight–I am really sorry that happened.

It seems you know just how unsustainable this is. Unfortunately, while I set aside a tidy nest egg for my mare, I am not independently wealthy and cannot keep up with her need for medical management indefinitely. If I knew there was nothing urgent in there, then I’d perhaps be okay managing her at home. But the ghost of what COULD be in there is what’s killing me.

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So….I’m sure this is dumb, or it would have been done, but what about ultrasound rectally?

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I do not take colic surgery lightly, but in your case I’d probably try the surgery. There are a couple of conditions that they might be able to help. Or they could find something really bad, and then, well, at least you know and can make some informed decisions. With recurrent displacements, you might be looking at stitching off the gap there above the spleen (if that’s where they are going), or tightening the ligaments holding the large intestine and mesentary area to the abdominal wall. Both abnormalities can cause displacement with any gas bubble. And looks like this horse has a variety of digestive problems that could cause precursor issues. Having lost a horse to the not very well attached colon, I’d either want to know at this point if that’s fixable or if you are just waiting for the worst. With my horse, he always had sensitive digestion but never colicked until he had a full twist, in a location where resection was not possible. He would have had to have been in the hospital already when it happened to have a hope in surgery. The surgeon said that when the defect is caught in surgery before the colon is too far damaged, that they can have success with surgically tightening things. At least so that particular risk is reduced.

But in your shoes with so many issues, I wouldn’t want to make it sound like surgery would totally fix things. And there are definitely risks. It sounds like quality of life is not great, and so if you think you could use the surgery to find some clarity in your decisions, I would do it while you still have insurance.

And they can make mid-surgery phone calls. Not ideal but my surgeon did come out once she got a look at things to update me, and she did have to get on the phone with my insurance for their permission to euthanize (even though his colon was dead and he was basically going septic and hemorrhaging and whatnot :face_with_symbols_over_mouth:).

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IMO, the major risks of surgery are going to come if something actually needs to be done such as bowel resection, etc. If an exploratory surgery is done and the surgeon decides nothing needs to be repaired, then complications are not terribly high. If resection or some sort of surgical modification needs to be done or something of that nature, then usually the benefits outweigh the risks as is. Side note - the surgeon can call you during surgery and walk you through options as long as you are readily available.

If you are avoiding surgery because you think she will be miserable for recovery - that may not be the case at all. Most horses do really well in recovery and if not, there are medications to make them more at ease. It’s a short period of time in the grand scheme of things.

As attentive of an owner as you are, I’m not sure you’ll be satisfied without going through with surgery. You may always have doubts.

That said - first thought was gas secondary to seasonal allergies. But if you are seeing colic signs in the winter, then I’d seriously consider surgery, especially considering the insurance conundrum.

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I would be doing my damnest to get information from her former owners although they may not be forthcoming about her history. Has she always had these or similar episodes? Was she fine before her pregnancy and foaling? Maybe she had some sort of internal damage foaling? How about the prior owner who put her through training? Have you changed where you board her to see if there is something where she is living now that sets her off? You would think based on your description of her early life if she had these spells she would be dead a long time ago.

But then again she might have a lipoma in a bad spot that has grown as she got older. Or maybe some intestinal changes that have progressed. It is certainly baffling and you have given her top notch veterinary care.

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We did a transvaginal ultrasound? And multiple abdominals? I never heard from vet about whether we did that or if it was recommended.

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Have you talked to her former owners to see if she ever had any episodes before you bought her?

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This is exactly what I went through for about 8 months. It was exhausting, expensive, and ultimately … the answers did not come from the route suggested to you.

Do not go through surgery without a better understanding of gut health.

You can turn this around - I am confident. Just not with the recommendations in place, just yet.

First, get a gastroscopy done where they check pH level in her gut, pull fluid and check for bacteria. Whether chicken or egg, my horse had pH wildly out of sorts, and a handful of REALLY nasty bacteria that were overgrown and likely caused the ulcers, inflammation in his small intestine, and gas colic. Attacking that problem resolved all colics.

I’m going to PM you with my phone number if you want to talk it through. I tried everything and can make some suggestions.

ETA - the thought was that improperly digested food left the stomach, created havoc in small intestine, was still improperly digested when it hit the colon, hence giant amounts of painful gas - also, bethanachol created a hypermotile gut, which caused it’s own pain.

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OP - I have a mare who had two colic surgeries as a result of displaced colons. As someone mentioned above I also do not regret the first one, but have often thought the 2nd one was not a great idea.
At that time I did a lot of reading on displaced colons and here is a brief summary: Once a horse has one there is an increased probability it will happen again. Displaced colons are more common in in deep chested/big barreled horses, and apparently more common in mares especially post-partum.
Hard to figure out WHY the colon displaces other than it has room to float around.
There is a procedure where the colon can be tacked to abdominal wall which will stop the displacement, but there are some other problems with that and interestingly my vets at the time didn’t push the idea.
I dont envy you this position, I guess i would consider it but ugh…

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I am 3 months post surgery for a displacement. I don’t regret doing the surgery for this horse, but the recovery process has been very difficult. There are several posters saying that no resection = easy recovery and that isn’t necessarily true. The likelihood is small but there are a number of potential post-op complications for even a “simple” colic surgery and my horse has had almost all of them.

In your shoes, I think I would either say goodbye on a good day or do the surgery. The current situation is untenable. But go into with the knowledge that recovery may be more than the standard 3 months and even if you “fix” the problem it may still be a bumpy road. I don’t say this to scare you away from the surgery and many sail right through recovery but it’s not always that simple.

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What was it?? So glad to hear of a good outcome.

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I mentioned my geriatric gelding above, but yes, this was what was causing his colics and colic-symptoms. Luckily, in his case the above was not caused by Delayed Gastric Emptying (which is very common with these cases and I assume ruled out by OP’s vets via whether there was still matter in the horse’s stomach after fasting for scope) but by him not fully masticating his roughage – which we were not aware of since at the time, his teeth looked fine. The improperly masticated food was scratching his intestines and colon, leading to severe inflammation and ulcers.

Not saying it is the case here, but just another little piece of the big jigsaw puzzle that is “Gastric Health”.

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