Nephrosplenic Entrapment

[Horseybird]

Thanks for that. She is just meters from the house. And I am keeping a close eye on her. I can see the spleen starting to get larger again as the drug is leaving her system.

The problem is we are expecting a massive bill from a yearling that severed a third of it’s foot. We have managed to save that one.

Hubby is EXTREMELY reluctant to pay for on the block surgery, but will pay for the standing surgery.

She is not having any bute and is grazing happily at the moment, but I can see it getting bigger. My vet is very pioneering and I trust him implicitly.

We wait: I have lined up some nice hills to go to over the weekend.

[Amwrider]

Jingling for you Horseybird, hope your girl gets jiggled back into proper place.

My only experience with this was a displacement to the right in a 20 year old saddlebred, it worked itself out with banamine. I have another that we suspected of NSE, it was a 17 year old ASB gelding that I was fostering for Saddlebred Rescue. I was awakened when he cast himself in the stall and with help we were able to get him out but I think he tore the NS ligament and bled out internally. He kept trying to go down and banamine wouldn’t even put a dent in his pain. He was even trying to “back away” from the pain. He passed away right as the vet pulled up the driveway but you could see a large hematoma on his left side getting bigger and bigger and I knew it was his spleen.

[Horseybird]

We have now done all we can non surgically for Dolly, and no change, she is now at the vets awaiting surgery today in the afternoon.

Although NE is rare she has a rarer form in the fact that the top part of the stomach has entrapped, leaving the lower half hanging from the spleen. There is a membrane that adjoins the 2 is caught over the spleen and is putting pressure on it.

It is thought this is why she will not stand to the side of a horse trailer over the wheels because it is painful for her. In the middle she is fine - less vibration.

My vet has never done this procedure before - so fingers very much crossed, but by doing the standing procedure it shouldn’t happen again.

Rolling we both feel is pointless because the gap is really large and he could roll her and she do it again next week.

She is so rare apparently she will be quoted in vet papers. why do I never get anything simple?

I will keep you guy’s updated.

[Horseybird]

Just the recovery now.

The deed is done. It was successful. It won’t happen again.

She is however looking rather hang dog. I apologised to her and explained it was that or a very long sleep! It made me feel better anyway.

She stays there for 5 - 6 days, then we bring her home and she and Fleur will be side by side!

Just a 4 inch cut, so she will still look stunning!
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[alteringwego]

My horse just underwent surgery for a NSE. Currently recovering well but thanks for the read! My surgeon suggested that rolling was not a good option because if you roll the colon off of the spleen there is a possibility of rolling up the other side. He tried with my horse to treat the NSE medically through lots of fluids, anti-inflammatory meds, and lunging to potentially bounce the colon off of the spleen. Within one hour it became very obvious that this was not going to resolve without surgery. My horse was draped on on the table within an hour. Surgery was about an hour and recovery was about an hour. About 8 hours after surgery my horse looked tired and very doped. He was allowed to take short walks several times a day and each time his expression improved tremendously. At 30 hours post-surgery his expression was bright, and he was eagerly walking. He was pulled off IV fluids roughly 24 hours after surgery and catheter was removed. Belly bandage gets changed every 12-24 hours as it loosens and his surgical site is monitored. At 30 hours he was given a very small mash with lots of water and has been allowed 2-6 bites of grass at every other hand walk. Over the next couple of days they continue to offer slightly larger meals and monitor vitals and manure.

[Horseybird]

Well I am pleased that someone has updated the thread, but of course not under the circumstances that have happened.

Our TB, unless you told someone what had happened you can not see the mark unless you know it’s there. This mare never liked jumping with us, and now is jumping 1m 10 courses, we think that her spleen had been a problem for a long time. Now it is safely secured to the gut wall it doesn’t move about any more.

When the did go inside, he found that just one part of the gut had gone over it, and the second part was the other side, and the two were suspended on the spleen by the membrane that holds them together.

However, he did check her the other day as we are due to move and he wanted “feel” his handy work, and he says the spleen is still large and feels that this may be a birth defect, as she has a couple of others.

I would fully endorse the going in through the side and having the repair as a first choice. my vet was reticent only because he had not done it before, but I impressed upon him that there was a first time for everything and he is a fab vet.

As there are quite a few people that have written on this thread maybe we can do a quick survey? I mentioned a few birth defects (markers) and I wonder if these can be linked to horses prone to NSE. If you could check the horses if you still have them. Or tell me of any different ones.

OK - our mare has a double tooth, it appears as a large tooth but has 2 roots, her jaw can just about be winched open wide enough to have her teeth done thus a jaw problem, also another marker maybe, she has a slightly domed forehead.

[alteringwego]

Can’t say that my guy has any markers or known abnormalities. Although hopefully this is not a recurring thing. From speaking with my vet, he believes that the colon becomes gassy and that is the main cause. Once the colon becomes gassy, gas floats and causes the colon to wrap up and over the spleen. The colon causes the spleen to become inflamed and traps the colon in the ‘shelf’ of the nephrosplenic ligament. My vet didn’t seem to believe that there had been any revealing research to suggest a means of preventing or predicting this type of entrapment.

[Lima_Bean]

I hope you guys don’t mind me digging this up. I did a search for nephrosplenic entrapment and this thread was one of the first that came up in the search results!

My mare was diagnosed with this (left dorsal displacement) on Monday. She is going home from the hospital today; she was treated with drugs and hand-jogging–it worked. Second colic in less than a week with the same symptoms; she went to the hospital the second time because–although the colic was more mild than the first–she had a grand mal seizure after being tubed with mineral oil at the barn.

My mare is a 20 year old 15h TB, life long cribber. She has a couple unusual health issues but nothing serious–I will note them if anyone is interested for comparison purposes.

This thread was an eye opener!

[alteringwego]

My gelding had 5 colics in less than six months, one of which involved a NSE and surgery. He was treated for gastric and colonic ulcers (gastrogard for 90 days tapering dose, and metamucil), put on a stool softener (Tractgard), Platinum Performance, wormed with Equimax and put on Strongid C2x, and Smartgut. Also added about 10 hours to to his turnout schedule. knocking on wood but so far so good.

[Lima_Bean]

alteringwego, it sounds like your gelding has been through a lot! I’m glad he is doing so well now (knock on wood).

They think that my mare originally had gas because the boarding barn she is at changed the hay type too abruptly…so I’ve talked to them and asked that they try to make the transition more seamless for my mare next time.

[ewells]

http://www.thehorse.com/articles/37358/nephrosplenic-entrapment-treatment-recurrence-and-survival

For those that might search and come across this thread which I found informative but also found this article to be full of good information.

Sadly I am researching this type of colic because my ever so loved just turned 6yr Gelding has had surgery Friday night for NSE he came up with mild colic symptoms Friday morning after banamine didn’t help we called the vet. She did a rectal exam and felt the displacement right away. Ultra sounded him and still didn’t seem right. He responded well to pain medication and was never rolling around much and easy to redirect and handle he was actually quite cute and blatantly pointed at his side right at the spot saying hey Mom it hurts right here! Hauled him an hour to the vet hospital where another rectal exam and ultrasound confirmed that they all agreed it was NSE. They tried to treat him medically first with the phenylephrine and exercise he was just as uncomfortable after, gave him more pain medication and a little time when that wore off still uncomfortable so next option surgery. I was devastated I wont lie and worried. Now he is a valuable horse at least to me and young and I have him insured so I didn’t have a hard time saying yes to the surgery but I will admit that if he dose it again well I hope I pray I don’t have to go there. He is still at the vet hospital looking good eating. Had a bright expression yesterday morning and out walked me on our short hand walking and 10minutes of allowed grass. There was no cutting of any bowel and when the vet opened him up the bowel had already moved off the ligament most likely because he was now rolled on his back and hoisted through the air to the table but there was still a small amount of bowel between the spleen and the abdominal wall. Also she noted that his colon had accordioned up on itself which was interesting I to think there was a good amount of gas in there that she had to release but no hard impactions that needed surgically removed all healthy bowel no abdominal fluid or anything. I so want to be optimistic that he will be in the 80% and not have a reaccurance. My stomach has been twisted in knots ever since Im gonna get an ulcer

[keysfins]

Jingles that he’ll recover just fine. What have the vets said?

[keysfins]

@ewells

http://www.thehorse.com/articles/37358/nephrosplenic-entrapment-treatment-recurrence-and-survival

For those that might search and come across this thread which I found informative but also found this article to be full of good information.

Sadly I am researching this type of colic because my ever so loved just turned 6yr Gelding has had surgery Friday night for NSE he came up with mild colic symptoms Friday morning after banamine didn’t help we called the vet. She did a rectal exam and felt the displacement right away. Ultra sounded him and still didn’t seem right. He responded well to pain medication and was never rolling around much and easy to redirect and handle he was actually quite cute and blatantly pointed at his side right at the spot saying hey Mom it hurts right here!

Hauled him an hour to the vet hospital where another rectal exam and ultrasound confirmed that they all agreed it was NSE. They tried to treat him medically first with the phenylephrine and exercise he was just as uncomfortable after, gave him more pain medication and a little time when that wore off still uncomfortable so next option surgery. I was devastated I wont lie and worried. Now he is a valuable horse at least to me and young and I have him insured so I didn’t have a hard time saying yes to the surgery but I will admit that if he dose it again well I hope I pray I don’t have to go there.

He is still at the vet hospital looking good eating. Had a bright expression yesterday morning and out walked me on our short hand walking and 10minutes of allowed grass. There was no cutting of any bowel and when the vet opened him up the bowel had already moved off the ligament most likely because he was now rolled on his back and hoisted through the air to the table but there was still a small amount of bowel between the spleen and the abdominal wall.

Also she noted that his colon had accordioned up on itself which was interesting I to think there was a good amount of gas in there that she had to release but no hard impactions that needed surgically removed all healthy bowel no abdominal fluid or anything.

I so want to be optimistic that he will be in the 80% and not have a reaccurance. My stomach has been twisted in knots ever since Im gonna get an ulcer

Jingles for a quick and easy recovery. What have the vets said, as far as prognosis and chance of recurrence?

[ewells]

Keysfins - I get the impression that they are optimistic about a really good recovery and the Vet said reaccurance rates of 15 to 20%. Honestly those are really pretty good numbers and if you read the article I linked to they suggested reaccurance rates in the 3-8% range but reported European research that had rates as high as 21%. Vet has to be careful what she says to me obviously they cant give you too much hope just in case it later goes all south and I get that thats how it is in the medical profession these days you just never can tell. she has said this was a much better colic surgery to have then most all other options so that’s a plus.
Im garded because this isn’t my first colic surgery 15yrs ago I had a WB mare 2 days post foaling colic with a twist and a displacement. I was in college but wisely also had that mare insured what a life saver especially for the foal. Mare hauled to WSU and had full colic surgery she recovered well and lived to raise her foal but sadly recoliced 9 months after the first surgery no coverage for surgery that time and not only the financial part but the mare had just reached the point where she was looking her normal self again but if she was going to colic bad enough to need surgery again (yes hauled her to WSU only option was surgery again) well it didn’t make sense. She was 12yrs old. I am feeling like I have pretty awful luck its not like I have a bunch of horses I have just this one boy.

[keysfins]

Thanks for the details. I have not dealt with a NSE, so I appreciate your posts as a learning opportunity.

I have one who has had multiple impaction colics, so I get the awful decisions that have to be made, plus the very real limitations that have to be part of the decision making process. Surgery was the right decision for the first episode; good outcome with no resection needed. Further episodes were treated medically, either at the home barn or at the clinic. So far, so good, once we made some diet and management changes almost two years ago.

Jingles for an uneventful recovery! It will take some time, but it sounds like you have a good chance to be in that 80% group!