Intestinal surgery in horses involves surgical procedures performed on the horse's intestines to address conditions such as colic, obstructions, or strangulations. This type of surgery is a component of equine veterinary medicine focused on resolving gastrointestinal issues that cannot be managed through medical treatment alone. The surgical process may include resection, anastomosis, or bypass of affected intestinal segments. Post-operative care is critical, as horses are prone to complications such as adhesions and infections. This page compiles peer-reviewed research studies and scholarly articles that explore the techniques, outcomes, and post-operative management associated with intestinal surgery in horses.
Freeman DE, Hammock P, Baker GJ, Goetz T, Foreman JH, Schaeffer DJ, Richter RA, Inoue O, Magid JH.The records of 74 horses that recovered from anaesthesia after surgery for a small intestinal lesion from 1994 to 1999 were reviewed. Sixty-three horses (85%) had a strangulating lesion and 43 of these (68%) had a resection and anastomosis. Four of 11 horses (36%) without a strangulating lesion had a resection and anastomosis. Sixty-three horses (85%) survived to discharge, with a survival rate of 53/63 in horses with a strangulating lesion (84%) and 10/11 (91%) in others. For all lesions, short-term survival for all end-to-end anastomoses (91%; 21/23) and for no resection (92%; 23/25) were su...
Dabareiner RM, White NA, Donaldson LL.To determine whether intraluminal distention and subsequent decompression of the equine jejunum affects intestinal blood flow, hemodynamics, and microvascular permeability. Methods: 5 healthy adu t horses. Methods: Horses were anesthestized and underwent exploratory laparotomy. Two jejunal segments were identified as sham-operated or instrumented segments. After baseline values were obtained, intraluminal distention was created in the experimental segment to induce an ntraluminal pressure of 18 cm H2O. After 120 minutes of distention, the intestine was decompressed for 120 minutes. Mesenteric ...
Bladon BM, Hillyer MH.Extensive resection of the ileum of the horse, using automated stapling equipment followed by a stapled jejunocaecostomy, without closure of the mesenteric defect, was evaluated prospectively as a surgical treatment for lesions involving the distal small intestine. Of 153 horses treated surgically for colic, 10 horses with strangulating lesions involving the distal ileum were treated by extensive resection and jejunocaecal anastomosis leaving a residual mesenteric defect. These were compared with 12 horses with jejunoileal lesions treated by jejunocaecal anastomosis with closure of the mesente...
Hubert JD, Hardy J, Holcombe SJ, Moore RM.To report a surgical technique for treatment of nonreducible cecocolic intussusception and outcome in 8 horses. Methods: Retrospective study. Methods: Eight horses with nonreducible cecocolic intussusception treated by cecal amputation through a right ventral colotomy. Methods: Data were obtained from medical records and telephone conversations by using a standardized questionnaire. The large colon was exteriorized and, if necessary, evacuated of its contents through a pelvic flexure enterotomy. A second colotomy was made on the ventral surface of the right ventral colon (RVC) centered over or...
Gayle JM, Blikslager AT, Bowman KF.To describe the clinical findings in horses with small intestinal strangulation through mesenteric rents, and to determine the recurrence and survival rates after surgery. Methods: Retrospective study. Methods: 15 horses with small intestinal obstruction via a mesenteric rent. Methods: Medical records of horses with obstruction of the small intestine via a mesenteric rent between January 1990 and December 1997 were reviewed. The signalment, history, initial physical examination findings, results of abdominocentesis, and clinical laboratory values were recorded. Surgical findings, including loc...
Mueller PO, Harmon BG, Hay WP, Amoroso LM.To evaluate the effect of sodium carboxymethylcellulose (SCMC) or a hyaluronate-carboxymethylcellulose membrane (HA membrane) on healing of the small intestine in horses. Methods: 18 healthy adult horses. Methods: Midline celiotomy and 2 jejunal resection-and-anastomosis surgeries were performed. In treated horses, SCMC (n = 6) or a HA membrane (6) was applied to the jejunum to cover the anastomosis. There were 6 untreated control horses. Horses were euthanatized 10 days after surgery. For each horse, 1 anastomosis was used for histologic examination, and the second was used to determine intes...
Mueller PO, Hay WP, Harmon B, Amoroso L.To evaluate the efficacy of a bioresorbable hyaluronate-carboxymethylcellulose membrane (HA-membrane) for prevention of experimentally induced abdominal adhesions in horses. Methods: Experimental study. Methods: Twelve healthy adult horses. Methods: The effect of an HA-membrane on adhesion formation was evaluated in 12 healthy horses using an established model of serosal trauma to induce adhesions. A ventral median celiotomy and two jejunal resections and end-to-end anastomoses were performed. Two separate jejunal areas were abraded, and three 2-0 chromic gut sutures placed in the abraded area...
Gerard MP, Blikslager AT, Roberts MC, Tate LP, Argenzio RA.Recent studies suggest that horses requiring surgical correction of strangulating intestinal obstruction may develop post operative complications as a result of ischaemia/reperfusion injury. Therefore, the mucosal and serosal margins of resected small intestine from 9 horses with small intestinal strangulating lesions were examined for evidence of ischaemia/reperfusion injury. Severe mucosal injury and marked elevations in myeloperoxidase activity were detected at ileal resection margins (n = 4), whereas the mucosa from proximal jejunal (n = 9) and distal jejunal (n = 5) resection margins was ...
Scott EA, Heidel JR, Snyder SP, Ramirez S, Whitler WA.To determine clinical and surgical abnormalities in, and long-term outcome of, horses that undergo surgery because of colic secondary to inflammatory bowel disease (IBD). Methods: Retrospective study. Methods: 11 horses. Methods: Medical records of horses that had undergone abdominal surgery and in which IBD had been diagnosed on the basis of histologic examination of intestinal biopsy specimens were reviewed. Results: 5 horses were examined because of acute colic and 6 were examined because of chronic colic. At surgery, all 11 horses had edematous or hemorrhagic bowel segments suggestive of I...
Sasaki N, Yoshihara T.Laparotomy was performed on seven thoroughbreds to attach a force transducer to the proximal jejunum, distal jejunum, and ileum, as well as to the serous membrane of the cecum. Following observation of intestinal motility in conscious horses, they were intravenously injected with motilin (0.6 microgram/kg) to examine its effect on intestinal motility. Strong contractions peculiar to horses were observed in small intestine. Further, motilin caused strong contractions in the proximal jejunum. The results suggested the involvement of motilin in the regulation mechanism of intestinal motility.
Rhoads WS, Parks AH.A 10-year-old castrated male pony was examined for intermittent signs of abdominal pain of 3 days' duration. An incarceration of the small colon through a rent in the gastrosplenic ligament was found. Resection and end-to-end anastomosis were performed on the affected portion of the small colon. The pony recovered and returned to its previous degree of activity. Incarceration of the small intestine and large colon through rents in the gastrosplenic ligament are documented, although involvement of the small intestine is more common. To the best of our knowledge, incarceration of the small colon...
Hassel DM, Langer DL, Snyder JR, Drake CM, Goodell ML, Wyle A.To identify breed, age, sex, physical findings, history, and outcome of treatment in horses and other equids with enterolithiasis. Methods: Retrospective study. Methods: 900 equids with enterolithiasis. Methods: Medical records from equids with enterolithiasis admitted between 1973 and 1996 were reviewed. Data on signalment, history, physical examination and clinicopathologic findings, surgical findings, and outcome were compiled from records and from telephone interviews with owners. Sex and breed predilections were determined by comparison of the study population with the general hospital po...
Deby-Dupont G, Grülke S, Caudron I, Mathy-Hartert M, Benbarek H, Deby C, Lamy M, Serteyn D.The strangulated intestinal pathologies of horses are accompanied by a local activation of the neutrophils, that can be revealed by measuring the tissular enzymatic activity of the granulocytic enzyme myeloperoxidase (MPO). To estimate the possible spreading of this neutrophil activation to the systemic circulation, we designed a radioimmunoassay (RIA) for equine neutrophil myeloperoxidase (MPO) (EC 1.11.1.7) using a specific rabbit antiserum. MPO was labeled with 1 mCi 125I by a technique of self-labeling in the presence of 10(-4) M hydrogen peroxide. The RIA was performed by incubation of 10...
Hughes FE, Slone DE.To describe an alternative technique for large colon resection and anastomosis in horses. Methods: Retrospective study of clinical patients. Methods: 37 horses that had ventral midline celiotomies between July 1, 1990, and July 1, 1994. Methods: Large colon resection and anastomosis was performed using a modification of previously described techniques. Modifications include mesocolon ligation with a stapling device and an end-to-end apposition of the right ventral and right dorsal colon. Results: Twenty-one of the 37 horses were discharged from the hospital without complications. Two horses we...
Hague BA, Honnas CM, Berridge BR, Easter JL.To evaluate the postoperative use of peritoneal lavage for prevention of experimentally induced intraabdominal adhesions in horses. Methods: Areas of serosal abrasion were created on the jejunum of 12 horses. Postoperatively, six horses had peritoneal lavage, and six horses did not (controls). The number of adhesions was determined at necropsy 2 weeks after surgery. Methods: 12 horses. Methods: Five sites of jejunal serosal abrasion were created in each horse. A 32 French thoracic catheter was placed into the right ventral aspect of the abdomen before closure of the abdominal incision. Treated...
Kuebelbeck KL, Slone DE, May KA.To determine if omentectomy would decrease the frequency of postoperative intraabdominal adhesions. Methods: Retrospective study. Methods: 44 horses that had either two ventral median celiotomies or a ventral median celiotomy and a necropsy more than 4 days later; 19 of these horses had their omentum removed at the initial surgery. Methods: Data retrieved from the records included location and type of intraabdominal adhesions; location of the surgical lesion; relationship of adhesions to the surgical lesion; surgical procedures; duration of initial surgery; time interval between procedures; ag...
Latimer FG, Blackford JT, Valk N, Wan P, Patton S.To use gastrointestinal linear stapling instrumentation to perform a closed one-stage functional end-to-end jejunojejunostomy in adult horses as an alternative to a stapled side-to-side jejunojejunostomy. Methods: Clinical outcome, anatomic and histological architecture, and anastomotic dimensions were determined at 2, 4, 8, 16, and 24 weeks postoperatively. Methods: 18 adult horses. Methods: The anastomosis and peritoneal cavity were inspected for adhesions. The diameter and circumference of the anastomosis and jejunum oral and aboral to the anastomosis were determined from digitized contrast...
Singer ER, Livesey MA.To determine, in a population of young horses, whether a variation exists among neonates, sucklings, weanlings, and yearlings regarding recovery from anesthesia, short- and long-term survival rates, and postoperative adhesion formation following exploratory laparotomy. Methods: Retrospective study. Methods: 102 horses < 25 months old that underwent exploratory laparotomy. Methods: Pre-, intra-, and postoperative information was retrieved from medical records, conversations with referring veterinarians, owners, or trainers, and race records. Survival rates (recovery from anesthesia and short- a...
Freeman DE.Although earlier reports describe a poor prognosis for small intestinal surgery in the horse, there is growing evidence that the short-term survival rate can exceed 80%. In addition to advancements in surgery and aftercare, early referral contributes considerably to the improved prognosis. Surgical procedures that restore anatomic and physiologic continuity to close to normal can minimize postoperative complications. Jejunojejunostomy carries a better prognosis than jejunocecostomy, probably because the latter involves anastomosis between two intestinal segments with dissimilar functions. Care...
Santschi EM, Juzwiak JS, Moll HD, Slone DE.This clinical report describes surgical correction of diaphragmatic hernia in three young horses. Methods: Retrospective investigation of medical records and subsequent racing performance. Methods: Three young horses with diaphragmatic hernia. Results: Three young horses with signs of abdominal pain had diaphragmatic hernia causing small intestinal strangulation. The strangulated small intestine was resected and an end-to-end jejuno-jejunal (two horses) or a side-to-side jejuno-cecal anastomosis (one horse) was performed. Diaphragmatic hernias were closed with a continuous suture pattern. All ...
Van Hoogmoed L, Snyder JR.Four horses were evaluated for clinical signs consistent with small intestinal disease. During exploratory surgery, primary hematomas in the mesentery were found in 2 horses. The third horse developed a hematoma secondary to a mesenteric rent, whereas in the fourth horse, a hematoma developed secondary to strangulation of the bowel by a mesenteric lipoma. Two horses were euthanatized at surgery, because the extensive nature of the hematoma precluded ligation and there was substantial risk of continued hemorrhage postoperatively. The remaining horses recovered from surgery but developed complic...
Frankeny RL, Wilson DA, Messer NT, Campbell-Beggs C.Jejunojejunal intussusception occurred after jejunal resection and stapled functional end-to-end anastomosis in two pony mares. In both mares, the lead point of the intussusception was the stapled functional end-to-end (FEE) anastomosis. The stapled free ends of jejunum were oversewn with an inverting suture pattern. A possible explanation for development of the intussusception was the acute angle created in the intestine by the FEE anastomosis. This angulation may have impaired flow of ingesta causing motility changes that predisposed the site to intussusception. Because the oversewn blind in...
Southwood LL.Horses with colic caused by intestinal strangulation can have an excellent outcome with early surgical correction of the obstruction. The expense associated with surgery is typically less with early lesion correction. The challenge is making an early diagnosis of intestinal strangulation. Although for some horses with a strangulating obstruction, the need for surgery is made based on severe colic signs or lack of response to analgesia, in other horses, it is less obvious. Signalment, history, and meticulous physical examination, combined with some targeted diagnostic procedures can help with e...
Durham AE, Phillips TJ, Walmsley JP, Newton JR.Several clinical variables were compared in two groups of 15 horses recovering from resection and anastomosis of a strangulated small intestine; 15 were treated with parenteral nutrition and 15 were starved routinely. There was some evidence that parenteral nutrition had a short-lived adverse effect on both the catheter sites and gastric emptying, but there were no marked adverse clinical effects and no evidence of any improvement in the horses' condition.
Hopster-Iversen C, Hopster K, Staszyk C, Rohn K, Freeman D, Rötting AK.Large intestinal diseases in horses are characterised by inflammation, which could arise from the disease process with some contribution from intestinal manipulation. The effects of the latter are unknown but important to surgeons and could contribute to post operative complications. Objective: To characterise type and degree of intestinal inflammation induced by various mechanical stimuli in the equine ascending colon. Methods: Laparotomy was performed in 12 horses, the left dorsal colon exteriorised and 3 segments randomly exposed to different mechanical manipulations: 1) enterotomy, 2) ente...
Dean PW, Robertson JT, Jacobs RM.In 7 horses, 4 anastomoses were done in the small intestine in each, using the combinations of synthetic absorbable monofilament and multifilament suture materials with continuous- and interrupted-suture patterns in the serosubmucosal layer of a 2-layer inverting-suture technique. Horses were evaluated 30 days after the operation for adhesion formation, lumen diameter, evidence of chronic obstruction, and suture tract inflammation at the anastomosis. Postoperative obstruction occurred in 5 of the 7 horses, and 6 horses survived. One horse was euthanatized on postoperative day 6 after 48 hours ...
Giusto G, Caramello V, Comino F, Gandini M.In this study the caecum and large colon were harvested from 24 slaughtered horses. On each sample, an 8‑cm long enterotomy was performed. Enterotomies were closed using either barbed or unbarbed glycomer‑631. We compared the time to close, appearance, length of suture material, bursting pressure, and costs associated with each type of material. Our findings demonstrated that time to close was significantly shorter (caecum, P = 0.034; pelvic flexure, P = 0.039) using barbed sutures (caecum 610.4 seconds; pelvic flexure 699.3 seconds) than unbarbed sutures (caecum 661.0 seconds, pelvic flex...
Grages AM, Verhaar N, Pfarrer C, Breves G, Burmester M, Neudeck S, Kästner S.In experimental studies investigating strangulating intestinal lesions in horses, different ischaemia models have been used with diverging results. Therefore, the aim was to comparatively describe ischaemia reperfusion injury (IRI) in a low flow (LF) and no flow (NF) model. Under general anaesthesia, 120 min of jejunal ischaemia followed by 120 min of reperfusion was induced in 14 warmbloods. During ischaemia, blood flow was reduced by 80% (LF, n = 7) or by 100% (NF, n = 7). Intestinal blood flow and oxygen saturation were measured by Laser Doppler fluxmetry and spectrophotometry. Clinical, hi...
Aristizabal FA, Lopes MA, Silva A, Avanza MF, Nieto JE.To evaluate the effect of onlay mesenteric flaps (MFs) with end-to-end jejunojejunostomy on stomal diameter, length of jejunum with reduced stomal diameter, abdominal adhesion formation, and healing. Methods: Experimental study. Methods: Healthy adult horses (n = 6). Methods: Two hand sewn end-to-end jejunal anastomoses using a 1 layer simple continuous serosubmucosal suture pattern were performed in each horse ∼ 2 and 5 m oral to the ileocecal fold. Using a random design for selection anastomosis location (oral or aboral), 1 anastomosis was covered with 2 adjacent onlay MFs secured with int...
Gayle JM, Blikslager AT, Bowman KF.To describe the clinical findings in horses with small intestinal strangulation through mesenteric rents, and to determine the recurrence and survival rates after surgery. Methods: Retrospective study. Methods: 15 horses with small intestinal obstruction via a mesenteric rent. Methods: Medical records of horses with obstruction of the small intestine via a mesenteric rent between January 1990 and December 1997 were reviewed. The signalment, history, initial physical examination findings, results of abdominocentesis, and clinical laboratory values were recorded. Surgical findings, including loc...
Crowhurst RC, Simpson DJ, McEnery RJ, Greenwood RE.Intestinal surgery in the foal is seldom necessary but some conditions in which it is essential are well recognized. The foal is a good surgical subject but success depends mainly on operating promptly before irreversible degenerative changes take place. Exploratory laparatomy is recommended whenever mechanical obstruction is suspected. Indications fall broadly into two main categories: 1. Cases arising from congenital defects. These form a miscellaneous group and present considerable difficulties in diagnosis and effective treatment. 2. Cases related to acute onset of obstruction, mainly due ...
Freeman DE, Orsini JA, Harrison IW, Muller NS, Leitch M.Of 147 horses treated for umbilical hernias over a 13.5-year period, 13 horses (8.8%) developed complications in association with umbilical defects. Six horses had intestinal incarceration; the incarceration was reduced manually in 3 horses before admission, resolved without treatment in 2 others, and was surgically reduced in one. Herniorrhaphy was performed on 4 of the 5 horses in which the incarceration did not require surgical reduction, and the fifth was managed conservatively. A horse with a parietal hernia and a horse with intestinal stragulation were treated surgically; in the latter, ...
Verhaar N, Geburek F.Clinical intestinal viability assessment is associated with significant limitations, and there is an undisputable need for ancillary diagnostics during colic surgery. Human and companion animal surgeons struggle with similar intraoperative issues, yet there is little exchange between specialists. Therefore, this narrative review aimed to create an overview of real-time ancillary diagnostics with the potential for intraoperative intestinal viability assessment in horses. Most real-time ancillary diagnostics can be classified as either tissue perfusion or oxygenation assessments. Intestinal perf...
Bell J, Radial SL, Cuming RS, Trope G, Hughes KJ.Diarrhea in foals can be associated with disruption of the intestinal microbiota (dysbiosis). Effective management of intestinal dysbiosis in foals has not been demonstrated. Objective: Fecal microbiota transplantation (FMT) in foals with diarrhea influences the intestinal microbiota and improves clinical and clinicopathological outcomes. Methods: Twenty-five foals <6 months of age with diarrhea and systemic inflammatory response syndrome at 3 veterinary hospitals. Methods: A prospective randomized placebo-controlled cohort study. Foals in the FMT group (n = 19) or control group (n =â€...
Tate LP, Ralston SL, Koch CM, Everitt JI.Small intestinal resection (SIR) is not uncommonly done in surgical treatment of equine colic, but little is known about the long-term effects of SIR on horses and ponies. Twelve ponies, fed maintenance amounts of pelleted feed, were divided randomly into 4 treatment groups. D-Xylose absorption curves were recorded for each pony before surgical treatments were performed. Treatments consisted of control (ileal bypass) and 40%, 60%, or 80% SIR. D-Xylose absorption, serum electrolyte, and enzyme profiles for each animal were recorded once every 30 days for 180 days after surgical treatment, and t...
Scott EA, Todhunter R.In 2 cases of chronic intestinal intussusception in horses, one involved jejunum and the other, ileum. The only clinical signs observed were intermittent colic. Surgery was performed on both horses, with successful outcomes.
Erwin SJ, Blikslager AT, Ziegler AL.Colic is a leading cause of death in horses, with the most fatal form being strangulating obstruction which directly damages the intestinal barrier. Following surgical intervention, it is imperative that the intestinal barrier rapidly repairs to prevent translocation of gut bacteria and their products and ensure survival of the patient. Age-related disparities in survival have been noted in many species, including horses, humans, and pigs, with younger patients suffering poorer clinical outcomes. Maintenance and repair of the intestinal barrier is regulated by a complex mucosal microenvironmen...
Jones ARE, Ragle CA, Anderson D, Scott C.To evaluate the feasibility and clinical outcomes after laparoscopic evaluation of the small intestines via laparoscopy. Methods: Prospective pilot study. Methods: Healthy adult horses (n = 5). Methods: Horses were restrained in standing stocks and received an infusion of detomidine. One port was placed in the left last intercostal space and 3 ports were placed in the right paralumbar fossa. The small intestine was run with atraumatic laparoscopic grasping forceps, from the duodenocolic plica to the ileocecal plica. Postoperative pain was scored every 4 hours for the first 48 hours. Horses...