Abstract: Standing flank laparotomy can be an alternative to ventral midline laparotomy in horses with colic. Standing flank laparotomy avoids general anaesthesia, provides excellent access to some regions of the abdominopelvic cavity and costs less than ventral midline laparotomy. Objective: To report a series of cases of peritoneal and intestinal diseases other than SC diseases managed with standing flank laparotomy. Methods: Retrospective case series. Methods: Records from equids with colic subjected to standing flank laparotomy at five hospitals (2003-2020) were reviewed. Descriptive data analysis was performed. Results: Thirty horses (sixteen survived to discharge), six ponies (four survived) and one donkey (euthanised) were subjected to standing flank laparotomy via the left flank (n = 31), right flank (n = 2) or both flanks (n = 4). The primary disease affected the peritoneum (0/5 survived), SI (5/9 survived) and caecum and/or LC (15/23 survived). Enterotomy was performed in four animals (all survived). Partial typhlectomy was performed in one horse (euthanised). Resection-anastomosis of the SI or LC was performed in three animals (one survived). Three animals had intraoperative complications that negatively affected the outcome: Two ponies had intolerance to abdominopelvic exploration; one mare had spontaneous exteriorisation of a long segment of the SI leading to a large tear in the mesentery. In seven cases, severe/extensive lesions found during standing flank laparotomy warranted immediate euthanasia. The survival rate was 54%. All owners were satisfied with the decision to perform standing flank laparotomy. Conclusions: The retrospective design, lack of a control group, small number of cases and lack of standardised protocols between hospitals. Conclusions: Although ventral midline laparotomy is the standard of care for horses with colic, standing flank laparotomy is a viable approach for some types of colic. Systemic administration of analgesics may not produce sufficient peritoneal analgesia, which can lead to intolerance to abdominopelvic exploration during standing flank laparotomy in horses with colic and may negatively affect the outcome.
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The study presents a case series where standing flank laparotomy was used as a treatment method for horses with colic as an alternative to traditional ventral midline laparotomy.
Cases and Methodologies
The study is a retrospective review of records of horses with colic that were treated using standing flank laparotomy across five hospitals from the year 2003 to 2020.
Descriptive data analysis was then performed on these records.
Results
A total of 37 standing flank laparotomies were performed – 31 via the left flank, 2 via the right flank, and 4 via both flanks.
The patients included 30 horses (of which 16 survived to discharge), 6 ponies (with 4 surviving), and 1 donkey (which was euthanized).
The primary diseases treated were those that affected the peritoneum, small intestines, and caecum/large colon.
Certain surgical interventions like enterotomies (in 4 animals), partial typhlectomy (in 1 horse), and resection-anastomosis (in 3 animals) were performed. Outcomes varied.
There were intraoperative complications in three animals that affected the outcomes negatively. These included intolerance to abdominopelvic exploration and spontaneous exteriorisation of a long segment of small intestines leading to a tear in the mesentery.
Severe/extensive lesions encountered during the procedure led to immediate euthanasia in seven cases.
Conclusions
The survival rate post standing flank laparotomy was 54% and despite the complications and outcomes, all owners were satisfied with the decision to carry out this procedure.
The limitations of this study included the retrospective design, lack of control group, small number of cases, and absence of standardized protocols across the hospitals.
Even though ventral midline laparotomy is the standard of care for horses with colic, standing flank laparotomy can be a viable alternative approach for certain types of colic.
The study indicates that systemic administration of analgesics may not provide sufficient peritoneal analgesia, which can lead to intolerance to abdominopelvic exploration during standing flank laparotomy. Hence, this could negatively impact the outcome of the procedure.
Cite This Article
APA
Lopes MAF, Hardy J, Farnsworth K, Labens R, Lam WYE, Noschka E, Afonso T, Cruz Villagrán C, Santos LCP, Saulez M, Kelmer G.
(2021).
Standing flank laparotomy for colic: 37 cases.
Equine Vet J, 54(5), 934-945.
https://doi.org/10.1111/evj.13511
Equine Health and Performance Centre, School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, South Australia, Australia.
Hardy, Joanne
Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA.
Farnsworth, Kelly
Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA.
Labens, Raphael
School of Animal and Veterinary Sciences, Faculty of Science, Charles Sturt University, Wagga Wagga, New South Wales, Australia.
Lam, W Y Eunice
Equine Health and Performance Centre, School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, South Australia, Australia.
Noschka, Erik
Equine Health and Performance Centre, School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, South Australia, Australia.
Afonso, Tiago
Equine Health and Performance Centre, School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, South Australia, Australia.
Cruz Villagrán, Claudia
Equine Health and Performance Centre, School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, South Australia, Australia.
Santos, Luiz C P
Equine Health and Performance Centre, School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, South Australia, Australia.
Saulez, Montague
Equine Health and Performance Centre, School of Animal and Veterinary Sciences, University of Adelaide, Roseworthy, South Australia, Australia.
Kelmer, Gal
Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel.
MeSH Terms
Anesthesia, General / veterinary
Animals
Colic / surgery
Colic / veterinary
Female
Horse Diseases / surgery
Horses
Laparotomy / methods
Laparotomy / veterinary
Retrospective Studies
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