by Carin A Smith, DVM
In the second part of our two-part series on equine surgery, we take a look at the inherent risks of surgery and what you can expect after your horse has undergone an operation.
What are the Risks of Surgery?
There are always risks associated with any surgical procedure.
An elective surgery is the safest of all, since the veterinarian has more control over the environment. Trained personnel can be summoned, an appropriate place to perform the surgery can be found, and the horse can be carefully prepared for the procedure.
With an emergency surgery, the risks rise. Fewer trained people may be available for assistance, or the veterinary specialist you desire may not be at hand. Maybe the horse can’t be transported to the best facility, or is in shock or very ill, raising the risk of infection or anesthetic complications.
Just what are the risks associated with surgery? While they are minimal, problems do occasionally occur. Perhaps the most overlooked is not the surgery itself, but the anesthetic procedure.
Anesthetic risks are minimized these days because veterinarians have a broad arsenal of anesthetic agents to choose from. Short-acting intravenous anesthetics are appropriate for a wide variety of minor procedures, while inhaled gas anesthetics are used on longer or more complex surgeries.
One complication of surgery occurs because of the horse’s large size. The horse may suffer severe muscle damage simply as a result of its position during surgery. Sometimes the large gluteal muscles of the horse’s rear end are affected; other horses suffer weakness of the forelimbs because of compression of the circulation to those muscles.
Careful positioning, use of special padding, and intravenous fluids to increase the horse’s circulation help prevent this complication of surgery.
A post-surgical infection is another possible complication of surgery. Wounds that have become dirty or weren’t discovered for several hours after they occurred are prime candidates for infection even after they are thoroughly scrubbed and sutured.
During abdominal surgery for colic, the abdomen can become contaminated, resulting in post-surgical peritonitis. This is usually a complication that occurs when the intestine must be opened to remove an obstruction; in spite of the surgeon’s meticulous care, there are a huge number of bacteria inside the equine gut and the potential for leakage into the abdominal cavity is always present.
Orthopedic surgery presents the horse with even more potential for complications. Because the horse is so big, any orthopedic repair must be extremely strong. Often the horse’s chances for recovery are directly dependent on its attitude.
The quiet horse will recover quickly, while one that paws, paces, or kicks at its stall runs the risk of breaking down the repair. Some horses will re-break a fracture while recovering from anesthesia.
These complications are minimized by the use of specially designed orthopedic devices, careful attention to the horse, and a thoughtful approach to the anesthetic recovery period.
What Happens After Surgery?
The post-surgical recovery period varies with the extent of the procedure done. Superficial wounds that are discovered soon after they occur can be cleanly sutured, will heal rapidly, and the stitches can be removed in about two weeks.
Horses that undergo colic surgery have a longer recovery period, and are often hospitalized for a week or more. Intensive care, including intravenous fluids, special feed, and various medications will continue for a day or more after surgery. And the horse can’t be returned to its previous exercise schedule for several months.
Even the most minute fracture requires six weeks for complete bone healing. After that, the horse will need a gradual return to exercise, to allow the bone to slowly regain its former strength.
The Surgery Decision
There may come a time when you must decide whether or not to have surgery performed on your horse. Even in an emergency situation, you’ll have time to ask some very important questions (see sidebar).
While some surgery is definitely needed to save a horse’s life, other procedures may not be so clearly defined. How will you know whether the cost and efforts are worth it?
Thinking about your priorities ahead of time may make it a bit easier. You may want to discuss your ideas with your veterinarian so that when and if a problem arises, you’ll have a basic understanding already in place.
Whatever course you do choose to take, you’ll be able to rest comfortably with your decision. T
EQUINE SURGERY
Questions to Ask Your Vet
If your veterinarian recommends surgery for your horse, you’ll need to ask some pointed questions in order to decide what’s best for you and your horse. Here are a few for thought.
• Is the surgery necessary to save the horse’s life? To make it rideable? To salvage it for breeding?
• What time frame do you have in which to make a decision?
• What will the surgery cost? What is the estimated cost of after-care? Often the surgery itself is cheap compared to the cost of post-operative care.
• What results can be expected? Will the athletic horse return to riding soundness, or just be suitable for breeding? What quality of life can be expected for the horse after the surgery?
• What are the alternatives to surgery? What do they cost? What results can be expected from those alternatives as compared to surgery?
• How experienced is the surgeon with this particular procedure?
• What type of results have been obtained in the past? No veterinarian will guarantee a result, but try to get an answer in percentages.
• Is there a specialist available who can do the surgery?
• Is this horse worth the cost in dollars, emotional outlay, and time for post-operative care, that will be necessary to help ensure a successful outcome? Will you be capable of taking care of all these aspects without significantly affecting your lifestyle?
