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PURDUE , jm\ veterinary medical ( ■ VOLUME 5, NUMBER 1 WINTER -SPRING 1979 COLIC SURGERY IN THE EQUINE Colic, the manifestation of abdominal pain, is a common syndrome in the horse. Fortunately most horses with colic respond satisfactorily to medical therapy, or, to no therapy at all. Occasionally surgical intervention is necessary. At Purdue approximately 30 laparotomies per year are being performed on horses with colic. Conditions successfully corrected by surgery include volvulus, torsion, intususception, strangulation, incarceration and infarction of the small or large intestine, enteroliths, and impactions not responsive to medical therapy. The majority of horses on which colic surgery is performed are initially attended by practitioners who subsequently refer the horses to Purdue. Upon arrival at the clinic a standard examination of the patient is performed. This examination includes passage of a stomach tube, auscultation of the abdomen, rectal exploration, assessment of the mucous membranes, determination of the pulse rate and character, and and determination of blood electrolytes and lactic acid levels are performed in selected cases. The examination Halothane is administered to the horse with intermittant positive pressure ventilation (IPPV) for maintenance of anesthesia. The instruments nearest the anesthetist allow continuous monitoring of the electrocardiogram and the mean arterial biood pressure during anesthesia. determination of the respiration rate and rectal temperature. Packed cell volume, total serum protein, and blood gases are also assessed. An abdominal paracentesis A grossly distended small intestine resulting from incarceration through a mesenteric rent. has three main purposes. These are to make a definitive diagnosis, decide whether the colic can be handled medically or surgically, and provide an accurate prognosis to the owner. Although it is not always possible to make a definitive diagnosis, the most important thing to deteimine ib whether or not a surgical condition is ] present. The horse with a surgical condition will not benefit from a delay in surgery. These horses are in some degree of endotoxic shock, and eventually this! shock will become irreversible. It is unlikely that the I horse with blue mucous membranes, a capillary refill time of 5 seconds, a heart rate of 140 and packed cell volume of 67% will survive a general anesthetic and surgical procedure even though it may be technically feasible to correct the initiating abdominal problem. Colic surgery is a team effort at the Large Animal Clinic. The team consists of a surgeon, 2 to 3 assistant surgeons, a surgical nurse, an anesthetist and several auxiliary personnel for performing laboratory procedures, maintaining fluid therapy and providing proper instruments for surgery. Most of the colic surgeries are performed at night as this seems to be the usual time for the horses to arrive at the clinic. During the interval needed for all personnel to arrive, the horse is prepared for surgery. Fluid therapy and antibiotics are administered and the abdomen clipped. The goal is to keep the surgical time and anesthetic period at two hours or less. Prolonged anesthesia in the "shocky" and toxic horse is contraindicated. Following surgery the horse is placed in a padded recovery stall and oxygen is administered until the horse is able to stand. The post-operative period is critical to survival and the horse is not "out of the woods" just because it has survived the surgical procedure. Continuous monitoring for 24 hours is the rule and is continued with complications. These include ileus, endotoxic shock, peritonitis, and gastroenteritis. During the period of intensive care clinical parameters are monitored as well as the blood gases, blood electrolytes, packed cell volume, and total serum protein. Senior students and technicians are an invaluable asset in monitoring and A ventral midline laparotomy is used for surgical exploration of the horse with colic. The horse in this figure is being positioned and secured in dorsal recumbancy prior to surgery. The air mattress is used to prevent postoperative myositis. treating the horses during the postoperative period. Early recognition and surgical intervention in the horse with a surgical colic is critical to a successful outcome. Factors suggesting surgical intervention include: reflux of fluids during passage of a nasogastric tube; extreme pain not responsive to analgesics; failure to respond to medical therapy; progressive systemic deterioration; extreme abdominal distension; turgid loops of intestine, displaced intestine or tight painful bands noted on rectal examination; and serosanquinous abdominal fluid. At Purdue a large part of the surgical success is the result of many early referrals by the initial examining veterinarian. The referring practitioner is a critical member of the colic team. The current success rate is about 60%, this being the percentage of horses operated on that have returned to normal preoperative use. It is felt that this percentage can be improved in the future by a combination of increased awareness of the need for early surgical intervention, refined surgical techniques, and improved medical management in the postoperative period. Dr. Stephen B. Adams Above - RECOGNITION TO OUTSTANDING STUDENTS. Front row (I to r): Cheryl Clenott, Phil Beachy, Barb Powers, Hedley Marks, Loren Weaver. Middle row: Leon Thorpe, Rick Hartigan, Kathleen Neuhoff, Janice Mcintosh, Jim Radcliffe, Dr. John Van Vleet. Back row: Dan Lochner, Scott Allenstein, Rob Holl, Mike Cook, Jim Rivere. A few were missing. Right - The profession and Purdue's School of Veterinary Medicine received some very supportive exposure from TV Channel 6 (Indianapolis) in February on an approximately ten-minute documentary. Linda Lupear of that station was the producer and she did, in our opinion, a very fine job of highlighting interesting and significant facets of the profession in a relative short time span. Pictured are students viewing the program u j^^schonl's programmed instruction audio-visual facility
Object Description
Title | Purdue veterinary medical update, 1979, v. 5, no. 1 (Winter-Spring) |
Subjects (MeSH) |
Veterinary Medicine Education, Veterinary |
Creators | Purdue University. School of Veterinary Medicine |
Purdue Identification Number | PSVM00051 |
Subjects (LCSH) | Veterinary medicine--Study and teaching (Higher) |
Genre | Periodical |
Coverage | United States |
Date of Original | 1979 |
Type | text |
Format | JP2 |
Collection Title | SVM Report |
Repository | Purdue University Libraries |
Language | eng |
Rights Statement | Digital object copyright Purdue University. All rights reserved. |
Date Digitized | 2009-08-06 |
Digitization Information | Original scanned at 300 ppi on a Bookeye 3 scanner using Bookeye 3 internal software, with 24 bit color depth. Display images generated in CONTENTdm as JP2000s; file format for archival copy is uncompressed TIF format. |
URI | ark:/34231/c63j39xw |
Description
Title | page 1 |
Subjects (MeSH) |
Veterinary Medicine Education, Veterinary |
Creators | Purdue University. School of Veterinary Medicine |
Subjects (LCSH) | Veterinary medicine--Study and teaching (Higher) |
Genre | Periodical |
Coverage | United States |
Type | text |
Format | JP2 |
Collection Title | SVM Report |
Repository | Purdue University Libraries |
Language | eng |
Rights Statement | Digital object copyright Purdue University. All rights reserved. |
Digitization Information | Original scanned at 300 ppi on a Bookeye 3 scanner using Bookeye 3 internal software, with 24 bit color depth. Display images generated in CONTENTdm as JP2000s; file format for archival copy is uncompressed TIF format. |
Transcript | PURDUE , jm\ veterinary medical ( ■ VOLUME 5, NUMBER 1 WINTER -SPRING 1979 COLIC SURGERY IN THE EQUINE Colic, the manifestation of abdominal pain, is a common syndrome in the horse. Fortunately most horses with colic respond satisfactorily to medical therapy, or, to no therapy at all. Occasionally surgical intervention is necessary. At Purdue approximately 30 laparotomies per year are being performed on horses with colic. Conditions successfully corrected by surgery include volvulus, torsion, intususception, strangulation, incarceration and infarction of the small or large intestine, enteroliths, and impactions not responsive to medical therapy. The majority of horses on which colic surgery is performed are initially attended by practitioners who subsequently refer the horses to Purdue. Upon arrival at the clinic a standard examination of the patient is performed. This examination includes passage of a stomach tube, auscultation of the abdomen, rectal exploration, assessment of the mucous membranes, determination of the pulse rate and character, and and determination of blood electrolytes and lactic acid levels are performed in selected cases. The examination Halothane is administered to the horse with intermittant positive pressure ventilation (IPPV) for maintenance of anesthesia. The instruments nearest the anesthetist allow continuous monitoring of the electrocardiogram and the mean arterial biood pressure during anesthesia. determination of the respiration rate and rectal temperature. Packed cell volume, total serum protein, and blood gases are also assessed. An abdominal paracentesis A grossly distended small intestine resulting from incarceration through a mesenteric rent. has three main purposes. These are to make a definitive diagnosis, decide whether the colic can be handled medically or surgically, and provide an accurate prognosis to the owner. Although it is not always possible to make a definitive diagnosis, the most important thing to deteimine ib whether or not a surgical condition is ] present. The horse with a surgical condition will not benefit from a delay in surgery. These horses are in some degree of endotoxic shock, and eventually this! shock will become irreversible. It is unlikely that the I horse with blue mucous membranes, a capillary refill time of 5 seconds, a heart rate of 140 and packed cell volume of 67% will survive a general anesthetic and surgical procedure even though it may be technically feasible to correct the initiating abdominal problem. Colic surgery is a team effort at the Large Animal Clinic. The team consists of a surgeon, 2 to 3 assistant surgeons, a surgical nurse, an anesthetist and several auxiliary personnel for performing laboratory procedures, maintaining fluid therapy and providing proper instruments for surgery. Most of the colic surgeries are performed at night as this seems to be the usual time for the horses to arrive at the clinic. During the interval needed for all personnel to arrive, the horse is prepared for surgery. Fluid therapy and antibiotics are administered and the abdomen clipped. The goal is to keep the surgical time and anesthetic period at two hours or less. Prolonged anesthesia in the "shocky" and toxic horse is contraindicated. Following surgery the horse is placed in a padded recovery stall and oxygen is administered until the horse is able to stand. The post-operative period is critical to survival and the horse is not "out of the woods" just because it has survived the surgical procedure. Continuous monitoring for 24 hours is the rule and is continued with complications. These include ileus, endotoxic shock, peritonitis, and gastroenteritis. During the period of intensive care clinical parameters are monitored as well as the blood gases, blood electrolytes, packed cell volume, and total serum protein. Senior students and technicians are an invaluable asset in monitoring and A ventral midline laparotomy is used for surgical exploration of the horse with colic. The horse in this figure is being positioned and secured in dorsal recumbancy prior to surgery. The air mattress is used to prevent postoperative myositis. treating the horses during the postoperative period. Early recognition and surgical intervention in the horse with a surgical colic is critical to a successful outcome. Factors suggesting surgical intervention include: reflux of fluids during passage of a nasogastric tube; extreme pain not responsive to analgesics; failure to respond to medical therapy; progressive systemic deterioration; extreme abdominal distension; turgid loops of intestine, displaced intestine or tight painful bands noted on rectal examination; and serosanquinous abdominal fluid. At Purdue a large part of the surgical success is the result of many early referrals by the initial examining veterinarian. The referring practitioner is a critical member of the colic team. The current success rate is about 60%, this being the percentage of horses operated on that have returned to normal preoperative use. It is felt that this percentage can be improved in the future by a combination of increased awareness of the need for early surgical intervention, refined surgical techniques, and improved medical management in the postoperative period. Dr. Stephen B. Adams Above - RECOGNITION TO OUTSTANDING STUDENTS. Front row (I to r): Cheryl Clenott, Phil Beachy, Barb Powers, Hedley Marks, Loren Weaver. Middle row: Leon Thorpe, Rick Hartigan, Kathleen Neuhoff, Janice Mcintosh, Jim Radcliffe, Dr. John Van Vleet. Back row: Dan Lochner, Scott Allenstein, Rob Holl, Mike Cook, Jim Rivere. A few were missing. Right - The profession and Purdue's School of Veterinary Medicine received some very supportive exposure from TV Channel 6 (Indianapolis) in February on an approximately ten-minute documentary. Linda Lupear of that station was the producer and she did, in our opinion, a very fine job of highlighting interesting and significant facets of the profession in a relative short time span. Pictured are students viewing the program u j^^schonl's programmed instruction audio-visual facility |
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