|Post-Op Colic Notes
We are happy that your horse is going home and getting back to a familiar environment! While your horse is no longer in a life-threatening situation, he/she will require special attention during the remainder of the recovery period. Follow-up care at home is an essential part of successful colic treatment and will contribute significantly to the eventual return of your horse to a full and active life.
FEEDING THE POST-OPERATIVE PATIENT
Any type of surgery requiring general anesthesia may result in "post-operative ileus", or a decrease in gut motility. As you can imagine, this phenomenon may be even more pronounced after colic surgery. It is our goal to effectively return your horse to a normal diet and normal course of digestion.
Since the episode of colic, your horse has undergone a significant change in both feeding regimen and how he/she is processing that feed. A gradual introduction to hay (primarily alfalfa hay) has been initiated post-operatively at the hospital to restimulate intestinal function. Your horse, however, is not yet on "full feed". We recommend that your horse be fed small amounts of good quality hay at frequent intervals over the next 2 weeks. Frequent feedings will depend on your own situation, but we encourage 4 feedings per day for the first 3-5 days with a gradual return to your normal feeding regimen over the 2 week period. If possible, alfalfa hay should be integrated into the feeding regimen for the first several days. As you know, feed changes should be gradual (over a 5-7 day period) and under the supervision of the owner and/or barn crew. Since your horse will be relatively inactive during the convalescent period, absence of grain in the feeding protocol may reduce the amount of energy that they (and you) have to contend with while stall-bound. Most resting horses will get plenty of nutrition from good quality hay alone. Fresh pasture grass is also an excellent source of nutrition for your horse, and rarely a cause of colic. We encourage plenty of fresh grass if it is available and if your horse is used to it.
We should note that in this area, a considerable number of horses diagnosed with ileal impactions (a type of colic) have a large percentage of their diet in the form of Coastal Bermuda hay. We have found that reducing their percentage of Coastal hay also reduces the horse's chances for developing this type of colic. Of course, not every horse eating Coastal hay will develop an ileal impaction; however, we encourage many owners not to feed coastal hay in excess of 60% of their horses' hay diet.
It will take some time for the abdominal incision to completely heal. For the first 7 days following surgery, the deep aspect of the incision (the linea alba) is held together by suture material alone. After 7 days, the strength of the linea alba begins to increase via scar tissue formation and improves considerably each day during the next 30 days. The suture material is gradually dissolving during this time, and the scar tissue is assuming a greater percentage of incisional strength with each day.
Any weak regions along the incision will typically develop within 30-45 days post-operatively. Excessive stress to the incision (such as a long trailer ride or exercise) may slow wound healing and predispose your horse to the development of a hernia, which is an opening in the body wall beneath the skin. Hernias may be of variable size and often appear like a soft bubble along the surgical incision. An incisional hernia is rarely a life threatening problem, but may require surgical repair at a later date. Hernias are best avoided by minimizing stress to the incision.
For this reason, we recommend that your horse be confined to a stall or small enclosure (usually no larger than 24x24) for a minimum of 45-60 days. During this time, we suggest hand walking your horse at least 10-15 minutes twice daily to decrease the likelihood of distal limb and incisional edema formation.
ABDOMINAL INCISION MANAGEMENT
Proper management of the abdominal incision is critical to the long range success of abdominal surgery. Your horse has a lengthy incision in an area which experiences a considerable amount of stress. Therefore, it is important to keep a close eye on the incision during the convalescent period.
A significant amount of tissue was violated while the abdomen was being incised. Numerous blood vessels were transected, resulting in some bleeding. As the blood vessels begin to heal, proteinaceous fluid, called "edema", frequently forms in the area of the incision. Edema tends to gravitate towards the most ventral aspect of the incision, and can be described as a firm swelling that is minimally painful. Typically, pressing your finger into an area of edema will leave a "dent" in the skin. Edema is not uncommon or unusual following colic surgery, and usually resolves spontaneously within 2-3 weeks.
The skin heals much more quickly than the deeper layers, such as the linea alba. The stainless steel skin staples should be removed by a veterinarian approximately 21 days after surgery. The skin incision is not the strongest part of the abdominal incision, and although it usually heals much faster than the deeper layers it is more prone to superficial infection, especially in horses that lay down often in the stall. An increase in incisional heat, swelling, pain, and/or drainage may occur even after your horse is home and may warrant further treatment. If any of these signs become evident, please contact us immediately.