Potential complications in equine colic surgery

There are many potential complications of intestinal surgery in the horse. Inability to reposition displaced intestines and rupture or life-threatening to fatal haemorrhage after manipulation of the intestines can impede surgical success. Postoperative complications include peritonitis, endotoxaemia, colitis, haemoabdomen and recurring colic because of paralytic ileus. Laminitis, cardiac arrhythmia, postoperative myopathy and hyperammonaemia are other potential postoperative problems. Suture failure, obscessation or constriction of the intestinal lumen may occur after enterotomy or anastomosis. Intestines that appear vital during surgery may later become necrotic. Intraabdominal adhesions are common sequelae of colic surgery. Important complications involving the laparotomy incision include suture line infection, suture dehiscence and incisional herniation. Differentiation of the various causes of postoperative colic is difficult and requires serial examination of the patient. Horses undergoing colic surgery present a particular challenge to the anaesthesia team because of circulatory compromise and the need for dorsal recumbency of the patient. Placement of a jugular catheter under aseptic conditions and regular catheter maintenance are critical for the prevention of thrombophlebitis. Postoperative analgesia is critical to the outcome, even after surgery without apparent complications. Because of advances in veterinary medicine, survival rates of approximately 80% are now seen in horses after colic surgery. There is a strong correlation between the experience of the surgeon and a favourable outcome.