New grading system could improve survival times in some horses with colic

Tsensation, a 25-year-old Arabian gelding, is shown with his owner, Rae Marie Smith, at her farm in Ocala, Florida. Tsensation is one of 35 horses that were treated successfully for a challenging form of colic through the use of a technique developed by UF equine surgeons.A novel approach to managing a challenging form of equine colic could save the lives of many horses and also save horse owners the cost and uncertainty of major surgery, say University of Florida veterinary researchers.

The approach, developed by the team of David Freeman, MVB, PhD, a professor of large animal surgery at the UF College of Veterinary Medicine, relies heavily on a surgeon's judgment during surgery to assess the viability of strangulated small intestine, an obstruction that impedes blood flow.

If the affected tissue shows improvements in intestinal color and muscle activity after corrective measures, the organ has an excellent chance of recovering function, and costly surgery to remove the intestinal obstruction is avoided, the researchers say.

“In general, the treatment for small intestinal strangulation isn't as successful as for many other forms of colic,” said Freeman, who also is the director of the college's Island Whirl Equine Colic Laboratory. “The question we always ask is, do we need to remove this piece of intestine or not?”

Freeman and his colleagues concluded that if certain criteria are met, in many cases, the answer would be no.

Their research appeared last fall in the Equine Veterinary Journal and was presented in July at the Equine Colic Research Symposium in Dublin.

The findings are based on a review of data from 35 cases that used the technique involving horses treated at two university veterinary hospitals between 1996 and 2011.

“I was very interested in this issue, so in each case, I recorded the severity of the small intestinal changes,” Freeman said. “I started off with a grading system, which was tweaked and modified along the way.”

Gradually, the team came up with the system UF is using today in equine clinical cases. “Once we've established the degree of intestinal injury, we can now say: This is the cutoff. If it's worse than this, we will have to remove that part of the intestine, but if it's better, we can leave it in place,” Freeman said.

All horses in the study were discharged after recovery, with only a few developing serious but manageable complications. Many horses survived more than 10 years, and some survived for up to15 years.

“These long-term survival data are very encouraging and might exceed what have been reported previously for this type of colic,” he said. “This study shows that in many cases, these horses can do very well with the affected intestine left in place.”

Also collaborating in the research were D.J. Schaeffer, DVSc, PhD, from the University of Illinois College of Veterinary Medicine, and Orlaith B. Cleary, MVB, a former large animal surgery resident at the University of Florida who now practices in Ontario.

The University of Florida College of Veterinary Medicine is supported through funding from UF Health and the UF Institute of Food and Agricultural Sciences.