Just 20 years ago, overall equine survival of surgical colic hovered at 39-48% due to anesthetic complications and breakdown of surgical incisions. Recent overall survival rates range from 55-95%, dependent on timely intervention and clinician/hospital experience. Barbara Dallap Schaer, VMD, Dipl. ACVS, ACVECC, assistant professor of Emergency Medicine and Critical Care at the University of Pennsylvania's New Bolton Center, addressed changes in equine surgical and postoperative care at the 2009 American Association of Equine Practitioners (AAEP) convention, held Dec. 5-9 in Las Vegas, Nev.

Veterinarians using diagnostics such as abdominal ultrasound now can identify surgical conditions earlier, even in the absence of rectal exam findings. An abdominocentesis (belly tap) has been a helpful tool to diagnose the presence of abdominal infection (peritonitis) or ruptured bowel. Also, veterinarians can diagnose strangulating intestinal lesions by detecting increased lactate in peritoneal fluid. She noted that in humans, timely intervention relies on treatment in less than six hours; there are even better results if treatment starts less than two hours after diagnosis.

Regarding surgery, Schaer noted that the collective increase in surgical experience and advances in techniques in handling bowel resection have increased survival rates. Bowel bypass procedures have improved survivability; 69% of foals who underwent the procedure survived past two years, and adult survival following large colon resections has risen to nearly 58%. While adhesions used to be a common postoperative sequel to colic surgery, current intra-operative methods minimize their formation.

Schaer noted that postoperative management has taken great strides with improved patient monitoring, stabilization of cardiovascular status, and careful monitoring of coagulation profiles (clot formation). It's important to provide nutritional support following surgery, taking steps to control blood glucose and triglycerides to avoid or manage sepsis (infection of the blood). Improving intestinal motility with lidocaine has been instrumental in postoperative colic success. In general, broad-reaching, goal-directed therapy has reduced organ failure and mortality; consequently, undertaking such measures is financially justified