Q: My 17-year-old Quarter Horse had surgery in September of 2000 for nephrosplenic entrapment (in which the large colon becomes hooked over the nephrosplenic ligament). We went back on June 13 for the same surgery. They recommended that we change his diet to senior feed and timothy hay, and begin light work after two months of recovery. I don't show; my horses are just for pleasure and mostly pastured. We wouldn't consider putting him down unless there were going to be major complications or chronic pain after surgery. But it is hard to afford $4,000-$6,000 every nine months. I would appreciate any information on this condition.

-- Jennifer

A: A horse's large colon is anchored to the abdominal wall only at its beginning and terminal ends. Therefore, a large loop of intestine is free to shift out of its normal position and move about the abdomen. This predisposes the horse to various types of twists and displacements. Nephrosplenic entrapment is a displacement that occurs when the large colon becomes trapped between the left kidney, spleen, and the ligament that runs between these two organs. As there is usually little damage to the bowel from the entrapment, surgical correction normally simply places the bowel in its normal position.

Studies have found that only 3.2-7.5% of successfully treated horses have a repeat episode. Obviously, this low recurrence rate does little to ease your anxiety as your horse is already in this unfortunate minority. The rationale behind the feeding changes recommended to you is to provide a diet that will help prevent gas buildup or alterations in the normal activity of the bowel that might have initiated the previous displacements. In some cases, this is enough to prevent recurrence.

Several surgical techniques can prevent twists and displacements. One is removal of the large colon; up to 90% of the horse's large colon can be removed safely. The surgery is somewhat difficult and time-consuming, and as a result is relatively expensive.

The large colon can also be sutured to the body wall, which provides another anchoring point and limits the ability of the colon to move out of its normal position. This procedure is called colopexy and can be done through a normal colic incision, or can be performed laparoscopically. The advantage of laparoscopic colopexy is that the surgery is performed by placing a scope and laparoscopic instruments through very small incisions that heal much more quickly and with fewer complications than standard abdominal incisions. If you are very concerned about experiencing another colic surgery, you might want to consider having this procedure performed now by an experienced laparoscopic surgeon to prevent a future displacement.

About the Author

Becky Frankeny, VMD, MS, Dipl. ACVS

Becky Frankeny, VMD, MS, Dipl. ACVS, worked out of Comstock Large Animal Hospital, in Reno, Nev. before moving back to Pennsylvania and starting her own practice: Juniata Mobile Veterinary Service.

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