Colic Surgery: Preventing Postoperative Diarrhea

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A diarrhea treatment might also be useful for preventing diarrhea in horses recovering from colic surgery, said researchers in a new study.

"Diarrhea following colic surgery is common with certain conditions such as colonic volvulus (twisted gut) and sand impactions due to the added injury to the intestinal mucosa that occurs in these cases," said Diana M. Hassel, DVM, PhD, Dipl. ACVS, ACVECC, of Colorado State University, a co-author of the study.

When the normal balance of "good" and "bad" flora are disturbed, bacterial endotoxins can be absorbed, causing illness. The researchers evaluated the effectiveness of di-tri-octahedral smectite (known commercially as Bio-Sponge), a natural clay that binds organic ions, such as endotoxins.

The researchers looked at horses that had colic surgery in which the colon was flushed with water to remove impacted food. This removal of normal bacterial populations and intestinal content can cause temporary diarrhea.

In the study, 67 horses received DTO smectite 4 hours after colic surgery and again at 24 and 48 hours after surgery, while 30 controls received a placebo of water through a nasogastric tube. Just more than 10% of the treated horses had postoperative diarrhea, compared with 41% of controls.

"This method appears to be quite effective," said Hassel. In practice, she repeats the treatment every 24 hours (up to three treatments) if she considers the patient to be at increased risk for postoperative diarrhea.

Only a veterinarian should administer DTO smectite.

The study, "Di-tri-octahedral smectite for the prevention of post-operative diarrhea in equids with surgical disease of the large intestine: Results of a randomized clinical trial," was published in the November issue of The Veterinary Journal. The abstract is available on PubMed.