Equine operations: what you need to know [H&H VIP]

  • Whether it’s elective (planned) surgery or emergency equine operations, the news that a horse must be admitted to hospital can trigger an avalanche of worry.

    An understanding of what’s involved in an equine operation can allay certain fears and, in some cases, enhance the chances of a positive outcome. Lynn Irving of the Rossdales Equine Hospital nursing team outlines common hospital practice.

    How do I prepare my horse?

    “While it can’t be helped if a horse comes in covered in mud in an emergency, for elective surgery it is helpful if he’s clean. Some owners give their horse a bath, but brushing him over and picking his hooves is sufficient.

    “Some hospitals will request that a horse’s shoes are removed before surgery. We don’t, as we cover and tape them before anaesthesia, but check with your vet before admission.

    “With a planned procedure it’s usual to receive paperwork beforehand, detailing anything you need to arrange. You might like to bring your horse with his own equipment, such as a headcollar and rugs, if a hospital allows, but at Rossdales we have everything that’s needed.”

    He’s a fussy eater – should I bring his own food?

    “Most hospitals supply standard food, although you may choose to bring supplements or a particular type of forage. You’ll be able to discuss your horse’s dietary needs or any food allergies with the head nurse when you arrive.

    “Keeping a horse in his usual routine can help reduce complications, stress and intestinal problems, so the nursing team will be keen to make him feel at home. Tell the hospital  about his likes and dislikes. A donkey once turned up with his own supply of gingerbread men!”

    Will the staff tolerate my horse’s bad habits?

    “Horses are out of their comfort zone in hospital and often need injections or other procedures. The aim is to make the experience as stress-free as possible.

    Be honest about your horse’s habits. It doesn’t matter if he kicks or bites — we’re not here to judge — but we can deal with him safely if we are aware. And if he resumes his usual habit of pulling faces or banging the door at feed time, we’ll know he’s starting to feel better too.”

    Should he be starved before an operation?

    Ideally he shouldn’t eat for six to seven hours before an elective procedure, so that his gastro-intestinal system is not full of food. It’s important that his system starts working again afterwards, so he’ll be offered a bran mash or a warm feed as soon as he is able to eat.”

    Hospitals vary on their policy on starving horses as it is not always necessary —nor practical, for instance in emergencies.

    Is my horse at risk of infection?

    “Strict hygiene protocols should be in place to prevent admission or spread of infection and to protect healthy patients. You’ll be expected to produce your horse’s passport and paperwork before he can be unloaded. Infectious cases are often dealt with in an isolation unit, away from the main yard area.”

    Will he settle?

    “Hospitals work to a routine and most horses settle into this surprisingly quickly. Nursing staff will appreciate how difficult it can be to leave a horse, giving you ample time to say goodbye and ask any questions about his treatment and care.”

    How long must he stay?

    “The post-op stay is kept as short as possible. Most referring vets have great practice set-ups for rehab, and there’s no better place for a horse to recover than in his familiar home environment. Expect a two- to three-day stay for simpler elective procedures, or around seven to 10 days for something more complicated, such as colic surgery.”

    Will I be able to visit him?

    “Very occasionally a horse will get stressed when his owner comes but in most cases a visit really peps up a horse and changes his demeanour for the better. Most hospitals try to facilitate this if it is safe to do so, once the post-op grogginess has passed, usually after 24 hours. Even horses in isolation can be visited if owners wear protective clothing.

    “There are exceptions, such as if the horse has had a bone scan or treatment with radioactive iridium wires.”

    What if the worst happens?

    “Sadly, there are some horses that do not recover or must be put to sleep. At Rossdales, euthanasia takes place in the padded recovery room. Owners can stay but it’s not something we encourage. If they do, it’s important that they’re aware of what they’ll see.

    “People are welcome to spend the time they need with their horse and take mementos home, such as his shoes, mane or tail hair.

    “Don’t be afraid to ask the questions that may be on your mind.”

    How do I care for my horse after surgery?

    “It can be worrying to take a horse home, especially after major surgery, but it’s an important step in the recovery process. The vet team should issue discharge instructions explaining any medication or management he will need and outlining feeding, turnout and exercise.

    Be vigilant for the usual signs of infection or illness, such as smell or discharge from a wound, or colic. Call the hospital sooner rather than later if you are unsure.

    “With luck, recovery will be trouble-free. Just don’t forget to send in a photo of your horse once he’s back in action or competing again — it’s what makes the job so worthwhile.”

    General anaesthesia: what are the risks?

    The decision to place a horse under general anaesthesia is not taken lightly. An estimated one in 100 (0.9%) horses die during or within seven days of anaesthesia, with the figure higher still (1.6%) for emergency cases. To put this in perspective, figures stand at one in 1,000 for small animals and one in 29,000 for humans.

    “The biggest risk for horses is heart failure,” says Amanda Piggot MRCVS of Rossdales. “Certain muscle conditions (myopathies) and nerve complications (neuropathies) can occur during surgery and recovery. There is danger of a leg fracture during recovery (e.g. leg or neck) and always a risk of colic post-surgery.”

    However, in recent years procedures have improved.

    “Many of the “knock-down” drugs used haven’t changed for decades but the inhalation agents — the “gas” — are much safer,” she explains. “Whereas previously we might not have been aware of complications until after the operation, we can now monitor blood pressure and oxygen levels more closely during surgery.

    “Some horses don’t cope as well under general anaesthesia. Age and breed don’t appear to affect outcome, although a heavier horse is more likely to suffer a myopathy or neuropathy due to muscle weight.

    “It takes between 20 minutes and two hours for the horse to stand after surgery. We place the horse in a padded room and assist with head and tail ropes to guide him to his feet.”

    While results of current research into mortality rates may well reveal slightly lower figures, it is likely that risks will remain.

    “Certain surgeries, such as colic surgery and arthroscopies, have to take place under general anaesthesia because of the high risk and expensive equipment used,” says Amanda. “But more procedures can be carried out ‘standing’ with local anaesthetic and sedation. These include ovariectomies, dental work and some kissing spine operations.”

    Don’t forget insurance for equine operations

    Notify your insurance company before an operation unless the procedure is an out-of-hours emergency.

    “This could include colic surgery, fracture repair or an emergency procedure on a mare struggling to foal,” says Fiona Gordon-Clarke of Carriagehouse Insurance.

    “If something happens during the night or at a weekend and a snap decision must be made, it should be OK to ring them on the Monday to explain.”

    This article was first published in Horse & Hound magazine (6 November 2014)