Outcome and long-term follow-up of 20 horses undergoing surgery for caecal impaction: a retrospective study (2000-2008).

Abstract

REASONS FOR PERFORMING STUDY: If untreated, caecal impaction may progress to rupture of the caecum and reports of long-term outcome for horses undergoing surgery for caecal impaction are required. OBJECTIVES: To describe short- and long-term complication rates for horses undergoing surgery for caecal impaction in an otherwise life-threatening gastrointestinal condition. METHODS: Case records were reviewed for horses undergoing surgery for caecal impaction. Horses were included in the study if an abnormally large, fluid-distended or feed-impacted caecum was the primary diagnosis at surgery and excluded if the caecum had already ruptured upon opening the abdomen, necessitating euthanasia. Short-term follow-up data were obtained from clinical records; and included complications, repeat celiotomy and survival to discharge. Long-term survival was defined as survival for >1 year post operatively. Long-term follow-up data were obtained through telephone interviews with owners and referring veterinary surgeons. Survival, occurrence of post operative colic and subsequent use of the horse were recorded. RESULTS: Twenty horses underwent surgery for caecal impaction: 16 horses underwent caecal bypass (typhlotomy and removal of caecal contents, ileal transection followed by ileocolostomy); 3 underwent typhlotomy alone; and one horse underwent typhlotomy followed by a second procedure where caecal bypass was performed. Five horses (25%) were admitted for colic evaluation with primary caecal impactions, in 10/20 (50%) of cases the impaction was secondary to previous orthopaedic surgery and in 5/20 (25%) caecal impaction was identified at repeat celiotomy following a previous colic surgery. Sixty-five percent (13/20) of horses survived to discharge; 11/13 (85%) of horses discharged survived long term; 100% (3/3) horses that received typhlotomy alone were discharged and survived long term. CONCLUSIONS: The prognosis following caecal impaction surgery is fair, if the horse survives to discharge then prognosis for long-term survival is good. POTENTIAL RELEVANCE: Surgery for caecal impaction carries a fair prognosis for a potentially life threatening disease, in particular where caecal dysfunction is suspected.