Attempted medical management of suspected ascending colon displacement in horses.
Authors: McGovern Kate F, Bladon Bruce M, Fraser Barny S L, Boston Raymond C
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Medical Management of Large Colon Displacement Between 1998 and 2008, researchers retrospectively analysed 127 horses with suspected large colon displacement (either right dorsal or left dorsal) to evaluate whether medical intervention could resolve this serious condition without surgery. The medically managed horses received intravenous fluids, analgesia, and controlled exercise, with those suspected of left dorsal displacement additionally given phenylephrine to encourage colonic contraction and repositioning. Medical management proved remarkably effective, achieving success rates of 64% for right dorsal displacement and 76% for left dorsal displacement, with only 4 horses dying or being euthanased and 36 requiring subsequent surgical intervention; overall survival to discharge was 94% across both medically and surgically treated cohorts. These findings suggest that suspected large colon displacement warrants a serious attempt at medical management before committing to surgery, potentially avoiding general anaesthesia and its associated risks in an already compromised patient. For practitioners managing colic cases, this research supports a protocol of aggressive medical support combined with appropriate exercise and, where indicated, pharmacological agents to stimulate colonic motility.
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Practical Takeaways
- •Medical management with exercise, IV fluids, analgesia, and phenylephrine (for LDD cases) should be attempted first for suspected large colon displacement, as it succeeds in ~70-75% of cases
- •Most horses with colon displacement have good survival outcomes (94%) whether managed medically or surgically, so don't assume surgery is always necessary
- •If medical management fails after appropriate trial period, surgical intervention can still be pursued with reasonable prognosis
Key Findings
- •Medical management was successful in 64% of horses with suspected right dorsal displacement (RDD) of the large colon
- •Medical management was successful in 76% of horses with suspected left dorsal displacement (LDD) of the large colon
- •94% of all horses (127 total) treated medically or surgically for colon displacement survived to hospital discharge
- •4 horses died or were euthanized during medical management; 36 horses required subsequent surgery