To Explore or Not To Explore: That is the Question
Sep 15, 2011
From the Recovery Room
By Ryan Rothenbuhler DVM, MS
By Ryan Rothenbuhler DVM, MS
One day a few weeks ago, I had the displeasure of having to euthanize another horse. As a veterinary surgeon, I have to help owners make the decision to euthanize or keep going when their animal is sick and not doing well. A lot of horses present for signs of colic. Colic means nothing more than abdominal pain. Most horses with colic are your typical gas colic; or as I like to refer to them as a "Fart Caught Sideways". However, most horses that come see me are not your typical gas colic. They have been seen by their regular veterinarian, had the traditional medications and stomach remedies, and still are showing signs of colic. They come into the hospital in some degree of distress or pain. I get to work them up using all of my resources to give the owner the best possible diagnosis.
Usually owners have the same question for me, is it a twisted gut? Traditionally, the answer is No! Most causes of surgical colic are not a twisted gut. Some of the horses that present to me can be treated medically with intravenous fluids and an assortment of laxatives and medications. The occasional horse needs more than medicine, it needs an exploratory surgery. I once had an owner tell me that I could not take the horse to surgery just to explore, that I needed to know why it needed surgery before she would give me permission. I had to pull out my crystal ball and tell her that I had a suspicion of the exact cause of the horse's colic, but an exploratory would give me close to 100% cause and lead me in the right direction to save her horse. Sometimes the only way to truly determine the cause of colic is to just do a surgical exploratory. That was not enough. She needed more than I could give her. She asked me what options she had. I laid them out as clear as I could.
1. Surgery: I would explore the abdomen and find an answer to why the horse was colicky.
2. Medical Treatment: Not really an option for this horse. The horse was so painful that medications would not keep the horse comfortable.
3. Euthanasia: If surgery was not an option, then we could euthanize instead of watching it suffer; rolling in pain and banging itself up.
With this horse, exploratory was not an option in this owners mind. So the owner opted to euthanize her horse.
After euthanasia I frequently open the abdomen and at least take a look to make sure I can learn from the experience. After opening this horse I found that it had a colon displacement that I would have easily corrected and more than likely it would have went home in just a few days. On multiple occasions, I have had the displeasure of finding an easily correctable lesion after I have euthanized the horse.
Most owners are concerned about money and getting too deep in the surgical costs before getting an opportunity to euthanize their horse. I don't like to talk out the door price because every horse is different. What I do like to talk is what it takes to start treatment and see what happens. Typically a medical colic that requires an intravenous catheter, some fluids, and observation will start around $1000-2000. To do an exploratory colic surgery will cost $2000-2500. An exploratory will provide you the peace of mind that we have done everything possible and give you the true options for treatment of your horse. Depending on what we find at surgery the option to continue or stop is always made available to the owner. If we continue through with surgery, the costs of surgery will obviously be more.
Owners frequently want to know where they are at in regards to costs of veterinary care. At Conley and Koontz we try to keep bills up to date and always available for owners to know where they are financially in the treatment of their horse.
As an owner, it may be very difficult to make the decision to explore or not to explore. You are faced with emotional, personal, and financial decisions that can be very difficult to make in a matter of minutes. If there is the financial backing, most of the time a surgical exploratory can be curative, allowing your horse to recover with no long term consequences.