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Discussion on Enterolith and ruptured intestine

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Carol Williams
New Member
Username: carol459

Post Number: 3
Registered: 5-2008
Posted on Wednesday, Jul 9, 2008 - 5:42 pm:   Edit PostPrint Post

Dr O, I just lost my beloved 23-year old QH to a ruptured intestine, presumably from the stone that showed up on xray (about 3 inches dia). I had only owned Chance for about 6 months, but he had never colicked, and his previous owner said he had no history of it. Other than a little arthritis, Chance was in great health. Until about 3 p.m. that day, there was never any sign of a problem. He then became very ill, with a quivering, distended abdomen and heavy sweating. Within 2 hours, the vet had examined him; 30 minutes later, we had him in the hospital and less than 3 hours after that I lost him. The hospital vet diagnosed the rupture based on low white cell count and sample of free abdominal fluid, and Chance's rapidly declining condition confirmed the shock from the leakage. The vet said there was no way to undo the damage of the leakage, that repairing the tear would only cause future problems (i.e., adhesions) and sensitivity, and that his condition made him a poor candidate for surgery in any event.

My questions to you are 1) do you agree that there is no real hope in trying to repair a ruptured intestine? (I don't doubt this doctor -- I know she would have done surgery if she thought there was a chance, but I'm interested your opinion) and 2) is there any way that I could have detected the stone, any subtle symptoms I might have missed, or anything I could have done as preventive measures to help Chance pass the stone before it became impacted? Is there a regular exam that would have detected this? I know it's too late for him, but it might help me in the future. (I've already learned the lesson about California alfalfa, although during his time with us, Chance was fed off the ground with a well-balanced diet of different hays and Senior.)
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 20994
Registered: 1-1997
Posted on Wednesday, Jul 9, 2008 - 6:12 pm:   Edit PostPrint Post

My condolences Carol,
Taking your questions in order:
1) No once ruptured the prognosis is grave.
2) No, without prior episodes of colic there would be no reliable way to detect this. It can be difficult to rule out even with the history of previous colic episodes.
DrO
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Chris
Member
Username: stevens

Post Number: 601
Registered: 8-2002
Posted on Wednesday, Jul 9, 2008 - 6:14 pm:   Edit PostPrint Post

Carol,

Sorry to hear about your loss.

Some vet clinics in So. Cal offer "free" radiographs with the intention of detecting stones. I have no idea if it works.

There have also been studies of the effects of feeding vinegar to help dissolve/break down stones so that they may be more easily passed.

My information is quite old as I haven't researched this since I had colic surgery done on a horse with an impaction due to a stone. He survived and I fed him psyllium afterwards in an effort to keep things moving through his gut so that there wouldn't be a base for a another stone to form around.

Again, my condolences.
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Sara Wolff
Member
Username: mrose

Post Number: 3682
Registered: 1-2000
Posted on Wednesday, Jul 9, 2008 - 7:31 pm:   Edit PostPrint Post

I'm so sorry you lost Chance. It's so difficult to loose an animal you care about. Over the years we've lost several of our herd, and each one is very difficult. My condolences. Chance has a lot of good company in "horse heaven."
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Fran C
Member
Username: canter

Post Number: 1552
Registered: 1-2000
Posted on Thursday, Jul 10, 2008 - 7:14 am:   Edit PostPrint Post

I'm very sorry for your loss, Carol. Sounds like you and your vet moved very quickly as soon as Chance showed distress. I hope you find some comfort knowing you did your best.
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 20998
Registered: 1-1997
Posted on Thursday, Jul 10, 2008 - 7:26 am:   Edit PostPrint Post

The efficacy of radiography is described in the article on enteroliths and I would not have recommended it as a screening tool in horses with no history of symptoms. However if it were free that certainly would change the cost benefit equation.

Though vinegar has been recommeneded more as a preventive, I don't know any work on the efficacy on existing stones or whether it is effective at reducing the incidence. Because the acetic acid is digested and absorbed the change in the ph at the level of the large bowel where the enterolith forms is pretty subtle. It should also be noted that the more acidic you make the digestive tract the likely ulcers are.
DrO
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Chris
Member
Username: stevens

Post Number: 604
Registered: 8-2002
Posted on Thursday, Jul 10, 2008 - 4:17 pm:   Edit PostPrint Post

Dr. O,

I think it was in an article I received from the vet school at Cornell. It was ages ago, but I seem to remember the study somehow was able to retrieve and re-introduce the stones after feeding vinegar, thereby being able to measure the effect of the vinegar on the stone's size. Then again, I could be remembering wrong.

I'll look for the reference later this week as I only have/had hardcopy of the article.

Chris
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Carol Williams
New Member
Username: carol459

Post Number: 4
Registered: 5-2008
Posted on Thursday, Jul 10, 2008 - 4:20 pm:   Edit PostPrint Post

Thank you, Dr. O, for giving me the comfort of knowing there was nothing more we could have done. Thanks also to all of you for your kind words and support. Sara, I read your posts about your mare from earlier this year -- very similar to my Chance's situation, and just as heart-breaking. Thanks again to all -- this is wonderful forum.
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Sara Wolff
Member
Username: mrose

Post Number: 3691
Registered: 1-2000
Posted on Thursday, Jul 10, 2008 - 5:31 pm:   Edit PostPrint Post

Sadly, there are just things we can't prevent or protect them from. The best we can do is give them the best care we are capable of giving and try and let go when we have to. It's not always easy, but the rewards of having horses always out weigh the negatives (imo at least.)
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Amanda
New Member
Username: fordy15

Post Number: 3
Registered: 2-2009
Posted on Friday, Feb 13, 2009 - 2:22 am:   Edit PostPrint Post

Dear All
Is it APPLE CIDEr vinegar which is recommended, and, if so, how much for a 700kg horse and for how long?
Thank you!
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Robert N. Oglesby DVM
Moderator
Username: dro

Post Number: 22343
Registered: 1-1997
Posted on Friday, Feb 13, 2009 - 9:15 am:   Edit PostPrint Post

As far as I know Amanda, the information I supplied above still applies. Chris should receive a notification of this post and hopefully he will have more info.
DrO
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Chris
Member
Username: stevens

Post Number: 690
Registered: 8-2002
Posted on Friday, Feb 13, 2009 - 11:32 am:   Edit PostPrint Post

I had totally forgotten about this. I'll look for the reference later tonight.
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Chris
Member
Username: stevens

Post Number: 696
Registered: 8-2002
Posted on Saturday, Feb 14, 2009 - 10:51 am:   Edit PostPrint Post

Looked through my files and couldn't find the article. If you want more information, I suggest you contact the vet school at Cornell; that's who sent me the article many moons ago.

Good Luck.
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