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Spotlight on Joint Aid

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For joint health

Sussex Equine Hospital's Veterinary Equine Elite Join Aid is one of the most powerful equine nutraceuticals for joint health available on the market. It contains the herb Boswellia Serrata blended with Chondroitin Sulphate, Hylauronic Acid, Glucosamine HCL (99% pure) and MSM. It's one of the most powerful equine joint supplements currently available on the UK market and is now widely used at the highest levels of competition, eventing and racing.

We've also found that it's ideal for older horses on maintenance joint support and as a supplement for young growing horses.

For ponies up to 300kg with a daily feed of 15g, a  2.75kg size tub will last 183 days. For horses and ponies over 300kg, an increased 30g feed will still last 91 days if you purchase the 2.75kg size.

Contact the Sussex Equine Hospital on 01903 883050 for more information and to order.

Spotlight on Electrolytes

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Replace essentials salts and minerals

Sussex Equine Hospital's Veterinary Equine Electrolyte compound is a complementary balanced powdered electrolyte for horses that compensates the loss of salts and minerals in cases of heavy sweating. It's formulated to include Sodium Chloride, Potassium Chloride, Calcium Carbonate and Magnesium Sulphate Heptahydrate and we have it on good authority that it's the electrolyte replacement product for many horse owners and keepers.

It's suitable for mixing in feed or water, widely used after racing, exercise or competition, and is very cost effective for daily long-term use.

For intensive exercise, you'd need a daily feed of 50g, so the 15kg tub would last you 300 days! For light to moderate exercise, we recommend 25g per day, so that's 600 days. Also comes in a 5kg tub.

Contact the Sussex Equine Hospital on 01903 883050 for more information and to order.

Spotlight on muscle strength

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Complementary feed

Our Veterinary Equine Muscle Pro is a complementary pellet feed, containing a high concentration of Amino Acids and the important antioxidant Vitamin E. Muscle Pro is especially recommended for feeding to young horses, pre-training horses or any horses that need to gain muscle mass.
Benefits include: improved strength, improved overall appearance and physical wellbeing, maximum muscular development in young stock and increased lean muscle mass. It's also free from naturally occuring prohibited substances, having been carefully tested by the Fauna & Flora Preservation Society (FFPS).
Have a chat to your Sussex Equine Hospital vet for more information on our Veterinary Equine Muscle Pro.

Contact the Sussex Equine Hospital on 01903 883050 for more information and to order.

Spotlight on gut health

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Sussex Equine Hospital's Veterinary Equine Gastric Aid is a trialled-and-tested complementary feed, suitable for horses that are displaying signs of gastrointestinal problems and will assist in maintaining optimum gut health and function in your horse.

The product supplies a unique formulation of prebiotics, amino acids, seaweed extract and specific minerals and comes in a convenient pellet form. Key features include:

  • Promoting weight gain
  • Allowing maximum utilisation of feed
  • Ideal for horses competing in all disciplines
  • Beneficial to horses prone to stress
  • Comes in 3.2kg and 12kg sizes

Feed 100g per day for horses, divided between the number of feeds. For example, horses fed three times daily add 33g per feed. (50g is recommended per day for ponies and foals equates to 16.5g per feed).

Contact the Sussex Equine Hospital on 01903 883050 for more information and to order.

Stud Newsletter 2018

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The team of dedicated stud vets at the Sussex Equine Hospital is made up of Ed Lyall, Paula Broadhurst, Simon Staempfli and Noelle Baxter. Together they provide a wide range of stud medicine services, including Artificial Insemination (AI) and Embryo Transfer (ET).  The team are all very experienced and hold postgraduate qualifications in reproductive medicine. Una Boyle, the fifth member of the team, joined the practice in 2016.

Sussex Equine Hospital is the only practice in the south of England that has a team of dedicated stud vets that provide routine and emergency services to stud clients 24 hours a day, 7 days a week for the entire stud season. This means that if your mare requires routine work to be done as part of her AI programme on a Sunday it will be a stud vet who does it, not just the duty vet. It also means that at night when your mare is foaling or your foal is not well, a stud vet with experience will be on hand to attend.

The hospital is fully equipped with a lab, foal care facilities and a surgical suite for performing all necessary mare and foal procedures including caesarean sections and assisted foaling under general anaesthesia.

Following is a brief overview of AI and ET; if you have any queries or want to discuss your requirements please do not hesitate to contact the practice and speak to one of the stud vet team.

Artificial Insemination

AI is the technique used to transfer appropriately processed semen, collected from a stallion, into the uterus of a mare at the correct time in her oestrus cycle in order to obtain a single pregnancy. The semen can either be fresh, chilled or frozen and it means stallions in the UK and abroad can be used, even semen from deceased stallions. Fresh semen is usually collected, extended and stored at room temperature in an airtight, light free container for use within 8 hours. Semen that is to be used longer than 8 hours after, but within 48 hours of collection should be chilled to 4ºC and stored for shipping in a special container. Semen that is required to last longer than 48 hours is frozen in liquid nitrogen at a temperature of -196ºC. The success of an AI programme is very dependent not only on the stallion’s semen but also on the careful veterinary management of the mare pre and post covering. This means that the semen is placed in the uterus at the correct stage in the mare’s cycle and that appropriate post insemination checks and treatments are made.

The other advantages of AI include keeping your mare and foal at home under your own supervision. Additionally, we find the intensive veterinary management required with mares to successfully perform AI can, in many circumstances, improve the chances of obtaining a pregnancy, as the probability of infection either bacterial or venereal is reduced. The addition of extenders and antibiotics to the semen can also improve the fertility of some stallions by improving the lifespan of the sperm. AI allows for the safe mating of mares or stallions with injuries and can prevent injury to valuable stallions by mares of poor temperament at natural mating.

At the Sussex Equine Hospital we use the most up-to-date techniques to manage AI mares, including insemination of frozen semen using a deep intrauterine technique. Over the last few years this technique has been used to inseminate mares with small volumes of chilled as well as frozen semen from the continent and we have seen a significant rise in the in-foal rate. Experience of dealing with thousands of mares over the years has allowed us to develop effective, simple routines and protocols for artificial insemination. Attention to detail is the key to good mare fertility and achieving a pregnancy as quickly as possible. The collection of frozen semen can allow a stallion to compete internationally without having to worry about stud duties and temperament changes whilst covering.

Embryo Transfer

Similarly Embryo Transfer (ET) is a technique that has been developed to enable mares to continue to compete while still producing foals. A mare’s fertility decreases as she gets older and this reduction in fertility appears to be more rapid in mares that have never had a foal. Therefore, once a mare is retired from competition in her teenage years and put to stud, her ability to become pregnant can actually be very poor.

To try and avoid this situation, owners will sometimes breed from fillies at 2 to 3 years of age prior to breaking in, so that they at least have 1 offspring before starting a competition career. Alternatively, ET can be used to produce foals while the mare is actively competing. Embryo Transfer involves the careful synchronisation of a donor mare (the mare you want the foal from) with a recipient mare (the mare we will transfer the pregnancy into). Then on a day individually selected depending on the situation, (usually day 7 or 8 after ovulation), the embryo is carefully flushed out of the donor mare and transferred to the recipient mare. A pregnancy scan is then performed about 1 week later on the recipient mare and subsequent scans as indicated.

The synchronisation of the recipient mare with the donor mare plays a large part in the success rate of this procedure and it can be quite difficult to do as not all mares ‘read the text book’ and respond to the medications the way we would like. Therefore, we ideally need to start off with a number of potential recipient mares so if some don’t respond as hoped we still have others to choose from. Fortunately, studies have shown no decrease in the success rate of the transfers, if the embryos are carefully chilled and transported within 24 hours to a facility with a number of recipient mares available.

Since 2008 the stud vet team at the Sussex Equine Hospital have performed a large number of successful ETs by flushing the donor mare and directly transferring the embryo into a recipient mare or sending the embryo chilled to a recipient mare facility. The donor mares are covered via AI in their own stable yard or at one of our AI centres. The flush can be carried out at the yard, AI centre or at our hospital. The flushing process takes between 30 and 60 minutes to perform, then the donor mare can go home to continue her normal competition routine. Once processed properly the embryo is either directly transferred into the recipient or transported chilled, same day by courier to the recipient mare facility where the embryo is transferred into the mare that was best synchronised with the donor.


Image shows a 7 day embryo

Over the last few years we have paid attention to detail and developed protocols that have given us excellent success rates with transferred embryos.

We aim to allow sport horse mares, that are of importance for breeding, to remain in work and competition. Our protocols mean that mares can remain at home with the rider so there is no check in training or competition.

New for 2018 we will be offering a service in the hospital where we will be able to freeze embryos, these can be stored for future transfer or even sold to other parties.

Packages for Veterinary Stud Work

Prior to embarking on an AI or ET programme with a mare it is important to become aware of all the facts and to balance out the pros and cons. One of the most important factors to consider is the cost. The keep, transport and veterinary costs sending the mare away to stud, must be balanced against the veterinary costs of AI or ET and keeping the mare at home. Many of the veterinary costs will be incurred either way and so it can be a real advantage to keep the mare at home. Some veterinary practices, as we do, will have a fixed price scheme for AI programmes. These can vary considerably, they may require the mare to go to a stud that the vet attends regularly and some may not include visit fees, pre-breeding swabs or pregnancy scans - when making price comparisons look very carefully at what is included in the package!

If you are interested in breeding from your mare in 2018 via natural cover, AI or ET contact the SEH now so that one of our dedicated Stud Vet team can explain the process in greater depth to you, one on one. Your options and which one of our competitive package deals best suits your individual situation can then be discussed. Mares can be worked on at owners’ yards within the practice area or mares from further afield can be boarded at the hospital or at one of several AI centres that we service.

Foal Care

Not only does the stud team take great care to get mares in foal as quickly as possible, they are also dedicated to the health of the newborn foal. We perform post foaling checks on both mares and foals within the first 12 hours after foaling, blood samples can be taken to assess health and also to make sure enough antibodies have passed from the mare to the foal by monitoring the IGG level of the foal's blood. All samples are processed in our own lab at the hospital.

The team will advise on future foal management, particularly of the limbs of the foal and also any other medical issues, as well as routine protocols such as worming and vaccination.

The hospital is equipped with two purpose built intensive care foal boxes, this allows us to deal with very sick foals and provide them with the very best levels of medicine possible. The hospital also has the surgical facilities required to perform all necessary mare and foal surgeries.

Stallion Semen Collection

Also new for the 2018 season we will be offering semen collection from stallions for fresh and chilled use. We will be able to send out semen 5 days a week across the UK. This service will be available to all stallion owners, however, prior to collection all stallions will need to have been tested to meet the strict health guidelines - for more information please do not hesitate to contact one of the stud team.

Worms & Worming

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There are numerous types of gastrointestinal parasites or “worms” as they are more frequently referred as. Worms are a burden on the horse’s gastrointestinal tract (GIT). This burden can range from being completely sub-clinical (the horse shows no ill effects from the infestation) to reducing a horse’s performance in events, causing colic, diarrhoea, weight loss and in severe cases horses can die as a result of parasitic infestation.

The most common and pathogenic worms that infest horses are, cyathostomins (small worms or small redworms), large strongyles (large red worms) and tapeworms. Large red worms were historically a problem but are now far less prevalent and cause less clinical disease. Small red worms are very common affecting all ages but mainly young horses (1-4 years old). Most infections are subclinical.
The small red worm life cycle: the larvae are eaten by the horse off the pasture and move through the GIT. They then burrow into the gut wall and can stay there for weeks, months or even years. They stay there until conditions are just right then they emerge from the gut wall and mature into adults where the adults produce eggs that are shed in the faeces. The eggs in the faeces then develop on the pasture into the larvae that are eaten and so the cycle continues.

The larvae in the gut wall are called “encysted” and these are very difficult to treat. Only two drugs can target these encysted larvae: a 5 day course of Fenbendazole or Moxidectin. If a large number of worms erupt from the gut wall at the same time then horses can develop severe problems. Encysted larvae don't produce eggs and so it is important to remember that a horse can have a low faecal egg count (FEC) but still have a high worm burden.

The tapeworm life cycle is different as they don't burrow into the wall but they shed their eggs intermittently so a negative WEC does not mean no tapeworms. A high tapeworm burden can cause colic. A blood test is available to detect antibodies against tapeworms, but this only gives an indication that they have been exposed at some point in the last 6 months.

Wormers Red Worms  Tapeworm
  Adults  Encysted Larvae Annual/6 month dose
1 d Fenbendazole     √    χ     χ
5 d Fendendazole     √    √        χ
Pyrantel         √    χ

   √  

double dose
Ivermectin       √    χ    χ
Moxidectin    √      √     χ
Praziquantel     χ    χ     √

Anthelmintic “wormers” have different effects and so target different worms at different stages of their life cycle. This table shows which worms are killed by the different active ingredients in wormers.
80% of worms produced in a field come from 20% of the horses. This means that the majority of horses on a pasture have few worms and so produce only a very small number of eggs. These horses are ‘low egg shedders’ and they do not need worming as they won’t be suffering adverse effects of having worms and won’t be significantly contributing to pasture contamination. The small group of horses that make up the 20% will be ‘high egg shedders’. These horses will have a FEC>200 eggs per gram. For an unknown reason these horses will be persistent egg shedders despite the same or similar pasture management as their herd mates. It is these horses we need to target with wormers to reduce pasture contamination and infectivity.

Each time you worm your horse a small number of the worms present will be resistant or “immune” to the effects of the wormers you use and so will survive worming. If you repeatedly give the same type of wormer to all horses on the pasture, over time the number of resistant worms in your horses' GIT will increase until all the worms are resistant and your wormer will no longer work. The oldest wormers (Fenbendazoles) have the highest resistance and the newest wormers have the least resistance (Moxidectin). It is important to understand that there are no new wormers being generated. Donkeys are already resistant to Moxidectin.

If you are worried about resistance developing on your yard then your vet can perform a faecal egg count reduction test (FECRT). This test measures the efficacy of the wormer you have used.
To reduce the development of resistance we can do four things:
1. Allow a population of sensitive worms “refugia” to survive the worming process. These refugee worms will dilute and compete with the resistant worms for resources. This competition will stop the development of an entirely resistant population. To do this we have to use a targeted worming protocol.
2. Reduce the use of wormers by only worming those horses with a FEC above 200 epg.
3. Manage the environment to minimise our reliance of wormers. We can do this by reducing the number of horses per acre, regular poo picking (everyone’s favourite summer pastime), mixed grazing with sheep and cattle and finally harrowing fields on hot dry days so the sun destroys the eggs in the soil.
4. Quarantine new horses so they don't bring resistant worms onto the yard. New horses should also be wormed for tapeworm and encysted larvae before being turned out.

Worming Programmes:
Firstly, no one protocol will work for every yard and if you have any concerns please consult your vet about your specific yard requirements so we can tailor a programme for you.
Regular worming - worming every 4-6 weeks will reduce disease BUT will lead to resistance and a shift in the type of worms you will see, so this is NOT a sustainable management protocol. Worming at specific times of the year can be successful in disrupting the worms' life cycle, however, changes in weather pattern or the introduction of heavily contaminated individuals will reduce your success and won’t help heavily burdened horses.

Targeted worming - treating each horse as an individual is the BEST strategy. You must use a FEC to select those horses who are shedding >200 epg and only worm those horses, the “high egg shedders”. By doing this you will reduce pasture contamination and reduce the development of resistance. It is also a CHEAPER worming protocol. You must have a FEC from every horse because 80% of the worms are produced by 20% of the horses so in a herd of 30 horses only 6 will be significantly shedding eggs but you won’t know which six unless you sample all 30.
We recommend that as part of any worming strategy, tapeworm should be targeted twice a year in autumn and spring, and that encysted worms are targeted in winter.

Blood transfusions

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Blood transfusions

Blood and plasma are vital fluid therapies for horses and foals. Unfortunately, there are no blood banks for horses (as there are for humans and some small animals) because horse red blood cells do not store well. Blood can only be drawn from a donor horse when a transfusion is needed.

In general blood transfusions are used to supply either plasma or whole blood. This article will discuss both and will also outline the ideal characteristics of a horse blood donor. Before this is discussed it is important to understand how blood is divided. Blood can be broadly divided into two parts; plasma and red blood cells. The plasma contains the white blood cells and antibodies effective in fighting infections. The plasma also contains large proteins and clotting factors that help the blood clot when bleeding occurs. The red blood cells deliver oxygen to the rest of the body.

When blood is taken from one horse and given to another there is a possibility that the white blood cells and antibodies will attack the recipients blood or the white blood cells and antibodies in the recipient can attack the red blood cells from the donor. To minimise this risk matching blood donors and recipients by blood type can be done. Humans have four major blood types and can be either negative or positive based on the rhesus factor but horses have 8 blood types and can be positive or negative on over 30 different factors! This makes getting a 100% match a one in half a million chance. However, there are only two real problem blood types to be concerned about, Qa and Aa. So, we can cross match the donor and recipient by mixing the two bloods together and looking for a reaction before administering the blood. This being said, a blood transfusion between two horses that have never received blood transfusions previously is unlikely to result in a reaction.

An ideal blood donor will be a large (>500kg) young, healthy horse. The horse cannot have or have had a blood disease (such as equine infectious anaemia) and cannot have had a blood transfusion previously, this is because if a horse has had a blood transfusion then its immune system has produced antibodies ready to fight against other blood types - these horses won’t match. Females and especially females that have had a foal, are also more likely to carry antibodies against different blood types, that may attack the recipient of the blood.

Blood donating

If your horse is donating blood, then the procedure is relatively innocuous. A catheter is placed in the horse’s jugular and 4-8L of blood is collected and mixed in a prepared sterile bag. The bag contains an anti-clotting preparation and stores the blood before its use. The donating horse may or may not need to be sedated but will make a full recovery after a couple of days’ rest. Horse can donate 20-25% of their blood volume at 2-4 weekly intervals however we do try not to take this amount on a regular basis.

Blood once it is collected, can either be given as whole blood, which is usually given to horses that have lost blood through haemorrhage, or as plasma only (blood without the red blood cells). All blood products are best used fresh but plasma can be frozen and stored for a longer period of time. Plasma also has fewer risk factors compared to whole blood so is generally safer to administer and doesn't require blood typing donor horses.  Plasma maybe administered to horses that are suffering from colic, colitis and numerous other conditions.

Because equine blood can’t be stored it is often a case of getting the blood as and when you need it. For this reason, if your horse is a blood donor you may not be required to donate for weeks or even months but when your horse does donate it will allow you to participate in a lifesaving treatment protocol.

The Move To Ashington

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Dear Client,

The Arundel Equine Hospital – New Hospital

We are pleased and excited to announce that the completion date of our brand new, purpose built, state-of-the-art equine hospital is imminent, and that we will be relocating to the new premises over the weekend of 22nd – 23rd July 2017. During this time, we will still be operating our normal weekend out of hours emergency service. On Monday 24th July, we will be running a full complement of hospital and ambulatory vets. If you need to book an appointment or speak to a vet please call the normal practice number (01903 883050) where your call will be answered and directed to the vet covering your area. Reception and Accounts will return to a normal service on Tuesday 25th July.

The Arundel Equine Hospital was founded in 1951 by Mike Ashton and since that time has undergone numerous changes, but the core aim of providing outstanding care to all horses, ponies and donkeys, has not and will not change. The new premises will enable us to expand on the range of services we are able to offer. For patients that do need to come into the new hospital, the new site provides a state-of-the-art, custom built facility to ensure the best possible treatment and care for all. We will be able to offer standing MRI from August 2017 and CT scanning from early 2018.

Our new location is more centralised within the area we cover, with good access just off the A24. The move to Ashington will not impact on the level of service that you currently experience, but will improve our coverage across the South. Vets will still attend yards as they do now, and our van will still be buzzing around with all the digital diagnostic equipment such as x-ray, ultrasound and endoscopy.

With effect from Saturday 1st July 2017, we will be changing our name to the Sussex Equine Hospital. This is designed to reflect our new location, but rest assured that all vets and staff will stay the same, and that we will retain the same friendly, helpful approach, understanding your horse’s needs.
Below is an information sheet, highlighting the new facilities, including the new logo and address of the new hospital. We are retaining our existing telephone numbers, so no need to update your phone book or speed dial, and our bank account details will remain the same too.

Finally, we thank you for your support, and if you have any questions or concerns please do not hesitate to contact us by either calling Reception on 01903 883050 or emailing info@arundelhorsevets.co.uk.

Kind regards,
Ed, Rob, Paula, Matt, Simon & Andy
Directors

Colic Surgery?

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Colic Surgery, should I put my horse through it?

The term colic simply denotes abdominal pain within the horse’s abdomen. There are over 70 different types of colic a horse can get, some of which can be managed medically but some conditions, unfortunately require surgery to correct the condition and save the horse’s life. Broadly speaking colic can be considered as either a medical or surgical colic, depending on the cause of the colic and how the horse responds to treatment. A medical colic is one that has the potential to resolve with medical management which may involve just starving and walking the horse or may require a variety of drugs and fluid therapies. A surgical colic includes any type of colic where blood supply to the gut is compromised, certain specific conditions that have not had chance of resolution with medical management, conditions that fail to respond to medical management, or are so painful, it is in the best interest of the horse to operate.

Surgical colics account for approximately 10% of colic cases seen, however, this number varies geographically around the UK. There are certain clinical examination findings that indicate a horse requires referral to an equine hospital. It should be remembered that referring your horse to an equine hospital doesn’t mean your horse necessarily requires colic surgery.

In some instances, it is unclear what it causing the colic in your horse and referring your horse to an equine hospital allows the vets to perform additional diagnostic tests such as abdominal ultrasound, rectal ultrasound and abdominocentesis (taking a sample of the fluid within your horse’s abdomen). Referral then allows the vets to monitor your horse closely and repeat those tests to determine if the horse is getting better or worse.

Some horses with confirmed medical conditions will require intense medical management including; regular veterinary monitoring, intravenous fluid therapy, regular nasogastric tubing, rectal examination and abdominocentesis. All of which can be done far easier, and sometimes cheaper than managing the horse at home.
The added benefit of referring your horse to an equine hospital is that if the colic worsens and the horse does require surgery, your horse is already in the best place and surgery can happen without delay of travel and re-assessment. Speed is of paramount importance when dealing with a colic.

Now we have established that referring your horse to an equine hospital doesn’t automatically mean colic surgery, we can discuss, what if your horse does require colic surgery.
Colic surgery is a life-saving procedure, but is also one of the most challenging surgeries and it is not without risk or complications. Horses that do require colic surgery are usually very sick individuals and that makes the anaesthesia very challenging. It has been reported that one in a hundred horses die under anaesthesia, this is an old figure and anaesthetic death rates are thought to be lower now because of better monitoring and a better understanding of anaesthesia in the horse. However, because horses with colic are systemically ill, the anaesthetic is complicated and anaesthetic death rates of horses with colic are greater. If a horse with colic is operated on sooner rather than later, the horse will be healthier and there will be fewer anaesthetic complications and a lower anaesthetic risk. This again leads to the merit of early referral of a colic so they are in a facility where an operation can be performed. There is no association with age and anaesthetic risk, this is to say older horses are not at a greater anaesthetic risk compared to young horses.

Common surgical conditions include; a displaced colon, a large colon torsion and a small intestinal obstruction. A displaced colon can be managed medically, however, some displacements fail to resolve medically or if the horse is too uncomfortable to manage medically, the aim of the surgery is to manually lift the colon out of the horse and put it back in the correct location. A large colon torsion describes that the colon is not only displaced (in the wrong place) but twisted on itself and the blood supply to the gut has been compromised. These horses will be incredibly uncomfortable, and require to lift the colon out of the abdomen, un-twist the colon and place it back in the abdomen in the correct position. If the twist in the colon has compromised the blood supply to the gut for too long a period, the colon may need to be removed. Removing a section of the horse’s colon is an incredibly complex surgery to perform, and success rates are low in these kinds of surgeries. Thankfully, this is a rare occurrence as most colons only require un-twisting. A small intestinal obstruction is almost always surgical and requires identification of the reason for the obstruction and correcting that problem. If the small intestine’s blood supply has been compromised a section may need to be removed, this unlike the colon, is a more common procedure during colic surgery and although it too carries additional risks, most horses do well following a small intestinal resection.

Reasons for a small intestinal obstruction can be, but are not limited to; a twist in the small intestine around itself, a twist around a lipoma or a lipoma cutting off the blood supply, or an epiploic entrapment (the small intestine becomes trapped in a small hole within the abdomen and requires manual removal).

An uncomplicated surgical colic operation will cost in the region of £5,000 and this is the limit to most insurance claims. However, if your horse has a prolonged recovery or there are complications, or your horse requires a second surgery, then the cost will breech that £5,000 limit. Some insurers are now offering claims up to £10,000 so it is worth shopping around and considering this when taking out an insurance policy.

In summary, colic referral doesn’t definitely mean colic surgery but it has the added benefit that if your horse does need surgery they are in the right place. An early colic referral with aggressive medical treatment may prevent colic surgery and be cheaper than managing your horse at home. Speed is essential when dealing with a colic, call the vet early and refer early to give your horse the best chance. Don’t rule colic surgery out, there are many success stories following colic surgery, even in the older horse, however prognosis will depend on diagnosis.