Senior Citizen Surgery

by Barrie Grant, DVM, DACVS

There are many factors that veterinarians and owners consider when a surgical treatment is recommended for a horse. Cost, type of surgery, severity of surgery, complications, outcome, rehabilitation time, expectations and possible use of the patient following the procedure, all play a role in determining if the procedure will be performed. Several years ago, old age was a significant factor in considering surgery. Old horses were not expected to survive colic surgery. In the last few years, with advances in anesthesia and surgical techniques, medical and surgical treatment of older horses has become more common. In some areas of the country (mainly urban), a significant number of horses in many practices are old horses still doing their jobs, still enjoying life and proceeding into the “golden years” with their owners and many times the owners’ grandchildren.

When an equine senior citizen needs surgery — especially emergency surgery (such as for colic) — there is a concern that he will not survive the procedure because of his age, and therefore why would surgery be performed as it would increase the discomfort to the patient and the expense to the owner?

Our advice to the owner of a senior horse is that as long as the horse has been in good health, with normal weight, and there isn’t a severe endotoxic shock situation, then the older horse has the same chance of tolerating anesthesia and surgery as a younger horse would. The older horse is often more sensible during the recovery process than yearlings and un-handled two-year-olds. This makes them less likely to injure themselves or traumatize the surgical site during the recovery process. Also, an older horse is usually very amendable to the around-the-clock handling that intestinal surgeries often require.

The most common surgery for older horses is for the treatment of colic. Older horses are more likely to have colic caused by lipomas (tumors) that strangulate the small intestine, or by having the small intestine strangulated by being entrapped in the epipolic foramen (a small place between the bowel and liver in younger horses that becomes larger as the liver shrinks in size or atrophies with the passage of time). Strangulations of the small intestine usually require resection of the dead intestine and rejoining (anastomosis) of the two ends of healthy intestine. This can be a complicated procedure, and the aftercare can be intense while we wait for the intestines to start their normal movement and pass ingesta downstream to the large intestine.

Older horses in California often have large stones (enteroliths) that develop over the years and finally block the intestine because of their size. Removal of these stones is usually a straightforward procedure with minimal aftercare other than 45 days of stall rest to allow for the midline incision to heal. Then they are fine and ready to go back to work.

The treatment of eye conditions (cancer and cataracts) is another reason for general anesthesia and surgery on older horses.

We also have surgically treated compression of the cervical spinal cord (wobbler) in a number of horses over 15 years of age — the oldest being 28 (Thoroughbred champion, Seattle Slew). Even though Slew only allowed his owner and longtime grooms (Tom and Carlos) to catch and handle him in the stall, he had the nicest recovery from a wobbler surgery that I ever had. He was a special horse when he was young, and when he was in his golden years, all he wanted was to be given a chance.

Article courtesy of AAEP Educational Partner, The Horse.