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Case Study: Cool

Cool, the once in a lifetime horse

You know how people talk about that once in a lifetime horse? That perfect partner that takes you places you never thought you would go? That horse that becomes a central part of a person’s life? For his owner, Cool is that horse. One of the last living stallions of a noble bloodline, in his youth Cool was a champion. Now in his golden years, the 27 year old is still his owner’s best friend and steady companion.

In the fall of 2016, while out of town, Cool’s owner got the call all horse owners dread. Her beloved stallion was colicking. While he was rushed to Southwest Equine Hospital, she was catching the first flight home, determined to be by his side through his ordeal or be there to say good-bye if treatment wasn’t possible.

When he arrived at SWEH, Cool was quite painful. A series of diagnostics including blood work, ultrasound, rectal exam, naso-gastric intubation, and abdominocentesis (belly tap) revealed that a portion of his small intestine was cut off from its oxygen supply and dying, most likely from a strangulating lipoma (a ball of fat hanging from a vascular “string” that can wrap around the intestine and cut off blood supply to the intestine). Time was not on our side, and a decision had to be made: surgery to remove the dying intestine or euthanasia to end his suffering. Thanks to modern technology, the plane that was bringing Cool’s owner home was equipped with WiFi and she was able grant permission for his life-saving surgery.

Cool was rushed to surgery where the offending lipoma was removed, as well as 10 feet of his lower small intestine including all of his ileum. Based upon the location of the lipoma, a complex procedure (jejuno-cecostomy) was required in which the middle portion of his small intestine (jejunum) was connected directly to his large intestine (cecum) in a “re-plumbing”. Cool was true to his name, waking up from anesthesia without complications. His owner was able to visit him shortly after surgery, groggy but still alive!

Surgery and anesthesia recovery were just the first hurdles Cool flew over. After a procedure like Cool’s, most horses have a difficult time regaining normal intestinal motility so that they can be fed again. They typically reflux (have excess fluid in their stomach that needs to be drained via a stomach tube) for 3-7 days; but once again Cool defied the “norm” and stopped refluxing in under 48 hours (apparently he is quite food motivated!) He started eating 2 days after surgery and never looked back. His loving owner visited every day to personally ice his feet (helping with his arthritis and to prevent lamintis) and to tend to the wounds he sustained when the colic episode first started. Cool was a model patient, and returned home with his owner to enjoy his retirement.

About Strangulating Lipomas:

Strangulating lipomas are unfortunately all-too-common in middle-aged to older horses, and there is absolutely no way to prevent them. While overweight horses are more pre-disposed, we have also seen many horses in excellent body condition and still in full work that have had intestinal lipomas. Strangulating lipomas cause “light switch” colic; horses with lipomas can be fine one minute, violently painful the next. Our rule of thumb is “any older horse with painful colic, small intestinal distension and naso-gastric reflux is a lipoma until proven otherwise.” Lipomas give us no warning, and are a surgical emergency if we are going to save the affected horse.

While some people may think it is crazy to have colic surgery performed on a 27 year old, Cool is a reminder that age is not a disease, and even older horses can recover fully after colic surgery. “He’s a tough one,” his regular vet told us, “if any 27 year old can pull through this, it’s Cool.” The bond between Cool and his owner is inspirational, and a reminder of why we do what we do for these beloved companions and their families.