A 17-year old Thoroughbred broodmare presented to the Cornell University Large Animal Emergency Service on 6/12/13 for colic five weeks post-partum. The patient was observed to be thrashing in the paddock three hours prior to presentation, at which time oral Flunixin meglumine was administered. Diagnostic efforts by the referring veterinarian included nasogastric tubing, rectal palpation, and abdominal ultrasound; the mare continued to break through sedation and was ultimately referred for a suspected large colon volvulus. The patient had a history of large colon volvulus that was surgically corrected at Cornell in October of 2012.

On presentation, the mare was quiet, alert, responsive, and moderately painful. Vital signs were within normal parameters, mucous membranes were dark pink and slightly tacky, and the patient’s abdomen appeared distended with minimal gastrointestinal sounds. Point-of-care blood work was relatively unremarkable. Rectal examination revealed a gas distended viscous in the caudal right abdomen and tight bands coursing transversely. Abdominal ultrasound revealed diffusely thickened colon walls and colonic mesenteric vessels positioned against the right body wall. No net reflux was obtained upon nasogastric intubation. Abdominocentesis yielded slightly serosanguinous peritoneal fluid with a mildly elevated lactate.

An exploratory celiotomy was performed and a 360° large colon volvulus entrapping the cecum was identified. The large colon was diffusely edematous but relatively non-compromised based on bowel color and mesenteric pulse quality. The colon was decompressed and replaced in the abdomen. Careful examination of the remaining gastrointestinal tract revealed no abnormalities. A colopexy was performed from the ventral band of the left ventral colon to the body wall. The patient recovered from anesthesia without incident and was treated post-operatively with intravenous fluids, plasma, Lidocaine, antibiotics, anti-inflammatories, anti-endotoxic agents, and precautions were taken to prevent laminitis. The patient’s foal was re-introduced the following day. The patient recovered well and was discharged from the hospital 6 days following surgery, but later returned due to an incisional infection and substantial weight loss.

This presentation will focus on colic diagnostics, surgical treatment options for large colon volvulus, and specific aspects of post-operative management for the colic patient.