Use of Integrative Medicine in the Post-operative Colic Patient
Integrative medicine can be extremely helpful to recovery for a post-operative colic patient. Colic is a general term for intestinal distress that can be result from a variety of causes. Although some colic cases are minor and resolve quickly, others are quite serious and require abdominal exploratory laparoscopy (colic surgery) to diagnose and treat. Exploratory abdominal surgery is a very serious surgical procedure for the horse that may require significant post-operative supportive care.
Your horse’s colic could be caused by a non-resolving displacement of the large colon; a severe impaction of the large colon or small colon; any type of strangulating lesion of the small or large intestine; or a non-strangulating lesion causing ileus (loss of motility). Surgical exploration allows diagnosis and treatment of the underlying cause for the abdominal pain. But there is a limit to the amount and types of medicines that can be used post-operatively. Therefore, integrative medicine can be very beneficial during the recovery period.
Immediate post-operative acupuncture offers a nonchemical process to support pain control. Intestinal blockages can reduce blood flow as well as feed movement within the bowels. Acupuncture has been shown to promote the normal motility of all sections of the intestinal tract by addressing stagnation of both qi and blood. Acupuncture further assists bowel motility by tonifying the spleen and the stomach, which is the underlying driver of the intestinal tract.
Dry needle, electro-acupuncture or aqua-acupuncture are all appropriate methods for post-operative treatment. Although the underlying cause of colic is treated surgically, these techniques can promote recovery by supporting the basic medical treatments; balancing the animal’s Yin and Yang; moving stagnation; and draining heat and damp that has occurred within the body. Acupuncture treatment should be repeated every 24 hours until improvement has been noted in clinical signs, motility is restored, and pain is under control.
Cold Laser Therapy
Cold laser therapy, technically known as photobiomodulation therapy, can be used to help in the healing of the abdominal incision. Photon energy enters the tissue where it stimulates the cells at the mitochondrial level to promote circulation and decrease release of inflammatory mediators, thus decreasing the horse’s pain. It also activates cellular healing, allowing for faster resolution of the secondary tissue trauma caused by the surgery and resolving stagnant fluid within the tissues. The immediate post-operative pain at the incision site can be managed with the use of the cold laser treatments as well. Cold laser treatments can be repeated once a day for the first 3 to 5 days post-operatively.
Chiropractic assessment and adjustment can be extremely valuable to recovery after colic surgery. Although abdominal distress is not initially a musculoskeletal issue, stress to the skeletal structure can result from colic patients thrashing around prior to surgery due to pain. Placement on and removal from the surgery table can also cause musculoskeletal stress. In chiropractic subluxation, the joints of the vertebral system are not moving as they should be, negatively affecting the nerve roots between the vertebra along the spinal column. These nerve roots innervate the gastrointestinal tract, the kidneys, the liver, and other organs. Any decrease in function of these nerves due to a chiropractic subluxation could significantly affect the patient’s ability to recover as well as possible from colic.
A chiropractic assessment and adjustment a few days after surgery could significantly improve the patient’s overall comfort as well as help keep the patient’s nervous system function at maximum capacity in the post-operative recovery period.
The longer-term recovery of the post-operative patient depends on the healing of the abdominal incision. Research indicates it takes about 2 months for the post-operative patient’s incision to get to 75% strength, allowing them to go back to work. During the rest period after a major abdominal surgery, equine patients lose epaxial and abdominal muscle, which leads to loss of strength in the core and back. This can lead to lower performance.
A recent study reported that a 4-week postoperative protocol of core abdominal rehabilitation exercises is not only safe but is also associated with faster return to training and improved postoperative performance. The specific strengthening and core building exercises are described in Drs. Stubbs and Clayton’s book, Activate Your Horse’s Core. The exercises can begin at the end of the fourth week post-surgery if there are no incisional complications. The core strengthening exercises are performed at least 3 times per week for 4 weeks with a specific exercise schedule outlined for the patient. During this time the patient is hand-walked 15-20 minutes daily and turned out in a small paddock.
If there have been no complications, after 8 weeks the horse can start under saddle for light walk work, gradually adding trot and canter work over the following 4 weeks. Horses that have undergone specific core strengthening exercises during their post-operative recovery under veterinary direction have a better chance of performing at a high level postoperatively.
An Integrative approach to equine colic can significantly improve horses’ recovery from colic surgery.