horse with high impaction? Help please!

Question
On march 18th ,we found our horse down in the pasture (we do not think she rolled).She got up for us but continued to want to lay. vet was called and out. He tubed her,gave oil and fluids and returned in the morning and did same. No stool ,off food and water(no interest) .Since horse obviously not well -to hospital where tx continued( aggressive tubing). Horse home less than 24h and developed fever 102.6 and fast heart-70. back to hospital for aggressive iv fluids ,tubing and antibiotics last2 days. (now march 26th) . By the way still not eating/ drinking. But horse has passed small amount cow pie stool. Finally to the question--are we appropriate to contine tx? Anything more to do? Prognosis from a distance? ANY info appreciated

Answer
Debby:

please understand my limitations in evaluateing a case over the internet, especially a colic. There is no way I can make that call for you. However, I am disturbed by the fact that there is no description of rectal exam findings. Also, as an internist,I would use an ultrasound machine extensively to evaluate this too. The fever and being off feed is not a major concern for me right now- in fact Id expect that. I dont know how your vet or the hosptial diagnosed a "high impaction" nor am I sure what that necesarily means, but some impactions can be VERY difficult to treat and take a long time. Another concern of mine is that when they say "high" they are doing so because they are not sure where it is and if its on the right side Id be concerned that it soulc be a cecal impaction. They are treated the same way, but they more often than other impactions require surgery and can rupture without much warning. Finally, a small colon impaction is also difficult and may require surgery and not uncommonly associated with fevers and being off feed. If there are fevers, Id be looking in the abdomen for evidence of bowel leakage now and peritonitis. I cant give you a prognosis when there is no diagnosis. I was hopeful that information you got from the vets on the rectal exam findings might give a better idea of that but there is no such information. If it is an impaction, stay the course. If it is a cecal impaction and goes on much longer or there is evidence of peritonitis, Id be thinking about surgery pretty seriously- same thing if its small colon impaction. However, if there is stool passing and the horse is getting more comfortable and needing less pain meds, Id consider holding off on surgery. If surgery is not an option for you then the choice is simple, medical therapy only unless you decide to quit. I would not based on this information. Good luck. Im sorry this is so ambiguous but colic is ambiguous enough when you are treateing the case let alone when you have never and cannot evaluate the horse yourself. let me know if I can help you in any other way. my best to you and your horse.