On Monday in Part 4 of this excerpt from the new book Equine ER, we took a deeper look at the prison farm program where an inmate met Marching Orders, the stoic Thoroughbred with the big heart. Today, we go back into the operating room and find out what the surgeon discovered with Marching Orders on the table.
In the operating room, what surgeon Scott Hopper found was a diaphragmatic hernia – a hole in the diaphragm between the chest and the abdominal cavity – and a section of the small colon had gotten trapped inside the opening. The ultrasound hadn’t picked it up because of the amount of gas distention and the hernia’s location, higher on the diaphragm, more toward the horse’s back. It wasn’t your everyday colic.
Dr. Scott Hopper operates on Thoroughbred Marching Orders.
Horses can live with diaphragmatic hernias for years (some are born with them). One original cause of a hernia is trauma – getting kicked, for example. Often, diaphragmatic hernias are small, and because the lung capacity of a horse is one of the largest of all species, horses don’t necessarily need all that capacity to function, especially a horse like Marching Orders who was retired and not running on the track.
A vet student visiting from New Zealand who was observing the surgery asked Hopper how big the hernia it was.
“Not very big,” he replied, “it’s fibrous,” meaning it had a ring of thick scar tissue around the edges, signifying it had likely been there a while.
The gastrointestinal tract of a horse is not only much larger than a person’s, it moves around more. The small intestine is more mobile than the small colon, so Hopper was surprised it was the latter not the former that had, for some reason, found its way up to the hernia that day and gotten trapped inside.
The surprise factor is one of the things that Hopper actually enjoys about his work. He isn’t burned out even though he’s been a surgeon for more than a decade. He likes that you never truly know what is going on inside a horse until you open the animal up (kind of like a Christmas package, he told me once), and that he can take something broken and fix it.
To fix Marching Orders, the vet couldn’t just pull the small colon out. The section that had gotten stuck was now bigger than the hole; that’s why it had gotten stuck to begin with. Nor could he manipulate the colon from the other side and try and milk the gas back out – the location made that impossible. He first attempted to reach deep inside the horse and expand the hernia with his finger so he could remove the colon.
Monday: Was surgeon Hopper able to extricate the small colon?
Equine ER was recently the cover story of Ace Weekly in Lexington, Ky. Writer Kim Thomas calls the book a "must-read" for horse lovers. To order Equine ER, click here. Thanks for visiting this blog.
