What is Abdominal Lavage?
Your horse has a large peritoneal space (abdominal cavity) that houses their abdominal organs, including digestive organs such as the small and large intestine. This area also contains a peritoneal fluid that lubricates the digestive organs. If bacterial infection of the peritoneal cavity occurs from blood borne infection, wounds, or post-surgically, peritonitis develops.
Surgery or trauma can cause compromise of the linings of the digestive organs, allowing digestive contents containing bacteria to be released into the abdominal cavity, resulting in peritonitis. This condition can be fatal in a few hours if not addressed immediately by a veterinarian. Your veterinarian will treat this condition with antibiotics, however, if this is not adequate to control infection the abdominal cavity may need to be “flushed” with an abdominal lavage in order to remove infected fluids and tissues. This is performed by surgically inserting a tube into the abdominal cavity and flushing the cavity with a sterile solution. The procedure is performed under sedation and local anesthetic by a veterinarian.
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Abdominal Lavage Procedure in Horses
Your veterinarian will first treat peritonitis aggressively with antibiotics. If antibiotics are not adequate to resolve the condition, abdominal lavage to flush out infected fluids in the peritoneal cavity will be recommended. Your horse will be sedated and allowed to remain in the standing position. The lower part of your horse's belly will be shaved and cleaned at the site of the procedure. The site will be numbed with a local anesthetic. Your veterinarian will make an incision with a scalpel and separate the abdominal wall from the organs to allow an area of the cavity for insertion of the lavage tube. A large, sterile, plastic drainage tube is placed into the abdominal cavity. The tube may contain a hard stylet to give it rigidity during insertion. The stylet is removed once the drainage tube is in place. The tube may be sutured in place to allow for repeated flushing procedures. Infected fluid will drain out of the abdominal cavity through the drainage tube. Sterile intravenous fluids are then instilled into the abdominal cavity through the tube. This procedure requires that large amount of 10 litres or more be instilled into the abdominal cavity, allowed to remain and permeate the cavity, and then drained out through the tube. This procedure may be repeated several times, and the tube left in place with a valve to close it off when flushing is not taking place. The flushing procedure may be performed 1 to 2 times per day for as long as infection is deemed present. Once peritonitis is resolved, the tube will be carefully removed and the opening repaired with sutures.
Efficacy of Abdominal Lavage in Horses
If profound rupture of a digestive organ occurs, prognosis is poor and euthanasia will usually be recommended. Localized or less severe peritonitis is treatable with antibiotics and abdominal lavage if necessary. Peritonitis can cause damage to organs that is irreversible and may not be resolved by medication and flushing of the abdominal cavity.
Abdominal Lavage Recovery in Horses
If the tube is left in place to allow multiple repetitions of abdominal flushing, your horse will need to be carefully monitored and their activity controlled to ensure that the tube does not become dislocated. Once removed, monitoring of your horse post-procedure is vital to ensure that peritonitis condition has been resolved and that complications such as local infection at the site of tube insertion does not occur and further illness does not manifest.
Cost of Abdominal Lavage in Horses
The cost of abdominal lavage or flushing procedure ranges from $100 to $500 depending on the cost of living in your area and includes anesthetic and procedure. Mileage charges and charges for medication or other procedures necessary to treat the peritonitis condition are not included.
Horse Abdominal Lavage Considerations
Severe peritonitis conditions caused by organ rupture may not be treatable and euthanasia may be recommended. If abdominal lavage is performed, careful monitoring of your horse while the flushing tube is in place and post-procedure will minimize complications such as continued infection, infection at the insertion site, and injury to abdominal organs resulting in illness.
Abdominal Lavage Prevention in Horses
Monitoring your horse post-surgery to diagnose peritonitis at the first indication and receiving immediate veterinary treatment may limit the severity of peritonitis and allow treatment by antibiotic alone. Regular parasite control is important to the general health of your horse's digestive system and will prevent many complications that occur due to the presence of parasites. Eursing your horse has a safe turn out area free from hazards will reduce the likelihood of accidents causing abdominal trauma.