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I have a 20 yr old Quarter horse gelding that had surgery to…

I have a 20...

I have a 20 yr old Quarter horse gelding that had surgery to remove a bladder stone. I have taken him back to the vet and he has a hernia at the incision site. The surgeon will not accept responsibility for this. The horse was discharged from the veterinary facility with the swelling. What can I do? I don't know how much this would cost. Why can't the surgeon take responsibility for this?

Veterinarian's Assistant: I'll do all I can to help. What is the horse's name?

******

Veterinarian's Assistant: Is there anything else the Veterinarian should be aware of about the horse?

When I brought him home I followed the post op instructions precisely.

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Answered in 20 minutes by:
1/17/2018
Doctor.A
Doctor.A, Veterinarian
Category: Horse Veterinary
Satisfied Customers: 327
Experience: I am licensed to practice Veterinary Medicine in multiple states, as well as Board Certified In Equine Surgery.
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Hello. I am Dr A and would love to help. I understand that your horse has developed a hernia after a surgery? What Can I do for you?

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The first step is to determine if it is truly a hernia, or just a fluid swelling after surgery. These swellings are common and often will resolve in time. If it is truly a hernia, Then you have to determine if a piece of intestine has come through the body wall. If so, then this will have to be corrected with surgery.

Some hernias also can display a protrusion, but still have a covering over them which keeps intestine inside. These can be treated with a supportive belt.

Once it is determined which kind of hernia is present, we can talk about treatment more!

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Customer reply replied 4 months ago
It has been determined to be a hernia after he was ultrasounded.

Do you know if there is a covering over the intestine (tother than the skin of course), or if they are protruding through the body wall

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Customer reply replied 4 months ago
No I do not know.

ok. Well, the more important of the two types is the type which has protruded through the body wall. In these situations, surgical correction is the only acceptable repair. Foregoing surgical repair puts your horse at risk for colic, as the intestine that have come through the body wall are at risk for being squeezed.

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Depending on the size, amount , and method of repair, I would estimate that the cost would be in the realm of 2500 to 5k dollars. That is a rough estimate.

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Customer reply replied 4 months ago
What has caused the development of this hernia?
Customer reply replied 4 months ago
Was it a poor choice of suture by the surgeon? Just a sloppy closure? Suture knot cut? Why won't the surgeon accept responsibility?

That is a great question. There are some hernias that develop and we know the cause (infection, post surgical trauma, Suture breakdown) but many , maybe around half of the ones that develop, we have no particular reason to know why. It is a complication of surgery that we as surgeons try to minimize with our technique, but on occasion, they still occur.

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Why wont the surgeon accept responsibility? perhaps there was no way of predicting this one. If the suture broke, then perhaps it was a suture choice issue from the sugeon. But, even with the right suture, sometimes it happens anyways. Often times, its the inability to truly make the horse be gentle with the surgery site which leads to the hernia. They are difficult to give instruction to, as you know

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Does anything that occurred during the surgery and post operative time lead you to question the hospitals methods?

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How long after surgery did the hernia develop?

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Customer reply replied 4 months ago
The horse stayed at the clinic for a couple days after surgery. He was discharged with swelling. One day after he was home I had to take him back due to severe swelling all over his abdomen. When I took him back they put a belly band on him and kept him a week before releasing him home. He still come home with the swelling at the incision site.
Customer reply replied 4 months ago
I was told that he had a seroma. I was also told that he had a suture site reaction.

So, the hernia occurred within 10 days of the surgery? That is extremely unfortunate, but within the scope of post operative complications. Could be due to a weak body wall in your horse, a difficult recovery, or as you said, suture choices during the surgery. Would need to get a copy of the Surgeons medical records to find out what happened in the surgery.

If everything in the report is within reason, then while it is CERTAINLY a terrible outcome, it is not due to negligence on the part of the surgeon. Purely bad luck. Im sure he will help you to correct the situation, but I dont think he can claim fault. This all depends on what his report says.

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Customer reply replied 4 months ago

I just feel like I have been given the run around. Should this hernia repair be performed without the use of mesh? What is the prognosis for ***** and the recovery for hernia surgery.

Well, any request for records has to be fulfilled. Dont be afraid to ask. And then have your vet read it, or post it here.

The mesh can be used if there is no current infection. It is used to aid in the bridging of holes that cannot be closed bc of too much tension. That would be decided on by the surgeon.

Prognosis for recovery from the hernia surgery is excellent.

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Customer reply replied 4 months ago
I received a Operative page from the surgeon upon his discharge and it listed the types of suture used and did not mention any abnormalities during the procedure.

what suture was used?

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Customer reply replied 4 months ago
per report: closed bladder with 2/0 PDS in 2 layers. Closed abdomen with 3 vicryl followed by 2 layers of subQ tissue and fat with 2/0 pds. sutured skin with 3/0 vicryl.
Customer reply replied 4 months ago
Would the above suture been your choice on a 1200 lb quarter horse? If in fact that is what was used.

Yes. The 3 vicryl is wonderful suture, and exactly what I have used hundreds of times for similar surgeries.

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Customer reply replied 4 months ago
Well I guess I will have to hope that the surgeon will want to discount the cost of repairs.

I wish you the best of luck getting your horse healthy again. While its not helpful financially, I do hope this conversation brings you a bit more faith in the skills of your surgeon. I hope you get the straightforward and forthcoming answers to your questions, and be sure to return here with any questions that might arise.

Doctor.A
Doctor.A, Veterinarian
Category: Horse Veterinary
Satisfied Customers: 327
Experience: I am licensed to practice Veterinary Medicine in multiple states, as well as Board Certified In Equine Surgery.
Verified
Doctor.A and 87 other Horse Veterinary Specialists are ready to help you
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Customer reply replied 4 months ago
Thank you.

I do have one more thing to offer that might be of assistance. Can you confirm or deny that there was an infection, rather than just a tissue reaction?

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Customer reply replied 4 months ago
If these questions are viewable to the public would you change the horses name to protect my privacy. Thank you.

I dont think we have used your horses name up until now.
Did you receive my last question?

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Customer reply replied 4 months ago
He was put on antibiotics when I took him back for all the abdominal swelling but I was told that this was for the edema. Never was told it was a infection.

OK. Excellent. Then nothing more to add. Sounds like you are on the right track!

Keep me posted.

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Customer reply replied 4 months ago
Please remove the horses name. Thank you.

Ive sent it to the site moderators for removal! keep me posted.

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Doctor.A
Doctor.A
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Category: Horse Veterinary
Satisfied Customers: 327
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Experience: I am licensed to practice Veterinary Medicine in multiple states, as well as Board Certified In Equine Surgery.

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