A HORSE has undergone pioneering surgery to remove a large mass that was causing a life-threatening blockage in his stomach.
Valtano, a 15-year-old Warmblood, underwent a two-and-a-half hour operation at Rainbow Equine Hospital in North Yorkshire to remove the 12cm-long tumour that was putting him at risk of a ruptured stomach.
While gastric surgery is not commonly performed in horses, the Rainbow Equine Hospital team was able to save Valtano using a pioneering keyhole technique. This involved making an incision along his abdomen, then passing keyhole instruments through smaller incisions in his stomach wall.
Two of Rainbow’s surgeons worked together to carefully cut away the mass, guided by images from a special camera called a gastroscope that was fed down Valtano’s throat and into his stomach.
Vet Lizzie Cullen, a European specialist in equine internal medicine, discovered the mass when Valtano was being examined for suspected stomach ulcers. A follow-up examination a few weeks later showed the mass had grown significantly in size and had become life-threatening. It was blocking food material from passing through the digestive system and causing it to build up in the horse’s oesophagus and stomach.
The Rainbow team has specialists in multiple disciplines, so Lizzie was able to discuss the case with her colleagues to find a solution which would save Valtano. Her husband and colleague Matthew Cullen is a European specialist in equine surgery and he suggested using keyhole surgery to remove the mass.
Matthew, who performed Valtano’s operation with fellow surgical specialist Jonathan Anderson, said the procedure combined techniques that have been used before, but not together.
He said: “Gastric surgery is not common in horses due to the stomach being positioned deep inside the abdomen, making it difficult to access. The keyhole approach allowed us to get bigger instruments into the stomach and also improved our access to the base of the mass so we could remove more of it.
“Valtano was anaesthetised and placed on his back for the surgery, then his abdomen was opened using a ‘J-shaped’ incision to make it easier to access the stomach. Small keyhole incisions were then made in the stomach so laparoscopic instruments measuring 1cm in diameter could be inserted to operate on the mass. At the same time, Lizzie passed a gastroscope into Valtano’s stomach so we could see the mass and the surgical instruments.
“We were very pleased with how the surgery went and we were able to remove the majority of the mass, cutting it as close to the stomach wall as possible.
“As well as successfully helping Valtano, this surgical method could be beneficial in the future by giving us another option to operate on the inside of other hollow organs inside the body that are difficult to access, such as the bladder, uterus and other parts of the gastrointestinal tract.”
Valtano was kept under observation at Rainbow Equine Hospital for two weeks after his surgery in October and a six-month follow up gastroscopy in April showed there was no regrowth of the mass.
Lizzie added: “Valtano made really good progress after his surgery and everyone was delighted to see him recover – he became very popular with all of the team. We had been concerned that the mass was cancerous because it looked quite nasty, but a sample was sent away for analysis and we were delighted to find out it was benign. The lab report said it was benign hyperplasia, which is an overgrowth of normal tissue. This is not something that’s commonly found in horses.”
Valtano is now back home with owner Katie Boddy, a lawyer who owns Sproxton Grange Equestrian Centre in Helmsley, where he’s undergone a rehab programme and is being ridden again.
Katie, who has owned Valtano for seven years, said: “I’m so grateful to Rainbow for all they’ve done for Valtano. It’s so exciting that Valtano has a future ahead of him and it’s all thanks to the team at Rainbow.
“It was a huge shock when Lizzie told me about the mass inside his stomach, as I’d been expecting a diagnosis of ulcers based on the signs he’d been showing and because he’d suffered from them before.
“At first, the mass appeared quite small but I took Valtano back to Rainbow a few weeks later because he’d started to eat intermittently and pass droppings infrequently, and that’s when we found out it had grown quite rapidly and was now causing serious issues. I needed to make a big decision quickly, which was to have him put to sleep or have the surgery.
“Rainbow talked me through all the options and what I needed to consider, and while at that point we didn’t know if the lump was cancerous or not, I wanted to do what I could to save Valtano. He’s such a lovely horse with a big personality and I knew that he was in safe hands and Rainbow would do the best for him. After the surgery he was bright and alert straight away and it was such a relief when we heard that the mass wasn’t cancerous.
“When he came home, he was on stable rest for 12 weeks, then progressed to a covered pen and a small paddock. He’s done really well and I’ve brought him back into work slowly and he’s now being ridden and rebuilding his fitness. He feels amazing to ride and I’m hoping to go out competing in dressage soon.”
Rainbow Equine Hospital is a Royal College of Veterinary Surgeons accredited hospital that provides 24-hour care to horses at its purpose built surgical and diagnostic centre in Old Malton and through a team of team of vets who go out on the road to visit patients. As well as caring for horses in North Yorkshire, its team of highly qualified specialist vets also treat horses that have been referred from veterinary practices all over the UK.