Irish draft mare gallops again after brutal colic scare
Leslie Ralston-Rakow couldn't do anything but watch. It was nearly 4 a.m. in late January, with temperatures in the single digits, and her horse, Mona, was down in her stall, anxious and in pain.
Ralston-Rakow had imported the 10-year-old Irish draft mare from Ireland in 2021 and has since been training her for English pleasure and fox hunting. Regular veterinary care was provided on the farm earlier in the evening when Mona first started showing colic signs. But despite appropriate veterinary care, her pain returned in the wee hours of the morning. Now Mona was in trouble, and Ralston-Rakow knew she needed to get her to people who could help as quickly as possible.
"I felt powerless to help her as she suffered," Ralston-Rakow said. "All I could do was get her to the right people who could help, even if it was at 4 a.m. in the middle of a brutal cold snap."
That call sent Mona to the Marion duPont Scott Equine Medical Center in Leesburg, one of three animal care facilities run by the Virginia-Maryland College of Veterinary Medicine. What followed was a week-long fight against a colon impaction that twisted into a life-threatening displacement, and a slow but successful recovery.
A colon in the wrong place
Mona arrived at the Equine Medical Center, walking calmly off the trailer despite the hour. While abdominal ultrasound and bloodwork were largely normal, abdominal palpation per rectum revealed a large colon impaction, a common but serious form of colic in which digested material backs up and blocks the gut.
Receiving veterinarian Emily Schaefer, clinical assistant professor of emergency and critical care, started Mona on intravenous fluids and began the process of checking her stomach every three hours and administering additional oral fluids, with the intent to clear the mild impaction with medical treatment.
Whenever possible, the Equine Medical Center favors medical management of colic, which can be a successful option for gas colic, certain types of impactions, or inflammatory conditions of the gastrointestinal tract. Pain management, fluid therapy, sedation, nasogastric intubation to relieve pressure within the stomach, and hand-walking the horse every few hours overnight can be enough for colic to resolve without the need for surgery.
However, throughout the following day, Mona grew more painful, pacing and lying down in the stall, and then trying to roll, each episode requiring sedation to keep her quiet and comfortable.
By evening, a repeat rectal exam and ultrasound revealed a tight band across her right abdomen, and a large blood vessel on her right flank that wasn’t there before — both signs of right dorsal displacement of the large colon. A “displacement” means that the colon has literally shifted out of its normal place, or position, in the abdomen. While some cases can continue to be managed medically, Mona’s discomfort and changes in clinical parameters made it clear that surgery was no longer optional.
Schaefer led the surgical team, assisted by surgery resident Bruno Malacarne. Once inside Mona's abdomen, the surgical team confirmed what the exam had suggested, that Mona’s large colon had shifted to the front of the abdomen towards the right side, and a thick, dough-like mass of impacted material filled the right dorsal and transverse colons.
“Even though both conditions, mild impactions and displacements, can sometimes be managed medically, you must listen to the horse.” explained Schaefer “We provided everything that she needed to resolve the displacement without surgery, and Mona told us that wasn’t enough — we had to help her by going in there and fixing it ourselves.”
Surgery went well — the displacement was manually corrected, and the impactions were removed — and Mona recovered from anesthesia without complication. But Mona wasn't out of the woods yet.
Too much of a good thing
Two days later, on a Saturday night, Mona stopped eating and began pawing constantly, classic signs that something was wrong. A nasogastric tube revealed the answer, a small gastric impaction, this time in her stomach.
Even on a restricted post-operative feeding program, Mona managed to eat well enough to make herself uncomfortable while her gut was still healing. Over the next 12 hours, Equine Medical Center staff lavaged her stomach, flushing it out every two to three hours, until they cleared the obstruction, and she was comfortable again.
“It's the kind of complication that explains why post-colic-surgery care matters as much as the surgery itself,” explained Elsa Ludwig, clinical assistant professor of equine surgery, who took over Mona's continued monitoring and post-operative care after surgery, restarting her on a slow refeeding protocol and switching her hay to a small-hole net to stretch out her eating time.
The following Monday, Mona was eating well without colic; bloodwork remained normal, and her antibiotics were discontinued. After seven days in the hospital, Mona was moved to a rehabilitation center for continued care.
Mona moved to Always There Horse Care, owned by Malena Brisbois, for post-surgical stall rest, where, Ralston-Rakow said, "Malena did a fabulous job" managing her recovery. The protocol that followed was deliberately slow to allow for proper post-operative healing. Thirty days of stall rest with hand-walking, then a month in a small paddock alone, then 30 more before any real exercise. Nearly three months of patience before Mona could be ridden again.
"I was slow and cautious to allow her ample time to heal and rebuild her muscles after the long confinement," Ralston-Rakow said.
Back to full speed
Ralston-Rakow's caution paid off. Mona is now back in regular work, fully recovered from what began as a routine-sounding colic call that escalated into emergency abdominal surgery and a second gastrointestinal scare within days.
"She now enjoys galloping out to the field at turnout like nothing happened," shared Ralston-Rakow.
For Ralston-Rakow, the ordeal underscored something many horse owners only learn the hard way; that colic can turn serious fast, and the right response in the first hours matters as much as anything that happens in the surgery room. Throughout Mona's hospitalization, she said that the Equine Medical Center team kept her regularly informed and let her visit every day Mona was hospitalized.
"Everyone at the Equine Medical Center was amazing in giving Mona the best care and treating both of us compassionately," Leslie said. "The staff was responsive to her medical needs and dealing with setbacks as they came up."
Ralston-Rakow connected with Mona through a recommendation from a good friend Willy Leahey who, at that time, was based in Ireland. After visiting Ireland and riding Mona for a week she signed the necessary paperwork and arranged for her transport to Virginia. Sadly, this would be the last horse that Leahey would sell as he died shortly after Ralston-Rakow’s visit to Ireland.
Mona's story started with a phone call to Ireland five years ago and a green 5-year-old mare who, Ralston-Rakow says, has only gotten more opinionated and more food-motivated since. It nearly ended on the worst night of winter. Instead, Mona is back under saddle, galloping in the field during turnout, and on the hunt for the next tasty thing to eat.
