It's major surgery

Originally published in The Arizona Daily Star, 2000. Tate Williams

An average patient for one Northwest Side hospital has gastrointestinal discomfort, needs immediate surgery, has a preference for standing upright and weighs upwards of 1,100 pounds.

Aside from the obvious, what sets Cortaro Equine Hospital apart from every other area clinic is that a case of gut pain sends Dr. Larry Shamis plunging into a couple hundred pounds of intestine to save a patient's life.

Shamis and Dr. Marlene Shamis, doctors of veterinary medicine, operate the hospital, 7340 N. Cortaro Road, and treat horses for reasons ranging from strained tendons to castrations to colic - digestive pain that is the top killer of horses.

The hospital opened in 1989, and since then has handled most equine referrals in Southern Arizona.

The Shamises studied for four years beyond regular veterinary education to gain advanced specialty training in equine medicine and surgery, which requires extensive research projects and article publication.

One of the field's biggest challenges is the tremendous size of the patient, inside and out.

"I've had a lot of (medical doctors) come in with horses and be a little shocked," Larry Shamis, 51, said. "There are some logistical differences, as you can see."

The six-acre facility resembles a hybrid of a ranch and an oversized doctor's office.

One barn holds recovering patients in seven stalls, while a second building holds an office, an examining room, an induction stall and an operating room.

Colic brings about 40 percent of the hospital referrals, and almost all require immediate surgery. The hospital is open every day, all day, and the doctors often operate in the middle of the night. They deal with about five to 10 horses on a typical day, with little down time.

Larry Shamis described the process of operating on such a large animal:

Four people lead the suffering horse into the induction stall, a heavily padded anteroom where the animal is put under for surgery with gas anesthesia. Once the horse is down, a rail-mounted, crane-like hoist lifts the animal upside-down by its hobbled legs and carries it onto a hydraulic operating table in the adjoining surgery room.

"It gets pretty hairy," he said.

The operating room is filled with recognizable medical machinery - a blood pressure monitor, x-ray equipment, a heart monitor - and a mounted garden hose.

From there, the doctor will sort through several feet of digestive tract, searching for abnormalities - which can stem from several factors - and try to solve whatever is causing the pain.

One potential malady comes from magnesium deposits in the form of large stones that build in horses' digestive systems. Several such stones - white, pumice-like balls of varying size - sit on a shelf in the exam room, one almost the size of a cantaloupe.

Shamis said the only way to describe the process is like going through garbage bags full of liquid and half-digested feed, externalizing as much as possible and feeling around in areas that can't be seen.

If the patient arrives early on, the hospital has about an 85 percent success rate with such surgeries.

Colic is a particular concern for the doctors, and stems from what Shamis calls a misunderstanding of the animal's system derived from decades of domestication.

Feeding habits and a wide range of consumer-targeted products tend to stray from what a horse needs naturally. One research endeavor the doctors have taken on is trying to determine where colic can be stopped before it starts.

Mary Bordonaro, 34, has worked at the hospital for four years as a technician. Yesterday, she watched over the patients in the recovery stables, where constant supervision is necessary.

One horse, Dream of Dawn, was recovering from recent colic surgery. The animal stood in one of seven stalls, with a 3-liter IV bag hanging from the ceiling and connected at the jugular vein.

Bordonaro was a client of Shamis' before she went to work for the hospital, and said she enjoys her job most of the time.

"Emotionally, you get upset with some stuff," she said.

Both doctors operate the hospital with a rotating staff of four technicians and one intern from Colorado State University. They live on the property with their 8-year-old daughter, Loran, and 14-year-old son, Corey.

Larry Shamis said he chose horses over small- animal veterinary medicine because it is more active, and offers work in the outdoors - and he likes horses.

"It's hard to explain," he said. "If you're a horse person, you're a horse person."