Long‐term outcomes of gastric bypass surgery in two Lusitano foals: Contemporary evidence for surgical decision‐making

Summary Gastric outflow obstruction (GOO) occasionally requires surgical intervention in foals when medical management fails. Current literature lacks consensus on several surgical decisions, with most comprehensive reports dating back over a decade. Critical aspects—including jejunal loop orientation and necessity of jejunojejunostomy—remain debated among surgeons. Long‐term data regarding complications, growth and athletic performance are scarce. This case series documents the long‐term outcomes of two Lusitano dressage foals that underwent bypass surgery, providing contemporary outcome data for specific surgical decisions where evidence remains limited. Two Lusitano foals underwent bypass procedures for GOO. Case 1: A 15‐day‐old orphan foal with pyloric stenosis underwent gastrojejunostomy without jejunojejunostomy, with jejunal loop oriented left‐to‐right. Six years post‐operatively, the horse performs dressage competitively with normal growth and conformation. Case 2: A 12‐h‐old foal underwent gastroduodenostomy; nearly 3 years later, it continues without complications. This series contributes recent outcome data for specific surgical decisions in bypass procedures including early surgical intervention, gastrojejunostomy without jejunojejunostomy, and left‐to‐right anastomotic orientation. Both foals achieved favourable results. Left‐to‐right orientation gastrojejunostomy without jejunojejunostomy worked well. Importantly, extended follow‐up documents absence of long‐term complications, normal growth and athletic performance—critically needed information for surgical decision‐making and owner communication regarding these uncommon, costly procedures.