Don’t Wait: Rapid Referral Key To Colic Survival

A horse that is actively colicking can be distressing to see.

It's imperative that veterinarians, horse owners, and other management personnel be prepared to make decisions quickly if a horse is colicking – with the understanding that the plan may change and what risks come along with those decisions. Dr. David Freeman, Appleton Chair of Equine Surgery at the University of Florida's College of Veterinary Medicine, discussed a paper he co-authored on the subject at the 2022 American Association of Equine Practitioners convention. 

According to The Horse, Freeman found that operating on horses before sections of their intestine become so damaged as to require removal is key to the possibility of a positive outcome. Taking the “wait and see” approach – and hoping that the colic resolves with medication before exploring surgical options – makes a successful surgery even less likely. 

Horses that undergo surgery eight to ten hours after the colic begins often have more complex surgeries that cost more and have a higher risk of complications. Additionally, equine survival rates are reduced, both over the short and long term. 

Freeman noted that quickly addressing strangulating lesions, where a section of intestine loses blood supply, is imperative to their resolution: these types of colic will never resolve with on-farm, medical treatment only. These colic cases represent at least 60 percent of colic in horses over 20 years old. There are additional types of lesions that worsen with time, even if on-farm medical care gives the impression that the horse is improving.

Freeman also said that if a field vet suspects a strangulating intestinal obstruction, he or she needs to refer the horse to a surgical facility rather than waste time with diagnostic procedures and time-consuming treatments like running fluids. Many of the tests that are run at the farm are repeated when the horse is referred to the hospital, adding to the expense.

Freeman concluded by noting that horses that are colicking – especially older horses that may have strangulating lipomas – should be referred to a surgical clinic early on in the colic episode. Doing so is likely to increase survival rates with fewer complications and therefore less cost when compared to a delayed presentation at a clinic. 

Freeman said that there are three reasons why owners may refuse surgery: 

  • The horse will not be the same after surgery
  • Old horses don't do well with anesthesia and colic surgery
  • Lack of owner funds

He noted that the first two reasons have proven to be myths. The last reason is a valid one, but if the owners change their mind hours after the colic begins, the outcome can still be dire as surgical treatment was delayed.

Communication between owners and veterinarians can prevent delays in colic care and minimize cost if the horse is referred to a surgical facility before complications arise. Early referral is also closely associated with positive surgical outcomes.

Read more at The Horse

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