Surgical treatment of equine colic - a retrospective study of 297 surgeries in Norway 2005–2011
Authors: Bjørn Wormstrand, C. Ihler, Ragnhild Diesen, R. Krontveit
Journal: Acta Veterinaria Scandinavica
Summary
# Editorial Summary When colic requires surgical intervention, equine practitioners face a critical decision-point with significant financial and welfare implications, making accurate prognostic assessment essential. This Norwegian retrospective analysis examined 297 colic surgeries performed between 2005 and 2011 across two equine hospitals, using logistic regression to identify which clinical indicators and case characteristics predicted short-term survival (discharge from hospital). Overall discharge rates were 54.5%, or 74.0% when excluding the 26.3% of cases euthanized intraoperatively due to grave prognosis; multivariate analysis identified three independent prognostic factors—mucosal membrane appearance, the anatomical site of gastrointestinal involvement, and surgeon board-certification—as significantly influencing survival outcomes. The finding that board-certified surgeons achieved better survival rates than non-board-certified colleagues is novel and warrants consideration in referral decisions, whilst the authors' higher intraoperative euthanasia rate compared to other published series suggests variation in how economical constraints and welfare considerations influence surgical case management across different regions. These results provide evidence-based benchmarks for counselling owners on realistic expectations and reinforce that detailed pre-operative clinical assessment—particularly evaluation of mucous membranes and determining which bowel segment is affected—should guide prognostication alongside consideration of surgeon expertise.
Read the full abstract on PubMed
Practical Takeaways
- •Mucosal membrane pallor, prolonged capillary refill time, and elevated heart rate should be used to counsel owners on realistic prognosis before referral for colic surgery
- •Refer horses with surgical colic to hospitals with board-certified surgeons when possible, as certification status significantly influences survival outcomes
- •Expect approximately 1 in 4 horses with surgical colic will be euthanized intraoperatively; use clinical parameters to discuss this possibility with owners early in case management
Key Findings
- •Short-term surgical survival rate was 54.5% overall (162/297 discharged), or 74.0% excluding intraoperative euthanasia (162/219)
- •26.3% of horses (78/297) were euthanized during surgery due to grave or poor prognosis
- •Mucosal membrane appearance, affected gastrointestinal segment, and surgeon board-certification were significant predictors of survival in multivariable analysis
- •Surgeon board-certification had a significant positive effect on survival, a finding not previously reported in equine colic literature