Trends in the management of horses referred for colic evaluation preceding and during the COVID-19 pandemic (2013-2023).
Authors: Elane George L, Blikslager Anthony T, Mair Tim S
Journal: Equine veterinary education
Summary
# Editorial Summary Colic management at equine referral hospitals shifted meaningfully during the COVID-19 pandemic, prompting George and colleagues to examine whether institutional caseload, treatment patterns, and costs changed between 2013 and 2023 across two contrasting practices—an academic centre (NCSU) and a private clinic (BEVC). Medical records were retrospectively reviewed to track total admissions, colic presentations, treatment categories (medical management, successful surgery, intraoperative euthanasia, or euthanasia without surgery), and invoice totals. Following the pandemic onset, NCSU experienced increased overall accessions and colic cases with improved surgical recovery rates, whilst BEVC showed no significant shifts; however, both hospitals recorded a declining proportion of colic cases undergoing surgical intervention across the study period, alongside rising mean costs for horses that survived surgery. The most striking finding was an apparent increase in intraoperative and pre-surgical euthanasia decisions, likely reflecting owners' constrained economic circumstances and reduced access to first-opinion care during pandemic restrictions—suggesting cost rather than medical necessity increasingly determined treatment pathways. These data warrant reflection among the profession: whilst improving diagnostic and anaesthetic protocols is valuable, the economic barriers preventing owners from pursuing surgery may now represent a greater threat to equine welfare than surgical risk itself, highlighting the importance of transparent communication about prognosis, cost-benefit analysis, and supporting clients in making informed decisions during financial hardship.
Read the full abstract on PubMed
Practical Takeaways
- •Referral practices experienced increased first-opinion colic cases during the pandemic as owner options became limited; ensure capacity and protocols for managing higher medical caseloads
- •Cost barriers to colic surgery appear to be driving euthanasia decisions; discuss financial constraints early with owners and consider payment planning or triage protocols
- •The decreasing proportion of surgical cases despite stable or increasing colic admissions suggests economic pressures are shifting treatment decisions toward medical management or euthanasia—factor this into staffing and surgical scheduling
Key Findings
- •Total equine accessions and colic referrals increased at NCSU following the COVID-19 pandemic onset, while remaining stable at BEVC
- •The proportion of horses presenting for colic that received surgery decreased at both hospitals over the 11-year study period
- •Mean invoice totals for horses surviving colic surgery increased significantly at both hospitals, but were not associated with euthanasia rates
- •Intraoperative euthanasia and euthanasia without surgery may be increasing due to rising medical care costs, particularly for surgical intervention