Age is associated with the requirement for surgery in horses with nephrosplenic ligament entrapment of the large colon at a single UK equine referral hospital.
Authors: Dollemore, McGovern, Tallon
Journal: Equine veterinary journal
Summary
# Editorial Summary: Age and Breed Factors in Nephrosplenic Ligament Entrapment Nephrosplenic ligament entrapment (NSLE) of the large colon represents a common surgical colic in horses, yet little is known about which animals will respond to conservative management versus those requiring surgical intervention. Dollemore and colleagues conducted a 15-year retrospective analysis of 179 NSLE cases (169 horses) at a single UK referral hospital, comparing outcomes between Thoroughbred and non-Thoroughbred populations using multivariable logistic regression modelling. Whilst Thoroughbreds showed a 2.5-fold increased odds of requiring surgery (70.8% surgical rate versus 49.6% in non-Thoroughbreds), multivariable analysis revealed that **age alone drove this difference**: each additional year of age reduced the likelihood of surgical intervention by 10%, with surgically managed Thoroughbreds having a median age of just 2 years compared to 4.5 years for conservatively managed cases. For equine practitioners and referring veterinarians, these findings suggest that young horses presenting with suspected NSLE—regardless of breed—warrant careful consideration of surgical options, whilst older animals show greater capacity for conservative management; however, the authors acknowledge that definitive diagnosis in non-surgical cases remains challenging, limiting confidence in predicting individual outcomes based on age alone.
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Practical Takeaways
- •Young Thoroughbreds presenting with NSLE should be considered higher risk for treatment failure with conservative management and may benefit from earlier surgical evaluation
- •Age appears to be the primary driver of surgical necessity in NSLE cases at this hospital, so clinicians should factor the patient's age into treatment planning discussions with owners
- •Non-Thoroughbred horses have better outcomes with conservative management overall, though breed should not be the sole factor in deciding between medical and surgical approaches
Key Findings
- •Thoroughbreds were significantly more likely to require surgical intervention for NSLE compared to non-Thoroughbreds (OR = 2.5; p = 0.04)
- •Young age was independently associated with increased likelihood of surgical intervention (OR = 0.9 per year; p = 0.03)
- •Thoroughbreds undergoing surgery were median 2 years old versus 4.5 years for conservative management (p ≤ 0.0001)
- •Overall surgical intervention rate was 26.8% (48/179 cases), with Thoroughbreds comprising 70.8% of surgical cases