Clinical findings, surgical techniques, prognostic factors for short-term survival and long-term outcome in horses with acquired inguinal hernias: Ninety-eight cases (2005-2020).
Authors: François Isé, Lepage Olivier M, Schramme Michael C, Salciccia Alexandra, Detilleux Johann, Grulke Sigrid
Journal: Veterinary surgery : VS
Summary
# Acquired Inguinal Hernia in Horses: Clinical Outcomes and Prognostic Indicators Early presentation substantially improves survival prospects in horses with acquired inguinal hernias (AIH), with cases admitted within 10 hours of colic onset achieving 72% survival to discharge compared to just 26% for delayed presentations. This retrospective analysis of 98 cases treated between 2005 and 2020 found that approximately one-quarter of AIH cases involved concurrent small intestinal volvulus—a serious complication that independently reduced short-term survival odds—whilst draft breeds and elevated heart rate on admission also emerged as negative prognostic indicators. Castration proved the predominant preventative technique (used in 68% of surgical cases), yielding an acceptable 11% recurrence rate, though 60% of horses survived to hospital discharge and encouragingly, 94% of the 52 cases tracked beyond discharge remained alive 12 months later. The considerably higher rate of concurrent volvulus and lower short-term survival figures in this cohort warrant reassessment of clinical expectations around AIH management. For practitioners, these findings underscore the critical importance of rapid referral, whilst also highlighting that breed predisposition and admission vital signs warrant careful consideration during prognostic counselling, even as long-term outcomes for survivors prove reasonably favourable.
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Practical Takeaways
- •Early presentation (within 10 hours of colic onset) dramatically improves survival—owner education about rapid transport to surgical facilities is critical
- •Suspect concurrent intestinal volvulus in any draft breed with inguinal hernia, as this complication significantly worsens prognosis
- •Castration is the most reliable prevention method for recurrence (used in 68% of cases with only 11% recurrence), making it the standard recommendation for stallions and geldings with AIH
Key Findings
- •Time to admission within 10 hours of colic signs increased survival odds to 72% versus 26% after 10 hours (p<0.001)
- •Concurrent small intestinal volvulus occurred in 27% of acquired inguinal hernia cases and was associated with reduced survival (p=0.048)
- •Overall short-term survival to hospital discharge was 60%, with 94% of discharged horses alive at 12 months; hernia recurrence rate was 11%
- •Draft breeds and elevated heart rate on admission were significant negative prognostic factors for short-term survival (p=0.021 and p=0.001 respectively)