Equine colic outcomes and prognostic factors at a South African academic hospital (2019-2021).
Authors: LM van der Merwe, EC Schliewert
Journal: Journal of the South African Veterinary Association
Summary
# Equine Colic: Prognostic Indicators and Outcomes at a South African Referral Hospital Between 2019 and 2021, van der Merwe and Schliewert reviewed 415 colic cases presented to Onderstepoort Veterinary Academic Hospital, with 375 receiving treatment (292 medical, 83 surgical), to establish baseline survival rates and identify reliable prognostic indicators for referral and case management decisions. Medical treatment achieved a 91% survival-to-discharge rate, compared with 77% for surgical cases and 88% overall—a 5% improvement over the institution's previous data, driven primarily by enhanced surgical outcomes. Key prognostic factors included treatment type and surgical lesion location: small intestinal lesions carried worse prognoses than large intestinal involvement, elevated heart rate on admission predicted poorer outcomes in medically managed cases, and elevated packed cell volume on admission was associated with reduced survival in surgical patients, whilst signalment variables showed no predictive value. These findings align with international benchmarks and provide South African practitioners with contemporary outcome data to guide informed discussions with owners regarding intervention choices, though the authors acknowledge that long-term survival tracking and investigation of additional prognostic markers remain necessary for refining outcome predictions in equine colic management.
Read the full abstract on PubMed
Practical Takeaways
- •Referral to surgery for colic now offers acceptable outcomes (77% survival), supporting discussion of surgical referral as treatment option for surgical colics
- •Admission heart rate elevation in medical cases and high PCV in surgical cases are red flags suggesting guarded prognosis regardless of treatment choice
- •Small intestinal colic surgery carries inherently worse prognosis than large intestinal surgery—use this when counseling owners on realistic expectations
Key Findings
- •Overall survival to discharge was 88% (375/415 cases), with 91% survival in medically treated and 77% in surgically treated horses
- •Surgical outcomes improved significantly compared to previous institutional data, with overall survival improving by 5% (p=0.025)
- •Small intestinal surgical lesions had lower survival rates compared to large intestinal lesions
- •Elevated admission heart rate predicted lower survival in medically treated cases, while elevated PCV predicted lower survival in surgically treated cases