Survival of horses following strangulating large colon volvulus.
Authors: Suthers J M, Pinchbeck G L, Proudman C J, Archer D C
Journal: Equine veterinary journal
Summary
# Survival of horses following strangulating large colon volvulus Large colon volvulus (LCV) represents one of equine surgery's most challenging cases, yet little evidence existed regarding long-term outcomes beyond the immediate perioperative period. Suthers and colleagues followed 116 horses undergoing emergency surgical treatment for strangulating LCV (≥360°), tracking survival through discharge, one year and two years post-operatively to identify which clinical indicators predicted favourable long-term prognosis. Of the 89 horses (76.7%) that survived general anaesthesia, 70.7% made it to discharge, but only 48.3% and 33.7% remained alive at one and two years respectively, with a median survival time of 365 days. Several variables emerged as significant mortality predictors: elevated preoperative packed cell volume (PCV) paradoxically correlated with poorer survival; intraoperative findings of abnormal serosal colour tripled mortality risk; and post-operative markers including tachycardia at 48 hours and recurrent colic during hospitalisation substantially increased hazard ratios. For practitioners involved in pre- and post-operative management—whether monitoring PCV trends, assessing tissue viability during surgery, or vigilantly managing the critical 48-hour window—these evidence-based markers offer concrete parameters to guide realistic prognostic discussions with owners and inform intensive supportive care protocols that may improve the currently modest long-term survival rate.
Read the full abstract on PubMed
Practical Takeaways
- •Preoperative PCV elevation, abnormal serosal appearance during surgery, and post-operative tachycardia are useful prognostic indicators to discuss realistic outcomes with owners following LCV colic surgery
- •Post-operative colic recurrence significantly worsens long-term prognosis—careful post-operative monitoring and management are critical to improving survival beyond the initial recovery period
- •Only one-third of horses that survive surgery live beyond 2 years; use these evidence-based factors to guide informed decision-making regarding surgical intervention in LCV cases
Key Findings
- •76.7% of horses survived general anaesthesia; of these, 70.7% survived to discharge, 48.3% to one year, and 33.7% to two years
- •Increased preoperative packed cell volume (PCV) was significantly associated with reduced post-operative survival (HR 1.08 per unit increase)
- •Abnormal serosal colour intraoperatively (HR 3.61), elevated heart rate at 48 hours post-surgery (HR 1.04 per beat/min), and post-operative colic (HR 2.63) were all significantly associated with reduced survival
- •Median survival time for horses surviving anaesthesia was 365 days