Colic in geriatric compared to mature nongeriatric horses. Part 2: Treatment, diagnosis and short-term survival.
Authors: Southwood L L, Gassert T, Lindborg S
Journal: Equine veterinary journal
Summary
# Editorial Summary: Colic Outcomes in Geriatric Versus Mature Horses Concerns about postoperative mortality in older horses often influence clinical decision-making, yet the evidence base comparing geriatric and mature horses with colic remains limited. Southwood and colleagues reviewed 600 medical records (300 geriatric horses aged ≥16 years versus 300 mature horses aged 4–15 years) admitted for colic between 2000 and 2006, stratifying outcomes by management approach (medical versus surgical) and lesion type. Whilst geriatric horses overall had substantially lower short-term survival than mature horses (59% versus 76%), this difference was largely driven by medical management cases; surgically managed geriatric horses achieved comparable survival to mature horses (59% versus 70%), with notably similar outcomes for strangulating lesions (86% versus 83% for small intestine) and jejunojejunostomy (75% versus 70%). The critical finding was that geriatric horses with large colon simple obstruction had markedly poorer surgical outcomes than mature horses (80% versus 97%), and geriatric horses were significantly more likely to be euthanised without surgery, suggesting either worse initial presentation or conservative owner/veterinary decision-making. These results should encourage practitioners to offer surgery to geriatric horses with many colic lesions, whilst exercising particular caution—and potentially earlier surgical intervention—with large colon obstructions in this population.
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Practical Takeaways
- •Geriatric horses presenting with colic have reduced overall survival; medical management outcomes are notably worse than surgical intervention, suggesting earlier surgical referral should be considered
- •Age ≥20 years is a critical threshold with substantially lower post-surgical survival (53%), warranting careful prognostic counselling and owner discussions before surgery
- •Large colon simple obstructions in geriatric horses carry higher mortality risk than in younger horses; strangulating lesions and jejunojejunostomy cases have comparable outcomes between age groups
Key Findings
- •Overall short-term survival was significantly lower in geriatric horses (≥16 years) compared to mature horses (59% vs 76%)
- •Medical management survival was lower in geriatric horses (58% vs 80%), but surgical survival was similar except for horses ≥20 years (53%)
- •Geriatric horses with large colon simple obstruction had lower survival than mature horses (80% vs 97%)
- •No significant survival difference between geriatric and mature horses with strangulating lesions or requiring jejunojejunostomy