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He’s down. He’s rolling. He’s up! … And, down again. Oh no, and now he’s got that look. The one that tells you, yeah, this seems pretty bad.
For horse owners, few situations create more anxiety than finding your horse in the throes of colic. You call the vet, you wait, and you watch. And you think of all the possibilities, all the unknowns….
Some research groups are helping owners and veterinarians better predict those unknowns, fortunately. By sifting through the various factors, like how the horse is acting and what kind of colic he has, scientists are starting to make some connections between those factors and outcome.
Is the horse likely to survive? And – the more uncomfortable question – is it worth sending him to the equine hospital (which might be several hours away)? It’s these kinds of questions, and more, that researchers are striving to answer.
Nora Biermann, Mag.med.vet./DVM, PhD, DACVS-LA, of the Clinical Unit of Equine Surgery at the University of Veterinary Medicine Vienna, in Austria, and her research team have just completed one such study.
Focusing on a Canadian region known for its single referral hospital in a radius of several hundred miles, they’ve looked at 16 years’ worth of data to find ways to help predict outcome in colic cases.
Advancing age, increased weight, more serious signs of pain and more significant indications of depression were all associated with a worse prognosis in this study, Dr Biermann said. The length of time the horse was colicking before arriving at the hospital was also a factor associated with survival, she said.
This was important in their study location where the average arrival time was 16 hours after colic started – probably due to the long travel times.
However, interestingly, if the horse reached the 36-hour mark, he actually stood as good a chance of survival as before the 12-hour mark. For horses undergoing surgery and surviving the surgery itself, chances of survival seemed equal across horses regardless of how long colic had lasted before surgery, added Dr Biermann.
“One of the reasons for doing this study was that we were seeing colic patients in really bad shape by the time they arrived in the hospital, and referring veterinarians who were doing a good job in working up the horses but seemed frustrated when those cases were euthanized quickly after arrival in hospital,” she said.
“I do think that has a lot to do with the remote location and the long travel times that cannot be changed,” continued Dr Biermann.
“But I would like to encourage owners and veterinarians to continue to try, because we also see a lot of cases that do well with intense medical therapy or surgical intervention. There are many severe cases that have a fighting chance and go back to normal life, and you can’t know if you don’t try.”
That’s true even for small intestine lesions, according to Biermann. Although these lesions have historically been associated with poorer prognosis, in some ways the statistics have to do with more owners opting for euthanasia when the diagnosis is related to the small intestine.
“Particularly with quick referral and a short duration until surgery is pursued, those horses have a reasonable chance –I feel closer to somewhere around 75-85% chances of survival,” she said.
“But it has to be recognized that due to the much more common need for bowel resection, small intestinal lesions come with larger expenses for the owner, which surely also plays a role in decision making. Personally, I encourage owners to go for surgery even when it is clear that it is a small intestinal lesion and likely needs resection, if finances are not a huge concern.”
In their study, the best outcomes came from neither small intestinal lesions nor large intestinal lesions, but from no clear diagnosis at all. When diagnostic procedures like ultrasound revealed nothing remarkable, and the cause of the colic could not be found, the horses generally improved with good hospital care and medical treatment, especially if the other factors like age, weight, severity of signs, and duration of colic were more favourable.
“If the cause of colic is suspected to require intense medical or even surgical treatment and referral is an option, fast referral is the best chance for the horse to survive, even in remote areas,” said Dr Biermann.
Clinical Findings, Diagnoses, and Outcomes of Horses Presented for Colic to a Referral Hospital in Atlantic Canada (2000-2015) by J.M. Kaufman, O. Nekouei, A.J. Doyle and N.M. Biermann is published by the Canadian Veterinary Medical Association and can be found at: https://bit.ly/3c168Bl
This article, titled “Fast Referral Gives Horses The Best Chance For Surviving Colic” was published in Horses and People May June 2020 magazine.