Your performance horse has a serious bout of colic and your veterinarian says the last remaining option is surgery.
Owners tend to weigh up a raft of factors when deciding whether to proceed, including the likelihood of the horse recovering.
Even if it does recover, is there any prospect of the horse returning to the showjumping arena or eventing course?
Researchers in Finland who followed up on the fate of 236 horses that underwent colic surgery have found that the odds are good.
The University of Helsinki study team, writing in the journal Acta Veterinaria Scandinavica, reported that 83.7% of the horses who survived to discharge were able to perform in their previous or intended discipline, and 78.5% of them regained their former or a higher level of performance.
“Surgical treatment of colic is expensive and complications may occur, ” Isa Anna Maria Immonen and her colleagues acknowledged.
They said information on the prognosis and the use of the horse after surgery for colic was important for both the surgeons and owners.
The study team set about reviewing equine colic surgical cases undertaken at the Veterinary Teaching Hospital in Helsinki, Finland, from 2006 to 2012. Their aim was to follow the horses, which were of different breeds, for surgical findings, post-surgical complications, long-term recovery and prognosis.
The average age of the horses at the time of surgery was 8.9 years, ranging from just 4 days old to 22.2 years. Warmblood horses were the most prominent breed, representing 38.6% of the study population.
Most of the operated horses − 82.6% − recovered from anesthesia and 74.9% made it to discharge.
The total follow-up time was 8 years and 10 months and the overall estimated average survival time was assessed at 79.2 months.
The age of the horse, the location of the abdominal problem (whether small or large intestine) and any incidents of postoperative colic did not significantly affect the probability of returning to their discipline, nor did any surgical site infections, incisional hernias or convalescence time after surgery.
More than four out of five of the discharged horses returned to their discipline, the vast majority of them performing to the same standard or higher than before their colic episode.
Operated horses had 0.18 colic episodes per horse-year during the long-term follow-up. However, the incidence of colic was 20% within the first year after surgery.
Horses who underwent surgery for large intestinal colic were 3.3-times more likely to suffer postoperative colic than those operated on for small intestinal colic.
Most owners (96.3%) were satisfied with the veterinary care and nearly all (98.5%) evaluated the recovery after the colic surgery to be satisfactory or better.
If the horse survived to discharge, the prognosis for long-term survival and a return to previous levels of sporting activity and performance was good, they said. “The majority of horses were able to return to their previous activity and perform satisfactorily for several years after surgery.”
Discussing their findings, the study team said long-term retrospective studies were challenging as 14 to 44% of horses were reportedly lost to follow-up. However, in this study, information on survival was obtained for nearly all of the discharged horses (97.9%) and full follow-up information regarding complications and their effect on postoperative use was obtained for 92.5% of the discharged horses.
They noted that horses in the study were 1.7 times more likely to develop colic again following their operations than horses with no history of colic surgery. “Previous reports found that operated horses have had 2.8 to 7.6 times higher incidences of colic compared to non-operated horses.”
“Complications are common during and after small intestinal surgery, and according to other reports these horses tend to have a slightly poorer postoperative prognosis.
“However, this study supports the finding that a number of horses operated on for small intestinal colic are able to live and perform surprisingly long, even up to 10 years after surgery.
“The age of the horse did not have a significant effect on overall survival.”
“Most importantly,” they concluded, “the majority of discharged horses had a good prognosis for long-term survival, were able to return to their intended use, compete postoperatively on a satisfactory level and also perform for several years after the operation.”
The research team comprised Isa Anna Maria Immonen, Ninja Karikoski, Anna Mykkänen, Tytti Niemelä, Jouni Junnila and Riitta-Mari Tulamo. All are with the University of Helsinki except for Junnila, who is head of statistics with pharmaceutical company 4 Pharma.
Long-term follow-up on recovery, return to use and sporting activity: a retrospective study of 236 operated colic horses in Finland (2006–2012)
Isa Anna Maria Immonen, Ninja Karikoski, Anna Mykkänen, Tytti Niemelä, Jouni Junnila and Riitta-Mari Tulamo
Acta Veterinaria Scandinavica 2017 59:5 DOI: 10.1186/s13028-016-0273-9