The challenges in making the urgent decisions often needed in critical colic cases in horses have been highlighted in a British study, with researchers finding potential costs ranging up to £10,000.
Significant shortfalls are likely under some insurance plans, they found.
Colic is the most common reason for out-of-hours emergency calls in equine veterinary practice.
Most horses with colic have mild to moderate disease that can be resolved with simple medical treatment. However, a significant proportion – as many as one in five cases – may be critical, requiring surgical treatment or euthanasia.
“In these situations, an owner and their veterinary surgeon will have to make a rapid decision on whether referral treatment is an option for their horse or whether the horse should be euthanised,” University of Nottingham researchers Isobel Barker and Sarah Freeman wrote in the journal, Vet Record.
The pair noted that several factors can affect this judgment, including the potential costs of treatment and the finances available to the owner.
Colic, they noted, can arise from several causes, including impactions, gut inflammation and strangulating lesions. There are many different diagnostic tests for investigation and a range of treatment options.
“For this reason, it is often challenging to predict what the total cost of an episode of colic might be,” they said.
The pair set out to assess the costs of different referral treatments for colic in Britain, and to review and compare the main insurance policies relevant to horses with colic.
“The costs of referral treatment vary widely,” they noted, “but this study provides data on the range of costs that might be expected for different types of colic.”
Information was collected from nine equine hospitals for case costs, categorised into four different outcomes:
- Horses that were admitted and euthanised;
- Those that were euthanised during or immediately after surgery;
- Those that received medical treatment and survived more than 24 hours;
- Those that underwent surgery and survived more than 24 hours.
They also examined the offerings from five UK equine insurance companies.
In all, costs were obtained for 108 cases.
The average cost for horses admitted and euthanised was £873.89 (ranging from £459.72 to £1471.51). The average for cases involving surgical treatment and survival more than 24 hours was £6437.80 (ranging from £3178.87 to £9100).
Cases that were euthanised within 24 hours with no surgical intervention were the least expensive, but still involved a significant cost (an average of £874, and ranging from £460 to £1472).
Cases that were treated medically and survived for more than 24 hours were the least expensive treatment category, with an average of £1501 and ranging from £554 to £3821. These cases, they noted, were likely to fall within insurance cover limits for veterinary fees.
“Cases that had surgery but were later euthanised had a mean cost of £3485, but there was a wide range of costs (up to £10,301), which could significantly exceed current insurance levels.”
The most expensive cases were those that received surgical intervention and survived for more than 24 hours.
“However, the major consideration is that the mean costs for surgical treatment would exceed cover provided by most insurance policies. Three policies were up to £5000, one was up to £5750 (but only £4600 of this was appropriate for colic costs), and the highest cover was up to £7500.”
The cost of referral treatment exceeded £5000 for 21 of the 27 cases (77.8 per cent) that had surgery and survived for more than 24 hours.
The authors noted that the costing data obtained from this study did not include the cost of the primary assessment by the referring veterinary surgeon, nor the cost of any veterinary care after the horse was discharged.
“Therefore the total cost of each specific episode will be higher than the figures described in this study.”
Turning to insurance in more detail, the researchers reported that monthly premium rates for a standardised case ranged from £27.06 to £47.06 among insurers.
“There is frequently a significant gap between insurance cover and the cost for surgical treatment that owners of insured horses should be aware of and consider in their decision-making.”
Terms and conditions of policies ranged in length from 2098 to 17,701 words, with reading scores indicating they were complex and difficult to read – a common issue for policy documents.
Improving their readability would ensure that these documents were understandable to as wide a range of horse owners as possible, they said.
The study revealed that all of the insurance companies varied in the types of cover offered, and that there may be a wide range of exclusions, which meant that owners should read policies carefully to understand how and when to make a claim.
“The role of the veterinary surgeon in guiding the owner through the complexity of decision-making and insurance policies should not be underestimated.”
Barker and Freeman, both with the School of Veterinary Medicine and Science at Nottingham University, said the study highlighted the complexity and challenges for decision-making in critical cases of colic.
They said the costings and insurance data from the study should help veterinary surgeons and horse owners with critical decision-making in horses with colic.
Assessment of costs and insurance policies for referral treatment of equine colic
Isobel Barker and Sarah L Freeman
Vet Record, http://dx.doi.org/10.1136/vr.105415