When to Cut and When to Kill: Predicting Survival in Colic Patients

Introduction

The art of predicting survival of horses at an individual level is fraught with difficulty. Whilst many surgeons can remember the pony that survived seemingly against all odds, there are others that appear to succumb to comparatively minor lesions. How to advise owners the correct course of action is dependent on a number of factors including signalment, clinical presentation, owner preference and economic issues.

Research currently being undertaken at the University of Nottingham of colic cases presented to first-opinion practitioners has demonstrated a euthanasia rate of 17.4% (95/547) amongst cases prior to any referral or otherwise surgical intervention (unpublished; www.colicsurvey.com. Survey ongoing, data correct to 30 April 2013). So what scientific evidence is there that might be beneficial to support these decisions?

Typically the rate quoted by many surgeons for survival to discharge is around 70% for all cases admitted for surgery, and over 80% for those allowed to recover from anaesthesia; however, on their own these values are somewhat misleading for owners as they do not reflect the ongoing death of cases due to post operative complications (Proudman et al. 2002; Mair and Smith 2005). Consequently a holistic and long-term approach is needed in order to provide, and indeed create, prognostic data. [...]