Factors Complicating Return to Work after Colic Surgery

It's one of every horse owner's worst nightmares--a case of colic that progresses into emergency surgery. Among the many other questions swirling in an owner's mind before colic surgery might be whether their horse will recover well enough to return to work when the ordeal is over. Researchers at North Carolina State University's (NCSU) College of Veterinary Medicine recently tried to provide better statistics to answer that question.

The research team followed up with owners whose horses underwent exploratory celiotomy procedures for acute colic at the university's clinic between 2003 and 2010 and survived at least six months after surgery. After six months, the team learned, 68% of the 195 horses had returned to their previous job; of those, 54% were working at or above preoperative performance levels. At one year, these numbers increased to 76% and 66% respectively.

Of horses that did not return work, several pre- and post-operative complications seemed to play a role, the team noted, including herniation at the surgical incision, pre-existing lameness, and laminitis during or after hospitalization.

If needed, repair of incisional hernias as the result of weakened body wall or as a complication after incisional infection must be delayed for four to six months to allow tissue to remodel, noted researchers. Affected horses were almost four times less likely to be working at one year as compared to horses without hernias.

Callie Fogle, DVM, Dipl. ACVS, clinical assistant professor of equine soft tissue surgery and an author on the study, speculated that this statistic might be due in part to the physical blemish left by the hernia for some types of competition horses, or hesitation on the owner's part to return the horse to work and risk straining the hernia. Fogle also noted that a disparity appears to exist between the owner's perception and the veterinary recommendations for an individual hernia regarding exercise-limitations. "Be sure to get all the information you need before making a decision to ... retire the horse," she said.

Prior stall rest for an orthopedic issue preceding colic surgery also reduced a horse's chances of returning to work after surgery, the team relayed. Horses that had concurrent lameness issues were 11.3 times less likely to return to levels of preoperative performance at one year. Fogle said she believes these are cases where a serious orthopedic injury occurred prior to the episode of colic. Fogle added that while horses with serious orthopedic injuries are predisposed to developing colic, this association is poorly understood and warrants further investigation.

Horses that developed laminitis during or after hospitalization for colic surgery were five to 10 times less likely to return to work than unaffected horses. Laminitis occurs in approximately 4% of horses that undergo colic surgery at NCSU, Fogle said. Although laminitis is a relatively uncommon complication, it is one that can severely limit a horse's long-term athletic activity, despite aggressive therapy.

"If there is a complication that develops after you bring the horse home, don't hesitate to have the horse re-evaluated ... by your local veterinarian and by the equine surgeon," Fogle concluded.

The study, "Return to use and performance following exploratory celiotomy for colic in horses: 195 cases (2003-2010)," will appear in an upcoming issue of the Equine Veterinary Journal. The abstract is available online.

Disclaimer: Seek the advice of a qualified veterinarian before proceeding with any diagnosis, treatment, or therapy.

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