01/09/2026
*** COLIC SURGERY; YES OR NO? ***
Having seen two colics since Friday evening (both seem fine now), I thought I’d address this topic, as it’s something I bring up with my clients almost immediately when attending a colic. The following article is based on my 18 years’ experience as an equine vet, and on owning horses for 35 years. It is my opinion on when I would, and wouldn’t, send a horse for colic surgery.
Colic; the word that every single horse owner dreads, and one which often means huge decisions need to be made within minutes. The biggest decision, and one which needs making immediately, is whether you would want to refer your horse for surgery, should the vet’s examination suggest surgery may be needed. I always ask my clients to start thinking about whether they’d want to refer for surgery, often before I’ve even put my stethoscope to my ears.
I’ve written many posts on colic, and how often the quiet colics can be the worst, so until your vet has examined your horse, there is often no way of telling how serious the colic is.
I base most of my decisions on whether to refer, on response to pain relief. This is obviously following a careful examination. A high heart rate in a very quiet horse, is definitely indicative of a surgical colic (due to cardiovascular compromise or severe pain), but a high heart rate in a very stressed/worried/anxious horse, is obviously not helpful, as the heart rate will be high in these circumstances anyway. Re**al exams are extremely useful, but obviously we cannot physically palpate the entire length of intestine, and often can only palpate the colon and a tiny bit of the small intestine.
Unless I’m extremely worried and referral is definitely an option, I don’t sedate any of my colics. Again, this is my personal preference. I don’t sedate because I want to know fairly immediately how they have responded to my pain relief. I’ll know within ten to fifteen minutes how the horse in front of me has responded to the intravenous pain relief, and that is one of my biggest deciders on whether this horse may need surgery. There is far more I could say about deciding factors for referral, but that would be an article aimed at vets, which most of you are not! On the extremely rare occasions that I sedate, as long as the horse wasn’t still trying to go down through the sedation, I’d wait until the horse was fully awake again before making a referral decision. Of the horses I’ve referred for surgery in my 15 years in practice, only two have ended up not needing surgery, so it’s been an effective method for me.
So the vet has said that your horse needs referring into hospital for possible surgery. How do you decide what to do? There are many deciding factors, but I’ll list my big three.
1. COST - most insurance limits won’t cover the full cost of colic surgery. Colic surgery is never £5000. Ask for a realistic estimate and decide if you can afford it. For some people, that will involve putting £5000 plus on a credit card, and they’ll be no question. For others, especially uninsured horses, a potential £10000 bill for colic surgery will be the deciding factor. Putting a horse to sleep due to very bad colic is 100% not the wrong decision; colic surgery is an enormous surgery, and is not guaranteed to be successful.
2. AGE OF HORSE - again, abdominal surgery in a horse is a big procedure, with a long recovery period of box rest. Some owners will decide not to put an elderly horse through a big surgery, with a very long recovery process, especially if they have other issues (poor dentition; arthritis; laminitis).
3. ABILITY TO BOX REST - some horses, regardless of age, are not candidates for colic surgery due to their inability to remain calm and happy on box rest. Colic surgery can mean 3-6 months of box rest, and for some horses, that just won’t work. If the horse is kept at a livery yard where everyone else gets turned out every morning, then many will get very distressed in that situation. Stress may then result in a repeat bout of colic, and the horse ends up put to sleep having gone through enormous surgery.
So if referral is not an option, when will I allow the horse to have some time, and when will I suggest, or even insist on, immediate euthanasia? I’ve already mentioned that I don’t make any decisions if I’ve sedated a horse, unless that horse is still colicking through the sedation. I always, always, give a strong pain killer (flunixin or banamine) to every colic I see. If a horse is still agitated, trying to go down, or extremely dull/quiet 10-20 minutes after this injection, I won’t leave the yard without referral, further immediate investigation (stomach tubing to check for reflux, which I very rarely do, or a tap of the fluid from the abdomen - again, more vet level article!), or euthanasia. If a horse looks calm and alert after my pain relief injection, then I’m happy to give the horse time, and I stay in regular contact with the owner. Depending on what I’ve found, the owner will be on hourly checks, in hand walking, maybe some hand grazing, and possibly lunging, but that’s very much dependent on the type of colic and what I’ve found during my exam.
To summarise, colic surgery is very much an individual decision for the horse, the owner, and the circumstances. It is always a good idea to have made a decision on whether you’d want your horse to undergo colic surgery, before you have to make that decision at 10pm at night, with your horse on the floor in pain. I know that if I was faced with that decision with any of mine, I’d send them all for surgery….but if I think about it with my sensible head on, I wouldn’t send all of mine for colic surgery, as some are just not suitable candidates.
Feel free to share, but not to copy and paste my words.
Unrelated photo of superstar Johnnie, because I still miss the partnership we had ❤️
