🩺 Vet Insight 2025: When Does Your Horse Need Colic Surgery? 🐴⚠️

Author: Dr Duncan Houston, BVSc

Colic remains the most common emergency condition in horses. While the majority of cases resolve with rest or medical management, about 10% require surgery. Knowing when that moment comes can mean the difference between recovery and a life-threatening crisis. In this 2025 guide, Dr Duncan Houston walks you through how colic surgery decisions are made—and when it's time to refer. 🐎🆘

🔬 The Colic Breakdown

• ✅ 90% of cases: Resolved medically or without intervention
• ⚠️ 10% of cases: Require emergency surgery

The challenge? It’s not always clear at the first exam which category your horse is in. Pain levels and clinical signs don’t always match the severity of the intestinal damage. 🩺🔍

🚨 Why Early Vet Involvement Is Critical

Administering pain medication at home before your vet arrives may mask serious signs and delay surgery. Horses can appear improved temporarily after pain meds—but the underlying issue could still be worsening. ⏱️

🧠 What Vets Look For When Assessing Surgery Need

1️⃣ Uncontrollable Pain

• 💊 Pain that returns quickly after meds is a red flag
• 🔥 Indicates likely surgical lesion or intestinal damage

2️⃣ Large Volumes of Reflux

• 🧪 If your vet is draining liters of stomach fluid, the intestines may be blocked
• 🚛 Time to consider referral immediately

3️⃣ High Heart Rate

• ❤️ Persistent tachycardia (fast heart rate) despite medication
• ⚠️ Sign of systemic stress or severe GI involvement

4️⃣ Physical Exam Findings

• 🔄 Feeling an intestinal twist or displacement on rectal exam
• 🧬 Distended bowel loops can suggest surgical obstruction

🚚 Timing Is Everything

If your vet waits until signs are “certain,” it may be too late for surgery to succeed. Many colic surgeries are referred to centers hours away—so decisions must be made early. 📦⏳

Even when symptoms seem mild, a quiet horse may still have a twisted bowel or strangulation lesion. Don't wait for obvious distress before taking action. 🧠

🏥 What Happens During Referral?

• 🧪 Continued monitoring, IV fluids, and diagnostic tests
• 🔬 Ultrasound and bloodwork to assess systemic involvement
• 🔪 Exploratory laparotomy (surgical exam of the abdomen)

💸 Is Colic Surgery Worth It?

While surgery can be expensive, early referral increases survival rates dramatically. Horses that receive timely surgery often return to full athletic performance. 🐴💪

🧠 Dr Duncan Houston’s Advice

"Don’t assume colic is always mild—especially if you’ve already tried pain meds. If the pain keeps coming back, trust your vet’s judgment about referral." 🐎🩺

📋 Summary: Colic Surgery Warning Signs

• 🚨 Pain unresponsive to medication
• 📉 Continuous or worsening depression
• 🩺 High heart rate with dehydration
• 🧪 Large gastric reflux volumes
• 🔄 Suspicion of displacement or twist

🔚 Final Word: Think Fast, Act Smart

Not every colic requires surgery—but when one does, the earliest decision is the safest one. Talk to your vet at the first signs of colic, avoid unnecessary painkillers, and be ready to transport if surgery is suspected. Early action saves lives. 🐴🚨

Need 24/7 vet support or surgical center guidance? Visit AskAVet.com or download the Ask A Vet app today. 📱🔍