How to Know if Colic Surgery is Worth it

A colic emergency makes the decision of surgery difficult. Here are some steps to make the call easier.
Carol Hamilton/

If you’ve owned horses for decades, you’ve been faced with colic. Use these steps to determine is colic surgery is worth it for you.

In fact, emergency colic cases make up 55-61% of all equine emergencies, with 23-45% of those requiring surgery, according to the Department of Veterinary Clinical Sciences at Washington State University.

Sometimes it’s difficult to get the horse under the knife soon enough, as was the case for the Burch brothers this spring when their great bronc Lunatic From Hell colicked in the middle of nowhere in a trailer en route to a rodeo, and died. Tragic as that was, hopefully you’ve got a vet on speed-dial for advice.

When colic surgery may be an option

You want to make that call if your horse is pawing at the ground, repetitively lying down and getting up or rolling, grunting, or kicking at the belly. The vet will likely tell you to remove all food and take vital signs (heart rate and breaths per minute, plus rectal temperature). You could also check the color of your horse’s gums and determine whether you can hear digestive sounds or see manure production. Likely, either the stomach or intestines are inflamed or ulcerated, obstructed by tumors or stones, or impacted by fecal matter or trapped gas.

It’s a good idea to haul the horse to a clinic if you get a heart rate consistently greater than 50 beats per minute, you’re unable to hear digestive sounds at all, or the horse seems to be getting worse even after being given pain-relieving drugs.

When it comes to doing surgery, that’s a big-time emotional, financial and time-consuming investment. You’ll have to take into account your particular horse’s chance of survival, your own financial considerations, age of the horse, and insurance status.

Statistics concerning colic surgery

If you’ve heard that horses come out of surgery with an increased incidence of repeat colic, it’s true. Here’s the real number, according to WSU’s College of Veterinary Medicine:  25–50% of post-surgical horses experience further episodes of abdominal pain (which is 1 to 7 times higher than in horses with no history of colic surgery). But, of those, only 5% had more than three episodes of colic in the three months post-surgery, according to the Equine Veterinary Journal in 2002. Of course, there are also complications that can occur with any surgery, including adhesions, founder, diarrhea and pneumonia.

Here are some details from a study completed in October 2023 on long-term outcomes. Researchers with the Dept. of Veterinary Clinical Sciences at WSU looked at 185 horses – most engaged in some type of athletic activity – that underwent colic surgery.

They found that right at 79% survived to go home. Of those, 86% were still alive a year later. The greatest nugget here is that 72% of the previously athletically active horses were reported to be athletically active a year later, with only one horse retired due to complications from surgery. Another interesting note was that the specific cause of colic or specific surgical procedure performed didn’t make any significant difference in likelihood of survival.

That differs a little bit from 2013 data from Practical Guide to Equine Colic, which showed that horses that required a resection of small intestine had a lower survival rate than horses with an easily cleared colon impaction. Makes sense.

But possibly the best news from that era was that older horses without other health issues had similar survival rates to younger horses. Dr. David Freeman reported in the 2012 American Association of Equine Practitioners (AAEP) Proceedings that horses older than 16 – even those in their late 20s to early 30s – handled anesthesia and colic surgery well, with survival rates comparable to those of younger horses.

As daunting as the surgery decision can be, let’s get our mind now around prevention. Dr. Noah Cohen, Professor and Associate Department Head at Texas A&M University’s College of Large Animal Medicine and Surgery, points out four main ways to prevent colic.

4 steps to prevent colic

Step one: Only make changes in your horse’s amount or type of feed gradually.

He cited research proving that switching hay can increase the risk of colic by 10 times, while switching grain increases risk by 5 times, surprisingly. He added that a supplement with prebiotics, enzymes, and yeast can help your horse during feed transitions.

Step two: Give your horse as much daily turnout or exercise as possible, since being stalled is a risk factor for the large colon. If that’s not an option, then limit grain, increase hydration and offer free-choice hay.

Step three: Don’t drastically switch your horse’s activity level. If you do increase or decrease it, consider a supplement to maintain a healthy GI tract, he wrote.

Step four: Deworm your horse regularly, rather than infrequently, which has been shown to decrease the risk of colic due to inflammation of the gut wall or GI blood vessels.

Peace of mind is always enhanced with knowledge. Plus, know that there are several insurance programs out there for colic, like SmartPak’s ColiCare, which reimburses you up to $15,000 for surgery.