Prospective case study of critical decision making for horses referred for treatment of colic

There is limited evidence on factors affecting critical decision making for horses with colic. This study's aim was to describe the assessment and decision making involved in horses referred for management of colic.

An in-depth case analysis was used to document case presentation, decision making and outcomes for horses referred for colic to two UK equine veterinary practices over a 12-month period. The data recorded included previous history, presenting signs, response to treatment, case outcome and factors affecting decisions for further treatment or euthanasia.

Data were available for 60 cases: 55 were hospitalised for medical or surgical treatment and five horses were euthanased following initial assessment. The main factors affecting treatment decisions were severity of clinical signs (80%, 47/59), financial concerns (10%, 6/59) and ongoing health issues or previous history of colic (5%, 3/59). Factors associated with euthanasia decisions were postoperative complications (5/18), poor prognosis (4/18), deteriorating clinical signs (3/18) and financial concerns (3/18).

The limited study population may affect the extent to which the findings can be generalised.

The severity of clinical signs was the key factor in treatment decision making. The main factors affecting euthanasia decisions were clinical deterioration, poor prognosis and financial constraints. These findings should be incorporated into clinical case recording to capture the multifactorial nature of decision making.