Horse owners' knowledge, and opinions on recognising colic in the horse

UK horse owners and veterinary practitioners' experiences of decision-making for critical cases of colic

BACKGROUND

The survival of horses diagnosed with critical colic (requiring referral or euthanasia) relies on rapid and effective decision-making by the owner and veterinary practitioner.

OBJECTIVES

To explore UK horse owners' and veterinary practitioners' experiences of decision-making for critical cases of equine colic.

STUDY DESIGN

Qualitative study using a phenomenological approach.

METHODS

Individual, semi-structured telephone interviews were conducted with 14 horse owners and 13 veterinary practitioners (vets) who had experienced a critical decision (referral or euthanasia) for a horse with colic. A purposive, convenience sample of participants was recruited. Sessions explored participant's experience of colic, including recognition, help-seeking behaviour, and challenges. Thematic analysis was performed on collected data.

RESULTS

Four over-arching themes were identified; 'head', 'heart', 'practicalities' and 'impact'. Owners acknowledged responsibility for their horse's welfare but had different perspectives than vets on the importance of finance ('head'). Both vets and owners described how the horse-human relationship ('heart') often led to conflict during decision-making. The vet-client relationship was influential on decision-making for both owners and vets; involving other people in decision-making was described both positively and negatively by participants ('heart'). 'Practicalities', such as lack of preparedness, transport issues and adverse weather conditions, were identified by both owners and vets as barriers. Owners described a 'rollercoaster' of emotions after a critical decision, with profound impacts on their mental wellbeing, feelings of guilt, and long-term changes in behaviour ('impact'), and a lack of support to manage these feelings.

MAIN LIMITATIONS

Small sample size.

CONCLUSIONS

This study describes stakeholder decision-making during critical cases of equine colic. Factors that commonly influenced decisions included an owner's previous knowledge and beliefs, social pressures, logistics and the relationship between the owner and vet. The study highlighted long-term impacts on the owner, including their management and decisions for subsequent horses. These factors should be considered in shared decision-making.

Exploring the relationship between horse-owner attributes and their approach to horse training

The way horses are trained has implications for equine welfare and training success, yet little is known about the factors that influence horse-owners' choice of training approach (TA). Limited understanding in this area will hinder the development and dissemination of evidence-based training advice to owners. Consequently, this study aims to identify demographic and attitudinal factors that influence horse-owner TA selection. A 22-question online survey collected information from 1,593 horse-owners about their demographics, equestrian activities, goals and beliefs. Participants rated how likely they were to use six different horse TAs on a five-point scale. Multinomial regression analysis and Spearman's correlation coefficients were used to identify factors associated with their likelihood of using each TA. Several factors were associated with reported TA use, including age, gender identity, goals, activities, industry role and whether they had training in animal behavior. Beliefs about equine sentience, cognitive ability and whether science should inform horse training correlated with likelihood of applying aversives. This study provides insight for further research and development of educational strategies to reduce the use of training approaches that may compromise equine welfare.

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

BACKGROUND

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.

METHODS

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.

RESULTS

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).

LIMITATION

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

CONCLUSION

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.

Colic incidence, risk factors, and therapeutic management in a working horse population in Tuban, Indonesia

Background and Aim

Colic is the primary problem affecting equestrian care worldwide. The primary cause of colic is digestive diseases; however, they can also affect organs from different systems in the abdominal region. In addition to a prior history of the disease and its treatment, risk factors may be assessed to determine the etiology of the disease in horses without or with a history of colic. This study aimed to present a summary of the incidence, risk factors, and medical procedures for colic in horses.

Materials and Methods

Based on owner reports, 223 horses in Tuban, Indonesia, suspected of having colic were investigated. During the investigation of clinical parameters, investigators went door-to-door with interested horse owners to gather information about potential risk factors related to equine colic. Information on horses diagnosed with colic was obtained from the medical records of treatment. A Chi-square test was used to investigate the potential association between the risk factors, medical protocol, and the outcome of colic in horses.

Results

Of the 187 cases, spasmodic colic was the most common (48.13%), but 17 (9.09%) had no definitive diagnosis. Poor body condition scores (χ2 = 58.73; p < 0.001), wheat bran feeding (χ2 = 26.79; p < 0.001), concentrate (χ2 = 10.66; p < 0.01), less access to water (χ2 = 128.24; p < 0.001), recurrence of colic (χ2 = 85.64; p < 0.001), no deworming program (χ2 = 54.76; p < 0.001), the presence of gastrointestinal parasites (χ2 = 56.79; p < 0.001), stressed physical activity (χ2 = 28.53; p < 0.001), and summer season (χ2 = 7.83; p < 0.01) were the risk factors for colic. We further reported that 185 (98.93%) patients who received the following medical interventions recovered: injection of non-steroidal anti-inflammatory drugs was necessary, Vitamin B complex (χ2 = 39.98; p < 0.001), fluid therapy (χ2 = 92.99; p < 0.001), and gastric intubation (χ2 = 4.09; p < 0.05).

Conclusion

The importance of colic was demonstrated in 187 (83.86%) of the 223 horses investigated in Tuban, Indonesia, documented. In this study, recommendations for medical procedures when colic risk factors have been determined are presented.

Use of human behaviour change models to investigate horse owner intention to adopt emergency colic recommendations

BACKGROUND

Behavioural models are widely used within human medicine to understand beliefs and intention associated with major health interventions.

OBJECTIVES

To investigate horse-owner beliefs and practices associated with emergency colic planning.

STUDY DESIGN

Cross-sectional study.

METHODS

An online survey incorporating the Trans-Theoretical Model of behaviour change and the Theory of Planned Behaviour was developed to assess owner intention to adopt three areas of emergency colic planning: (1) prevention/recognition, (2) involvement of others and (3) personal preparation. Participants were recruited using a snowball sampling strategy; multivariable logistic regression of data was performed.

RESULTS

There were 701 horse-owners who completed the survey. Respondents fell into one of two categories: no intention to adopt or already implementing emergency planning recommendations. Most agreed that emergency colic plans would improve their horse's welfare (68%) and aid in decision making (78%). Most disagreed that colic was inevitable (66%) and that treatment options were not within their control (69%). Multivariable analysis showed that those who believed emergency plans were worth creating were more likely to adopt preventive (OR: 2.33, 95% CI: 1.27-4.30, p = 0.007) and personal preparation (OR: 1.61, 95% CI: 1.31-1.97, p < 0.001) recommendations. Preventive recommendations were also associated with 'REACT' campaign awareness (OR 2.36, 95% CI: 1.40-3.97, p = 0.001). Favourable behavioural beliefs, such as the acknowledgement of welfare and decision-making benefits, were linked to the involvement of others in planning (OR: 2.93, 95% CI: 1.78-4.81, p < 0.001).

MAIN LIMITATIONS

Potential response bias and small sample size.

CONCLUSIONS

The majority of owners were either unwilling to adopt suggested recommendations or believed that their approach was currently sufficient. Most owners perceived veterinary professionals as most influential on their decision to plan for a colic emergency, highlighting their importance in any educational campaign.

Survey on sanitary practices and knowledge about infectious diseases among equine owners in the State of Rio Grande do Norte, Brazil

As the primary decision-maker about the health, nutrition, and well-being of their horses, owners' knowledge of correct management practices and clinical changes can potentially affect the immediate health of their horses, in addition to having an impact on the prevention of disease spread in the herd. The adoption of management practices to prevent the introduction and spread of pathogens depends on various factors, including demographics, awareness of the problem, perceived responsibility, previously held beliefs, and sociocultural norms. This study aimed to evaluate the health management practices and the level of knowledge about infectious diseases of equine owners in the state of Rio Grande do Norte, Brazil. A cross-sectional study was conducted by distributing a questionnaire to horse owners in Rio Grande do Norte, Brazil. The participants included horse owners irrespective of the duration of ownership, experience, or sports practiced. In addition to the hygiene and management of animals, the questionnaire addressed topics related to the facilities where the horses were kept. Three hundred and two horse owners distributed in 60 of the 167 municipalities in the state of Rio Grande do Norte participated in this study. Among the interviewed owners, 63.90% (193/302) answered that they do not quarantine animals introduced into the herd or those visiting the property. Regarding the deworming program, 95.03% (287/302) of the owners regularly dewormed their animals. However, more than half of the participants sought veterinary guidance (54.30%). Investing in educational programs and increasing the awareness of equine owners in the state of Rio Grande do Norte about the main infectious diseases in horses is essential toward improving sanitary management and the general health of animals. Informed owners play an essential role in creating safer environments for their horses, thereby contributing to the sustainability of the equine industry.

Long-term outcome after colic surgery: retrospective study of 106 horses in the USA (2014-2021)

Objective

To determine long-term survival rate, defined as survival to 1 year after discharge from the hospital, and rate of return to prior athletic, breeding, or other function in horses undergoing colic surgery at the first presentation at one referral hospital in the Pacific northwest region of the United States.

Procedures

Records were reviewed for all horses that underwent colic surgery between October 2014 and October 2021. Owners of horses that survived to discharge were contacted to obtain follow-up information via internet-based questionnaire or telephone interview. The percentage of horses that survived to 1 year after discharge, rates of return to function, and complications occurring after hospital discharge were determined. The possible association of patient signalment, lesion type, and surgical procedures with long-term survival was examined with Chi-square and Fisher's exact tests. Overall satisfaction was indicated on a scale of 1 (unsatisfied) to 5 (very satisfied).

Results

Of 185 horses that underwent surgical intervention for colic and met the inclusion criteria, 134 horses recovered from anesthesia, with 106 of these recovered horses (79.1%) surviving to discharge. Of the 71 horses for which follow-up information was obtained, 61 horses survived to 1 year after discharge (long-term survival rate of 85.9%). There were no demographic, lesion type, or surgical procedure variables significantly associated with long-term survival. Prior to surgery, 59/71 horses (83.1%) were engaged in some type of athletic activity. After surgery, 44/61 horses (72.1%) were reported to be athletically active. Only one horse was reported to be retired from athletic activity as a direct result of a complication from surgery. Overall satisfaction with the decision to proceed with colic surgery was rated by all respondents as 4 or 5.

Conclusions and clinical relevance

The long-term survival for this sample of horses was similar to previously published reports of long-term survival after colic surgery. Horses that survived to hospital discharge were highly likely to remain alive and be athletically active 1 year later. There were no factors related to the signalment of the horse, the specific cause of colic, or the surgical procedures performed that were significantly associated with likelihood of survival.

Dental and oral cavity alterations in Quarter Horses of Vaquejada: retrospective study of 416 cases (2012-2022)

Oral and dental diseases are common in horses, as evidenced by the results of incidence studies of dental diseases carried out on abattoir specimens or sports horses. Thus, periodic dental examinations in horses are essential to ensure the maintenance of dental health and proper use of ingested food. A retrospective study of the dental records of 416 Quarter Horses (256 males, 160 females), distributed in the western region of the Rio Grande do Norte, Brazil, was conducted. Horses were examined between July 2012 and August 2022. The variables collected were age, sex, type of diet, dental alterations identified, and history of colic in the last 365 days. The animals were divided into three groups according to age: group I (2 to 6 years old), group II (7to12 years old), and group III (13to 24 years old). Pairwise comparisons were performed using Tukey's correction. The most frequent dental alterations were excessive tip of the tooth enamel, limited/asymmetric lateral excussion, oral ulceration, eruption of the first premolar tooth, and rostral hook. Statistical differences (p<0.05) were observed between the age groups in the following alterations: excessive tip of the tooth enamel, limited/asymmetric lateral excussion, eruption of the first premolar tooth, rostral hook, palatitis, step, caudal hook, retention of deciduous cheek teeth, wave, tartarus, underbite, periodontal disease, and incisors of the dorsal curve. Dental disorders in horses are of major clinical importance.

Epidemiology of Colic: Current Knowledge and Future Directions

Epidemiologic studies are essential for the generation of evidence-based, preventive health care strategies. This includes ways to minimize colic risk and assist informed decision making concerning diagnosis, treatment, and likely outcomes. It is important to consider that colic is not a simple "disease" but is a syndrome of abdominal pain that encompasses multiple different disease processes, and which is multifactorial in nature. This review focuses on prevention and diagnosis of colic, including specific forms of colic, communications with owners/carers concerning colic risk and management, and areas of future research.

Updates on Diagnosis and Management of Colic in the Field and Criteria for Referral

Gastrointestinal colic is the most common primary care equine emergency and affects nearly one of four horses per year. Colic is a significant welfare concern for equine patients and a financial and emotional burden for owners. The primary care practitioner is instrumental in identifying critical cases quickly and making appropriate management recommendations to improve patient outcomes.

Survey on the recognition, attitudes, and experience of horse owners during episodes of equine colic in Rio Grande do Norte, Brazil

Horse owners are crucial in recognizing colic because they are responsible for identifying the signs of colic and deciding whether to seek veterinary intervention. Common reasons for delayed response to clinical issues include lack of understanding or knowledge of the subject and difficulty in recognizing subtle clinical signs of abdominal pain. Examining horse owners' basic knowledge of colic, their motivations, obstacles in seeking veterinary care, and their responses to the various clinical symptoms manifested during colic will identify current knowledge gaps and decision-making barriers. This study aimed to examine the experiences, recognition, and attitudes of horse owners during an episode of equine colic in Rio Grande do Norte, Brazil. A cross-sectional study was conducted using questionnaires in Rio Grande do Norte, Brazil. The sample consisted of horse owners, competitors of any equestrian modality (provided that they were responsible for a horse at the time of the application of the questionnaire), or individuals who had previously owned a horse. There were differences related to the recognition and attitudes adopted towards colic in horses compared to the studies performed in other countries. The overall results of this study highlight the need for educational campaigns for horse owners to fill knowledge gaps about colic and the need for a clearer picture of colic, including what it is, the predisposing factors, and the range of symptoms. Additionally, this knowledge will equip horse owners to appropriately respond to these symptoms.

Retrospective Study on Risk Factors and Short-Term Outcome of Horses Referred for Colic from 2016 to 2022

Simple Summary

Colic syndrome is the most common out-of-hours call for equine practitioners. In most cases, medical treatment at home is effective for the resolution of the disorders. In 20% of cases, hospital intensive care is required. Several factors have been addressed as predisposing to the disorder. Cardiovascular and hemodynamic variables are the most reliable indicators of the severity of the condition and, thus, are important prognostic factors. The aim of the study was to highlight the predisposing factors and best prognostic clinical signs for discharge in a cohort of horses referred for colic syndrome. Medical records from 2016 to 2022 were examined. One hundred and fifty-seven horses were included in the study. Month and time of admission were the main predisposing factors. Cardiovascular variables (heart rate on admission and after 3–6 h, packed cell volume, capillary refill time, and mucosal membranes) and the presence of gastric reflux were negatively associated with discharge as well as time to standing after surgery. The results from this retrospective study may help the clinician in evaluating prognosis, deciding on the best treatment, and adequately informing the owner of the rates of success.

Abstract

(1) Background: colic syndrome is a multifactorial life-threatening condition in equids. Awareness of predisposing and prognostic indicators is useful to adequately inform the owner of the outcome and plan the best treatment. The aim of the study was to identify the variables associated with short-term survival in a cohort of horses referred for colic to a veterinary teaching hospital; (2) Methods: medical records of horses referred for colic from 2016 to 2022 were retrospectively reviewed. Univariate and multivariate regression models were built to assess the odds ratios of discharge from the hospital, both on the whole sample and in those patients undergoing surgery; (3) Conclusions: Month, time of admission, cardiovascular variables (heart rate on admission and after 3–6 h, packed cell volume, capillary refill time, and mucosal membranes), and presence of gastric reflux were significantly associated with discharge in the univariate regression in all horses and in those surgically treated. In the multivariate regression model, heart rate, packed cell volume, and capillary refill time showed significant association with the outcome in the whole sample. Although comparison between this study and previous studies is difficult due to the number and type of variables included, cardiovascular variables and markers of hypovolemia were also shown to be associated with outcome.

Multi-Institutional Retrospective Case-Control Study Evaluating Clinical Outcomes of Foals with Small Intestinal Strangulating Obstruction: 2000–2020

Simple Summary

Lower survival rates have been reported in foals than adults with severe colic lesions obstructing blood flow to the small intestine, but this has not been compared directly. These survival rates are important to horse owners making medical decisions surrounding colic, for both the foal’s wellbeing and the owner’s finances. In this retrospective case-control study, hospital records of surgical colic cases were collected from five US academic referral hospitals to directly compare foal and adult survival following surgery for specific colic lesions. It was hypothesized that foals would exhibit lower survival than case-matched adults. This study was limited by incomplete medical and surgical records, relatively small sample size, and lack of long-term follow-up. Short-term survival in foals was not significantly different than in adults with comparable colic lesions and may have been partly driven by decision-making on the farm prior to referral. More optimism toward surgical treatment of foals with suspected SISO may be warranted.

Abstract

Lower survival has been reported in foals than adults with small intestinal strangulating obstruction (SISO), but age-dependent outcomes have not been examined directly. Hospital records were collected from five US academic referral hospitals. It was hypothesized that foals would exhibit lower survival than case-matched adults. Foal cases 6-months-of-age or younger, and adult cases between 2- and 20-years-of-age were collected. Data revealed 24 of 25 (96.0%) foals and 66 of 75 (88.0%) adults that were recovered from surgery for SISO survived to hospital discharge. Sixteen of the total 41 (39.0%) foals studied were euthanized intraoperatively, whereas 30 of 105 (28.6%) adults were euthanized intraoperatively. Common lesions in foals that were recovered from surgery were volvulus (n = 13) and intussusception (n = 5), whereas common lesions in adults were volvulus (n = 25) and strangulating lipoma (n = 23). This study was limited by incomplete medical records, relatively small sample size, and lack of long-term follow-up. Unexpectedly, short-term survival tended to be higher in foals than adults and may have been partly driven by case selection prior to referral or surgery or decision-making intraoperatively. More optimism toward surgical treatment of foals with SISO may be warranted.

Pain severity scores for common equine disorders as provided by horse owners and equine veterinarians

BACKGROUND

Understanding factors influencing assessment of pain in horses will facilitate communication between veterinarians and horse owners.

OBJECTIVES

To compare estimates of pain experienced by horses as provided by veterinarians and horse owners and to determine factors associated with individuals who perceive horses to be experiencing extreme pain or minimal pain.

STUDY DESIGN

Cross-sectional study.

METHODS

Internet-based questionnaires for horse owners and veterinarians included items related to recognition of pain in horses, estimated degree of pain experienced by horses, and demographic information. Variables associated with perception of a high or low degree of pain were investigated using logistic regression analyses.

RESULTS

Final data sets included responses from 553 horse owners and 263 veterinarians. Pain scores varied widely and differences in median scores from horse owners and veterinarians were small. Horse owners providing high pain ratings were more likely to have < 10 horses (odds ratio [OR] = 2.0, 95% CI = 1.1 - 3.5) and to not have a college degree (OR = 1.5, 95% CI = 1.0-2.2). Those providing low pain ratings were less likely to own < 10 horses (OR = 0.6, 95% Confidence Interval [CI] = 0.4 - 0.9). Veterinarians providing high pain ratings were more likely to be employed in a mixed animal practice (OR = 2.8, 95% CI = 1.3 - 5.9) and to lack board-certification in a veterinary specialty (OR = 2.1, 95% CI = 1.1 - 4.2). Veterinarians providing low pain ratings were more likely to be male (OR = 2.4, 95% CI = 1.3 - 4.2).

MAIN LIMITATIONS

The respondent population may be biased because of the method of questionnaire distribution and associated sampling bias. Respondents were primarily from the United States.

CONCLUSIONS

Assessments of the degree of pain horses are experiencing vary widely among horse owners and equine veterinarians.

Mixed methods investigation of the use of telephone triage within UK veterinary practices for horses with abdominal pain: A Participatory action research study

BACKGROUND

Telephone triage is an integral part of modern patient care systems in human medicine, and a key component of veterinary practice care systems. There is currently no published research on telephone triage within the veterinary profession.

OBJECTIVE

To investigate current approaches to telephone triage of horses with abdominal pain (colic) in veterinary practice and develop new resources to support decision-making.

STUDY DESIGN

Participatory action research using mixed-methods approach.

METHODS

An online survey assessed current approaches to telephone triage of horses with colic in UK veterinary practices. Structured group and individual interviews were conducted with four equine client care (reception) teams on their experiences around telephone triage of colic. Evidence-based resources, including an information pack, decision flow chart and recording form, were developed and implemented within the practices. Participant feedback was obtained through interviews six months after implementation of the resources.

RESULTS

There were 116 participants in the online survey. Management and client care staff (53/116) felt less confident giving owner advice (p<0.01) and recognising critical indicators (p = 0.03) compared to veterinary surgeons and nurses (63/116). Thirteen themes were identified in the survey relating to owner advice; exercise and owner safety were most frequently mentioned, but conflicting guidance was often given. Fourteen client care staff were interviewed. They were confident recognising colic during a telephone conversation with an owner and identified the most common signs of critical cases as sweating and recumbency. The new resources received positive feedback; the decision flow chart and information on critical indicators were identified as most useful. After resource implementation, there was an increase in confidence in recognising critical cases and giving owners advice.

MAIN LIMITATIONS

Limited sample population.

CONCLUSIONS

This study described existing approaches to telephone triage, identified variations in advice given, and worked with client care teams to develop new resources to aid decision-making.