Horse Colic Surgery: Making Hard Decisions

Last Updated on February 25, 2022 by Allison Price

It is possible to save your horse’s life by knowing what to do and how to pay for colic surgery.

Your heart poundes as you try and soothe your 21-year-old mare, who is in pain from his stomach. When he nearly catches you with his hoof, keep your eyes open. He waves his tail and swings his head to check his flank. You worry more the more he becomes agitated. The veterinarian interrupts your thoughts and confirms one of your worst fears.

She says, “It’s definitely severe colic and he should go to the nearest horse veterinary hospital for an examination.” He may require surgery but they will be able to tell you more once the horse is there. We must get him there as soon as possible.

Horse Colic Surgery

Your thoughts start to swirl. Is that a colic surgery? Is he going to survive? We can manage him at the farm. How will he cope with the two-hour drive. How much air do I need to add to the trailer tires? How much does surgery cost? How much will it cost? What length of time will he need to stay?

Horse owners who find themselves in this situation are often overwhelmed by the many questions. A severe colic diagnosis and referral for possible surgery can cause anxiety and distress. Many horses are able to survive an emergency with calm and clear thinking and quick decisions by their veterinarian and owner. Sometimes, however, it might be necessary to make difficult decisions in order to save your horse’s life. Although it can be difficult to imagine all possible outcomes, you can plan ahead and save your horse’s lives.

When Colic Strikes

You have a better chance of getting a positive prognosis in a case of colic if you identify the signs sooner. Jarred Williams, DVM PhD, Dipl., suggests that you should have a plan for what to do if your horse is colic. ACVS-LA ACVECC, clinical assistant professor of large-animal emergency medicine at The University of Georgia’s College of Veterinary Medicine in Athens.

Dealing With Equine Colic: Here are 33 Do’s and Don’ts

Colic symptoms include excessive sweating, pawing and biting the flanks, excessive looking at the flanks or biting them, excessive sweating, rolling over or wanting to lie down. Call your veterinarian immediately to assess the horse and to do what he or she tells you until help arrives.

Keep a trailer and a truck on hand in case of an emergency. Also, know the address and phone number of the referral center that your veterinarian refers patients to.

Time is of the Essence

Anthony Blikslager DVM, PhD and Dipl. ACVS, a professor of equine medicine and gastroenterology at North Carolina State University (NCSU), College of Veterinary Medicine in Raleigh, states that the first step to dealing with colic is to make a triage decision. He says that the only thing that you should care about in colic is whether the horse must be referred to a specialist. You don’t need to know the reason your horse is colicking. It’s enough to be concerned that it is distressing enough to want to take it to the next level.

Williams states that accurate diagnosis (defined as any abnormality in tissue) and prompt treatment and referral is the most important step. For example, a horse suffering from a suspected strangulating blockage should be immediately referred to a hospital for assessment. This is especially important if the obstruction involves the colon or large colon volvulus. He says that these horses can suffer from severe respiratory difficulties and cardiovascular collapse due to pressure on their diaphragm. They can also die in a matter of hours.

David Freeman, MVB, PhD, Dipl. ACVS chief of large animal surgery at University of Florida’s College of Veterinary Medicine in Gainesville says that sometimes it can make matters worse by delaying referrals to the hospital for intravenous fluids. He says that this is because the horse believes that he is already dehydrated and will be better if he is presented to the hospital. However, the horse needs to go to the clinic immediately.

Freeman says that if a horse isn’t responding to painkillers, it’s important to get him to a referral facility. He warns that any delay could make what was a minor operation into a major surgery with increased risks for complications and death.

Referral Hospital

Due to the distance horses live from a referral facility, it is often difficult for veterinary surgeons evaluate horses as quickly as they wish. Williams sees horses often four to six hours after their owners notice the first signs and symptoms of colic.

A referral hospital veterinarian will conduct a workup on the horse once it has arrived. This usually takes between 40-60 minutes. The veterinarian will then share the results with the owner and suggest either exploratory or medical treatment. Finally, the vet will give the horse’s prognosis.

Williams states that the attending veterinarian will use a number of parameters to determine the severity of the condition. These include packed cell volume and systemic milk. (Increases in blood Lactate can indicate that cells are not getting enough oxygen). The attending veterinarian might also monitor systemic glucose (also measured from blood samples), abdominal milk (from a peritoneal tap), and shock.

He says that these factors are often more important in predicting the outcome than the time since colic started.

The following factors can influence the owner’s decision whether to send their horse to surgery:

  • Type of lesion;
  • Prognosis;
  • It is important to know the horse’s medical history, including whether or not he has any other conditions that could impact his ability to recover from surgery.
  • It does not matter if the horse has ever colicked before.
  • How the horse will recover from surgery.
  • The emotional attachment of the owner to their horse
  • Care costs
  • Anesthesia can pose a risk
  • Recoverion takes time
  • Age of the horse and more

The horse’s worth and ability to return to his original purpose are two aspects of the decision-making process. Blikslager says that if the horse’s prognosis for a return to function is not good, his value will likely drop after he has surgery. While most colic patients are able to return to their original purpose after surgery, recovery can be long.

Freeman claims that many senior horses are healthy and can cope with major colic surgery. This is contrary to the belief that older horses cannot handle anesthesia or surgery. The owner may consider euthanasia if there are other health conditions that might affect the horse’s quality of life.

All other considerations aside, the most important factor in deciding to have surgery is finances.

The Procedure

According to Blikslager:

  • $1,500 for the initial assessment;
  • $1,000 for exploratory surgery
  • A small intestine resection (surgical treatment to remove the damaged part) costs $2,500. However, this price varies depending on the type of surgery.
  • Aftercare services can cost up to $3,000 depending on the complications.
  • According to him, the cost of managing a horse medically is much less than that of surgery. The average colic bill at NCSU, which includes both medical and surgical cases is $4,200, is between medical and surgical cases. It could go as high as $8,000 to $10,000.

Related: How Much Does My Horse’s Vet Fee Cost?

Some horse owners also have other payment options than their bank accounts. Owners can apply for CareCredit loans at NCSU, according to Blikslager. The hospital also has funds that can be donated to those who are unable to afford surgery but still meet its guidelines. Each referral hospital offers different financial assistance options.

Crowdfunding is a popular way for owners to pay for medical emergencies. You can search GoFundMe for a variety of crowdfunding campaigns to help fund horse’s medical or surgical care.

Any delay in arranging finances can have a negative impact on the horse’s prognosis. Equine insurance is a blessing. Blikslager states that if a horse has basic medical coverage, the decision to agree to a colic procedure is easy because the insurance covers it. After owners have provided all relevant policy information, NCSU staff verify the benefits with adjusters from insurance companies to ensure this.

There are many details to consider when purchasing equine insurance. Blikslager states that if an owner purchases mortality insurance but not major medical, and a horse develops colic, the insurance company will require that treatment be given to the horse and not pay for him to be put down.

He says, “If the veterinarian states that there is no reasonable treatment, then of course euthanasia would be the best to stop the suffering and death would then pay out.”

Blikslager warns that only the actual surgery is covered by surgical insurance. Pre- and postoperative costs are not covered.

Blikslager says that unless you own a horse of great value, it is difficult to cash-in on a loss-of-use policy. You have to show the horse cannot (fulfill) his intended purpose.” The insurance company will take a long time to resolve this matter.


Blikslager said that he often discusses Euthanasia early in life, in case the owners are unable or unwilling to continue with medical treatment. He says that many people feel terrible for their animals. “And horses might be in very bad health, and may not have enough funding.”

Blikslager states that the veterinarian must act objectively and not emotionally in order to guide the client through the decision-making process.

Freeman states that horse management is the most important priority. He reminds horse owners that the purpose behind euthanasia was to alleviate suffering.

Also, the veterinarian should discuss with the owner how long it takes to make the decision: euthanasia or surgery? And how it can prolong the pain and reduce the chance of a successful operation.

The Recovery Process

According to Blikslager after surgery, most complications are manageable (shock, hypoxemia and electrolyte imbalances , dehydration, etc. ).

According to him, around 15% of patients who have had colic surgery are hospitalized develop incision site infection. This can cause swelling, pain and/or drainage. Hernias can be caused by infections in the body’s wall.

The NCSU staff begin slowly reintroducing feed between Days 2 and 3. Blikslager says that horses can colic again at this point, particularly if adhesions form between the intestines, and the abdominal wall. The horse should be able to go home after about one week, assuming he has not had any complications or colic again.

After returning home, put the horse in a stall for one month. Then, move him to a small paddock and allow him to exercise for the next month. If the horse was an athlete, it may take three more months before he can return to his former level of fitness. Blikslager says that it can take six months to return to full performance. However, rehabilitation modalities such as the underwater treadmills can reduce this time.

The length of time that the colic has been present before the horse was able to have surgery is often a determining factor in long-term survival rates. Adhesion formation is the greatest threat to your survival. It is more difficult to save a horse with a second operation if he colics.

When Surgery isn’t an Option

Sometimes surgery is not an option due to logistics, finances (no way to reach a referral hospital), and other factors. The best thing to do is to treat the horse medically. This can be done at home by your veterinarian or at the referral center.

Freeman says that waiting for the horse’s response to medical treatment is a sensible approach, provided the horse isn’t showing any signs of pain or distress. Some horses may have life-threatening colic, which cannot be treated.

A strangulating obstruction can’t be fixed without surgery. Williams says that a dead or dying bowel cannot be fixed medically.

If the horse is suffering from a non-strangulating obstruction, there are more options to manage it medically.

Williams says that when surgery is not an option, it is crucial to determine if the obstruction is nonstrangulating or strangulating before deciding on a treatment plan.

In Summary

Before an emergency occurs, create a colic plan for each horse. Consider purchasing equine major health insurance. This can make it easier to decide whether to send your horse for life-saving surgery.

Williams says that communication is key to a successful outcome. The more things are done before colic occurs, the easier it will be to handle the situation.

There are many things you can do to improve the odds of a colicking horse. It’s not the death sentence that it used to be. With proper preparation, colic care has advanced.

Allison Price
Allison Price

I’m Allison, born and raised in San Diego California, the earliest memory I have with horses was at my grandfather’s farm. I used to sit at the stable as a kid and hang out with my Papa while he was training the horses. When I was invited to watch a horse riding competition, I got so fascinated with riding!