Prospective case study of critical decision making for horses referred for treatment of colic.
Journal
The Veterinary record
ISSN: 2042-7670
Titre abrégé: Vet Rec
Pays: England
ID NLM: 0031164
Informations de publication
Date de publication:
21 Nov 2023
21 Nov 2023
Historique:
revised:
20
10
2023
received:
17
01
2023
accepted:
27
10
2023
medline:
22
11
2023
pubmed:
22
11
2023
entrez:
22
11
2023
Statut:
aheadofprint
Résumé
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.
Sections du résumé
BACKGROUND
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
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
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
CONCLUSIONS
The limited study population may affect the extent to which the findings can be generalised.
CONCLUSION
CONCLUSIONS
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.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e3615Subventions
Organisme : University of Nottingham
Organisme : World Horse Welfare
Informations de copyright
© 2023 The Authors. Veterinary Record published by John Wiley & Sons Ltd on behalf of British Veterinary Association.
Références
Southwood LL. Patient signalment and history. In: Fehr J, Southwood LL, editors. Practical guide to equine colic with illustrations. Ames, IA: Wiley-Blackwell. 2012. p. 1-11.
Bowden A, England GCW, Brennan ML, Mair TS, Furness WA, Freeman SL, et al. Indicators of ‘critical’ outcomes in 941 horses seen ‘out-of-hours’ for colic. Vet Rec. 2020:187(12):492.
Curtis L, Burford JH, Thomas JSM, Curran ML, Bayes TC, England GCW, et al. Prospective study of the primary evaluation of 1016 horses with clinical signs of abdominal pain by veterinary practitioners, and the differentiation of critical and non-critical cases. Acta Vet Scand. 2015;57(1):69.
Proudman CJ, Smith JE, Edwards GB, French NP. Long-term survival of equine surgical colic cases. Part 2: modelling postoperative survival. Equine Vet J. 2002;34(5):438-443.
Bowden A, Burford JH, Brennan ML, England GCW, Freeman SL. Horse owners' knowledge, and opinions on recognising colic in the horse. Equine Vet J. 2020;52(2):262-267.
Scantlebury CE, Perkins E, Pinchbeck GL, Archer DC, Christley RM. Could it be colic? Horse-owner decision making and practices in response to equine colic. BMC Vet Res. 2014;10(Suppl 1):S1.
Davis W, Fogle CA, Gerard MP, Levine JF, Blikslager AT. Return to use and performance following exploratory celiotomy for colic in horses: 195 cases (2003-2010). Equine Vet J. 2013;45(2):224-228.
Ireland JL, Clegg PD, McGowan CM, Platt L, Pinchbeck GL. Factors associated with mortality of geriatric horses in the United Kingdom. Prev Vet Med. 2011;101(3-4):204-218.
Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach. BMC Med Res Methodol. 2011;11(1):100.
Carroll C, Huntington P. Body condition scoring and weight estimation of horses. Equine Vet J. 1988;20(1):41-45.
Mair TS, Smith LJ. Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 1: short-term survival following a single laparotomy. Equine Vet J. 2005;37(4):296-302.
Southwood LL, Fehr J. Referral of the horse with colic. In: Southwood LL, editor. Practical guide to equine colic. Ames, IA: Wiley-Blackwell. 2012. p. 71-78.
Sutton GA, Dahan R, Turner D, Paltiel O. A behaviour-based pain scale for horses with acute colic: scale construction. Vet J. 2013;196(3):394-401.
Sutton GA, Paltiel O, Soffer M, Turner D. Validation of two behaviour-based pain scales for horses with acute colic. Vet J. 2013;197(3):646-650.
Hsieh H-F, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277-1288.
Dukti S, White NA. Prognosticating equine colic. Vet Clin North Am Equine Pract. 2009;25(2):217-231.
Furr MO, Lessard P, White NA. Development of a colic severity score for predicting the outcome of equine colic. Vet Surg. 1995;24(2):97-101.
Ihler CF, Venger JL, Skjerve E. Evaluation of clinical and laboratory variables as prognostic indicators in hospitalised gastrointestinal colic horses. Acta Vet Scand. 2004;45(1-2):109-118.
Orsini JA, Elser AH, Galligan DT, Donawick WJ, Kronfeld DS. Prognostic index for acute abdominal crisis (colic) in horses. Am J Vet Res. 1988;49(11):1969-1971.
Parry BW, Gay CC, Anderson GA. Assessment of the necessity for surgical intervention in cases of equine colic: a retrospective study. Equine Vet J. 1983;15(3):216-221.
Proudman CJ, Dugdale AHA, Senior JM, Edwards GB, Smith JE, Leuwer ML, et al. Pre-operative and anaesthesia-related risk factors for mortality in equine colic cases. Vet J. 2006;171(1):89-97.
Thoefner MB, Ersbøll AK, Jensen AL, Hesselholt M. Factor analysis of the interrelationships between clinical variables in horses with colic. Prev Vet Med. 2001;48(3):201-214.
van der Linden MA, Laffont CM, van Oldruitenborgh-Oosterbaan MMS. Prognosis in equine medical and surgical colic. J Vet Intern Med. 2003;17(3):343-348.
White NA, Elward A, Moga KS, Ward DL, Sampson DM. Use of web-based data collection to evaluate analgesic administration and the decision for surgery in horses with colic. Equine Vet J. 2005;37:347-350.
Southwood L, Gassert T, Lindborg S. Colic in geriatric compared to mature nongeriatric horses. Part 2: treatment, diagnosis and short-term survival. Equine Vet J. 2010;42(7):628-635.
Krista KM, Kuebelbeck KL. Comparison of survival rates for geriatric horses versus nongeriatric horses following exploratory celiotomy for colic. J Am Vet Med Assoc. 2009;235(9):1069-1072.
Christophersen MT, Dupont N, Berg-Sørensen KS, Konnerup C, Pihl TH, Andersen PH. Short-term survival and mortality rates in a retrospective study of colic in 1588 Danish horses. Acta Vet Scand. 2014;56:20.
Barker I, Freeman SL. Assessment of costs and insurance policies for referral treatment of equine colic. Vet Rec. 2019;185(16):508.
Bowden A, England GCW, Brennan ML, Mair TS, Furness WA, Freeman SL, et al. Early indicators of critical outcomes in horses presenting with abdominal pain (colic): retrospective study of out-of-hours first-opinion emergency cases from two practices over a 3-year period (2011-2013). Equine Vet J. 2017;49(S51):13.
Cohen ND, Matejka PL, Honnas CM, Hooper RN. Case-control study of the association between various management factors and development of colic in horses. J Am Vet Med Assoc. 1995;206(5):667-673.