Trends in the Management of Horses Referred for Colic Evaluation Preceding and During the COVID-19 Pandemic (2013-2023)

Background: The COVID-19 pandemic represented a significant source of anxiety and stress for equine veterinarians and clients, with the potential for measurable effects on caseload and owner economics. Objective: To compare the number of horses presenting for emergency colic evaluation and treatment, as well as costs at two equine referral hospitals. Study design: Retrospective cohort. Methods: Medical records of horses admitted to North Carolina State University (NCSU) and Bell Equine Veterinary Clinic (BEVC) were compared. Total equine accessions, number of horses referred for colic and patient age were recorded over an 11-year period (2013-2023). Horses were categorised based on treatment as medical, surgical treatment with recovery, surgical exploration with intraoperative euthanasia, or euthanasia without surgery. Total invoice of each case was also recorded. Results: Total equine accessions, total number and proportion of horses presenting for evaluation of colic, and number of horses recovering from colic surgery at NCSU increased following onset of the pandemic, while they remained similar to pre-pandemic levels at BEVC. The proportion of horses presenting for colic that received surgery decreased at both hospitals over the study period. Mean invoice totals for horses surviving colic surgery increased at both hospitals over the study period, but was not significantly associated with euthanasia. Age was not significantly different between categories of colic. Main limitations: Retrospective study design, differences in academic and private practices. Conclusions: The decreasing proportion of horses admitted for colic that received surgery is likely due to the increased caseload of first-opinion care at referral practices during the pandemic, as fewer options were available to owners. The increasing number of horses euthanised intraoperatively or euthanised without receiving surgery may be due to the dramatically rising costs of medical care, particularly surgery.