Colic in Horses

In this CareCredit-sponsored episode of the Equine Express Podcast, Modern Equine Vet editor Marie Rosenthal speaks with Dr. Louise Southwood, large animal surgeon at the New Bolton Center (University of Pennsylvania School of Veterinary Medicine), about the colicky horse. Drawing on more than 30 years of experience, Dr. Southwood discusses how survival and long-term outcomes for surgical colic have improved through earlier referral and intervention, refined perioperative care, and a shift toward recovering more cases rather than euthanizing on the table.
The conversation covers practical decision-making for equine practitioners: distinguishing the majority of gas or simple medical colics from the smaller percentage that require surgery; key clinical indicators of strangulating lesions (persistent or severe pain unresponsive to analgesia, facial grimace, abrasions, dilated small intestine on rectal examination or ultrasound, serosanguinous peritoneal fluid); the critical 3–4 hour window for large colon volvulus; age-related considerations (including higher odds of strangulating lipoma in older horses); tailored postoperative protocols that balance support with cost control; refeeding strategies by lesion type; and transparent, empathetic communication with owners about prognosis, costs, and the legitimacy of humane euthanasia when surgery is not an option.
Listeners gain actionable insights on building the client–primary care veterinarian–referral hospital team that gets horses to surgery sooner, managing expectations around survival (often >80% long-term with early small-intestinal cases; more variable for delayed large-colon volvulus due to transport logistics), and supporting both the patient and the owner through one of the most stressful emergencies in equine practice.