The Horse

OCT 2018

The Horse:Your Guide To Equine Health Care provides monthly equine health care information to horse owners, breeders, veterinarians, barn/farm managers, trainer/riding instructors, and others involved in the hands-on care of the horse.

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20 October 2018 The Horse | might involve the horse's value and whether he can return to his intended use. If his prognosis to return to function is poor, his worth will likely plummet once he goes through a surgery, says Blikslager. And while most colic surgery patients do return to their intended pur- pose, the recovery period is a long one. Freeman says many healthy senior horses do well, even after major colic surgery, despite the myth that old horses can't handle anesthesia and surgery. However, if the horse has other condi- tions that could affect his quality of life, the owner might realistically consider euthanasia. Health considerations aside, it all boils down to one of the biggest factors for electing to do surgery: finances. Affording the Procedure The general expenses involved in colic surgery at NCSU, says Blikslager, include: ■ $1,500 for the initial workup; ■ $1,000 for initial exploratory surgery; ■ $2,500 for a small intestine resection (surgical removal of the damaged part), although this cost varies by type of surgery; and ■ $3,000 or more for the aftercare, de- pending on complications. He says the costs to manage a horse medically are a lot less than surgery. At NCSU the average colic bill, between medical and surgical cases, is $4,200. On the high end it could be $8,000-$10,000. Fortunately, some horse owners have payment options besides their bank ac- counts. At NCSU, says Blikslager, owners can apply for a loan with CareCredit. If that isn't enough, the hospital has a pool of donated funds available for those who can't afford surgery yet meet the hospital's guidelines and whose horses have a reasonable prognosis for recovery. However, each referral hospital has differ- ent financial assistance options. These days, another way owners pay for a medical emergency is through crowdfunding. Search sites such as GoFundMe to find a multitude of cam- paigns underway to fund horses' surgical or medical care. As owners figure out finances, any delay before surgery can affect the horse's prognosis. This is why equine insurance can be such a blessing. Blikslager says if a horse is insured with basic medical cover- age, then the decision to say yes to a colic surgery is an easy one, because insur- ance covers it. To ensure this, NCSU staff members verify benefits with insurance company adjusters after owners have pro- vided all pertinent policy information. However, there are many nuances when it comes to equine insurance. Blikslager says if an owner buys mortality insurance but not major medical, and the horse de- velops a colic that can be treated, whether medically or surgically, the insurance company will mandate that the horse receive treatment and will not pay out if he is euthanized without it. "If the veterinarian says there is no rea- sonable treatment option, then of course euthanasia is best to stop the suffering, and mortality would then pay out," he says. Blikslager also cautions that surgical insurance only pays for the actual surgery and not for pre- and postoperative costs, which are where most of the expenses lie. "Unless you have a really, really valuable horse, the loss-of-use policy is really difficult to cash in on because you have to prove the horse can no longer (fulfill) his intended purpose," says Blik- slager. "That's going to be a long, drawn- out affair with the insurance company." Euthanasia Blikslager says he usually discusses euthanasia early on in case owners don't want to or can't continue medical treatment. "A lot of people feel really bad for their animals," he says. "And the horse might be in really bad shape, and they may not have much in the way of funding." Blikslager says the veterinarian must be the objective force and not react emo- tionally, so he or she can lead the client through the decision-making process. Freeman says the main priority is managing the horse in a humane way; he reminds the horse owner that the purpose of euthanasia is to relieve suffering. The veterinarian should also discuss with the owner the time ramifications of delaying the decision—euthanasia vs. surgery—and how it can both prolong pain and decrease the chances of a suc- cessful surgery. The Recovery Process After surgery, says Blikslager, it's easy to manage most complications (shock, endotoxemia, electrolyte imbalances, dehydration, reflux, etc.). COLIC SURGERY: MAKING HARD DECISIONS Hospital recovery and aftercare can be the most expensive part of a colic surgery case. COURTESY VIRGINIA TECH'S MARION DUPONT SCOTT EQUINE MEDICAL CENTER Around 15% of colic surgery patients develop incision site infections

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