STANDARDISATION OF CRITICAL DECISIONS AND COSTS TO REDUCE EUTHANASIA IN COLIC SURGERY. A SINGLE-CENTRE PROSPECTIVE STUDY IN ITALY

Background: Pre- or intra-operative euthanasia is oftenchosen forfinancial constraints or presumed poor prognosis.This can reduce the total number of horses potentially savedwith colic surgery, despite the actual condition of the horse.Objectives:To reduce pre- and intra-operative euthanasia ofcolic cases due tofinancial constraints and presumptive‘poor prognosis’.Methods:For cases admitted for colic surgery, a standardprotocol for critical decisions was used. To eliminate thefinancial factors, owners were offered a standard range ofprice for colic surgery, regardless of the eventual need forresection and anastomosis.Results:Price quotation for colic surgery was 4800-5800 eurosand was well accepted by owners and sustainable by thehospital. Two-hundred and eleven cases were admitted (66medical, 145 surgical). Consent to surgery was given in 132/145 horses. Euthanasia for decision of the surgeon were 2/132before surgery (viscera rupture), and 8/130 intraoperatively (5because of viscera rupture, 2 for excessive length of necroticsmall intestine, 1 for unresectable large colon). Two horsesdied during anaesthesia and 4 were euthanised in therecovery stall. This led to 115 horses that stood afteranaesthesia. Twelve horses were euthanised because of post-operative complications. Seventy-nine percent of operatedand 89.5% of recovered horses were discharged from thehospital.Conclusions:Standardisation of procedures and costs resultedsustainable, while reducing biases due to the surgeon choiceor owner decision, and with survival rates comparable toother studies. One of the main causes of death was theowner not giving consent to surgery