Why is torsion in horses still as deadly now as it was back in the 1930s despite advancements in veterinary medicine?

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Got curious about torsion in horses while reading All Creatures Great and Small by James Herriot. The book takes place in the 1930s, but when I did a quick search it seems it is as deadly now.

ETA: By veterinary medicine I mean all treatments, including surgery, not just drugs.

In: 448

Despite all medical advancements in general, some diseases/conditions didn’t have any advancements at all.

There are multiple examples, veterinary or not, were the condition is now better understood, but there is still no cure and therefore the chances and outcome essentially didn’t change.

Equine anatomy hasn’t changed in 90 years, and torsion is a mechanical problem rather than one that can be more easily resolved via new sorts of meds.

It’s sorta how getting shot in the gut is still pretty much just as deadly now as it was in world war 2. It’s not an illness or disease you can just vaccinate for — it’s a mechanical emergency situation for which if you don’t get surgery right away you’re pretty much doneskies.

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Recent veterinarian graduate here, so I (hopefully) was taught the most recent information on this kind of stuff. As other have already pointed out, the horse hasn’t changed it’s anatomy, and torsion isn’t something that can be medically managed or prevented with pills. Torsion is the physical twisting of guts, something that has to be surgically corrected. And horses anatomy is so stupid; the word “colic” is thrown around a lot because it literally is just what you call abdominal pain. Do you know how many things cause abdominal pain in a horse?? And their only outward symptoms is colic?? So you could have a physical problem like torsion, or dietary indiscretion, or endocrine problems, or a foreign body or kidney/liver/non-GI issues, and they ALL present as “colic”. So torsion is still deadly because it takes time to figure out exactly what is causing this pain in the horse, and depending on the problem, different treatments are required. However I’m sure the survival rate for corrective surgery for torsion is better than it used to be!

Dogs can also have torsion, and it’s particularly common in some breeds. I have lost two standard poodles to bloat, despite immediate medical care. One dog bloated twice; the first time, the vet was able to de-torse her, but the second, the torsion had already caused her stomach to begin dying. The other dog could only have been potentially saved with a specialized surgery that our emergency vet did not know how to perform, and we wouldn’t have had time to get her to another surgeon before her stomach died.

Bloat is horrible and strikes frighteningly fast. My second dog went from fine at 9pm to gone at 11pm. I was home and around her all evening, and the instant she started biting at her sides, I knew exactly what it was and rushed her immediately to the vet. Same story with the first dog, and it didn’t matter, because tissue death can happen so quickly with a severe torsion.

Prophylactic gastropexy (tacking the stomach to the abdominal walls) does exist, but was a big-deal open surgery several years ago. I’ve read it’s beginning to be performed laparoscopically now… but it’s still major surgery, with major recovery and complication potential. It’s also expensive and specialized.

It isn’t as deadly as it was. If we can get the horse into surgery promptly their chance of survival is significantly higher than it was in the 1930s.

Torsion is still a very serious emergency that progresses very quickly and a horse will die unless it is surgically corrected. As a result, they are often very sick by the time they get to us.

Lost a mare to this recently. It happened so quickly. She was fine the night before but in the morning she had bolted through a fence and ran into the barn. I watched her on camera from work lie down, seize violently and die while my poor teen son tried to help her. The necropsy showed a twisted and perforated bowel. She was 2 weeks post-partum and this is a common complication.

Her baby got a nurse mare the next day and is doing great. It was so awful though.

If you can get help fast enough, it’s treatable. But often the condition just strikes so quickly. I’ve known horse owners who left the barn one day when the horse was fine, and came back the next day to find the horse dead or too far gone for treatment. There might be a critical 8-10 hour window overnight when no one is in the barn checking on the horses. Also that kind of medical care is extremely expensive. While most horse owners love their animals dearly, they may not all have the thousands of dollars on hand for emergency treatment.

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