Cost of referral treatment for colic in the United Kingdom—What has changed in the last 5 years?
Cost of referral treatment for colic in the United Kingdom—What has changed in the last 5 years?

our summary:
Wilson, F.E., Mair, T.S., and Freeman, S.L. (2025) Cost of referral treatment for colic in the United Kingdom—What has changed in the last 5 years? Equine Veterinary Journal
The aims of this cross-sectional study were to evaluate any changes in the cost of referral treatment for colic, the cost of insurance cover and the readability of insurance documents between 2018 and 2023.
Thirty equine referral hospitals in the United Kingdom were contacted in January 2024 and asked about their colic caseload, including if there had been any changes in caseload and selection of treatment options over the last five years, and the costs of their last three cases across six categories (surgical with or without resection, euthanasia before, during or after surgery, and medical treatment) via an online survey. Using a similar methodology to a previous study a standardised case example was used to request data on insurance cover, monthly premiums, and veterinary fees from five insurance companies. This data was then compared with actual, and inflation adjusted information from the 2018 study. The readability of the insurance documents was assessed using validated readability assessment tools.
Eighteen hospitals responded to the survey submitting data on a total of 248 cases. The number of colic surgeries performed annually was a mean of 41 (range 10-100), when compared to the previous five years the mean has had stayed the same for seven hospitals, gone down for six hospitals, and gone up for 4 hospitals. When compared to 2018 data the mean/median costs for all treatment options had increased for all categories except for cases that were euthanised during or after surgery.
The maximum insurance cover provided by the insurance companies was between £5,000 and £7,500; the actual cover value had not changed since 2018 for 3/5 insurance companies and had reduced for 4/5 companies when adjusted for inflation. Monthly premiums that would be paid by an owner for the example case had increased for all five insurance companies compared with inflation-adjusted data from 2018, premiums for two companies were more than double the inflation-adjusted 2018 figures.
No terms and conditions documentation met the recommended reading ease score for businesses, and all were above the recommended score for years of education needed to understand the text.
Limitations of the study include the small number of cases and that only equine hospitals in the UK were included.
This study provides some evidence of the costs of referral treatment for colic and highlights that costs now frequently exceed maximum insurance cover. Insurance documentation remained hard to read which means that owners may find it difficult to understand the available cover. This data will be useful to veterinary surgeons when advising owners on the average costs for specific categories of colic.
Reference for previous study
Barker, I. and Freeman, S.L. (2019) Assessment of costs and insurance policies for referral treatment of equine colic. Veterinary Record, 185 (16) p. 508. https://doi.org/10.1136/vr.105415
The following may also be of interest:
inFOCUS: Use of human behaviour change models to investigate horse owner intention to adopt emergency colic recommendations. [RCVS Knowledge] [Online] Available from: https://infocus.rcvsknowledge.org/use-of-human-behaviour-change-models-to-investigate-horse-owner-intention-to-adopt-emergency-colic-recommendations/ [Accessed 17 October 2025]
inFOCUS: Horse owners’ knowledge, and opinions on recognising colic in the horse. [RCVS Knowledge] [Online] Available from: https://infocus.rcvsknowledge.org/horse-owners-knowledge-and-opinions-on-recognising-colic-in-the-horse/ [Accessed 17 October 2025]
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