As surgical patients, donkeys and mules have distinct differences from horses (Taylor and Matthews 2002). These differences stem primarily from specific physiologic and behavioral attributes (McLean and Wang 2013; McLean et al. 2019). That is not to say that mules and donkeys do not suffer many of the same diseases or injuries of the horse! Although the need for surgical treatment of colic in the mule seems rarer than it is in horses and surgical treatment of colic in the donkey appears to have poorer outcomes and more complications (Merridale-Punter et al. 2023) as compared to the horse, we still require more data to drive improvements in treatments and outcomes. With few exceptions mules and donkeys are afflicted with the same maladies as the horse. There are however some surgical conditions that are either more or less prevalent in the mule or donkey as compared to the horse. Two examples of surgical issues that mules all most never suffer from are, left laryngeal hemiplegia and cryptorchism. It is more difficult to prove this claim with scientific analysis due to lack of large population comparisons. As there are disease differences recognized within breeds of horses, there is a variation within breeds of donkeys and crosses of mules. As humans have certain diseases that are related to occupations, so does the equine. A study of mules removed from use as pack mules in the Germany military was most commonly due to, degenerative hock disease considered related to the job and terrain where the mules performed and was similar to the findings of the Halflinger horses doing similar work (Brunner et al., 2002). All factors being equal it is this authors experience that the “use” and “lifestyle” of a horse, donkey or mule will have a greater influence on disease patterns than specie differences. For successful treatment of donkeys and mules the veterinarian must appreciate; the medical, behavioral and use differences, within and between the breeds, as well as the vast similarities of the Equus genus.