Equine Colic (AAEP Convention 2004)

As one might expect in a gathering of equine veterinarians discussing colic, much of the Sunrise Session dedicated to the topic covered evaluation of the colicky horse to determine severity and decide on medical vs. surgical management.
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As one might expect in a gathering of equine veterinarians discussing colic, much of the Sunrise Session dedicated to the topic covered evaluation of the colicky horse to determine severity and decide on medical vs. surgical management. Moderators Dana Zimmel, DVM, Dipl. ACVIM, Dipl. ABVP, assistant professor of equine extension at the University of Florida's Department of large animal clinical sciences; and Liz Santschi, DVM, Dipl. ACVS, clinical associate professor and chief of large animal surgery at the University of Wisconsin-Madison, discussed their take on several hypothetical colic situations.

When evaluating a colicky horse, Zimmel said she starts with the horse's vital signs and interprets them. "Go back to the basic mechanisms of pain in the horse, and interpret them in context of the horse's age," she said. "I teach that if the horse's heart rate (which rises with pain) is more than 60 beats per minute, my actions will be different than if it is lower than that. I'll reflux the horse (pass a nasogastric tube to attempt to relieve pressure in the stomach) quick because I'm worried about a distended stomach. If the horse's heart rate is over 100 beats per minute, the horse has a decreased chance of survival.

"After getting significant reflux from the horse (say, 10-15 liters), I take his heart rate again," she said. "If it doesn't decrease, that implies that the horse may have a more serious problem such as ischemic bowel. A rectal exam and an abdominal tap are indicated to obtain the diagnosis. One attendee asked if they would refer the horse to a hospital if there was a lot of reflux, because of a likely obstruction. "There's no one thing to do," said Santschi. "Different practitioners have different skills and situations like distance to the referral hospital. It also depends on the character of the reflux. If it's grass, OK, but if it's yellow, bloody stuff, I'll investigate. If I get more than four liters of reflux and a distended small intestine, I'll prepare for surgery."

Another attendee asked if heart rate was a less accurate indicator of pain in heavy horses, citing a case where a draft's heart rate was only about 24, but he wanted to roll for two days. Then when they opened him up, his colon was black (dead). "You can't get hung up on just one thing," Santschi said. "If the heart rate is low but the horse is flipping around like a flounder out of water, he goes to surgery. Also, I've seen many horses with a volvulus of the large colon (twisted obstruction) with a low heart rate, especially if the pain is recurrent

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Written by:

Christy West has a BS in Equine Science from the University of Kentucky, and an MS in Agricultural Journalism from the University of Wisconsin-Madison.

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