Get access to all handy features included in the IVIS website
- Get unlimited access to books, proceedings and journals.
- Get access to a global catalogue of meetings, on-site and online courses, webinars and educational videos.
- Bookmark your favorite articles in My Library for future reading.
- Save future meetings and courses in My Calendar and My e-Learning.
- Ask authors questions and read what others have to say.
Equine Colic: Making the Decision for Referral and What Happens at the Referral Facility
N.A. White
Get access to all handy features included in the IVIS website
- Get unlimited access to books, proceedings and journals.
- Get access to a global catalogue of meetings, on-site and online courses, webinars and educational videos.
- Bookmark your favorite articles in My Library for future reading.
- Save future meetings and courses in My Calendar and My e-Learning.
- Ask authors questions and read what others have to say.
Read
Take Home Message
Signs of pain and response to treatment are the most useful indicators in making a decision about the need for referral for possible surgery and/or intensive care. When in doubt, early transport to a facility that can monitor signs and complete surgery immediately increases the chance of survival. Communications and transfer of information during the referral process is necessary for the best possible outcome.
Determining the need for referral or surgery for a horse with colic is usually made on an emergency basis. The decision is best based on a diagnosis, however, a specific diagnosis is not always possible and use of clinical signs is often necessary to make the decision. The specific signs most helpful in indicating surgery are presented in Table 1.1
There are no strict guidelines that decide the need for surgery or intensive care, as there are varying degrees of severity and a range of clinical signs for each disease. Therefore each case should be judged on its own merits based on the history and a thorough examination. In certain cases a rapid decision can be made if a diagnosis is made from the clinical signs. The history and presentation may indicate immediate surgical intervention without processing all the information from a complete colic examination. Pain by itself, especially if severe and persistent or recurrent is an indication for surgery.2 This is particularly true if there is no response to analgesic administration. For example, a broodmare presented 5 days after foaling with an acute history of severe abdominal pain, severe large colon distension, and clinical signs of endotoxemia indicative of a large colon volvulus is in need of immediate referral for surgery based on the presumptive diagnosis.
With the advent of potent analgesics flunixin meglumine and detomidine, veterinarians have used the response to treatment to effectively determine which horses need surgery. This is logical and if used with other physical signs, monitoring pain after treatment is highly successful in determining which horses will need surgery prior to other indicators. The timing of the response still needs refinement, but most veterinarians have determined the response time for the analgesics they use in their practice for most cases of colic. Horses that have constant pain particularly after an analgesic has been administered are significantly more likely to need surgery. Horses that have return of pain or those requiring a second administration or multiple administrations of an analgesic are also significantly more likely to need surgery (Table 2).3 The key is adjusting one’s tolerance for any recurrence of pain, as horses may show pain after administration of an analgesic, but the signs of colic may be markedly decreased. Though decreased, any recurrence of pain should be considered a failure of resolution of the problem and therefore an indicator of increased odds that the condition will not respond to basic medical therapy, and referral for further evaluation or surgery is necessary.
[...]
Get access to all handy features included in the IVIS website
- Get unlimited access to books, proceedings and journals.
- Get access to a global catalogue of meetings, on-site and online courses, webinars and educational videos.
- Bookmark your favorite articles in My Library for future reading.
- Save future meetings and courses in My Calendar and My e-Learning.
- Ask authors questions and read what others have to say.
Comments (0)
Ask the author
0 comments