Signalment and history
•
The history can be very brief in order to speed up the examination process
• The history can be conducted after the initial exam for horses with active signs of colic.
• The most critical pieces of the history:
o
Treatments already administered
o
Any known reactions to medications
o
Duration of colic
o
Severity of colic
Examination of the horse with colic
•
Physical examination (TPR, peripheral pulse quality, mucous membrane color, capillary refill time, auscultation of the chest
and abdomen)
•
Assessment of dehydration
• Listen for the frequency and quality of gut sounds (Over 1-minute, gut sounds should be present in the upper and lower
quadrants of both sides of the abdomen). Specific gut sounds include:
o
Opening of the ileocecal orifice (sounds like emptying of a drain)
o
Sand in the ventral colon (sounds like sand within a paper bag as you slowly turn it over)
o
Short, sharp tinkling sounds such as those you experience with 'GI upset.'
• Rectal findings. Normal findings include:
o
Bladder
o
Reproductive tract
o
Ventral band of the cecum on the right
o
Aorta dorsally
o
Left kidney
o
Nephrosplenic ligament
o
Spleen
o
Pelvic flexure (or doughy colon on the lower left quadrant)
•
Nasogastric reflux (up to 2L is normal)
• Abdominocentesis (normal: TNCC < 10,000 cells/μl; TP < 2.5g/dl)
When to refer to a case(see table)
•
Refractory or unrelenting pain
•
Lack of response to therapy
o
Be thinking of referral the second time you go out to see a patient
o Evidence of endotoxemia (consistently elevated heart rate, congested gums, prolonged capillary refill time)
o
A finding inconsistent with a simple colic, such as excessive reflux (> 2-5L), a distended viscous, tight band, or extensive
impaction on rectal examination, a serosanguinous abdominocentesis
Causes of nasogastric reflux:
•
Pyloric obstruction
•
Small intestinal obstruction or strangulation
•
Nephrosplenic entrapment of the large colon
•
Occasionally with large colon volvulus
•
Anterior enteritis
Causes of tight bands:
•
Large colon displacement or volvulus
•
Grossly distended cecum
•
Mesentery under tension
•
Uterine torsion
Causes of abnormal abdominal taps:
•
Small intestinal compromise (strangulation or prolonged simple obstruction)
•
Enteritis
•
Large intestinal compromise (prolonged simple obstruction)
• Splenic tap
