Stabilizing the Surgical Colic Patient for Referral

CHAPTER 84 Stabilizing the Horse with Surgical Colic for Referral

An acute, severe gastrointestinal crisis, or “colic,” is arguably the most common potentially life-threatening condition encountered by equine practitioners. It is also invariably accompanied by a considerable degree of anxiety and emotional distress on the part of the owner and other individuals tending to the horse. For these reasons, it is imperative that the attending veterinarian be able to think and act clearly, expediently, competently, and with compassion during the diagnosis and emergency management of such cases. To that end, it is incumbent on the practitioner to have a well-organized, logical, and thorough therapeutic approach tailored to each horse’s clinical status and any existing logistic challenges before referral to a surgical facility.


It is beyond the scope of this chapter to address in detail the various types of surgical lesions affecting the gastrointestinal tract in horses, the diagnostic techniques used in the workup of these cases, or implications of various findings. However, in light of the importance of prompt identification of the horse that will require surgery for resolution of surgical colic, a short discussion of diagnostic findings that are strongly suggestive of or highly consistent with surgical lesions is warranted.

Other Findings

When time and equipment are available to pursue additional diagnostic testing, abnormal findings that are suggestive of or more compatible with a surgical condition include distended nonmotile small intestine visible during transabdominal sonography; sonographic evidence of mural thickening of the small intestine corresponding to vascular congestion; and serosanguineous peritoneal fluid, although not highly sensitive or specific, clearly suggests that bowel is inflamed or congested and possibly compromised and constitutes further impetus to consider referral without hesitation. In my opinion, a peritoneal fluid sample is rarely required in the field to determine whether a horse should be referred to a surgical facility. Abdominocentesis is most important for ruling out or confirming rupture of the gastrointestinal tract or when further evidence is necessary to convince a reluctant owner that the horse should be referred without hesitation if this is an option they are willing to pursue.

The preceding list is not intended to be entirely inclusive or exclusive. Gray areas almost always exist, particularly in horses with nonstrangulating obstructions such as impactions or simple displacements. In virtually all horses with a surgical lesion, some combination of these abnormalities is detected. The practitioner ultimately incorporates any or all of the diagnostic findings and, on the basis of experience and judgment, reaches a conclusion about the likelihood and severity of a surgical problem.

May 28, 2016 | Posted by in EQUINE MEDICINE | Comments Off on Stabilizing the Surgical Colic Patient for Referral

Full access? Get Clinical Tree

Get Clinical Tree app for offline access