HOW to decide when to refer a colic case was the topic of Italian veterinary surgeon Camilla Quattrini at the 18th Irish Equine Veterinary Conference.

Factors such as age, breed, primary use of the patient, the duration, nature and severity of colic, what if any medicines had been already administered and if it is a pregnant mare, are among the key ones to condider.

Practitioners should ask themselves is referral an option and does the patient need surgery?

Key steps in the decision-making process are pain evaulation, e.g. mild, moderate, severe. The patient should be thoroughly examined and the degree of heart rate elevation was described as the most reliable indication of pain (over 80 severe, over 100 poor prognosis).

Quattrini urged delegates to assess temperature and analyse gut sounds. Silent guts could indicate an obstruction and the passing of a nasogastric large-bore tube should always be performed in colic cases. Four litres of net reflux indicate an obstruction and the horse needs to be referred for more investigatons at a clinic. Practitioners were advised to leave the tube in place during transport and tape it to the headcollar.

ACT FAST

Emptying the rectum manually with plenty of lubricant may allow distenson to be palpated (feels like bicycle tyres) and if so, refer the patient to a clinic.

Transabdominal ultrasound exams can help diagnose what’s going on and are another useful tool.

Abdominocentesis can be done in the field, Quattrini advised vets that they want to see a yellow transparent fluid. If it is cloudy, that is not good and the patient should be referred.

Medicines will not mask signs of a severe colic for long so if there is no improvement with drugs, that case should be referred on.

To get the best outcome for colicky horses, early referral is always preferable.