Equine Health Update EHU Vol 19 Issue 3 | Page 25

EQUINE | Proceedings tency and mechanism of action. NSAIDs inhibit local in- flammation through peripheral action (cyclo-oxygenase inhibition), but vary considerably in their efficacy in re- lieving colic. Flunixin is by far the most effective NSAID for treating visceral pain in horses, and provides relief for 6 to 8 hours. Since this drug is also a potent inhibitor of endotoxin-induced cardiovascular derangements, it has a tendency of delaying the clinical signs of cardio- vascular impairment associated with stra ngulating ob- struction. It is therefore best reserved for cases where a definitive diagnosis or a decision to perform surgery has been made. References 1. Busoni V, De Busscher V, Lopez D, Verwilghen D, Cassart D. (2011) Evaluation of a protocol for fast localised abdominal sonogra- phy of horses (FLASH) admitted for colic. Vet J. 188(1):77-82. 2. Delesalle C, Dewulf J, Lefebvre RA, Schuurkes JAJ, Proot J, Lefere L and Deprez P. (2007) Determination of Lactate Concentrations in Blood Plasma and Peritoneal Fluid in Horses with Colic by an Accus- port Analyzer. Journal of Veterinary Internal Medicine 21 ( 2) 293–301 3. Freeman S and Issaoui L (2013) Code red for colic: Decision- making for acute abdominal pain in the horse. Equine Veterinary Education 25 (5) 245–246. 4. Klohnen A, Vachon AM and Fischer AT (1996) Use of diagnostic ultrasonography in horses with signs of abdominal pain. J. Am. Vet. Med Ass. 209, 1597-1601. 5. Pease AP, Scrivani VP, Herb HN, Cook VL (2004) Accuracy of increased large-intestine wall thickness during ultrasonography for diagnosing large-colon torsions in 42 horses. Vet Radiol Ultrasound. 45, 220-224. Medical Treatment Surgery of Euthanasia Mild to moderate pain: good response to mild analgesics Severe unrelenting pain; no or short-term response to analge- sics Pulse < 60 bpm; strong Pulse > 60 bpm; rising & weak Positive response to therapy;  PCV & TP, CRT<2s, pink MM, lac- Progressive cardiovascular collapse; PCV > 55, MM injected or cyanotic, despite fluid therapy tate < 1.9 mM/L No rectal evidence of distension or displacement Positive rectal findings of distension or displacement Continuous or revived intestinal motility; no or minimal reflux Progressive reduction in intestinal motility; continued gastric reflux No or resolving abdominal distension Increasing or severe abdominal distension Paracentesis negative: straw coloured fluid, TP < 25g/l, < 10,000 Paracentesis positive: serosanguinous fluid, increased TP > WBCs/µl, lactate < 1.9 mM/L 25g/l, > 10,000 WBCs/µl Ultrasonography: normal intestinal diameter, motility and Ultrasonography: intestinal distension, presence of abdominal thickness, absence of fluid fluid, absence of movement and thickening intestinal wall Table 1 – Summary of parameters used for surgical decision-making in colic. • Volume 19 no 3 • September 2017 • 25