Everything Horse UK Everything Horse Magazine, October 2018 issue 38 | Page 29

REDUCED FAECAL OUTPUT LYING DOWN PAWING AT THE GROUND STRET- CHING COLIC FLANK WATCHING SYMPTOMS GROANING ROLLING PACING BITING AT ABDOMEN BRUXISM (TEETH GRINDING) although you might think these are irrelevant they are actually very important and help to build an accurate picture as to what is going on and how best to treat your horse. Such questions may include the following: • Age of horse • How long has the horse been collicing for and what symptoms has it been displaying? • Has the horse passed any droppings? • Any previous episodes of colic? • Have there been changes to diet and/or management recently? • Has the horse been wormed, if so when? • Is the horse pregnant? • Has the horse had it’s teeth rasped, if so when? The colic examination involves building up a picture of a number of clinical parameters and symptoms, providing vets clues as to what type of colic is occurring. A full clinical examination will be carried out, assessing everything from respiratory rate to temperature as well as their general demeanour and condition, however the following observations are particularly useful:- • Mucus membranes (gums) and capillary refill time: By checking the colour, moistness and the speed of blood refilling when the gums are pressed, helps vets to assess the horse’s hydration status and blood perfusion. Normal gums are pink and moist with a refill time of less than two seconds. Concerning signs are alterations in the colour to brick red, paleness, muddy grey or purple and extended refill times. • Heart rate: A normal resting heart rate for a horse is approximately 32-40 beats per minute. Any elevations in heart rate can indicate both pain and/ or a compromised cardiovascular system. • Skin tent: By pinching a section of skin, often over the neck, and seeing how quickly it returns to normal can indicate the hydration status of the horse. • Gut sounds: As well as listening to the heart, your vet will also use their stethoscope to determine how active the abdominal contents are. We divide the left and right sides of the abdomen into upper and lower quadrants and group gut sounds into increased, normal, decreased or absent. Increased gut sounds tend to occur with spasmodic colic and reduced gut sounds with an impaction, complete absence of gut sounds is a concerning sign and can indicate a surgical colic. • Rectal examination: Abnormalities within the abdomen (for example an impaction or enlarged loops of bowel due to a twist) if within reach, can be identified by rectal examination. Such examinations do convey a small amount of risk for both horse and the vet. Resentment to the procedure by the horse can result in kicking out and hence injury to the attending vet. The risk to the horse is much smaller but there is potential for a rectal tear. However, the potential benefit of rectal examination is far greater than the small risk to your horse. In order to minimise the danger to both vet and horse we will sometimes use sedation as even the calmest, most gentle horse can become dangerous when it is painful. • Nasogastric tubing: By passing a long plastic tube via the nasal passage into the oesophagus and then into the stomach vets can both diagnose colic and also help correct it. Horses are unable to vomit, therefore if something stops the stomach contents emptying into the intestines (for example due to a blockage) fluid builds up within the limited capacity of the stomach and this is very painful and even runs the risk of rupture. If gastric reflux (stomach contents exiting the stomach via the tube) occurs it is often an indication that the colic could be surgical. Stomach tubing is also used to help administer fluids to a dehydrated horse or to help break down and move impactions. • Abdominocentesis: In certain cases we may perform abdominocentesis or a ‘belly tap’. This is performed by placing a needle into the abdomen to sample the fluid that surrounds the abdominal contents. By analysing the fluid it can give us an indication to the condition of the bowel. HOW IS COLIC TREATED? Depending on the clinical signs and the type of colic suspected, treatment generally involves the use of some or all of the following:- pain relief, anti-spasmodic drugs, nasogastric fluid supplementation, intravenous fluid supplementation and occasionally sedation. The response to this treatment can also be diagnostic and if colic signs reoccur despite pain relief, this may be an indication that the case needs referring to a hospital for possible surgery. The decision as to whether to take your horse to surgery is a very difficult one and is based on a variety of factors including the severity of the colic, the likelihood of success and cost. Unfortunately it is often a decision that needs to be made quickly and therefore it can be useful to have thought about this should such a situation arise. The vet however will always help you