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Colic

By: Dr Philip Johnson

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Referral to a Hospital Facility

Emergency treatment of severe colic represents one of the most common reasons that horses are referred to veterinary hospital facilities. Referral may be made for various reasons, such as the need for surgery, the need for intensive care (IV fluids, etc), the need for continual observation (insufficient personnel available locally), a second opinion (primary veterinarian uncertain as to whether there is a need for surgery), and the request of the owner (some owners prefer that colic should be managed in the hospitalized environment).

Considerations

Proper communication with the receiving clinician at the hospital (ideally by both telephone and in written notes sent with the client) should be made by the local (primary) veterinarian. The horse owner should be provided with directions to the hospital. If fluid accumulation in the stomach is a problem, it might be appropriate to transport the patient with an in-dwelling nasogastric tube (to prevent rupture of the stomach).

The owner of the patient should be advised by the local veterinarian regarding the likely prognosis (if known) and costs of hospitalized treatment. Some horses that arrive at the hospital for emergency surgery after a 5-hour journey are euthanatized because the cost of surgery is high and the prognosis (for some conditions) is unfavorable.
It is preferable that this type of discussion is carried out before transport, since many owners want to take their horse home for burial. This gets much more complicated once a horse has been transported to a hospital.

It might be possible to provide IV fluids during the journey in some instances; certainly further injections of pain-relieving drugs may be needed during a long journey. The colicky horse should not be fed during the trip to the hospital. Any drugs given to the patient should be done after discussion with the clinician to whom the horse is being referred.

Necesary Information

Various diseases lead to an increased risk for mild colic. The veterinarian may address various preventive strategies or special diagnostic tests to individual horses that have been experiencing recurrent bouts of colic. If the patient has been examined and treated by different veterinarians, the precise colic history may not be apparent to the attending veterinarian. Therefore, good records of the horse's prior medical history should be maintained and made available to the veterinarian whenever possible. The medical and surgical treatment of some horses may be covered by insurance policies. In those cases, the insurance company should be notified of the horse's status as soon as possible. The insurance company may require information regarding the horse's current problem, treatment, and prognosis.

When The Owner is Absent

Sometimes, the veterinarian is called to examine and treat a horse affected with "colic" (or anything else for that matter) by someone who is NOT THE OWNER! When faced with a colic emergency, someone must take responsibility for permission to treat the horse and for meeting the veterinarian's fee.

Some horse owners leave their horses under someone else's care (for example, to go on a business or vacation trip) but fail or forget to make arrangements for the horse in the event of a medical or surgical emergency. It is recommended that whoever is in charge of the horse should have already obtained clear instructions from the owner as to how to proceed in the event of a medical or surgical emergency. In the case of "colic," specific information should include:

  • Which local veterinarian should be called?

  • The insurance company contact person?

  • Who will be accepting responsibility for treatment administered by the veterinarian until the owner returns?

  • If the colic is severe and the horse will need surgery, who will be giving permission for surgery?

  • Who will be accepting responsibility for the costs of surgery in lieu of the owner?

  • If the colic is severe and the prognosis (even with surgery) for survival is unfavorable or guarded, who will be responsible for providing permission for euthanasia?

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