Equine Colic Management and Long-Term Survival
Looking back over the past several decades, it is evident that advances in colic treatment, both medical and surgical, have improved case results to an impressive extent. Progress in diagnostic methods, anesthesia approaches, and surgical procedures, combined with information gained through clinical experiences and research, have all contributed to this headway.
Among the general equine population four to 10 out of every 100 horses experience a colic episode during their lifetime; of these, 1-2% require surgical treatment (2006 AAEP Proceedings). In 35 years of performing colic surgeries, David Freeman, MVB, PhD, Dipl. ACVS, professor of large animal surgery at the University of Florida’s College of Veterinary Medicine, has noticed some trends: For example. 33-50% of referred colic cases now go on to surgery while most of the rest are resolved with medical treatment. On the other hand, Eric Mueller, DVM, PhD, Dipl. ACVS, professor and director of equine programs at the University of Georgia’s College of Veterinary Medicine, reports that 25-30% of horses admitted to the university clinic for colic require surgery while the rest are treated with medical therapy. "In 5-10% of cases a horse is humanely euthanized because of a poor prognosis or economical considerations," he adds.
Freeman describes salient colic management approaches that promote long-term survival: "The most important factor in (promoting post-) colic survival is to minimize the time interval from the onset of colic to the horse being taken to surgery." This begins with the owner promptly recognizing a horse in crisis and immediately notifying a veterinarian, followed by the referring veterinarian obtaining good clinical information and making appropriate judgments during evaluation. In addition, Freeman says communication between the horse owner and veterinarian is critical to ensuring a sick horse’s timely referral and transport to a hospital. He urges owners to bring horses to clinics with surgical facilities for further assessment if colic persists despite conservative treatment, even if a decision hasn’t been made on whether to go to surgery.
The most important indicator of the need for further assessment and potentially surgery is recurring pain, which can be assessed rapidly using short-term analgesics such as xylazine. Veterinarians can diagnose the source of colic pain through clinical evaluation and rectal exam, diagnostic ultrasound and radiography (X ray), and abdominocentesis (belly
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