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Created page with 'Once the veterinarian has carried out the examination, a decision as to whether the horse is a candidate for medical treatment or referral to a surgical facility for exploration,…'
Once the veterinarian has carried out the examination, a decision as to whether the horse is a candidate for medical treatment or referral to a surgical facility for exploration, has to be made. Some cases will be difficult to diagnose and pose a problem to the decision to refer the horse. It is better for the veterinarian to refer the horse if there is any doubt as any further delay can make the difference between a sucessful and fatal outcome. The decision is based on a number of parameters listed below.

===Parameters to Assist the Decision to Treat Medically or Surgically===
* Pain
* Cardiovascular status
* Response to analgesia
* Response to medical therapy
* Rectal examination findings
* Quantity of garstric reflux
* Abdominal Distension
* Intestinal motility
* Abdominocentesis results
* Ultrasonogaphic findings

These parameters will need to be reassessed over time to monitor for any change in the horse's condition and response to any therapy. A change in one or more of these parameters may be sufficient for referral to a surgical facility. The clinical signs as a result of pain and the response to analgesia are very important in assessing the need for surgery. Horse's with unrelenting pain that is not responsive to analgesia should be refered immediately. Rectal examinations are very useful in evaluating the colic patient as some surgical abnormalities of the gastrointestinal tract can be palpated.
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