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* What is the vaccination, deworming and dental prophylaxis of this and other animals at the yard?
* What is the vaccination, deworming and dental prophylaxis of this and other animals at the yard?
* Are any other horses on the yard showing similar signs?
* Are any other horses on the yard showing similar signs?
* Does the horse live outdoors or stabled?
* Does the horse live in an environment with much sand?
===Cardiovascular Parameters===
=====Recent History=====
* Is there evidence of abdominal pain?
* Is there evidence of weight loss?
* When did the horse last defecate?
* What is the degree of pain (flank watching,pawing,rolling, kicking at abdomen) and has it changed?
* Has the horse received any treatment and how has it responded?
===General Physical Examination===
A physical examination including the following parameters should be carried out immediately and thoroughly.
* Attitude and External appearance
* Abdominal contour (distention-unilateral vs. bilateral?
* Body Temperature
* Heart Rate and pulse character
* Respiratory Rate and effort
* Skin Turgor, Mucous membrane color and moisture, Capillary refil time (CRT)
* Presence of digital pulses
* Abdominal Auscultation
=====Attitude and External Appearance=====
It is important to assess the degree of pain. It is best do keep the patient in a quiet environment to fully assess them. If the owner or trainer of the horse has administered any treatments then the patients status may not be a true reflection of the clinical condition. If the horse is in severe, unrelenting pain and it is difficult to assess it safely, it is advisable to administer some analgesics prior to the examination.
=====Cardiovascular Parameters=====
Heart rate rises with progression of colic, in part due to pain, but mainly due to decreased circulating volume, decreased [[preload]], and [[endotoxemia]]. The rate should be measured over time, and its response to analgesic therapy ascertained. A pulse that continues to rise in the face of adequate analgesia is considered a surgical indication.
Heart rate rises with progression of colic, in part due to pain, but mainly due to decreased circulating volume, decreased [[preload]], and [[endotoxemia]]. The rate should be measured over time, and its response to analgesic therapy ascertained. A pulse that continues to rise in the face of adequate analgesia is considered a surgical indication.
[[Mucous membrane]] colour can be assessed to appreciate the severity of haemodynamic compromise. Reddening of membranes reflects worse prognosis, and [[cyanotic]] membranes indicate a very poor chance of a positive outcome.
[[Mucous membrane]] colour can be assessed to appreciate the severity of haemodynamic compromise. Reddening of membranes reflects worse prognosis, and [[cyanotic]] membranes indicate a very poor chance of a positive outcome.
Laboratory tests can be performed to assess the cardiovascular status of the patient. [[Packed Cell Volume]] (PCV) is a measure of hydration status, with a value 45% being considered significant. Increasing values over repeated examination are also considered significant. The total protein (TP) of blood may also be measured, as an aid in estimating the amount of protein loss into the intestine. Its value must be interpreted along with the PCV, to take into account the hydration status. Blood lactate levels are useful in determining severity of disease, and as a prognostic indicator; levels between 1-2mmol/L are considered normal, while levels above 5.7mmol/L are considered significant. "Colic scores" that combine several parameters can be relatively accurate prognostic indicators, although most laboratory tests have limited use in terms of specific diagnosis.
Laboratory tests can be performed to assess the cardiovascular status of the patient. [[Packed Cell Volume]] (PCV) is a measure of hydration status, with a value 45% being considered significant. Increasing values over repeated examination are also considered significant. The total protein (TP) of blood may also be measured, as an aid in estimating the amount of protein loss into the intestine. Its value must be interpreted along with the PCV, to take into account the hydration status. Blood lactate levels are useful in determining severity of disease, and as a prognostic indicator; levels between 1-2mmol/L are considered normal, while levels above 5.7mmol/L are considered significant. "Colic scores" that combine several parameters can be relatively accurate prognostic indicators, although most laboratory tests have limited use in terms of specific diagnosis.
=====Abdominal Distension=====
Any degree of abdominal distension is usually indicative of a condition affecting the large intestines, as distension of structures upstream of here would not be large enough to be visible externally.
===Rectal Examination===
===Rectal Examination===
The extraction of fluid from the peritoneum can be useful in assessing the state of the intestines. A [[sanguinous]] fluid can be caused by an [[infarction]], which indicates surgery is necessary. However, sanguinous fluid can also be caused by external trauma (e.g. rib fractures), middle uterine artery rupture in post-foaling mares, or by inadvertent bleeding caused by the procedure itself. A cloudy fluid is suggestive of an increased number of white blood cells, which indicates the disease is relatively advanced. The protein level of abdominal fluid can be analysed, and may also give information as to the integrity of intestinal blood vessels. Elevated lactate levels in the sample can also give an indication of the degree of compromise to bowel, particularly as a peritoneal:peripheral lactate ratio. Peritoneal fluid that contains food material can indicate rupture of the gastro-intestinal tract, although care should be taken that intestine has not been punctured inadvertently.
The extraction of fluid from the peritoneum can be useful in assessing the state of the intestines. A [[sanguinous]] fluid can be caused by an [[infarction]], which indicates surgery is necessary. However, sanguinous fluid can also be caused by external trauma (e.g. rib fractures), middle uterine artery rupture in post-foaling mares, or by inadvertent bleeding caused by the procedure itself. A cloudy fluid is suggestive of an increased number of white blood cells, which indicates the disease is relatively advanced. The protein level of abdominal fluid can be analysed, and may also give information as to the integrity of intestinal blood vessels. Elevated lactate levels in the sample can also give an indication of the degree of compromise to bowel, particularly as a peritoneal:peripheral lactate ratio. Peritoneal fluid that contains food material can indicate rupture of the gastro-intestinal tract, although care should be taken that intestine has not been punctured inadvertently.
A normal peritoneal fluid sample does not rule out a strangulating lesion. For example, in the case of a diaphragmatic hernia, the strangulating gut is contained within the thoracic cavity, so will not affect fluid within the abdominal cavity. A similar situation is true of intussuception, where the strangulating gut is contained with another piece of non-strangulating gut.
A normal peritoneal fluid sample does not rule out a strangulating lesion. For example, in the case of a diaphragmatic hernia, the strangulating gut is contained within the thoracic cavity, so will not affect fluid within the abdominal cavity. A similar situation is true of intussuception, where the strangulating gut is contained with another piece of non-strangulating gut.
===Auscultation===
===Auscultation===