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A thorough and detailed examination of a horse with suspected gastrointestinal tract disorders is extremely important. After collection of a history from the owner,a logical process including the examination of other body systems as well as the gastrointestinal tract should be followed. The examination usually starts at the head and proceeds caudally. Many different diagnostic tests can be used to diagnose the cause of equine colic, which may have greater or lesser value in certain situations. The most important distinction to make is whether the condition should be managed medically or surgically. If surgery is indicated, then it must be performed with utmost haste, as delay is a dire prognostic indicator.
A thorough and detailed examination of a horse with suspected gastrointestinal tract disorders is extremely important. After taking a history from the owner,a logical process including the examination of other body systems as well as the gastrointestinal tract should be followed. The examination usually starts at the head and proceeds caudally. Many different diagnostic tests can be used to diagnose the cause of equine colic, which may have greater or lesser value in certain situations. The most important distinction to make is whether the condition should be managed medically or surgically. If surgery is indicated, then it must be performed with utmost haste, as delay is a dire prognostic indicator.
===History===
===History===
A physical examination including the following parameters should be carried out immediately and thoroughly.
A physical examination including the following parameters should be carried out immediately and thoroughly.
* Attitude and External appearance
* Attitude and External appearance
* Abdominal contour (distention-unilateral vs. bilateral?
* Abdominal contour (distention-unilateral vs. bilateral)
* Body Temperature
* Body Temperature
* Heart Rate and pulse character
* Heart Rate and Pulse character, Respiratory rate and effort
* Skin Turgor, Mucous membrane color and moisture, Capillary refil time (CRT)
* Skin Turgor, Mucous membrane color and moisture, Capillary refil time (CRT)
* Presence of digital pulses
* Presence of digital pulses
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.
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.
A horse with severe pain that is unresponsive to analgesics warrants going to surgery as soon as possible if it is a case of a strangulating obstruction. Multiple abrasions around the head and periorbital area indicate that the horse is experiencing severe pain. The duration of clinical signs is important to note as once the strangulated portion of intestine degenerates to a certain point, the pain will subside but the horse becomes increasingly depressed.
Non-infarctive conditions such as impactions and some ileal intussusceptions are demonstrated as intermittently, moderately painful cases.
A depressed horse that is pyrexic and displaying signs of moderate abdominal pain may indicate an inflammatory condition such as an enteritis, colitis of peritonitis.
The examination should also include the mouth for the presence of malocclusion, dental abnormalities, damage to the lips and gums, nasal discharge and excessive salivation. The abdominal contour should be examined for any swellings or recent enlargements which could indicate edema or umbilical, abdominal or scrotal herniations.
=====Abdominal Distension=====
Any degree of abdominal distension is usually indicative of a condition affecting the large intestines, as distension of the stomach and small intestine would not be large enough to be visible externally.
=====Body Temperature=====
Pyrexia may indicate an inflammatory or infectious condition and should be interpreted with other diagnostic tests such as fecal samples, hematology, biochemistry and blood cultures.
=====Cardiovascular Parameters=====
=====Cardiovascular Parameters=====
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.
===Rectal Examination===
===Rectal Examination===