The Horse

OCT 2018

The Horse:Your Guide To Equine Health Care provides monthly equine health care information to horse owners, breeders, veterinarians, barn/farm managers, trainer/riding instructors, and others involved in the hands-on care of the horse.

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18 October 2018 The Horse | poor appetite, abnormally high heart rate (more than 50 beats per minute), loud gut sounds or lack of normal gut noises, anxi- ety, dark mucous membranes, depression, unwillingness to move, and more. You should call your veterinarian to evaluate the horse immediately and do as he or she instructs you to until help arrives. Always have a truck and trailer at the ready, should an emergency happen, and know which referral center your veteri- narian sends patients to and where it is located. Time Is of the Essence Anthony Blikslager, DVM, PhD, Dipl. ACVS, professor of equine surgery and gastroenterology at North Carolina State University's (NCSU) College of Veterinary Medicine, in Raleigh, says that when dealing with colic, the first step is mak- ing a triage decision. "For colic, the only thing you care about is whether the horse needs to be referred for further evalua- tion," he says. "You don't have to know why the horse is colicking. You just need to know it's concerning enough that you want to get it to the next level." Williams says accurate diagnosis of the lesion (defined as any abnormal change in tissue) type and prompt treatment and referral are the most important steps. A horse with a suspected strangulating obstruction, for instance, needs immedi- ate referral and assessment at a hospital, especially if it involves the colon, such as a large colon volvulus. "These can have significant cardiovascular collapse and respiratory difficulty due to pressure on the diaphragm, so immediate surgery is necessary, as they can die within a short period of time—hours," he says. David Freeman, MVB, PhD, Dipl. ACVS, chief of large animal surgery at the University of Florida's College of Veterinary Medicine, in Gainesville, says delaying referral to the hospital to give intravenous fluids on the farm can sometimes make things worse. "This is done in the belief that the horse is dehy- drated and will be in a better state when presented at the surgical facility," he says, when, in fact, he needs to get to the clinic right away. If a horse is not responding to pain- killing medications, it's urgent you get him to a referral hospital, says Freeman. Any delay can turn what would be a minor surgery into a major one with an increased risk for postoperative complica- tions and death, he adds. At the Referral Hospital Often, it's not realistic for veterinary surgeons to evaluate the horse as quickly as they would like due to the distance many horses live from a referral hospital. Williams often sees horses four to six hours after owners noticed the first signs of colic. Once the horse reaches the refer- ral hospital, a veterinarian there will perform a workup, which usually takes 40-60 minutes, says Blikslager. He or she then shares the findings with the owner, suggests either medical management or exploratory surgery, and provides horse's prognosis. To determine prognosis, Williams says the attending veterinarian uses a variety of parameters to gauge severity, such as packed cell volume and systemic lactate (increases in blood lactate indicate cells aren't getting enough oxygen). He or she might also monitor systemic glucose (also assessed on blood samples), abdominal lactate (from peritoneal fluid from an abdominal tap), heart rate, and whether the horse is in shock. "These factors are often more impor- tant for predicting outcome than the amount of time since the colic began," he says. Factors that affect an owner's decision to send a horse to surgery include: ■ Lesion type; ■ Prognosis; ■ The horse's health history and whether he has any other conditions, especially those that could affect his ability to survive surgery and heal normally, such as pituitary pars intermedia dysfunc- tion, equine asthma, or an underlying inflammatory condition; ■ Whether the horse has colicked before; ■ Whether the horse will be able to rise after surgery (doesn't have osteoar- thritis or other conditions that could impact his ability to get up); ■ The owner's emotional attachment to the horse; ■ Cost of care; ■ Risk that comes with anesthesia; ■ Time required for recuperation; ■ Age of the horse; and more. Part of the decision-making process COLIC SURGERY: MAKING HARD DECISIONS Upon a horse's arrival at the referral hospital, veterinarians will perform a 40-60-minute workup to determine whether he can be managed medically or requires surgery. FRÉDÉRIC CHÉHU/WWW.ARND.NL

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