19. Photos courtesy of –Ben Espsy, DVM, DACT –Diana Zimmel, DVM, DACVIM, DABVP www.aaep.org/horseowner

20. Surgery? Most cases of colic resolve with medical treatment Surgical cases minority of total colics

21. Surgery? Most common cause of equine mortality –These are the ones that don’t resolve Treat every case as it is surgical

22. Indications for Surgery Pain –Recurrent or intractable –The longer it persists, the less severe required to indicate surgery Gastric reflux (large amount) –Not necessarily

23. Indications for Surgery Rectal exam –Small intestinal distention –Displacement or distended large colon –Mass Ultrasound –Thickened bowel wall –Gas in bowel wall

24. Indications for Surgery Absence of borborygmi –Ileus Peritoneal fluid –Increased protein –Serosanguinous

25. Normal Mucosa

26. Strangulation Obstruction Endotoxin

27. Verminous Arteritis

28. Contraindications for Surgery Fever –Most often means enteritis CBC –Neutropenia: enteritis Auscultation –Good motility

29. Preoperative Prognostic Indicators Cardiovascular status (shock) –Indicates severity of problem –Reversible? Small intestinal distention –Usually strangulated –Small intestine has more postoperative complications –Peritoneal fluid elevations

30. Thank You Ben Buchanan, DVM, DACVIM, DACVECC –Brazos Valley Equine Hospital –bbuchanan@bveh.com –936-825-2197