Equine · Gastrointestinal · Emergency medicine
Acute equine colic triage
Decide surgical versus medical early. Persistent pain despite analgesia, net gastric reflux, and a distended small intestine on rectal exam push toward referral.
A structured triage is heart rate, mucous membranes and CRT, gut sounds, nasogastric intubation, rectal palpation, abdominal ultrasound, and abdominocentesis. More than two liters of net reflux suggests small intestinal obstruction or proximal enteritis and mandates decompression. Rectal findings of multiple distended loops of small intestine, a tight cecal band, or displaced colon are high value. Peritoneal fluid lactate exceeding blood lactate suggests devitalized bowel. Flunixin controls endotoxin-driven pain but can mask deterioration, so reassess after analgesia rather than before. Refer early: transport time, not the decision itself, is often what determines outcome.