VEH: Przypadek 26 - Kolka
Just Jack – a six year old Thoroughbred gelding
The above gelding presented at the Valley Equine Hospital as an emergency admission at 10:30pm on the 18th May 2013 for evaluation of colic of approximately 8 hours duration. The owners described him as previously medically sound but had changed him onto barley straw recently, which they were concerned had precipitated the colic episode.
On admission the horse was visibly distressed, arriving standing but shortly becoming recumbent in the trailer. Jack was unloaded and assisted to a stable where he continued to show severe colic signs, rolling, thrashing and refusing to stand. At this point it was deemed necessary to sedate him heavily to provide short acting analgesia and to provide a safe working environment where he could be fully assessed. Clinical examination revealed numerous superficial abrasions to both orbital regions, around the point of the poll, the right point of the withers and both tuber coxae, presumably inflicted whilst colicking prior to admission. He had a temperature of 37.6ºC, a pulse of 60 beats per minute, a respiratory rate of 24 breaths per minute with mild generalised muscle fasciculations and sweating. His mucous membranes were pale pink and moist and his capillary refill time was approximately 2 seconds. Auscultation of all four gastrointestinal quadrants revealed hypomotility dorsally and normal motility within the ventral quadrants. Peripheral blood sampling revealed a haematocrit of 45.3%, total protein of 68g/l and a lactate of 9mmol/l; no other haematological abnormalities were observed. A rectal examination revealed a gas distended viscus with a tight taenial band coursing from left to right within the caudal abdomen. Nasogastric intubation elicted no reflux.
At this juncture it was decided to initially treat the horse medically and monitor intensively, with the intention of taking him to surgery immediately should his condition further deteriorate. Jack was given a bolus of 20 litres of spiked Hartmanns intravenously over 6 hours followed by twice maintenance fluids. He was walked out in hand for 20 minutes every 2 hours throughout the night and received no further analgesia in addition to that you administered prior to admission.
Over the following 8 hours Jack made excellent progress, passing multiple piles of loose faeces and demonstrating no signs of colic. All clinical examinations within this period revealed no abnormalities. Jack had a repeat rectal examination at 12pm on 19th May 2013 which revealed no abnormalities. He was introduced to small bran mashes every 4 hours and small soaked handfuls of hay every hour with which he coped very well. Jack remained bright, alert and clinically normal and was discharged on 20th May 2013 with instructions to slowly re-introduce his normal feeding regime over a period of 48 hours and monitor closely for any signs of abdominal discomfort.