Equine Colic

Preface
E q u i n e C o l i c : C a n We D o Be t t e r ?

Louise L. Southwood, BVSc, PhD,

DACVS, DACVECC
Editor

Colic is often described in the lay literature as the “number one killer of horses.” Suc-
cessful outcome for horses with colic is dependent on a team approach between
owners, caregivers, primary care veterinarians, specialists, and clinical researchers.
This issue focuses on gastrointestinal causes of colic, covering a wide array of diag-
nostic, therapeutic, and research updates. The focus throughout is on early referral
(“Updates on diagnosis and management of colic in the field and criteria for referral”
by Bookbinder and Prisk), early recognition of intestinal strangulation (“Early identifi-
cation of intestinal strangulation: why it is important and how to make an early diag-
nosis” by Southwood), prevention of complications (“When things don’t go as
planned: update on complications and impact on outcome” by Kilcoyne), and opti-
mizing prognosis. A successful outcome is no longer defined as survival to hospital
discharge. Rather, the expectations following colic surgery should be high with hors-
es (and other equids) having a long, colic-free, and purposeful life. Decision making
for euthanasia is addressed throughout this issue, underscoring the importance of
communication and support for owners and caregivers. Economics is a critical
component of veterinary medicine, and, as equine veterinarians, we must be fiscally
responsible when making decisions to perform diagnostic and monitoring tests and
avoid unnecessary treatment. Economics is discussed in several of the articles in
this issue.
Much of the information that we have on the “causes” of colic and recurrent colic
comes from epidemiologic studies. “By identifying modifiable risk-factors, epidemio-
logical studies have enabled evidence-based strategies to be devised to reduce the

Vet Clin Equine 39 (2023) xiii–xv

https://doi.org/10.1016/j.cveq.2023.05.001 vetequine.theclinics.com
0749-0739/23/ª 2023 Published by Elsevier Inc.
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risk of colic”; the current knowledge and future directions for epidemiologic studies in
equine colic are described in “Epidemiology of colic: current knowledge and future di-
rections” by Archer and Gillen. Comprehensive details of current standards of care for
management of horses with colic in the field, including decision making for referral
(“Updates on diagnosis and management of colic in the field and criteria for referral”
by Bookbinder and Prisk) and postoperative colic patients (“Basics of postoperative
care of the equine colic patient” by Bauck and “Critical care of the colic patient: moni-
toring, fluid therapy, and more” by Barton and Hassel), are provided. Updates on diag-
nosing and managing gastric impaction and gastric glandular disease, inflammatory
bowel disease, and medical management of colonic displacement (“Current topics
in medical colic” by Barton and Hallowell), colic surgery (“Colic surgery: what’s
new?” by Aitken), and tips and tricks for diagnosis and management of mares and
foals with colic (“Neonates, pregnant mares, and signalment-specific diseases and
complications” by Slovis) are discussed. Recently, there has been research published
on the equine intestinal microbiome, and “What is the microbiota and what is its role in
colic?” by Arnold and Pilla explains the terminology used and interprets some of the
findings of this research. Recurrent colic is a particularly frustrating problem for
owners, caregivers, and veterinarians. A methodical approach to these horses is
described in “Recurrent colic: diagnosis, management, and expectations” by Mair
and Sherlock.
Considerable advances have been made over the past 15 years or so in transabdo-
minal sonographic techniques, including accessibility and quality of available equip-
ment, skill of the sonographer, and veterinary education on sonographic
techniques, and interpretation of sonographic findings. Sonographic evaluation is
mentioned throughout the issue, and “Abdominal sonographic evaluation: in the field,
at the hospital, and after surgery” by Navas de Solis and Coleman provides informa-
tion on progress in sonographic evaluation of the horse with colic and the potential of
this diagnostic modality. Similarly, while laparoscopy in human surgery has replaced
many invasive procedures, it is still somewhat in its infancy in equine abdominal sur-
gery. There are, however, several reported laparoscopic procedures for diagnosis,
treatment, and prevention of colic. “Role of laparoscopy in diagnosis and manage-
ment of equine colic” by Martens and Haardt provides an update on these surgical
procedures.
Horses with intestinal strangulation require emergency surgery. Recent reports in
the literature show that, not surprisingly, a shorter colic duration leads to better
long-term survival with fewer complications leading to less treatment-associated
expense. In some instances, where the horse is persistently and moderately to mark-
edly in pain, it is readily apparent that surgery is indicated. One the other hand, in other
instances, it is less apparent. Similarly, early repeat celiotomy is essential for a suc-
cessful outcome, for economic reasons, and for humane considerations in horses
with certain types of complications particularly after small intestinal surgery and in
horses with an initial diagnosis of a strangulating obstruction. “Early identification of
intestinal strangulation: why it is important and how to make an early diagnosis” by
Southwood describes tips for early identification of horses with intestinal
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strangulation, and “Repeat celiotomy: Current status” by Freeman and Bauck de-
scribes indications, technique, and outcome for repeat celiotomy.

Louise L. Southwood, BVSc, PhD, DACVS, DACVECC

Department of Clinical Studies
New Bolton Center
University of Pennsylvania
School of Veterinary Medicine
382 West Street Road
Kennett Square, PA 19348, USA
E-mail address:
southwoo@vet.upenn.edu