Colic: nursing the horse and supporting the client - Veterinary Practice
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InFocus

Colic: nursing the horse and supporting the client

Sarah Baillie offers some practical advice on the role of the veterinary nurse in dealing with cases of colic.

COLIC is the most common
medical condition of the horse and
it can be extremely distressing for
a client to witness. Fast decision
making can be important but when
faced with an emotional owner this
may not be possible.

Treatment decisions can also be
delayed if the patient’s owner has to
be tracked down for consent. So it is a
good idea to ask our clients to consider
what their wishes may be if their horse
suffered from colic, before it happens.

Client talks, newsletters and social
media are a great way to get owners
thinking about how they would deal
with colic.

We are in a
good position
to encourage
them to
consider the
following questions and ensure their
wishes are known to yard staff and
anyone caring for the horse:

  1. Can you easily contact your vet from
    your yard?
  2. Does everyone who cares for your
    horse know who to contact in an
    emergency?
  3. How would you transport your horse
    to a veterinary hospital at very short
    notice (possibly at night)?
  4. Is your horse insured and what does
    the policy cover?
  5. Would you consider allowing your
    horse to undergo colic surgery?

Prevention

As well as planning for colic before
it happens, it’s also worth educating
clients on prevention. Some measures
they can take to help prevent some
cases of colic include:

  • Making any changes in diet or
    management as gradually as possible.
  • Ensuring free access to water and
    feeding a moist diet.
  • Feeding plenty of fibre.
  • Regular worming and/or worm egg
    counts.
  • Having dental checks/teeth rasping
    every 6-12 months.
  • Preventing the horse from eating its
    bedding.
  • Avoiding grazing on sandy soil or if
    this is not possible feeding a psyllium
    husk supplement to aid passage of
    sand.
  • If a horse is prescribed box rest,
    ensuring hay and feed is soaked and
    ensuring adequate water intake.
  • After sedation or anaesthesia,
    following feeding recommendations
    from their vet.

Phone advice

Faced with an upset client on the
phone, reassurance that the importance
of their call is understood and a vet
will be on the yard as soon as possible
is the most essential thing to most
owners. Some calmly delivered practical advice is also usually appreciated.

It may also be useful to establish that no home remedies or “bute from
the tack box” has been given and to
make clear to the caller not to do this.
The majority of clients will want to
do something helpful for their horse
whilst waiting for a visit and there’s
no harm in this as long as no one puts
themselves in unnecessary danger.

The caller can be advised to remove
any food and ensure the horse doesn’t
eat any bedding.

Often clients will already have
removed the horse from the stable and
started walking it around the yard so
it may be a good idea to advise them
to walk the horse on a lunge line in a
sand school and reduce the risk to both
handler and horse.

Decision to operate

Colic surgery is a major operation and
several factors play a part in making the
decision to undertake this procedure.

Unfortunately, cost often means
surgery is not an option. It is an
expensive procedure with long-term
intensive aftercare which means costs
can easily add up.

Having insurance does not
necessarily mean the insurance
company will cover the full bill and in
most cases hospitalisation costs are not
covered.

It’s a good idea to get the client to
check their policy to see if colic is
excluded or if they have an injury-only
policy.

Different policies have varying
amounts of vet’s fee cover and
frequently clients end up covering
some of the cost of treatment.

It is important to ensure the client
understands that recovery from
colic surgery is a long process and there are many potential
complications which could
prolong recovery further.

Home care

It’s easy to think once the
patient has been discharged
that it’s fixed, job done!
Home care is something
often overlooked and its
importance underestimated.
Most clients appreciate
written home care
instructions and, even with
these, will often call for
further advice. Obviously,
specific home care
instructions will depend on
the condition treated but
the main considerations are
usually diet and exercise.

Feeding small frequent amounts of fibre may be required as well as walking
out to grass, progressing to turnout.
Feeds should be wetted well and hay
soaked or steamed as well as free
access to fresh clean water. Monitoring
should include appetite and amount
of food eaten and amount of faeces
produced.

Water intake should also be
monitored and if insufficient amounts
are being taken then the horse will
need encouragement to drink. It is
often underestimated how much fluid
intake a horse obtains from soaked
feed and hay, so bear this in mind if a
client reports their horse is
not drinking a lot.

Encouraging a horse to
drink can be tricky and
what works for one horse
won’t for the next. There
are products which can
be added to the water to flavour it; however, fruit
juice or peppermint tea
can be a good (cheaper)
alternative. Access to a salt
lick or salt added to the feed
can also be helpful.

A clean deep bed is a
good idea both for comfort
and in case of recurrence
of colic episodes. Bedding
should not be edible and so
shavings or paper would be
preferable.

If the horse has had
surgery, the client will have
an incision to monitor.
As well as advising them
to check for any sign
of wound breakdown,
discharge, heat or swelling,
it can also be useful to show
pictures of what is normal
and what isn’t.

Make sure they are aware
of when stitches or staples are due to be removed and they aren’t
forgotten about.

Demonstrating how to monitor for
an increase in temperature and heart
rate and the presence of strong digital
pulses can help early detection of
potential complications.

It may also be useful to explain
the importance of changes in faecal
consistency, especially if the patient
is still receiving antibiotics, so colitis
may be detected quickly. Periodic
follow-up calls to the client are rarely
unappreciated and allow them to ask
questions they may have already asked
all of their horsey friends because they
didn’t want to bother the vet!

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