Preliminary study to evaluate the use of Fast Abdominal Ultrasonography
of Horses with Colic in First Opinion Ambulatory Practice.
Abstract
Background: Colic is the commonest emergency in first opinion equine
practice. Early referral is important for horses requiring surgery. Fast
localised abdominal ultrasonography of horses (FLASH) is frequently used
as a diagnostic tool in the investigation of colic at referral
hospitals, but its use in first opinion practice has not been evaluated.
Objective: To assess the value of FLASH scanning in the primary
assessment of horses with colic in the field, using a portable wireless
ultrasound system. Study design: Prospective study (2018-2021). Methods:
Any horse examined for colic as an emergency in a first opinion
ambulatory practice was eligible for inclusion in the study. A FLASH
examination was performed using a wireless handheld ultrasound scanner,
with the images displayed on a smartphone or tablet. The findings on
FLASH scans and outcome of the case (recovered, referred for surgery or
euthanised without referral) were recorded. Results: 135 equids with
acute colic were evaluated. Of the 135 horses, 49 (36%) had an abnormal
finding on FLASH scanning, including distended loops of small intestine
(n=34), thickened small intestinal walls (n=23) and/or distension of the
stomach (n=7). Reduced small intestinal motility was recorded in 52
animals (38%). Follow-up information was available in all animals: 50
(37%) were euthanised due to clinical deterioration and the owners’
decision not to undertake surgery; 85/135 (63%) survived, including
5/85 (6%) that underwent surgery and 80/85 (94%) that resolved with
medical management. Main limitations: Small number of cases. Lack of
results of post-mortem examination of horses that were euthanised.
Potential selection bias. Conclusion: The FLASH technique can be
valuable in the primary assessment of horses with colic in first opinion
ambulatory practice. Further evaluation with more cases is required.