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Table 1 Disease categories for 1016 horses from a survey of veterinary practitioners’ primary assessment of colic

From: Prospective study of the primary evaluation of 1016 horses with clinical signs of abdominal pain by veterinary practitioners, and the differentiation of critical and non-critical cases

Disease category Definition/inclusion criteria for disease category and sub-category Number of cases
No definitive diagnosis Defined as cases in which a definitive diagnosis was not determined at the primary or any subsequent assessments 580
 Sub category: spasmodic Inclusion criteria: described by veterinary surgeon as spasmodic, no abnormalities on rectal examination, and resolved with medical treatment
Exclusion criteria: cases subsequently found to have other lesions were excluded and categorised according to the final diagnosis/outcome
254
 Sub category: gas Inclusion criteria: with gas distension of intestines on rectal examination, with no underlying cause of distension identified
Exclusion criteria: cases with gas distension associated with another lesion were excluded and categorised according to the primary lesion
68
 Sub category: unknown Inclusion criteria: diagnosis undetermined by veterinary surgeon, or where proposed diagnosis could not be confirmed from diagnostic work up (including cases where there were no clinical or diagnostic findings to support the veterinary surgeon’s proposed diagnosis (e.g. cases reported as ‘impactions’ where no rectal examination was performed, recurrent or geriatric cases euthanased for colic with mild signs of pain, no rectal findings and no post mortem results) 258
SCOD (impaction or simple displacement) Defined as simple obstruction with subsequent distension of the large colon [2] diagnosed on the basis of positive findings on rectal examination either at the primary or any subsequent assessments, and resolved with medical treatment 155
 Sub category: large colon impaction Inclusion criteria: positive rectal finding of a primary large colon impaction
Exclusion criteria: impactions with a positive sand test were categorised as a separate category under category 4
Cases which required surgical intervention, euthanasia or died were excluded and categorised as category 3. Surgical/strangulating lesion
121
 Sub category: large colon displacement Inclusion criteria: positive rectal finding of a large colon displacement on rectal examination (including palpation of a LDD displacement, RDD displacement, Pelvic flexure retroflexion or abnormal taenial bands)
Exclusion criteria: cases which required surgical intervention, euthanasia or died were excluded and categorised as category 3. Surgical/strangulating lesion
34
Surgical/strangulating lesion Defined as cases that required surgical treatment, were euthanased or died due to surgical or strangulating lesions either at the primary or any subsequent assessments 178
 Sub category of SI lesion Inclusion criteria: identification of small intestinal lesion at surgery or post mortem, or where these were not available, positive rectal findings of small intestinal distension 72
 Sub category of LI lesion Inclusion criteria: identification of large intestinal lesion at surgery or post mortem, or where these were not available, positive rectal findings of large intestinal distension. This sub category includes large colon displacements which had surgical treatment or were euthanased 36
 Sub category of other location Inclusion criteria: identification of other intestinal lesion (gastric obstruction n = 1 and small colon strangulation n = 1) at surgery or post mortem 2
 Sub category of no lesion site identified Inclusion criteria: cases where the site of the surgical lesion was not determined, including surgical cases where the data could not be obtained, and horses that were euthanased or died with no rectal examination, or no findings on rectal examination and no post mortem 68
Other Defined as cases where a definitive diagnosis was obtained either at the primary assessment or subsequent investigations, and which did not have either SCOD or a surgical/strangulating lesion 103
 Gastric diseases (EGUS) Inclusion criteria: EGUS diagnosed by endoscopy 2
 Simple SI obstruction Inclusion criteria: distended small intestine on rectal or ultrasound examination of thickened small intestine, and resolved with medical treatment 7
 Caecal disease Inclusion criteria: abnormalities of the caecum identified on rectal examination, including caecal tympany (n = 4), caecal impaction (n = 2), and typhlitis (n = 1) which resolved with medical treatment 7
 Small colon obstruction Inclusion criteria: positive rectal finding of impaction of the small colon, which resolved with medical treatment 6
 Rectal impaction Inclusion criteria: positive rectal finding of impaction of the rectum (n = 5), or meconium impaction (n = 1), which resolved with medical treatment 6
 Grass sickness Inclusion criteria: euthanased with a diagnosis of grass sickness confirmed by biopsy, post mortem or clinical signs (ptosis, dysphagia, sweating) 13
 Neoplasia Inclusion criteria: neoplasia confirmed on surgery or post mortem 2
 Parasitic Inclusion criteria: worms seen in faeces, high faecal egg count (>800 eggs per gram), positive surgical or post mortem findings, clinical history and laboratory results consistent with cyathastomiasis 9
 Peritonitis/PUO Inclusion criteria: pyrexic, with no underlying cause identified (PUO) (n = 3) or peritonitis confirmed on abdominocentesis (n = 4) 7
 Enteritis, colitis or enterocolitis Inclusion criteria: presence of diarrhoea, or ultrasound or surgical findings consistent with colitis or enteritis 13
 Sand colic Inclusion criteria: positive sand test (faecal sand test or on radiography) 14
Rupture of the gastro-intestinal (GI) tract Inclusion criteria: rupture or tear of GI tract identified at surgery or post mortem, regardless of location
Lesion location: 1 large colon, 1 small colon, 1 rectal, 1 unrecorded
4
 Non-GI causes Inclusion criteria: non-gastrointestinal problem confirmed by other clinical findings or diagnostic tests. This included cardiac disease diagnosed on auscultation and clinical signs of cardiac failure (n = 1), choke (n = 2), haematuria (n = 1), hepatic disease diagnosed based on blood biochemistry (n = 5) and ‘maggots in sheath’, diagnosed on physical examination (n = 2), urticarial/allergic reaction (n = 1), muscle abscess (n = 1) 13
  1. Disease categories were determined retrospectively by reviewing the veterinary surgeon’s diagnosis, presenting signs, physical examination findings, diagnostic test findings, further information provided by the veterinary surgeon and final outcomes recorded