History

• A full description of the symptoms by the owner and that of any other handler of the horse: any previous attacks, pre-treatments, other involved veterinarians, etc..
• Feeding regimen, recent changes.
• Vices
• The stable and its environment: sandy areas, rubber fences, climate.
• Exercise program and recent changes.
• Recent tooth eruption.
• Frequency, quality and nature of the faeces and urine.
• Other horses in the stable with similar symptoms

Phisical Examination

• General

- Signs, type and extent of pain, any type of positioning or unusual behavior of the horse
- Hydration: elasticity of the skin, sunken eyes, PCV and TP, osmolarity
- Temperature: take a rectal temperature reading and palpate extremities
- Mucous membranes: color, injection, icterus, TRC
- Urine: quantity, colour, pH
- Blood: hemogram, leukocytes and differential count, Gram's stain, electrolytes, acid-base equilibrium, pH, enzymes, lactate

• Cariovascular

- Heart rate, character, pulse deficit, murmurs, arrhythmias, digital pulse
- Symptoms of shock

• Gastrointestinal

- Auscultate the abdomen on both sides
- Gastric decompression via nasogastric tubing: volume, pH, odor
- Rectal exploration: complete and careful palpation including the bladder, uterus, broad ligament and inguinal rings

Hospital Intervention

• Anesthesia

- Gastric decompression
- Evaluation of fluids, electrolytes and acid-base equilibrium
- Preparation of the surgical area
- Adequate and quick anesthetic induction
- Evaluation of the EKG
- Ventilation
- Control of vital signs

• Surgery

- Proceed with skill and speed

• Recovery

- Oxygenation
- Wound support if necessary

• Posoperative

- Oxygenation
- Proportion water, food and electrolytes: light diet, controlled exercise and antibiotics
- Controlling of pain