LARGE ANIMAL EMERGENCY SERVICE DIFFERENTIAL DIAGNOSIS

    

Before listing the differential diagnoses, let's quickly review the findings from the history, initial assessment, and diagnostics:
History mare recently foaled; acute onset of pain; no history of colic
Physical Exam
Heart rate 96
Respiratory rate rapid 
Capillary refill time >2 sec
Temperature 97.4
Peripheral pulse character reduced in both facial and feet
Mucous membrane color pale,cyanotic
Borborygmi absent
Nasogastric tube only a small amount of green/brown reflux was present
Rectal palpation horse was too painful to do a rectal
Blood Gas: pH = 7.303
  lactate = 10.0 mmol/L
Chemistry: chloride = 89.0 mEq/l
  creatinine = 2.4 mg/dl
Hematology: PCV = 49%
  TP = 7.1 g/dl

**What can you conclude from these results and the fact that you had to sedate the horse three times just to get to this point?

**That this horse is in an uncontrollable amount of pain.

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Copyright © 2000 - University of Pennsylvania School of Veterinary Medicine
Faculty: Dr. Barbara Dallap
Student: Shari C. Silverman, V'02
Comments to bldallap@vet.upenn.edu
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