Preliminary study to evaluate the use of fast abdominal ultrasonography of horses with colic in first opinion ambulatory practice
Authors: Samantha Corrie, Kristina Chapman, Imogen Schofield, T. Mair
Journal: Equine Veterinary Education
Summary
# Editorial Summary: FLASH Ultrasonography for Field Colic Assessment Colic remains the most frequent emergency presentation in first opinion equine practice, and early identification of surgical cases is critical for prognosis. Corrie and colleagues evaluated whether portable wireless ultrasonography using the FLASH (Fast Localised Abdominal Sonography for Horses) technique could effectively guide clinical decision-making at the point of care, examining 135 acute colic cases across a four-year period in ambulatory practice settings. Abnormal findings were detected in 36% of cases—predominantly distended small intestinal loops (25%), thickened intestinal walls (17%), and gastric distension (5%)—whilst reduced small intestinal motility was noted in 38% of animals, yet the majority of horses (63%) survived with medical management alone, with only 6% of survivors requiring surgical referral. The technique's practical value lies in its ability to identify horses with genuine structural abnormalities warranting early referral versus those likely to respond to conservative treatment, though the relatively low surgical intervention rate and lack of post-mortem data on euthanised cases limit definitive conclusions about diagnostic accuracy. For practitioners seeking objective evidence to support referral decisions and owner communication in the field, FLASH scanning offers a promising adjunct to clinical assessment, though further investigation with larger case numbers and comprehensive follow-up diagnostics is needed to establish its true sensitivity and specificity in primary practice.
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Practical Takeaways
- •FLASH scanning with a portable wireless ultrasound system is feasible and practical to use during ambulatory colic examinations, enabling earlier identification of horses requiring surgical referral
- •Abnormal FLASH findings (particularly small intestinal distension and reduced motility) may help guide triage decisions in first opinion practice and support owner discussions about prognosis and referral necessity
- •The technique shows promise but requires further validation; practitioners should not rely on FLASH alone to rule out surgical colic, as 63% of horses survived with conservative management despite some having abnormal findings
Key Findings
- •36% of horses with acute colic had abnormal FLASH findings; 38% showed reduced small intestinal motility
- •Of 135 horses examined, 63% survived (80 with medical management, 5 with surgery) and 37% were euthanised due to clinical deterioration
- •Portable wireless ultrasound (FLASH) was successfully deployed in first opinion ambulatory practice for real-time colic assessment
- •Common FLASH findings included distended small intestinal loops (n=34), thickened small intestinal walls (n=23), and gastric distension (n=7)