Speaking Equine Sample Site

	Colic Case History Form (below)
Links	Speaking Equine Newsletter, Colic the Number One Killer of Horses! Symptoms of Colic Recurring Colic Sand Colic Winter Colic
Resources	AAEP Veterinary Rounds Internal Parasites and Colic Classification of Types of Colic "Doc, Colic in my horses scares me to death! I'd like to know more about it!" Part II, AJ Neumann DVM.

This form outlines the information to provide to your veterinarian.

Colic Case History
It is important to provide your veterinarian with a clear and detailed history. Because episodes of colic are frequently triggered, this form will help you to work with your veterinarian to determine the source of your horse's colic attack. Depending on the history you provide, your veterinarian may need to see your horse immediately, or may ask you to observe the horse to see if the problem resolves on its own.
Contact Person’s Name:				Phone Number:
Horse's Name:
				Date:	Time:	AM:	PM:
When was the symptoms of colic first observed?
What is the duration of the colic?
What activities was the horse involved in when colic was first observed?

How severe is the pain?				Mild:	Moderate:	Severe:
Was any medication given to alleviate the pain?				Yes:	No:
If yes, what medication(s) was administered?
What dosage(s) were administered?
When was the medication(s) given?
Has there been any recent change in feed?
feeding routine?
feeding practice?
Has the horse urinated recently?
Has the horse defecated recently?	Yes:	No:	If yes, was the feces	Normal:	Small, hard balls:	Profuse diarrhea:
Did this colic follow?				Foaling:	Exercise:	Breeding:
Has this horse had colic before?	Yes:	No:	If yes,	When:	How often:
Describe the circumstances when previous colic(s) occurred:
Provide your veterinarian a copy of vaccination and worming schedule for the horse.

Sample Vet Site