Speaking Equine

This form outlines the information to provide to your veterinarian

Case History, Colic
It is important to provide your veterinarian a clear and detailed history, episodes of colic seem to be "triggered". Work with your veterinarian to determine what "triggered" 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 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.

Colic History Form