Abdominal palpation per rectum is highly sensitive for identifying small versus large intestinal lesions in horses presenting for colic.

Transrectal palpation is highly sensitive for identifying small versus large intestinal colic lesions in horses.

This retrospective cohort study evaluated the diagnostic accuracy of transrectal abdominal palpation in 453 horses surgically treated for colic over five years (2019-2024). The technique demonstrated high sensitivity (86%) and positive predictive value (79%) for differentiating small versus large intestinal lesions, with overall accuracy of 71% for both lesion types. However, specificity and negative predictive value were low (5% and 7%, respectively). Interestingly, examiner experience did not significantly influence diagnostic accuracy or patient survival outcomes. Prognostic factors associated with nonsurvival included elevated heart rate, packed cell volume, serum and peritoneal lactate concentrations, and advanced age, but accurate transrectal diagnosis did not correlate with short-term survival. Small intestinal lesions were significantly associated with poor outcomes. The authors conclude that transrectal palpation represents a valuable diagnostic tool in equine colic management, with improved accuracy compared to historical data, and can be reliably performed across all experience levels when safety parameters are met.

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