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Harry was a 5 year Arab horse. He had shown signs of colic (abdominal pain) for 36 hours before being referred to the Equine Hospital. His pain was getting worse and he was no longer responding to pain relief.
When he arrived at the College a very important decision had to be made - was the cause of Harry's pain a trapped or twisted piece of gut? The treatment for this problem is surgery, and the sooner that surgery is undertaken the better the chances of survival for the horse.
Harry had many of the worrying signs of a horse with colic. His heart rate was twice what it should be, he had had pain killers but was still extremely uncomfortable, his mucus membranes (the linings of his mouth and eyelids) were a dark purple colour instead of being pink, and he was barely able to stand. Harry was a very sick horse.
To make a more certain diagnosis further tests were carried out. Samples of fluid were taken from his abdomen and a rectal examination (where the vet places their gloved arm into the rectum to feel the intestines, kidneys etc) carried out. These failed to find anything to suggest that Harry needed surgery, as there was no evidence of twisted or damaged guts.
Harry was very dehydrated and had fluids restored rapidly through a drip in his neck, making him a little more comfortable. When his first blood tests came back there was some evidence of an acute infection, as Harry's white blood cell numbers were extremely low. With the concern of infection spreading from Harry to other horses in the yard he was moved to the Equine Isolation facility.
He remained comfortable for several hours but the abdominal pain returned. 
A tube was passed through his nose into his stomach to see if fluid was collecting there, stretching it and causing the pain. No fluid was found. Additional pain killers worked for the next two hours before severe pain signs restarted. Injections of morphine only brought relief for 20 minutes (usually they provide good pain relief for 2-4 hours in a horse) so morphine and two other pain killing drugs were added to his drip and administered continuously. A second sample of fluid from his abdomen was taken and again there was no evidence of twisted gut.
Despite the pain relief Harry was receiving, over the next hours his pain continued to get worse. After discussing the options with his owner it was decided that the only humane action was to put Harry to sleep.
A post-mortem examination was carried out later that day. It confirmed there was no twisted gut. Harry had had a severe inflammation of his large intestines called Colitis X (so called because the veterinary profession is not entirely clear what causes this condition). A high percentage of horses diagnosed with this condition are put to sleep, as Harry was, because it is not fair to let them suffer through such pain.
