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We are currently investigating if certain characteristics of hay fed to horses may predispose a horse to developing colic. In order to do this we need a sample of the hay that your horse was eating at the time that he/she developed signs of colic. The sample ideally consists of three handfuls, one handful from the center of each of three bales of hay. Please put the sample into the bag provided. Please also answer the questions below and return to us in the envelope provided together with the hay sample. Name of Horse _____________________ Name of Owner _________________ Hospital Case Number ___________
Date Admitted to hospital for Colic _____________
Did your horse require surgery? Yes / No Did your horse survive to discharge from hospital? Yes / No
What is your horse used for? _______________________________________________________________________
Has your horse had colic before? Yes / No If yes when and diagnosis _____________________________________
Has your horse had a change in routine in the last 2 weeks? Stall rest Increased turnout Foaled Transport New barn/change in stall Show Other (describe) ________________________________________________
1.How many hours was your horse turned out for each day at the time he/she developed colic? (circle best answer) 0 0-6 6-12 >12 2. Does your horse have free access to water? In stall Yes / No In pasture Yes / No3. Which description best fits your turnout? (circle best answer(s)) Fenced paddock Roundpen Sandy soilClay soil Mainly grass Grass with bare patches Sparse grass Dirt lot4. How often each day do you feed hay? ______ grain/concentrates?__________5. How much (pounds) of each of the following do you feed each day? sweet feed ___, pellets ____, coarse mix________, oats________, sugar beet pulp __________,other?________________________________________________________ 6. What type of hay do you feed? ______________ How much each day? _____________ 7. Where in the USA did the hay come from? _________________ First cut / Second cut / Unknown? 8. Did you introduce a new batch or type of hay in the two weeks before the colic episode? New Batch? Yes/No New Type? Yes/No What type?__________________________ 9. Do you feed a daily dewormer? Yes /No 10. What dewormers have you used in the last 6 months? Moxidectin (Quest) Ivermectin (Eqvalan, Zimectrin), Pyrantel palmoate (Strongid), Fenbendazole (Panacur) Double dose Strongid 5 day course Panacur Other _____________________________________________ 11. How often did you use them ? _________________________________________________ 12. How long
ago were your horses teeth last floated? (circle best answer)
Within 1 month Last 6months
Last 6-12 months
More than 1 year Never
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Mail form and hay sample to:
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