COLIC
COLIC
COLIC
Presented by:
Hafiza Areej Atta
2023-Mphil-1117
PG-Clinic - 1
COLIC
Introduction:
It is the number one killer in Horses.
Colic is the behavioral sign associated with abdominal pain in horses, which is due to
any problem in intra abdominal region.
Most of time pain may be due to any distention or torsion in intestines.
Risk factors
Horse characteristics
Age
Horses of age 2 to 10 years of age >>> horses of age < 2years
Foals less than 6month <<<< foals of more than 6month
Older horses>21years are more prone to get colic due to pedunculated lipomas
Sex
Male horses have high chances of inguinal hernia due to which colic may develop
In mares high chances of entrapment of intestines in mesometrium
Mares that have had foal are more prone to develop large colon volvulus.
Epidemiology Continued….
Exercise
Horses are at greater risk of colic undertaking physical activity or a sudden change in exercise.
Stabling i.e. increased stabling >>>> large colon volvulus
Medical history
Horses have had colic in past >>>> horses don’t suffer with colic
Horses have had colic surgery >>>> 5x more chances than horses have not had colic in past.
Horses with a history of crib biting or wind sucking>>>> high risk of developing colic (~2-fold risk
Epidemiology Continued….
Parasitic load
• Inadequate parasite control program>>>> risk of developing colic high
• Presence of tapeworms observed in feces >>>> greater risk of developing ileac
impaction>>>>increased risk of developing colic
• Infestation by roundworms (Parascaris equorum) is associated with severe colic in young
horses as a result of impaction or obstruction of the small intestine.
• Internal parasites – especially Strongyles, cause severe damage to the intestinal arteries,
reducing blocking the flow of blood to segment of the intestines>>>>Migration of larvae in the
walls of the arteries >>>>walls of the vessels to become roughened and scarred. Clots form in
the arteries >>>> thromboembolic colic
Classification of colic
This term refers to an uncommon sudden occlusion of the intestinal lumen by organized impaction.
This may be due to enteroliths, phytoliths, hardened fecal mass, foreign body ( hair ball ) & clump of
parasites.
It divided into two group
- Vascular/ Functional obstruction
- Mechanical obstruction.
Impactive colic
The most common cause of colic is impactions of the large intestine. Most impaction colic
cases occurs at the pelvic flexure.
Poor dental care, irregular feeding or where the horse suddenly starts to eat its bedding are
important factors.
Gastric impaction is characterize by dilatation of the stomach with food or indigestible
materials ultimately leading to atony of the musculature of the stomach.
Vascular shock may be evident due to dehydration and absorption of toxic material from the
stomach
Sand colic
This is most likely to occur in horses that graze sandy or heavily grazed pastures.
Ingested sand or dirt accumulates in the pelvic flexure, right dorsal colon and the caecum of the
large intestines irritates the lining of the bowel diarrhea.
The weight and abrasion of the sand/dirt inflammation of bowel wall reduced colonic motility
peritonitis in severe cases.
Sand irritation and impaction of intestines.
Risk factors for sand colic-Soil type, pasture quality and feeding practices.
Clinical findings:
Behavior
• Pawing
• Stamping Indicate pain
• Kicking
• Pacing in small circles
• Lying down and getting up
• Looking or nipping at flank
• Rolling
• Lying on back
• Frequent urination with small urine
• Sham drinking
• Abnormal posture >>>> horse standing stretched out with the fore feet more cranial and the hindfeet
more caudal than normal or the so-called “saw-horse” stance.
Physical examination
Respiration rate
• < 40/ min. in mild colic.
• Up to 80/ min. in severe colic.
• > 120/ min. in terminal stage of colic.
Heart rate
• 40-50/ min. in torsion of colon.
• 50-60/ min. in Obstructive colic.
• > 80/ min. in Strangulating colic.
• 100 & above indicate irreversible damage.
Abdominocentesis
• Red to brown color of fluid show small intestine strangulation, Orange to green show
bowel necrosis/ rupture Green and turbid show enterocentesis and Yellow & turbid show
anterior enteritis.
Abdominal radiographs
• It is used to diagnose the colic due to enteroliths and sand impaction.
Ultrasonography
• Evaluation of the abdomen is very useful to detect the presence of abdominal fluid for
abdominocentesis, determine distension, mural thickening, displacement or
intussusceptions.
Categorization of abdominal pain
On the basis of the intensity
• Mild
• Moderate
• Severe
• Laminitis
• Enterocolitis
• Rhabdomyolysis
• Obstructive urolithiasis
• Foaling and dystocia
• Uterine torsion
• Duodenitis-proximal jejunitis
• Gastric ulceration
• Tetanus
• Rabies
• Botulism
• Clostridial myonecrosis (gas gangrene)
• Psychogenic colic
Medical management of colic
Most causes of colic can be managed medically, only 4-10% require surgery.
The decision whether a colic case should be managed medically or surgically depends on 5
main points-
Severity of pain
Cardiovascular and systemic status.
Findings on trans-rectal palpation.
The presence of nasogastric reflux.
Result of abdominocentesis.
Click icon to add picture
Treatment
Correction of pain
Hydration therapy
• Replacement therapy
• Maintenance therapy
Other therapy
• Antibiotics
• Lubricants
• Fecal softeners
• Promotility agents
• Antiulcerative therapy
Treatment Continue….
NSAID
Flunixin Meglumine @ 1.1 mg/kg, IM or IV once or twice daily, is Excellent visceral analgesia.
Alpha-2 agonist
Xylazine @ 0.1-1.0 mg/kg, IV or IM, is Potent analgesia and sedation up to 30 min., decreases
intestinal motility, often combined with butorphanol.
Opiates
Butorphanol @ 0.0025-0.1 mg/kg, IV or IM, is Potent analgesia for 30-90 min., safe, often
combined with an alpha-2 agonists, may cause ataxia.
Antibiotics
Gentamycin @ 6.6mg/kg IV or IM once daily
Ceftriaxone @ 25-50 mg/kg, IV or IM at 12-24 hr interval.
Treatment Continue….
Lubricants
Mineral oil @ 10-15 ml/kg, via nasogastric tube, every 12-24 hrs. It is safe, lubricant only, does not soften
feces usually passed in 18-36 hrs.
Parrafin @ 2-3 bottles PO or through rectum do anema.
Luxatives
Magnesium sulphate @ 0.5-1.0 gm/kg, via nasogastric tube, in water. It is osmotic cathartic, toxic (CNS
signs) with repeated dosing.
Promotility agent
Neostigmine @ 0.02 mg/ kg, IM or SC every 8-12 hrs. It increases large colon motility, decreases small
intestinal motility.
Antacids
Ranitidine @ 1.5 mg/ kg, IV, every 6 hrs interval.
Fluid therapy
Fluid therapy @ 60ml/kg/day in adult is daily maintenance requirements.
Preventions