COLIC

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COLIC IN HORSES

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.

Any problem in pelvic


Gastrointestinal diseases – region i.e. urine
frequent and important obstruction/ kidney pain,
cause of death rectal tear, foaling trauma
etc.
Epidemiology

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….

Diet and feeding practices


Horses on pasture are at a lower risk of developing colic than are stabled horses fed concentrate
feeds.
The risk of colic increases with the amount of concentrate fed
Changing of horse diet qualitatively and quantitatively can hype the risk of colic.
 Management
Watering
Horses having free access to water <<<< horses don’t have constant access to water
Horses have access to ponds and lakes <<<< horses fed water with buckets or troughs
Housing:
Increased duration of stabling per day is associated with an increased risk of colic.
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

• On the basis of etiology colic is divided into 4 major types:

Obstructive, non Obstructive and Non strangulating Inflammatory


strangulating: strangulating: and infarctive: (peritonitis, enteritis):
Aboral movement of Obstruction of aboral Reduction in nutritive Inflammation of the
ingesta and secretions movement of ingesta blood supply stomach, intestines,
is prevented or and secretions with (infarction) that is not or parietal and
hindered by luminal or impairment of blood attributable to visceral peritoneum
extraluminal flow by mechanical mechanical Example: colitis,
obstructions without a compression of the compression of the peritonitis.
physiological reduction vessels. Both the vessels
in blood flow to the obstruction and Example:
gastrointestinal tract. impairment of blood Thromboembolic
Example: Impaction of flow occur at the same colic
the large colon time
Example: SI-volvulus.
Classification of colic Continued….

 On the basis of duration colic is divided into 3 major types:


1. Acute (< 24 h),
2. Chronic (> 24-36 h)
3. Recurrent (multiple episodes separated by periods of > 2 days of normality)

 On the basis of anatomical sites


1. Stomach
2. Small intestine
3. Caecum
4. Ascending ( large ) colon
5. Descending ( small ) colon
Spasmodic colic

 It is the most common type of colic.


 This type of colic may be caused by changes to the diet, inadequate deworming, teeth
problems, and excessive intake of cold water following exercise.
 The signs usually discontinue after a few hours. The signs during the colic may include
increased gut sounds and a slightly elevated pulse (60bpm).
 It also considered as medical colic.
 About 80% of colic cases are Spasmodic. In a Spasmodic Colic, a section of the gut goes into
a spasm, preventing anything from moving past it.
Obstructive 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.

 The more serious colic having very elevated heart rates.


Physical examination Continued…..

Auscultation and percussion-


• On auscultation, continuous and loud borborygmi abdominal sound indicates intestinal
hyper-motility.
• On percussion, pinging sound indicate small or large colon impaction, gas colic or colon
displacement, torsion of colon or cecum.
Naso gastric intubation
• Passing a Naso-gastric Tube (NGT) is useful both diagnostically and therapeutically.
 Rectal palpation
• It helps to diagnose uterine torsion, viscous distension ( by gas, fluid or feces), large
bowel displacement and dilated small intestinal loops.
Physical examination Continued…..

 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

 On the basis of Character


• Recurrent
• Occasional
• Intermittent
• Continuous

 On the basis of duration of action


• Per acute: < 1 hr
• Acute : < 24 hr
• Sub acute : 24-72 hr
• Chronic : > 72 hr
Diagnosis
 History and Clinical findings
 Physical examination
 Auscultation and percussion
 Rectal examination
 Nasogastric intubation
 Laboratory tests
 Radiography
 Ultrasonography
Differential diagnosis

• 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.
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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

 Maintain a regular feeding schedule.


 Ensure constant access to clean water.
 Provide at least 60% of digestible energy from forage.
 Do not feed moldy hay or grain.
 Feed hay and water before grain.
Provide access to forage for as much of the day as possible.
Do not over graze pastures.
Do not feed or water to horses before they have cooled out.
Maintain a consistent exercise regime.
Control intestinal parasites through periodical deworming programme.

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