Topic:Colic
Colic is a common gastrointestinal condition in horses characterized by abdominal pain and discomfort. It can result from various causes, including gas buildup, intestinal blockage, or inflammation. The severity of colic can vary, ranging from mild discomfort to life-threatening situations requiring surgical intervention. Signs of colic in horses may include restlessness, pawing at the ground, rolling, and changes in eating or drinking behavior. Diagnosis often involves physical examination, rectal palpation, and sometimes imaging techniques. Treatment depends on the underlying cause and may involve medical management or surgical procedures. This page compiles peer-reviewed research studies and scholarly articles that explore the causes, diagnosis, treatment, and management of colic in horses.
Examination of the horse with colic. The purpose of this detailed description of the clinical examination of the colic patient is to arrive at a specific diagnosis. However, this is hardly ever possible, but the practitioner should be in the position to establish the suspicion of an intestinal obstruction or to rule out its presence during the course of the development. Single clinical findings should not be interpreted in isolation but in relation to one another, so that a false diagnosis is not made. All clinical findings should be documented, so that when repeated examinations are carried out, findings can be compared with one...
Incarceration of the small intestine by the epiploic foramen in fifteen horses. In 15 horses with acute abdominal disease, a diagnosis of incarceration of small intestine through the epiploic foramen was made, either at the time of exploratory celiotomy or at necropsy.The horses exhibited signs of moderate to severe abdominal pain and were suffering from hypovolaemic and/or endotoxic shock. Nasogastric intubation produced either gas or fluid, the pH of which was in the range of 5 to 7.2, indicating reflux of small intestinal content into the stomach. Consistent physical findings included absence of gut sounds on auscultation, dilated small intestine palpable on rectal exa...
Recognition and management of ileus. Ileus may occur in horses of all ages secondarily to drug administration, colic, exhaustion, peritonitis, or metabolic disorders. Ileus most commonly occurs following abdominal surgery for colic and is a significant cause of postoperative mortality in these horses. The most common clinical signs of ileus are decreased or absent intestinal sounds and gastric reflux. Ileus is treated by eliminating the initiating causes, correcting metabolic imbalances, decompressing distended bowel, providing analgesia, stimulating motility with drugs, and regulating exercise and feed and water intake.
Initial treatment of colic. This article discusses some of the rationales for the medical management of colic during the initial treatment period. The issue of colic pain control and the masking of clinical signs that may indicate severe gastrointestinal disease is addressed. Therapeutic considerations related to dehydration, metabolic imbalances, hemostatic disorders, antimicrobial therapy, fecal consistency, gastrointestinal decompression, and regulation of intestinal motility are reviewed.
Selected aspects of the clinical pharmacology of visceral analgesics and gut motility modifying drugs in the horse. Comparison of the visceral analgesic effects of xylazine, morphine, butorphanol, pentazocine, meperidine, dipyrone, and flunixin in a cecal distention model of colic pain indicated that xylazine produces the most relief from abdominal discomfort. Repeated administration of xylazine may reduce visceral pain so effectively that the seriousness of abdominal disease is obscured. Xylazine decreased propulsive motility in the jejunum and pelvic flexure of healthy ponies. Morphine and butorphanol also gave relief from visceral pain in the cecal distention model. Morphine may inhibit colonic, and buto...
Alternative diagnoses in the colic patient. Despite clinical signs compatible with obstruction or ischemia of the gastrointestinal tract, the clinician occasionally is unable to identify a gastrointestinal cause for colic. In this article, disorders not originating from obstruction or ischemia of the gastrointestinal tract but causing real or apparent abdominal pain are presented as alternative causes of colic. In addition, colic of gastrointestinal origin may be the primary inciting factor or a secondary complication of an alternative disorder, causing colic-like signs. Recognition of alternative diagnoses relies on a thorough and cons...
Decision for surgery. Based on the clinical impression and the current knowledge of the clinical variables (rectal examination, abdominal distention, abdominal fluid, intractable pain) most likely to differentiate between medical and surgical cases, three decision trees are provided as a guide to making the management decision in a horse with abdominal pain. Prior elimination of horses with limited life expectancy because of age or function or where financial constraints are present is understood. It must be emphasized that most of the information presently available originates from referral centers where the preva...
[An impacted bladder stone]. A case of colic in a Haflinger gelding is reported. This was due to a calculus in the penis. The operation is described.
Equine large intestinal volvulus. A review of 124 cases. The average age of 122 horses with ascending colon volvulus was 6.6 +/- 0.4 years. Gastric reflux was a presenting sign in 35% of the cases. Peritoneal fluid protein levels had a mean of 2.54 +/- 0.14 g/dl and 20 horses had grossly normal peritoneal fluid at the time of presentation. Ascending colon volvulus was most commonly found at the level of the cecocolic fold with the initial ventral colon movement in a dorsomedial direction about the ascending mesocolic axis. The overall survival rate was 34.7% with a recurrence rate of only 4.9%.
Duodenal impaction in a horse. An 8-cm compressed mass of dry cracked corn was found obstructing the duodenum of a horse with signs of colic. The mass was manipulated aborally and removed through jejunal enterotomy. The horse recovered and the impaction did not recur.
Ciliated protozoa in the colonic wall of horses. Ciliated protozoa of several morphological types were found in the colonic tissue of 8 horses, mostly immature Standardbreds. Most of the protozoa observed appeared similar to those normally found as commensals in the equine large intestinal lumen. In all cases, organisms were located in the lamina propria; organisms were also found in the submucosa of 2 horses. The association of colonic disease with the presence of intramural ciliates was unclear.
Colopexy of the large colon in four horses. Colopexy of the left ventral colon to the abdominal wall was performed in 4 horses with recurrence of large-colon displacement or volvulus. Horses were discharged between 5 and 27 days after surgery. At follow-up evaluation (mean, 10.5 months; range, 7 to 13 months) of the horses, none had recurrence of signs of abdominal pain, and all had normal body weight. Three horses were exercised regularly; signs of abdominal pain were not observed.
Survival rates and post-operative complications after equine colic surgery. A retrospective analysis of 74 cases that underwent surgery for colic was undertaken to determine short and long term survival rates and the incidence of post-operative complications. In 28 cases colic was related to small intestinal lesions and in 46 cases to large intestinal lesions. Pre-operative packed cell volume and heart rate were found to be inversely related to short-term survival. Twenty-five horses (34%) recovered from surgery and were discharged. Of 18 of these cases with available histories, 6 subsequently had one or more episodes of colic since surgery of which 5 eventually died ...
Intramural hematoma in the jejunum of a mare. An intramural hematoma involving a 40-cm segment of the distal portion of the jejunum caused intestinal obstruction and colic in a mature mare. The involved intestine was resected, and an end-to-end anastomosis was performed. The mare recovered completely, but 4 years later had colic caused by incarceration and volvulus of the distal portion of the jejunum, involving fibrous abdominal adhesions. The cause of hematoma was not identified; however, rupture of an intramural vessel after migration of Strongylus vulgaris larvae was considered a possibility because of the histologic observation of an...
Colopexy of the equine large colon: comparison of two techniques. A study was designed to evaluate 2 colopexy techniques (A and B) in 8 clinically normal horses to determine which technique would prevent recurrence of large-colon displacement and/or volvulus. For technique A, 35 cm of the lateral free band of the left ventral colon was sutured to the abdominal wall, 6 cm to the left of ventral midline. For technique B, the medial free band of the left ventral colon was sutured to the medial free band of the right ventral colon, and 8 cm of the lateral free band of the left ventral colon was sutured to the abdominal wall, 6 cm to the left of ventral midline. ...
Equine Colic: Seventy-six Cases Resulting from Incarceration of the Large Colon by the Suspensory Ligament of the Spleen. Incarceration of the large colon by the suspensory ligament of the spleen was diagnosed and surgically corrected on exploratory celiotomy in 76 horses exhibiting abdominal pain. The condition was diagnosed most frequently during the winter months in mature males of mean age 4.7 years. Clinical signs progressed slowly and included mild to moderate abdominal pain and distension with moderate tachycardia. The mean duration of colic prior to surgical intervention was 20.7 hours. The mild nature of the colic, the findings on palpation per rectum, and the continued passage of feces in 40% of horses,...
Exploratory celiotomy for gastrointestinal disease in neonatal foals: a review of 20 cases. The medical records of 20 neonatal foals in which exploratory celiotomies were performed for gastrointestinal disease were reviewed. In all 20 foals, persistent pain and/or progressive abdominal distension were the primary clinical findings influencing the decision to operate. However, ancilliary laboratory data were important to the proper medical management of these foals during anaesthesia and following surgery. Surgical diagnoses of the 20 foals included ileus (nine foals; 45 per cent), small colon obstruction (five foals; 25 per cent), large colon displacement (three foals; 15 per cent), ...
Bypass surgery for the treatment of small intestinal ileus in the horse. A report of three cases. The medical management of three horses with simple and strangulating small intestinal obstructions was unsuccessful and was therefore supported by surgical bypasses. Jejunocecostomies were used to treat horses with postoperative paralytic ileus that was unresponsive to medical management. These horses had abdominal pain, gastric distention, heart rate elevations greater than 60/minute, and small intestinal distention on rectal palpation. Two horses experienced weight loss which responded to bypass removal. The bypass effectively decreased the need for intravenous fluid administration and repea...
Results of operative treatment of equine colic with special reference to surgery of the ileum. This retrospective study presents the results of surgical treatment of obstructive colic in horses operated in the last decade (1976-1985). The overall short-term recovery rate (i.e. discharged from hospital) was 51% of cases presented for surgery, and 68% of cases which were considered to be amenable to surgical therapy. For long-term results (6 months-8 years follow up) these percentages must be reduced by about 15% due to mortality after discharge. Special attention has been given to surgery of the ileum, which is often involved in strangulation or obturation, and accounts for about 26% of ...
Colonic alpha 2-adrenoceptor-mediated responses in the pony. The motor responses of the caecum and colon to stimulation of alpha 2-adrenoceptors by xylazine and detomidine at the recommended dose levels of 0.6 and 0.1 mg/kg were investigated in three ponies. The motor changes of the left ventral colon induced by continuous intra-arterial infusion of a prostaglandin (PGF2 alpha) were used to assess the relative inhibitory effects of xylazine and detomidine in a colic model. The administration of alpha 2-agonists inhibited the spiking activity on the whole of the large intestine for 20-30 min (xylazine) or 2-3 h (detomidine). However, the detomidine-induc...
Use of clinical pathology in evaluation of horses with colic. Clinical pathology is a valuable adjunct to physical examination of cases of colic. The present review considers evaluation of cases of colic for three main purposes: (1) making a prognosis, (2) deciding whether to operate, and (3) making a diagnosis. Blood tests noted to be useful for prognostication were hematocrit, lactate and urea nitrogen concentrations, pH, anion gap, fibrin/fibrinogen degradation products, antithrombin III activity, prothrombin time, and thrombin time. Horses with a poor prognosis often have relative polycythemia, marked lactic acidosis, high anion gap, azotemia, and co...
Pharmacological modulation of postprandial colonic motor activity in the pony. The contractile activity of the equine large intestine exhibited a biphasic response to feeding: enhancement of migrating complexes passing along the colon and an increase of 50% in cyclic variations in smooth muscle at intervals of 20 min on the left ventral colon for a period of 5 to 7 h postfeeding. The cholinergic agonist, bethanechol (50 micrograms/kg subcutaneously), induced both the migrating complexes and the cyclic variations at intervals of 10-15 min. In contrast, the intra-arterial infusion of PGF2 alpha (3 micrograms/kg/min) increased the contractile activity during infusion, but w...
Ileocolostomy. A technique for surgical management of equine cecal impaction. Several surgical alternatives have been described for the management of cecal impaction in the horse, but none has met with consistently successful results. This study was done to evaluate a surgical bypass of the cecum by anastomosis of the ileum to the right ventral colon (ileocolostomy). A ventral midline celiotomy was performed on nine adult ponies (155-350 kg) and a mechanically stapled 10 cm side-to-side ileocolostomy was created. In five ponies a complete cecal bypass (CCB) was created by transecting the ileum distal to the anastomosis. In the other four, an incomplete cecal bypass (ICB...
Comparison of duodenitis/proximal jejunitis and small intestinal obstruction in horses: 68 cases (1977-1985). Sixty-eight horses with colic caused by small intestinal disease were allotted into 2 groups of 34 on the basis of recorded findings during exploratory celiotomy, necropsy, or response to medical treatment alone. Signalment, history, physical examination findings, and laboratory findings were compared between the group of horses with small intestinal obstruction and the group with duodenitis/proximal jejunitis. A significantly greater proportion of horses with duodenitis/proximal jejunitis were older than 2 years old (P less than 0.05). Differences in sex or breed distribution, or in seasonali...
Jejunocolic anastomosis for the surgical management of recurrent cecal impaction in a horse. A 5-year-old Thoroughbred gelding with recurrent cecal impaction refractory to medical management was treated with a side-to-side jejunocolic anastomosis. Cecal impaction did not recur after surgery. The horse gained weight and performed successfully for 14 months, but experienced three episodes of mild abdominal pain between 14 and 20 months after surgery. Mild cecal gas distention and firm ingesta in the colon were detected on rectal examination. The horse's feces remained soft after surgery, except during the colic episodes when dry, firm feces were passed.
Pleuroscopic diagnosis of gastroesophageal squamous cell carcinoma in a horse. A 15-year-old Quarter Horse gelding was examined because of chronic intermittent colic of 40 days' duration. The clinical signs included acute onset of depression, ptyalism, abdominal splinting, and rolling within an hour of eating. An intramural mass of the esophagus was identified during esophagoscopy. A large soft-tissue density surrounding the distal portion of the esophagus, creating a stricture, was identified on an esophagogram. With the horse slightly sedated, pleuroscopy was performed, allowing direct visualization and biopsy of the mass. The histopathologic diagnosis was squamous cel...