what are the 11 causes of colic?
- Become blocked (impaction/obstruction)
- Form excessive gas (gas/tympanic colic)
- Move too much (spasmodic colic)
- Stop moving (ileus)
- Telescope into themselves (intussusception)
- Go through hole within body (herniated intestine)
- Move from normal position (displacement)
- Become infected/inflamed (enteritis)
- Develop ulcers
- Lose blood supply (strangulation)
◦ eg Epiploic foramen entrapment, - Become twisted (torsion)
what are the risk factors and signs of epiploic foramen entrapment?
risk factors: crib-biting and wind-sucking.
Signs: development of severe abdominal pain with circulatory compromise.
what are the sings of colic?
- reduced appetite
- no droppings/change in droppings/few droppings
- pacing
- depressed/dull
- yawning/lip curling/teeth grinding
- pawing
- lying down
- rolling
- flank watching
what are the clinicla signs assocciated with server/critical cases of colic?
- Severe unrelenting pain (including signs of self trauma)
- Dullness and depression (can indicate septicaemia, rupture)
- Abdominal distension
- Heart rate >60bpm
- Discoloured mucous membranes or delayed capillary refill time
- Absence of gut sounds in one or more quadrants
what is the key information needed when taking a history for colic?
- when was the horse last seen behaving normally
- when did the horse last pass faeces
- if colic has occured previously
- age of horse
- recent changes in management or enviroment of horse
what is the basic assesment that needs to be done when present with a horse with colic signs?
- pain assessment
- HR
- MM - CRT, colour, moistness
- gut sounds
- rectal temp
what is the acronym used to remamber the 5 items to check with a horse in colic and what do they stand for?
“Painful Horse Must Get Treatment”
- Pain
- Heart rate
- Mucous membranes
- Gut sounds
- Temperature
what is the definition of a critical case of colic?
cases where the horse requires:
- euthanasia on humane grounds
- hospitalisation for intensive medical or surgical treatment
why is it important to identify critial cases of colic early?
It is important to identify critical cases of colic early because rapid diagnosis and recognition of the horse’s critical status can have a major impact on welfare
what are the signs of pain in a case of critial colic?
- Pain despite analgesia
- Abrasions
- Result from rolling/thrashing/being cast
- Typically found above the eyes and on other bony prominences
- Thrashing
- Unresponsive
- Rolling continuously/throwing themselves to the ground
- Continuous box walking
- Sudden alleviation of signs
- This usually indicates gastric or intestinal rupture
Case progression - rapid deteriation of signs
what are the cardiovascular signs of a critical case of colic?
- Tachycardia (heart rate >60 bpm)
- Abnormal mucous membranes
- Colour: Red, purple, blue, grey
- Moistness: Dry
- ‘Toxic ring’ (red or purple line above teeth)
- Capillary refill time >2.5 seconds
- Weak pulse character
- Elevated packed cell volumet
what are the allimentary system signs of a critical case of colic?
- Significant (>4L in a 500 kg horse) of spontaneous NG reflux, and/or foul mouth odour
- Identification per rectum of:
- Distended SI loops
- Severe LI distension
- Li displacement
- Peritoneal fluid discoloured or turbid
- Abnormal abdominal ultrasound
- Severe abdominal distension on visual observation
- No gut sounds in 21 quadrant
- Peritoneal lactate >2 mmol/L$
what are the diagnostic tests for colic used in the field situations?
- Response to analgesia
- Rectal examination
- Nasogastric intubation
what are the complication of the diagnostic tests used in the diagnosis of colic?
- Injury to vet or handler
◦ Assess situation
◦ Consider yours and handlers safety first
◦ Sedate when needed
◦ Ask for help / refer when needed
◦ Euthanasia is realistic option if horse is uncontrollable and dangerous - Rectal examination
◦ Rectal tear - Nasogastric intubation
◦ Epistaxis
◦ Inadvertent administration of treatment into lungs
why do rectal tears occur?
◦ Most occur as a result of a contraction around the hand or forearm
◦ Less commonly as a result of finger tip penetration
◦ Can occur as a result of external trauma, impaction, or spontaneously
what are the grades of rectal tears?
◦ Grade I – mucosa and submucosa torn
◦ Grade II – muscular layer only torn
◦ Grade IIIa and b – all layers torn except serosa or mesorectum
◦ Grade IV – all layers torn
what general medical first aid is used in the case of rectal tears to reduce straining and contamination?
A. epidural
B. sedation
C. spasmolytic
D. antibiotics
what are the first action taken inthe case of a retal tear ( after informing the owner and ringing senior partner and VDS)
- Sedate horse, administer spasmolytic (if not done already)
- Repalpate carefully with ungloved hand to identify extent of injury
- Gently remove faeces from tear and rectum
- Treat septic shock and peritonitis (NSAIDs and broad spectrum antibiotics)
- If able to, administer epidural and pack rectum
- Refer
what are the outcomes of the different grades of rectal tares?
- Grade I and II – most will heal with medical treatment (antibiotics, laxatives and dietary changes)
- Grade III – require careful monitoring and most will require surgery
- Grade IV – many euthanased, some can be managed surgically
- Surgical options are direct suturing if possible, plus temporary indwelling rectal liner and colostomy
what are the complication of nasogastric tube intubation?
Epistaxis
* Common and messy, prewarn owner before procedure, normally self limiting – bleed from pharynx or turbinates, so packing nostrils does not reach site of origin
2. Incorrect tube placement
how do you prevent incorrect nasogastric tube placement?
- Check that tube is in oesophagus – watch left side of neck during placement, check for tracheal ‘rattle’, suck back on tube (oesophagus closes round tube end, trachea does not), listen and smell contents to check in stomach, administer small amount of water first
- Presence or absence of coughing does not confirm correct tube placement
- Do not use liquid paraffin – no evidence of benefits, higher risk of complications (lipid pneumonia)
- Risk of pneumonia – treat with NSAIDs and broad spectrum antibiotics (flunixin, pencillin and gentamicin)
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Weight loss14
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weightloss diagnosis14
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weightloss treatment16
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colic21
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colic decision making22
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Dysautonomia18
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Atypical colic2
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Equine adult diarrhoea16
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equine young diarrhoea6
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equine neonatal diarrhoea8
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management of equine diarrhoea15
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chocking horse7
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equine ptyalism9
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eqine gastric disease8
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peritonitis4
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SIRS, sepsis, MODs, DIC9
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critically ill hors18
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Equine gastro parasites15
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Equine gastro praasites treatments8
