colic in equines prof. dr hamed attia

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Colic in equines Prof. Dr Hamed Attia Department of internal Medicine- faculty of veterinary medicine - Zagazig University Egypt

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Page 1: Colic in equines Prof. Dr hamed attia

Colic in equines

Prof. Dr Hamed Attia

Department of internal Medicine-

faculty of veterinary medicine

-Zagazig University

Egypt

Page 2: Colic in equines Prof. Dr hamed attia

Colic

(Equine indigestion)

It is a collection of symptoms

indicating abdominal pain (Grunting,

groaning, looking round at the flank

Page 3: Colic in equines Prof. Dr hamed attia

left side of horse

Page 4: Colic in equines Prof. Dr hamed attia

Right side of horse

Page 5: Colic in equines Prof. Dr hamed attia

I-Anatomical classification

of colic:

1-True colic:

pain from GIT.

2-False colic:

Pain from other parts than GIT

(Liver, kidney, uterus, etc).

Page 6: Colic in equines Prof. Dr hamed attia

II-Clinical classification of colic

1- Spasmodic colic

2- Flatulent colic

3- Obstructive colic

4- Specific colic due to outside obstruction of bowel :

e.g. Volvulus; invagination; torsion; strangulated hernia; scrotal, diaphragmatic & umbilical hernia.

Page 7: Colic in equines Prof. Dr hamed attia

1-Spasmodic colic

Definition :

It is a severe attacks of abdominal pain caused by increase peristaltic movement of the intestine, characterized by:

intermittent fits of colic, rapid course (short duration) and favorable prognosis.

Page 8: Colic in equines Prof. Dr hamed attia

Etiology

(1) Drinking cold water when horse is hot

and sweat after work.

(2) Exposure of the body to external cold or

wetness.

Page 9: Colic in equines Prof. Dr hamed attia

Symptoms

(1) It occurs suddenly in the form of

fits of colic, each fit lasts from 5-15

minutes (short attacks).

during attack the animal kicks at the

abdomen, lies down on the ground

and rolls with violence .

Page 10: Colic in equines Prof. Dr hamed attia

but often rise again after rolling.

(2)There is slight increase in body

temperature, respiration, pulse &

congested mucosa.

(3) An increases in the peristaltic sound.

(4) Defecation occurs at short intervals and

the feces may be semisolid or fluid.

Page 11: Colic in equines Prof. Dr hamed attia

(5) Frequent passage of small quantity of

urine.

(6) Local or patchy sweating on back,

gluteal region, brisket & hindleg region.

(7) Horse may looks at the flank region

towards the site of colic.

(8) After the attach, the horse look normal

till second fit.

Page 12: Colic in equines Prof. Dr hamed attia

Diagnosis

Depends on symptoms which

respond rapidly to the treatment with

narcotics and sedative.

Page 13: Colic in equines Prof. Dr hamed attia

Treatment

(1) Give intestinal sedative and

antispasmodic drugs

R/ Atropine sulfate 4-6 ml 1%IM or IV.

R/ Anlagen 10 ml/100KgBW injected IV

(2) Rectal enema using warm water

and soft soap to stimulates and

regulates peristaltic movement of the

intestine and consequently relief pain.

Page 14: Colic in equines Prof. Dr hamed attia

2-Flatulent colic

(Intestinal tympany)

It is a form of colic due to

excessive distension of the

bowel with gases particularly

cecum and colon.

Page 15: Colic in equines Prof. Dr hamed attia

Etiology

(1) Feeding on large quantities of highlyfermentable green feed such asbarseem.

(2) Ingestion of spoiled or moldy food orgrains, which has tendency to swell.

(3) Sudden change in the ration.

(4) Atony of the bowel.

(5) Obstruction of the bowel by sands.

Page 16: Colic in equines Prof. Dr hamed attia

Symptoms

(1) Sudden attacks of continuous abdominal pain.

(2) Abdominal distension (especially in the right flank).

(3) Cecal percussion gives tympanic sound

Page 17: Colic in equines Prof. Dr hamed attia

(6) Congested mucosa, increase of

pulse & respiration, with moderate

to severe dyspnea.

(5) Affected horse may roll and

paw violently and lies down very

carefully.

(7) Small amount of feces may be

voided.

Page 18: Colic in equines Prof. Dr hamed attia

Diagnosis

(1) History (fermentable food intake),

pass of gases from recum.

2 Obstruction is evident through pre-

rectal exploration.

Page 19: Colic in equines Prof. Dr hamed attia

Treatment:

(1) Apply massage externally in flank

regions and internally through the

rectum using the hand.

(2) Rectal enema

(3) Purgatives:

Oral liquid paraffin 2-3 liters by

stomach tube

Page 20: Colic in equines Prof. Dr hamed attia

(5) Non steroidal anti-

nflammatory drugs:

Finadin

(6) Antifermentive such as

formaline solution, 10-20 ml

dissolved in 2 liters of water

given per os.

Page 21: Colic in equines Prof. Dr hamed attia

3-Obstructive colic

Page 22: Colic in equines Prof. Dr hamed attia

3-Obstructive colic

(Colic due to impaction of the intestine)

It occurs when the large intestine

remains impacted with undigested food

material causing partial obstruction,

colic, depression & anorexia.

Page 23: Colic in equines Prof. Dr hamed attia

left side of horse

Page 24: Colic in equines Prof. Dr hamed attia

Left side of the horse, after removal of the diaphragm, showing the

gastrointestinal tract, spleen, liver, and kidneys.

Page 25: Colic in equines Prof. Dr hamed attia

Right side of horse

Page 26: Colic in equines Prof. Dr hamed attia

cecum

RDC

RVC

LDC

LVC

Duodenum

jejunum

ileum

2

3

1

Page 27: Colic in equines Prof. Dr hamed attia

Etiology

(1) Overfeeding of grains or coarse food rich in cellulose and bran for long period.

(2) Ingesting food materials, which contain large amounts of mud or sand.

(3) Sluggish intestinal peristalsis especially in old debilitated & or draught horses.

(4) Greedy feeding & defective teeth.

Page 28: Colic in equines Prof. Dr hamed attia

(5) Obstruction of the intestine or natural

opening by large foreign bodies or parasite.

(6) Inadequate water intake or green food.

(7) Enterolith, fiber balls, hairball.

(8) Encephalitic (equine rectal paralysis).

Page 29: Colic in equines Prof. Dr hamed attia

Colic may be due to

(1) Impaction of the small intestine.

(2) Impaction of the colon.

Page 30: Colic in equines Prof. Dr hamed attia

[1] Impaction of the small

intestine

Causes:

It occurs due to accumulation of sand

in the small intestine (sandy colic) or

large number of parasites (Ascaris).

Page 31: Colic in equines Prof. Dr hamed attia

Symptoms

(1) The symptoms varies according to the location of impaction:

when the duodenum is affected, the symptoms occurs after feeding within few hours.

when the ileum is affected symptoms appear after several hours.

(2) Restlessness and beats the ground with the forelimbs.

.

Page 32: Colic in equines Prof. Dr hamed attia

(3) In severe attacks the animal lies on the

ground and rolls

(4) During urination the animal throw the

hindlegs backward and outward and urine

comes out at intervals.

Page 33: Colic in equines Prof. Dr hamed attia

[2] Impaction of the colon

It is due to

accumulation of

undigested

materials in the

colon.

The large colon is

the most common

seat of impaction in

horse.

Page 34: Colic in equines Prof. Dr hamed attia

Symptoms

(1) Subacute colic which occurs slowly,

started with dullness and abdominal

discomfort, the animal looks at the flank

and kicking its belly.

(2) Constipation, Feces are passed in

small amounts, hard in consistency and

covered with thick & sticky mucous.

(3) Intestinal sound are absent or much

decreased in intensity.

Page 35: Colic in equines Prof. Dr hamed attia

4) Moderate increase in pulse but the

temperature & respiration are normal.

(5) Rectal palpation revealed balloon

shape colon impacted with fecal mass.

(6) Dehydration, thirst, anorexia occur

with constant effort to urinate.

Page 36: Colic in equines Prof. Dr hamed attia

Diagnosis

Page 37: Colic in equines Prof. Dr hamed attia

1-Case history

A-How sever has the pain been?

B-When did the horse last defecate?

And what was the character of the

feces?

C-Has the horse shown specific

behaviour such as playing with water?

D-Could the horse have gaine access

highly fermentable food?

Page 38: Colic in equines Prof. Dr hamed attia

2- Examination of pulse:

The heart rate and the character of

pulse are important in determining the

degree of severity of colic.

Rates greeter than 80 bpm should be

considered the result of sever lesion or

disease

Page 39: Colic in equines Prof. Dr hamed attia

3- Examination of M.M

In simple dehydration the oral mm is

slight bluish but in sever dehydration it

becomes brick red or cyanosed. In

sever cases it becoms pale blue-grey

color.

Page 40: Colic in equines Prof. Dr hamed attia

4- Auscultaion of

abdomen

Site: the caudal edge of the last ribe from the paralumber fossa to ventral abdomen on both right and left side:

Deacrease or absence of intestinal sounds in case of clonic impaction

NB:

Gas/fluid interface sounds cause by the movments of the horse should not be mistaken

Page 41: Colic in equines Prof. Dr hamed attia
Page 42: Colic in equines Prof. Dr hamed attia

5-Rectal examination

In lare colon impaction is characterized

by an enlarged, firm, filled viscous

located on the pelvic floor

Page 43: Colic in equines Prof. Dr hamed attia

6-Abdomenocentesis

Analysis of peritoneal fluid reflects the

changes. More than 500 white blood

cells/Ul. increase Of protein and RBcs

in colonic impaction & strangulation.

Page 44: Colic in equines Prof. Dr hamed attia

7-Laboratory ex

PCV and Total plasma protine are used

to detrmine the hydration state of the

animal.

Electrolyte and acid base balance.

Page 45: Colic in equines Prof. Dr hamed attia

8-Radiology and ultra-

sonography

9-Endosopy

Page 46: Colic in equines Prof. Dr hamed attia

10-Faecal examination

Ascaris & strongyloides are

the most common causes of

colic in equines.

Page 47: Colic in equines Prof. Dr hamed attia

Differential diagnosis

Differential diagnosis between

impaction in the intestine and colon

by rectal palpation.

Page 48: Colic in equines Prof. Dr hamed attia

والعاديات ضبحا

Page 49: Colic in equines Prof. Dr hamed attia

Treatment

(1)Pain killer:

R/Finadyne 1ml?45Kg BW IV

(2)oral sedative:

such as chloral hydrate 30 given at

once by the stomach tube for a

horse.

Page 50: Colic in equines Prof. Dr hamed attia

(2) Laxative:

per os or direct into the cecum by long

needle as liquid paraffin or mineral oil

or lin seed oil (2-3 liters).

Page 51: Colic in equines Prof. Dr hamed attia

(3)Fluid therapy:

R/Saline (0.09%Na Cl) 5-6LI/V

(4) Rectal enema :

using warm water and soft soap or lubricant.

According to the the degree of dehydration

(5) Parasympathetic drug:

R/Neo-stigmine 1 amp/70 Kg BW

ملحوظة مهمة:

يعطى هذا الدواء بنصف ساعة من إعطاء شربة زيت البرافين وعمل

الحقنة الشرجية ثم عمل رياضة المشى للحصان لمدة نصف ساعة

اليعطى للحوامل من اإلتاث 5و 4رقم

Page 52: Colic in equines Prof. Dr hamed attia

Meconium impaction in

foals

Meconium is the first fecal material

produced in the uterus by a newborn

foal.

It is Composed of cellular debris,

amniotic fluid and intestinal secretions.

Page 53: Colic in equines Prof. Dr hamed attia

It is normally passes within 30 minutes to

two hours after birth.

It is dark brown and forms small balls,

but in meconium impaction it becoms dry

and hard.

Page 54: Colic in equines Prof. Dr hamed attia

Causes

lack of oxygen at birth may affect

intestinal motility.

Dehydration may also effect the

passage of fecal material.

A narrower pelvis in male foal may

predispose it to impaction.

Page 55: Colic in equines Prof. Dr hamed attia

Abdominal pain manifested by tail swishing and restlessness

Reduced attempts to nurse

recumbency and violent rolling

Clinical finding

Page 56: Colic in equines Prof. Dr hamed attia

Abdominal distention.

Absent fecal

production

Eversion of rectal

mucosa

Tenesmus (straining

to defecate) .

Page 57: Colic in equines Prof. Dr hamed attia

Treatment

As in obstructive colic

Divide the dose mention on 8

Page 58: Colic in equines Prof. Dr hamed attia

4-specific colic

Page 59: Colic in equines Prof. Dr hamed attia

4-specific colic

[1] Embolic colic (Verminous

aneurism):

2-Intestinal torsion (Volvulus)

[3] Intestinal strangulation.

[4] Invagination (Intussusception,

telescoping

Page 60: Colic in equines Prof. Dr hamed attia

[1] Embolic colic

(Verminous aneurism)

It is disorder in the intestine due to

the presence of larvae of strongylus

vulgaris in the anterior mesenteric

artery of the horse, causing

aneurisms, emboli and thrombi of the

mesenteric artery and its branches.

Page 61: Colic in equines Prof. Dr hamed attia

Clinical symptoms

It is characterized by intermittent

and attacks of colic which

occurs suddenly during work as

in spasmodic colic, beside that

the feces are bloody &parasitic

eggs are present in fecal

examination

Page 62: Colic in equines Prof. Dr hamed attia

22--Intestinal Intestinal torsiontorsion

((VolvulusVolvulus))

( Gut tie)( Gut tie)

It is an intestinal obstruction

due to rotation of segment of

the intestine around its

mesenteric axis.

It is either partial or complete.

Page 63: Colic in equines Prof. Dr hamed attia
Page 64: Colic in equines Prof. Dr hamed attia
Page 65: Colic in equines Prof. Dr hamed attia

CausesCauses

(1) Severe attack of colic.

(2) violent movements, or sudden fall of

the animal.

(2) Injections of large dose of

parasympathetic drugs

(3) Heavy infestation with parasite

(Ascaris) cause irregularity in peristaltic

movement of the intestine .

Page 66: Colic in equines Prof. Dr hamed attia

SymptomsSymptoms

(1) Peracute abdominal pain, .

(2) Profuse sweating due to fatigue & pain.

(3) Initially temperature is elevated,

terminally becomes subnormal.

(6) Clean rectum by rectal palpation

(7) Short course, death within 48 hours.

Page 67: Colic in equines Prof. Dr hamed attia

DiagnosisDiagnosis

(1) History & symptoms.

(2) Back racking indicates empty rectum

& colon, free from feces.

Page 68: Colic in equines Prof. Dr hamed attia

Treatment:Treatment:

Surgical removal of obstruction.

Page 69: Colic in equines Prof. Dr hamed attia

[[33] Intestinal strangulation] Intestinal strangulation

It occurs when a lope of the intestinepasses through a natural or artificialopening in the peritoneum as in case ofinguinal hernia in stallion. Also in caseof pedunculated tumour which causestrangulation.

Symptoms: as torsion.

Treatment: Surgical.

Page 70: Colic in equines Prof. Dr hamed attia

Umblical hernia Inguinal hernia

Page 71: Colic in equines Prof. Dr hamed attia
Page 72: Colic in equines Prof. Dr hamed attia

[[44] ] InvaginationInvagination ((IntussusceptionIntussusception, ,

telescopingtelescoping

This is a form of acute

intestinal obstruction

caused by telescoping

of a section of the

bowel into a portion

immediately behind it

especially in ileocecal

junction.

Page 73: Colic in equines Prof. Dr hamed attia

The affected part form a

sausage shaped, painful

swelling.

It is composed of three

segments (outer, middle &

inner) .

Page 74: Colic in equines Prof. Dr hamed attia

Intestinal invagination

Page 75: Colic in equines Prof. Dr hamed attia

Causes:(1) As in intestinal torsion.

Symptoms:As in intestinal torsion.

Treatment:Laparotomy