Horse colic

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Colic in the horse is defined as abdominal pain, but this is a clinical sign rather than a diagnosis. The term colic may include all forms of gastrointestinal conditions that cause pain as well as other causes of abdominal pain not involving the gastrointestinal tract. The most common forms of colic are gastrointestinal in nature and most commonly associated with colonic disorders. There are various causes of colic, some of which can be fatal without surgical intervention. Colic surgery is usually an expensive procedure because it is a large stomach surgery, often with intensive care. Among the pets, colic is the leading cause of premature death. The colic incidence in the general horse population has been estimated between 4 and 10 percent during their lifetime. Clinical signs of colic generally require treatment by a veterinarian.

Video Horse colic

Pathophysiology

Colic can be divided into several categories:

1. excessive gas accumulation in the gut (gas colic)
2. simple obstruction
3. choked obstruction
4. infarks that are not strangled
5. gastrointestinal inflammation (enteritis, colitis) or peritoneum (peritonitis)
6. gastrointestinal mucosal ulceration

These categories can be further differentiated by the location of the lesion and the underlying cause (See Colic Type).

Simple obstruction

It is characterized by physical obstruction of the intestine, which can be caused by foodstuffs affected, stricture formation, or foreign body. The primary pathophysiological disorder caused by this obstruction is associated with a trap of fluid in the oral intestine to obstruction. This is because of the large amounts of fluid produced in the upper gastrointestinal tract, and the fact that it is especially reabsorbed in the lower intestine part of the obstruction. The first problem with the level of fluid loss from circulation is one of the decreases in plasma volume, leading to reduced cardiac output, and acid-base disorders.

The intestine becomes swollen from fluid and gas production trapped from bacteria. This is this distension, and the activation of the next stretch receptor within the intestinal wall, leading to the associated pain. With progressive distension of the intestinal wall, there is occlusion of blood vessels, first the less rigid veins, then the arteries. This disorder of blood supply causes hyperemia and congestion, and eventually becomes ischemic necrosis and cellular death. Poor blood supply also has an effect on the vascular endothelium, leading to increased permeability that first leaks plasma and eventually blood enters the intestinal lumen. In contrast, gram-negative bacteria and endotoxins may enter the bloodstream, leading to further systemic effects.

Obstruction strangulation

Strangulation obstruction has all the same pathological features as a simple obstruction, but the blood supply is immediately affected. Both arteries and veins can be affected immediately, or progressively like a simple obstruction. Common causes of strangulation obstruction are intussusception, torsion or volvulus, and intestinal movement through holes, such as hernia, mesenteric tendon, or epiploic foramen.

Non-strangulating infarction

In non-strangulated infarcts, the blood supply to the intestine is blocked, with no obstruction to the ingesta present in the intestinal lumen. The most common cause is an infection with the larvae, which mainly develops within the cranial mesenteric arteries.

Inflammation or ulceration of the gastrointestinal tract

Inflammation along any part of the GI can cause colic. This causes pain and possibly peristaltic stasis (Ileus), which can lead to excessive accumulation of fluid in the gastrointestinal tract. This is a functional blockage rather than a mechanical blockage of the intestine, but like mechanical obstruction seen with simple obstruction, it can have serious effects including severe dehydration. Colitis can cause subsequent increased permeability and endotoxemia. The underlying causes of inflammation may be infection, toxicity, or trauma, and may require special treatment to resolve colic.

Ulceration of the mucosal surface occurs very commonly in the stomach (gastric ulceration), due to damage from gastric acid or changes in gastric protective mechanism, and is usually non-life-threatening. Right dorsal colon can also cause ulceration, usually secondary to excessive use of NSAID, which alters the balance of homeostatic prostaglandins that protect the mucosa.

Maps Horse colic

Type

This type of colic is incomplete but details some types that may be encountered.

Spasmodic gas and colic

Colic gas, also known as tympanic colic, is the result of accumulation of gases in the horse's digestive tract due to excessive fermentation in the gut or decreased ability to move the gas through it. Usually this is the result of changes in the diet, but can also occur due to low dietary drought, parasites (22% spasmodic colic associated with tapeworm), and anthelminthic administration. This buildup of gas causes distension and increases pressure in the intestines, causing pain. In addition, it usually causes an increase in peristaltic waves, which can lead to painful bowel spasms, resulting in subsequent spasmodic colic. Clinical signs of these colic forms are generally mild, transient, and respond well to spasmolytic drugs, such as buscopan, and analgesics. Gas colonies usually self-correct, but there is a risk of subsequent torque (volvulus) or bowel movement due to gas distension, which causes the affected part of the intestine to rise upward in the abdomen.

Abdominal distension is sometimes seen in adult horses in the pelvic region, if the cecum or large intestine are affected. Children, however, may show signs of gas in the small intestine with severe abdominal distension.

Impaction

pelvic bending implants

This is caused by the impaction of foodstuffs (water, grass, straw, grains) in the part of the large intestine known as pelvic flexibility of the left colon where the intestines take a 180 degree spin and narrow. Impaction generally responds well to medical care, usually requiring several days of fluid and laxatives such as mineral oil, but more severe cases may not heal without surgery. If left unchecked, severe colic impaction can be fatal. The most common cause is when the horse is in the break box and/or consumes a large concentrate of feed, or the horse has dental disease and can not chew properly. This condition can be diagnosed on rectal examination by a veterinarian. Impaction is often associated with winter months because horses do not drink as much water and eat drier matter (straw, not grass), resulting in a more dry contents of the intestine that is more likely to get stuck.

Ileal impaction and ileal hypertrophy

The ileum is the last part of the small intestine that ends in the cecum. Ileal impaction can be caused by ingesta obstruction. The straw hay coast is associated with impaction in the lower segment of the small intestine, although it is difficult to separate these risk factors from geographic locations, as the southeastern United States has a higher prevalence of ileal impaction and also has regional access to the Bermuda coast. straw. Other causes can be obstructed by ascarids ( Parascaris equorum ), usually occurring at 3-5 months after intestinal worms, and tapeworms ( Anoplocephala perfoliata ), which has been associated with up to 81% of the ileal impact (See Ascarids). The horses show intermittent colic, with moderate to severe signs and with time, split the small intestine loop in the rectum. Although most ileal impactions will sometimes pass without intervention, those present for 8-12 hours will cause the fluid to rise again, leading to gastric reflux, which is seen in about 50% of horses requiring surgical intervention. Diagnosis is usually made on the basis of clinical signs, the presence of reflux, rectal examination, and ultrasound. Often impaction can not be felt on the rectum because of an enlarged small intestine loop that blocks the examiner. Unresponsive effects on medical management, which include IV fluid and reflux removal, can be treated by a single injection into the ileum with 1 liter of carboxymethylcellulose, and then massaging the ileum. This allows impaction to be treated without actually cutting into the ileum. The prognosis for survival is good.

Eileal hypertrophy occurs when the layer is circular and extends from the hypertrophy of the ileal intestinal wall, and can also occur with jejunal hypertrophy. The mucosa remains normal, so malabsorption is not expected to occur in this disease. Bungal hypertrophy may be idiopathic, with current theories for such cases include nerve dysfunction in the intestinal wall secondary to parasitic migration, and an increase in ileocecal valve tone leading to ileal hypertrophy while attempting to push the contents into the cecum. Hypertrophy can also occur secondary to obstruction, especially those who have undergone surgery for obstruction requiring anastomosis. Hypertrophy gradually decreases the size of the lumen, producing intermittent colic, and in about 45% of cases including weight loss of 1-6 months duration and anorexia. Although rectal examination may show a thickened ileal wall, usually a diagnosis is performed during surgery, and an ileocecal or jejunocecal anastomosis is made to allow the intestinal contents to pass through the affected area. If surgery and bypass are not performed, there is a risk of rupture, but a fair prognosis with surgical treatment.

Sand impaction

This is most likely to occur in horses grazing in grassy or heavy grasslands that leave only dirt to digest. Small children, weanlings, and yearlings most likely absorb the sand, and therefore most often seen with colic sand. The term sand also includes dirt. Sand or grime that is digested most often accumulates in pelvic bending, but can also occur in the right dorsal colon and cecum of the large intestine. Sand can cause colicky signs similar to other impurities of the large intestine, and often cause abdominal distention. Because sand or dirt irritates the intestinal lining, it can cause diarrhea. The weight and abrasion of sand or dirt cause the intestinal wall to become inflamed and may lead to decreased intestinal motility and, in severe cases, cause peritonitis.

Diagnosis is usually made based on history, environmental conditions, ventral ventilation, radiography, ultrasound, or faecal examination (See Diagnosis). Historically, medical treatment problems were with laxatives such as paraffin or oil fluids and psyllium husk. Recently the vet handled cases with a combination of synbiotic (pro and prebiotic) and certain psyllium. Psyllium is the most effective medical treatment. It works by binding to the sand to help remove it, although some care may be necessary. Mineral oil is mostly ineffective because it floats on the surface of the impact, rather than penetrating it. Horses with sand or dirt impurities are susceptible to Salmonella infection and other GI bacteria, so antibiotics are often added to help prevent infection. Medical management usually resolves colic, but if repairs do not occur within a few hours then surgery should be performed to water the intestines of each sand, which procedures have a survival rate of 60-65%. Untreated horses, or treated late after onset of clinical symptoms, are at risk of death.

Horses should not be fed directly on the ground in areas where sand, dirt and mud are prevalent, although a small amount of sand or dirt may still be digested by grazing. Management to reduce sand intake and prophylactic treatment with sand removal products is recommended by most veterinarians. Such prophylaxis includes feeding psyllium pellets for one week every 4-5 weeks. Longer duration of treatment will result in changes in the gastrointestinal flora and psyllium will be damaged and ineffective for sand removal. Other methods include feeding horses before the turnout, and turning horses out in the middle of the day so they are more likely to stand in the shade than grazing.

Impaction cecal

Only 5% of bowel impaction at referral hospitals involves cecum. The impact of primary cecal usually consists of dry feed ingredients, with horses slowly developing clinical signs for several days. Secondary cecal impacts may occur postoperatively, orthopedic or otherwise, and the cecum is not functioning properly. Horses usually show clinical signs 3-5 days post general anesthesia, including decreased appetite, decreased production of manure, and gas in the caecum that can auscultate. Rapid swells swell due to fluid and gas accumulation, often causing rupture within 24-48 hours if not repaired. This impaction may be overlooked as decreased production of manure can be attributed to secondary operations, and often ruptures before severe signs of illness. Horses are most at risk for this type of impaction if surgery is longer than 1 hour, or if insufficient analgesia is given postoperatively.

Diagnosis is usually done by rectal palpation. Treatments include fluid and analgesic therapy, but surgery is indicated if there is severe cecal secretion or if medical therapy does not improve the situation. Surgery includes typhlotomy, and although cecal bypass has been done in the past to prevent a recurrence, recent studies show that it is not necessary. Surgery has a good prognosis, although rupture may occur during surgical manipulation. The cause of cecal impact is unknown. The cecal impasion must be distinguished from large colonic impaction via rectal, since cecal impaction has a high risk of rupture even before severe pain. The overall prognosis is 90%, regardless of medical or surgical treatment, but rupture does not occur, often without warning.

Gastric behavior

The impact of the stomach is relatively rare, and occurs when the food is not cleansed at an appropriate level. It is most often associated with swollen food intake after eating or eating roughly (bed or poor quality), poor dental care, poor mastication, inadequate drinking, foreign body consumption, and changes in normal functioning of the stomach. Persimmon, which forms a sticky gel in the abdomen, and haylage, are both associated with it, such as wheat, barley, mesquite nuts, and beet porridge. Horses usually show signs of mild chronic colic, unresponsive to analgesia, and may include signs such as dysphagia, ptyalism, bruxism, fever, and lethargy, although severe colic signs may occur. Signs of shock can be seen if gastric rupture has occurred. Usually, the impaction must be considerable before the onset of symptoms, and may be diagnosed by gastroscopy or ultrasound, although rectal examination does not help. Impact tingling is treated with a Coca-Cola infusion. Other gastric effects are often lost with enteral fluid. Fast treatment generally results in a favorable prognosis.

Small impotence of the colon

The small colon impact represents a small amount of colic on the horse, and is usually caused by obstruction of fecalith, enterolith, and meconium. Horses usually present with standard colic marks (scavenging, side viewing, rolling) on ​​82% of horses, and occasionally with diarrhea (31%), anorexia (30%), straining (12%), and depression ( 11%), and Rectal examination will reveal a strong loop of small colon or a completely palpable obstruction in the rectum. Damage is most common in miniature horses, probably because they do not chew their feed, and during autumn and winter. Medical management includes the use of aggressive fluids, laxatives and lubricants, and enemas, as well as analgesics and anti-inflammation. However, these impactions often require surgical intervention, and the surgeon will empty the large intestine either with enterotomy or with lubrication and massage. Surgical intervention usually results in longer recovery time in the hospital. The prognosis is excellent, and horses treated with surgical care have survival by returning to athletic function level of 91%, while 89% of medically managed horses return to previous use.

Large colon impact

The large impact on the colon occurs in pelvic bend and right dorsal colon, two areas where the intestinal lumen narrows. Large intestinal effects are most often seen in horses that have recently experienced a sudden decline in exercise, such as after musculoskeletal injuries. They are also associated in the practice of grain feeding twice a day, which causes a brief but significant secretion of fluid into the intestinal lumen, resulting in a 15% reduction in plasma volume (hypovolemia in the circulatory system) and subsequent activation of the renin-angiotensin-aldosterone system. Aldeosterone secretion activates the absorption of fluid from the large intestine, decreases the ingesta water content and increases the risk of impaction. Amitraz has also been associated with impaction of the colon, due to changes in motility and retention of the intestinal contents, leading to further uptake of water and dehydration ingesta. Other factors that may include poor dental care, grass alone, dehydration, and limited exercise.

Horses with impaction of the colon usually have mild signs that slowly get worse if the impaction does not resolve, and can produce severe signs. Diagnosis is often done with rectal palpation of the masses, although this is not always accurate because some of the colon is not palpable in the rectum. The additional part of the intestine may be swollen if there is a liquid reserve. The production of manure decreases, and if passed, it is usually hard, dry and mucus closed. Horses are treated with analgesics, fluid therapy, mineral oil, dactyl sodium sulfosuccinate (DSS), and/or epsom salts. Analgesics can usually control stomach discomfort, but may become less effective over time if impaction does not resolve. Continuous effects may require fluids administered intravenously and orally via a nasogastric tube, at a rate of 2-4 times maintenance for the animal. Bait is kept secret. Horses that do not improve or become very painful, or those with large amounts of gas distension, are advised to undergo surgery to remove impaction through enterotomy from the pelvic arch. Approximately 95% of horses undergoing medical management, and 58% of surgical cases, survive.

Enteroliths and fecaliths

Enteroliths on horses are round from mineral deposits, usually from ammonium magnesium phosphate (struvite) but occasionally magnesium vivainite and some amounts of sodium, potassium, sulfur and calcium, which develop in the horse's digestive tract. They can form around a piece of foreign material that is digested, such as wire nidus or small sand (similar to how oysters form pearls). When they move from their original site, they can block the intestine, usually in the dorsal colon and right transverse, but rarely in small colon. They can also cause mucosal irritation or pain as they move in the gastrointestinal tract. Enterolith is not a common cause of colic, but is known to have a higher prevalence in countries with sandy soils or the abundance of alfalfa straw that is fed, such as California, a country where 28% of surgical colic is caused by enterolith. Alfalfa straw is considered to increase the risk due to the high protein content in straw, which is likely to increase levels of ammonia nitrogen in the intestine. They may be more common in horses with high-magnesium diets, and are also seen more frequently in Arabs, Morgans, American Saddlebreds, miniature horses, and donkeys, and usually occur in horses older than four years old. Horses with enteroliths usually have chronic, low, recurrent colic markers, which can cause acute colic and large colon distension after luminal occlusion occurs. This horse may also have a history of enterolith in their filth. The degree of pain is related to the level of luminal occlusion. Abdominal radiography can confirm the diagnosis, but smaller enteroliths may not be visible. In rare cases, enteroliths can be palpated on rectal examination, usually if they are in small colon. After the horse is diagnosed with colic due to enterolith, surgery is needed to remove it, usually with pelvic bending enterotomy and occasionally additional right dorsal rightopathic intestine, and fully resolve the colic signs. Horses will usually feature a round enterolith if it is the only one present, while some enteroliths usually have a flat side, hinting to the surgeon to find more stones. The main risk of surgery is colon rupture (15% of cases), and 92% of horses found surviving for at least a year from their date of operation.

Fecalite is a hard-to-swallow formation that blocks the digestive tract, and may require surgery to complete it. This is most often seen in miniature horses, ponies, and foals.

Moving

The shift occurs when most of the large intestine - usually pelvic bending - moves to an abnormal location. There are four major displacements described in horse medicine:

1. Left dorsal displacement (nephrosplenic trap) : pelvic veins move to the back toward the nephrosplenic space. This space is found between the spleen, the left kidney, the nephrosplenic ligament (which runs between the spleen and kidney), and the body wall. In some cases, the intestine becomes trapped over the nephrosplenic ligaments. LDD accounts for 6-8% of all colic.
2. Right dorsal displacement : the large intestine moves between the cecum and the body wall.
3. Pelvic reflex retroflex to the diaphragm
4. The colon develops 180 degree volvulus , which may or may not clog the organ's blood vessels.

The cause of displacement is not known for certain, but one explanation is the intestine becomes abnormal because of gas (from excessive grain fermentation, microbiota changes secondary to antibiotic use, or secondary gas buildup from impaction) leading to an abnormal shift of the intestine. Since most of the gut is not anchored to the body wall, it is free to move out of position. Displacement is usually diagnosed using a combination of findings from rectal and ultrasound examinations.

Many displacements (~ 96% LDD, 64% RDD) are resolved with medical management that includes fluids (oral or intravenous) for horse rehydration and softening possible impactions. Systemic, antispasmodic, and sedation analgesics are often used to keep horses comfortable during this time. Horses with left dorsal displacement are sometimes treated with exercise and/or phenylephrine - a drug that causes spleen contractures and allows the intestines to escape from the nephrosplenic ligaments. Sometimes anesthesia and scrolling procedures, in which the horse is placed on the lateral side are tilted and rolled towards the right lateral when jostling, can also be used to try to shift the colon from the nephrosplenic ligament. Displacement that does not respond to medical therapy requires surgery, which generally has a very high success rate (80-95%).

Reoccurrence can occur with all types of displacement: 42% of horses with RDD, 46% of horses with retroflexions, 21% of them with volvulus, and 8% of those with LDD having colic back. LDD can be prevented by closing the nephrosplenic space with stitches, although this does not prevent other types of displacements occurring in the same horse.

Torque and volvulus

Volvulus is a rotation along the mesentery axis, the torque is round along the longitudinal axis of the intestine. The various parts of the horse's digestive tract can rotate on themselves. Most likely the small intestine or part of the large intestine. The occlusion of the blood supply means that it is a painful condition that causes rapid decline and requires emergency surgery.

Large colonic colellulus usually occurs where the mesentery is attached to the body wall, but can also occur in the diaphragm or sternal indentation, with rotation of up to 720 degrees reported. This is most often seen in postpartum horses, usually accompanied by severe colic markers that are refractory to analgesic administration, and horses often lie on the back of the back. Abdominal distension is common due to rapid strangulation and swelling of the intestine with gas, which can then cause dyspnea as the developing bowel pushes the diaphragm and prevents normal ventilation. In addition, compression may place pressure on the caudal cava vein, leading to blood collection and hypovolemia. However, the horse may not have a high heart rate, probably due to increased vagal tone. Rectal palpation will show severe distention colon, and the examiner may not be able to push beyond the pelvic periphery due to obstruction. The large intestine may be irreversibly damaged within 3-4 hours of the initial volvulus time, requiring immediate surgical correction. The surgeon works to repair the volvulus and then removes the damaged colon. 95% of the colon can be resected, but often volvulus damages more than this amount, requiring euthanasia. Plasma lactate levels can help predict survival rates, with an increase in survival seen in horses with lactate below 6.0 mmol/L. The prognosis is usually poor, with a survival rate of about 36% of horses with 360-degree volvulus, and 74% of them with a volvulus of 270 degrees, and a recurrence rate of 5-50%. Postoperative complications include hypoproteinemia, endotoxic shock, laminitis, and DIC.

Small intestinal Volvulus is thought to be caused by local peristaltic changes, or because mesenterial lesions may revolve around (such as ascarid impulses), and usually involve the distal jejunum and ileum.w This is one of the most common causes of small bowel obstruction in foals, perhaps because of sudden changes into bulkier food. Animals present with acute and severe colic signs, and some loop of the distended intestines, usually seen radiographs in foals. Small intestinal volvulus often occurs secondary to other disease processes in adult horses, where small bowel obstruction leads to distension and then rotation around the mesentery root. Surgery is needed to rescue intestinal parts that can not survive, and prognosis correlates with the length of the intestine involved, with animals with more than 50% of small bowel involvement having a cemetery prognosis.

Intussusception

The intussusception is a colic form in which a piece of "telescope" intestines in a part of itself is due to the paralyzed part, so the motile part pushes itself into the non-motile part. This is most common at ileocecal junctions and requires immediate surgery. Almost always associated with parasitic infections, usually tapeworms, although small masses and foreign bodies may also be responsible, and most commonly occur in young horses usually around the age of 1 year. Ileocecal intussusception may be acute, involving longer (6-457 cm) intestinal, or chronic segments involving shorter sections (up to 10 cm). Horses with an acute form of colic usually have a colic duration of less than 24 hours, while chronic cases have mild but intermittent colic. Horses with chronic forms tend to have a better prognosis.

Rectal examination revealed masses at the base of the cecum in 50% of cases. Ultrasound reveals a very distinctive "target" pattern on the cross section. The results of abdominocentesis may vary, as the strangulated intestine is trapped in healthy intestine, but there are usually signs of obstruction, including reflux and some loop of small bowel felt in the rectal. Surgery is required for intussusception. Reduction of this area is usually ineffective because of swelling, so the jejunojejunal intusception is resected and ileomic intussusception resected as far as possible and jejunocecal anatomy is performed.

Entrapment

Epiploic foramen entrapment

On rare occasions, a small intestinal (or rarely colon) piece may be trapped through the epiploic foramen into the omental bursa. This blood supply to the intestine is blocked immediately and surgery is the only treatment available. This type of colic has been linked to cribbers, probably due to changes in abdominal pressure, and to older horses, perhaps because the foramen is enlarged as the right lobe of liver atrophy with age, although it has been seen in horses as young as 4 months old. Horses usually present with colicky signs that can be referred to small bowel obstruction. During surgery, the foramen can not be enlarged because of the risk of rupture of the vena cava or portal vein, which will lead to fatal bleeding. Survival is 74-79%, and survival is consistently correlated with abdominocentesis findings before surgery.

Mesenterika old trap

Mesenterium is a thin sheet attached to the entire length of the intestine, attaching blood vessels, lymph nodes, and nerves. Sometimes, small rents (holes) can form on the mesenterium, where intestinal segments can sometimes enter. As with epiploic foramen branching, the first intestine enlarges, because the artery does not close as easily as the vein, which causes edema (fluid accumulation). As the intestines expand, the less likely it is to get out of the trap. Colic signs may be referred to strained lesions, such as moderate to severe abdominal pain, endotoxemia, decreased intestinal sound, rectal swelling in the rectal, and nasogastric reflux. This problem requires surgical correction. Survival for mesenteric traps is usually lower than other small intestinal strangulation lesions, possibly due to hemorrhage, difficulty in fixing the traps, and generally involved intestinal length, with & lt; 50% of cases survive until disposal.

Inflammatory and ulcerative conditions

Proximal enteritis

Proximal enteritis, also known as anterior enteritis or duodenalitis-proximal jejunitis (DPJ), is an inflammation of the duodenum and upper jejunum. This is potentially caused by infectious organisms, such as the Salmonella and Clostridial species, but other factors that may contribute include Fusarium infection or high concentrate diets. Intestinal inflammation causes large secretions of electrolytes and fluids to the lumen, and thus a large amount of gastric reflux, which causes dehydration and sometimes shock.

Signs include acute onset of moderate to severe pain, large orange-brown volume and fetal stomach reflux, small bowel swelling on rectal examination, fever, depression, elevated heart rate and respiratory rate, prolonged CRT, and dark mucous membranes. Pain level usually improves after gastric decompression. It is important to distinguish DPI from small bowel obstruction, because obstruction may require surgical intervention. This can be difficult, and often requires a combination of clinical signs, the result of a physical examination, laboratory data, and ultrasound to help suggest a diagnosis over another, but a definitive diagnosis can only be done surgically or on necropsy.

DPI is usually administered medically with nasogastric intubation every 1-2 hours to relieve secondary stomach pressure due to reflux, and support aggressive fluid to maintain hydration and improve electrolyte imbalance. Horses often hold food for several days. Use of anti-inflammatory, anti-endotoxin, anti-microbial, and prokinetic drugs is common in this disease. Surgery may be necessary to exclude obstruction or strangulation, and in long standing cases to perform painful bowel resections and anastomosis. The survival rate for DPJ is 25-94%, and the horses in the southeastern United States appear to be more affected.

colitis

Colitis is a colitis. The acute case is a medical emergency because the horse rapidly loses fluid, protein, and electrolytes into the intestine, which causes severe dehydration that can lead to hypovolemic shock and death. Horses generally come with colicky signs before developing watery, runny and rotten diarrhea.

Both infectious and noninfectious causes for colitis exist. In adult horses, Salmonella , Clostridium difficile , and Neorickettsia risticii (the causative agent of Potomac Horse Fever) are common causes of colitis. Antibiotics, which can cause unhealthy and unhealthy microbiota, sand, excess seeds, and toxins such as arsenic and cantharidin can also cause colitis. Unfortunately, only 20-30% of cases of acute colitis can be diagnosed definitively. NSAIDs may lead to a slower onset of colitis, usually in the right dorsal colon (see right dorsal dyst).

Treatment involves administering large volumes of intravenous fluids, which can be very expensive. Antibiotics are often given if deemed appropriate based on suspected underlying causes and horse CBC results. Therapy to help prevent endotoxemia and increase blood protein levels (plasma or synthetic colloid administration) can also be used if budget constraints permit. Other therapies include probiotics and anti-inflammatory drugs. Horses who do not eat well may also need parenteral nutrition. Horses usually require 3-6 days of treatment before clinical signs improve.

Because of the risk of endotoxemia, laminitis is a potential complication for horses suffering from colitis, and can be a major cause for euthanasia. Horses are also at risk of developing thrombophlebitis.

Gastric ulcer

Horses form a fairly common stomach ulcer, a disease called horse stomach ulcer syndrome. Risk factors include confinement, rare feeding, high concentrate feed proportions, such as grains, excessive use of non-steroidal anti-inflammatory drugs, and stress on delivery and show. Gastric ulcers have also been associated with the consumption of the cantharidin beetle in alfalfa hay which is very caustic when chewed and digested. Most ulcers can be treated with drugs that inhibit gastric acid-producing cells. Antacids are less effective in horses than in humans, because horses produce virtually constant stomach acid, while humans produce acid especially when eating. Food management is very important. Bleeding ulcers that cause gastric rupture are rare.

Right dorsal colitis

Long-term use of NSAIDs may cause colonic mucosal damage, secondary to a decrease in homeostatic prostaglandin levels. Mucosal injury is usually confined to the right dorsal colon, but can be more common. Horses may exhibit acute or chronic intermittent colic, peripheral edema secondary to loss of protein enteropathy, decreased appetite, and diarrhea. Treatment involves decreasing the fiber level of the horse diet by reducing grass and straw, and placing horses on easily digestible feeds until the large intestine gets healed. In addition, horses may be given misoprostol, sucralfate, and psyllium to try to improve mucosal healing, as well as metronidazole to reduce colon inflammation.

Tumor

Curbing stemmed lipoma

Benign fatty tumors known as lipomas can form on the mesentery. When the tumor enlarges, it stretches the connective tissue into a stalk that can wrap the intestinal segment, usually the small intestine, cut off its blood supply. The tumor forms a button attached to the stalk of the tumor, locks it in place, and requires surgery for resolution. Surgery involves cutting the stem of the tumor, opening the intestine, and lifting the intestines that are no longer feasible. If colic is identified and brought to surgery quickly, there is a reasonable rate of success of 50-78%. This type of colic is most often associated with ponies, and gelding age, 10 years and older, probably due to the distribution of fat in this group of animals.

Other cancers

Cancer (neoplasia) in addition to lipoma is a relatively rare cause of colic. Cases have been reported with bowel cancer including intestinal lymphosarcoma, leiomyomas, and adenocarcinoma, stomach cancers such as squamous cell carcinoma, and lymphocarcinoma of the lizard.

Gastric squamous cell carcinoma is most commonly found in areas of non-horse abdominal glands over 5 years, and horses often present with weight loss, anorexia, anemia, and ptyalism. Gastric carcinoma is usually diagnosed by gastroscopy, but it can sometimes be felt in the rectal if they have metastasized to the peritoneal cavity. In addition, laparoscopy can also diagnose metastatic cancers, as well as the presence of neoplastic cells in the abdominocentesis. Often signs of intestinal neoplasia are not specific, and include weight loss and colic, usually only if bowel lumen obstruction occurs.

Ileus

Ileus is a lack of bowel motility, leading to functional obstruction. Often postoperative after all types of abdominal surgery, and 10-50% of all cases of surgical colic will develop these complications, including 88% of horses with strangulation obstruction and 41% of all colic with colon lesions. The exact cause is unknown, but presumably due to intestinal inflammation, possibly due to manipulation by the surgeon, and increased sympathetic tone. It has a high mortality rate of 13-86%.

Ileus is diagnosed based on several criteria:

1. Nasogastric reflux: 4 liters or more in single intubation, or more than 2 liters of reflex through more than one intubation
2. Heart rate greater than 40 bpm
3. Colicky signs, which can vary from mild to severe
4. Distal intestines, based on rectal or abdominal ultrasound findings. In ultrasound, ileus is present as more than 3 loop of small bowel, with a lack of peristaltic waves.

This form of colic is usually medically administered. Because there is no motility, the contents of the intestine back up to the stomach. Therefore, gastric decompression although nasogastric intubation is essential to prevent rupture. Horses are closely monitored after abdominal surgery, and a sudden increase in heart rate indicates the need to check for nasogastric reflux, as this is an early indication of postoperative ileus. Horses are placed in intravenous fluids to maintain hydration and electrolyte balance and prevent hypovolemic shock, and the rate of fluid is calculated based on daily care needs plus fluid loss through nasogastric reflux.

Motility is driven by the use of prokinetic drugs such as erythromycin, metoclopramide, bethanechol and lidocaine, as well as through a strong pathway, which is also shown to have beneficial effects on GI motility. Lidocaine is very useful, because it not only promotes motility, but also has anti-inflammatory properties and can improve post-operative pain. Metoclopramide has been shown to reduce reflux and stay in hospital, but it has a stimulating effect on the central nervous system. Anti-inflammatory drugs are used to reduce inflammation of the gastrointestinal tract, which is thought to be the cause of the disease, as well as to help control the absorption of LPS in cases of endotoxemia because the substance decreases motility. However, care should be taken when administering these medications, as NSAIDs have been shown to alter bowel motility.

Uileus colon is most often seen in horses after orthopedic surgery, but the risk is also increased in cases where postoperative pain is not well controlled, after prolonged surgery, and possibly after ophthalmologic surgery. This is characterized by decreased dirt output (& lt; 3 piles per day), rather than nasogastric reflux, as well as decreased intestinal sounds, colic signs, and occasional impaction of the cecum or colon. Cecal impactions can be fatal, so be careful to monitor horses for ileus colon after orthopedic surgery, especially with regard to decreased production of manure.

Reduced intestinal motility can also be the result of medications such as Amitraz, which is used to kill lice and mites. Xylazine, detomidine, and butorphanol also reduce motility, but will not cause colic if given appropriately.

Parasites

Ascarids (roundworm)

Sometimes there is an obstruction by a large number of roundworms. This is most often seen in young horses as a result of very severe attacks of Parascaris equinum that can cause blockage and small bowel rupture. Rarely, dead worms will be seen on reflux. The eradication of severe worms in horses can cause severe immune reactions to the dead worms, which can damage the intestinal wall and cause fatal peritonitis. Veterinarians often treat horses with heavy worm loads suspected with corticosteroids to reduce the inflammatory response to dead worms. Small bowel obstruction, especially ileum, may occur with Parascaris equinum and may require colic surgery to remove it manually. Large roundworm infections are often the result of poor worm eradication programs. Horses develop immunity to parascarids between the ages of 6 months and one year so this condition is rare in adult horses. Prognosis is fair unless the children have hypovolemia and septic shock, with a survival rate of 33%.

Tapeworm

Tapeworm at the caecal intersection has been involved in causing colic. The most common species of horse tapeworm on the horse is Anoplocephala perfoliata . However, a 2008 study in Canada showed that there was no association between tapeworm and colic, conflicting studies conducted in the UK.

Cyathostomes

Acute diarrhea can be caused by cyathostomes or "small Strongylus -type" worms that are castrated as larvae in the intestinal wall, especially if large numbers appear simultaneously. The disease is most common in winter. Pathological changes in the gut reveal the distinctive color of "pepper and salt" from the colon. Animals suffering from cyathostominosis usually have a poor history of worms. Now there is a lot of resistance to fenbendazole in the UK.

Strength

The large strong worms, most often Strongylus vulgaris, are involved in colic secondary to non-strangulated infarction of the cranial mesenteric arteries supplying the intestine, most likely due to vasospasm. Usually the small intestine of the distal and large colon are affected, but any segment provided by this artery can be compromised. This type of colic becomes relatively rare with the advent of modern anthelminthics. Clinical signs vary by the degree of vascular compromise and the length of the affected bowel, and include acute and severe colic seen with other forms of strangulation obstruction, so the diagnosis is usually made on the basis of a history of anthelminthic administration although it can be diagnosed definitively during surgery. exploratoration. Treatments include typical management of colic and endotoxaemia, and aspirin to reduce the risk of thrombosis, but surgery usually does not help because the lesions are often patchy and may be located in areas that are not easily resectable.

Colic Foal

Meconium impaction

Meconium, or the first feces produced by foals, is a hard pellet substance. It is usually passed within the first 24 hours of foal life, but may affect the distal colon or rectum. Meconium impaction is most commonly seen in foals 1-5 days of age, and is more common in miniature foals and in colts more than fillies (probably because fillies have wider pelvis). Children will stop breastfeeding, strain to defecate (a gift of curved back and raised tail), and may begin to show real signs of colic such as rolling and rising and falling. In the next stage, the stomach will grow because it continues to fill with gas and dirt. Meconium impacts are often diagnosed with clinical signs, but digital examinations to feel the effects of meconium, radiography, and ultrasound can also be used.

Treatment of meconium impaction usually involves the use of enemas, although persistent cases may require mineral oil or IV fluids. It is possible to say that meconium has passed when the foal begins to produce softer and more yellow dirt. Although meconium impaction rarely leads to perforation, and is usually not life-threatening, foals are at risk of dehydration and may not get enough IgG levels due to decreased suckling and inadequate consumption of colostrum. In addition, the horses will eventually bloat, and will require surgical intervention. Surgery in foals can be very risky because immature immune systems and low levels of colostrum are ingested.

Lethal white syndrome

White lethal syndrome, or ileokolonic aganglionosis, will produce meconium impaction because foals do not have sufficient neural innervation to the colon, in essence, a malfunctioning bowel. Foals that are homozygous for the frame overo gene, often seen in Cat's horse heritage, will develop the condition. They present with colicky signs within the first 12 hours after birth, and die within 48 hours of constipation. This syndrome can not be treated.

Congenital abnormalities

Atresia coli and atresia ani can also appear as meconium impaction. This foal loses its distal colonic lumen or anus respectively, and usually shows signs of colic within 12-24 hours. Atresia coli is usually diagnosed by a barium contrast study, in which the foal is given a barium, and then a recombination to see if and where the barium is trapped. Atresia ani is only diagnosed with a digital examination by a veterinarian. Both situations require emergency surgery to prevent death, and often still have a poor prognosis for survival with surgical correction.

Contagious organism

Clostridial enterocolitis due to infection by Clostridium perfringens is most commonly seen in children under 3 months of age. Clostridial toxin damages the intestines, causing dehydration and toxemia. Children usually present with colic signs, decreased breastfeeding, abdominal distension, and diarrhea that may contain blood. Diagnosis is made with fecal culture, and while some foals do not require serious intervention, others require intravenous fluids, antibiotics, and aggressive treatments, and may still be dead. Other bacterial infections that can cause enterocolitis include Salmonella, Klebsiella, Rhodococcus equi, and Bacteriodes fragilis.

Parasitic infections, especially with caterpillars ( Strongyloides westeri ) and ascarids ( Parascaris equorum ) can produce colicky signs in foals (See Ascarids). Other conditions that can cause colicky signs in foals include congenital abnormalities, gastric ulcers (see gastric ulcers), which can cause gastric perforation and peritonitis, small bowel volvulus, and uroabdomen due to bladder rupture.

Herniation

Inguinal herniation

Inguinal hernias are most commonly seen in Standardbred and Tennessee Walking Horse stallions, probably due to the prevalence of large inguinal ring breeds, as well as Saddlebred and Warmblood breeds. Inguinal hernias in adult horses are usually suffocating (unlike foals, which are not usually suffocating). Male horses usually show acute signs of colic, and the testes are cold and enlarged on one side. Hernias are classified as indirect, where the intestines remain in the parietal vaginal tunnel, or directly, in this case rupture through the tunic and run subcutaneously. Hernia is seen most often in foals, and is usually congenital. Indirect hernia can be treated with manual repetitive recur, but a direct hernia often requires surgery to repair. The testes on the resection side will often require removal due to vascular compromise, although the prognosis for survival is good (75%) and the horse can be used for breeding in the future.

umbilical herniation

Although umbilical hernia often occurs in foals, strangulation is rare, occurs only 4% of the time and usually involves the small intestine. Rarely, a hernia will only involve part of the intestinal wall (referred to as Richter hernia ), which can cause enterocutaneous fistulas. The umbilical strangulation hernia will appear as enlarging, firm, warm, and painful with colicky signs. Foals usually survive to be thrown away.

Diaphragm herniation

Diaphragmatic hernia is rare in horses, accounting for 0.3% of colic. Usually the small intestine undergoes a herniation through the diaphragm rent, although there are parts of the intestine that may be involved. Hernias are most commonly acquired, not congenital, with 48% of horses having a recent history of trauma, usually during labor, abdominal distension, falling, or strenuous exercise, or direct trauma to the chest. Congenital hernia occurs most often in the most ventral part of the diaphragm, while the acquired hernia is usually seen at the junction of the muscular and diaphragm tendons. Clinical signs are usually similar to obstruction, but sometimes a decrease in lung sound can be heard in one section of the chest, although dyspnea is only seen in about 18% of horses. Ultrasonography and radiography can be used to diagnose diaphragmatic herniation.

Poison

Swallowed poison rarely causes colic in horses. Toxins that can produce colic signs include organophosphate, monensin, and cantharidin. In addition, excessive use of certain medications such as NSAIDs can cause colicky signs (See Gastric Ulcers and Right Back Colitis).

rips and uterine torque

Often ruptures of the uterus a few days after delivery. They can cause peritonitis and require surgical intervention to be corrected. Uterine torsion may occur in the third trimester, and while some cases may be corrected if the horse is anesthetized and overturned, others require surgery.

Other causes that may show clinical signs of colic

Strictly speaking, colic refers only to signs derived from the horse's digestive tract. Colicky signs can be caused by problems other than the digestive tract for example. problems in the liver, ovaries, spleen, urogenital system, testicular torsion, pleuritis, and pleuropneumonia. Diseases that sometimes cause symptoms that appear similar to colic include uterine contractions, laminitis, and rhabdomyolysis during activity. Colic pain due to kidney disease is rare.

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Diagnosis

Many different diagnostic tests are used to diagnose the cause of certain forms of horse colic, which may have a greater or lesser value in certain situations. The most important difference to make is whether the condition is administered medically or surgically. If surgery is indicated, it should be done as soon as possible, because the delay is a terrible prognostic indicator.

History

A thorough history is always taken, including signals (age, gender, breed), recent activity, diet and recent dietary changes, anthelmintic history, if the horse is a cribber, the quality of the stool and when it was last, and the history of colic. The most important factor is the time elapsed since the onset of clinical signs, as this has a profound impact on prognosis. In addition, veterinarians need to know which drugs are given to horses, their numbers, and time given, as they can help with the assessment of colic development and how it responds to analgesia.

Physical exam

Heart rate increases with the development of colic, partly due to pain, but mainly due to decreased volume of secondary circulation due to dehydration, decreased preload of hypotension, and endotoxemia. Levels are measured over time, and their response to analgesic therapy is ensured. The increasing pulse in the face of adequate analgesia is considered a surgical indication. The color of the mucous membranes can be assessed to appreciate the degree of hemodynamic compromise. Pale mucous membranes may be caused by decreased perfusion (such as shock), anemia due to chronic blood loss (seen with GI ulceration), and dehydration. The color of the pink or cyanotic (blue) membrane is associated with a greater chance of survival (55%). Dark red, or "injected", the membrane reflects increased perfusion, and the presence of "toxic pathways" (the red ring above the teeth where it meets the gum line, with pale or gray mucous membranes) may indicate endotoxemia. Both the injected mucous membrane and the presence of a toxic line correlate with a 44% chance of a survival decrease. Capillary filling time was assessed to determine the degree of hydration and strongly correlated with intestinal perfusion. CRT from & lt; 2 seconds has a 90% survival rate, from 2.5-4 seconds survival rate of 53%, and & gt; 4 seconds survival rate of 12%.

Laboratory tests can be performed to assess the patient's cardiovascular status. The volume of packed cells (PCV) is a measure of hydration status, with a value of 45% considered significant. An increase in the value of more than repeated checks is also considered significant. Total blood protein (TP) can also be measured, as aids in estimating the amount of protein loss into the intestine. Its value should be interpreted together with PCV, to account for the hydration status. When laboratory tests are not available, hydration can be roughly assessed by tenting the skin of the neck or eyelids, looking for sunken eyes, depression, high heart rate, and feelings to overcome the gums. Jugular filling and the quality of peripheral pulses can be used to estimate blood pressure. Capillary refill time (CRT) may decrease early in colic, but generally prolongs as disease progresses and cardiovascular status worsens.

Body weight and body scores (BCS) are important when evaluating horses with chronic colic, and poor BCS in the face of good quality nutrition may indicate malabsorptive and maldigestive disorders.

Rectal temperature may help to ascertain whether the cause of infection or inflammation is the cause of colic, which is suspected if the temperature if & gt; 103F. Temperature should be taken before rectal examination, since the introduction of air will decrease rectal temperature. Cold extremities may show decreased perfusion secondary to endotoxemia. Increased respiratory frequency may indicate pain and acid-base disorders. Rectal examination, abdominal auscultation, and nasogastric intubation should always occur in addition to basic physical examination.

Rectal examination

Rectal examination is a cornerstone of colicky diagnosis, since many conditions of the colon can be definitively diagnosed by this method alone. Due to the risk of damage to the horse, the rectal examination is performed by a veterinarian. Approximately 40% of the gastrointestinal tract can be checked by rectal palpation, although this may vary based on the size of the horse and the length of the examiner's arm. Identifiable structures include aorta, left renal caudal pole, nephrosplenic ligament, caudal boundary of the spleen, ascending colon (left dorsal and ventral, pelvic bending), small intestine if distended (usually not palpable in the rectum). ), mesenteric roots, cecal base and medial cecal bands, and rarely inguinal rings. Locations in the colon are identified by size, presence of sacculations, number of bands, and if fecal balls are present.

Displocation, torsion, strangulation, and impaction can be identified on rectal examination. Other non-specific findings, such as small bowel loop dilatation, may also be detected, and may play a major role in determining whether surgery is necessary. The thickness of the intestinal wall may indicate infiltrative disease or abnormal muscle enlargement. Serous bowel surface hardness may occur secondary to peritonitis. Horses that have experienced gastrointestinal rupture may have sandy feelings and free gas in the abdominal cavity. Surgery is usually recommended if rectal examination finds severe distension in any part of the GI tract, tight cecum or some tight loops from the small intestine, or inguinal hernia. However, even if the exact cause can not be determined on the rectum, significant abnormal findings without a specific diagnosis may indicate a need for surgery. Rectal examination is often repeated during colic to monitor the gastrointestinal tract for signs of change.

Rectal is a risk to the practitioner, and the horse is ideally inspected either in stock or over the door of the cage to prevent kicking, with the horse twitching, and possibly anesthetized if it is very painful and tends to try to descend. Buscopan is sometimes used to facilitate rectal examination and reduce the risk of tearing, as it reduces smooth muscle tone of the gastrointestinal tract, but can be contraindicated and will result in very rapid heart rate. Because the rectum is relatively fragile, the risk of the rectum is always present every time the examination is done. Rectal tears often cause death or euthanasia. However, the diagnostic benefits of rectal examination are almost always greater than this risk.

nasogastric intubation

Passing the nasogastric tube (NGT) is useful both diagnostically and therapeutically. A long tube is passed through one of the nostrils, down the esophagus, and into the abdomen. The water is then pumped into the stomach, creating a siphon, and the liquid and the excess material (reflux) are pulled out of the stomach. A healthy horse will usually have less than 1 liter removed from the stomach; any more than 2 liters of liquid is considered significant. Horses can not vomit or vomit, therefore therapeutic nasogastric intubation is important for gastric decompression. The fluid reserves in the gastrointestinal tract will cause it to accumulate in the abdomen, a process that can ultimately lead to rupture of the stomach, which is definitely fatal.

Fluid reserves through the intestinal tract are usually caused by downstream obstruction, ileus, or proximal enteritis, and its presence usually indicates small bowel disease. In general, the closer the obstruction to the stomach, the greater amount of gastric reflux will be present. About 50% of horses with gastric reflux require surgery.

Auscultation

Auscultation of the abdomen is subjective and not specific, but may be useful. Auscultation is usually performed in a four quadrant approach:

1. Upper side, right side: according to cum
2. Kaudoventral stomach, right side: associated with the colon
3. The top, left side: corresponds to the small intestine
4. Kaudoventral stomach, left side: associated with the colon

Each quadrant should ideally be listened for 2 minutes. Bowel sound (borborygmi) correlates with intestinal motility, and care should be taken to record intensity, frequency, and location. Increased bowel sound (hyper-motility) may be an indication of spasmodic colic. Decreased sound, or no sound, may be suggestive of serious changes such as ileus or ischaemia, and perseverance of the hipomotil intestine often indicates the need for surgical intervention. Intestinal sounds that occur alongside pain may show intestinal lumen obstruction. The sound of gas can occur with ileus, and fluids are associated with diarrhea that can occur with colitis. Sand is sometimes heard in the midline of the stomach, presenting the typical "beach waves" sound in horses with sand colic after the lower abdomen is forcibly pushed by the fist. Abdominal abdomen ("ping") can sometimes be used to determine if there is a gas distension in the intestine. This may be useful to help determine the need for trokarization, either from the cecum or colon.

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Ultrasound provides visualization of the thoracic and abdominal structures, and can sometimes rule out or narrow the diagnosis. Information that may be collected from ultrasound findings including the presence of sand, distens

Source of the article : Wikipedia