Equine Colic Management Quiz
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Questions and Answers

What is the primary clinical syndrome associated with abdominal pain in horses?

  • Colic (correct)
  • Coughing
  • Bloat
  • Diarrhea

    • What is the estimated colic incidence rate in the USA general horse population?

  • 8.5 episodes/100 horses per year
  • 4.2 episodes/100 horses per year (correct)
  • 6.0 episodes/100 horses per year
  • 2.5 episodes/100 horses per year

    • Which of the following is NOT a sign of mild colic in horses?

  • Lying down flat out (correct)
  • Pawing
  • Restlessness
  • Inappetance

    • What percentage of horses with colic recover spontaneously according to the UK Thoroughbred population statistics?

    <p>28.7%</p> Signup and view all the answers

    Which symptom is most indicative of severe colic in horses?

    <p>Rolling/thrashing</p> Signup and view all the answers

    What is the fatality rate associated with colic in the UK Thoroughbred population?

    <p>6.2%</p> Signup and view all the answers

    Which treatment principle is crucial for managing pain in horses with colic?

    <p>Analgesia</p> Signup and view all the answers

    What condition may result in severe signs such as dullness and violent rolling in colic cases?

    <p>Acute, severe strangulation</p> Signup and view all the answers

    What is the recommended dosage of magnesium sulfate for treating impaction colic in horses?

    <p>1g/kg by nasogastric tube once daily</p> Signup and view all the answers

    Which of the following is a potential systemic effect of repeated administration of magnesium sulfate?

    <p>Electrolyte derangements</p> Signup and view all the answers

    In what situation should you refer a horse case for surgery or hospitalization?

    <p>Rapid deterioration despite therapy</p> Signup and view all the answers

    What is the effect of liquid paraffin when administered via nasogastric tube?

    <p>Lubricates the lumen of the gut</p> Signup and view all the answers

    What should be monitored if a horse is not referred for further treatment?

    <p>Signs of pain, food intake, and faecal output</p> Signup and view all the answers

    What is the primary goal in treating hyperlipaemia in donkeys?

    <p>Reverse the negative energy balance</p> Signup and view all the answers

    What does the presence of >2L nasogastric reflux indicate in a colic case?

    <p>Indication for possible referral or surgery</p> Signup and view all the answers

    What is the recommended initial fluid therapy for a 500kg horse requiring volume expansion?

    <p>3-5mL/kg of hypertonic saline followed by isotonic fluids</p> Signup and view all the answers

    What is a primary cause of colic pain in horses?

    <p>Smooth muscle contraction</p> Signup and view all the answers

    Which condition is commonly associated with endotoxic shock in horses?

    <p>Non-strangulating obstructions</p> Signup and view all the answers

    Which sign indicates a potential problem with horse colic?

    <p>Hyperemia of mucous membranes</p> Signup and view all the answers

    What is the first priority when approaching a colic case in horses?

    <p>Provide analgesia and triage</p> Signup and view all the answers

    What is a common result of mucosal injury in the horse's gastrointestinal tract?

    <p>Increased LPS absorption</p> Signup and view all the answers

    What is a possible consequence of using opioids for treating colic in horses?

    <p>Ileus</p> Signup and view all the answers

    Which of the following factors increases the risk of impaction colic due to stabling?

    <p>Increased hours of stabling</p> Signup and view all the answers

    Which type of colic is more prevalent among younger horses and those recently moved to new premises?

    <p>Equine Grass Sickness (EGS)</p> Signup and view all the answers

    Which of the following drugs is associated with a risk of right dorsal colitis in horses?

    <p>NSAIDs</p> Signup and view all the answers

    What type of parasitic infection is recognized as a risk factor for ileal impaction in horses?

    <p>Tapeworms</p> Signup and view all the answers

    Which condition is classified as a small intestinal disease that can lead to colic?

    <p>Anterior enteritis</p> Signup and view all the answers

    What is a potential consequence of a strangulating obstruction in a horse?

    <p>Gastric rupture</p> Signup and view all the answers

    Which of the following is considered a 'false' colic?

    <p>Liver disease</p> Signup and view all the answers

    What factor is crucial for formulating a differential diagnosis list in colic cases?

    <p>Accurate history</p> Signup and view all the answers

    Which of the following conditions involves a large colon disease that can contribute to colic?

    <p>Nephrosplenic ligament entrapment</p> Signup and view all the answers

    Which condition is identified as a cause of colic that involves neoplasia?

    <p>Intra-abdominal neoplasia</p> Signup and view all the answers

    What aspect should be considered to assess the severity of colic?

    <p>Nature of colic</p> Signup and view all the answers

    Which of these diseases is associated with the small (descending) colon?

    <p>Right dorsal colitis</p> Signup and view all the answers

    Which statement is true regarding making a diagnosis in colic cases?

    <p>Accurate assessment of severity is critical.</p> Signup and view all the answers

    What is a common risk factor to identify in colic cases?

    <p>Dietary changes</p> Signup and view all the answers

    What type of obstruction is associated with equine grass sickness?

    <p>Functional obstruction</p> Signup and view all the answers

    Which common gastrointestinal disease may also result in colic?

    <p>Enterolithiasis</p> Signup and view all the answers

    Which of the following is not a form of colic?

    <p>Rhabdomyolysis</p> Signup and view all the answers

    What is the purpose of assessing when the horse was last seen normal?

    <p>To identify onset of colic symptoms</p> Signup and view all the answers

    What does hypermotility of the gastrointestinal tract indicate?

    <p>Increased smooth muscle activity</p> Signup and view all the answers

    Which observation is typically not associated with uncomplicated colic cases?

    <p>Marked-severe tachycardia</p> Signup and view all the answers

    How is a digital pulse primarily used in clinical examinations?

    <p>To identify laminitis</p> Signup and view all the answers

    Which of the following is an indicator of endotoxaemia during respiration assessment?

    <p>Tachypnoea</p> Signup and view all the answers

    What is a common sign observed in donkeys that is significant for diagnosing pain?

    <p>Less interest in the environment</p> Signup and view all the answers

    Which clinical examination method provides important insights for all colic cases at first presentation?

    <p>Trans-rectal examination</p> Signup and view all the answers

    What does the presence of >2 liters of fluid reflux during nasogastric intubation indicate?

    <p>Small intestinal obstruction</p> Signup and view all the answers

    Which condition would likely show a palpable ingesta-filled area during a rectal examination?

    <p>Pelvic flexure impaction</p> Signup and view all the answers

    What type of pain management may be necessary to facilitate a clinical examination?

    <p>Quick-acting potent analgesics</p> Signup and view all the answers

    What condition is most commonly seen in donkeys with colic?

    <p>Impaction colic</p> Signup and view all the answers

    What might indicate a severe/end stage shock during a clinical examination?

    <p>Very low core temperature</p> Signup and view all the answers

    How does hyperlipaemia generally occur in donkeys?

    <p>Negative energy balance</p> Signup and view all the answers

    What is the purpose of performing abdominocentesis in colic cases?

    <p>Not indicated in every case</p> Signup and view all the answers

    Which of the following is a treatment consideration for cases of hyperlipaemia in donkeys?

    <p>Reverse negative energy balance</p> Signup and view all the answers

    Study Notes

    Approach to Colic

    • Colic is a clinical syndrome in horses associated with abdominal pain, predominantly involving the gastrointestinal tract (GIT) but potentially affecting other body systems
    • Colic is a common and significant problem
    • US general population experienced 4.2 colic episodes /100 horses per year with a 11% fatality rate.
    • UK thoroughbred population experienced 7.19 colic episodes/100 horses per year with a 6.2% fatality rate.
    • Spontaneous recovery 28.7%
    • Medical recovery 63.1%
    • Surgical recovery 2.0%

    Signs of Colic

    • Signs vary depending on the source and degree of pain, breed, and individual horse
    • Mild signs include restlessness, pawing, flank watching, gas build-up, or smooth muscle spasms
    • Moderate signs involve lying down flat, groaning, or impaction
    • Severe signs include very fractious behaviour, violent rolling, acute strangulation, and dullness
    • End-stage colic shows severe illness and potential rupture

    Aetiology of Colic

    • Smooth muscle spasm, inflammation (colitis/ulceration), impaction, gas accumulation, obstruction, tension on the mesentery, displacement, tissue congestion/infarction/necrosis, torsion/volvulus and strangulation
    • Endotoxaemia is a common feature of strangulating intestinal lesions, but also possible with non-strangulating obstructions.
    • Endotoxins (LPS) are abundantly present in the horse's GIT, but are normally prevented from absorption by the mucosa.
    • Mucosal injury increases LPS absorption, making horses extremely sensitive to even small amounts in the blood

    Approach to Colic: Priorities

    • Provide analgesia and triage
    • Assess severity of the case
    • Construct a treatment plan

    Colic Aetiologies (Gastro-intestinal)

    • Gastric Diseases: ulceration, impaction, rupture
    • Small intestinal diseases: inflammatory disease, anterior enteritis, simple obstruction, ileal impaction, ascarid impaction, functional obstruction (equine grass sickness, strangulating obstruction, etc)
    • Caecal diseases: impaction, caecocolic intussusception, caecal perforation
    • Large (ascending) colon diseases: inflammatory disease, colitis, right dorsal colitis, simple obstruction, impaction
    • Small (descending) colon diseases: impaction, mesenteric rent, meconium retention, neoplasia

    Causes of Colic

    • Many cases are not able to be definitively diagnosed
    • About 50% of cases have a non-specific diagnosis.
    • Other factors include poor management, and/or other diseases which may show as colic

    Differentials for Colic

    • Any non-gastrointestinal source of abdominal pain
    • Liver disease, hepatomegaly, urinary disease (renal pain or urolithiasis)
    • Peritonitis, intra-abdominal abscess, intra-abdominal neoplasia
    • Peritonitis
    • Intra-abdominal abscess
    • Intra-abdominal neoplasia
    • Reproductive disorders (e.g., uterine torsion, dystocia)
    • Broad ligament haemorrhage
    • Retained placenta

    History

    • Accurate history to formulate differential diagnosis

    • Signalment (animal's characteristics)

    • Recent management (feeding, stabling, pasture access, exercise, dental history, parasitic control, geographical area, vices)

    • Nature of colic (onset, duration etc)

    • Results from clinical examination

    • Assess severity and duration (signs)

    • Food and water intake since colic started

    • Faecal output

    • Has any treatment been administered?

    • Previous history of colic

    Clinical Examination

    • Assess severity of the horse's condition

    • Establish appropriate "level" of treatment

    • Conservative treatment

    • Refer for more intensive medical therapy

    • Referral for surgery

    • Establish prognosis for cases not suitable for treatment

      • Observing the horse from a distance:
        • Current status of colic
        • Pain level/signs of depression
        • Respiratory rate & depth
        • Abdominal distension
        • Presence of faeces
        • Evidence of duration / severity
        • Injuries or signs of stress e.g. traumatic/ bedding injuries or soil/shavings on back

    • Rapid assessment of cardiovascular status (heart rate, pulse quality, jugular refill, mucous membrane colour, CRT)

    • Assessment of hydration status (moisture content of oral MM, HR, CRT)

    • Auscultation of GI tract: listen to the abdomen area for normal/ abnormal bowel sounds

    • Rectal temperature using a thermometer

    • Digital pulses asses circulation for presence of laminitis (not suitable for assessing circulation)

    Clinical Examination - Impact of pain on the clinical exam

    • Mild-moderate increase in HR (40-60 bpm) Is common
    • Marked-severe tachycardia (>60 bpm) is a sign of hypovolemic shock
    • Tachypnoea
    • Can make it very difficult to examine the horse

    Clinical Examination - Treatment to provide pain relief

    • Use alpha-2 agonists (Xylazine, Detomidine, Romifidine) and opioids (butorphanol) for pain relief
    • NSAIDs (Flunixin meglumine, Phenylbutazone, Ketoprofen, Meloxicam) for more prolonged pain relief
    • Consider the potential anti-inflammatory effects of medications like flunixin, which may mask early signs of endotoxaemia, and use Phenylbutazone if unsure.
    • Should take care to NOT TOP-UP NSAIDs, to avoid overdose, and associated renal compromise or right dorsal colitis

    Clinical Examination - Spasmolytics

    • N-Butylscopolamine (Buscopan) is a smooth muscle relaxant with a rapid onset and short duration of activity.
    • Use it to treat hypermotile/spasm type colic)
      • "Gas" colic

    Clinical Examination - Fluid Therapy

    • Use enteral fluids in most colic cases.

    • Contraindicated if NG reflux are present or suspect small intestinal lesion

    • Possible to leave a nasogastric tube in-dwelling and bolus of isotonic fluids (tap water, nacl, or KCl) can be administered

    • 5-8L can be given q2-4hrs to a 500 kg horse

    • 10-20mL/kg over 30 minute-1 hr (5-10L/500kg horse)

    • Use hypertonic saline, 3-5mL/kg in a bolus, to rehydrate (2L per 500kg horse)). followed up with isotonic fluids, to resuscitate or in rapid volume expansion

    Clinical Examination - Purgatives

    • Magnesium Sulphate (Epsom Salts) 1g/kg by NG tube once daily.
    • The osmotic effect softens gut content
    • Systemic effects, or possible electrolyte derangements may be seen with repeated administration
    • Liquid Paraffin/Mineral Oil is a lubricant and may help to loosen impactions

    Donkeys: Hyperlipaemia Treatment

    • Reverse the negative energy balance.

    Prognosis

    • When to refer a colic case for surgery and/or hospitalisation:
      • Non-response to analgesia
      • Significant compromise (e.g., heart rate > 60)
      • Rapid deterioration despite therapy
      • Complex abnormalities (e.g., large distended loops of small intestine [DSIs])
      • Presence of ≥2 L NG reflux
      • Recurrent/chronic cases with unclear diagnosis

    Client Advice

    • If you haven't referred the horse:
      • Establish if referral is necessary
      • Leave the owner with a plan.
      • Withhold food
      • Monitor signs
      • What, when, and how much to feed.
      • Re-check or follow up (phone calls/appointments etc)

    Further Diagnostics

    • Nasogastric Intubation:
      • Check for reflux
      • Fluid/ingesta reflux: indicative of small/large intestinal obstruction

      • 2 litres fluid = abnormal

      • Pressure on the duodenum may occur due to large colon displacement
      • Reflect time and/or location of lesion
      • To relieve the reflux and prevent rupture
    • Abdominocentesis
      • Assess presence of changes in peritoneal fluid (appearance, colour, clarity)
      • Perform laboratory analysis for cell count and other factors suggestive of ischaemia (e.g., total protein, lactate)
    • Abdominal Ultrasound
      • Detect abnormalities by assessing the abdomen area
    • Imaging: to visualise the entire abdomen (for foals)

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    Related Documents

    Approach to Colic - A. Prutton - PDF

    Description

    Test your knowledge on equine colic, focusing on clinical syndromes, treatment principles, and recovery statistics. This quiz covers common symptoms, management strategies, and the implications of various treatments for colic in horses. Perfect for veterinarians and equine enthusiasts alike.

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