Acute Colic

Question 1

What are the most common signs of colic in horses?

Answer 1

• frequent pawing
• kicking at abdomen
• stretching out as if to urinate
• laying down
• rolling
• anorexia
• sweating
• muscle fasciculations
• Flehman response

Question 2

What is the pathogenesis of strangulating lipoma? What horses are most commonly affected?

Answer 2

mesenteric lipoma on a stalk twists around one or more pieces of the small intestines causing strangulation

older horses, usually 20+ y/o

Question 3

What is the pathogenesis of small intestinal volvulus in horses?

Answer 3

twist in the small intestines causes strangulation at the root of the twist

Question 4

What horses are most commonly affected by small intestinal intussusception? What are 2 common causes?

Answer 4

younger horses

1. diet changes
2. parasites, especially tapeworms

Question 5

Where is intussusception most common in horses?

Answer 5

ileocecal

Question 6

What are the 3 most common places of small intestinal herniation in horses? What is the pathogenesis?

Answer 6

1. inguinal - congenital, acquired traumatic, castration-associated
2. umbilical
3. incisional

small openings usually only allow SI to herniate through and become strangulated

Question 7

What mesenteric defects commonly cause small intestinal strangulation in horses?

Answer 7

• mesenteric rent
• epiploic foramen entrapment

Question 8

What does anterior/proximal enteritis mimic? How does it differ?

Answer 8

SI obstruction

pain is less severe, but there is significant GI reflux

Question 9

What are 2 characteristic signs of small intestinal disease in horses? What else is commonly seen?

Answer 9

1. severe pain with poor response to analgesics
2. gastric reflux

elevated HR, systemic shock

Question 10

What is seen on AUS in cases of small intestinal disease in horses?

Answer 10

dilated/non-motile loops of small intestine

Question 11

What happens as small intestinal disease develops and becomes more chronic in horses?

Answer 11

serosanguinous abdominal fluid with elevated proteins/WBCs accumulated within the abdomen

Question 12

What is seen on rectal exam in horses with small intestinal disease?

Answer 12

palpable distended loops of small intestines

Question 13

What is the most commonly effective treatment of small intestinal strangulation in horses? What is prognosis like? What is a common complication?

Answer 13

surgical - resection and anastomosis if bowel has devitalized

guarded - poor with longer duration or large amounts of dead bowel (>15 ft)

post-op ileus if resection is required

Question 14

What is the pathogenesis of large intestinal volvulus/torsion in horses?

Answer 14

portion of colon twists, rapidly becomes ischemic, and begins to necrose

Question 15

What is a common risk factor that increases the development of large intestinal volvulus/torsion in horses?

Answer 15

older broodmares just before parturition or up to 4 months postpartum, especially larger horses (more room for colon to twist)

Question 16

What are 2 classic signs of large intestinal volvulus/torsion in horses? How is it differentiated from small intestinal disease?

Answer 16

1. severe pain poorly responsive to analgesics
2. elevated HR and systemic shock

NO gastric reflux - lesion is too caudal to allow fluid back up to the stomach

Question 17

What is seen on rectal exam in cases of large intestinal volvulus/torsion in horses?

Answer 17

palpable diffuse gas-distended large intestine

Question 18

What treatment is required for large intestinal volvulus/torsion in horses? What complication is associated? What is prognosis like?

Answer 18

surgical - nearly impossible to resect the LI

endotoxic shock once volvulus is corrected

good/fair if early surgical correction; poor if more than a few hours

Question 19

What are 2 risk factors associated with colonic impaction in horses?

Answer 19

1. older horses or those with poor dental care, especially when fed hay or coarse feed
2. decreased water intake - stress, cold weather, frozen water

Question 20

In what horses is colonic impaction most common?

Answer 20

miniature horses - frequently impacted with hair from grooming self/other horses or feed material due to poor dentition

Question 21

What clinical signs are associated with colonic impaction in horses?

Answer 21

mild or intermittent colic that worsens as time progresses + noticeable decrease in manure production

• may appear “normal” with analgesics

Question 22

What are 3 important treatments used for colonic impaction in horses? What is prognosis like?

Answer 22

1. analgesics
2. oral fluids with laxatives via intermittent or indwelling NG tube - mineral oil, psyllium, Epsom salts
3. IV fluids
   (main goal is to hydrate impaction)

good - surgical correction is only necessary with severe pain or several day duration

Question 23

What are 2 common causes of colonic tympany (gas colic)?

Answer 23

1. diet change
2. grain overload

(can happen anytime!)

Question 24

What is a characteristic sign of colonic tympany (gas colic) in horses? What else may be seen?

Answer 24

often spasmodic mild to severe pain –> as gas passes, pain subsides

• increased HR
• abdominal distension

Question 25

What are 3 important parts of treating colonic tympany (gas colic) in horses? What is prognosis like?

Answer 25

1. analgesics
2. sedation
3. IV fluids
   (often remains medical unless it becomes severe and causes circulatory issues)

good

Question 26

What is the most common colon displacement in horses? What other 2 can be seen?

Answer 26

left dorsal displacement - nephrosplenic entrapment (colon goes into the deep space between the left kidney and spleen and becomes distended with gas

1. right dorsal displacement - colon between cecum and right body wall
2. pelvic flexure displacement

Question 27

What is the major risk factor associated with colonic displacement in horses? Why?