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Colic in the Older Horse
Colin Mitchell BVM&S CertEP MRCVSScottMitchellAssociates, Hexham
General
• Diagnosis & treatment – similar to younger animals
• Increased prevalence of certain conditions
• Reduced prevalence of certain conditions
Increased Prevalence
• Pedunculated lipoma• Large bowel
impaction• Some forms of
neoplasia / cancer
Decreased Prevalence
• Grass sickness
• Small intestinal “twists”
• Some forms of intussusception
Pedunculated Lipoma
• 70 % of surgical cases >20yo
• a lump of fat, on a string, suspended in abdomen wraps around loops of intestine!!!
obstruction, distension and pain
Pedunculated Lipoma
• May be intermittent
• If persistent – need surgical correction
• +/- bowel resection
Large Bowel Impaction
• “oro – dental syndrome”
• Reduced water intake
• Can be managed medically
1. Oral liquid paraffin
2. Intravenous fluids
• May need surgical correction
Older Horse Colic
• Pre-existing disease conditions
• Should be considered in decision making process
• ECS – poor wound healing
• Chronic laminitis - welfare
Conclusion
1. Do not rule out possibility of referral for possible surgery on basis of age alone
2. Better to refer early and not need surgery, than send a surgical case too late
Conclusion
1. Do not rule out possibility of referral for possible surgery on basis of age alone
2. Better to refer early and not need surgery, than send a surgical case too late
Majority of colic is medical !!!
Prevention of Colic
1. “Rules” of good feeding
2. Worm Control
3. Routine
Good Feeding
• Feed according to work , temperament & condition
• Plenty of roughage• Little & often – 3kg
max hard feed at any 1 time
• Routine
• Change gradually• Water before feeding• Good quality
feedstuffs
Worm Control
1. Worm egg counts
2. Routine interval worming
Worm Control
YEAR 1• Equest every 13 weeks• Tape worm Spring /
Autumn• (Equitape / DD Stro-P
DD Pyratape P etc)
YEAR 2• Ivermectin every 6-8
weeks (Eqvalan etc)• Tape worm as Year 1
Routine
• Feeding times• Feeding quality /
quantity• Turn-out• Bedding : straw v
shavings / paper• Dental prophylaxis
Recurrent Airway Obstruction
• RAO• Heaves• Asthma in horses• COPD
Recurrent Airway Obstruction
• RAO• Heaves• Asthma in horses• COPD
RAO
• Reaction of small airways to inhaled substances
• Fungal spores, dust, noxious gases, ammonia, mites
RAO
• Increased resp rate & effort
• +/- cough• +/- nasal discharge• Poor performance
RAO - management
1. Drug therapy
2. Environmental control
Drug Therapy
1. Oral
2. Inhaled
3. Systemic
Oral Therapy
• “Ventipulmin”, “Sputulosin”,
• “Prednisolone”
Inhaled
• Less side-effects• High local
concentration of drug• Rapid onset of action• Delivered at site where
required
Systemic Therapy
• Usually at time of respiratory distress :-
1. Frusemide
2. Steroid
3. Atropine
Environmental
• Turn – out• Haylage• Paper / dust-extracted
shavings• Rubber matting• Soak hay
Weight Loss
Mechanisms of Weight Loss
1. Reduced intake
2. Reduced digestion, absorption
3. Increased losses
4. Increased requirements
Common causes
• Malnutrition• Dental disease• Inability to compete
for feed• Chronic Peritonitis• Grass sickness
• Protein losing enteropathy ( PLE )
• Neoplasia ( GI / non-GI )
• Liver disease• Internal parasitism
My Approach
1. Good history• Feeding• Worming• Previous disease /
lameness• Housing
My Approach
• Clinical Examination
1. Worm & rasp teeth
My Approach
• Clinical Examination
1. Worm & rasp teeth
2. Blood tests – liver / PLE
My Approach
• Clinical Examination
1. Worm & rasp teeth
2. Blood tests – liver / PLE
3. Peritoneal fluid / urine
My Approach
Hospitalise :-
• Oral glucose tolerance test ( OGTT )
• Rectal biopsy if diarrhoea
• Gastroscopy
• Ultrasonography
OGTT
• Starve overnight
• 1g per kg glucose administered by naso-gastric tube
• Blood sample regularly
• Plot glucose level in blood – compare peak
OGTT
• >85% increase : normal
• 15 – 85 % : partial
• <15 % : complete
OGTT
• Tests small intestinal function
• Blood glucose should peak 2hrs after glucose given
• If not – reduced absorption
OGTT - normal
blood glucose
time2 hrs
OGTT - partial
blood glucose
time2 hrs
OGTT - complete
blood glucose
time2 hrs
OGTT - compare
blood glucose
time2 hrs
Weight Loss - further
• Laparotomy• Once gone beyond
common causes – can be difficult to pinpoint cause