Colic in the Older Horse Colin Mitchell BVM&S CertEP MRCVS ScottMitchellAssociates, Hexham

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