BASICS
- Chronic colic originating usually, but not exclusively, from the GI tract and that has been present constantly or intermittently for >3 days. It may also originate from other abdominal organs such as liver, spleen, kidney, uterus, and peritoneum
- Chronic abdominal pain refers to continuous or intermittent signs of abdominal pain of >3 days’ duration
- Recurrent abdominal pain refers to several episodes of transient or prolonged abdominal pain separated by a period of a few days or weeks in which the horse is usually normal
Pain from within the intestinal tract may result from intramural tension, tension on a mesentery, inflammation, spasm associated with hypermotility, or a combination of those. Most cases of chronic colic usually exclude strangulating obstructive events.
- GI
- Cardiovascular—may be affected as a result of progressive dehydration, toxemia
- Other systems such as urinary, reproductive, or hepatic may be involved
Non-specific. Previous abdominal surgery results in a risk of adhesions leading to chronic colic.
- There may be a recent history of change in diet or exercise regimen, lack of access to drinking water, deworming, weight loss, previous infection, or abdominal surgery
- A change in attitude (depression), appetite, and fecal output may be noticed
Vital signs are usually normal to moderately affected. The following signs might be observed:
- General findings—none to moderate abdominal distention; weight loss
- Cardiovascular findings—normal to mild changes in color of the mucous membrane, increase in capillary refill time, normal to moderate increase in heart rate, and dehydration may occur with time. May have signs of endotoxemia such as hyperemic mucous membranes and increase in heart rate
- GI findings—normal, decreased, or increased gut motility; abnormal sounds may be heard in sand impactions; may have a gas-filled viscus on percussion; may have presence of gastric reflux on passage of the nasogastric tube. Feces are normal, reduced, or absent, or there may be diarrhea
- Abnormalities on rectal examination—distention of a viscus by gas, liquid, or food; displacement of a viscus; abnormal intestinal diameter or wall thickness; uterine or renal abnormalities; palpation of a mass. May have a painful response on palpation of a specific area
The most common cause of chronic colic located at the GI level is large colon impaction, but there are others causes, such as chronic peritonitis, enteritis/colitis, colonic displacement, parasite infestation, ulceration, and intussusception. For recurrent abdominal pain, the most common cause is spasmodic colic but also includes processes such as chronic ulceration, non-total disturbance of the intestinal lumen due to adhesions, stricture, intussusception, enteroliths, intra-abdominal masses such as abscesses and neoplasms, and sand impactions.
- Gastric—gastric ulcer, gastric neoplasia
- Small intestine—duodenal ulcer, duodenojejunal enteritis, chronic inflammatory bowel disease, adhesions, stricture, intussusception, neoplasia, impaction, muscular hypertrophy, etc.
- Large intestine, cecum, and small colon—impaction, adhesions, ulceration, spasmodic colic, enteroliths, fecalith, sand impaction, neoplasia, chronic inflammatory bowel disease, displacement
- Renal/ureteral/bladder/urethral calculi
- Pyelonephritis
- Cystitis
- Renal inflammatory process
Previous surgery, diet, environment, excessive use of NSAIDs, Anoplocephala infestation, larval cyathostomiasis, strongylosis, no access to water, sudden change in exercise, history of deworming, pregnancy. Horses with severe dental disease may fail to masticate coarse herbage and be prone to impactions.
DIAGNOSIS
TREATMENT
MEDICATIONS
FOLLOW-UP
MISCELLANEOUS