ISSN 2398-2977      

Abdomen: pain - adult

pequis

Synonym(s): Colic


Decision making

  • Goals of initial assessment:
    • Evaluate the severity of pain and degree of cardiovascular compromise.
    • Look for evidence of possible etiology.
    • Decide if surgery is indicated or not.

Reassess mild or moderate colic cases not less than every 2 h so that a decision to undertake surgery is made sooner rather than later. If pain is controlled, owner can assess regularly.

  • Early and accurate diagnosis of gastrointestinal disorders will strongly influence the prognosis of surgical cases.

Print off the Owner factsheets on Colic - a serious belly ache and Emergencies - when to call your vet to give to your clients.

Pre-operative cardiovascular status directly influences prognosis.
  • Make decisions about laboratory tests and other examinations early in the course of assessment.
  • About 6% of colic cases will require surgery.
  • Most cases of colic will respond to conservative management.

Duration of pain before initial examination is often unknown.

Initial evaluation

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Diagnostic techniques

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Medical management

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Surgical management

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Prognosis

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Differential diagnoses

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Further Reading

Publications

Refereed papers
  • Recent references from PubMed and VetMedResource.
  • Findley J & Archer D (2014) Management of the surgical equine colic patient following hospital discharge. In Pract 36 (5), 229-236 VetMedResource.
  • Salciccia A et al (2013) Sensitivity and specificity of blood leucocyte counts as an indicator of mortality in horses after colic surgery. Vet Rec 173 (11), 267 PubMed.
  • Linnenkohl W, Mair T & Fews D (2013) Case report of atypical infiltrative lipomatosis of the equine mesojejunum. Equine Vet Educ 25 (5), 237-240 VetMedResource.
  • de Bont M P, Malbon A J, Sardon D & Archer D C (2013) Caecal lipomatosis as a cause of colic in a 9-year-old gelding. Equine Vet Educ 25 (5), 241-244 VetMedResource.
  • Freeman S & Issaoui L (2013) Code red for coli: Decision-making for acute abdominal pain in the horse. Equine Vet Educ 25 (5), 245-246.
  • Durward-Akhurst S A et al (2013) Comparison of two antimicrobial regimens on the prevalence of incisional infections after colic surgery. Vet Rec 172 (11), 287 PubMed.
  • Southwood L L (2012) Complicated colic case raises interesting questions: What can we learn? Equine Vet Educ 24 (11), 569-572.
  • Santschi E M (2012) Equine colic caused by neoplasia. Equine Vet Educ 24 (9), 437-438 VetMedResource.
  • Fielding C L & Dechant J E (2012) Colic in competing endurance horses presenting to referral centres: 36 cases. Equine Vet J 44 (4), 472-475 PubMed.
  • Alexander G R & Haines G R (2012) Surgical colic in racing endurance horses. Equine Vet Educ 24 (4), 193-199 VetMedResource.
  • Scantlebury C E, Archer D C, Proudman C J & Pinchbeck G L (2011) Recurrent colic in the horse: Incidence and risk factors for recurrence in the general practice population. Equine Vet J 43 (Suppl 39), 81-88 PubMed.
  • Archer D C (2011) Chronic persistent colic: Can I have a retrospectoscope please? Equine Vet Educ 23 (6), 286-288 VetMedResource.
  • Malamed R et al (2010) Retrospective evaluation of crib-biting and windsucking behaviours and owner-perceived behavioural traits as risk factors for colic in horses. Equine Vet J 42 (8), 686-692 PubMed.
  • Hart S & Southwood L L (2010) The enigma of post-operative recurrent colic: Challenges with diagnosis and management. Equine Vet Educ 22 (8), 408-411.
  • Torre F, Gasparin J & Andreasi B (2010) Rupture of the mesocolon as a cause of recurrent colic in a showjumper mare. Equine Vet Educ 22 (8), 403-407 VetMedResource.
  • Arguelles D et al (2010) Peritoneal concentrations of transforming growth factor beta in horses with colic. Equine Vet J 42 (5), 451-455 PubMed.
  • Monreal L et al(2010)Enteral fluid therapy in 108 horses with large colon impactions and dorsal displacements. Vet Rec166(9), 259-263PubMed.
  • Sutton G A, Ertrzman-Ginsburg R, Steinman A & Milgram J (2009)Initial investigation of mortality rates and prognostic indicators in horses with colic in Israel: A retrospective study. Equine Vet J41(5), 482-486PubMed.
  • Saulez M N, Burton A, Steyl J C A, Williams J H & Clift S J (2009)Perforation of the gastrointestinal tracts of four horses by metallic wires. Vet Rec164(3), 86-89PubMed.
  • Robert M P, Benamou-Smith A E, Cadore J L, Rosengarten M S & Lepage O M (2008)Recurrent colics in a 9-year-old Arabian stallion due to several congenital anomalies. Equine Vet Educ20(11), 567-571VetMedResource.
  • Johnson P J & Kellam L L (2007)Risk of colic associated with persimmon fruit ingestion. Equine Vet Educ19(11), 576-578VetMedResource.
  • Coomer R (2007)Colic Part 7: Rectal examination 5: Management of rectal tears. UK Vet12(8), 5-8.
  • Coomer R (2007)Colic Part 6: Rectal examination 4: Small colon and reproductive tract. UK Vet12(7), 5-9.
  • Coomer R (2007)Colic Part 5: Rectal examination 3: Large colon. UK Vet12(6), 5-10.
  • Coomer R (2007)Colic Part 4: Rectal examination 2: Small intestine and caecum. UK Vet12(5).
  • Brunott A et al(2007)A colonic epidermoid cyst as a cause of chronic recurrent colic in a horse. Equine Vet Educ19(3), 123-128VetMedResource.
  • Coomer R (2007)Colic Part 3: Rectal examination 1 - Normal findings and technique. UK Vet12(4), 5-6.
  • Coomer R (2007)Colic Part 2: Physical evaluation. UK Vet12(3), 5-12.
  • Coomer R (2007)Colic Part 1: History, pain and analgesics. UK Vet12(2), 5-10.
  • Mair T S & Edwards G B (2007)Chronic and recurrent colic: challenging clinical syndromes. Equine Vet Educ19(3), 137-138.
  • Walmsley J P (2007)Laparoscopy in horses with abdominal pain. Equine Vet Educ19(2), 64-66VetMedResource.
  • Borer K E & Corley K T T (2006)Electrolyte disorders in horses with colic. Part 2: Calcium, sodium, chloride and phosphate. Equine Vet Educ18(6), 320-325VetMedResource.
  • Borer K E & Corley K T T (2006)Electrolyte disorders in horses with colic. Part 1: Potassium and magnesium. Equine Vet Educ18(5), 266-271VetMedResource.
  • Andersen M A, Clark L, Dyson S J & Newton J R (2006)Risk factors for colic in horses after general anesthesia for MRI or non-abdominal surgery: absence of evidence of effect from peri-anesthetic morphine. Equine Vet J38(4), 368-374PubMed.
  • Perez Olmos J F, Schofield W L, Dillon H, Sadlier M & Fogarty U (2006)Circumferential mural bands in the small intestine causing simple obstructive colic: a case series. Equine Vet J38(4), 354-359PubMed.
  • Semevolos S A et al(2006)Perforating jejunal diverticulosis in 2 horses. Equine Vet Educ18(3), 139-142.
  • Blikslager A T (2006)Peritonitis in the horse. Equine Vet Educ18(3), 143.
  • Soler-Rodriguez F et al(2006) Datura stramoniumpoisoning in horses: a risk factor for colic. Vet Rec158(4), 132-133PubMed.
  • Proudman C J et al(2006)Pre-operative and anaesthesia related risk factors for mortality in equine colic cases. Vet J171(1), 89-97PubMed.
  • Saulez M N, Cebra C K & Dailey M (2005)Comparative biochemical analysis of venous blood and peritoneal fluid from horses with colic using a portable analyser and an in-house analyser. Equine Vet J157(8), 217-223PubMed.
  • Rendle D I et al(2005)End-to-end jejuno-ileal anastomosis following resection of strangulated small intestine in horses: a comparative study. Equine Vet J37(4), 356-359PubMed.
  • Husted L et al(2005)Risk factors for faecal sand excretion in Icelandic horses. Equine Vet J37(4), 351-355PubMed.
  • White N A et al(2005)Use of web-based data collection to evaluate analgesic administration and the decision for surgery in horses with colic. Equine Vet J37(4), 347-350PubMed.
  • Latson K M et al(2005)Evaluation of peritoneal fluid lactate as a marker of intestinal ischaemia in equine colic. Equine Vet J37(4), 342-346PubMed.
  • Ryan C A et al(2005)Pharmacokinetics and pharmacodynamics of pantoprazole in clinically normal neonatal foals. Equine Vet J37(4), 336-341PubMed.
  • Little D, Tomlinson J E & Blikslager A T (2005)Post-operative neutrophilic inflammation in equine small intestine after manipulation and ischaemia. Equine Vet J37(4), 329-335PubMed.
  • van Hoogmoed L M & Boscan P L (2005)  In vitroevaluation of the effect of the opioid antagonist N-methylnaltrexone on motility of the equine jejunum and pelvic flexure. Equine Vet J37(4), 325-328PubMed
  • Tschetter J R et al(2005)Detection of differentially regulated genes in ischaemic equine intestinal mucosa. Equine Vet J37(4), 319-324PubMed.
  • Mair T S & Smith L J (2005)Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 4: Early (acute) relaparotomy. Equine Vet J37(4), 315-318PubMed.
  • Mair T S & Smith L J (2005)Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 3: Long-term complications and survival. Equine Vet J37(4), 310-314PubMed.
  • Mair T S & Smith L J (2005) Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 2: Short-term complications. Equine Vet J 37(4), 303-309PubMed.
  • Mair T S & Smith L J (2005) Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 1: Short-term survival following a single laparotomy. Equine Vet J37(4), 296-302PubMed.
  • Freeman D E & Schaeffer D J (2005) Short-term survival after surgery for epiploic foramen entrapment compared with other strangulating diseases of the small intestine in horses. Equine Vet J37(4), 292-295PubMed
  • Senior J M, Pinchbeck G, Dugdale A H A & Clegg P D (2004) A Retrospective study into risk factors and prevalence of post-operative colic after orthopaedic surgery in horses. Vet Rec 155 (11), 321-325.
  • Senior J M, Pinchbeck G L, Dugdale A H A & Clegg P D (2004) Retrospective study of the risk factors and prevalence of colic in horses after orthopaedic surgery. Vet Rec 155 (11), 321-325 PubMed.
  • Hunt R J (2004) Surgical management of colic. J Equine Vet Sci 24 (5), 212-213.
  • Bosch G & van der Velden M A (2004) Impaired growth and colic caused by congenital defects in the mesenteric attachments of caecum and colon in a yearling. Equine Vet Educ (3), 151-154.
  • van Der Linden M A et al (2003) Prognosis in equine medical and surgical colic. J Vet Intern Med 17 (3), 343-348 PubMed.
  • McGowan C & Freeman S (2003) Abdominal pain in a aged pony. Equine Vet Educ 15 (4), 179-181.
  • Kim L M, Morley P S, Traub-Dargatz J L, Salmon M D & Gentry-Weeks C (2001) Factors associated with Salmonella shedding among equine colic patients at a veterinary teaching hospital. JAVMA 218 (5), 740-748 PubMed.
  • Steel D M & Gibson K T (2001) Colic in the pregnant and periparturient mare. Equine Vet Educ (2), 122-135.
  • Traub-Daragat J L et al (2001) Estimate fo the national incidence of and operation-level risk factors for colic among horses in the United States, spring 1999. JAVMA 219 (1), 67.
  • Proudman C J (1999) The role of parasites in equine colic. Equine Vet Educ 11 (4), 219-224.
  • Mee A M et al (1998) A retrospective study of mortality associated with general anesthesia in horses - emergency procedures. Vet Rec 142, 307-309 PubMed.
  • Hughes F E et al (1998) A modified technique for extensive large colon resection and anastomosis in horses. Vet Surg 27, 127-131 PubMed.
  • Tinker M K et al (1997) Prospective study of equine colic risk factors. Equine Vet J 29, 445-448 PubMed
  • Tinker M K et al (1997) Prospective study of equine colic incidence and mortality. Equine Vet J 29, 448-453 PubMed.
  • Hillyer M H et al (1997) Recurrent colic in the mature horse - a retrospective review of 58 cases. Equine Vet J 29, 415-420 PubMed.
  • Mair T S et al (1997) Chronic colic in the mature horse - a retrospective review of 106 cases. Equine Vet J 29, 415-420 PubMed.
  • Blikslager A T et al (1997) How important is intestinal reperfusion injury in horses? JAVMA 211, 1387-1389 PubMed.
  • Dart A J et al (1997) Cecal disease in equids. Aust Vet J 75, 552-557 PubMed.

Other sources of information

  • Manley W et al (2004) Nitric Oxide and Cytokine Levels may have a Prognostic Value in Equine Colic. In: Proc 43rd BEVA Congress. Equine Vet J Ltd, UK. pp 194.
  • Picavet M T (2004) A Retrospective Clinical Survey on the Outcome of 442 Colic Surgeries in Two Belgian Equine Referral Practices. In: Proc 43rd BEVA Congress. Equine Vet J Ltd, UK. pp 193.
  • Maranon G et al (2004) Evidence of Production of Nitric Oxide and Carbon Monoxide in Horses with Colic. In: Proc 43rd BEVA Congress. Equine Vet J Ltd, UK. pp 191.
  • Maranon G et al (2004) Arachidonic Acid Metabolites could be Implicated in Equine Colic. In: Proc 43rd BEVA Congress. Equine Vet J Ltd, UK. pp 191.
  • Verdegaal E J M M & van der Kolk J H (2004) Salivery Cortisol Concentrations in Healthy, Aged Horses, Horses with Hirsuitism and Horses with Colic. In: Proc 43rd BEVA Congress. Equine Vet J Ltd, UK. pp 103-104.
  • Proudman C (2004) Post-Operative Care of the Colic Patient. In: Proc 43rd BEVA Congress. Equine Vet J Ltd, UK. pp 70.
  • Mair T S (2004) BEVA Evidence-Based Medicine Colic Surgery. In: Proc 43rd BEVA Congress. Equine Vet J Ltd, UK. pp 58-59.
  • Blikslager A T (2004) Can the Prognosis for Colic Cases be Predicted from Post Operative Data? In: Proc 43rd BEVA Congress. Equine Vet J Ltd, UK. pp 56.
  • Proudman C (2004) Long-Term Post Operative Survival of Colic Cases. In: Proc 43rd BEVA Congress. Equine Vet J Ltd, UK. pp 54.
  • Blikslager A T (2004) Colic in the Geriatric Horse. In: Proc 43rd BEVA Congress. Equine Vet J Ltd, UK. pp 52.
  • Zimmel D N (2003) How to Manage Pain and Dehydration in Horses with Colic. In: Proc 49th AAEP Convention. pp 127-131.

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Abdomen: adhesions

Abdomen: hernia - incisional

Abdomen: laparotomy

Abdomen: lipoma - pedunculated

Abdomen: pain - neonate

Abdomen: pain - spasmodic colic

Abdomen: penetrating wounds

Abdomen: peritonitis

Abdomen: surgical approaches

Abdomen: uroperitoneum

Abdomen: ventral midline hernioplasty

Acid-base imbalance

Activated charcoal

Acupuncture: channel (meridian) systems

African Horse Sickness

Anesthesia: analgesia - overview

Anesthesia: general - overview

Anthrax

Behavior: crib-biting and wind-sucking

Bismuth subsalicylate

Bladder: calculi

Bladder: displacement

Bladder: urinary tract infection

Blood: biochemistry - creatinine

Blood: biochemistry - glucose

Blood: biochemistry - lactate dehydrogenase

Blood: biochemistry - total protein

Blood: biochemistry - urea

Blood: overview

Blood: packed cell volume (PCV)

Blood: transfusion reactions

Butorphanol

Buttercup (Ranunculus bulbosus)

Cardiovascular: aortoiliac thrombosis

Cardiovascular: arterial pulse palpation

Cardiovascular: parasitic arteritis

Cardiovascular: vein - thrombosis

Cecum: impaction

Cecum: intussusception - cecocecal / cecocolic

Cecum: perforation

Cecum: torsion

Colon: displacement - left dorsal

Colon: displacement - pelvic flexure

Colon: displacement - right dorsal

Colon: impaction

Colon: infarction - non-strangulating

Colon: small - obstruction

Colon: torsion

Coronavirus

Cryptococcosis

Cyathostomins: small strongyles

Detomidine hydrochloride

Diaphragm: hernia

Diarrhea: idiopathic

Diarrhea: neonate

Diarrhea: parasitic

Dispensing (USA)

Disseminated intravascular coagulation

Dysuria

Endotoxemia: overview

Equine coronavirus infection

Feces: parasitology

Female: estrus suppression

Fluid therapy: acute circulatory collapse

Fluid therapy: diarrhea

Fluid therapy: intestinal obstruction

Flunixin meglumine

Foot: laminitis

Foxglove (Digitalis pupurea)

Gastrointestinal endoscopy

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Gastrointestinal: fecalith / bezoar

Gastrointestinal: ileus

Gastrointestinal: nasogastric intubation

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Gastrointestinal: physical examination

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Gastrointestinal: small intestine - intussusception

Gastrointestinal: small intestine - torsion

Gastrointestinal: stricture

Gastrointestinal: tympany/flatulent colic

Gentamicin

Grass sickness

Habronemiasis

Heart: atrial fibrillation

Heart: examination - overview

Heart: sinus tachycardia

Heart: ventricular premature complex

Heparin

Hyoscine butylbromide

Hyperlipemia syndrome

Hypocalcemia

Ileum: impaction

Ileum: muscular hypertrophy

Inguinal ring: hernia

Inguinal ring: rupture

Intestine: enteritis

Intestine: enteritis - anterior

Intestine: enteritis - granulomatous

Intestine: resection and anastomosis

Intestine: salmonellosis

Jejunocolic / ileocolic anastomosis

Jejunum: jejunocecostomy

Jejunum: jejunojejunostomy

Kaolin

Laburnum (Laburnum anagyroides)

Large colon: intussusception

Liquid paraffin

Liver disease: overview

Liver: cholangiohepatitis

Liver: hepatitis - chronic active

Lung: pleuropneumonia - bacterial (pleuritis)

Lymphosarcoma: overview

Metamizole

Muscle: myopathy - atypical

Muscle: myopathy - exertional rhabdomyolysis

Musculoskeletal: rectal palpation

Nightshade

Nose: nasal discharge

Nutrition: adult

Nutrition: commercial feeds

Nutrition: energy

Nutrition: geriatric

Nutrition: nutritional myopathy

Nutrition: probiotics

Nutrition: sick horse

Oak (Quercus spp)

Ovary: neoplasia - overview

Pancreas: chronic pancreatitis - diabetes mellitus

Parascaris equorum infestation

Pectin

Peritoneal fluid: cell count and differential

Peritoneal fluid: cytology

Peritoneal fluid: protein

Pheochromocytoma

Polyneuritis equi

Poor performance: cardiac causes and treatment

Potomac Horse Fever

Purpura hemorrhagica

Rabies

Ragwort (Senecio jacobaea)

Rectum: meconium impaction

Rectum: tear

Rhododendron (Rhododendron ponticum)

Rotavirus

Septic shock

Spermatic cord: torsion

Stomach: gasterophilus infestation

Stomach: gastric ulceration

Stomach: impaction

Stomach: rupture

Strongyle infestation: large

Strongylus spp

Tapeworm infection

Teeth: abnormal wear

Teratoma

Tetanus

Therapeutics: antimicrobials

Therapeutics: gastrointestinal system

Therapeutics: reproductive system

Thorax: radiography

Toxicity: cantharidin

Toxicity: iron

Toxicity: mercury

Toxicity: nitrate / nitrite

Toxicity: pentachlorophenol

Toxicity: slaframine

Toxicity: snakebite

Transport

Transvenous cardioversion

Ultrasonography: overview

Umbilicus: hernia (strangulating)

Urine: anuria/oliguria

Urine: hematuria

Urine: overview

Urine: specific gravity

Urogenital: rectal palpation

Uterus: prolapse

Uterus: torsion

Uterus: uterine artery/vein rupture

Vagina: trauma

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