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Medical treatments for colic when options are limited
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Summary
Colics touch rich and poor equally, however the treatment options available may vary enormously depending on where in the world you are working.
While this does not mean that all equids affected by colic in developing countries are doomed to die, it does require a degree of inventiveness and at times luck!
During this talk we will review some of the main money draining factors during colic therapy (such as intravenous fluids) and discuss some alternative options (such as homemade sterile IV solutions or other alternative rehydrating solutions).
Colics can often be prevented with appropriate management practices, so this brief presentation will review the main causes for colic amongst working equids with a goal to identify preventative methods, as well as discussing and critiquing less common treatments options.
Body
This talk aims at reviewing our options in managing and hopefully treating colics, when our diagnostic and treatment options are limited.
Working with scarce or inadequate equipment requires us to be inventive, and while a diagnosis may be reached, treatment options can then be limited by the lack of finances and supplies. These are circumstances not uncommon amongst working equids present in poorer or developing countries, where medical supplies are lacking not only for animals but also for humans.
With an estimated global population of working equids at 112 million working, colic ranks in the top three welfare concerns reported by owners to NGO employees and local vets.
While this is data can be extrapolated from the annual reviews of a number of veterinary/welfare NGOS giving assistance to working equids, the scarce published studies on this matter give a greatly varied percentage of incidence, ranging from 3-54%. This may be a reflection of the area where the study was conducted (financial means, access to veterinary assistance, ect), and the degree of recognition and willingness to refer a colic by owners.
While the symptoms and types of colic are similar between working equids and pleasure/sport horses, the inciting cause of the colic differs throughout the world.
Commonly, working horses presented for colic are geldings or stallions and are aged between 5-10yrs old. This reflects the prevalent working age population and the use males for work while females are kept in rural areas for breeding purposes. There is also no reported seasonality in the incidence of colic episodes in Sub Saharan Africa, probably due to the mild temperature fluctuations between seasons, which translates in the diet being maintained constant throughout the year.
While working equids are similar to pleasure/sport horses, in that the most common types of colic are spasmodic and or tympanic, the underlying cause to such colics differ. Working equids commonly develop tympani and even a paralytic intestine, following ingestion of left over/crushed crops that have been treated with pesticides. This is instead an uncommon cause amongst sport/pleasure horses which are fed bespoke commercial feeds and forage. Treatment involves gastric lavage of the pesticide contaminated feed via NG tube and pain relief in the form of NSAIDs or sedation.
Another common cause is severe parasite infestation, which can occasionally still be seen amongst youngsters and broodmares in certain parts of Europe and America, and may become more common as drug resistance evolves. Treatment options include appropriate deworming programs with careful nursing post administration to avoid subsequent obstructions, strangulations and intussusceptions.
Impactions are the next most common cause, often due to the specific lifestyle of these working animals. Working equids have very few opportunities to stop and drink/rehydrate during the day, and they work in a climate at a pace that favors sweating and dehydration.Treatment options include large amounts of fluids via NG tubing (as IV fluids are not available) given at steady inetrvals. Osmotic agents such as salts should never be used in the first 24hrs as these cases may have a dry impacted gastric mass that could obstruct the outflow of any fluid inserted by NG tube. Hence use gravity via a funnel and measure the amounts given at each interval (risk of stomach rupture!!)
Lastly are displacements and strangulations. The reported incidence is comparable to that of pleasure/sport horses, however the outcomes are much more negative as working equids often do not have access to veterinarians and if they do there are no resources or adequate ability to intervene. Sadly, only few and specific cases can be treated with trocarization and for the vast majority the only treatment options is euthanasia.
In the rare cases where surgical correction is attempted, it is commonly performed via flank laparotomy. Such approach is not ideal as it limits the amount of intestinal tract which can be exteriorized, but it is preferred over a midline celiotomy which requires a general anesthetic that could only be done under TIVA and therefore the operating time is limited to 45 minutes. A standing flank laparotomy instead, is performed under standing sedation and local blocks and can be prolonged easily and safely.
Get access to all handy features included in the IVIS website
- Get unlimited access to books, proceedings and journals.
- Get access to a global catalogue of meetings, on-site and online courses, webinars and educational videos.
- Bookmark your favorite articles in My Library for future reading.
- Save future meetings and courses in My Calendar and My e-Learning.
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[1] Voit et al (2009). Causes of GI colic at an equine referral hospital in South Africa (1998-2007). J.S.Afr.Vet.Assoc. 80:192-198
[2] Gitari et al (2017). Occurrence, treatment protocols and outcomes of colic in horses within Nairobi, Kenya. Veterinary World 10(10):1255-1263
[3] Salem et al (2016). Colic in a horse population in Egypt: prevalence and risk factors. EVJ 49(2):201-06
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