Part 1 colic in equines( causes- classification- clinical signs) Prof. Dr. Hamed Attia الحلقة الاولى

1. Colic In Equines
1- Classification-Diagnosis& Differential Diagnosis

2. ‫ا‬
.
‫د‬
‫عطية‬ ‫حامد‬
‫الحيوان‬ ‫طب‬ ‫استاذ‬
–
‫البيطرى‬ ‫الطب‬ ‫كلية‬
‫الزقازيق‬ ‫جامعة‬
-
‫مصر‬
‫الخبربالرياض‬ ‫اوميجا‬ ‫بمؤسسة‬ ‫الفنى‬ ‫المستشار‬
‫البيطرية‬ ‫لألدوية‬
‫الخيول‬ ‫فى‬ ‫المغص‬
‫االول‬ ‫الجزء‬
:
‫المغص‬ ‫انواع‬
-
‫أسبابه‬
-
‫التشخيص‬ ‫وطرق‬ ‫أعراضه‬

3. ‫الخيول‬ ‫فى‬ ‫المغص‬
‫االول‬ ‫الجزء‬
:
‫المغص‬ ‫انواع‬
-
‫أسبابه‬
-
‫التشخيص‬ ‫وطرق‬ ‫أعراضه‬

‫االكلينيكى‬ ‫التشخيص‬ ‫خطوات‬
.

‫التفريقى‬ ‫التشخيص‬
.

‫المغص‬ ‫لحاالت‬ ‫المعملي‬ ‫التشخيص‬
.

‫سيئة؟‬ ‫الحالة‬ ‫ان‬ ‫علي‬ ‫نحكم‬ ‫كيف‬

‫مهمة‬ ‫اخري‬ ‫عملية‬ ‫ونقاط‬
.

‫الخي‬ ‫فى‬ ‫لألمعاء‬ ‫التشريحى‬ ‫التركيب‬
‫ول‬
.

‫المغص‬ ‫تعريف‬
.

‫الخطورة‬ ‫وعومل‬ ‫األسباب‬
.

‫المغص‬ ‫من‬ ‫نوع‬ ‫لكل‬ ‫المميزة‬ ‫األعراض‬
.

‫حاالت‬ ‫لبعض‬ ‫توضيحية‬ ‫فيديوهات‬
‫المغص‬
.

4. left side of horse

5. Right side of horse

6. Left side

7. Right side

10. Equine Colic
It is a collection of symptoms
indicating abdominal pain

12. I-Anatomical classification
of colic:
(
1
) True colic:
pain from GIT.
(
2
) False colic:
Pain from other parts than GIT (Liver,
kidney, uterus, etc.)

13. II-Clinical classification of colic
1- Spasmodic colic
2- Flatulent colic
3- Obstructive colic

14. 4- Specific colic due to outside
obstruction of bowel
• Volvulus
• Invagination
• Torsion;
• StrangulatIion:
• Hernia:
(scrotal, diaphragmatic & umbilical hernia).

15. Pathophysiology
Colic may be due to:
Dysfunction Displacement Inflammation
• Spasmodic colic
• Gas colic
• Impaction
• Displacement
• Strangulation
• Ineususeption
• Gastritis
• Enteritis
• Colitis

16. Risk
Factors

17. Horse are More Risk for
Colic
Arabian horses
2-10 years old
Prgnancy & Lactation

18. More Risk
Transport- Fever- Vaccination
Increase amount of feed
Previous history of colic

19. 1-
Spasmodi
c colic

20. 1-Spasmodic colic
Definition :
It is a severe attacks of abdominal pain
caused by increase peristaltic movement
of the intestine, characterized by:
• Intermittent fits of colic,
• Rapid course
• Short duration.
• Favorable prognosis.

21. Etiology
Tapeworm infestation .
Excessive grain.
Moldy feed.
Physical exertion.
Diet changes.
Weather changes.

22. Video
Spasmodic colic

23. 2-Flatulent
colic

24. 2-Flatulent colic
(Intestinal tympany)
It is a form of colic due to
excessive distension of the
bowel with gases particularly
cecum and colon.

25. Etiology
(1) Feeding on large quantities of highly
fermentable green feed .
(2) Ingestion of spoiled or moldy food or
grains, which has tendency to swell.
(3) Sudden change in the ration.
(4) Atony of the bowel.
(5) Obstruction of the bowel by sands.

26. 3-
Obstructive
colic

27. 3-Obstructive colic
(Impaction of the intestine)
• It occurs when the large intestine
remains impacted with undigested food
material causing partial obstruction,
colic, depression & anorexia.

28. Etiology
•
(1) Overfeeding of grains or coarse
food rich in cellulose and bran for long
period.
•
(2) Ingesting food materials, which
contain large amounts of mud or sand.
•
(3) Sluggish intestinal peristalsis
especially in old debilitated & or
draught horses.
•
(4) Greedy feeding & defective teeth.

29. • (5) Obstruction of the intestine or
natural opening by large foreign bodies
or parasite.
• (6) Inadequate water intake or green
food.
• (7) Enterolith, fiber balls, hairball.
• (8) Encephalitic (equine rectal
paralysis).

30. ‫فيديو‬
(
‫االمعاء‬ ‫فى‬ ‫حصوات‬
)

31. 4-Gastric
Dilatation

32. Gastric Dilatation
Primary causes:
▪ Gastric impaction,
▪ food engorgement,
▪ excessive water intake after exercise,
Gasterophilus infestation
▪

33. Secondary causes:
• small or large intestinal obstruction.
• Dilation resulting from small intestinal
obstruction is the most common cause.
Fluid from the obstructed small intestine
accumulates in the stomach, causing
nasogastric reflux.
• ‫السوائل‬ ‫تراجع‬ ‫الى‬ ‫يؤدى‬ ‫الدقيقة‬ ‫االمعاء‬ ‫فى‬ ‫انسداد‬ ‫وجود‬
‫المعدة‬ ‫الى‬ ‫وارتدادها‬
.

34. Excess carbohydrate in one meal
Remove the worms by the
hand
•It will be rapidly fermented to
lactic acid by bacteria.
Anthelmintic drug such as
Levamisole at 5 mg/kg
under the skin and
Ivermectin and
Doramectin both at 0.2
mg/kg SC or in the muscle
are effective treatments.
•An increase in acid will lower the
pH of the hindgut
Topical application of
Levamisole or topical
Ivermectin. Bother are
given as a 1% aqueous
solution directly into the
eye.
•kill other bacteria and lead to the
release of endotoxins into the blood.
•The combination of these two factors
may lead to colic or laminitis.

35. 1- Ration
‫للخيول‬ ‫العليقة‬ ‫كمية‬
Remove the worms by the
hand
•
‫العليقة‬
‫االساسية‬
(
2
‫كيلو‬
‫صباحا‬
‫و‬
2
‫كيلو‬
‫مساءا‬
)
Anthelmintic drug such as
Levamisole at 5 mg/kg under
the skin and Ivermectin and
Doramectin both at 0.2
mg/kg SC or in the muscle
are effective treatments.
•
‫فى‬ ‫كيلو‬ ‫نصف‬ ‫عن‬ ‫الشوار‬ ‫نسبة‬ ‫تزيد‬ ‫أال‬ ‫يجب‬
‫اليوم‬ ‫طوال‬ ‫الوجبة‬
Topical application of
Levamisole or topical
Ivermectin. Bother are given
as a 1% aqueous solution
directly into the eye.
•
‫العليقة‬
‫المالئة‬
(
‫رودس‬
6
‫كيلو‬
‫تقدم‬
‫على‬
3
‫مرات‬
‫فى‬
‫اليوم‬
)

36. 3-Clinical
Survey
‫في‬ ‫المغص‬ ‫حاالت‬ ‫علي‬ ‫تمت‬ ‫دراسة‬
40
‫اوروبا‬ ‫في‬ ‫للخيول‬ ‫مستشفي‬

37. Clinical survey
for cases of of colic in hospitals
Mild Colic(Spasmodic ) 83%
Impaction 7%
Gas colic 3%

38. Follow
Gastric Rupture 2%
Strangulation 3%
Enteritis 1%

39. 3-Clinical
Finding

40. Degree of Pain
According to clinical signs
Mild
• Pawing
• Flank watching
• Stretching out
• Lying Down
Moderate
• Restlenes
• Pawing
• Kicking
the abdomen
• Rolling
Sever
• Extreme restlene
• Drooping to
the ground
• Violent rolling
• Sweeting

44. ‫ملحوظة‬
‫مهمة‬

45. In Gastric Reflux
‫المعدة‬ ‫لكمة‬

46. Clinical signs
of Gastric dilation produces:
• Acute, severe colic.
• Tachycardia.
• Pale mucous membranes.
• Retching.
• Ingesta at the nares in severe cases .
• Gastric reflux.

48. Sand Impactions
of the Large Colon
• Sand may be found
in the feces,
• Auscultation of the ventral abdomen
may reveal sounds of sand moving
within the large colon.
• Sand also may be detected on
abdominal radiography.

49. Inflammatory colic
Enteritis(Salmonella)
Peritonitis(Postoperative)
Colitis

50. Signs Inflammatory Colic
(Intermittent colic)
Fever
Depression
Diarrhea

51. Specific
Colic

52. cecum
RDC
RVC
LDC
LVC
Duodenum
jejunum
ileum
2
3
1
Special types of colic

53. ‫االمعاء‬ ‫فى‬ ‫انسداد‬ ‫حالة‬
•
‫ضربات‬
‫القلب‬
‫اكثر‬
‫من‬
80
•
‫برودة‬
‫االطراف‬
•
‫جفاف‬
•
‫عدم‬
‫وجود‬
‫براز‬
‫فى‬
‫المستقيم‬

54. Ischemia and gangrene
due to twisting

55. 4- Method of
diagnosis

56. Normal Temp. Pulse & Resp.
Temp 37.5
Pulse 28-40
Resp 8-18

57. ‫التشخيص‬ ‫أساسيات‬

58. 1-Case history
• A-How sever has the pain been?
• B-When did the horse last defecate?
And what was the character of the
feces?
• C-Has the horse shown specific
behavior such as playing with water?

59. 1-Case history
• D-Could the horse have graine access
highly fermentable food?
• What is the horse’s past medical
history?

60. 2- Examination of pulse:
• The heart rate and the character of
pulse are important in determining the
degree of severity of colic.
• Rates greeter than 80 bpm should be
considered the result of sever lesion or
disease
• ‫عن‬ ‫القلب‬ ‫ضربات‬ ‫زيادة‬
60
‫مؤشر‬ ‫يعتبر‬ ‫الدقيقة‬ ‫فى‬ ‫ضربة‬
‫خطر‬

61. 3-Estimation to
Degree of
Dehydration:
‫الجفاف‬ ‫درجة‬ ‫تحديد‬
A- Skin Pinch Test.
B-Capillary Refile
Time(CRT).

62. A-Skin-pinch test
• Pinch the skin near the point of the
shoulder.
• Skin snaps quickly back into place =
sufficient hydration.
• Skin stays tented for 2-4 seconds =
moderate dehydration.
• Skin remains lifted from the flesh for 4-
6 seconds = severe dehydration.

63. B-Capillary Refile Time(CRT)
• Pressing a finger or thumb on the upper
gum, above an incisor, for a second or
two.
• Color returns to the gum in one to two
seconds: horse is amply hydrated.
• Gums remain blanched for longer than
two seconds: horse is likely dehydrated.

64. Degree dehydration
1- Mild
• Mild:
• 5-7% body weight in water loss.
Symptoms:
• Depression.
• Dry mucous membranes.
• Slow capillary refill time (>2 seconds).

65. 2-Moderate Dehydration
• Moderate:
• 8-10% water loss.
• Signs:
• Depression,
• Weak pulse,
• Elevated heart rate
• Prolonged capillary refill time (2-4
seconds).

66. 3-Severe Dehydration
• Greater than 10% water loss.
• Symptoms:
• Cold limbs
• lethargy.
• persistent skin “tenting.”
• Horses may be near death with
multiple organ failure.

67. 4 Colure of the
MM

68. • In simple dehydration the oral
mm is slight bluish.
• in mild dehydration it becomes
brick red or cyanosed.

69. • In Sever Dehydration:
• it becomes pale blue-grey color.
• Severe dehydration normally occurs when
the damaged gut is no longer capable of
absorbing fluid into the body.

70. 4- Auscultaion of abdomen
• Site of stesoscope:
• Place your stethoscope head behind
the last rib and at the mid-height of the
abdomen.
• Listen to the upper left quadrant.
• Drop the stethoscope down about 8
inches and listen to the lower left
quadrant.

71. Right side
• Listen to the upper right quadrant
where gas is often heard since this
roughly corresponds to the base of the
cecum.
• Move down to the lower right quadrant

72. 4- Auscultaion of abdomen
• Normal Sounds:
• Intestinal or gut sounds are caused by
action of the equine intestines that
contain gas, water and feed.
• The normal digestive sounds in horses
range from deep gurgling to “tinkling”
sounds .

73. Motilty may be one the following
• 0 - Silent, no motility heard during 30
seconds.
• 1 - Less than normal motility.
• 2 - Normal motility.
• 3 - Hypermotile, more gut sounds than
usual.
• ‫الرمل‬ ‫حركة‬ ‫صوت‬ ‫نسمع‬ ‫القولون‬ ‫فى‬ ‫رمال‬ ‫وجود‬ ‫حالة‬ ‫فى‬
‫ورقة‬ ‫على‬

74. Absence of sound
• Complete lack of any sounds:
• Is an indication of impaction or
serious condition such as:
• Strangulation.
• Twisting.
• Telescoping.

75. ‫السماعة‬ ‫وضع‬ ‫مكان‬
‫ومن‬ ‫اليمين‬ ‫جهة‬ ‫من‬
‫اليسار‬ ‫جهة‬
‫اليمين‬
‫اليسار‬

77. 5-Nasogastric intubation
‫والعالج‬ ‫للتشخيص‬ ‫المعدى‬ ‫اللى‬ ‫انبوبة‬

78. 1-Passing a Nasogastric
(Stomach) Tube
‫استخدام‬ ‫دواعى‬
‫المعدى‬ ‫اللى‬ ‫انبوبة‬
‫الخيول‬ ‫فى‬

79. ‫المعدى‬ ‫اللى‬ ‫انبوبة‬ ‫ادخال‬ ‫خطوات‬
1
-
‫االولى‬ ‫الخطوة‬

80. ‫المعدى‬ ‫اللى‬ ‫انبوبة‬ ‫ادخال‬ ‫خطوات‬
1
-
‫الثانية‬ ‫الخطوة‬

81. ‫المعدى‬ ‫اللى‬ ‫انبوبة‬ ‫ادخال‬ ‫خطوات‬
1
-
‫الثالثة‬ ‫الخطوة‬
‫انها‬ ‫للتأكد‬ ‫االنبوب‬ ‫نفخ‬
‫المعدة‬ ‫داخل‬

82. Introduction of naso -gastric
intubation

83. Introduction of naso -gastric
intubation
Diagnosis Therapy

84. Gastric reflux
•
:
‫ظاهرة‬
‫ارتداد‬
‫السوائل‬
‫فى‬
‫المعدة‬
:
• A blockage in the bowel
(usually the small intestine)
that causes the build up of fluid
in front of it.

85. Complications
• Hemorrhage
• Aspiration
Pneumonia
• Gastric rupture
• Esophageal
necrosis

86. Any
Question?