Colic in equines can be diagnosed through various methods including ultrasonography, radiography, endoscopy, and laboratory tests. A thorough clinical examination involves assessing vital signs, hydration status, gastrointestinal sounds via auscultation, and rectal palpation. Nasogastric intubation allows for evaluation of gastric contents and may help relieve gastric distention. Differential diagnosis of colic includes sand accumulation, intestinal obstructions, inflammation, and parasites. Precautions must be taken when performing rectal examination to avoid complications.

1. Colic In Equines
2-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
‫الثانى‬ ‫الجزء‬
:
‫التفريقى‬ ‫والتشخيص‬ ‫التشخيص‬

3. ‫الخيول‬ ‫فى‬ ‫المغص‬
‫الثانى‬ ‫الجزء‬
:
‫التفريقى‬ ‫والتشخيص‬ ‫التشخيص‬ ‫طرق‬

‫السونار‬ ‫باستخدام‬ ‫التشخيص‬

‫اكس‬ ‫أشعة‬ ‫بأستخدام‬ ‫التشخيص‬

‫البطن‬ ‫منظار‬ ‫باستخدام‬ ‫التشخيص‬

‫المعملى‬ ‫التشخيص‬

‫البطن‬ ‫فتح‬ ‫طريق‬ ‫عن‬ ‫التشخيص‬
‫االستكشافى‬

‫التفريقى‬ ‫التشخيص‬

‫الحالة‬ ‫على‬ ‫الحكم‬
.

‫الحالة‬ ‫تاريخ‬

‫األكلينيكى‬ ‫الفحص‬

‫النبض‬ ‫قياس‬

‫الجفاف‬ ‫درجة‬ ‫قياس‬

‫المخاطية‬ ‫األغشية‬ ‫فحص‬

‫السماعة‬ ‫باستخدام‬ ‫التشخيص‬

‫ال‬ ‫اللى‬ ‫انبوبة‬ ‫باستخدام‬ ‫التشخيص‬
‫معدى‬

‫الشرجى‬ ‫الفحص‬ ‫طريق‬ ‫عن‬ ‫التشخيص‬

4. Method of diagnosis

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

6. ‫التشخيص‬ ‫أساسيات‬

7. 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?

8. 1-Case history
• D-Could the horse have graine access
highly fermentable food?
• What is the horse’s past medical
history?

9. Clinical Signs
• Flank-watching or -biting,
• pawing,
• trying to roll,
• an elevated heart rate,
• a lack of gut sounds or bowel
movements.
• While these signs and others are pretty
clear, common indicators your horse is
colicking,

11. 2- Auscultation of the
heart

12. 2- Examination of heart:
• 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

13. 3-Estimation to
Degree of
Dehydration:
‫الجفاف‬ ‫درجة‬ ‫تحديد‬
A- Skin Pinch Test.
B-Capillary Refile
Time(CRT).

14. 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.

15. 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.

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

17. 2-Moderate Dehydration
• Moderate:
• 8-10% water loss.
• Signs:
• Depression,
• Weak pulse,
• Elevated heart rate
• Prolonged capillary refill time (2-4
seconds).

18. 3-Severe Dehydration
• Greater than 10% water loss.
• Symptoms:
• Cold limbs
• lethargy.
• persistent skin “tenting.”
• Horses may be near death with
multiple organ failure.

19. 4 Colure of the
MM

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

21. • 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.

22. 5- Auscultation of the
abdomen

23. 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

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

26. Listen to the upper right
quadrant
• 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
•
‫عدم‬
‫سماع‬
‫صوت‬
‫حركة‬
‫األمعاء‬
‫فى‬
‫الجزء‬
‫العلوى‬
‫من‬
‫ناحي‬
‫ة‬
‫اليمين‬
‫احتمال‬
‫امتالء‬
‫االعور‬
‫بالغازات‬
‫او‬
‫الطعام‬
•
‫فى‬
‫حالة‬
‫الغازات‬
‫نسمع‬
‫الصوت‬
‫المعدنى‬
•
‫عدم‬
‫سماع‬
‫صوت‬
‫حركة‬
‫األمعاء‬
‫فى‬
‫الجزء‬
‫السفلى‬
‫دليل‬
‫وجود‬
‫لكمة‬
‫فى‬
‫القولون‬
‫او‬
‫رمال‬

27. Listen to the upper& lower left
quadrant
• Listen to the upper left quarter
• Drop the stethoscope down about 8
inches and listen to the lower left
quadrant.
‫ضعف‬
‫حركة‬
‫االمعاء‬
‫فى‬
‫الجزء‬
‫العلوى‬
‫من‬
‫اليسار‬
‫دليل‬
‫على‬
‫حدوث‬
‫شلل‬
‫فى‬
‫االمعاء‬
‫عدم‬
‫سماع‬
‫صوت‬
‫فى‬
‫الجزء‬
‫السفلى‬
‫من‬
‫اليسار‬
‫يدل‬
‫على‬
‫احتمال‬
‫حدوث‬
‫انزياح‬
‫للقولون‬
‫اليسار‬
‫السفلى‬
‫من‬
‫مكانه‬

28. 6-Nasogastric intubation
‫والعالج‬ ‫للتشخيص‬ ‫المعدى‬ ‫اللى‬ ‫انبوبة‬

29. 1-Passing a Nasogastric
(Stomach) Tube
‫استخدام‬ ‫دواعى‬
‫المعدى‬ ‫اللى‬ ‫انبوبة‬
‫الخيول‬ ‫فى‬

30. ‫المعدى‬ ‫اللى‬ ‫انبوبة‬ ‫ادخال‬ ‫خطوات‬
1
-
‫االولى‬ ‫الخطوة‬

31. ‫المعدى‬ ‫اللى‬ ‫انبوبة‬ ‫ادخال‬ ‫خطوات‬
1
-
‫الثانية‬ ‫الخطوة‬

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

33. Introduction of naso -gastric
intubation

34. Introduction of naso -gastric
intubation
Diagnosis Therapy

35. 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.

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

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

38. 7-Rectal palpation
• :‫اآلتية‬ ‫االعضاء‬ ‫فحص‬ ‫يمكن‬

39. 7-Rectal palpation
• :‫اآلتية‬ ‫االعضاء‬ ‫فحص‬ ‫يمكن‬
• Caudal portions of the large intestine,
• Caudal edge of spleen,
• Left kidney,
• Aorta,
• Mesenteric root,
• Reproductive tract of mares,
• Inguinal rings in stallions.

40. Precautions
• Administration of sedatives:
• (Buscopan :hyosin hydrobromide)
• VET:(N-Butylscopolammonium
bromide)
• Xylazine:
• Doses of up to 0.5mg/kg of xylazine IV
can be useful for short durations (15 to
30 minutes)

41. Precautions
• Glove lubricated with lubricant.
• Short nails
• Application of a nose twitch
• Lifting one of the fore limb

42. Normal anatomical structure viewed from the caudal
aspect of the equine abdomen.

43. Examination of colon & cecum
A-In large colon impaction:
is characterized by an enlarged, firm,
filled viscous located on the pelvic floor.
B-Cecal impaction :
• palpation of a firm, impacted cecum or
a grossly distended
• fluid-filled cecum per rectum.

44. 8-Ultasonography
2-5 MGz

45. Indications
1- Intestinal motility and distension
can be evaluated for both the large
and small intestine.
2-The thickness of the intestinal wall
can be evaluated and measured.

46. Indications
3-some abdominal abscesses.
4- Intussusception.
5-Peritoneal effusion(Volume and
type).
6-Gastric dilatation

47. Indications
• 7-Adhesions, masses,
• 8-Left dorsal displacement of the
large colon,
• 9-Hemoperitoneum
• 10-Splenic abnormalities.

48. Trans-abdominal ultrasonography
showing thickened loops of small
intestine due to inflammatory bowel
disease.

49. 9- Radiography

50. 8-Radiology
• Sand accumulation
• Enteroliths

51. 10- Endoscopy

52. Endoscopic examination
• Through esophagus and the rectum
can be performed to evaluate for:
• the presence of obstructions,
• tears or other perforations.
• Inflammation.
• ulcers .
• in association with a colic episode,

53. Gastric ulcer
• Sand accumulation
• Enteroliths
Gastric ulceration – endoscopic
appearance of grade 1 ulcers.

54. 11- Laboratory
Investigations

55. A-Faecal examination
• Ascaris
• Strongyloides
are the most common causes of
colic in equines.

56. B- CBC
▪ Blood picture revealed increase
in case of:
▪ Hb and PCV percentage in all
the three types of colic.
▪
‫هذا‬
‫دليل‬
‫على‬
‫حدوث‬
‫جفاف‬
‫فى‬
‫معظم‬
‫أنواع‬
‫المغص‬
‫ويتم‬
‫تحديد‬
‫كمية‬
‫المحاليل‬
‫بناءا‬
‫على‬
‫نسبة‬
‫الج‬
‫فاف‬

58. Bile acid concentrations
▪ Can be increased in some
horses with intestinal
disorders, such as colic,
enteritis,

59. Bile acid concentrations
▪ Horses with displacement of the
left colon to the right occasionally
have increases in:
▪ GGT activity .
▪ Direct (conjugated) bilirubin.
▪ Bile acids.
▪ ( resulting from obstruction of bile
flow)

60. Plasma volume contraction
▪ An Increase in:
▪ hematocrit PCV.
▪ electrolyte derangements
(hyponatremia- hypochloremia, and
hypomagnesemia).
▪ Occurs secondarily to fluid
sequestration and loss via the
intestines.

61. Total protien
▪ Lower than total protein (especially
albumin) concentration .
▪ indicates protein loss from the
diseased bowel.

62. Analysis of peritoneal fluid
Reflects these changes.
• Leukocytosis
• Increase of protein
• ( in colonic impaction & strangulation.)

63. SURGICAL DIAGNOSTICS
Exploratory celiotomy and laparoscopy
are both surgical procedures.
This done when all other methods of
diagnosis are failed to reach the actual
cause of colic.

65. 11- Surgical exploratory
examination

66. Ileo- cecal impaction

67. Colon impaction

68. Differential Diagnosis

70. Prognosis

71. Causes of Endotoxemia in
Horses
• Toxin called lipopolysaccharide (LPS),
which is present in the cell walls of
gram-negative bacteria.
• Some types of gram-negative bacteria
are naturally in the gut flora and don’t
cause any harm unless the horse is
sick for some other reason .

72. Causes of Endotoxemia in
Horses
• and these bacteria excessively proliferate
and then breach the intestinal wall, thus
entering the bloodstream.
• When these bacteria die, their cell walls
rupture, releasing the LPS into the
bloodstream and causing endotoxemia.
• E. coli, Salmonella, and Enterobacter are
common Gram-negative bacteria that
cause endotoxemia.

73. Symptoms of Endotoxemia in
Horses
• Fever
• Dehydration
• Dark mucous membranes .
• Sweating
• Increased heart and respiratory rate
• Laminitis
• Pain

74. Endotoxin shock
• Acute strangulation.
• Intussusception.
• Salmonellosis.
• Neonatal bacteremia and
septicemia

75. The value of measurement blood
pressure in prognosis of colic

78. a 17- to 21-gauge catheter is placed into a
metatarsal, metacarpal, facial, or transverse
facial artery and is connected to a monitor

79. Prognosis
• The most notable prognostic indicators
include :
• heart rate.
• packed cell volume.
• plasma lactate.
• creatinine.
• blood glucose concentrations

80. Pad prognosis
• Increase in heart rate.(more than 80/m)
• Increase packed cell volume.(more than 40)
• Increase plasma lactate.
• Increase creatinine.
• Increase blood glucose concentrations.
• Hypotension ( less than 60 mmHg).

81. Need Surgery
‫سريع‬ ‫جراحى‬ ‫تدخل‬ ‫الى‬ ‫تحتاج‬ ‫الحاالت‬ ‫هذه‬
• 1- Clean rectum( No feces in the
rectum).
• 2- pulse rate over 80/M.
• 3- Cyanosed mm.
• 4- Absence of intestinal sounds
• 5- Gastric reflux
• 6- Sandy colic

82. Any
Question?