Equine Colic Types

Gas colics and Displacements

Displacement pathophysiology

The microbes in the colon produce gas and create a balloon-like response. Since the colon is not adhered to the body, it is free to float up and down. Sometimes it floats out of position. Many simple displacements will self correct.

Nephrosplenic entrapment (left dorsal displacement)

Signalment
  • Deep chested breeds
Clinical signs
  • Mild to severe colic, depending upon the amount of distension; slowly progressive
  • Good response to analgesics
  • Reflux is relatively common due to compression of the duodenum
Diagnosis
  • Rectal palpation – colon identified in the nephrosplenic space; spleen deviated axially
  • Ultrasound – kidney not visible on left
  • GGT increased
  • Differentials – gas colic, impactions, other displacements
Complications
  • Secondary impaction and gas buildup
  • Secondary colon torsion
  • Colon rupture
Treatment
  • Treat as for gas colic – withhold feed 48-72 hours; may self correct if not stuck
  • Phenylephrine to shrink spleen (2-8mg, up to 20 mg Neosynephrine (two 10mg ampules, dilute to 60 ml); jog to loosen
    • NOT in horses over 15 yo – risk of large vessel rupture and fatal hemorrhage
  • Roll under GA (lots of work)
  • Surgery
Risk factors
  • Diet change, other as with gas colic
Prognosis
  • Good; may recur
Prevention
  • Laparoscopic obliteration of the nephrosplenic space
  • Colopexy

Since this type of colic can be treated in the field, it is useful to be able to identify it.

Nephrosplenic entrapment, J Jewell, NEEMSC

Right dorsal displacement

If the colon displaces to the right, it may not get stuck. Some of these will fix themselves and others will need surgery. Trocarization may help if the colon has a ping and if surgery isn’t an option as there is a risk of peritonitis.

Signalment
  • Deep chested breeds
Clinical signs
  • Mild to severe colic, depending upon the amount of distension; slowly progressive
  • Good response to analgesics
Diagnosis
  • Rectal palpation – gas distended colon which lies horizontally in front of the pelvic canal with a tight horizontal band.  Unable to palpate the pelvic flexure.
  • Right flank distension
  • GGT increased
  • Differentials – gas colic, impactions, other displacements
Complications
  • Secondary impaction and gas buildup
  • Secondary colon torsion
  • Colon rupture
Treatment
  • Treat as for gas colic – withhold feed 48-72 hours; may self correct if not stuck
  • Fluids and antispasmodics
  • Surgery
Risk factors
  • Diet change, other as with gas colic
Prognosis
  • Good; may recur
Prevention
  • Colopexy or colon removal

The use of phenylephrine in the treatment of nephrosplenic entrapment of the large colon in horses, Equine vet. Educ. (2020) 32 (11) 568-570

Lindegaard et al: Nephrosplenic entrapment of the large colon in 142 horses. EVJ 43(Suppl 39):63‐68, 2011

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Large Animal Surgery - Supplemental Notes by Erin Malone, DVM, PhD; Elaine Norton, DVM PhD; Erica Dobbs, DVM; and Ashley Ezzo, DVM is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.