Impactions – cecal, colon and small colon

Equine Colic Types

Pelvic flexure impactions

Large colon impactions (intestinal blockage by food material) are very common and generally occur at the pelvic flexure due to the narrowed turn

Category	Disorder related findings
Signalment	All ages and breeds. Show horses?
Clinical signs	Mild colic, slow onset Decreased manure production Small dry feces +/- mucus covered
Diagnosis	History, response to therapy Rectal palpation – doughy mass near pelvis Differentials – gas colic, colon displacement
Complications	Eventually the impaction can damage the local blood supply. This leads to necrosis and bowel rupture
Treatment	See field colics. Improve motility, control pain, soften the impaction, prevent worsening Surgery if not responsive
Risk factors	Sudden feed changes, management changes, exercise changes Motility disorders, other illness, atropine or anesthesia Following surgery and not on analgesics Inadequate mastication Poor dentition Poor feed quality Reduced water intake
Prognosis	Good
Prevention	Minimize management and feed changes Ensure good water intake Feed off the ground to minimize sand intake Good dental care Parasite control Owner involved in animal care

Category	Disorder related findings
Signalment	Especially Arabs, Appaloosas and Morgans Especially >15 yo
Clinical signs	Mild colic, slow onset Decreased manure production- may be the only sign due to the NSAIDs masking pain Anorexia, depression
Diagnosis	Rectal palpation – doughy mass to right of midline
Complications	Cecal rupture, recurrence if treated
Treatment	Challenging – laxatives bypass the cecum. Surgery may be required.
Risk factors	Eye conditions being treated with atropine Hospitalized horses treated with NSAIDs Sandy environment Tapeworms
Prognosis	Grave
Prevention	Monitor animals on atropine and hospitalized animals closely

Category	Disorder related findings
Signalment	Especially 5-15 yo Arabs, Morgans, Saddlebreds, donkeys, miniature horses Mares
Clinical signs	Intermittent mild colic Pain after exercise Can -> acute severe pain
Diagnosis	Rectal palpation on a hill (so transverse colon floats back) Radiographs Differentials – gas colics, impactions
Complications	Intestinal rupture Diarrhea, fever postop
Treatment	Surgery
Risk factors	Another horse on the property has enteroliths Life in California, Indiana, Florida Water with high levels of Mg Eating alfalfa Limited pasture access Confinement >50% of the day
Prognosis	Good – may recur
Prevention	Feed grass hay Feed 1 c vinegar per day Avoid bran mashes

youtube video– surgery to remove enterolith

Category	Disorder related findings
Signalment	All ages and breeds
Clinical signs	Mild colic, slow onset Intermittent diarrhea Weight loss
Diagnosis	Sand test – put feces in a plastic bag or rectal sleeve and let stand – does sand settle out? Not a great test but it is easy to try Auscultate ventral abdomen for “ocean” sounds Radiographs- best test
Complications	Mucosal erosion Secondary large colon torsion
Treatment	Psyllium + mineral oil Psyllium + magnesium sulfate- most useful Surgery
Risk factors	High sand content in soil Eating off the ground or short/nonexistent pastures Insufficient roughage
Prognosis	Fair to good
Prevention	Food off ground or use mats to catch grain Long term psyllium is likely ineffective Ensure eating sufficient fiber

Category	Disorder related findings
Signalment	Arabs, minis, and ponies predisposed to small colon lesions (better able to maintain hydration by removing water from ingesta?) Broodmares in the third trimester >15 yo
Clinical signs	Mild colic, slow onset -> significant pain Decreased manure production May reflux (compression of duodenum?) Fever (if Salmonellosis) Anorexia
Diagnosis	Rectal palpation – doughy tube instead of fecal balls
Complications	Colon rupture due to mural necrosis Associated with greater risk of Salmonellosis and diarrhea
Treatment	Oral and iv fluids Enemas and laxatives Surgical decompression (enema)
Risk factors	Dehydration and other factors as for colon impactions Parasites
Prognosis	Good
Prevention	As for colon impactions- ensure good water intake, good forage, good dental care

Category	Disorder related findings
Signalment	foals, especially males?
Clinical signs	mild colic within 24 hours of birth becomes more severe with accompanying tympany
Diagnosis	Digital rectal Radiology +barium enema Differentials – congenital lesions, ruptured bladder
Complications	Patent urachus FPT
Treatment	Enemas Analgesics Oral laxatives
Risk factors	Delayed colostrum
Prognosis	Good
Prevention	Early colostrum

Perirectal abscesses can lead to obstipation due to pain

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