1. Colic in the Older Horse
Colin Mitchell BVM&S CertEP MRCVS
ScottMitchellAssociates, Hexham

2. General Diagnosis & treatment – similar to younger animals
Increased prevalence of certain conditions
Reduced prevalence of certain conditions

3. Increased Prevalence Pedunculated lipoma Large bowel impaction
Some forms of neoplasia / cancer

4. Decreased Prevalence Grass sickness Small intestinal “twists”
Some forms of intussusception

5. Pedunculated Lipoma 70 % of surgical cases >20yo
a lump of fat, on a string, suspended in abdomen wraps around loops of intestine!!!
 obstruction, distension and pain

6. Pedunculated Lipoma May be intermittent
If persistent – need surgical correction
+/- bowel resection

12. Large Bowel Impaction “oro – dental syndrome” Reduced water intake
Can be managed medically
Oral liquid paraffin
Intravenous fluids
May need surgical correction

14. Older Horse Colic Pre-existing disease conditions
Should be considered in decision making process
ECS – poor wound healing
Chronic laminitis - welfare

15. Conclusion
Do not rule out possibility of referral for possible surgery on basis of age alone
Better to refer early and not need surgery, than send a surgical case too late

16. Majority of colic is medical !!!
Conclusion
Do not rule out possibility of referral for possible surgery on basis of age alone
Better to refer early and not need surgery, than send a surgical case too late
Majority of colic is medical !!!

17. Prevention of Colic
“Rules” of good feeding
Worm Control
Routine

18. Good Feeding Feed according to work , temperament & condition
Plenty of roughage
Little & often – 3kg max hard feed at any 1 time
Routine
Change gradually
Water before feeding
Good quality feedstuffs

19. Worm Control
Worm egg counts
Routine interval worming

20. Worm Control YEAR 1 Equest every 13 weeks Tape worm Spring / Autumn
(Equitape / DD Stro-P DD Pyratape P etc)
YEAR 2
Ivermectin every 6-8 weeks (Eqvalan etc)
Tape worm as Year 1

21. Routine Feeding times Feeding quality / quantity Turn-out
Bedding : straw v shavings / paper
Dental prophylaxis

22. Recurrent Airway Obstruction
RAO
Heaves
Asthma in horses
COPD

23. Recurrent Airway Obstruction
RAO
Heaves
Asthma in horses
COPD

24. RAO Reaction of small airways to inhaled substances
Fungal spores, dust, noxious gases, ammonia, mites

25. RAO Increased resp rate & effort +/- cough +/- nasal discharge
Poor performance

26. RAO - management
Drug therapy
Environmental control

27. Drug Therapy
Oral
Inhaled
Systemic

28. Oral Therapy
“Ventipulmin”, “Sputulosin”,
“Prednisolone”

29. Inhaled Less side-effects High local concentration of drug
Rapid onset of action
Delivered at site where required

30. Systemic Therapy Usually at time of respiratory distress :- Frusemide
Steroid
Atropine

31. Environmental Turn – out Haylage Paper / dust-extracted shavings
Rubber matting
Soak hay

32. Weight Loss

33. Mechanisms of Weight Loss
Reduced intake
Reduced digestion, absorption
Increased losses
Increased requirements

34. Common causes Malnutrition Dental disease
Inability to compete for feed
Chronic Peritonitis
Grass sickness
Protein losing enteropathy ( PLE )
Neoplasia ( GI / non-GI )
Liver disease
Internal parasitism

35. My Approach Good history Feeding Worming Previous disease / lameness
Housing

36. My Approach
Clinical Examination
Worm & rasp teeth

37. My Approach Clinical Examination Worm & rasp teeth
Blood tests – liver / PLE

38. My Approach Clinical Examination Worm & rasp teeth
Blood tests – liver / PLE
Peritoneal fluid / urine

39. My Approach Hospitalise :- Oral glucose tolerance test ( OGTT )
Rectal biopsy if diarrhoea
Gastroscopy
Ultrasonography

40. OGTT
Starve overnight
1g per kg glucose administered by naso-gastric tube
Blood sample regularly
Plot glucose level in blood – compare peak

41. OGTT
>85% increase : normal
15 – 85 % : partial
<15 % : complete

42. OGTT Tests small intestinal function
Blood glucose should peak 2hrs after glucose given
If not – reduced absorption

43. OGTT - normal
blood glucose
time
2 hrs

44. OGTT - partial
blood glucose
time
2 hrs

45. OGTT - complete
blood glucose
time
2 hrs

46. OGTT - compare
blood glucose
time
2 hrs

47. Weight Loss - further Laparotomy
Once gone beyond common causes – can be difficult to pinpoint cause