Horse colic - Knowledge

2582:, or complete failure of the incision leading to spillage of the abdominal contents out of the incision site, and the horse is not allowed turn-out until the incision has healed, usually after 30 days of stall rest. Abdominal bandages are sometimes used to help prevent the risk of dehiscence. Incisional infection doubles the time required for postoperative care, and dehiscence may lead to intestinal herniation, which reduces the likelihood of return to athletic function. Therefore, antibiotics are given 2–3 days after surgery, and temperature is constantly monitored, to help assess if an infection is present. Antibiotics are not used long-term due to the risk of antimicrobial resistance. The incision usually takes 6 months to reach 80% strength, while intestinal healing following resection and anastomosis is much faster, at a rate to 100% strength in 3 weeks. After the incision has healed adequately, the horse is turned out in a small area for another 2–3 months, and light exercise is added to improve the tone and strength of the abdominal musculature. 674:) but sometimes of magnesium vivianite and some amounts of sodium, potassium, sulfur and calcium, which develop within the horse's gastrointestinal tract. They can form around a piece of ingested foreign material, such as a small nidus of wire or sand (similar to how an oyster forms a pearl). When they move from their original site they can obstruct the intestine, usually in the right dorsal and transverse colon, but rarely in the small colon. They may also cause mucosal irritation or pain when they move within the gastrointestinal tract. Enteroliths are not a common cause of colic, but are known to have a higher prevalence in states with a sandy soil or an abundance of alfalfa hay is fed, such as California, a state where 28% of surgical colics are due to enteroliths. Alfalfa hay is thought to increase the risk due to the high protein content in the hay, which would likely elevate ammonia nitrogen levels within the intestine. They may be more common in horses with diets high in magnesium, and are also seen more often in 1941:

A strangulating lesion may produce high levels of red blood cells, and a serosanguinous fluid containing blood and serum. White blood cell levels may increase if there is death of intestine that leads to leakage of intestinal contents, which includes high levels of bacteria, and a neutrophil to monocyte ratio greater than or equal to 90% is suggestive of a need for surgery. "High" nucleated cell counts (15,000–800,000 cells/microliter depending on the disease present) occur with horses with peritonitis or abdominal abscesses. The protein level of abdominal fluid can give information as to the integrity of intestinal blood vessels. High protein (> 2.5 mg/dL) suggests increased capillary permeability associated with peritonitis, intestinal compromise, or blood contamination. Horses with gastrointestinal rupture will have elevated protein the majority of the time (86.4%) and 95.7% will have bacteria present. Occasionally, with sand colic, it is possible to feel the sand with the tip of the needle.

659:

Additional sections of intestines may be distended if there is fluid backup. Manure production decreases, and if passed, is usually firm, dry and mucus covered. Horses are treated with analgesics, fluid therapy, mineral oil, dactyl sodium sulfosuccinate (DSS), and/or epsom salts. Analgesics usually can control the abdominal discomfort, but may become less efficacious over time if the impaction does not resolve. Persistent impactions may require fluids administered both intravenously and orally via nasogastric tube, at a rate 2–4 times the maintenance for the animal. Feed is withheld. Horses that do not improve or become very painful, or those that have large amounts of gas distention, are recommended to undergo surgery to remove the impaction via enterotomy of the pelvic flexure. Approximately 95% of horses that undergo medical management, and 58% of surgical cases, survive.

1670:(PCV) is a measure of hydration status, with a value 45% being considered significant. Increasing values over repeated examination are also considered significant. The total protein (TP) of blood may also be measured, as an aid in estimating the amount of protein loss into the intestine. Its value must be interpreted along with the PCV, to take into account the hydration status. When laboratory tests are not available, hydration can be crudely assessed by tenting the skin of the neck or eyelid, looking for sunken eyes, depression, high heart rate, and feeling for tackiness of the gums. Jugular filling and quality of the peripheral pulses can be used to approximate blood pressure. Capillary refill time (CRT) may be decreased early in the colic, but generally prolongs as the disease progresses and cardiovascular status worsens. 779:

and the examiner may not be able to push beyond the brim of the pelvis due to the obstruction. The colon may be irreversibly damaged in as little as 3–4 hours from the initial time of the volvulus, so immediate surgical correction is required. The surgeon works to correct the volvulus and then removes any damaged colon. 95% of the colon may be resected, but often the volvulus damages more than this amount, requiring euthanasia. Plasma lactate levels can help predict survival rates, with an increased survival seen in horses with a lactate below 6.0 mmol/L. Prognosis is usually poor, with a survival rate of approximately 36% of horses with a 360 degree volvulus, and 74% of those with a 270 degree volvulus, and a reoccurrence rate of 5–50%. Complications post-surgery include hypoproteinemia, endotoxic shock, laminitis, and

2547:, leading to adhesion formation between adjacent tissues with either fibrinous or fibrous material. Adhesions may encourage a volvulus, as the attachment provides a pivot point, or force a tight turn between two adjacent loops that are now attached, leading to partial obstruction. For this reason, clinical signs vary from silent lesions to acute obstruction, encouraging future colics including intestinal obstruction or strangulation, and requiring further surgery and risk of adhesion. Generally, adhesions form within the first two months following surgery. Adhesions occur most commonly in horses with small intestinal disease (22% of all surgical colics), foals (17%), those requiring enterotomy or a resection and anastomosis, or those that develop septic peritonitis. 493:). Horses show intermittent colic, with moderate to severe signs and with time, distended small intestinal loops on rectal. Although most ileal impactions will sometimes pass without intervention, those present for 8–12 hours will cause fluid to back up, leading to gastric reflux, which is seen in approximately 50% of horses that require surgical intervention. Diagnosis is usually made based on clinical signs, presence of reflux, rectal exam, and ultrasound. Often the impaction can not be felt on rectal due to distended small intestinal loops that block the examiner. Those impactions that are unresponsive to medical management, which includes IV fluids and removal of reflux, may be treated using a single injection into the ileum with 1 liter of 568:

does not function properly. Horses usually show clinical signs 3–5 days post general anesthesia, including decreased appetite, decreased manure production, and gas in the cecum which can be auscultated. The cecum quickly distends due to fluid and gas accumulation, often leading to rupture within 24–48 hours if not corrected. This impaction may be missed since decreased manure production can be attributed secondarily to surgery, and often rupture occurs before severe signs of pain. Horses are most at risk for this type of impaction if surgery is greater than 1 hour in length, or if inadequate analgesia is provided postoperatively.

1788:

by rectal palpation, although this can vary based on the size of the horse and the length of the examiner's arm. Structures that can be identified include the aorta, caudal pole of the left kidney, nephrosplenic ligament, caudal border of the spleen, ascending colon (left dorsal and ventral, pelvic flexure), the small intestine if distended (it is not normally palpable on rectal), the mesenteric root, the base of the cecum and the medial cecal band, and rarely the inguinal rings. The location within the colon is identified based on size, presence of sacculations, number of bands, and if fecal balls are present.

787:

possibly because of a sudden change to a bulkier foodstuff. Animals present with acute and severe signs of colic, and multiple distended loops of small intestine, usually seen radiographically in a foal. Small intestinal volvulus often occurs secondary to another disease process in adult horses, where small intestinal obstruction causes distention and then rotation around the root of the mesentery. Surgery is required to resect nonviable sections of bowel, and prognosis is correlated to the length of bowel involved, with animals with greater than 50% of small intestinal involvement having a grave prognosis.

2520:

require resection and anastomosis. 90% of large intestinal colic surgeries that are not due to volvulus, and 20–80% of large colon volvuluses, are discharged; while 85–90% of non strangulating small intestinal lesions, and 65–75% of strangulating intestinal lesions are discharged. 10–20% of small intestinal surgical cases require a second surgery, while only 5% of large intestinal cases do so. Horses that survive colic surgery have a high rate of return to athletic function. According to one study, approximately 86% of horses discharged returned to work, and 83.5% returned to same or better performance.

2079:, or have persistent signs that require multiple administrations of such drugs. Heart rate is often used as a measure of the animal's pain level and a heart rate >60 bpm is more likely to require surgery. However, this measure can be deceiving in the early stages of a severe colic, when the horse may still retain a relatively low rate. Additionally, pain tolerance of the individual must be taken into account, since very stoic animals with severe cases of colic may not show adequate levels of pain to suggest the need for surgery. High heart rates (>60 bpm), prolonged 508:, with current theories for such cases including neural dysfunction within the intestinal wall secondary to parasite migration, and increased tone of the ileocecal valve which leads to hypertrophy of the ileum as it tries to push contents into the cecum. Hypertrophy may also occur secondary to obstruction, especially those that have had surgery for an obstruction that required an anastomosis. Hypertrophy gradually decreases the size of the lumen, resulting in intermittent colic, and in approximately 45% of cases includes weight loss of 1–6 month duration and 1804:. Horses that have had gastrointestinal rupture may have gritty feeling and free gas in the abdominal cavity. Surgery is usually suggested if rectal examination finds severe distention of any part of the GI tract, a tight cecum or multiple tight loops of small intestine, or inguinal hernia. However, even if the exact cause can not be determined on rectal, significant abnormal findings without specific diagnosis can indicate the need for surgery. Rectal examinations are often repeated over the course of a colic to monitor the GI tract for signs of change. 799:

parasitic infections, usually tapeworms, although small masses and foreign bodies may also be responsible, and is most common in young horses usually around 1 year of age. Ileocecal intussusception may be acute, involving longer (6–457 cm) segments of bowel, or chronic involving shorter sections (up to 10 cm in length). Horses with the acute form of colic usually have a duration of colic less than 24 hours long, while chronic cases have mild but intermittent colic. Horses with the chronic form tend to have better prognosis.

2303:

making oral fluids ineffective and possibly dangerous if they cause gastric distention and rupture. This process of secretion into the intestinal lumen leads to dehydration, and these horse require large amounts of IV fluids to prevent hypotension and subsequent cardiovascular collapse. Fluid rates are calculated by adding the fluid lost during each collection of gastric reflux to the daily maintenance requirement of the horse. Due to the fact that horses absorb water in the cecum and colon, the IV fluid requirement of horses with

1898: 1821:, and excess fluid and material (reflux) is pulled off the stomach. Healthy horses will often have less than 1 liter removed from the stomach; any more than 2 litres of fluid is considered to be significant. Horses are unable to vomit or regurgitate, therefore nasogastric intubation is therapeutically important for gastric decompression. A backup of fluid in the gastrointestinal tract will cause it to build up in the stomach, a process that can eventually lead to stomach rupture, which is inevitably fatal. 521:

commonly accumulates in the pelvic flexure, but may also occur in the right dorsal colon and the cecum of the large intestines. The sand can cause colic signs similar to other impactions of the large colon, and often causes abdominal distention As the sand or dirt irritates the lining of the bowel it can cause diarrhea. The weight and abrasion of the sand or dirt causes the bowel wall to become inflamed and can cause a reduction in colonic motility and, in severe cases, leads to peritonitis.

572:

past to prevent reoccurrence, a recent study suggests it is not necessary. Surgery has a good prognosis, although rupture can occur during surgical manipulation. The cause of cecal impactions are not known. Cecal impaction should be differentiated from large colon impaction via rectal, since cecal impaction has a high risk of rupture even before developing severe pain. Overall prognosis is 90%, regardless of medical or surgical treatment, but rupture does occur, often with no warning.

749:—a medication that causes contracture of the spleen and may allow the bowel to slip off the nephrosplenic ligament. At times anesthesia and a rolling procedure, in which the horse is placed in left lateral recumbency and rolled to right lateral recumbency while jostling, can also be used to try to shift the colon off of the nephrosplenic ligament. Displacements that do not respond to medical therapy require surgery, which generally has a very high success rate (80–95%). 1519:

usually through during parturition, distention of the abdomen, a fall, or strenuous exercise, or direct trauma to the chest. Congenital hernias occur most commonly in the most ventral part of the diaphragm, while acquired hernias are usually seen at the junction of the muscular and tendinous sections of the diaphragm. Clinical signs usually are similar to an obstruction, but occasionally decreased lung sounds may be heard in one section of the chest, although

1493:, or direct, in which case it ruptures through the tunic and goes subcutaneously. Direct hernias are seen most commonly in foals, and usually congenital. Indirect hernias may be treated by repeated manual reduction, but direct hernias often require surgery to correct. The testicle on the side of resection will often require removal due to vascular compromise, although prognosis for survival is good (75%) and the horse may be used for breeding in the future. 699:

flexure enterotomy and sometimes an additional right dorsal colon enterotomy, and fully resolve the signs of colic. Horses will usually present a round enterolith if it is the only one present, while multiple enteroliths will usually have flat sides, a clue to the surgeon to look for more stones. The main risk of surgery is rupture of the colon (15% of cases), and 92% of horses that are recovered survive to at least one year from their surgery date.

2286:, a mainstay of colic management, is often repeated multiple times until resolution of clinical signs, both as a method of gastric reflux removal and as a way to directly administer fluids and medication into the stomach. Reflux must be removed periodically to prevent distention and possible rupture of the stomach, and to track reflux production, which aids in monitoring the progression of the colic. Its use is especially important in the case of 655:. Aldosterone secretion activates absorption of fluid from the colon, decreasing the water content of the ingesta and increasing risk of impaction. Amitraz has also been associated with large colon impaction, due to alterations in motility and retention of intestinal contents, which causes further absorption of water and dehydration of ingesta. Other possible factors include poor dental care, course roughage, dehydration, and limited exercise. 1321:. Clinical signs vary based on the degree of vascular compromise and the length of intestine that is affected, and include acute and severe colic seen with other forms of strangulating obstruction, so diagnosis is usually made based on anthelminthic administration history although may be definitively diagnosed during surgical exploratoration. Treatment includes typical management of colic signs and endotoxemia, and the administration of 1808:

the risk of tears, because it decreases the smooth muscle tone of the gastrointestinal tract, but can be contraindicated and will produce a very rapid heart rate. Because the rectum is relatively fragile, the risk of rectal tears is always present whenever an examination is performed. Severe rectal tears often result in death or euthanasia. However, the diagnostic benefits of a rectal examination almost always outweigh these risks.

2319:, such as those suffering from endotoxemia, require very high rates of IV fluid administration. Oral fluids via nasogastric tube are often given in the case of impactions to help lubricate the obstruction. Oral fluids should not be given if significant amounts of nasogastric reflux are obtained. Access to food and water will often be denied to allow careful monitoring and administration of what is taken in by the horse. 1128:. Gastric carcinoma is usually diagnosed via gastroscopy, but may sometimes be felt on rectal if they have metastasized to the peritoneal cavity. Additionally, laparoscopy can also diagnose metastasized cancer, as can presence of neoplastic cells on abdominocentesis. Often the signs of intestinal neoplasia are non-specific, and include weight loss and colic, usually only if obstruction of the intestinal lumen occurs. 1629:, fecal quality and when it was last passed, and any history of colic. The most important factor is time elapsed since onset of clinical signs, as this has a profound impact on prognosis. Additionally, a veterinarian will need to know any drugs given to the horse, their amount, and the time they were given, as those can help with the assessment of the colic progression and how it is responding to analgesia. 469:. Ileal impaction can be caused by obstruction of ingesta. Coastal Bermuda hay is associated with impactions in this most distal segment of the small intestine, although it is difficult to separate this risk factor from geographic location, since the southeastern United States has a higher prevalence of ileal impaction and also has regional access to coastal Bermuda hay. Other causes can be obstruction by 25: 907:

gastric decompression. It is important to differentiate DPI from small intestinal obstruction, since obstruction may require surgical intervention. This can be difficult, and often requires a combination of clinical signs, results from the physical examination, laboratory data, and ultrasound to help suggest one diagnosis over the other, but a definitive diagnosis can only be made with surgery or on

559:

Such prophylaxis includes feeding a pelleted psyllium for one week every 4–5 weeks. Longer duration of treatment will result in gastrointestinal flora changes and the psyllium to be broken down and ineffective for sand clearance. Other methods include feeding the horse before turnout, and turning the horses out in the middle of the day so they are more likely to stand in the shade rather than graze.

857:, decrease gut sounds, distended small intestine on rectal, and nasogastric reflux. This problem requires surgical correction. Survival for mesenteric rent entrapment is usually lower than other small intestinal strangulating lesions, possibly due to hemorrhage, difficulty correcting the entrapment, and the length of intestine commonly involved, with <50% of cases surviving until discharge. 2507:, or infection of the incisional site. Additionally, surgical cases may develop post-operative ileus which requires further medical management. However, surgery may be required to save the life of the horse, and 1–2% of all colics require surgical intervention. If a section of intestine is significantly damaged, it may need to be removed (resection) and the healthy parts reattached together ( 694:, and usually occur in horses older than four years of age. Horses with enteroliths typically have chronic, low-grade, recurring colic signs, which may lead to acute colic and distention of the large colon after occlusion of the lumen occurs. These horse may also have had a history of passing enteroliths in their manure. Level of pain is related to the degree of luminal occlusion. Abdominal 828:, possibly due to changes in abdominal pressure, and in older horses, possibly because the foramen enlarges as the right lobe of the liver atrophies with age, although it has been seen in horses as young as 4 months old. Horses usually present with colic signs referable to small intestinal obstruction. During surgery, the foramen can not be enlarged due to the risk of rupture of the 1180:, as well as through vigorous walking, which has also been shown to have a beneficial effect on GI motility. Lidocaine is especially useful, as it not only encourages motility, but also has anti-inflammatory properties and may ameliorate some post-operative pain. Metoclopramide has been shown to reduce reflux and hospital stay, but does has excitatory effects on the 1161:

sudden increase in heart rate indicates the need to check for nasogastric reflux, as it is an early indication of postoperative ileus. The horse is placed on intravenous fluids to maintain hydration and electrolyte balance and prevent hypovolemic shock, and rate of fluids is calculated based on daily maintenance requirement plus fluid lose via nasogastric reflux.

915:

anti-endotoxin, anti-microbial, and prokinetic drugs are common with this disease. Surgery may be needed to rule out obstruction or strangulation, and in cases that are long-standing to perform a resection and anastomosis of the diseased bowel. Survival rates for DPJ are 25–94%, and horses in the southeast United States appear to be more severely affected.

367:), which can cause excessive accumulation of fluid in the gastrointestinal tract. This is a functional rather than mechanical blockage of the intestine, but like the mechanical blockage seen with simple obstructions, it can have serious effects including severe dehydration. Inflammation of the bowel may lead to increased permeability and subsequent 1914:

Horses with proximal enteritis usually have an intestinal diameter that is narrower, but wall thickness is often greater than 6mm, containing a hyperechoic or anechoic fluid, with normal, increased, or decreased peristalsis. However, obstructions that have been present for some time may present with thickened walls and distention of the intestine.

803:

including reflux and multiple loops of distended small intestine felt on rectal. Surgery is required for intussusception. Reduction of the area is usually ineffective due to swelling, so jejunojejunal intussusceptions are resected and ileocolic intussusceptions are resected as far distally as possible and a jejunocecal anatomosis is performed.

633:, possibly because they do not masticate their feed as well, and during the fall and winter. Medical management includes the aggressive use of fluids, laxatives and lubricants, and enemas, as well as analgesics and anti-inflammatories. However, these impactions often require surgical intervention, and the surgeon will empty the colon either by 1353:, although persistent cases may require mineral oil or IV fluids. It is possible to tell that the meconium has passed when the foal begins to produce a softer, more yellow manure. Although meconium impactions rarely cause perforation, and are usually not life-threatening, foals are at risk of dehydration and may not get adequate levels of 548:) and psyllium combinations. Psyllium is the most effective medical treatment. It works by binding to the sand to help remove it, although multiple treatments may be required. Mineral oil is mostly ineffective since it floats on the surface of the impaction, rather than penetrating it. Horses with sand or dirt impaction are predisposed to 629:. Horses usually present with standard colic signs (pawing, flank watching, rolling) in 82% of horses, and occasionally with diarrhea (31%), anorexia (30%), straining (12%), and depression (11%), and rectal examination will reveal firm loops of small colon or actually palpable obstruction in the rectum. Impactions are most common in 512:. Although rectal examination may display a thickened ileal wall, usually the diagnosis is made at surgery, and an ileocecal or jejunocecal anastomosis is made to allow intestinal contents to bypass the affected area. If surgery and bypass is not performed, there is a risk of rupture, but prognosis is fair with surgical treatment. 717:: the pelvic flexure moves dorsally towards the nephrosplenic space. This space is found between the spleen, the left kidney, the nephrosplenic ligament (which runs between the spleen and kidney), and the body wall. In some cases, the bowel become entrapped over the nephrosplenic ligament. LDD accounts for 6-8% of all colics. 1097:

bowel, and removing bowel that is no longer viable. If the colic is identified and taken to surgery quickly, there is a reasonable rate of success of 50–78%. This type of colic is most commonly associated with ponies, and aged geldings, 10 years and older, probably because of fat distribution in this group of animals.

1658:

reflect increased perfusion, and the presence of a "toxic line" (a red ring over the top of the teeth where it meets the gum line, with pale or gray mucous membranes) can indicate endotoxemia. Both injected mucous membranes and the presence of a toxic line correlate to a decreased likelihood of survival, at 44%.

1906:

of intestinal loops, as well as diagnose nephrosplenic entrapment, peritonitis, abdominal tumors, and inguinal or scrotal hernias. Abdominal ultrasound requires an experienced operator to accurately diagnose the cause of colic. It may be applied against the side of the horse, as well as transrectally.

2633:

Turnout is thought to reduce the likelihood of colic, although this has not been proven. It is recommended that a horse receive ideally 18 hours of grazing time each day, as in the wild. However, many times this is difficult to manage with competition horses and those that are boarded, as well as for

2568:

may be used post-surgery to look for and break down adhesions, however there is risk of additional adhesions forming post-procedure. Encouraging motility post-surgery can also be useful, as it decreases the contact time between tissues. Adhesion-induced colic has a poor prognosis, with a 16% survival

1940:

Abdominocentesis allows for the evaluation of red and white blood cells, hemoglobin concentration, protein levels, and lactate levels. A high lactate in abdominal fluid suggests intestinal death and necrosis, usually due to strangulating lesion, and often indicates the need for surgical intervention.

1917:

Horses experiencing intussusception may have a characteristic "bullseye" appearance of intestine on ultrasound, which is thickened, and distended intestine proximal to the affected area. Those experiencing nephrosplenic entrapment will often have ultrasonographic changes including an inability to see

1766:

Rectal temperature can help ascertain if an infectious or inflammatory cause is to blame for the colic, which is suspected if the temperature if >103F. Temperature should be taken prior to rectal examination, as the introduction of air will falsely lower rectal temperature. Coolness of extremities

1608:

Many different diagnostic tests are used to diagnose the cause of a particular form of equine colic, which may have greater or lesser value in certain situations. The most important distinction to make is whether the condition is managed medically or surgically. If surgery is indicated, then it must

1345:

foals and in colts more than fillies (possibly because fillies have a wider pelvis). Foals will stop suckling, strain to defecate (presents as an arched back and lifted tail), and may start showing overt signs of colic such as rolling and getting up and down. In later stages, the abdomen will distend

1295:

in the bowel wall, particularly if large numbers emerge simultaneously. The disease most frequently occurs in winter time. Pathological changes of the bowel reveal a typical "pepper and salt" color of the large intestines. Animals suffering from cyathostominosis usually have a poor deworming history.

1096:

into a stalk which can wrap around a segment of bowel, typically small intestine, cutting off its blood supply. The tumor forms a button that latches onto the stalk of the tumor, locking it on place, and requiring surgery for resolution. Surgery involves cutting the stalk of the tumor, untwisting the

778:

and prevents normal ventilation. Additionally, compression can place pressure on the caudal vena cava, leading to pooling of blood and hypovolemia. However, horses may not have a high heart rate, presumably due to increased vagal tone. Rectal palpation will demonstrate a severely gas distended colon,

744:

Many displacements (~96% of LDD, 64% of RDD) resolve with medical management that includes fluids (oral or intravenous) to rehydrate the horse and soften any impaction that may be present. Systemic analgesics, antispasmodics, and sedation are often used to keep the horse comfortable during this time.

554:

infection and other GI bacteria, so antibiotics are often added to help prevent infection. Medical management usually resolves the colic, but if improvement doesn't occur within a few hours then surgery must be performed to flush the colon of any sand, which procedure that has a 60–65% survival rate.

447:

where the intestine takes a 180 degree turn and narrows. Impaction generally responds well to medical treatment, usually requiring a few days of fluids and laxatives such as mineral oil, but more severe cases may not recover without surgery. If left untreated, severe impaction colic can be fatal. The

80:

conditions which cause pain as well as other causes of abdominal pain not involving the gastrointestinal tract. What makes it tricky is that different causes can manifest with similar signs of distress in the animal. Recognizing and understanding these signs is pivotal, as timely action can spell the

2519:

In the case of colics requiring surgery, survival rates are best improved by quick recognition of colic and immediate surgical referral, rather than waiting to see if the horse improves, which only increases the extent of intestinal compromise. Survival rates are higher in surgical cases that do not

2398:

or hypertonic saline. NSAIDs are commonly given to reduce systemic inflammation. However, they decrease the levels of certain prostaglandins that normally promote healing of the intestinal mucosa, which subsequently increases the amount of endotoxin absorbed. To counteract this, NSAIDs are sometimes

2041:

Laparoscopy involves inserting a telescoping camera approximately 1 cm in diameter into the horse's abdomen, through a small incision, to visualize the gastrointestinal tract. It may be performed standing or under general anesthesia, and is less invasive than an exploratory celiotomy (abdominal

1787:

Rectal examinations are a cornerstone of colic diagnosis, as many large intestinal conditions can be definitively diagnosed by this method alone. Due to the risk of harm to the horse, a rectal examination is performed by a veterinarian. Approximately 40% of the gastrointestinal tract can be examined

1419:

is most commonly seen in foals under 3 months of age. Clostridial toxins damage the intestine, leading to dehydration and toxemia. Foals usually present with signs of colic, decreased nursing, abdominal distention, and diarrhea which may contain blood. Diagnosis is made with fecal culture, and while

1160:

This form of colic is usually managed medically. Because there is no motility, intestinal contents back up into the stomach. Therefore, periodic decompression of the stomach though nasogastric intubation is essential to prevent rupture. Horses are monitored closely following abdominal surgery, and a

798:

is a form of colic in which a piece of intestine "telescopes" within a portion of itself because a section is paralyzed, so the motile section pushes itself into the non-motile section. It most commonly occurs at the ileocecal junction and requires urgent surgery. It is almost always associated with

786:

Small intestinal volvulus is thought to be caused by a change in local peristalsis, or due to a lesion that the mesentery may twist around (such as an ascarid impaction), and usually involves the distal jejunum and ileum.w It is one of the most common causes of small intestinal obstruction in foals,

698:

can confirm the diagnosis, but smaller enteroliths may not be visible. In rare instances, enteroliths may be palpated on rectal examination, usually if they are present in the small colon. Once a horse is diagnosed with colic due to an enterolith, surgery is necessary to remove it, usually by pelvic

2577:

Small amounts of food is usually introduced as soon as possible after surgery, usually within 18–36 hours, to encourage motility and reduce the risk of ileus and the formation of adhesions. Often horses are stall rested with short bouts of hand walking to encourage intestinal motility. The incision

2559:

is often applied to the GI tract intraoperatively, to decrease trauma from handling by the surgeon and provide a physical barrier between the intestine and adjacent intestinal loops or abdominal organs. It has been shown to double the survival rate of horses, and its use is now a standard practice.

2050:

Rectal biopsy is rarely performed due to its risks of abscess formation, rectal perforation and peritonitis, and because it requires a skilled clinical to perform. However, it can be useful in cases of suspected intestinal cancer, as well as some inflammatory diseases (such as IBD) and infiltrative

1909:

Sand presents as a homogeneous gray and allows the ultrasound waves to penetrate deep. It is distinguishable from feces, which is less homogeneous, and gas colic, which does not allow the operator to see pass the gas. Additionally, the sand usually "sparkles" on ultrasound if it moves. Sand is best

1905:

Ultrasound provides visualization of the thoracic and abdominal structures, and can sometimes rule out or narrow down a diagnosis. Information that may be gleaned from ultrasonographic findings include the presence of sand, distention, entrapment, strangulation, intussusception, and wall thickening

1807:

Rectals are a risk to the practitioner, and the horse is ideally examined either in stocks or over a stall door to prevent kicking, with the horse twitched, and possibly sedated if extremely painful and likely to try to go down. Buscopan is sometimes used to facilitate rectal examination and reduce

1191:

Large intestinal ileus is most commonly seen in horses following orthopedic surgery, but its risk is also increased in cases where post-operative pain is not well-controlled, after long surgeries, and possibly following ophthalmologic surgeries. It is characterized by decreased manure output (<3

1139:

is the lack of motility of the intestines, leading to a functional obstruction. It often occurs postoperatively following any type of abdominal surgery, and 10–50% of all cases of surgical colic will develop this complication, including 88% of horses with a strangulating obstructions and 41% of all

752:

Reoccurrence can occur with all types of displacements: 42% of horses with RDD, 46% of horses with retroflexion, 21% of those with volvulus, and 8% of those with LDD had reoccurrence of colic. LDD may be prevented by closing the nephrosplenic space with sutures, although this does not prevent other

740:

The cause of displacement is not definitively known, but one explanation is that the bowel becomes abnormally distended with gas (from excessive fermentation of grain, a change in the microbiota secondary to antibiotic use, or a buildup of gas secondary to impaction) which results in a shift in the

637:

or by lubricants and massage. Surgical intervention usually results in longer recovery time at the hospital. Prognosis is very good, and horses treated with surgical treatment had a survival with return to athletic function rate of 91%, while 89% of the medically managed horses returned to previous

452:

properly. This condition could be diagnosed on rectal examination by a veterinarian. Impactions are often associated with the winter months because horses do not drink as much water and eat drier material (hay instead of grass), producing drier intestinal contents that are more likely to get stuck.

177:

to the obstruction. This is due to the large amount of fluid produced in the upper gastrointestinal tract, and the fact that this is primarily re-absorbed in parts of the intestine downstream from the obstruction. The first problem with this degree of fluid loss from circulation is one of decreased

2327:

In addition to fluid support, impactions are often treated with intestinal lubricants and laxatives to help move the obstruction along. Mineral oil is the most commonly used lubricant for large colon impactions, and is administered via nasogastric tube, up to 4 liters once or twice daily. It helps

2302:

Fluids are commonly given, either orally by nasogastric tube or by intravenous catheter, to restore proper hydration and electrolyte balance. In cases of strangulating obstruction or enteritis, the intestine will have decreased absorption and increased secretion of fluid into the intestinal lumen,

923:

Colitis is inflammation of the colon. Acute cases are medical emergencies as the horse rapidly loses fluid, protein, and electrolytes into the gut, leading to severe dehydration which can result in hypovolemic shock and death. Horses generally present with signs of colic before developing profuse,

571:

Diagnosis is usually made by rectal palpation. Treatment includes fluid therapy and analgesics, but surgery is indicated if there is severe distention of the cecum or if medical therapy does not improve the situation. Surgery includes typhlotomy, and although cecal bypass has been performed in the

567:

Only 5% of large intestinal impactions at referral hospital involve the cecum. Primary cecal impactions usually consist of dry feed material, with the horse slowly developing clinical signs over several days. Secondary cecal impactions may occur post-surgery, orthopedic or otherwise, and the cecum

2337:(DDS) is also commonly given in oral fluids. It is more effective in softening an impaction than mineral oil, and helps stimulate intestinal motility, but can inhibit fluid absorption from the intestine and is potentially toxic so is only given in small amounts, two separate times 48 hours apart. 1518:

Diaphragmatic hernias are rare in horses, accounting for 0.3% of colics. Usually the small intestine herniates through a rent in the diaphragm, although any part of the bowel may be involved. Hernias are most commonly acquired, not congenital, with 48% of horses having a history of recent trauma,

906:

Signs include acute onset of moderate to severe pain, large volumes orange-brown and fetid gastric reflux, distended small intestine on rectal examination, fever, depression, increased heart rate and respiratory rate, prolonged CRT, and darkened mucous membranes. Pain level usually improves after

646:

Large colon impactions typically occur at the pelvic flexure and right dorsal colon, two areas where the lumen of the intestine narrows. Large colon impactions are most frequently seen in horses that have recently had a sudden decrease in exercise, such as after a musculoskeletal injury. They are

558:

Horses should not be fed directly on the ground in areas where sand, dirt and silt are prevalent, although small amounts of sand or dirt may still be ingested by grazing. Management to reduce sand intake and prophylactic treatments with sand removal products are recommended by most veterinarians.

520:

This is most likely to occur in horses that graze sandy or heavily grazed pastures leaving only dirt to ingest. Foals, weanlings, and yearlings are most likely to ingest sand, and are therefore most commonly seen with sand colic. The term sand also encompasses dirt. The ingested sand or dirt most

285:

features as a simple obstruction, but the blood supply is immediately affected. Both arteries and veins may be affected immediately, or progressively as in simple obstruction. By far the most common strangulating obstruction in horses is from a pedunculated lipoma. Other causes of strangulating

2589:

Draft horses tend to have more difficulty post-surgery because they are often under anesthesia for a longer period of time, since they have a greater amount of gastrointestinal tract to evaluate, and their increased size places more pressure on their musculature, which can lead to muscle damage.

2002:

produced, and its character can be helpful, although as changes often occur relatively distant to the anus, changes may not be seen for some time. In areas where sand colic is known to be common, or if the history suggests it may be a possibility, faeces can be examined for the presence of sand,

1989:

is usually indicative of a condition affecting the large intestines, as distension of structures upstream of here would not be large enough to be visible externally. Abdominal distention may indicate the need for surgical intervention, especially if present with severe signs of colic, high heart

802:

Rectal examination reveals a mass at the base of the cecum in 50% of cases. Ultrasound reveals a very characteristic "target" pattern on cross-section. Abdominocentesis results can vary, since the strangulated bowel is trapped within the healthy bowel, but there are usually signs of obstruction,

658:

Horses with a large colon impaction usually have mild signs that slowly get worse if the impaction does not resolve, and can produce severe signs. Diagnosis is often made by rectal palpation of the mass, although this is not always accurate since a portion of the colon is not palpable on rectal.

580:

Gastric impactions are relatively rare, and occur when food is not cleared at the appropriate rate. It is most commonly associated with ingestion of foods that swell after eating or feeds that are coarse (bedding or poor quality roughage), poor dental care, poor mastication, inadequate drinking,

398:

Gas colic, also known as tympanic colic, is the result of gas buildup within the horse's digestive tract due to excessive fermentation within the intestines or a decreased ability to move gas through it. It is usually the result of a change in diet, but can also occur due to low dietary roughage

1913:

Differentiation between proximal enteritis and small intestinal obstruction is important to ensure correct treatment, and can be assisted with the help of ultrasound. Horses with small intestinal obstruction will usually have an intestinal diameter of -10 cm with a wall thickness of 3-5mm.

1657:

compromise. Pale mucous membranes may be caused by decreased perfusion (as with shock), anemia due to chronic blood loss (seen with GI ulceration), and dehydration. Pink or cyanotic (blue) membrane colors are associated with a greater chance of survival (55%). Dark red, or "injected", membranes

2105:

Gas distention usually produces mild clinical signs, but in some cases leads to severe signs due to pressure and tension on the mesentery. Simple obstructions often present with a slightly elevated heart rate (<60 bpm) but normal CRT and mucous membrane color. Strangulating obstructions are

1404:

contrast studies, in which foals are given barium, and then radiographed to see if and where the barium is trapped. Atresia ani is simply diagnosed with digital examination by a veterinarian. Both situations requires emergency surgery to prevent death, and often still has a poor prognosis for

2403:

drip, which appears to reduce this particular negative effect. Flunixin may be used for this purpose at a dose lower than that used for analgesia, so can be safely given to a colicky horse without risking masking signs that the horse requires surgery. Other drugs that bind endotoxin, such as

1249:

and may well require colic surgery to remove them manually. Large roundworm infestations are often the result of a poor deworming program. Horses develop immunity to parascarids between 6 months age and one year and so this condition is rare in adult horses. Prognosis is fair unless the foal

769:

Volvulus of the large colon usually occurs where the mesentery attaches to the body wall, but may also occur at the diaphragmatic or sternal flexures, with rotations up to 720 degrees reported. It is most commonly seen in postpartum mares, usually presents with severe signs of colic that are

2003:

often by mixing it in water and allowing the sand to settle out over 20 minutes. However, sand is sometimes present in a normal horse's feces, so the quantity of sand present must be assessed. Testing the feces for parasite load may also help diagnose colic secondary to parasitic infection.

1559:

Uterine tears often occur a few days post parturition. They can lead to peritonitis and require surgical intervention to fix. Uterine torsions can occur in the third trimester, and while some cases may be corrected if the horse in anesthetized and rolled, others require surgical correction.

1316:

of the cranial mesenteric artery supplying the intestines, most likely due to vasospasm. Usually the distal small intestine and the large colon are affected, but any segment supplied by this artery can be compromised. This type of colic has become relatively rare with the advent of modern

963:

results. Therapy to help prevent endotoxemia and improve blood protein levels (plasma or synthetic colloid administration) may also be used if budgetary constraints allow. Other therapies include probiotics and anti-inflammatory medication. Horses that are not eating well may also require

1488:

breeds. Inguinal hernias in adult horses are usually strangulating (unlike foals, which are usually non-strangulating). Stallions usually display acute signs of colic, and a cool, enlarged testicle on one side. Hernias are classified as either indirect, in which the bowel remains in the

1341:, or the first feces produced by the foal, is a hard pelleted substance. It is normally passed within the first 24 hours of the foal's life, but may become impacted in the distal colon or rectum. Meconium impaction is most commonly is seen in foals 1–5 days of age, and is more common in 914:

DPI usually is managed medically with nasogastric intubation every 1–2 hours to relieve gastric pressure secondary to reflux, and aggressive fluid support to maintain hydration and correct electrolyte imbalances. Horses are often withheld food for several days. Use of anti-inflammatory,

2564:) is a quick, simple procedure that also greatly decreases the risk of adhesions, since the omentum is one organ that commonly adheres to the intestines. The abdomen is usually lavaged copiously before the abdomen is sutured closed, and anti-inflammatories are given postoperatively. A 81:

difference between a brief moment of discomfort and a life-threatening situation. The most common forms of colic are gastrointestinal in nature and are most often related to colonic disturbance. There are a variety of different causes of colic, some of which can prove fatal without

761:

A volvulus is a twist along the axis of the mesentery, a torsion is a twist along the longitudinal axis of the intestine. Various parts of the horse's gastrointestinal tract may twist upon themselves. It is most likely to be either small intestine or part of the colon.

1910:

diagnosed using a 3.5 megahertz probe. Horses with gastrointestinal rupture will have peritoneal fluid accumulation, sometimes with debris, visible on ultrasound. Horses with peritonitis will often have anechoic fluid, or material in between visceral surfaces.

1876:, and persistence of hypomotile bowel often suggests the need for surgical intervention. Gut sounds that occur concurrently with pain may indicate obstruction of the intestinal lumen. Sounds of gas can occur with ileus, and those of fluid are associated with 585:, which form a sticky gel in the stomach, and haylage, have both been associated with it, as has wheat, barley, mesquite beans, and beet pulp. Horses usually show signs of mild colic that is chronic, unresponsive to analgesics, and may include signs such as 2016:

Radiographs (x-rays) are sometimes used to look for sand and enteroliths. Due to the size of the adult horse's abdomen, it requires a powerful machine that is not available to all practitioners. Additionally, the quality of these images is sometimes poor.

2311:, are able to absorb more oral fluid than those obstructed in the small intestine, and therefore require less IV fluid support. Impactions are usually managed with fluids for 3–5 days before surgery is considered. Fluids are given based on results of the 1048:, decreased appetite, and diarrhea. Treatment involves decreasing the fiber levels of the horse's diet by reducing grass and hay, and placing the horse on an easily digestible pelleted feed until the colon can heal. Additionally, the horse may be given 2235:. Immediate surgical intervention may be required, but surgery can be counter-indicated in some cases of colic, so diagnostic tests are used to help discover the cause of the colic and guide the practitioner in determining the need for surgery (See 1140:

colics with a large intestinal lesion. The exact cause is unknown, but is suspected to be due to inflammation of the intestine, possibly a result of manipulation by the surgeon, and increased sympathetic tone. It has a high fatality rate of 13–86%.

844:

The mesentery is a thin sheet attached to the entire length of intestine, enclosing blood vessels, lymph nodes, and nerves. Occasionally, a small rent (hole) can form in the mesentery, through which a segment of bowel can occasionally enter. As in

96:, colic is the leading cause of premature death. The incidence of colic in the general horse population has been estimated between 4 and 10 percent over the course of the average lifespan. Clinical signs of colic generally require treatment by a 2418:

is a major concern in horses suffering from endotoxemia. Ideally, prophylactic treatment should be provided to endotoxic horses, which includes the use of NSAIDs, DMSO, icing of the feet, and frog support. Horses are also sometimes administered

1836:, and its presence usually indicates a small intestinal disease. Generally, the closer the obstruction is to the stomach, the greater amount of gastric reflux will be present. Approximately 50% of horses with gastric reflux require surgery. 2341:

are also useful for impactions, since they act both as an osmotic agent, to increase fluid in the GI tract, and as a laxative, but do run the risk of dehydration and diarrhea. Strong laxatives are not recommended for treating impactions.

1951:

fluid indicates an excess of red blood cells or hemoglobin, and may be due to leakage of the cells through a damaged intestinal wall, splenic puncture during abdominocentesis, laceration of abdominal viscera, or contamination from a skin

2294:, since both of these cause excessive secretion of fluid into the intestine, leading to fluid back-up and distention of the stomach. Nasogastric intubation also has the benefit of providing pain relief resulting from gastric distention. 741:

bowel to an abnormal position. Because much of the bowel is not anchored to the body wall, it is free to move out of position. Displacement is usually diagnosed using a combination of findings from the rectal exam and ultrasonography.

1199:

Decreased intestinal motility can also be the result of drugs such as Amitraz, which is used to kill ticks and mites. Xylazine, detomidine, and butorphanol also reduce motility, but will not cause colic if appropriately administered.

2550:

Prevention of adhesions begins with good surgical technique to minimize trauma to the tissue and thus reparative responses by the body. Several drugs and substances are used to try to prevent adhesion formation. Preoperative use of

1795:

small intestinal loops, may also be detected, and can play a major part in determining if surgery is necessary. Thickness of the intestinal walls may indicate infiltrative disease or abnormal muscular enlargement. Roughening of the

1662:

time is assessed to determine hydration levels and highly correlates to perfusion of the bowel. A CRT of < 2 seconds has a survival rate of 90%, of 2.5–4 seconds a survival rate of 53%, and > 4 seconds a survival rate of 12%.

2585:

Weight loss of 75–100 pounds is common after colic surgery, secondary to the decreased function of the gastrointestinal tract and from muscle atrophy that occurs while the horse is rested. This weight is often rapidly replaced.

902:

infection or high concentrate diets. The inflammation of the intestine leads to large secretions of electrolytes and fluid into its lumen, and thus large amounts of gastric reflux, leading to dehydration and occasionally shock.

1816:

Passing a nasogastric tube (NGT) is useful both diagnostically and therapeutically. A long tube is passed through one of the nostrils, down the esophagus, and into the stomach. Water is then pumped into the stomach, creating a

853:(fluid buildup). As the bowel enlarges, it becomes less and less likely to be able to exit the site of entrapment. Colic signs are referable to those seen with a strangulating lesion, such as moderate to severe abdominal pain, 2560:

Hyaluraonan can also be used to produce a physical barrier. Intraperitoneal unfractionated heparin is sometimes used, since it decreases fibrin formation and thus may decrease fibrinous adhesions. Omentectomy (removal of the

2098:. Soon after this apparent improvement, the horse will display signs of shock, including an elevated heart rate, increased capillary refill time, rapid shallow breathing, and a change in mucous membrane color. It may also be 418:

Abdominal distention may occasionally be seen in adult horses in the flank region, if the cecum or large colon is affected. Foals, however, may show signs of gas within the small intestines with severe abdominal distention.

2378:

in the liver. Endotoxemia occurs when there is an overgrowth and secondary die-off of gram negative bacteria, releasing mass quantities of endotoxin. This is especially common when the mucosal barrier is damaged, as with

1933:, can be useful in assessing the state of the intestines. Normal peritoneal fluid is clear, straw-colored, and of serous consistency, with a total nucleated cell count of less than 5000 cells/microliter (24–60% which are 1501:

Although umbilical hernias are common in foals, strangulation is rare, occurring only 4% of the time and usually involving the small intestine. Rarely, the hernia will only involve part of the intestinal wall (termed a

597:, fever, and lethargy, although severe colic signs may occur. Signs of shock may be seen if gastric rupture has occurred. Usually, the impaction must be quite large before it presents symptoms, and may be diagnosed via 407:, which can lead to painful spasms of the intestine, producing subsequent spasmodic colic. The clinical signs of these forms of colic are generally mild, transient, and respond well to spasmolytic medications, such as 2629:

Supplementing with previously mentioned form of psyllium fiber may reduce risk of sand colic if in a high-risk area. Most supplement forms are given one week per month and available wherever equine feed is purchased.

2332:

since it may simply bypass the obstruction. Mineral oil has the added benefit of crudely measuring GI transit time, a process which normally takes around 18 hours, since it is obvious when it is passed. The detergent

1884:

after the lower abdomen is forcefully pushed with a fist. Abdominal percussion ("pinging") can sometimes be used to determine if there is gas distention in the bowel. This may be useful to help determine the need for

415:. Gas colics usually self-correct, but there is the risk of subsequent torsion (volvulus) or displacement of the bowel due to gas distention, which causes this affected piece of bowel to rise upward in the abdomen. 1965:

Green fluid indicates either gastrointestinal rupture or enterocentesis, and a second sample should be drawn to rule out the latter. Gastrointestinal rupture produces a color change in peritoneal fluid in 85.5% of

647:

also associated in the practice of twice daily feeding of grain meals, which causes a short-lived but significant secretion of fluid into the lumen of the intestine, resulting in a 15% decrease in plasma volume (

958:

Treatment involves administration of large volumes of intravenous fluids, which can become very costly. Antibiotics are often given if deemed appropriate based on the presumed underlying cause and the horse's

2083:(CRT), and congested mucous membranes suggest cardiovascular compromise and the need for more intense management. Decreased or absent gut sounds often suggest the need for surgical intervention if prolonged. 770:

refractory to analgesic administration, and horses often lie in dorsal recumbency. Abdominal distention is common due to strangulation and rapid engorgement of the intestine with gas, which then can lead to

1399:

can also present as meconium impaction. The foal is missing the lumen of its distal colon or anus, respectively, and usually show signs of colic within 12–24 hours. Atresia coli is usually diagnosed with

1346:

as it continues to fill with gas and feces. Meconium impactions are often diagnosed by clinical signs, but digital examination to feel for impacted meconium, radiographs, and ultrasound may also be used.

1361:. Additionally, the foals will eventually bloat, and will require surgical intervention. Surgery in a foal can be especially risky due to immature immune system and low levels of ingested colostrum. 1124:

Gastric squamous cell carcinoma is most often found in the non-glandular region of the stomach of horses greater than 5 years of age, and horses often present with weight loss, anorexia, anemia, and

1372:, or ileocolonic aganglionosis, will result in meconium impaction since the foal does not have adequate nerve innervation to the large intestine, in essence, a nonfunctioning colon. Foals that are 1420:

some foals do not require serious intervention, others need IV fluids, antibiotics, and aggressive treatment, and may still die. Other bacterial infections that may lead to enterocolitis include

1156:

Distended small intestine, based on rectal or abdominal ultrasound findings. On ultrasound, ileus presents as more than 3 loops of distended small intestine, with a lack of peristaltic waves.

2275:

to prolong the analgesic effects of the opioid. Early colic signs may be masked with the use of NSAIDs, so some practitioners prefer to examine the horse before they are given by the owner.

1384:

heritage, will develop the condition. They present with signs of colic within the first 12 hours after birth, and die within 48 hours due to constipation. This syndrome is not treatable.

2606:

including sugars from feeds with excessive molasses, providing clean feed and drinking water, preventing the ingestion of dirt or sand by using an elevated feeding surface, a regular

2408:

and Bio-Sponge, are also often used. Polymixin B prevents endotoxin from binding to inflammatory cells, but is potentially nephrotoxic, so should be used with caution in horses with

1184:. Anti-inflammatory drugs are used to decrease inflammation of the GI tract, which is thought to be the underlying cause of the disease, as well as to help control any absorption of 1044:. Mucosal injury is usually limited to the right dorsal colon, but can be more generalized. Horses may display acute or chronic intermittent colic, peripheral edema secondary to 1020:

are less effective in horses than in humans, because horses produce stomach acid almost constantly, while humans produce acid mainly when eating. Dietary management is critical.

710:

A displacement occurs when a portion of the large colon—usually the pelvic flexure—moves to an abnormal location. There are four main displacements described in equine medicine:

2531:, or scar tissue between various organs that are not normally attached within the abdomen, may occur whenever an abdominal surgery is performed. It is often seen secondary to 1188:

in cases of endotoxemia since the substance decreases motility. However, care must be taken when giving these drugs, as NSAIDs have been shown to alter intestinal motility.

702:

Fecaliths are hard formations of ingest that obstruct the GI tract, and may require surgery to resolve. These are most commonly seen in miniature horses, ponies, and foals.

1763:(BCS) is important when evaluating a horse with chronic colic, and a poor BCS in the face of good quality nutrition can indicate malabsorptive and maldigestive disorders. 1016:

beetles in alfalfa hay which are very caustic when chewed and ingested. Most ulcers are treatable with medications that inhibit the acid producing cells of the stomach.

1868:) correlate to motility of the bowel, and care should be taken to note intensity, frequency, and location. Increased gut sounds (hyper-motility) may be indicative of 1196:

can be fatal, so care must be taken to monitor the horse for large intestinal ileus after orthopedic surgery, primarily by watching for decreased manure production.

1490: 2354:

may be instituted. Once clinical signs improve, the horse will slowly be re-fed (introduced back to its normal diet), while being carefully monitored for pain.

2247:

The intensity of medical management is dependent on the severity of the colic, its cause, and the financial capabilities of the owner. At the most basic level,

2159:

Increased attention toward the abdomen, including flank watching (turning of the head to look at the abdomen and/or hind quarters), nipping, biting, or kicking

824:. The blood supply to this piece of intestine is immediately occluded and surgery is the only available treatment. This type of colic has been associated with 2033:, gastric impactions, and gastric masses. A 3-meter scope is required to visualize the stomach of most horses, and the horse must be fasted prior to scoping. 504:, and can also occur with jejunal hypertrophy. The mucosa remains normal, so malabsorption is not expected to occur in this disease. Ileal hypertrophy may be 46: 4156: 1192:

piles per day), rather than nasogastric reflux, as well as decreased gut sounds, signs of colic, and the occasional impaction of the cecum or large colon.

403:

administration. This gas buildup causes distention and increases pressure in the intestines, causing pain. Additionally, it usually causes an increase in

947:) are common causes of colitis. Antibiotics, which may lead to an altered and unhealthy microbiota, sand, grain overload, and toxins such as arsenic and 524:

Diagnosis is usually made by history, environmental conditions, auscultation of the ventral abdomen, radiographs, ultrasound, or fecal examination (See

448:

most common cause is when the horse is on box rest and/or consumes large volumes of concentrated feed, or the horse has dental disease and is unable to

836:, which would result in fatal hemorrhage. Survival is 74–79%, and survival is consistently correlated with abdominocentesis findings prior to surgery. 382:

may also develop ulceration, usually secondary to excessive NSAID use, which alters the homeostatic balance of prostaglandins that protect the mucosa.

2106:

usually extremely painful, and the horse may have abdominal distention, congested mucous membranes, altered capillary refill time, and other signs of

1325:

to reduce the risk of thrombosis, but surgery is usually not helpful since lesions are often patchy and may be located in areas not easily resected.

975:

is a potential complication for horses suffering from colitis, and may become the primary cause for euthanasia. Horses are also at increased risk of

4029:

Cohen ND, Woods AM (February 1999). "Characteristics and risk factors for failure of horses with acute diarrhea to survive: 122 cases (1990-1996)".

1637:

Heart rate rises with progression of colic, in part due to pain, but mainly due to decreased circulating volume secondary to dehydration, decreased

2423:, which is thought to reduce the risk of laminitis by decreasing blood coagulability and thus blood clot formation in the capillaries of the foot. 371:. The underlying cause of inflammation may be due to infection, toxin, or trauma, and may require special treatment in order to resolve the colic. 1880:

which may occur with colitis. Sand may sometimes be heard on the ventral midline, presenting a typical "waves on the beach" sound in a horse with

1105:

Cancers (neoplasia) other than lipoma are relatively rare causes of colic. Cases have been reported with intestinal cancers including intestinal

497:, and then massaging the ileum. This allows the impaction to be treated without actually cutting into the ileum. Prognosis for survival is good. 1271:. However, a 2008 study in Canada indicated that there is no connection between tapeworms and colic, contradicting studies performed in the UK. 1284: 1767:

can indicate decreased perfusion secondary to endotoxemia. Elevated respiratory rate can indicate pain as well as acid-base disturbances. A

3681:

Plummer AE, Rakestraw PC, Hardy J, Lee RM: Outcomes of medical and surgical treatment of cecal impaction in horses: 114 cases (1999-2004),

1944:

Clinical analysis is not necessarily required to analyze the fluid. Simple observation of color and turbidity can be useful in the field.

652: 4121:

Chandler KJ, Collins MC, Love S (December 2000). "Efficacy of a five-day course of fenbendazole in benzimidazole-resistant cyathostomes".

1510:. Strangulating umbilical hernias will present as enlarged, firm, warm, and painful with colic signs. Foals usually survive to discharge. 1760: 1455:), which may lead to gastric perforation and peritonitis, small intestine volvulus, and uroabdomen secondary to urinary bladder rupture. 4064:

Divers TJ (December 2003). "Prevention and treatment of thrombosis, phlebitis, and laminitis in horses with gastrointestinal diseases".

2071:). Horses are more likely to require surgery if they display severe clinical signs that can not be controlled by the administration of 1791:

Displacements, torsions, strangulations, and impactions may be identified on rectal examination. Other non-specific findings, such as

33: 4599: 1229:

heavily infected horses may cause a severe immune reaction to the dead worms, which can damage the intestinal wall and cause a fatal

317: 4453: 2374:, antibodies and enzymes which bind and neutralize it and, for the small amount that manages to enter the blood stream, removal by 1847:

of the abdomen is subjective and non-specific, but can be useful. Auscultation typically is performed in a four-quadrant approach:

378:), due to damage from stomach acid or alteration in protective mechanisms of the stomach, and is usually not life-threatening. The 2165:

Rolling, especially when not followed by shaking after standing, and which may become violent when the colic is severe (thrashing)

1147:

Nasogastric reflux: 4 liters or greater in a single intubation, or greater than 2 liters of reflex over more than one intubation

1001:. Risk factors include confinement, infrequent feedings, a high proportion of concentrate feeds, such as grains, excessive non- 2059:

Clinical signs of colic are usually referable to pain, although the horse may appear depressed rather than painful in cases of

1523:

is only seen in approximately 18% of horses. Ultrasound and radiography may both be used to diagnose diaphragmatic herniation.

780: 3802: 1621:

A thorough history is always taken, including signalment (age, sex, breed), recent activity, diet and recent dietary changes,

3768: 3422: 2474:

to contract the spleen, and is followed by light exercise to try to shift the displaced colon back into its normal position.

205:

within the intestinal wall, that leads to the associated pain. With progressive distension of the intestinal wall, there is

4572: 3439: 1649:

therapy ascertained. A pulse that continues to rise in the face of adequate analgesia is considered a surgical indication.

952: 2626:

their feed are at risk of colic, and several management techniques may be used to slow down the rate of feed consumption.

2090:. While this releases the pressure that originally caused so much discomfort for the horse, it results in a non-treatable 2366:) is released from the cell wall of gram-negative bacteria when they die. Normally, endotoxin is prevented from entering 4002:

Merritt AM, Bolton JR, Cimprich R (March 1975). "Differential diagnosis of diarrhoea in horses over six months of age".

2812: 3531: 3025: 795: 4340: 2555:, a free radical scavenger, potassium penicillin, and flunixin meglumine may be given. The thick intestinal lubricant 2511:). Horses may have up to 80% of their intestines removed and still function normally, without needing a special diet. 766:

of the blood supply means that it is a painful condition causing rapid deterioration and requiring emergency surgery.

3666: 2955: 3707: 876:

Proximal enteritis, also known as anterior enteritis or duodenitis-proximal jejunitis (DPJ), is inflammation of the

3976: 2383:

of the GI tract secondary to a strangulating lesion or displacement. Endotoxemia produces systemic effects such as

1451:). Other conditions that may lead to signs of colic in foals include congenital abnormalities, gastric ulcers (see 951:

can also lead to colitis. Unfortunately, only 20–30% of acute colitis cases are able to be definitively diagnosed.

933: 617:

Small colon impactions represent a small number of colics in the horse, and are usually caused by obstruction from

4494: 316:

In a non-strangulating infarction, blood supply to a section of intestine is occluded, without any obstruction to

2503:, complications secondary to general anesthesia, injury upon recovery of the horse which may require euthanasia, 4296: 4895: 4536: 4626: 3741: 165:

This is characterised by a physical obstruction of the intestine, which can be due to impacted food material,

4682: 3884: 2756: 2350:

Horses are withheld feed when colic signs are referable to gastrointestinal disease. In long-standing cases,

2334: 2255:

is administered to the horse. The most commonly used analgesics for colic pain in horses are NSAIDs, such as

2086:

A horse showing severe clinical signs, followed by a rapid and significant improvement, may have experienced

2030: 998: 988: 375: 354: 3852: 2464:

Anti-microbials may be administered if an infectious agent is suspected to be the underlying cause of colic.

2307:

is dependent on the location of the obstruction. Those that are obstructed further distally, such as at the

601:

or ultrasound, although rectal examinations are unhelpful. Persimmon impaction is treated with infusions of

359:

Inflammation along any portion of the GI tract can lead to colic. This leads to pain and possibly stasis of

2128: 2087: 2063:(tissue death) of the gastrointestinal tract, inflammation of the intestines, endotoxemia, or significant 555:

Horses that are not treated, or treated too late after the onset of clinical signs, are at risk of death.

529: 147:

These categories can be further differentiated based on location of the lesion and underlying cause (See

4777: 4748: 4722: 209:

of blood vessels, firstly the less rigid veins, then arteries. This impairment of blood supply leads to

2371: 1045: 330: 4266:

Ileocolonic aganglionosis, or overo lethal white foal syndrome (OLWS), is an autosomal recessive trait

4178: 1592:. Diseases which sometimes cause symptoms which appear similar to colic include uterine contractions, 1531:

Ingested toxins are rarely a cause of colic in the horse. Toxins that can produce colic signs include

390:

This list of types of colic is not exhaustive but details some of the types which may be encountered.

4909: 1833: 1477: 871: 849:

entrapment, the bowel first enlarges, since arteries do not occlude as easily as veins, which causes

346: 4720: 2712:"Understanding Colic In Horses: Causes, Diagnosis, Treatment, And Prevention - Complete Horse Guide" 1572:

of the horse. Signs of colic may be caused by problems other than the GI-tract e.g. problems in the

3222: 2264: 1267: 485: 214: 4240:

Finno CJ, Spier SJ, Valberg SJ (March 2009). "Equine diseases caused by known genetic mutations".

76:, but it is a clinical symptom rather than a diagnosis. The term colic can encompass all forms of 4929: 4924: 3501: 3105: 2539:

to move into the serosa and mesothelium to be lost, which the body then attempts to repair using

2412:, especially neonatal foals. Plasma may also be given with the intent of neutralizing endotoxin. 1473: 1415: 1118: 955:

can cause slower-onset of colitis, usually in the right dorsal colon (see Right dorsal colitis).

197:

due to the trapped fluid and gas production from bacteria. It is this distension, and subsequent

38: 500:

Ileal hypertrophy occurs when the circular and longitudinal layers of the ileal intestinal wall

173:

abnormality caused by this obstruction is related to the trapping of fluid within the intestine

2866: 2618:, a regular diet that does not change substantially in content or proportion and prevention of 2556: 1569: 1181: 939: 816:

On rare occasions, a piece of small intestine (or rarely colon) can become trapped through the

494: 77: 4214: 4150: 2362:

Endotoxemia is a serious complication of colic and warrants aggressive treatment. Endotoxin (

2080: 1369: 545: 236: 3661:(3rd ed.). St. Louis, Missouri: Mosby, Inc. pp. 644–47, 650–52, 662–65, 670, 682. 3153: 1265:

have been implicated in causing colic. The most common species of tapeworm in the equine is

2367: 2351: 1986: 1872:

colic. Decreased sound, or no sound, may be suggestive of serious changes such as ileus or

1638: 960: 670:

in horses are round 'stones' of mineral deposits, usually of ammonium magnesium phosphate (

194: 4376: 4098:

Stephen, Jennifer (2009). The horse professional guide to colic. www.horseprofessional.com

2711: 2119:

Elevated body temperature: most commonly associated with medically managed colics such as

8: 4882: 2528: 2384: 2316: 2029:

evaluation of the stomach, is useful in chronic cases of colic suspected to be caused by

944: 683: 433: 322: 187: 100:. The conditions that cause colic can become life-threatening in a short period of time. 4721:

University of Kentucky College of Agriculture, Food, and Environment (29 January 2010).

2894:"Causes of gastrointestinal colic in horses in western Canada: 604 cases (1992 to 2002)" 2672:"Causes of gastrointestinal colic in horses in western Canada: 604 cases (1992 to 2002)" 1217:. This is most commonly seen in young horses as a result of a very heavy infestation of 4826: 4799: 2910: 2893: 2688: 2671: 2552: 2532: 2388: 2363: 2256: 1667: 1185: 968:

nutrition. Horses usually require 3–6 days of treatment before clinical signs improve.

775: 763: 509: 475: 206: 4798:

Scantlebury, CE; Perkins, E; Pinchbeck, GL; Archer, DC; Christley, RM (July 7, 2014).

2642:. Turnout on a dry lot with lower-quality fodder may have similar beneficial effects. 1666:

Laboratory tests can be performed to assess the cardiovascular status of the patient.

1040:

can lead to mucosal damage of the colon, secondary to decreased levels of homeostatic

581:

ingestion of a foreign object, and alterations in the normal function of the stomach.

436:

of food material (water, grass, hay, grain) at a part of the large bowel known as the

4831: 4257: 4138: 4081: 4046: 4011: 3662: 3418: 3178:

Current Therapy in Equine Medicine, 5th ed. Reid Hanson. Chapter 3.13 Ileal Impaction

2915: 2837: 2693: 2591: 2239:). The majority of colics (approximately 90%) can be successfully managed medically. 1543:. Additionally, overuse of certain drugs such as NSAIDs may lead to colic signs (See 1093: 1005: 120: 86: 4821: 4811: 4249: 4130: 4073: 4038: 2995: 2905: 2683: 2651: 2607: 2579: 2504: 2436: 2162:

Repeatedly lying down and rising, which may become violent when the colic is severe

1926: 1659: 1626: 1396: 1392: 1354: 1025: 976: 846: 825: 817: 299: 202: 136:

inflammation of the gastrointestinal tract (enteritis, colitis) or the peritoneum (

4042: 2231:

often suggest the need for surgery, especially if they can not be controlled with

1969:

Colorless (dilute) peritoneal fluid, especially in large quantities, can indicate

4899: 2623: 2561: 2535:

where there is ischemic bowel or after intestinal distention. This injury causes

1650: 1589: 1532: 1342: 1222: 927:

Both infectious and non-infectious causes for colitis exist. In the adult horse,

687: 630: 444: 240: 170: 1897: 1824:

Backing up of fluid through the intestinal tract is usually due to a downstream

1241:

response to the dead worms. Blockages of the small intestine, particularly the

745:

Horses with left dorsal displacement are sometimes treated with exercise and/or

4887: 4816: 4253: 4077: 3412: 2443: 1751:

Decrease in jugular fill and quality of peripheral pulses; sunken eyes present

1597: 1234: 1169: 1114: 1021: 399:

levels, parasites (22% of spasmodic colics are associated with tapeworms), and

225: 183: 73: 2394:

Fluid support is essential to maintain blood pressure, often with the help of

320:

present within the intestinal lumen. The most common cause is infection with

4918: 3917:

Munsterman, Amelia. "Lefts and Rights: Medical Management of Displacements".

2483: 2467: 2431:

Specific causes of colic are best managed with certain drugs. These include:

1318: 1106: 1061: 1041: 821: 746: 675: 400: 244: 528:). Historically, medical treatment of the problem is with laxatives such as 4835: 4261: 4142: 4085: 4050: 2919: 2697: 2619: 2603: 2455: 2375: 1844: 1654: 1622: 1469: 1297: 1238: 1165: 994: 679: 336: 282: 179: 97: 90: 4134: 4015: 2315:, such as mucous membrane quality, PCV, and electrolyte levels. Horses in 1233:. Veterinarians often treat horses with suspected heavy worm burdens with 439: 2635: 2615: 2565: 2536: 2508: 2496: 2451: 2405: 2338: 2260: 2107: 2091: 2064: 1934: 1801: 1642: 1540: 1381: 1377: 1230: 1173: 1049: 1013: 948: 892: 833: 648: 598: 501: 404: 360: 232: 137: 2471: 2263:

may be used if the pain is more severe. Butrophanol is often given with

1792: 2461:

Anti-inflammatories are often used in the case of enteritis or colitis.

2328:

coat the intestine, but is not very effective for severe impactions or

2272: 2095: 1930: 1865: 1864:

Each quadrant should ideally be listened to for 2 minutes. Gut sounds (

1645:, and endotoxemia. The rate is measured over time, and its response to 1481: 1373: 1313: 1250:

experiences hypovolemia and septic shock, with a survival rate of 33%.

1053: 1012:. Gastric ulceration has also been associated with the consumption of 1009: 965: 886: 695: 667: 634: 622: 550: 505: 374:

Ulceration of the mucosal surface occurs very commonly in the stomach (

198: 131: 4904: 3912: 3910: 3908: 3906: 1955:

Cloudy fluid is suggestive of an increased number of cells or protein.

489:), which have been associated with up to 81% of ileal impactions (See 3417:(Third ed.). St Louis, MO: Saunders. pp. 846–850, 878–891. 2639: 2611: 2602:

The incidence of colic can be reduced by restricted access to simple

2447: 2415: 2400: 2248: 2232: 2120: 2072: 2026: 1869: 1646: 1610: 1593: 1585: 1563: 1485: 1358: 1280: 1226: 1214: 1177: 1110: 1089: 972: 829: 602: 586: 582: 541: 537: 479:), usually occurring at 3–5 months of age right after deworming, and 449: 412: 248: 218: 210: 2067:. Pain levels are often used to determine the need for surgery (See 4892: 3903: 2544: 2477: 2409: 2380: 2278: 2268: 2252: 2200: 2172: 2076: 2060: 1948: 1877: 1873: 1568:

Strictly speaking, colic refers only to signs originating from the

1536: 1338: 1258: 1125: 1057: 908: 898: 877: 671: 626: 618: 590: 533: 480: 470: 408: 229: 221: 166: 2949: 2178:

Change in feces: decreased fecal output or a change in consistency

609:

fluids. Quick treatment generally produces a favorable prognosis.

239:

which first leaks plasma and eventually blood into the intestinal

4797: 2947: 2945: 2943: 2941: 2939: 2937: 2935: 2933: 2931: 2929: 2420: 2395: 2194: 2182: 2124: 1970: 1520: 1507: 1322: 1017: 1002: 881: 771: 606: 594: 85:. Colic surgery is usually an expensive procedure as it is major 82: 651:

of the circulatory system) and the subsequent activation of the

251:

can enter the bloodstream, leading to further systemic effects.

24: 2540: 2188:

Stretching, abnormal posturing, or frequent attempts to urinate

1886: 1818: 1581: 1401: 1349:

Treatment for meconium impaction typically involves the use of

1085: 1077: 691: 295: 4600:"Changes in Equine Surgical and Postoperative Care, AAEP 2009" 2926: 1164:

Motility is encouraged by the use of prokinetic drugs such as

2099: 1999: 1959: 1829: 1797: 1577: 1573: 1350: 1292: 1262: 1242: 1213:

Occasionally there can be an obstruction by large numbers of

1136: 1081: 1037: 850: 466: 462: 326: 174: 93: 68: 3413:

Reed, Stephen M.; Waewick M. Bayly; Debra C. Sellon (2010).

2006: 1779:

should always occur in addition to the basic physical exam.

884:. It is potentially caused by infectious organisms, such as 736:, which may or may not occlude the vasculature of the organ. 536:

husk. More recently veterinarians treat cases with specific

1476:

stallions due, likely due to a breed prevalence of a large

2670:

Abutarbush SM, Carmalt JL, Shoemaker RW (September 2005).

2669: 2590:

Miniature horses and fat ponies are at increased risk for

1857:

Upper flank, left side: corresponds to the small intestine

1854:

Caudoventral abdomen, right side: corresponds to the colon

1221:

that can subsequently cause a blockage and rupture of the

753:

types of displacements from occurring in that same horse.

294:, and displacement of intestine through a hole, such as a 4107:

Oke, Stacy. "Research Ongoing for Tapeworm, Colic Link."

3846: 3844: 3796: 3794: 3792: 3790: 3769:"Horse Vets Say: Hold the Persimmons, Please (AAEP 2009)" 1312:, are implicated in colic secondary to non-strangulating 896:

species, but other possible contributing factors include

860: 465:

is the last part of the small intestine that ends in the

4066:

The Veterinary Clinics of North America. Equine Practice

3842: 3840: 3838: 3836: 3834: 3832: 3830: 3828: 3826: 3824: 2175:, pacing, or a constant shifting of weight when standing 1990:

rate, congested mucous membranes, or absent gut sounds.

456: 337:

Inflammation or ulceration of the gastrointestinal tract

2495:

Surgery poses significant expense and risks, including

4031:

Journal of the American Veterinary Medical Association

3787: 2480:

may be given via nasogastric tube to treat sand colic.

2322: 1357:

due to decreased suckling and not enough ingestion of

272: 108:

Colic can be divided broadly into several categories:

4573:"Gastrointestinal Rupture Clinical Signs (AAEP 2003)" 4001: 3878: 3876: 3874: 3821: 3440:"Colic Surgery and Intestinal Lubricants (AAEP 2010)" 2227:

Colic may be managed medically or surgically. Severe

1976:

Large amount of fluid can indicate acute peritonitis.

1860:

Caudoventral abdomen, left side: corresponds to colon

1609:

be performed as soon as possible, as delay is a dire

4852:

The Illustrated Veterinary Encyclopedia for Horsemen

3735: 3733: 3731: 3729: 1653:

color can be assessed to appreciate the severity of

1072: 4370: 4368: 4366: 4364: 4362: 4120: 4004:

Journal of the South African Veterinary Association

3147: 715:

Left dorsal displacement (nephrosplenic entrapment)

605:. Other gastric impactions are often resolves with 4858:Veterinary Medications and Treatments for Horsemen 3871: 3525: 3523: 3145: 3143: 3141: 3139: 3137: 3135: 3133: 3131: 3129: 3127: 1901:Ultrasound is a useful diagnostic tool for colics. 1600:. Colic pain secondary to kidney disease is rare. 1564:Other causes that may show clinical signs of colic 1439:Parasitic infection, especially with threadworms ( 1153:Signs of colic, which may vary from mild to severe 723:: the colon moves between the cecum and body wall. 4239: 4155:: CS1 maint: DOI inactive as of September 2024 ( 3726: 3701: 3699: 3697: 3695: 3693: 3691: 2638:with access to lush pasture and hence at risk of 1851:Upper flank, right side: corresponds to the cecum 997:in the stomach fairly commonly, a disease called 4916: 4488: 4486: 4484: 4482: 4480: 4478: 4476: 4474: 4359: 3532:"Cecal Impaction: Surgery Can Make a Difference" 3216: 3214: 3212: 3210: 3208: 3206: 3204: 3026:"Pfizer Introduces New Daily+ Deworming Program" 2813:"Equine Colic Management and Long-Term Survival" 2279:Nasogastric intubation and gastric decompression 1800:surface of the intestine can occur secondary to 228:. The poor blood supply also has effects on the 4746: 4341:"When a Horse Colics: The Physical Examination" 3977:"Colic in the Horse: When is Surgery Necessary" 3520: 3202: 3200: 3198: 3196: 3194: 3192: 3190: 3188: 3186: 3184: 3124: 2750: 2748: 2426: 1921: 305: 4910:Colic in Horses in the Merck Veterinary Manual 3708:"The Equine Stomach (AAEP 2003:Milne Lecture)" 3688: 3495: 3493: 3491: 3489: 3487: 3485: 3483: 3481: 2956:"Horse Colic: Surgical and Medical Management" 2746: 2744: 2742: 2740: 2738: 2736: 2734: 2732: 2730: 2728: 2287: 2102:, act depressed, or become extremely painful. 1413:Clostridial enterocolitis due to infection by 1060:to try to improve mucosal healing, as well as 811: 125: 4793: 4791: 4740: 4676: 4674: 4672: 4670: 4668: 4566: 4564: 4562: 4560: 4558: 4471: 3479: 3477: 3475: 3473: 3471: 3469: 3467: 3465: 3463: 3461: 2860: 2858: 2856: 2854: 2852: 2850: 2308: 1554: 1225:. Rarely, dead worms will be seen in reflux. 839: 281:Strangulating obstructions have all the same 112:excessive gas accumulation in the intestine ( 4771: 4769: 4666: 4664: 4662: 4660: 4658: 4656: 4654: 4652: 4650: 4648: 3181: 662: 254: 113: 4495:"Chronic Colic in Horses: What to Consider" 4290: 4288: 4286: 4284: 4282: 4280: 4278: 4276: 4274: 4172: 4170: 4168: 4166: 3970: 3968: 3966: 3964: 3962: 3960: 3958: 3956: 3954: 3952: 3950: 3948: 2989: 2987: 2985: 2983: 2981: 2979: 2977: 2806: 2804: 2802: 2800: 2798: 2725: 2283: 2142:Change in mucous membrane (gum) color (See 1918:the left kidney and/or tail of the spleen. 1776: 1513: 1468:Inguinal hernias are most commonly seen in 1447:) can produce signs of colic in foals (See 1387: 1143:Ileus diagnosed based on several criteria: 854: 427: 368: 4866:James M. Giffin, M.D. and Tom Gore, D.V.M. 4788: 4555: 4208: 4206: 4204: 4202: 4200: 4028: 3946: 3944: 3942: 3940: 3938: 3936: 3934: 3932: 3930: 3928: 3458: 2891: 2847: 2796: 2794: 2792: 2790: 2788: 2786: 2784: 2782: 2780: 2778: 2068: 1448: 1092:. As the tumor enlarges, it stretches the 490: 393: 169:formation, or foreign bodies. The primary 4825: 4815: 4766: 4645: 4537:"Rectal Examination of the Colicky Horse" 4530: 4528: 4526: 4524: 4522: 4520: 4518: 4516: 4448: 4446: 4444: 4442: 4440: 4438: 4436: 4434: 4432: 4430: 4428: 4426: 4424: 4422: 4420: 4418: 4297:"Colic in Horses: An Overview for Owners" 4233: 3099: 3097: 3095: 3093: 3091: 3089: 3087: 3085: 3083: 3081: 3079: 3077: 3075: 3073: 3071: 3069: 3067: 3020: 3018: 3016: 2909: 2687: 2372:barrier function of the intestinal mucosa 2357: 2312: 2242: 2143: 2007:Radiography, gastroscopy, and laparoscopy 1811: 1548: 1008:drug use, and the stress of shipping and 379: 291: 260: 143:ulceration of the gastrointestinal mucosa 4416: 4414: 4412: 4410: 4408: 4406: 4404: 4402: 4400: 4398: 4271: 4163: 3742:"Gastric Impactions in Horses: A Review" 3652: 3650: 3648: 3646: 3644: 3642: 3640: 3638: 3636: 3634: 3632: 3630: 3628: 3626: 3624: 3622: 3620: 3618: 3616: 3614: 3612: 3610: 3608: 3606: 3604: 3602: 3600: 3598: 3596: 3594: 3592: 3590: 3588: 3586: 3584: 3582: 3580: 3578: 3576: 3574: 3572: 3065: 3063: 3061: 3059: 3057: 3055: 3053: 3051: 3049: 3047: 2974: 2490: 2218:Poor coat or weight loss (chronic colic) 2149:Change in the degree of gut sounds (See 2051:diseases, like granulomatous enteritis. 1973:or uroperitoneum (urine in the abdomen). 1896: 1506:), which can lead to an enterocutaneous 1364: 1208: 774:as the growing bowel pushes against the 641: 612: 273:§ Strangulating pedunculated lipoma 89:, often with intensive aftercare. Among 49:of all important aspects of the article. 4775: 4197: 3925: 3800: 3570: 3568: 3566: 3564: 3562: 3560: 3558: 3556: 3554: 3552: 3408: 3406: 3404: 3402: 3400: 3398: 3396: 3394: 3392: 3390: 3388: 3386: 3384: 3382: 3380: 3378: 3376: 3374: 3372: 3370: 3368: 3366: 3364: 3362: 3360: 3358: 3356: 3354: 3352: 3350: 3348: 3346: 3344: 3342: 3340: 3338: 3336: 3334: 3332: 3330: 3328: 3326: 3324: 3322: 3320: 3318: 3316: 3314: 3312: 3310: 3308: 3306: 3304: 3302: 3300: 3298: 3296: 3294: 3292: 3290: 3288: 3286: 3284: 3282: 3280: 3278: 3276: 3274: 3272: 3270: 3268: 3266: 3264: 2775: 2500: 2304: 2291: 1980: 1892: 1825: 1768: 1632: 1544: 1496: 1452: 1408: 1031: 756: 4917: 4627:"Protein-losing Enteropathy Diagnosis" 4597: 4570: 4534: 4513: 4492: 4374: 4063: 3974: 3916: 3850: 3739: 3705: 3262: 3260: 3258: 3256: 3254: 3252: 3250: 3248: 3246: 3244: 3103: 3013: 2864: 2810: 2754: 2594:post-surgery, a serious complication. 2572: 2439:, especially in the case of gas colic. 2345: 1929:, or the extraction of fluid from the 1463: 1333: 861:Inflammatory and ulcerative conditions 45:Please consider expanding the lead to 4893:The horse professional guide to colic 4716: 4714: 4712: 4710: 4708: 4706: 4704: 4624: 4395: 4338: 4334: 4332: 4330: 4328: 4326: 4324: 4322: 4320: 4318: 4176: 3885:"Correcting Large Colon Displacement" 3656: 3220: 3152:Lyons, D.J. Carey (9 December 2013). 3151: 3044: 2993: 2757:"Equine Postoperative Ileus Insights" 2523: 2222: 1782: 1308:Large strongyle worms, most commonly 1064:to reduce inflammation of the colon. 982: 865: 457:Ileal impaction and ileal hypertrophy 329:, which primarily develop within the 311: 154: 4683:"The Clinical Signs of Equine Colic" 4339:Bentz, Bradford (21 February 2014). 4294: 4212: 3882: 3853:"Managing Severe Colic in the Field" 3766: 3549: 3499: 1993: 1889:, either of the cecum or the colon. 1296:There is now a lot of resistance to 1193: 653:renin–angiotensin–aldosterone system 575: 287: 264: 18: 4618: 3529: 3437: 3241: 2953: 2329: 2323:Intestinal lubricants and laxatives 2228: 1937:) and a total protein of 2.5 g/dL. 1405:survival with surgical correction. 1303: 13: 4845: 4701: 4571:Conrad, Sarah (17 February 2004). 4315: 4177:Cable, Christina (February 1999). 3975:Larson, Erica (21 February 2012). 3851:Larson, Erica (21 February 2012). 2435:Spasmolytic agents, most commonly 1291:-type" worms that are encysted as 790: 562: 103: 14: 4941: 4876: 4864:Horse Owner's Veterinary Handbook 4723:"Colic in Horses: General Review" 4680: 4598:Loving, Nancy (22 January 2010). 4375:Loving, Nancy (28 October 2013). 3801:Sellnow, Les (13 February 1998). 3767:West, Christy (21 January 2010). 3706:Conrad, Sarah (31 January 2004). 2514: 2391:, and coagulation abnormalities. 2150: 2054: 1772: 1073:Strangulating pedunculated lipoma 728:retroflexes towards the diaphragm 515: 4778:"Decreasing Abdominal Adhesions" 4749:"Minimizing Abdominal Adhesions" 4747:The Horse Staff (October 2004). 4535:Peloso, John (11 October 2001). 4493:Larson, Erica (22 August 2011). 2578:site is carefully monitored for 2297: 2045: 1150:A heart rate greater than 40 bpm 1100: 971:Due to the risk of endotoxemia, 23: 4591: 4114: 4101: 4092: 4057: 4022: 3995: 3883:West, Christy (11 March 2008). 3760: 3675: 3431: 3172: 2865:Loving, Nancy (November 2011). 2676:The Canadian Veterinary Journal 2139:Increased capillary refill time 1881: 1839: 1274: 705: 276: 268: 37:may be too short to adequately 4625:Diehl, Nancy (February 2002). 4295:West, Christy (28 July 2007). 4213:King, Marcia (February 2005). 4179:"Foals and Meconium Impaction" 3659:Large Animal Internal Medicine 3500:King, Marcia (February 2000). 2885: 2838:"10 Tips for Preventing Colic" 2830: 2755:Larson, Erica (22 July 2013). 2704: 2663: 2486:for parasitic causes of colic. 2236: 2036: 2020: 2011: 525: 160: 47:provide an accessible overview 1: 4776:Piscopo, Susan (April 2005). 4454:"Overview of Colic in Horses" 4043:10.2460/javma.1999.214.03.382 3438:Oke, Stacey (15 March 2011). 2657: 2597: 2335:dioctyl sodium sulfosuccinate 1711:Decrease in urine production 1580:, spleen, urogenital system, 1458: 1328: 1121:, and splenic lymphosarcoma. 999:equine gastric ulcer syndrome 989:Equine gastric ulcer syndrome 806: 355:equine gastric ulcer syndrome 4872:Christine King, BVSc, MACVSc 4804:National Library of Medicine 2811:Loving, Nancy (April 2012). 2427:Case-specific drug treatment 2088:gastrointestinal perforation 1922:Abdominocentesis (belly tap) 1603: 1253: 1203: 422: 306:Non-strangulating infarction 298:, a mesenteric rent, or the 7: 4884:Vet advice: Colic in horses 3223:"The Epidemiology Of Colic" 3104:Briggs, Karen (July 2011). 2898:Canadian Veterinary Journal 2645: 2458:are used in cases of ileus. 2259:, although opioids such as 1773:auscultation of the abdomen 1731:Decrease in blood pressure 1625:history, if the horse is a 812:Epiploic foramen entrapment 350: 261:§ Torsion and volvulus 243:. In the opposite fashion, 182:volume, leading to reduced 10: 4946: 4870:Preventing Colic in Horses 4817:10.1186/1746-6148-10-S1-S1 4254:10.1016/j.tvjl.2008.03.016 4078:10.1016/j.cveq.2003.08.002 3740:Larson, Erica (May 2011). 3530:Oke, Stacey (2 May 2010). 3221:White, Nat (August 1999). 3032:(Press release). The Horse 2994:Moore, James (June 2001). 2954:Oke, Stacey (March 2010). 2215:Dorsal recumbency in foals 2171:Change in activity level: 2113: 1616: 1555:Uterine tears and torsions 1117:, stomach cancers such as 1046:protein losing enteropathy 986: 918: 869: 840:Mesenteric rent entrapment 364: 342: 340: 309: 258: 235:, leading to an increased 158: 148: 3502:"Dealing with Sand Colic" 3106:"The Many Faces of Colic" 2288:strangulating obstruction 2136:Elevated respiratory rate 1526: 1067: 872:Equine proximal enteritis 721:Right dorsal displacement 663:Enteroliths and fecaliths 347:equine proximal enteritis 331:cranial mesenteric artery 255:Strangulating obstruction 126:strangulating obstruction 3803:"Small Colon Impactions" 3657:Smith, Bradford (2002). 3415:Equine Internal Medicine 2472:nephrosplenic entrapment 1514:Diaphragmatic herniation 1388:Congenital abnormalities 1268:Anoplocephala perfoliata 1131: 943:(the causative agent of 924:watery, fetid diarrhea. 486:Anoplocephala perfoliata 428:Pelvic flexure impaction 385: 4905:Colic information sheet 4458:Merck Veterinary Manual 4248:(3). Elsevier: 336–47. 4137:(inactive 2024-09-12). 2867:"Endotoxemia Explained" 1702:Moist to slightly tacky 1682:Mucous membrane quality 1474:Tennessee Walking Horse 1416:Clostridium perfringens 1261:at the junction of the 1119:squamous cell carcinoma 394:Gas and spasmodic colic 312:§ Large strongyles 2892:Abutarbush, S (2005). 2557:carboxymethylcellulose 2358:Endotoxemia prevention 2284:Nasogastric intubation 2243:Analgesia and sedation 2042:exploratory surgery). 1958:White fluid indicates 1902: 1812:Nasogastric intubation 1777:nasogastric intubation 1745:Usually > 4 seconds 1570:gastrointestinal tract 1491:parietal vaginal tunic 1182:central nervous system 940:Neorickettsia risticii 495:carboxymethylcellulose 265:§ Intussusception 193:The intestine becomes 188:acid-base disturbances 4215:"GI Disease in Foals" 4135:10.1136/vr.147.23.661 4123:The Veterinary Record 2491:Surgical intervention 2442:Pro-motility agents: 2081:capillary refill time 2069:Surgical intervention 1900: 1441:Strongyloides westeri 1370:Lethal white syndrome 1365:Lethal white syndrome 1209:Ascarids (roundworms) 934:Clostridium difficile 732:The colon develops a 642:Large colon impaction 613:Small colon impaction 432:This is caused by an 341:Further information: 310:Further information: 259:Further information: 159:Further information: 83:surgical intervention 4860:Equine Research Inc. 4854:Equine Research Inc. 3919:NAVC Conference 2015 3685:231:1378-1385, 2007. 3154:"An Unwanted Impact" 2399:administered with a 2385:cardiovascular shock 2368:systemic circulation 2352:parenteral nutrition 2313:physical examination 2212:Abdominal distention 2144:Physical examination 1987:abdominal distension 1981:Abdominal distension 1893:Abdominal ultrasound 1761:body condition score 1688:Time skin tent holds 1633:Physical examination 1611:prognostic indicator 1549:Right dorsal colitis 1497:Umbilical herniation 1434:Bacteroides fragilis 1409:Infectious organisms 1380:gene, often seen in 1032:Right dorsal colitis 757:Torsion and volvulus 684:American Saddlebreds 217:, and ultimately to 4800:"could it be colic" 2573:Post-operative care 2569:rate in one study. 2499:, the formation of 2470:: used in cases of 2346:Nutritional support 2199:Excess salivation ( 2133:Elevated heart rate 2127:, peritonitis, and 1725:Usually 2–3 seconds 1676:Percent Dehydration 1464:Inguinal herniation 1334:Meconium impactions 1310:Strongylus vulgaris 1024:leading to stomach 945:Potomac Horse Fever 734:180-degree volvulus 726:The pelvic flexure 323:Strongylus vulgaris 292:torsion or volvulus 4898:2009-12-12 at the 4377:"Mucous Membranes" 4242:Veterinary Journal 3683:J Am Vet Med Assoc 2610:schedule, regular 2533:reperfusion injury 2524:Adhesion formation 2389:insulin resistance 2364:lipopolysaccharide 2305:simple obstruction 2257:flunixin meglumine 2223:Medical management 2129:intestinal rupture 1903: 1834:proximal enteritis 1783:Rectal examination 1769:rectal examination 1668:Packed cell volume 1545:Gastric ulceration 1453:Gastric ulceration 1445:Parascaris equorum 1247:Parascaris equorum 1219:Parascaris equorum 983:Gastric ulceration 866:Proximal enteritis 476:Parascaris equorum 380:right dorsal colon 376:gastric ulceration 171:pathophysiological 155:Simple obstruction 130:non-strangulating 4681:Bentz, Bradford. 3424:978-1-4160-5670-6 2634:animals that are 2592:hepatic lipidosis 2317:circulatory shock 2206:Excessive yawning 1994:Fecal examination 1755: 1754: 1596:, and exertional 1283:can be caused by 1245:, can occur with 1094:connective tissue 1036:Long-term use of 1006:anti-inflammatory 576:Gastric impaction 405:peristaltic waves 277:§ Herniation 269:§ Entrapment 203:stretch receptors 87:abdominal surgery 64: 63: 4937: 4840: 4839: 4829: 4819: 4795: 4786: 4785: 4782:www.thehorse.com 4773: 4764: 4763: 4761: 4759: 4744: 4738: 4737: 4735: 4733: 4718: 4699: 4698: 4696: 4694: 4687:www.thehorse.com 4678: 4643: 4642: 4640: 4638: 4631:www.thehorse.com 4622: 4616: 4615: 4613: 4611: 4604:www.thehorse.com 4595: 4589: 4588: 4586: 4584: 4577:www.thehorse.com 4568: 4553: 4552: 4550: 4548: 4541:www.thehorse.com 4532: 4511: 4510: 4508: 4506: 4499:www.thehorse.com 4490: 4469: 4468: 4466: 4464: 4450: 4393: 4392: 4390: 4388: 4381:www.thehorse.com 4372: 4357: 4356: 4354: 4352: 4345:www.thehorse.com 4336: 4313: 4312: 4310: 4308: 4301:www.thehorse.com 4292: 4269: 4268: 4237: 4231: 4230: 4228: 4226: 4219:www.thehorse.com 4210: 4195: 4194: 4192: 4190: 4183:www.thehorse.com 4174: 4161: 4160: 4154: 4146: 4118: 4112: 4105: 4099: 4096: 4090: 4089: 4061: 4055: 4054: 4026: 4020: 4019: 3999: 3993: 3992: 3990: 3988: 3981:www.thehorse.com 3972: 3923: 3922: 3914: 3901: 3900: 3898: 3896: 3889:www.thehorse.com 3880: 3869: 3868: 3866: 3864: 3857:www.thehorse.com 3848: 3819: 3818: 3816: 3814: 3807:www.thehorse.com 3798: 3785: 3784: 3782: 3780: 3773:www.thehorse.com 3764: 3758: 3757: 3755: 3753: 3746:www.thehorse.com 3737: 3724: 3723: 3721: 3719: 3712:www.thehorse.com 3703: 3686: 3679: 3673: 3672: 3654: 3547: 3546: 3544: 3542: 3527: 3518: 3517: 3515: 3513: 3506:www.thehorse.com 3497: 3456: 3455: 3453: 3451: 3444:www.thehorse.com 3435: 3429: 3428: 3410: 3239: 3238: 3236: 3234: 3227:www.thehorse.com 3218: 3179: 3176: 3170: 3169: 3167: 3165: 3158:www.thehorse.com 3149: 3122: 3121: 3119: 3117: 3110:www.thehorse.com 3101: 3042: 3041: 3039: 3037: 3030:www.thehorse.com 3022: 3011: 3010: 3008: 3006: 2991: 2972: 2971: 2969: 2967: 2960:www.thehorse.com 2951: 2924: 2923: 2913: 2889: 2883: 2882: 2880: 2878: 2871:www.thehorse.com 2862: 2845: 2844: 2842: 2834: 2828: 2827: 2825: 2823: 2808: 2773: 2772: 2770: 2768: 2761:www.thehorse.com 2752: 2723: 2722: 2720: 2719: 2708: 2702: 2701: 2691: 2667: 2652:Geriatric horses 2265:alpha-2 agonists 2209:Loss of appetite 2025:Gastroscopy, or 1960:chylous effusion 1927:Abdominocentesis 1673: 1672: 1660:Capillary refill 1533:organophosphates 1504:Richter's hernia 1443:) and ascarids ( 1430:Rhodococcus equi 1304:Large strongyles 1194:Cecal impactions 1088:can form on the 977:thrombophlebitis 847:epiploic foramen 818:epiploic foramen 688:miniature horses 631:miniature horses 300:epiploic foramen 288:intussusceptions 286:obstruction are 161:§ Impaction 78:gastrointestinal 59: 56: 50: 27: 19: 16:Clinical symptom 4945: 4944: 4940: 4939: 4938: 4936: 4935: 4934: 4915: 4914: 4900:Wayback Machine 4888:Colic in Horses 4879: 4848: 4846:Further reading 4843: 4810:(Suppl 1): S1. 4796: 4789: 4774: 4767: 4757: 4755: 4745: 4741: 4731: 4729: 4719: 4702: 4692: 4690: 4679: 4646: 4636: 4634: 4623: 4619: 4609: 4607: 4596: 4592: 4582: 4580: 4569: 4556: 4546: 4544: 4533: 4514: 4504: 4502: 4491: 4472: 4462: 4460: 4452: 4451: 4396: 4386: 4384: 4373: 4360: 4350: 4348: 4337: 4316: 4306: 4304: 4293: 4272: 4238: 4234: 4224: 4222: 4211: 4198: 4188: 4186: 4175: 4164: 4148: 4147: 4119: 4115: 4106: 4102: 4097: 4093: 4062: 4058: 4027: 4023: 4000: 3996: 3986: 3984: 3973: 3926: 3915: 3904: 3894: 3892: 3881: 3872: 3862: 3860: 3849: 3822: 3812: 3810: 3799: 3788: 3778: 3776: 3765: 3761: 3751: 3749: 3738: 3727: 3717: 3715: 3704: 3689: 3680: 3676: 3669: 3655: 3550: 3540: 3538: 3528: 3521: 3511: 3509: 3498: 3459: 3449: 3447: 3436: 3432: 3425: 3411: 3242: 3232: 3230: 3219: 3182: 3177: 3173: 3163: 3161: 3150: 3125: 3115: 3113: 3102: 3045: 3035: 3033: 3024: 3023: 3014: 3004: 3002: 2992: 2975: 2965: 2963: 2952: 2927: 2890: 2886: 2876: 2874: 2863: 2848: 2840: 2836: 2835: 2831: 2821: 2819: 2809: 2776: 2766: 2764: 2753: 2726: 2717: 2715: 2710: 2709: 2705: 2668: 2664: 2660: 2648: 2600: 2575: 2526: 2517: 2493: 2429: 2360: 2348: 2325: 2300: 2281: 2245: 2225: 2116: 2057: 2048: 2039: 2023: 2014: 2009: 1996: 1983: 1924: 1895: 1842: 1814: 1785: 1651:Mucous membrane 1635: 1619: 1606: 1590:pleuropneumonia 1566: 1557: 1529: 1516: 1499: 1466: 1461: 1411: 1390: 1367: 1336: 1331: 1306: 1277: 1256: 1235:corticosteroids 1223:small intestine 1211: 1206: 1134: 1103: 1075: 1070: 1034: 1022:Bleeding ulcers 991: 985: 921: 874: 868: 863: 842: 814: 809: 796:Intussusception 793: 791:Intussusception 759: 708: 665: 644: 615: 578: 565: 563:Cecal impaction 530:liquid paraffin 518: 459: 430: 425: 396: 388: 357: 339: 314: 308: 279: 257: 163: 157: 106: 104:Pathophysiology 60: 54: 51: 44: 32:This article's 28: 17: 12: 11: 5: 4943: 4933: 4932: 4930:Horse diseases 4927: 4925:Abdominal pain 4913: 4912: 4907: 4902: 4890: 4885: 4878: 4877:External links 4875: 4874: 4873: 4867: 4861: 4855: 4847: 4844: 4842: 4841: 4787: 4765: 4739: 4700: 4644: 4617: 4590: 4554: 4512: 4470: 4394: 4358: 4314: 4270: 4232: 4196: 4162: 4113: 4111:July 2008: 20. 4100: 4091: 4056: 4021: 3994: 3924: 3902: 3870: 3820: 3786: 3759: 3725: 3687: 3674: 3667: 3548: 3519: 3457: 3430: 3423: 3240: 3180: 3171: 3123: 3043: 3012: 2973: 2925: 2904:(9): 800–805. 2884: 2846: 2829: 2774: 2724: 2703: 2661: 2659: 2656: 2655: 2654: 2647: 2644: 2622:. Horses that 2599: 2596: 2574: 2571: 2525: 2522: 2516: 2515:Survival rates 2513: 2492: 2489: 2488: 2487: 2484:Anthelminthics 2481: 2475: 2465: 2462: 2459: 2444:metoclopramide 2440: 2428: 2425: 2359: 2356: 2347: 2344: 2324: 2321: 2309:pelvic flexure 2299: 2296: 2280: 2277: 2244: 2241: 2229:clinical signs 2224: 2221: 2220: 2219: 2216: 2213: 2210: 2207: 2204: 2197: 2192: 2189: 2186: 2179: 2176: 2169: 2166: 2163: 2160: 2157: 2154: 2147: 2140: 2137: 2134: 2131: 2115: 2112: 2094:that requires 2056: 2055:Clinical signs 2053: 2047: 2044: 2038: 2035: 2031:gastric ulcers 2022: 2019: 2013: 2010: 2008: 2005: 1998:The amount of 1995: 1992: 1985:Any degree of 1982: 1979: 1978: 1977: 1974: 1967: 1963: 1956: 1953: 1923: 1920: 1894: 1891: 1862: 1861: 1858: 1855: 1852: 1841: 1838: 1813: 1810: 1784: 1781: 1753: 1752: 1749: 1746: 1743: 1740: 1737: 1733: 1732: 1729: 1726: 1723: 1720: 1717: 1713: 1712: 1709: 1706: 1705:< 2 seconds 1703: 1700: 1697: 1693: 1692: 1689: 1686: 1683: 1680: 1677: 1634: 1631: 1618: 1615: 1605: 1602: 1598:rhabdomyolysis 1565: 1562: 1556: 1553: 1528: 1525: 1515: 1512: 1498: 1495: 1465: 1462: 1460: 1457: 1410: 1407: 1389: 1386: 1366: 1363: 1335: 1332: 1330: 1327: 1319:anthelminthics 1305: 1302: 1276: 1273: 1255: 1252: 1237:to reduce the 1210: 1207: 1205: 1202: 1170:metoclopramide 1158: 1157: 1154: 1151: 1148: 1133: 1130: 1115:adenocarcinoma 1102: 1099: 1074: 1071: 1069: 1066: 1042:prostaglandins 1033: 1030: 987:Main article: 984: 981: 920: 917: 870:Main article: 867: 864: 862: 859: 841: 838: 813: 810: 808: 805: 792: 789: 758: 755: 738: 737: 730: 724: 718: 707: 704: 664: 661: 643: 640: 614: 611: 577: 574: 564: 561: 517: 516:Sand impaction 514: 458: 455: 429: 426: 424: 421: 395: 392: 387: 384: 338: 335: 307: 304: 256: 253: 226:cellular death 184:cardiac output 156: 153: 149:Types of colic 145: 144: 141: 134: 128: 123: 117: 105: 102: 74:abdominal pain 72:is defined as 62: 61: 41:the key points 31: 29: 22: 15: 9: 6: 4: 3: 2: 4942: 4931: 4928: 4926: 4923: 4922: 4920: 4911: 4908: 4906: 4903: 4901: 4897: 4894: 4891: 4889: 4886: 4883: 4881: 4880: 4871: 4868: 4865: 4862: 4859: 4856: 4853: 4850: 4849: 4837: 4833: 4828: 4823: 4818: 4813: 4809: 4805: 4801: 4794: 4792: 4783: 4779: 4772: 4770: 4754: 4750: 4743: 4728: 4724: 4717: 4715: 4713: 4711: 4709: 4707: 4705: 4688: 4684: 4677: 4675: 4673: 4671: 4669: 4667: 4665: 4663: 4661: 4659: 4657: 4655: 4653: 4651: 4649: 4632: 4628: 4621: 4605: 4601: 4594: 4578: 4574: 4567: 4565: 4563: 4561: 4559: 4542: 4538: 4531: 4529: 4527: 4525: 4523: 4521: 4519: 4517: 4500: 4496: 4489: 4487: 4485: 4483: 4481: 4479: 4477: 4475: 4459: 4455: 4449: 4447: 4445: 4443: 4441: 4439: 4437: 4435: 4433: 4431: 4429: 4427: 4425: 4423: 4421: 4419: 4417: 4415: 4413: 4411: 4409: 4407: 4405: 4403: 4401: 4399: 4382: 4378: 4371: 4369: 4367: 4365: 4363: 4346: 4342: 4335: 4333: 4331: 4329: 4327: 4325: 4323: 4321: 4319: 4302: 4298: 4291: 4289: 4287: 4285: 4283: 4281: 4279: 4277: 4275: 4267: 4263: 4259: 4255: 4251: 4247: 4243: 4236: 4220: 4216: 4209: 4207: 4205: 4203: 4201: 4184: 4180: 4173: 4171: 4169: 4167: 4158: 4152: 4144: 4140: 4136: 4132: 4129:(23): 661–2. 4128: 4124: 4117: 4110: 4104: 4095: 4087: 4083: 4079: 4075: 4072:(3): 779–90. 4071: 4067: 4060: 4052: 4048: 4044: 4040: 4037:(3): 382–90. 4036: 4032: 4025: 4017: 4013: 4009: 4005: 3998: 3982: 3978: 3971: 3969: 3967: 3965: 3963: 3961: 3959: 3957: 3955: 3953: 3951: 3949: 3947: 3945: 3943: 3941: 3939: 3937: 3935: 3933: 3931: 3929: 3920: 3913: 3911: 3909: 3907: 3890: 3886: 3879: 3877: 3875: 3858: 3854: 3847: 3845: 3843: 3841: 3839: 3837: 3835: 3833: 3831: 3829: 3827: 3825: 3808: 3804: 3797: 3795: 3793: 3791: 3774: 3770: 3763: 3747: 3743: 3736: 3734: 3732: 3730: 3713: 3709: 3702: 3700: 3698: 3696: 3694: 3692: 3684: 3678: 3670: 3668:0-323-00946-8 3664: 3660: 3653: 3651: 3649: 3647: 3645: 3643: 3641: 3639: 3637: 3635: 3633: 3631: 3629: 3627: 3625: 3623: 3621: 3619: 3617: 3615: 3613: 3611: 3609: 3607: 3605: 3603: 3601: 3599: 3597: 3595: 3593: 3591: 3589: 3587: 3585: 3583: 3581: 3579: 3577: 3575: 3573: 3571: 3569: 3567: 3565: 3563: 3561: 3559: 3557: 3555: 3553: 3537: 3533: 3526: 3524: 3507: 3503: 3496: 3494: 3492: 3490: 3488: 3486: 3484: 3482: 3480: 3478: 3476: 3474: 3472: 3470: 3468: 3466: 3464: 3462: 3445: 3441: 3434: 3426: 3420: 3416: 3409: 3407: 3405: 3403: 3401: 3399: 3397: 3395: 3393: 3391: 3389: 3387: 3385: 3383: 3381: 3379: 3377: 3375: 3373: 3371: 3369: 3367: 3365: 3363: 3361: 3359: 3357: 3355: 3353: 3351: 3349: 3347: 3345: 3343: 3341: 3339: 3337: 3335: 3333: 3331: 3329: 3327: 3325: 3323: 3321: 3319: 3317: 3315: 3313: 3311: 3309: 3307: 3305: 3303: 3301: 3299: 3297: 3295: 3293: 3291: 3289: 3287: 3285: 3283: 3281: 3279: 3277: 3275: 3273: 3271: 3269: 3267: 3265: 3263: 3261: 3259: 3257: 3255: 3253: 3251: 3249: 3247: 3245: 3228: 3224: 3217: 3215: 3213: 3211: 3209: 3207: 3205: 3203: 3201: 3199: 3197: 3195: 3193: 3191: 3189: 3187: 3185: 3175: 3159: 3155: 3148: 3146: 3144: 3142: 3140: 3138: 3136: 3134: 3132: 3130: 3128: 3111: 3107: 3100: 3098: 3096: 3094: 3092: 3090: 3088: 3086: 3084: 3082: 3080: 3078: 3076: 3074: 3072: 3070: 3068: 3066: 3064: 3062: 3060: 3058: 3056: 3054: 3052: 3050: 3048: 3031: 3027: 3021: 3019: 3017: 3001: 2997: 2990: 2988: 2986: 2984: 2982: 2980: 2978: 2961: 2957: 2950: 2948: 2946: 2944: 2942: 2940: 2938: 2936: 2934: 2932: 2930: 2921: 2917: 2912: 2907: 2903: 2899: 2895: 2888: 2872: 2868: 2861: 2859: 2857: 2855: 2853: 2851: 2839: 2833: 2818: 2814: 2807: 2805: 2803: 2801: 2799: 2797: 2795: 2793: 2791: 2789: 2787: 2785: 2783: 2781: 2779: 2762: 2758: 2751: 2749: 2747: 2745: 2743: 2741: 2739: 2737: 2735: 2733: 2731: 2729: 2713: 2707: 2699: 2695: 2690: 2685: 2681: 2677: 2673: 2666: 2662: 2653: 2650: 2649: 2643: 2641: 2637: 2631: 2627: 2625: 2621: 2617: 2613: 2609: 2605: 2604:carbohydrates 2595: 2593: 2587: 2583: 2581: 2570: 2567: 2563: 2558: 2554: 2548: 2546: 2542: 2538: 2534: 2530: 2521: 2512: 2510: 2506: 2502: 2498: 2485: 2482: 2479: 2476: 2473: 2469: 2468:Phenylephrine 2466: 2463: 2460: 2457: 2453: 2449: 2445: 2441: 2438: 2434: 2433: 2432: 2424: 2422: 2417: 2413: 2411: 2407: 2402: 2397: 2392: 2390: 2386: 2382: 2377: 2376:Kupffer cells 2373: 2369: 2365: 2355: 2353: 2343: 2340: 2336: 2331: 2320: 2318: 2314: 2310: 2306: 2298:Fluid support 2295: 2293: 2289: 2285: 2276: 2274: 2270: 2266: 2262: 2258: 2254: 2250: 2240: 2238: 2234: 2230: 2217: 2214: 2211: 2208: 2205: 2202: 2198: 2196: 2193: 2190: 2187: 2184: 2180: 2177: 2174: 2170: 2167: 2164: 2161: 2158: 2155: 2152: 2148: 2145: 2141: 2138: 2135: 2132: 2130: 2126: 2122: 2118: 2117: 2111: 2109: 2103: 2101: 2097: 2093: 2089: 2084: 2082: 2078: 2074: 2070: 2066: 2062: 2052: 2046:Rectal biopsy 2043: 2034: 2032: 2028: 2018: 2004: 2001: 1991: 1988: 1975: 1972: 1968: 1964: 1961: 1957: 1954: 1950: 1947: 1946: 1945: 1942: 1938: 1936: 1932: 1928: 1919: 1915: 1911: 1907: 1899: 1890: 1888: 1887:trocarization 1883: 1879: 1875: 1871: 1867: 1859: 1856: 1853: 1850: 1849: 1848: 1846: 1837: 1835: 1831: 1827: 1822: 1820: 1809: 1805: 1803: 1799: 1794: 1789: 1780: 1778: 1774: 1770: 1764: 1762: 1757: 1750: 1747: 1744: 1741: 1738: 1735: 1734: 1730: 1727: 1724: 1721: 1718: 1715: 1714: 1710: 1707: 1704: 1701: 1698: 1695: 1694: 1690: 1687: 1684: 1681: 1678: 1675: 1674: 1671: 1669: 1664: 1661: 1656: 1652: 1648: 1644: 1640: 1630: 1628: 1624: 1614: 1612: 1601: 1599: 1595: 1591: 1587: 1583: 1579: 1575: 1571: 1561: 1552: 1550: 1546: 1542: 1538: 1534: 1524: 1522: 1511: 1509: 1505: 1494: 1492: 1487: 1483: 1480:, as well as 1479: 1478:inguinal ring 1475: 1471: 1456: 1454: 1450: 1446: 1442: 1437: 1435: 1431: 1427: 1423: 1418: 1417: 1406: 1403: 1398: 1394: 1385: 1383: 1379: 1375: 1371: 1362: 1360: 1356: 1352: 1347: 1344: 1340: 1326: 1324: 1320: 1315: 1311: 1301: 1299: 1294: 1290: 1286: 1282: 1272: 1270: 1269: 1264: 1260: 1251: 1248: 1244: 1240: 1236: 1232: 1228: 1224: 1220: 1216: 1201: 1197: 1195: 1189: 1187: 1183: 1179: 1175: 1171: 1167: 1162: 1155: 1152: 1149: 1146: 1145: 1144: 1141: 1138: 1129: 1127: 1122: 1120: 1116: 1112: 1108: 1107:lymphosarcoma 1101:Other cancers 1098: 1095: 1091: 1087: 1083: 1079: 1065: 1063: 1062:metronidazole 1059: 1055: 1051: 1047: 1043: 1039: 1029: 1027: 1023: 1019: 1015: 1011: 1007: 1004: 1000: 996: 990: 980: 978: 974: 969: 967: 962: 956: 954: 950: 946: 942: 941: 936: 935: 930: 925: 916: 912: 910: 904: 901: 900: 895: 894: 889: 888: 883: 879: 873: 858: 856: 852: 848: 837: 835: 831: 827: 823: 822:omental bursa 819: 804: 800: 797: 788: 784: 782: 777: 773: 767: 765: 754: 750: 748: 747:phenylephrine 742: 735: 731: 729: 725: 722: 719: 716: 713: 712: 711: 703: 700: 697: 693: 689: 685: 681: 677: 673: 669: 660: 656: 654: 650: 639: 636: 632: 628: 624: 620: 610: 608: 604: 600: 596: 592: 588: 584: 573: 569: 560: 556: 553: 552: 547: 543: 539: 535: 531: 527: 522: 513: 511: 507: 503: 498: 496: 492: 488: 487: 482: 478: 477: 472: 468: 464: 454: 451: 446: 442: 441: 435: 420: 416: 414: 410: 406: 402: 401:anthelminthic 391: 383: 381: 377: 372: 370: 366: 362: 356: 352: 351:§ Toxins 348: 344: 334: 332: 328: 325: 324: 319: 313: 303: 301: 297: 293: 289: 284: 278: 274: 270: 266: 262: 252: 250: 247:bacteria and 246: 245:gram-negative 242: 238: 234: 231: 227: 223: 220: 216: 212: 208: 204: 200: 196: 191: 189: 185: 181: 176: 172: 168: 162: 152: 150: 142: 139: 135: 133: 129: 127: 124: 122: 118: 115: 111: 110: 109: 101: 99: 95: 92: 88: 84: 79: 75: 71: 70: 58: 48: 42: 40: 35: 30: 26: 21: 20: 4869: 4863: 4857: 4851: 4807: 4803: 4784:. The Horse. 4781: 4756:. Retrieved 4752: 4742: 4730:. Retrieved 4726: 4691:. Retrieved 4686: 4635:. Retrieved 4630: 4620: 4608:. Retrieved 4603: 4593: 4581:. Retrieved 4576: 4545:. Retrieved 4540: 4503:. Retrieved 4498: 4461:. Retrieved 4457: 4385:. Retrieved 4380: 4349:. Retrieved 4344: 4305:. Retrieved 4300: 4265: 4245: 4241: 4235: 4223:. Retrieved 4218: 4187:. Retrieved 4182: 4151:cite journal 4126: 4122: 4116: 4108: 4103: 4094: 4069: 4065: 4059: 4034: 4030: 4024: 4007: 4003: 3997: 3985:. Retrieved 3980: 3918: 3893:. Retrieved 3888: 3861:. Retrieved 3856: 3811:. Retrieved 3806: 3777:. Retrieved 3772: 3762: 3750:. Retrieved 3745: 3716:. Retrieved 3711: 3682: 3677: 3658: 3539:. Retrieved 3535: 3510:. Retrieved 3505: 3448:. Retrieved 3443: 3433: 3414: 3231:. Retrieved 3226: 3174: 3162:. Retrieved 3157: 3114:. Retrieved 3109: 3034:. Retrieved 3029: 3003:. Retrieved 2999: 2964:. Retrieved 2959: 2901: 2897: 2887: 2875:. Retrieved 2870: 2832: 2820:. Retrieved 2816: 2765:. Retrieved 2760: 2716:. Retrieved 2714:. 2023-08-06 2706: 2682:(9): 800–5. 2679: 2675: 2665: 2636:easy keepers 2632: 2628: 2601: 2588: 2584: 2576: 2549: 2527: 2518: 2494: 2456:erythromycin 2430: 2414: 2393: 2361: 2349: 2326: 2301: 2282: 2246: 2226: 2151:Auscultation 2104: 2085: 2058: 2049: 2040: 2024: 2015: 1997: 1984: 1943: 1939: 1925: 1916: 1912: 1908: 1904: 1863: 1845:Auscultation 1843: 1840:Auscultation 1823: 1815: 1806: 1790: 1786: 1765: 1758: 1756: 1665: 1655:haemodynamic 1636: 1623:anthelmintic 1620: 1607: 1567: 1558: 1530: 1517: 1503: 1500: 1470:Standardbred 1467: 1444: 1440: 1438: 1433: 1429: 1425: 1421: 1414: 1412: 1393:Atresia coli 1391: 1368: 1348: 1337: 1309: 1307: 1298:fenbendazole 1288: 1285:cyathostomes 1278: 1275:Cyathostomes 1266: 1257: 1246: 1239:inflammatory 1218: 1212: 1198: 1190: 1166:erythromycin 1163: 1159: 1142: 1135: 1123: 1104: 1076: 1035: 993:Horses form 992: 970: 957: 938: 932: 928: 926: 922: 913: 905: 897: 891: 885: 875: 843: 815: 801: 794: 785: 768: 760: 751: 743: 739: 733: 727: 720: 714: 709: 706:Displacement 701: 666: 657: 645: 616: 579: 570: 566: 557: 549: 523: 519: 499: 484: 474: 460: 443:of the left 437: 431: 417: 397: 389: 373: 358: 343:§ Ileus 321: 315: 283:pathological 280: 237:permeability 192: 164: 146: 107: 98:veterinarian 91:domesticated 66: 65: 52: 36: 34:lead section 4689:. The Horse 4633:. The Horse 4606:. The Horse 4579:. The Horse 4543:. The Horse 4501:. The Horse 4383:. The Horse 4347:. The Horse 4303:. The Horse 4221:. The Horse 4185:. The Horse 4010:(1): 73–6. 3983:. The Horse 3891:. The Horse 3859:. The Horse 3809:. The Horse 3775:. The Horse 3748:. The Horse 3714:. The Horse 3508:. The Horse 3446:. The Horse 3229:. The Horse 3160:. The Horse 3112:. The Horse 2996:"Gas Colic" 2962:. The Horse 2873:. The Horse 2763:. The Horse 2616:dental care 2566:laparoscope 2537:neutrophils 2509:anastomosis 2497:peritonitis 2452:bethanechol 2406:polymyxin B 2339:Epsom salts 2261:butorphanol 2108:endotoxemia 2092:peritonitis 2065:dehydration 2037:Laparoscopy 2021:Gastroscopy 2012:Radiography 1935:neutrophils 1826:obstruction 1802:peritonitis 1759:Weight and 1728:3–5 seconds 1708:1–3 seconds 1643:hypotension 1541:cantharidin 1397:atresia ani 1382:Paint horse 1378:frame overo 1300:in the UK. 1231:peritonitis 1174:bethanechol 1050:misoprostol 1014:cantharidin 949:cantharidin 893:Clostridial 855:endotoxemia 834:portal vein 696:radiographs 668:Enteroliths 649:hypovolemia 623:enteroliths 599:gastroscopy 532:or oil and 502:hypertrophy 369:endotoxemia 361:peristalsis 233:endothelium 138:peritonitis 121:obstruction 4919:Categories 2718:2023-08-07 2658:References 2620:heatstroke 2614:, regular 2598:Prevention 2580:dehiscence 2505:dehiscence 2330:sand colic 2273:detomidine 2233:analgesics 2096:euthanasia 2073:analgesics 2027:endoscopic 1952:capillary. 1949:Sanguinous 1931:peritoneum 1882:sand colic 1866:borborygmi 1748:5+ seconds 1679:Heart rate 1582:testicular 1482:Saddlebred 1459:Herniation 1426:Klebsiella 1422:Salmonella 1374:homozygous 1329:Foal colic 1314:infarction 1289:Strongylus 1287:or "small 1215:roundworms 1054:sucralfate 1028:are rare. 966:parenteral 929:Salmonella 887:Salmonella 880:and upper 807:Entrapment 635:enterotomy 583:Persimmons 551:Salmonella 506:idiopathic 413:analgesics 249:endotoxins 215:congestion 199:activation 132:infarction 55:April 2023 4753:The Horse 4727:The Horse 4109:The Horse 3536:The Horse 3000:The Horse 2817:The Horse 2640:laminitis 2612:deworming 2529:Adhesions 2501:adhesions 2448:lidocaine 2416:Laminitis 2401:lidocaine 2292:enteritis 2249:analgesia 2237:Diagnosis 2181:Repeated 2121:enteritis 2077:sedatives 1870:spasmodic 1719:40-60 bpm 1647:analgesic 1604:Diagnosis 1594:laminitis 1586:pleuritis 1584:torsion, 1486:Warmblood 1359:colostrum 1343:miniature 1259:Tapeworms 1254:Tapeworms 1227:Deworming 1204:Parasites 1178:lidocaine 1111:leiomyoma 1090:mesentery 1084:known as 1003:steroidal 973:laminitis 830:vena cava 820:into the 776:diaphragm 764:Occlusion 619:fecaliths 603:Coca-Cola 587:dysphagia 546:prebiotic 538:synbiotic 526:Diagnosis 481:tapeworms 450:masticate 434:impaction 423:Impaction 219:ischaemic 211:hyperemia 207:occlusion 195:distended 167:stricture 114:gas colic 67:Colic in 39:summarize 4896:Archived 4836:25238026 4262:18472287 4143:11131553 4086:14740769 4051:10023402 2920:16231649 2698:16231649 2646:See also 2545:collagen 2478:Psyllium 2437:Buscopan 2410:azotemia 2396:colloids 2381:ischemia 2269:xylazine 2267:such as 2253:sedation 2201:ptyalism 2191:Groaning 2185:response 2173:lethargy 2168:Sweating 2061:necrosis 1878:diarrhea 1874:ischemia 1537:monensin 1449:Ascarids 1376:for the 1339:Meconium 1281:diarrhea 1126:ptyalism 1058:psyllium 1018:Antacids 909:necropsy 899:Fusarium 878:duodenum 826:cribbers 676:Arabians 672:struvite 627:meconium 591:ptyalism 534:psyllium 510:anorexia 491:Ascarids 471:ascarids 409:buscopan 230:vascular 222:necrosis 4827:4122872 4463:20 July 4016:1177243 3863:27 June 2911:1187790 2689:1187790 2608:feeding 2562:omentum 2421:heparin 2370:by the 2195:Bruxism 2183:flehmen 2125:colitis 2114:General 2100:pyretic 1971:ascites 1798:serosal 1793:dilated 1739:60+ bpm 1639:preload 1627:cribber 1617:History 1578:ovaries 1521:dyspnea 1508:fistula 1323:aspirin 1086:lipomas 1026:rupture 1010:showing 919:Colitis 882:jejunum 772:dyspnea 692:donkeys 680:Morgans 607:enteral 595:bruxism 440:flexure 438:pelvic 318:ingesta 119:simple 4834: 4824: 4758:4 July 4732:4 July 4693:4 July 4637:4 July 4610:5 July 4583:5 July 4547:4 July 4505:4 July 4387:4 July 4351:5 July 4307:4 July 4260: 4225:5 July 4189:5 July 4141: 4084: 4049: 4014: 3987:4 July 3895:4 July 3813:5 July 3779:5 July 3752:5 July 3718:5 July 3665: 3541:5 July 3512:5 July 3450:5 July 3421: 3233:4 July 3164:5 July 3116:4 July 3036:5 July 3005:4 July 2966:4 July 2918: 2908: 2877:4 July 2822:4 July 2767:4 July 2696: 2686: 2541:fibrin 2454:, and 2156:Pawing 1966:cases. 1819:siphon 1775:, and 1736:10-12% 1699:Normal 1691:Other 1588:, and 1539:, and 1527:Toxins 1432:, and 1402:barium 1351:enemas 1293:larvae 1279:Acute 1113:, and 1082:tumors 1080:fatty 1078:Benign 1068:Tumors 1056:, and 1038:NSAIDs 995:ulcers 953:NSAIDs 937:, and 690:, and 625:, and 411:, and 353:, and 327:larvae 296:hernia 275:, and 186:, and 180:plasma 94:horses 69:horses 2841:(PDF) 2000:feces 1832:, or 1830:ileus 1722:Tacky 1641:from 1574:liver 1263:cecum 1243:ileum 1137:Ileus 1132:Ileus 851:edema 638:use. 467:cecum 463:ileum 445:colon 386:Types 365:Ileus 241:lumen 4832:PMID 4760:2014 4734:2014 4695:2014 4639:2014 4612:2014 4585:2014 4549:2014 4507:2014 4465:2014 4389:2014 4353:2014 4309:2014 4258:PMID 4227:2014 4191:2014 4157:link 4139:PMID 4082:PMID 4047:PMID 4012:PMID 3989:2014 3897:2014 3865:2020 3815:2014 3781:2014 3754:2014 3720:2014 3663:ISBN 3543:2014 3514:2014 3452:2014 3419:ISBN 3235:2014 3166:2014 3118:2014 3038:2014 3007:2014 2968:2014 2916:PMID 2879:2014 2824:2014 2769:2014 2694:PMID 2624:bolt 2553:DMSO 2543:and 2271:and 2251:and 2075:and 1547:and 1484:and 1472:and 1395:and 1176:and 890:and 544:and 461:The 224:and 213:and 175:oral 4822:PMC 4812:doi 4250:doi 4246:179 4131:doi 4127:147 4074:doi 4039:doi 4035:214 2906:PMC 2684:PMC 2290:or 1742:Dry 1685:CRT 1551:). 1355:IgG 1186:LPS 961:CBC 832:or 781:DIC 542:pro 201:of 151:). 4921:: 4830:. 4820:. 4808:10 4806:. 4802:. 4790:^ 4780:. 4768:^ 4751:. 4725:. 4703:^ 4685:. 4647:^ 4629:. 4602:. 4575:. 4557:^ 4539:. 4515:^ 4497:. 4473:^ 4456:. 4397:^ 4379:. 4361:^ 4343:. 4317:^ 4299:. 4273:^ 4264:. 4256:. 4244:. 4217:. 4199:^ 4181:. 4165:^ 4153:}} 4149:{{ 4125:. 4080:. 4070:19 4068:. 4045:. 4033:. 4008:46 4006:. 3979:. 3927:^ 3905:^ 3887:. 3873:^ 3855:. 3823:^ 3805:. 3789:^ 3771:. 3744:. 3728:^ 3710:. 3690:^ 3551:^ 3534:. 3522:^ 3504:. 3460:^ 3442:. 3243:^ 3225:. 3183:^ 3156:. 3126:^ 3108:. 3046:^ 3028:. 3015:^ 2998:. 2976:^ 2958:. 2928:^ 2914:. 2902:46 2900:. 2896:. 2869:. 2849:^ 2815:. 2777:^ 2759:. 2727:^ 2692:. 2680:46 2678:. 2674:. 2450:, 2446:, 2387:, 2123:, 2110:. 1828:, 1771:, 1716:8% 1696:5% 1613:. 1576:, 1535:, 1436:. 1428:, 1424:, 1172:, 1168:, 1109:, 1052:, 979:. 931:, 911:. 783:. 686:, 682:, 678:, 621:, 593:, 589:, 349:, 345:, 333:. 302:. 290:, 271:, 267:, 263:, 190:. 4838:. 4814:: 4762:. 4736:. 4697:. 4641:. 4614:. 4587:. 4551:. 4509:. 4467:. 4391:. 4355:. 4311:. 4252:: 4229:. 4193:. 4159:) 4145:. 4133:: 4088:. 4076:: 4053:. 4041:: 4018:. 3991:. 3921:. 3899:. 3867:. 3817:. 3783:. 3756:. 3722:. 3671:. 3545:. 3516:. 3454:. 3427:. 3237:. 3168:. 3120:. 3040:. 3009:. 2970:. 2922:. 2881:. 2843:. 2826:. 2771:. 2721:. 2700:. 2203:) 2153:) 2146:) 1962:. 540:( 483:( 473:( 363:( 140:) 116:) 57:) 53:( 43:.

Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.

Index