Equis ISSN 2398-2977

Abdomen: pain - adult

Synonym(s): Colic

Contributor(s): Roberta Baxter, Prof Jonathon Naylor, Chris Whitton, Nicola Menzies-Gow

Decision making

  • Goals of initial assessment:
    • Evaluate the severity of pain and degree of cardiovascular compromise.
    • Look for evidence of possible etiology.
    • Decide if surgery is indicated or not.

Reassess mild or moderate colic cases not less than every 2 h so that a decision to undertake surgery is made sooner rather than later. If pain is controlled, owner can assess regularly.

  • Early and accurate diagnosis of gastrointestinal disorders will strongly influence the prognosis of surgical cases.

Print off the Owner factsheets on Colic - a serious belly ache and Emergencies - when to call your vet to give to your clients.

Pre-operative cardiovascular status directly influences prognosis.
  • Make decisions about laboratory tests and other examinations early in the course of assessment.
  • About 6% of colic cases will require surgery.
  • Most cases of colic will respond to conservative management.

Duration of pain before initial examination is often unknown.

Initial evaluation

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Diagnostic techniques

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Medical management

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Surgical management

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Prognosis

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Differential diagnoses

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Further Reading

Publications

Refereed papers
  • Recent references fromPubMed andVetMedResource.
  • Findley J & Archer D (2014)Management of the surgical equine colic patient following hospital discharge. In Pract36(5), 229-236VetMedResource.
  • Salciccia A et al(2013)Sensitivity and specificity of blood leucocyte counts as an indicator of mortality in horses after colic surgery. Vet Rec173(11), 267PubMed.
  • Linnenkohl W, Mair T & Fews D (2013)Case report of atypical infiltrative lipomatosis of the equine mesojejunum. Equine Vet Educ25(5), 237-240VetMedResource.
  • de Bont M P, Malbon A J, Sardon D & Archer D C (2013)Caecal lipomatosis as a cause of colic in a 9-year-old gelding. Equine Vet Educ25(5), 241-244VetMedResource.
  • Freeman S & Issaoui L (2013)Code red for coli: Decision-making for acute abdominal pain in the horse. Equine Vet Educ25(5), 245-246.
  • Durward-Akhurst S A et al(2013)Comparison of two antimicrobial regimens on the prevalence of incisional infections after colic surgery. Vet Rec172(11), 287PubMed.
  • Southwood L L (2012)Complicated colic case raises interesting questions: What can we learn? Equine Vet Educ24(11), 569-572.
  • Santschi E M (2012)Equine colic caused by neoplasia. Equine Vet Educ24(9), 437-438VetMedResource.
  • Fielding C L & Dechant J E (2012)Colic in competing endurance horses presenting to referral centres: 36 cases. Equine Vet J44(4), 472-475PubMed.
  • Alexander G R & Haines G R (2012)Surgical colic in racing endurance horses. Equine Vet Educ24(4), 193-199VetMedResource.
  • Scantlebury C E, Archer D C, Proudman C J & Pinchbeck G L (2011)Recurrent colic in the horse: Incidence and risk factors for recurrence in the general practice population. Equine Vet J43(Suppl 39), 81-88PubMed.
  • Archer D C (2011)Chronic persistent colic: Can I have a retrospectoscope please? Equine Vet Educ23(6), 286-288VetMedResource.
  • Malamed R et al(2010)Retrospective evaluation of crib-biting and windsucking behaviours and owner-perceived behavioural traits as risk factors for colic in horses. Equine Vet J42(8), 686-692PubMed.
  • Hart S & Southwood L L (2010)The enigma of post-operative recurrent colic: Challenges with diagnosis and management. Equine Vet Educ22(8), 408-411.
  • Torre F, Gasparin J & Andreasi B (2010)Rupture of the mesocolon as a cause of recurrent colic in a showjumper mare. Equine Vet Educ22(8), 403-407VetMedResource.
  • Arguelles D et al(2010)Peritoneal concentrations of transforming growth factor beta in horses with colic. Equine Vet J42(5), 451-455PubMed.
  • Monreal L et al(2010)Enteral fluid therapy in 108 horses with large colon impactions and dorsal displacements. Vet Rec166(9), 259-263PubMed.
  • Sutton G A, Ertrzman-Ginsburg R, Steinman A & Milgram J (2009)Initial investigation of mortality rates and prognostic indicators in horses with colic in Israel: A retrospective study. Equine Vet J41(5), 482-486PubMed.
  • Saulez M N, Burton A, Steyl J C A, Williams J H & Clift S J (2009)Perforation of the gastrointestinal tracts of four horses by metallic wires. Vet Rec164(3), 86-89PubMed.
  • Robert M P, Benamou-Smith A E, Cadore J L, Rosengarten M S & Lepage O M (2008)Recurrent colics in a 9-year-old Arabian stallion due to several congenital anomalies. Equine Vet Educ20(11), 567-571VetMedResource.
  • Johnson P J & Kellam L L (2007)Risk of colic associated with persimmon fruit ingestion. Equine Vet Educ19(11), 576-578VetMedResource.
  • Coomer R (2007)Colic Part 7: Rectal examination 5: Management of rectal tears. UK Vet12(8), 5-8.
  • Coomer R (2007)Colic Part 6: Rectal examination 4: Small colon and reproductive tract. UK Vet12(7), 5-9.
  • Coomer R (2007)Colic Part 5: Rectal examination 3: Large colon. UK Vet12(6), 5-10.
  • Coomer R (2007)Colic Part 4: Rectal examination 2: Small intestine and caecum. UK Vet12(5).
  • Brunott A et al(2007)A colonic epidermoid cyst as a cause of chronic recurrent colic in a horse. Equine Vet Educ19(3), 123-128VetMedResource.
  • Coomer R (2007)Colic Part 3: Rectal examination 1 - Normal findings and technique. UK Vet12(4), 5-6.
  • Coomer R (2007)Colic Part 2: Physical evaluation. UK Vet12(3), 5-12.
  • Coomer R (2007)Colic Part 1: History, pain and analgesics. UK Vet12(2), 5-10.
  • Mair T S & Edwards G B (2007)Chronic and recurrent colic: challenging clinical syndromes. Equine Vet Educ19(3), 137-138.
  • Walmsley J P (2007)Laparoscopy in horses with abdominal pain. Equine Vet Educ19(2), 64-66VetMedResource.
  • Borer K E & Corley K T T (2006)Electrolyte disorders in horses with colic. Part 2: Calcium, sodium, chloride and phosphate. Equine Vet Educ18(6), 320-325VetMedResource.
  • Borer K E & Corley K T T (2006)Electrolyte disorders in horses with colic. Part 1: Potassium and magnesium. Equine Vet Educ18(5), 266-271VetMedResource.
  • Andersen M A, Clark L, Dyson S J & Newton J R (2006)Risk factors for colic in horses after general anesthesia for MRI or non-abdominal surgery: absence of evidence of effect from peri-anesthetic morphine. Equine Vet J38(4), 368-374PubMed.
  • Perez Olmos J F, Schofield W L, Dillon H, Sadlier M & Fogarty U (2006)Circumferential mural bands in the small intestine causing simple obstructive colic: a case series. Equine Vet J38(4), 354-359PubMed.
  • Semevolos S A et al(2006)Perforating jejunal diverticulosis in 2 horses. Equine Vet Educ18(3), 139-142.
  • Blikslager A T (2006)Peritonitis in the horse. Equine Vet Educ18(3), 143.
  • Soler-Rodriguez F et al(2006) Datura stramoniumpoisoning in horses: a risk factor for colic. Vet Rec158(4), 132-133PubMed.
  • Proudman C J et al(2006)Pre-operative and anaesthesia related risk factors for mortality in equine colic cases. Vet J171(1), 89-97PubMed.
  • Saulez M N, Cebra C K & Dailey M (2005)Comparative biochemical analysis of venous blood and peritoneal fluid from horses with colic using a portable analyser and an in-house analyser. Equine Vet J157(8), 217-223PubMed.
  • Rendle D I et al(2005)End-to-end jejuno-ileal anastomosis following resection of strangulated small intestine in horses: a comparative study. Equine Vet J37(4), 356-359PubMed.
  • Husted L et al(2005)Risk factors for faecal sand excretion in Icelandic horses. Equine Vet J37(4), 351-355PubMed.
  • White N A et al(2005)Use of web-based data collection to evaluate analgesic administration and the decision for surgery in horses with colic. Equine Vet J37(4), 347-350PubMed.
  • Latson K M et al(2005)Evaluation of peritoneal fluid lactate as a marker of intestinal ischaemia in equine colic. Equine Vet J37(4), 342-346PubMed.
  • Ryan C A et al(2005)Pharmacokinetics and pharmacodynamics of pantoprazole in clinically normal neonatal foals. Equine Vet J37(4), 336-341PubMed.
  • Little D, Tomlinson J E & Blikslager A T (2005)Post-operative neutrophilic inflammation in equine small intestine after manipulation and ischaemia. Equine Vet J37(4), 329-335PubMed.
  • van Hoogmoed L M & Boscan P L (2005)  In vitroevaluation of the effect of the opioid antagonist N-methylnaltrexone on motility of the equine jejunum and pelvic flexure. Equine Vet J37(4), 325-328PubMed
  • Tschetter J R et al(2005)Detection of differentially regulated genes in ischaemic equine intestinal mucosa. Equine Vet J37(4), 319-324PubMed.
  • Mair T S & Smith L J (2005)Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 4: Early (acute) relaparotomy. Equine Vet J37(4), 315-318PubMed.
  • Mair T S & Smith L J (2005)Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 3: Long-term complications and survival. Equine Vet J37(4), 310-314PubMed.
  • Mair T S & Smith L J (2005) Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 2: Short-term complications. Equine Vet J 37(4), 303-309PubMed.
  • Mair T S & Smith L J (2005) Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 1: Short-term survival following a single laparotomy. Equine Vet J37(4), 296-302PubMed.
  • Freeman D E & Schaeffer D J (2005) Short-term survival after surgery for epiploic foramen entrapment compared with other strangulating diseases of the small intestine in horses. Equine Vet J37(4), 292-295PubMed
  • Senior J M, Pinchbeck G, Dugdale A H A & Clegg P D (2004)A Retrospective study into risk factors and prevalence of post-operative colic after orthopaedic surgery in horses.  Vet Rec155(11), 321-325.
  • Senior J M, Pinchbeck G L, Dugdale A H A & Clegg P D (2004)Retrospective study of the risk factors and prevalence of colic in horses after orthopaedic surgery. Vet Rec155(11), 321-325PubMed.
  • Hunt R J (2004)Surgical management of colic. J Equine Vet Sci24(5), 212-213.
  • Bosch G & van der Velden M A (2004)Impaired growth and colic caused by congenital defects in the mesenteric attachments of caecum and colon in a yearling. Equine Vet Educ6(3), 151-154.
  • van Der Linden M A et al(2003)Prognosis in equine medical and surgical colic. J Vet Intern Med17(3), 343-348PubMed.
  • McGowan C & Freeman S (2003)Abdominal pain in a aged pony. Equine Vet Educ15(4), 179-181.
  • Kim L M, Morley P S, Traub-Dargatz J L, Salmon M D & Gentry-Weeks C (2001)Factors associated with Salmonella shedding among equine colic patients at a veterinary teaching hospital. JAVMA218(5), 740-748PubMed.
  • Steel D M & Gibson K T (2001)Colic in the pregnant and periparturient mare. Equine Vet Educ3(2), 122-135.
  • Traub-Daragat J L et al(2001)Estimate fo the national incidence of and operation-level risk factors for colic among horses in the United States, spring 1999. JAVMA219(1), 67.
  • Proudman C J (1999)The role of parasites in equine colic. Equine Vet Educ11(4), 219-224.
  • Mee A M et al(1998)A retrospective study of mortality associated with general anesthesia in horses - emergency procedures. Vet Rec142, 307-309PubMed.
  • Hughes F E et al(1998)A modified technique for extensive large colon resection and anastomosis in horses. Vet Surg27, 127-131PubMed.
  • Tinker M K et al(1997)Prospective study of equine colic risk factors. Equine Vet J29, 445-448PubMed.
  • Tinker M K et al(1997)Prospective study of equine colic incidence and mortality. Equine Vet J29, 448-453PubMed.
  • Hillyer M H et al(1997)Recurrent colic in the mature horse - a retrospective review of 58 cases. Equine Vet J29, 415-420PubMed.
  • Mair T S et al(1997)Chronic colic in the mature horse - a retrospective review of 106 cases. Equine Vet J29, 415-420PubMed.
  • Blikslager A T et al(1997)How important is intestinal reperfusion injury in horses? JAVMA211, 1387-1389PubMed.
  • Dart A J et al(1997)Cecal disease in equids. Aust Vet J75, 552-557PubMed.

Other sources of information

  • Manley W et al (2004)Nitric Oxide and Cytokine Levels may have a Prognostic Value in Equine Colic.In: Proc 43rd BEVA Congress. Equine Vet J Ltd, Newmarket. pp 194.
  • Picavet M T (2004)A Retrospective Clinical Survey on the Outcome of 442 Colic Surgeries in Two Belgian Equine Referral Practices.In: Proc 43rd BEVA Congress. Equine Vet J Ltd, Newmarket. pp 193.
  • Maranon G et al(2004)Evidence of Production of Nitric Oxide and Carbon Monoxide in Horses with Colic.In: Proc 43rd BEVA Congress. Equine Vet J Ltd, Newmarket. pp 191.
  • Maranon G et al(2004)Arachidonic Acid Metabolites could be Implicated in Equine Colic.In: Proc 43rd BEVA Congress. Equine Vet J Ltd, Newmarket. pp 191.
  • Verdegaal E J M M & van der Kolk J H (2004)Salivery Cortisol Concentrations in Healthy, Aged Horses, Horses with Hirsuitism and Horses with Colic.In: Proc 43rd BEVA Congress. Equine Vet J Ltd, Newmarket. pp 103-104.
  • Proudman C (2004)Post-Operative Care of the Colic Patient.In: Proc 43rd BEVA Congress. Equine Vet J Ltd, Newmarket. pp 70.
  • Mair T S (2004)BEVA Evidence-Based Medicine Colic Surgery.In: Proc 43rd BEVA Congress. Equine Vet J Ltd, Newmarket. pp 58-59.
  • Blikslager A T (2004)Can the Prognosis for Colic Cases be Predicted from Post Operative Data?In: Proc 43rd BEVA Congress. Equine Vet J Ltd, Newmarket. pp 56.
  • Proudman C (2004)Long-Term Post Operative Survival of Colic Cases.In: Proc 43rd BEVA Congress. Equine Vet J Ltd, Newmarket. pp 54.
  • Blikslager A T (2004)Colic in the Geriatric Horse.In: Proc 43rd BEVA Congress. Equine Vet J Ltd, Newmarket. pp 52.
  • Zimmel D N (2003)How to Manage Pain and Dehydration in Horses with Colic.In: Proc 49th AAEP Convention.pp 127-131.


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