Equine G.I ICVA Diseases

Aute Colitis/ Diarrhea cPathogens

1. Salmonella

2. Clostridium

Aute Colitis/ Diarrhea:C.S

1. Profuse, watery diarrhea

   1. foul odor

2. Fever: salmonella endotoxemia

3. Severe dehydration

4. Endotoxemia: Tachycardia, Tachypnea, dark or hyperemic mm+ toxic line (blue/purple gums)

Aute Colitis/ Diarrhea:DX

1. Fecal culture is gold standard but time consuming(salmonella)

2. PCR

3. CBC/CHEM: Leukopenia, Lyte imbalance( lo Cl,K,Na), Azotemia

4. Blood gas analysis: Metabolic Acidosis

   1. Due to severe diarrhea:Bicarb loss+ Deydration

5. U/S

Aute Colitis/ Diarrhea:TX

1. Intensive care + Supportive therapy

2. Fluid therapy: IV Isotonic or if severe, colloids or hypotonic

3. Antiendotoxic therapy: NSAIDs w/ caution, Polymyxin B*

4. Antimicrobial therapy: Clostridium(Metronidazole), Salmonella(dont use ABX unless septic:enrofloxaxin,tms)

5. Gastroprotectants: Bisponge, probiotics

6. Nutritional support: alfalfa pellets, soaked hay (easy digest)

Chronic Diarrhea/Granulomatous Enteritis:C.S

Similar to IBD

Adult horses 1 to 5 years old

1. Chronic diarrhea unresponsive to typical tx

2. Weight loss despite adequate appetite

3. Edema: Due to hypoproteinemia on ventral abdomen+limbs

4. Intermittent colic

5. Dull coat, poor condition

Chronic Diarrhea/Granulomatous Enteritis:D.X

1. CBC/CHEM: Hypoproteinemia + hypoalbuminemia, leukocytosis, hyperfibrinogenemia

2. Fecal test: Fecal egg count, culture, PCR

3. Rectal Biopsy

4. Abdominal Exploratory Laparotomy

5. Serum Amyloid A: Elevated

Chronic Diarrhea/Granulomatous Enteritis:TX

1. Immunosuppressive Therapy: Corticosteroids,

   1. Azathioprine if refractory

2. ±Antimicrobial therapy

3. Dietary management: Low carb, high digestible

   1. Elimination trial

4. Supportive care: Plasma transfusion, hetatach : for protein loaa

Guarded Prognosis

Small intestinal Colic:Causes

1. Mostly due to strangulation

   1. Lipoma (20+ age)

   2. Volvulus

   3. Intussusception (younger horse, parasites)

   4. Hernation

   5. Mesenteric defect (rents)

   6. Anterior/Proximal enteritis

Small intestinal Colic:C.S

1. Severe pain

2. Increased gastric reflux

3. Tachycardia

4. Serosanguinous abdominal fluid

5. Systemic shock

Picture:Strangulated SI due to pedunculated lipoma

Small intestinal Colic: D.X

1. Transabdominal U/S: dilated/non-motile loops of SI

2. Abdominocentesis: Serosanguinous with ^ Protein+WBC

Small intestinal Colic:TX

Surgical

1. Devitalized loops: Resect + Anastomosis (Picture)

2. Vitalized(rare): reduction

Guarded Prognosis

Large Intestinal Volvulus/Torsion:C.S

Severe form of colic for a horse at any age

Older broodmares before parturition or up to 4 months post are @ risk

1. Severe Pain

2. No gastric reflux

3. Tachycardia, systemic shock

4. palpable diffuse gas distension in L.I

Large Intestinal Volvulus/Torsion:DX

1. Rectal exam

2. C.S

Large Intestinal Volvulus/Torsion:T.X

1. Surgical correction: nearly impossible to resect LI

   1. If volvulus, risk of endotoxic shock once corrected

Colonic Impaction:

Colonic Tympany (Gas Colic)

Colon Displacement:

Enteroliths/Sand Colic

Gastric Ulcers

Parasite-Associated Colic

What other diseases can mimic colic

Acute colitis

Urolithiasis

Uterine Torsion