Colic, Medical Treatment

Colic should always be viewed as an emergency as almost every colic case starts with a medical aspect. Over 90% of colics are medical and of these, the majority are associated with spasmodic intestinal colic. It can be difficult for veterianarians to distinguish between medical colic and an early surgical colic because the clinical signs are often very similar. It is often a lack of response to medical therapy that makes the decision. If referral is necessary then it should be done as soon as possible as a slow approach by the veterinarian will result in time delay and incorrect therapy and a poor outcome.

Medical colic is defined as colic that will respond to drug therapy and management alone. Once treated, cases of medical colic should not have any further complications that could have been avoided hd surgery been undertaken. Medical colic is a common condition in equine practice. It can be potentially life threatening so referral centres still play a role in the mnagement of medical coic. Some cases may also be contagious and/or zoonotic. The differentiation between medical and surgical colics is critical and can be acheived by a thorough clinical examination. There are important considerations to keep in mind when interpreting colic clinical signs. Some horses and especially donkeys and zebras, are very stoical in their nature and show only mild clinical signs, despite having a serious surgical condtion. Some horses have a low pain threshold and so may show severe, unrelenting signs of colic that are features of surgical colic cases. Medical causes of colic are often less painful than surgical causes. However, anterior enteritis can cause extreme pain, but can be managed medically with Metronidazole, penicillin, analgesia and repeated gasric decompression. Few medical cases have a complete abscence of borboygmi. The faecal output can also provide valuable information. Cases with diarhoea are often medical in nature and require medical management. Cases with a reduced faecal output for a couple of days usually have an impaction of the large colon. Very hard, mucous covered faeces indicate a reduced transit time through the small colon. This could be due to Grass Sickness.

Pain management is an important aspect of treating any colic patient, whether it be surgical or medical. There are two major types of pain; visceral pain and parietal pain. Visceral pain is associated with inflammation r distention of a viscus, tension on the mesentery or a reduction in the blood supply.

Diet

Management of medical colic should also inlude diet management. Food is usually withheld until the resolution of the condition and re-introduced slowly over 1-2 days.