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{{horse}}

{{horse}}

'''Colic in [[horse]]s''' is defined as [[abdominal pain]], and can be caused by a wide variety of conditions.  Many of these conditions are life threatening, and therefore it is essential to diagnose and treat cases of colic as quickly as possible. The most common causes of colic are [[Gastrointestinal tract|gastrointestinal]] conditions, although it can also be caused by other abdominal conditions.  In the latter case, it is often called false colic.  Treatment of colic is largely dependent upon identifying the underlying reason for the pain, and treating this cause appropriately.  Most commonly this is done [[medicine|medically]]{{cn}}, but in a small percentage of cases, [[surgery|surgical intervention]] is needed.{{cn}} Among [[domesticated]] horses, colic is a major cause of premature death.{{cn}} The incidence of colic in the general horse population has been estimated between 10 and 20 percent on an annual basis{{cn}}. It is important that any person who owns or works with horses be able to recognize the signs of colic, so that a [[veterinarian]] may be called promptly.

'''Colic in [[horse]]s''' is defined as [[abdominal pain]], and can be caused by a wide variety of conditions.  Many of these conditions are life threatening, and therefore it is essential to diagnose and treat cases of colic as quickly as possible. The most common causes of colic are [[Gastrointestinal tract|gastrointestinal]] conditions, although it can also be caused by other abdominal conditions.  In the latter case, it is often called false colic.  Treatment of colic is largely dependent upon identifying the underlying reason for the pain, and treating this cause appropriately.  Most commonly this is done [[medicine|medically]], but in a small percentage of cases, [[surgery|surgical intervention]] is needed.  Among [[domesticated]] horses, colic is a major cause of premature death. The incidence of colic in the general horse population has been estimated between 10 and 20 percent on an annual basis. It is important that any person who owns or works with horses be able to recognize the signs of colic, so that a [[veterinarian]] may be called promptly.

==Pathophysiology==

==Pathophysiology==

====Stomach====

====Stomach====

=====Food engorgement=====

=====Food engorgement=====

This is a life threatening condition, with a great risk of gastric rupture, and also of secondary [[laminitis]].  It is caused by excess food intake, for example, a horse that has broken into a food store.{{cn}}

This is a life threatening condition, with a great risk of gastric rupture, and also of secondary [[laminitis]].  It is caused by excess food intake, for example, a horse that has broken into a food store.

=====Gastric/pyloric spasm=====

=====Gastric/pyloric spasm=====

This commonly affects racehorses, immediately after racing, and is known colloquially as 'racehorse colic'.  Typically, the animal will have had access to cold water, but this is not always the case.  Although the signs of colic seen may be very violent, this condition is not associated with any risk of gastric rupture.  [[Spasmolytic]] drugs are ineffective in treatment, however, naso-gastric intubation is immediately curative.{{cn}}

This commonly affects racehorses, immediately after racing, and is known colloquially as 'racehorse colic'.  Typically, the animal will have had access to cold water, but this is not always the case.  Although the signs of colic seen may be very violent, this condition is not associated with any risk of gastric rupture.  [[Spasmolytic]] drugs are ineffective in treatment, however, naso-gastric intubation is immediately curative.

=====Inappropriate feed/poor [[mastication]]=====

=====Inappropriate feed/poor [[mastication]]=====

Either of these may lead to a condition where the stomach is unable to efficiently empty.  A common example is feeding of unsoaked [[sugar beet]], which then expands within the stomach.{{cn}}

Either of these may lead to a condition where the stomach is unable to efficiently empty.  A common example is feeding of unsoaked [[sugar beet]], which then expands within the stomach.

=====Neurological [[atony]]=====

=====Neurological [[atony]]=====

A [[chronic]] motility dysfunction, leading to a slow filling of the stomach with [[ingesta]].  Inhibition of gastric outflow is not normally a feature, and therefore gastric rupture is not a risk.  A mild colic may be seen, but far more common is poor condition and reduced performance.  [[Warmblood]] horses are more commonly affected than other breeds{{cn}}, leading to the suggestion that there may be a genetic component to the disorder. {{cn}}

A [[chronic]] motility dysfunction, leading to a slow filling of the stomach with [[ingesta]].  Inhibition of gastric outflow is not normally a feature, and therefore gastric rupture is not a risk.  A mild colic may be seen, but far more common is poor condition and reduced performance.  [[Warmblood]] horses are more commonly affected than other breeds, leading to the suggestion that there may be a genetic component to the disorder.  

=====[[Ulceration]]=====

=====[[Ulceration]]=====

[[Image:Benign_gastric_ulcer_1.jpg‎|thumb|right|A benign gastric ulcer]]

[[Image:Benign_gastric_ulcer_1.jpg?|thumb|right|A benign gastric ulcer]]

Equine Gastric Ulcer Syndrome (EGUS) is a common cause of mild to moderate colic, and is more prevalent than had been appreciated.  In racehorses, the prevalence is as high as 90%.  In other performance horses, prevalence ranges from 40-60%.  In foals, prevalence is approximately 25%, and probably higher in those being hospitalized for other reasons.{{cn}}<!-- Murray's work would be a good source...don't have it here right now -->  

Equine Gastric Ulcer Syndrome (EGUS) is a common cause of mild to moderate colic, and is more prevalent than had been appreciated.  In racehorses, the prevalence is as high as 90%.  In other performance horses, prevalence ranges from 40-60%.  In foals, prevalence is approximately 25%, and probably higher in those being hospitalized for other reasons.<!-- Murray's work would be a good source...don't have it here right now -->  

In adult horses, ulceration commonly occurs in the non-glandular portion of the stomach, unlike in humans, where [[peptic ulcers]] are far more common.  While the bacterium ''Helicobacter pylori'' is a common cause of ulcers in humans, equine gastric ulcers are not typically infectious in origin.  It is thought that EGUS is often stress-related, such as after travelling or confinement, and gastric ulceration is a known potential side-effect of treatment with [[non-steroidal anti-inflammatory drugs|non-steroidal anti-inflammatory drugs]].  A diet consisting of a high proportion of concentrates is also considered a risk factor.  In affected horses, pain is often associated with eating, and the horse typically takes one or two bites of food, then no more.  A definitive diagnosis requires [[endoscopy]].  Treatment is usually effected using [[H2 antagonist|H₂ receptor antagonists]], such as [[Cimetidine]], or [[proton pump inhibitors]], such as [[Omeprazole]].{{cn}}

In adult horses, ulceration commonly occurs in the non-glandular portion of the stomach, unlike in humans, where [[peptic ulcers]] are far more common.  While the bacterium ''Helicobacter pylori'' is a common cause of ulcers in humans, equine gastric ulcers are not typically infectious in origin.  It is thought that EGUS is often stress-related, such as after travelling or confinement, and gastric ulceration is a known potential side-effect of treatment with [[non-steroidal anti-inflammatory drugs|non-steroidal anti-inflammatory drugs]].  A diet consisting of a high proportion of concentrates is also considered a risk factor.  In affected horses, pain is often associated with eating, and the horse typically takes one or two bites of food, then no more.  A definitive diagnosis requires [[endoscopy]].  Treatment is usually effected using [[H2 antagonist|H₂ receptor antagonists]], such as [[Cimetidine]], or [[proton pump inhibitors]], such as [[Omeprazole]].

=====[[Neoplasia]]=====

=====[[Neoplasia]]=====

===Incidence===

===Incidence===

Colic occurs relatively frequently in horses, with an incidence estimated at 0.1-0.2 episodes per horse-year.{{cn}} In context, this would mean an average holding of 100 horses could reasonably expect to see 10-20 cases every year.

Colic occurs relatively frequently in horses, with an incidence estimated at 0.1-0.2 episodes per horse-year.  In context, this would mean an average holding of 100 horses could reasonably expect to see 10-20 cases every year.

===Classification===

===Classification===

Approximately 90% of colic episodes can be succesfully managed using medical treatments, with the remainder requiring surgery.{{cn}} Assuming surgical and medical cases of colic are accurately distinguished, survival rates of 95% and 80% are considered normal for medical and surgical colic, respectively.{{cn}}

Approximately 90% of colic episodes can be succesfully managed using medical treatments, with the remainder requiring surgery.  Assuming surgical and medical cases of colic are accurately distinguished, survival rates of 95% and 80% are considered normal for medical and surgical colic, respectively.

===Post-operative Survival===

===Post-operative Survival===

Studies have shown that there is an increased risk of death with certain factors{{cn}}:

Studies have shown that there is an increased risk of death with certain factors:

*Abnormal [[hematocrit|Packed Cell Volume]] (PCV) on presentation

*Abnormal [[hematocrit|Packed Cell Volume]] (PCV) on presentation

*Increased length of intestine resected

*Increased length of intestine resected