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The response to mild analgesia is ofteen used to determine the level of pain and decide whether the case is medical or surgical. Mild analgesics include phenylbutazone or hyoscine-n-butyl bromide (Buscopan). Cases that do not respond within 2 hours require reassessment and potentially referral. Stong analgesics such as flunixin should not be used until the diagnosis has been made as many early surgical cases can be misdiagnosed as medical colics.  
 
The response to mild analgesia is ofteen used to determine the level of pain and decide whether the case is medical or surgical. Mild analgesics include phenylbutazone or hyoscine-n-butyl bromide (Buscopan). Cases that do not respond within 2 hours require reassessment and potentially referral. Stong analgesics such as flunixin should not be used until the diagnosis has been made as many early surgical cases can be misdiagnosed as medical colics.  
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===Diet===
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Treatment for the colicking horse should include all of the following:
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* Pain relief
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* Stabilization of the cardiovascular and metabolic status
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* Minimizing the effects of endotoxaemia
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* Establishing a functional intestine
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Therapies should include the following, where clinically indicated:
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* Analgesia
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* Fluid therapy
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* Cardiovascular support
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* Laxatives and cathartics
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* Antiendotoxin therapy
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* Therapy for ischaemia-reperfusion injury
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* Antimicrobial therapy
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* Nutritional support
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* Surgical intervention
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===Nutrition===
 
Management of medical colic should also inlude diet management. All food including hay and straw bedding should be withheld until the resolution of  the condition. The normal diet can then be re-introduced slowly over 1-2 days beginning with a moist bran and alfalfa pellet mash, then grazing grass, followed by moist hay and finally grain. If the patient does not have continuous gastric reflux then ad lib water and a trace mineral salt lick should be provided. If there is any doubt regarding the diagnosis and exploratory surgery is a possibility then all food should be withheld during transport to the referral facility.
 
Management of medical colic should also inlude diet management. All food including hay and straw bedding should be withheld until the resolution of  the condition. The normal diet can then be re-introduced slowly over 1-2 days beginning with a moist bran and alfalfa pellet mash, then grazing grass, followed by moist hay and finally grain. If the patient does not have continuous gastric reflux then ad lib water and a trace mineral salt lick should be provided. If there is any doubt regarding the diagnosis and exploratory surgery is a possibility then all food should be withheld during transport to the referral facility.
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