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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. It is an obvious pain and the horse will exhibit [[Colic Diagnosis - Clinical Signs|signs of abdominal discomfort]]. The pain is oftern persistent and the horse maybehave violently if the pain is severe. Severe, unrelenting pain despite the administration of analgesia is an indication for surgery. Spasmodic colic that responds to analgesia is most likely to me medical. Parietal pain is associated with inflammation of the serosal surfaces of the organs of the peritoneum and parietal peritoneum. This pain is less obvious and the horse may be immobile guard the abdomen. This type of pain features in cases with a ruptured viscus and secondary peritonitis.
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. It is an obvious pain and the horse will exhibit [[Colic Diagnosis - Clinical Signs|signs of abdominal discomfort]]. The pain is oftern persistent and the horse maybehave violently if the pain is severe. Severe, unrelenting pain despite the administration of analgesia is an indication for surgery. Spasmodic colic that responds to analgesia is most likely to me medical. Parietal pain is associated with inflammation of the serosal surfaces of the organs of the peritoneum and parietal peritoneum. This pain is less obvious and the horse may be immobile guard the abdomen. This type of pain features in cases with a ruptured viscus and secondary peritonitis.
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.
===Diet===
===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.
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.