Author, Donkey, Bureaucrats, Administrators
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==Introduction==
==Introduction==
'''Heart rate'''
'''Heart rate'''
The normal heart rate for an adult donkey is considered to be 44 beats per minute on average. The heart rate and character of the pulse are important criteria in assessing the colic patient and also the severity of the disease. As in the horse, pain has only a relatively minor effect on the donkey’s heart rate. The rate is influenced much more by haemoconcentration and diminished venous return and by the cardiovascular response to endotoxaemia.
The normal heart rate for an adult donkey is considered to be 41 beats per minute on average. The heart rate and character of the pulse are important criteria in assessing the colic patient and also the severity of the disease. As in the horse, pain has only a relatively minor effect on the donkey’s heart rate. The rate is influenced much more by haemoconcentration and diminished venous return and by the cardiovascular response to endotoxaemia.
In the horse the elevation in pulse rate can be different, depending on the cause of the colic. Impactive colic may only cause mild elevations in pulse rate. Donkeys with impactive colic are more likely to have heart rates of 60 beats per minute or less, compared to donkeys with colic from other causes, which are more likely to have pulse rates of 60-100 beats per minute (H. Duffield's unpublished data). This may be because the impactions have little effect on circulating blood volume. It should also be considered that donkeys may cope better with dehydration and hypovolaemia due to their adaptations to arid environments.
In the horse the elevation in pulse rate can be different, depending on the cause of the colic. Impactive colic may only cause mild elevations in pulse rate. Donkeys with impactive colic are more likely to have heart rates of 60 beats per minute or less, compared to donkeys with colic from other causes, which are more likely to have pulse rates of 60-100 beats per minute (H. Duffield's unpublished data). This may be because the impactions have little effect on circulating blood volume. It should also be considered that donkeys may cope better with dehydration and hypovolaemia due to their adaptations to arid environments.
'''Respiratory rate'''
'''Respiratory rate'''
The normal respiratory rate for the donkey is similar to that of the horse, 16-20 breaths per minute. Severe abdominal pain may increase the respiratory rate in an apparent attempt to reduce the movement of the diaphragm and chest. Pressure on the diaphragm from a grossly distended colon will also elevate the respiratory rate. An elevation in respiratory rate, accompanied by cyanosis, should be considered as evidence of very serious disease.
The normal respiratory rate for the donkey is similar to that of the horse, 13-31 breaths per minute. Severe abdominal pain may increase the respiratory rate in an apparent attempt to reduce the movement of the diaphragm and chest. Pressure on the diaphragm from a grossly distended colon will also elevate the respiratory rate. An elevation in respiratory rate, accompanied by cyanosis, should be considered as evidence of very serious disease.
A donkey suffering from other respiratory diseases such as pleuropneumonia and pneumothorax may also present with signs of
A donkey suffering from other respiratory diseases such as pleuropneumonia and pneumothorax may also present with signs of
[[Image:Mucous membrane examination.jpg|right|thumb|150px|<small><center>Mucous membrane examination (Image courtesy of [http://drupal.thedonkeysanctuary.org.uk The Donkey Sanctuary])</center></small>]]
[[Image:Mucous membrane examination.jpg|right|thumb|150px|<small><center>Mucous membrane examination (Image courtesy of [http://drupal.thedonkeysanctuary.org.uk The Donkey Sanctuary])</center></small>]]
A rectal temperature should be taken routinely before the examination is performed. The normal rectal temperature of the adult donkey has been found to be slightly lower than the temperature of the adult horse with the average being 37.1°C (range 36.2-37.8°C). Elevations may occur due to physical exertion or response to infections ''e.g.'' Salmonellosis.
A rectal temperature should be taken routinely before the examination is performed. The normal rectal temperature of the adult donkey has been found to be slightly lower than the temperature of the adult horse with the average being 37.1°C (range 36.5-37.7°C). Elevations may occur due to physical exertion or response to infections ''e.g.'' Salmonellosis.
'''Mucous membrane colour and capillary refill time'''
'''Mucous membrane colour and capillary refill time'''
The faecal output and character of the faeces should be assessed. Donkeys with large intestinal impactions may have little or no faecal output. Hyperlipaemic donkeys frequently have dry, mucus covered faecal balls and the dry rectal mucosa is more prone to tearing. Coprological examinations can be carried out as a possible indicator of problems. Faecal samples may also be cultured for organisms such as ''Salmonella''.
The faecal output and character of the faeces should be assessed. Donkeys with large intestinal impactions may have little or no faecal output. Hyperlipaemic donkeys frequently have dry, mucus covered faecal balls and the dry rectal mucosa is more prone to tearing. Coprological examinations can be carried out as a possible indicator of problems. Faecal samples may also be cultured for organisms such as ''Salmonella''.
Displacement or distension of the intestines should be assessed. The practitioner should try to decide if the distension is due to ingesta, fluid or gas. Even if it is not possible to palpate the abdomen thoroughly, abnormal structures may be palpable at the pelvic inlet. 53% of all impactions have been found to be pelvic flucture (Cox ''et al'', 2007).
Displacement or distension of the intestines should be assessed. The practitioner should try to decide if the distension is due to ingesta, fluid or gas. Even if it is not possible to palpate the abdomen thoroughly, abnormal structures may be palpable at the pelvic inlet. 53% of all impactions have been found to be at the pelvic flexure (Cox ''et al'', 2007).
<u>Normal structures</u> which may be palpable include the following, although this is not always the case:
<u>Normal structures</u> which may be palpable include the following, although this is not always the case:
A normal range for biochemical and haematological parameters for the healthy donkey has been established by The Donkey Sanctuary. Complete blood count and biochemical analysis may allow the following abnormalities to be diagnosed:
A normal range for biochemical and haematological parameters for the healthy donkey has been established by The Donkey Sanctuary. Complete blood count and biochemical analysis may allow the following abnormalities to be diagnosed:
* [[Hyperlipaemia - Donkey|Hyperlipaemia]]
** Triglyceride assay may not be included in a routine screen and may need to be specifically requested
** Triglyceride assay may not be included in a routine screen and may need to be specifically requested
** If biochemical analysis is not available immediately then a visual assessment of the triglyceride level can be made. A blood sample should be taken in a tube without anticoagulant. When the clot retracts the serum will appear cloudy if the donkey is severely hyperlipaemic
** If biochemical analysis is not available immediately then a visual assessment of the triglyceride level can be made. A blood sample should be taken in a tube without anticoagulant. When the clot retracts the serum will appear cloudy if the donkey is severely hyperlipaemic
* Hepatopathy
* Nephropathy
* [[Pancreatitis - Donkey|Pancreatitis]]
* Anaemia
* Immune responses to infection
* Myopathy
* Hyopalbuminaemia
Conditions affecting the liver, kidneys and pancreas may be causing the abdominal pain, ''i.e.'' ‘false colic’. If these occur concurrently with a gastrointestinal crisis then the blood results may influence the prognosis. In horses with colic, packed cell volume (PCV) and total plasma protein are used to assess hydration of the patient. The reliability of these parameters for
Conditions affecting the liver, kidneys and pancreas may be causing the abdominal pain, ''i.e.'' ‘false colic’. If these occur concurrently with a gastrointestinal crisis then the blood results may influence the prognosis. In horses with colic, packed cell volume (PCV) and total plasma protein are used to assess hydration of the patient. The reliability of these parameters for
assessing dehydration in the donkey has not yet been evaluated. It should be noted that protein may also be lost into the abdomen if peritonitis is present and the presence of hypoproteinaemia is not uncommon in the geriatric donkey. Ideally acid base balance should also be monitored in the colic patient to allow the correct choice of fluid replacement.
assessing dehydration in the donkey has not yet been evaluated. It should be noted that protein may also be lost into the abdomen if peritonitis is present and the presence of hypoproteinaemia is not uncommon in the [[Geriatric Donkey|geriatric donkey]]. Ideally acid base balance should also be monitored in the colic patient to allow the correct choice of fluid replacement.
==Decision-making==
==Decision-making==
When considering surgery in the geriatric donkey in the early stages of an abdominal crisis, additional factors have to be considered
When considering surgery in the geriatric donkey in the early stages of an abdominal crisis, additional factors have to be considered
before severe circulatory compromise has occurred. If there is severe dental disease present this may have been a contributing factor to the development of the impaction and may impair recovery post surgery, due the decreased ability to masticate long fibres. Dental disease may also increase the likelihood of the recurrence of any impaction. Concurrent conditions, such as liver disease, renal disease, pancreatitis, anaemia, immune responses to infection, or hypoalbuminaemia, will all heavily influence the decision to go to surgery. The presence of chronic [[Musculoskeletal Disorders - Donkey|musculo-skeletal conditions]] such as [[Laminitis - Donkey|laminitis]] and arthritis should also be considered, as medical or surgical treatment of the colic may exacerbate such conditions.
before severe circulatory compromise has occurred. If there is severe dental disease present this may have been a contributing factor to the development of the impaction and may impair recovery post surgery, due to the decreased ability to masticate long fibres. Dental disease may also increase the likelihood of the recurrence of any impaction. Concurrent conditions, such as liver disease, renal disease, pancreatitis, anaemia, immune responses to infection, or hypoalbuminaemia, will all heavily influence the decision to go to surgery. The presence of chronic [[Musculoskeletal Disorders - Donkey|musculo-skeletal conditions]] such as [[Laminitis - Donkey|laminitis]] and arthritis should also be considered, as medical or surgical treatment of the colic may exacerbate such conditions.
==Treatment==
==Treatment==
'''Pain relief'''
'''Pain relief'''
Relief of gastric distension using nasogastric intubation will help to relieve pain. '''NSAIDs''' (non-steroidal anti-inflammatory drugs), especially flunixin meglumine, are commonly used to control the pain associated with colic. The potential for gastric mucosal problems and renal toxicity should also be considered when administering NSAIDs. Spasmolytics may also relieve the signs of colic.
Relief of gastric distension using nasogastric intubation will help to relieve pain. '''[[NSAIDs]]''' (non-steroidal anti-inflammatory drugs), especially flunixin meglumine, are commonly used to control the pain associated with colic. The potential for gastric mucosal problems and renal toxicity should also be considered when administering NSAIDs. Spasmolytics may also relieve the signs of colic.
'''Correcting dehydration'''
'''Correcting dehydration'''
Rapid infusion of a '''balanced electrolyte solution''' via an intravenous catheter will restore circulating blood volume and improve tissue perfusion. It will also help to correct shock caused by the absorption of endotoxin through a compromised intestinal wall. Intravenous infusion of fluids is useful when rehydration via the oral route is inappropriate, ''i.e.'' when there is gastric reflux, ileus or an intestinal obstruction. If perfusion is very poor, '''hypertonic saline''' may help in the short term but must be
Rapid infusion of a '''balanced electrolyte solution''' via an intravenous catheter will restore circulating blood volume and improve tissue perfusion. It will also help to correct shock caused by the absorption of endotoxins through a compromised intestinal wall. Intravenous infusion of fluids is useful when rehydration via the oral route is inappropriate, ''i.e.'' when there is gastric reflux, ileus or an intestinal obstruction. If perfusion is very poor, '''hypertonic saline''' may help in the short term but must be
followed up quickly by large volumes of isotonic fluids.
followed up quickly by large volumes of isotonic fluids.
'''Feeding'''
'''Feeding'''
When a lesion requiring surgical corrrection has been diagnosed, feeding may be contra-indicated until post surgery. However, a source of nutrition is needed as soon as possible in order to '''maintain a positive energy balance''' and prevent the development of hyperlipaemia. Rectal findings should be monitored, and in horses with caecal or colon impactions it is believed that feed should only be given once the impaction is no longer palpable. However, H. Duffield's experience, if the impacted donkey wants to eat and there are normal borborygmi present and a good faecal output, then small amounts of high calorie feed with a high water content may be useful to prevent hyperlipaemia. Mineral oil or glucose powder may also be added to the feeds to avoid using a nasogastric tube.
When a lesion requiring surgical corrrection has been diagnosed, feeding may be contra-indicated until post surgery. However, a source of nutrition is needed as soon as possible in order to '''maintain a positive energy balance''' and prevent the development of hyperlipaemia. Rectal findings should be monitored, and in horses with caecal or colon impactions it is believed that feed should only be given once the impaction is no longer palpable. However, in H. Duffield's experience, if the impacted donkey wants to eat and there are normal borborygmi present and a good faecal output, then small amounts of high calorie feed with a high water content may be useful to prevent hyperlipaemia. Mineral oil or glucose powder may also be added to the feeds to avoid using a nasogastric tube.
Blood parameters need to be monitored closely, especially glucose levels which need checking every four hours.
Turning an impacted donkey out into the field to eat fresh grass and move around may also encourage the passage of ingesta. Long fibres such as hay and straw should be restricted until the normal transit of ingesta has been completely re-established and should be reintroduced gradually.
Turning an impacted donkey out into the field to eat fresh grass and move around may also encourage the passage of ingesta. Long fibres such as hay and straw should be restricted until the normal transit of ingesta has been completely re-established and should be reintroduced gradually.
If oral nutrition is not possible due to ileus, then '''partial or total parenteral nutrition''' can be used to supply energy. [http://drupal.thedonkeysanctuary.org.uk/ The Donkey Sanctuary] has little experience with this kind of therapy. Hospitalisation is required for this treatment and in certain cases the movement of an anorexic, geriatric donkey to a hospital may not be indicated.
If oral nutrition is not possible due to ileus, then '''partial or total parenteral nutrition''' can be used to supply energy. [http://drupal.thedonkeysanctuary.org.uk/ The Donkey Sanctuary] has little experience with this kind of therapy. Hospitalisation is required for this treatment and in certain cases the movement of an anorexic, geriatric donkey to a hospital may not be indicated.
==[[Nursing Care - Donkey|Nursing Care]]==
Provide the donkey with a deep bed, as it may go down and start rolling if its condition deteriorates. Companions should be separated, but kept in sight. The patient can then be left on intravenous fluids, with '''faecal output and food intake monitored'''. It may be necessary to withhold food.
[[Impaction Colic - Donkey|Colonic impaction]] is a common cause of colic in donkeys associated with [[Dental Problems - Donkey|dental problems]], diet changes and [[Hyperlipaemia - Donkey|hyperlipaemia]].
==[[Impaction Colic - Donkey|'''Impactive conditions''']]==
==Prevention of impactive conditions==
==[[Gastric Ulceration - Donkey|'''Gastric ulceration''']]==
==[[Pancreatitis - Donkey|'''Pancreatitis''']]==
==Literature Search==
[[File:CABI logo.jpg|left|90px]]
Use these links to find recent scientific publications via CAB Abstracts (log in required unless accessing from a subscribing organisation).
<br><br><br>
[http://www.cabdirect.org/search.html?rowId=1&options1=AND&q1=colic&occuring1=title&rowId=2&options2=AND&q2=donkeys&occuring2=od&rowId=3&options3=AND&q3=&occuring3=freetext&x=48&y=13&publishedstart=yyyy&publishedend=yyyy&calendarInput=yyyy-mm-dd&la=any&it=any&show=all Colic in donkeys publications]
==References==
* Duffield, H. (2008) Colic In Svendsen, E.D., Duncan, J. and Hadrill, D. (2008) ''The Professional Handbook of the Donkey'', 4th edition, Whittet Books, Chapter 3
* Dabinett, S. (2008) Nursing care In Svendsen, E.D., Duncan, J. and Hadrill, D. (2008) ''The Professional Handbook of the Donkey'', 4th edition, Whittet Books, Chapter 18
* Cox, R., Proudman, C., Burden, F., Trawford, A., Gosden, L., and Pinchbeck, G. (2007). ‘A case control study to investigate risk factors for impaction colic in UK donkeys’. ''Proceedings of British Equine Veterinary Association Congress 2007''.
* Cox, R., Proudman, C., Burden, F., Trawford, A., Gosden, L., and Pinchbeck, G. (2007). ‘A case control study to investigate risk factors for impaction colic in UK donkeys’. ''Proceedings of British Equine Veterinary Association Congress 2007''.
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|linkpage =Alimentary Disorders - Donkey
|linktext =Alimentary Disorders - Donkey
|linktext =Alimentary Disorders - Donkey
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|Maintitle = [[Sponsors#The Donkey Sanctuary|This section was sponsored and content provided by '''THE DONKEY SANCTUARY''']]
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[[Category:Donkey]]
[[Category:Alimentary Disorders - Donkey]]
[[Category:Nursing_Care_-_Donkey]]