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#REDIRECT[[Ascarid Impaction - Horse]]
 
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{| cellpadding="10" cellspacing="0" border="1"
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| Also known as:
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|'''Colic in foals<br>
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'''Impaction<br>
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'''Simple Obstruction<br>
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'''Small Intestinal Simple Obstruction<br>
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'''Small Intestinal Obstruction<br>
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'''Small Intestinal Impaction'''
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|}
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==Signalment==
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Foals younger than 6 months in poor condition, on a poor worming schedule and with a heavy parasite burden.<ref name="Bliks">Blikslager, A.T (2010) ''Obstructive Disorders of the Gastrointestinal Tract'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Chapter 15, ''Saunders''.</ref>  Adult horses demonstrate age-related immunity which starts to develop from around 6 months and is substantial by about 15 months depending on worm exposure.
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==History==
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Recent history (within the previous 24 hours) of being wormed with a product effective against ascarids.
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==Aetiology==
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Products that cause sudden death<ref name="Bliks">Blikslager, A.T (2010) ''Obstructive Disorders of the Gastrointestinal Tract'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Chapter 15, ''Saunders''.</ref> or paralysis<ref name="Merck">Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''', ''Merial''.</ref> of ascarids, particularly [[Parascaris equorum|''Parascaris equorum'']] within the small intestine.  Adult ascarids are large and thus readily cause small intestinal impaction.<ref name="Bliks">Blikslager, A.T (2010) ''Obstructive Disorders of the Gastrointestinal Tract'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Chapter 15, ''Saunders''.</ref>  It has been suggested that disruption of the surface of the ascarid releases antigenic fluids that inhibit intestinal muscular activity, thereby increasing the likelihood of intestinal obstruction.<ref name="Merck">Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''', ''Merial''.</ref>  Anthelmintics that are suspected to induce episodes of ascarid impaction include<ref name="Cribb">Cribb, N.C, Cote, N.M, Boure, L.P, Peregrine, A.S (2006) Acute small intestinal obstruction associated with ''Parascaris equorum'' infection in young horses: 25 cases (9185-2004).  ''N Z Vet J'', 54:338-343.  In: Blikslager, A.T (2010) ''Obstructive Disorders of the Gastrointestinal Tract'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Chapter 15, ''Saunders''.</ref>:
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*Organophosphates
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*[[Macrocyclic Lactones|Ivermectin]]
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*Pyrantel pamoate
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*Piperazine
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==Clinical Signs==
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*Acute onset mild to severe colic after administration of anthelmintic (onset varies with degree of obstruction<ref name="Cribb">Cribb, N.C, Cote, N.M, Boure, L.P, Peregrine, A.S (2006) Acute small intestinal obstruction associated with ''Parascaris equorum'' infection in young horses: 25 cases (9185-2004).  ''N Z Vet J'', 54:338-343.  In: Blikslager, A.T (2010) ''Obstructive Disorders of the Gastrointestinal Tract'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Chapter 15, ''Saunders''.</ref>)
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*Signs compatible with [[Colic Diagnosis - Clinical Signs|small intestinal obtruction]]<ref name="Bliks">Blikslager, A.T (2010) ''Obstructive Disorders of the Gastrointestinal Tract'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Chapter 15, ''Saunders''.</ref>
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**[[Colic Diagnosis - Naso-gastric Intubation|Nasogastric reflux]] (occasionally dead parasites are seen in reflux)
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*The foal may be in poor body condition with a poor coat, pot-bellied appearance and stunted growth.<ref name="Merck">Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''', ''Merial''.</ref>
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==[[:Category:Colic_Diagnosis_in_the_Horse|Diagnosis]]==
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*History
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*[[Colic Diagnosis - Clinical Signs|Clinical signs]] referable to small intestinal obstruction
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*Abdominal imaging (radiography and [[Colic Diagnosis - Abdominal Ultrasound|ultrasonography]]) may demonstrate multiple loops of distended small intestine, but imaging is not required if the clinical presentation indicates immediate surgery.<ref name="Bliks">Blikslager, A.T (2010) ''Obstructive Disorders of the Gastrointestinal Tract'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Chapter 15, ''Saunders''.</ref>
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==Treatment<ref name="Bliks">Blikslager, A.T (2010) ''Obstructive Disorders of the Gastrointestinal Tract'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Chapter 15, ''Saunders''.</ref>==
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*[[Colic, Medical Treatment|'''Medical treatment:''']] immediate treatment of hypovolaemic shock resulting from sequestration of fluid in small intestine
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*'''Surgical treatment:''' enterotomy made over the intraluminal impaction and removal of ascarids
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==Prognosis==
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Fair in cases that are rapidly treated but poor in foals with evidence of hypovolaemia and septic shock.  Surgical cases also carry a poorer prognosis than cases which are resolved medically.<ref name="Merck">Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''', ''Merial''.</ref>  In a recent study, long term survival of 25 affected horses was 33%.<ref name="Cribb">Cribb, N.C, Cote, N.M, Boure, L.P, Peregrine, A.S (2006) Acute small intestinal obstruction associated with ''Parascaris equorum'' infection in young horses: 25 cases (9185-2004).  ''N Z Vet J'', 54:338-343.  In: Blikslager, A.T (2010) ''Obstructive Disorders of the Gastrointestinal Tract'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), Chapter 15, ''Saunders''.</ref>:  Failure to relieve the impaction may lead to intestinal rupture.<ref name="Merck">Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''', ''Merial''.</ref>
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==Prevention==
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*Regular worming programme until at least 15 months of age that prevents a build-up of large ascarid burdens in the foal:
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**Macrocyclic lactones (Ivermectin in Equimax® or Eqvalan® paste) 0.2mg/kg at 60 day intervals (NB: NOT the drug of choice because resistance is widespread)
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**Tetrahydropyrimidines (Pyrantel embonate in Strongid-P® paste) 6.6mg/kg PO at 56 day intervals
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**Benzimidazoles (Fenbendazole in Panacur®) 10mg/kg PO at 56 day intervals
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*For foals that have not been on a controlled programme or if a large burden is suspected:
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**Fenbendazole at 5mg/kg PO (lower dose with only 50% efficacy against ''Parasacaris'')
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**Followed one week later by a full dose of Fenbendazole at 10mg/kg PO
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*Regular faecal worm egg counts should be conducted to monitor the effects of the anthelmintic schedule and the presence of resistance
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*Clean pasture management including the regular removal of faeces
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*The worming programme for adult horses should reflect the circumstances and efficiency of clean pasture management.  A strategic or targeted startegic dosing plan is recommended.
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*Thorough cleaning of stables that have been occupied by foals or weanlings
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*Bathe mare and clean udder before arrival at foaling premises to remove any ascarid eggs on the coat
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==References==
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Pasquini, C, Pasquini, S, Woods, P (2005) '''Guide to Equine Clinics Volume 1: Equine Medicine''' (Third edition), ''SUDZ Publishing''
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<references/>
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[[Category:Colic_in_Horses]]
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[[Category:To_Do_-_Nina]]
 
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