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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 Oral Paste for Horses® which also contains praziquantel) 0.2mg/kg ivermectin and 1.5mg/kg praziquantel.  Treatment is recommended at least twice a year, in spring and autumn or according to veterinary advice.  Not for foals under 2 weeks of age.  Withdrawal period 35 days.(NB: NOT the drug of choice because resistance is widespread)
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Eqvalan® Paste for Horse: 0.2mg/kg POFoals should be treated initially at 6 to 8 weeks of age, and routine treatment repeated as appropriate.  Meat withdrawal 21 days.
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**Tetrahydropyrimidines (Pyrantel embonate in Strongid-P® paste) 19mg/kg PO: for foals over 4 weeks of age up to eight months - dose every four weeks.  For horses over eight months of age routinely dose every 6 to 8 weeks, but during the summer and
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autumn when at grass dose every 4 to 6 weeks.  Always dose three to four days before turning out after
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in-wintering.
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**Benzimidazoles (Fenbendazole in Panacur® Equine Oral Paste) 10mg/kg PO
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It is recommended that horses and ponies are routinely wormed with a single dose of this product every 6 to 8 weeks. In Late Winter or Spring, mass emergence of encysted mucosal small redworm from the horse’s gut can cause parasitic diarrhoea, mild recurring colic, weight and appetite loss and weakness.To avoid this, it is recommended that horses are administered the 5-day Panacur treatment in the Autumn (ideally late October/November) and again in the Spring (ideally in February). All new horses whose worming history is unknown should also be administered the 5-day Panacur treatment.Pregnant mares and young foals may also be safely treated with Panacur at the recommended dosage levels.Not to be used in horses intended for human consumption.Treated horses may never be slaughtered for human consumption.The horse must have been declared as not intended for human consumption under national horse passport legislation.
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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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Care should be taken to avoid the following practices because they increase the risk of development of resistance and could ultimately result in ineffective therapy:(1) Too frequent and repeated use of anthelmintics from the same class, over an extended period of time.(2) Underdosing, which may be due to underestimation of bodyweight, misadministration of the product, or lack of calibration of the dosing device (if any).Suspected clinical cases of resistance to anthelmintics should be further investigated using appropriate tests (e.g. Faecal Egg Count Reduction Test). Where the results of the test(s) strongly suggest resistance to a  particular anthelmintics belonging to another pharmacological class and having a different mode of action should be used.
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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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NOAH Compendium of Data Sheets for Animal Medicines.  At http://www.noahcompendium.co.uk.
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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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