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Colic should always be viewed as an emergency as almost every colic case starts with a medical aspect. Over 90% of colics are medical and of these, the majority are associated with spasmodic intestinal colic. It can be difficult for veterianarians to distinguish between medical colic and an early surgical colic because the clinical signs are often very similar.  It is often a lack of response to medical therapy that makes the decision. If referral is necessary then it should be done as soon as possible as a slow approach by the veterinarian will result in time delay and incorrect therapy and a poor outcome.
 
Colic should always be viewed as an emergency as almost every colic case starts with a medical aspect. Over 90% of colics are medical and of these, the majority are associated with spasmodic intestinal colic. It can be difficult for veterianarians to distinguish between medical colic and an early surgical colic because the clinical signs are often very similar.  It is often a lack of response to medical therapy that makes the decision. If referral is necessary then it should be done as soon as possible as a slow approach by the veterinarian will result in time delay and incorrect therapy and a poor outcome.
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===Antiendotoxin Therapy===
 
===Antiendotoxin Therapy===
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Polymyxin B
    
===Treatment for Ischaemia-Reperfusion Injury===
 
===Treatment for Ischaemia-Reperfusion Injury===
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===Surgical Intervention===
 
===Surgical Intervention===
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The decision to treat the patient surgically or medically depends on a number of [[Colic, Decision Making|criteria]]. Most colic cases seen in first opinion practice are mild and respond well to medical management. A small proportion of cases will require surgery and a lack of response to medical therapy is often the deciding factor. Candidates who are dificult to categorise should be referred early as procrastination and time delay during transportation could worsen the prognosis of the patient. A ventral midline celiotomy is the surgical approach for most cases but specific treatments for specific disorders also apply.
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Large colon impactions can be difficult to manage.Most cases will respond to aggressive medical treatment with analgesics, laxatives, oral and intravenous fluid therapy. Some may not respond to medical therapy and are secondary to another lesion, such as a concurrent large colon displacement or impaction of the right dorsal colon, which may only be resolved with surgery.
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[[Category:To Do - Major]][[Category:To Do - Alimentary]]
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[[Category:Medical_Colic_in_the_Horse]]
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