doi: 10.14202/vetworld.2017.1255-1263
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Article history: Received: 16-05-2017, Accepted: 15-09-2017, Published online: 23-10-2017
Corresponding author: Anderson Gitari
E-mail: surgeons@andysvet.co.ke
Citation: Gitari A, Nguhiu J, Varma V, Mogoa E (2017) Occurrence, treatment protocols, and outcomes of colic in horses within Nairobi County, Kenya, Veterinary World, 10(10): 1255-1263.Aim: The aim of this study was to determine the treatments and their outcomes in horses with colic in Nairobi County, Kenya.
Materials and Methods: This is a retrospective study to determine the occurrence, treatments, pain management, and outcomes of colic in horses in Nairobi County. Association between pain management protocols and the outcomes of colic with regard to recovery or death was also determined. Data collected from four equine practitioners were organized manually and given numerical codes as appropriate to facilitate entry into the computer. The coded data were entered into Microsoft Excel 2010 and exported to StatPlus pro 5.9.8 statistical package for analysis. Simple association tests were done between various factors and occurrence of colic.
Results: The incidence of colic for the 11 years was 3.1%, which constituted 68.0% spasmodic colic, 27.8% impaction colic, and 4.2% displacement colic. Flunixin meglumine as a nonsteroidal anti-inflammatory drug (NSAID) was used as the only pain management treatment in 85.3% of the cases, flunixin meglumine and butorphanol as NSAID-OPIOD combination in 6.4% of the cases, while buscopan as an antispasmodic was recorded in 5.9% of the cases mainly in spasmodic colic. Univariate analysis revealed simple association between various factors and the type of colic a horse was having. There was an association between the type of colic and the decision-making on the pain management protocol to use, whether single analgesic protocol (χ2=22.5, p<0.001) or use of analgesic combinations (χ2=18.3, p<0.001). The type of colic strongly influenced the decision for performing nasogastric intubation (χ2=265, p<0.001), but performing nasogastric intubation was weakly (χ2=4.9, p=0.03) associated with horse recovery from colic. Type of colic also strongly influenced the need for the use of metabolic stimulants, particularly vitamin B-complex (χ2=99.3, p<0.001). Recovery or death of the horse from colic was strongly associated with the type of colic (χ2=250, p<0.001). The possibility of recurrence of colic was weakly (χ2=4.6, p=0.04) determined by the type of colic, a horse had. Multivariate logistic regression revealed that the main cause of death was intestinal displacement and the majority of the horses with intestinal displacement died (β-estimate 2.7, odds ratio=0.07, p=0.007) compared to horses that had impaction colic.
Conclusion: The incidence of colic is 3.1%, and the most common type of colic is spasmodic followed by impaction. The most common pain management protocol for colic is NSAIDs, mainly flunixin meglumine, followed by flunixin-butorphanol combination. Surgery for horses with colic in Nairobi County is not commonly done due to impeding poor prognoses. The horse owners tend to prefer euthanasia for such cases.
Keywords: pain management, colic, incidence, Nairobi, treatment.
1. Cohen, N.D., Gibbs, P.G. and Woods, A.M. (1999) Dietary and other management factors associated with equine colic. J. Am. Vet. Med. Assoc., 215: 53-60. [PubMed]
2. Krunkosky, T.M., Jarrett, C. and Moore, J.N. (2008) Gross and microscopic anatomy of the equine gastrointestinal tract. In: White, N.A., Moore, J.N. and Mairm, T.S., (editors). The Equine Acute Abdomen. Teton New Media, Jackson, WY. p5-21.
3. David, E.F. (2011) How to manage severe colic in the field. In: Proceedings Annual Convention of the American Association of Equine Practioners. Vol. 57. Texas, San Antonio. p284-289.
4. Curtis, L., Burford, J.H., Thomas, J.S., Curran, M.L., Bayes, T.C., England, G.C. and Freeman, S.L. (2015) Prospective study of the primary evaluation of 1016 horses with clinical signs of abdominal pain by veterinary practitioners, and the differentiation of critical and non-critical cases. Acta Vet. Scand., 57: 69. [Crossref]
5. Van der Linden, M.A., Laffont, C.M. and Van Oldruitenborgh-Oosterbaan, M.S. (2003) Prognosis in equine medical and surgical colic. J. Vet. Intern Med., 17(3): 343-348. [Crossref]
6. Fleming, K. and Mueller, P.O.E. (2011) Ileal impaction in 245 horses: 1995-2007. Can. Vet. J., 52(7): 759-763. [PubMed] [PMC]
7. Ness, S.L., Bain, F.T., Zantingh, A.J., Gaughan, E.M., Story, M.R., Nydam, D.V. and Divers, T.J. (2012) Ultrasonographic visualization of colonic mesenteric vasculature as an indicator of large colon right dorsal displacement or 180° volvulus (or both) in horses. Can. Vet. J., 53(4): 378-382. [PubMed] [PMC]
8. Mair, T.S. and Smith, L.J. (2005) Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 1: Short-term survival following a single laparotomy. Equine Vet. J., 37(4): 296-302. [Crossref] [PubMed]
9. Jennings, K.M., Laila, C., Burford, J.H. and Freeman, S.L. (2014) Prospective survey of veterinary practitioners' primary assessment of equine colic: Clinical features, diagnoses, and treatment of 120 cases of large colon impaction. BMC Vet. Res., 10 Suppl 1: S2. [Crossref] [PubMed] [PMC]
10. Louise, L.S. (2013) Management of impactions. In: Proceedings: 13th International Congress of World Equine Veterinary Association, 3rd-5th October, 2013, Budapest, Hungary.
11. Lowe, J.E., Sellers, A.F. and Brondum, J. (1980) Equine pelvic flexure impaction. A model used to evaluate motor events and compare drug response. Cornell Vet., 70: 401-412. [PubMed]
12. Dabareiner, R.M. and White, N.A. (1995) Large colon impaction in horses: 147 cases (1985-1991). J. Am. Vet. Med. Assoc., 206: 679-685. [PubMed]
13. Adams, S.B., Lamar, C.H. and Masty, J. (1984) Motility of the distal portion of the jejunum and pelvic flexure in ponies: Effects of six drugs. Am. J. Vet. Res., 45: 795-799. [PubMed]
14. Roelvink, M.E., Goossens, L. and Kalsbeek, H.C. (1991) Analgesia and spasmolytics effects of dipyrone, hoscine -N-butylbromide and a combination of the two in ponies. Vet. Rec., 129: 378-380. [Crossref] [PubMed]
15. White, N.A. (1987) When equine colic calls for surgical intervention. Equine Vet. J., 29: 448-453.
16. Davis, J.L., Ramirez, S., Campbell, N. and Jones, S.L. (2001) Acute and chronic mineral oil pneumonitis in two horses. Equine Vet. Educ., 13: 230-234. [Crossref]
17. Niinisto, K., Hewetson, M., Kaikkonen, R., Sykes, B.W. and Raekallio, M. (2014) Comparison of the effects of enteral psyllium, magnesium sulphate and their combination for removal of sand from the large colon of horses. Vet. J., 202(3): 608-611. [Crossref] [PubMed]
18. Lopes, M.A., Walker, B.L., White, N.A. and Ward, D.L. (2002) Treatments to promote colonic hydration: Enteral fluid therapy versus intravenous fluid therapy and magnesium sulphate. Equine Vet. J., 34: 505-509. [Crossref]
19. Cook, V.L. and Blikslager, A.T. (2008) Use of systemically administered lidocaine in horses with gastrointestinal tract disease. J. Am. Vet. Med. Assoc., 232(8): 1144-1148. [Crossref] [PubMed]
20. Cook, V.L., Neuder, L.E., Blikslager, A.T. and Jones, S.L. (2009) The effect of lidocaine on in vitro adhesion and migration of equine neutrophils. Vet. Immunol. Immunopathol., 129(1-2): 137-142. [Crossref] [PubMed]
21. Elfenbein, J.R., Robertson, S.A., MacKay, R.J., KuKanich, B. and Sanchez, L.C. (2014) Systemic and anti-nociceptive effects of prolonged lidocaine, ketamine, and butorphanol infusions alone and in combination in healthy horses. BMC Vet. Res., 10 Suppl 1: S6. [Crossref] [PubMed] [PMC]
22. Scantlebury, C.E., Perkins, E., Pinchbeck., G.L., Archer, D.C. and Christley, R.M. (2014) Could it be colic? Horse-owner decision making and practices in response to equine colic. BMC Vet. Res., 10 Suppl 1: S1. [Crossref] [PubMed] [PMC]
23. Peloso, J., Cohen, N. and Taylor, T. (1996) When to send a horse with clinical signs of colic: Is it surgical, or is it referable? A survey of the opinions of 117 equine veterinary specialists. In: Proceedings of the 42nd Annual Convention of the American Association of Equine Practitioners, 8th-11th December, 1996, Denver, Colorada, USA, p250-253.
24. Ragle, C.A., Meagher, D.M., Lacroix, C.A. and Honnas, C.M. (1989) Surgical treatment of sand colic. Results in 40 horses. Vet. Surg., 18: 48-51. [Crossref] [PubMed]
25. Heather, A.D. and Amelia, M. (2012) Ileal impaction and jejunal enterotomy in a 4-month-old Arabian filly. Can. Vet. J., 53(1): 71-74.
26. Honnas, C.M. and Cohen, N.D. (1997) Risk factors for wound infection following celiotomy in horses. J. Am. Vet. Med. Assoc., 210: 78-81. [PubMed]
27. Southwood, L.L., Gassert, T. and Lindborg, S. (2010) Colic in geriatric compared to mature non-geriatric horses. Part 1: Retrospective review of clinical and laboratory data. Equine Vet. J., 42: 621-627. [Crossref] [PubMed]
28. Southwood, L.L., Ragle, C.A. and Synder, J.R. (1996) Surgical treatment of ascarid impactions in horses and foals. Am. Assoc. Equine Pract., 42: 258.
29. Underwood, C., Southwood, L.L., McKeown, K.P. and Knight, D. (2008) Complications and survival associated with surgical compared with medical management of horses with duodenitis-proximal jejunitis. Equine Vet. J., 40: 373-378. [Crossref] [PubMed]
30. Gitari, A.N., Nguhiu-Mwangi, J., Mogoa, E.M., Varma, V.J., Mwangi, W.E., Konde, A.M. and Rashid, F. (2016) Hematological and biochemical changes in horses with colic in Nairobi County, Kenya. Int. J. Vet. Sci., 5(4): 250-255.
31. Pihl, T.H., Scheepers, E., Sanz, M., Goddard, A., Page, P., Toft, N., Kjelgaard-Hansen, M., Andersen, P.H. and Jacobsen, S. (2016) Acute-phase proteins as diagnostic markers in horses with colic. J. Vet. Emerg. Crit. Care (San Antonio), 26(5): 664-674. [Crossref] [PubMed]
32. Pihl, T.H., Scheepers, E., Sanz, M., Page, P., Goddard, A., Toft, N., Andersen, P.H. and Jacobsen, S. (2015) Influence of disease process and duration on acute phase proteins in serum and peritoneal fluids of horses with colic. J. Vet. Med., 29(2): 651-658. [Crossref]
33. Wormstrand, B.J., Ihler, C.I., Diesen, R. and Krontveit, R.I. (2014) Surgical treatment of equine colic-a retrospective study of 297 surgeries in Norway 2005-2011. Acta Vet. Scand., 56: 1-9. [Crossref] [PubMed] [PMC]
34. Voigt, A., Sauleza, M.N., Donnellana, D.C. and Gummow, B. (2009) Causes of gastrointestinal colic at an equine referral hospital in South Africa (1998-2007). J. S. Afr. Vet. Assoc., 80: 192-198. [Crossref] [PubMed]
35. Traub-Dargatz, J.L., Kopral, C.A., Seitzinger, A.H., Garber, L.P., Forde, K. and White, N.A. (2001) Estimate of the national incidence of and operation-level risk factors for colic among horses in the United States, spring 1998 to spring 1999. J. Am. Vet. Med. Assoc., 219: 67-71. [Crossref]
36. White, N.A. (1990) Examination and diagnosis of the acute abdomen. In: The Equine Acute Abdomen. Lea and Febiger, Philadelphia, PA. p619-623. [PubMed]
37. Hillyer, M.H., Taylor, F.G., Proudman, C.J., Edwards, G.B., Smith, J.E. and French, N.P. (2002) Case control study to identify risk factors for simple colonic obstruction and distension colic in horses. Equine Vet. J., 34: 455-463. [Crossref] [PubMed]
38. Tinker, M.K., White, N.A. and Lessard, P. (1997) Prospective study of equine colic incidence and mortality. Equine Vet. J., 29: 448-453. [Crossref] [PubMed]
39. Moore, R.M. and Leise, B.S. (2009) Diagnosis and treatment of selected diseases of the cecum and colon in horses. In: Proceedings of the 11th International Congress of the World Equine Veterinary Association, 24th-27th, September 2009, Guaruja, SP, Brazil.
40. Zimmel, D.N. (2003) Hemostatic disorders. In: Robinson, N.E. (editor). Current Therapy in Equine Medicine. Vol. 5. WB Saunders, Philadelphia, PA. p335-351. [Crossref]
41. Naylor, R.J., Taylor, A.H., Knowles, E.J., Wilford, S., Linnenkohl, W., Mair, T.S. and Johns, I.C. (2014) Comparison of flunixin meglumine and meloxicam for post operative management of horses with strangulating small intestinal lesions. Equine Vet. J., 46(4): 427-434. [Crossref] [PubMed]
42. Taylor, P.M., Hoare, H.R., Vries, A.D.E., Love, E.J., Coumbe, K.M., White, K.L., and Murrell, J.C. (2016) A multicentre, prospective, randomised, blinded clinical trial to compare some perioperative effects of buprenorphine or butorphanol premedication before equine elective general anaesthesia and surgery. Equine Vet. J., 48(4): 442-450. [Crossref] [PubMed] [PMC]
43. Lopes, M.A., Hepburn, R.J. and McKenzie, H.C. (2003) Enteral fluid therapy for horses. Compend. Contin. Educ. Pract. Vet., 25: 390-397.
44. Topliff, D.R., Potter, G.D., Kreider, J.L. and Creagor, C.R. (1981) Thiamin supplementation for exercising horses. In: Proceedings of the 7th Equine Nutrition Physiology Symposium, Warrenton, VA. p167.
45. McGowan, C.M. and Ireland, J.L. (2016) Welfare, quality of life, and euthanasia of aged horses. Vet. Clin. N. Am. Equine Pract., 32(2): 355-367. [Crossref] [PubMed]
46. Christophersen, M.T., Dupont, N., Berg-Sorensen, K.S., Konnerup, C., Pihl, T.H. and Andersen, P.H. (2014) Short-term survival and mortality rates in a retrospective study of colic in 1588 Danish horses. Acta Vet. Scand., 56(1): 20. [Crossref]
47. Baird, A.N., Cohen, N.D. and Taylor, T.S. (1991) Renosplenic entrapment of the large colon in horses: 57 cases (1983 - 1988). J. Am. Vet. Med. Assoc., 198: 1423-1426. [PubMed]
48. Immonen, A.M., Karikoski, N., Mykkanen, A., Niemela, T., Junnila, J. and Tulamo, R.M. (2017) Long-term follow-up on recovery, return to use and sporting activity: A retrospective study of 236 operated colic horses in Finland (2006-2012). Acta Vet. Scand., 59: 5. [Crossref]
49. Salem, S.E., Proudman., C.J. and Archer, D.C. (2016) Prevention of post operative complications following surgical treatment of equine colic: Current evidence. Equine Vet. J., 48(2): 143-151. [Crossref] [PubMed]