Advances in Diagnostics and Treatments in Horses with Acute Colic and Postoperative Ileus

Colic incidence, risk factors, and therapeutic management in a working horse population in Tuban, Indonesia

Background and Aim

Colic is the primary problem affecting equestrian care worldwide. The primary cause of colic is digestive diseases; however, they can also affect organs from different systems in the abdominal region. In addition to a prior history of the disease and its treatment, risk factors may be assessed to determine the etiology of the disease in horses without or with a history of colic. This study aimed to present a summary of the incidence, risk factors, and medical procedures for colic in horses.

Materials and Methods

Based on owner reports, 223 horses in Tuban, Indonesia, suspected of having colic were investigated. During the investigation of clinical parameters, investigators went door-to-door with interested horse owners to gather information about potential risk factors related to equine colic. Information on horses diagnosed with colic was obtained from the medical records of treatment. A Chi-square test was used to investigate the potential association between the risk factors, medical protocol, and the outcome of colic in horses.

Results

Of the 187 cases, spasmodic colic was the most common (48.13%), but 17 (9.09%) had no definitive diagnosis. Poor body condition scores (χ2 = 58.73; p < 0.001), wheat bran feeding (χ2 = 26.79; p < 0.001), concentrate (χ2 = 10.66; p < 0.01), less access to water (χ2 = 128.24; p < 0.001), recurrence of colic (χ2 = 85.64; p < 0.001), no deworming program (χ2 = 54.76; p < 0.001), the presence of gastrointestinal parasites (χ2 = 56.79; p < 0.001), stressed physical activity (χ2 = 28.53; p < 0.001), and summer season (χ2 = 7.83; p < 0.01) were the risk factors for colic. We further reported that 185 (98.93%) patients who received the following medical interventions recovered: injection of non-steroidal anti-inflammatory drugs was necessary, Vitamin B complex (χ2 = 39.98; p < 0.001), fluid therapy (χ2 = 92.99; p < 0.001), and gastric intubation (χ2 = 4.09; p < 0.05).

Conclusion

The importance of colic was demonstrated in 187 (83.86%) of the 223 horses investigated in Tuban, Indonesia, documented. In this study, recommendations for medical procedures when colic risk factors have been determined are presented.

Arterial Blood Gas, Electrolyte and Acid-Base Values as Diagnostic and Prognostic Indicators in Equine Colic

The study aimed to investigate if arterial blood analysis in conscious horses presenting with signs of colic and breathing ambient air had diagnostic or prognostic value. Arterial blood samples from 352 horses presenting with colic at a university equine referral hospital were analysed for pH, partial pressure of carbon dioxide (PaCO2), partial pressure of oxygen (PaO2), concentrations of sodium (Na+), potassium (K+), ionised calcium (Ca2+) and chloride (Cl-), actual and standardised plasma bicarbonate concentration (HCO3- (P) and HCO3- (P, st)), blood and extracellular fluid base excess (Base (B) and Base (ecf)) and anion gap (AG). Results were compared to previously reported values for healthy horses, and comparisons were made between final diagnosis, treatment and survival to hospital discharge. Significant differences were found between colic cases and healthy reference values between some primary aetiologies. Overall, surgical and non-surgical colic cases differed in Ca2+ and Cl- concentrations and Ca2+ differed between cases that survived to discharge and those that did not. PaO2 differed between small intestinal surgical cases that survived and those that did not. From these results, we developed regression models that demonstrated excellent or good predictive value in identifying the likelihood of surgical versus medical management and survival to hospital discharge.

Changes in Oxidative Status Biomarkers in Saliva and Serum in the Equine Gastric Ulcer Syndrome and Colic of Intestinal Aetiology: A Pilot Study

Changes in the oxidative status of the blood of horses suffering from gastric ulcers and colic of intestinal aetiology (CIE) have been reported. However, saliva can also be a source of biomarkers of oxidative status. Therefore, this study aims to validate automated assays for the measurement of oxidative status biomarkers (ferric reducing ability of saliva/serum-FRAS/FRAP, cupric reducing antioxidant capacity-CUPRAC, the Trolox equivalent antioxidant capacity-TEAC, uric acid, and advanced oxidation protein products-AOPP) in the saliva and serum of horses, to assess their changes in the different ulcer gastric diseases (squamous-ESGD and glandular-EGGD) and CIE, and to evaluate their relationship with serum amyloid A (SAA), adenosine deaminase (ADA), and the systemic inflammatory response syndrome (SIRS) status. The assays showed a low imprecision and good linearity with enough sensitivity in both fluids. In EGGD, higher levels of FRAS, uric acid, and AOPP in saliva were observed compared to the healthy group, correlating with the salivary ADA levels. Horses with CIE showed increases in uric acid concentrations in serum associated with their SIRS status and outcome of the disease. In conclusion, analytes related to the oxidative status can be measured in the saliva and serum from horses by automated assays, and some of them can potentially be assessed as biomarkers in horses with gastric ulcers and CIE.

Medical Management of Hemorrhagic Bowel Syndrome in a Beef Bull

A two and a half-year old Simmental bull was presented to Iowa State University's Food Animal and Camelid Hospital for anorexia and lethargy of several days. Clostridium perfringens type A was identified via fecal culture and toxin genotyping. Hemorrhagic bowel syndrome (HBS) was diagnosed based on microbiological results along with abdominal ultrasonography, complete blood count, and serum biochemistry. Aggressive multi-modal therapy was employed including intravenously administered fluid therapy, potassium penicillin, lidocaine, flunixin, and pantoprazole among other supportive care. The bull was discharged after 15 days of hospitalization and recovered uneventfully to full function by the next breeding season. Currently all case reports with regard to HBS in beef cattle describe mortality. While the dairy cattle literature demonstrates that HBS has a high mortality rate, and suggests that surgical intervention has a higher prognosis when compared to medical therapy in dairy cattle. Our case would provide support to aggressive medical treatment for HBS in beef cattle.

Evaluation of the Effect of Oral Pyridostigmine on the Ileus after Abdominal Surgery: A Blinded Randomized Clinical Trial

Postoperative ileus is one of the most important and common complications after abdominal surgery. This single-blind randomized clinical trial study was conducted with the aim of evaluating the effect of oral pyridostigmine (60 mg) on the duration and frequency of response to the treatment of ileus after abdominal surgery on 40 patients in two 20-subject groups of oral pyridostigmine (interventional) and starch (control) in 2015. All 40 people completed the study process and entered the final analysis. In the oral Pyridostigmin group (60 mg) the mean response time for the disposal of gas and stool were 5.4 ± 4.7 h and 4.9 ± 3.4 h, respectively. Most of the participants 10 (50%) (Disposal of stool) responded to treatment 4 h after the administration of oral pyridostigmine. In the starch group, the mean response time for the disposal of gas and stool were 32.4 ± 9.9 h and 36.2 ± 10.3 h, respectively. The mean treatment response time in two groups showed a significant difference between both groups (p = 0.001). Regarding the frequency of response to treatment (disposal of gas or stool) in the 24-h period after the initiation of treatment in the oral pyridostigmine group, 95% (n = 19) of the subjects responded to the treatment in the first 24 h. However, in the starch group, only 50% (n = 10) responded to treatment in the first 24 h, the results showed a significant difference between the two groups (p = 0.001). The results indicate that oral pyridostigmine can be used as a simple and effective treatment for gastrointestinal ileus.