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Risk factors for history of previous colic and for chronic, intermittent colic in a population of horses.
OBJECTIVE: To identify risk factors for recurrent colic and chronic, intermittent colic in horses. DESIGN: Case control study. ANIMALS: The population included 768 horses examined by veterinarians for emergencies other than colic (control group). PROCEDURE: Horses with colic that had history of colic (n = 232) were compared with those without such history (n = 536), using logistic regression analysis to identify risk factors for history of previous colic and to determine odds ratios (OR) for these associations. Among the 232 horses in the history of colic group, 58 horses that had chronic, intermittent colic were compared with the no history of colic group and the control group to identify factors associated with chronic, intermittent colic, using multiple logistic regression analysis. RESULTS: Among horses with colic, factors significantly associated with history of colic by multiple logistic regression analysis included history of abdominal surgery (OR = 3.1; P < 0.0001), age > 8 years (OR = 1.5; P < 0.0001), feeding of coastal grass hay (OR = 1.34; P 0.012), Arabian bread (OR = 1.28; P = 0.044), and recent change in stabling (OR = 0.76, P = 0.024). Among horses with colic, factors significantly associated with chronic, intermittent colic were history of previous abdominal surgery (OR = 2.2; P = 0.021), age > 8 years (OR = 2.0; P < 0.0001), being a gelding (OR = 1.7 with female as the reference population; P = 0.002), feeding of coastal grass hay (OR = 1.6; P = 0.045), and farm density < 0.5 horses/acre (OR = 1.6; P = 0.003). When the CIC group was compared with the control group, significant risk factors included history of abdominal surgery (OR = 270.7; P < 0.0001), age > 8 years (OR = 2.4; P < 0.0001), recent change in diet (OR = 2.1; P = 0.005), farm density < 0.5 horses/acre (OR = 2.0; P = 0.0001); being a gelding (OR = 1.8, with female as the reference population; P = 0.002), and Arabian breed (OR = 1.6; P = 0.050). CLINICAL IMPLICATIONS: Certain findings of signalment and management factors may identify horses at increased risk of recurrent forms of colic.
Tapeworm infection is a significant risk factor for spasmodic colic and ileal impaction colic in the horse.
The association between the equine intestinal tapeworm Anoplocephala perfoliata and specific types of intestinal disease was investigated by matched case-control study using coprological and serological diagnosis. We have previously shown that the host IgG(T) response to 12/13 kDa antigens of A. perfoliata correlates well with infection intensity, therefore this antibody response was used to investigate the risk of colic at different levels of parasite infection intensity. One hundred and three spasmodic colic cases with an equal number of controls matched for age, breed and gender, and 20 ileal impaction cases each with 2 similarly matched controls were obtained. Cases of spasmodic colic were much more likely (odds ratio = 8.0) to be associated with A. perfoliata infection detected coprologically than controls. Serological diagnosis revealed an increasing risk of spasmodic colic with increasing infection intensity. Calculation of an aetiological fraction suggests that 22% of spasmodic colic cases in this study were tapeworm associated. No significant association was found between colic and strongyle egg count. Conditional logistic regression analysis demonstrated that the relationship between colic and A. perfoliata infection intensity was not confounded by strongyle egg count and there was a linear relationship between infection intensity and the log-odds of spasmodic colic. For cases of ileal impaction, a strong association was found between colic and A. perfoliata as diagnosed by coprological means (odds ratio of 34.0). Serological diagnosis also revealed a strong association that increased with higher levels of infection intensity (odds ratio = 26.0). The aetiological fraction for the ileal impaction data suggests that 81% of the ileal impaction cases in this study were tapeworm associated. This study concludes that A. perfoliata is a significant risk factor for spasmodic colic and ileal impaction colic in the horse; and that the risk of spasmodic colic increases with infection intensity.
Case-control study of the association between various management factors and development of colic in horses. Texas Equine Colic Study Group.
The association between various management factors and development of colic was studied in 821 horses treated for colic and 821 control horses treated for noncolic emergencies by practicing veterinarians in Texas between Oct 1, 1991 and Dec 31, 1992. History of previous colic and history of previous abdominal surgery were found to be significantly associated with colic. Change in stabling conditions during the 2 weeks prior to the time of examination, recent change in diet, and recent change in level of activity significantly increased the risk for development of colic. Changes in activity level, diet, and stabling conditions were identified as potentially alterable risk factors for colic. Logistic regression was used to adjust for the effects of all variables found to be significantly associated with colic by means of univariate analysis, and only history of previous colic, history of previous abdominal surgery, and history of recent change in diet remained significantly associated with colic. Results of this study indicate that a proportion of colic cases might be prevented by minimizing changes in management practices.
A comparison of colo-colic and ileo-colic intussusception.
There are many differences in the clinical features of intussusception between African and temperate countries. The records of 192 patients with intussusception who presented to the Pediatric Surgical Service at King Edward VIII Hospital, Durban, South Africa during a 10-year period were reviewed. Compared with temperate countries, the patients were older (median, 1 year 7 months), presented later (median, 4.2 days), had a higher proportion of colo-colic lesions (17%), had absence of primary bowel pathology, and had a high surgical rate (82%). To define clinically important differences, the clinical and pathological features of 158 cases of ileo-colic intussusceptions were compared with 34 colo-colic cases. Compared with the ileo-colic group, colo-colic lesions occurred in older children (median, 3.8 years) (v 1.5 years; P < .001). In the colo-colic group, there were fewer shocked and pyrexial patients, and the rate of successful nonoperative reduction was higher. The groups had a similar incidence of surgical intervention (82%). In the ileo-colic group, there was a higher mortality rate and more complications, but only the higher resection rate (P < .001) was statistically significant.
[Infants with colic. A heterogenous group possible to cure? Treatment by pediatric consultation followed by a study of the effect of zone therapy on incurable colic].
INTRODUCTION: The aim of the study was to investigate and treat infants with colic by conventional medicine followed by an investigation of the effect of reflexological treatment. MATERIAL AND METHODS: The investigation was prospective, followed by a randomised, single-blind, double-controlled, prospective study of reflexological treatment with an interview and diary. Sixty-three infants aged 1-3 months referred by general practitioners with crying for > 90 minutes a day were given a paediatric examination and intervention. The cause of crying was discovered in 33 infants: Vitamin D (5), elimination of cow's milk protein (3), and anal stenosis (3); counselling on feeding, sleep, reduction of stimulation, and avoidance of passive smoking (22). Thirty infants without the benefit of paediatric consultation were randomised to three groups for a duration of two weeks: A: Presumed non-effective reflexological treatment vs B: Presumed effective reflexological treatment vs C: No treatment--only observation. The most important parameter was the number of crying hours over 24 hours. Cure was defined as crying for less than or equal to 30 minutes. RESULTS: Examination by the paediatrician: Thirty-three of 63 infants benefited with a reduction in crying of less than 90 minutes and 13 of these infants were cured. The randomised study: In group C (control), none of the patients was cured. In groups A and B (presumed non-effective reflexological treatment and presumed effective treatment), half the patients were cured, which was significantly better than in group C. There was no significant difference between groups A and B, but B seemed better than group A. B was significantly better than C. DISCUSSION: Infantile colic had a significant cure rate at paediatric consultation and the children who did not benefit from this intervention had a significantly better outcome after reflexological treatment than had the observation group. Further investigations in reflexological treatment in infants are recommended.
Development of a colic severity score for predicting the outcome of equine colic.
Thirty-two physical examination and laboratory variables were recorded during examination of 165 horses admitted for acute abdominal disease. Univariate analyses were performed to determine which of the variables were significantly different between horses that lived or died. Stepwise logistic regression was performed to identify variables with the best predictive value. Four variables (heart rate, peritoneal fluid total protein concentration, blood lactate concentration, and abnormal mucous membrane) remained significant when entered into the model. Histograms for each significant variable were used to set "cutting-points," establishing categories that were made into a table of assigned values from which a Colic Severity Score (CSS) for each horse was calculated. Seventy-one horses in a second group were used to validate the scoring chart. Case mortality rate was similar in both groups (20.6% in development group versus 21.1% in validation group). All horses with a CSS > 7 died, whereas 75% of those with a score of < or = 7 lived. For the validation group, use of the scoring table yielded a positive predictive value of 100%, negative predictive value of 91.8%, sensitivity of 66.7%, and specificity of 100%. The overall accuracy of the CSS was 93%. The CSS is a rapid and accurate method for predicting survival in cases of equine acute abdominal disease.
Propinox in biliary colic: a multicenter, randomized, prospective and parallel double-blind study of three doses of propinox versus placebo in acute biliary colic pain.
The aim of this study was to assess the efficacy and tolerance of propinox administered i.v., and establish a dose-response relation according to three dose levels (10, 20 and 30 mg), vs. placebo in patients with moderate to severe acute biliary pain. Three hundred and fifty patients were included: 85 received placebo treatment, 81 were treated with propinox 10 mg, 91 with propinox 20 mg and 93 received propinox 30 mg. Spontaneous pain intensity was assessed according to a visual analog and a verbal scale before treatment and 20, 60 and 120 min after. All treatments induced significant and progressive pain reduction at all controls, but patients treated with 20 and 30 mg of propinox showed significantly lower pain intensity after 120 min compared to the placebo group. The last control revealed that 28% of patients receiving placebo had no pain while 60% of patients treated with propinox 30 mg reported absence of pain with a statistically significant difference (p < 0.001). All treatments were very well tolerated and there were no dropouts due to adverse events. Mouth dryness was the adverse effect occurring with a significantly higher frequency than that observed with placebo although it was only seen in patients treated with 20 mg and 30 mg active doses. The results of this study showed that propinox was an effective drug in the treatment of moderate to severe colic pain of biliary origin. Concerning efficacy and side effects, a clear dose-response relation was observed; the 20 mg and 30 mg doses being significantly superior to placebo.
Propinox in intestinal colic: multicenter randomized prospective double-blind study of three doses of propinox vs. placebo in acute intestinal colic pain.
The aim of this double-blind study was to assess the efficacy and tolerability of propinox administered i.v. and to establish a dose-response relationship according to three dose levels (10 mg, 20 mg and 30 mg), vs. placebo in patients with moderate-to-severe acute intestinal colic pain. Four hundred patients (100 per treatment group) were included and allocated to the following treatment groups: propinox 10 mg, 20 mg, 30 mg and placebo. All treatments induced significant and progressive pain reduction as from the 20 min evaluation of 20.3% in the placebo group, 45% in the group treated with propinox 10 mg; 52% in the group receiving propinox 20 mg and 56% in the propinox 30 mg group. Statistical comparison showed differences between placebo and the three active doses as well as between propinox 10 mg and the 20 mg and 30 mg doses. The 20 min evaluation revealed that 40% of patients receiving placebo had to be excluded from the study due to lack of efficacy; the percentage of which was significantly higher compared with those observed with the three doses of propinox ranging between 10% and 13%. The 120 min evaluation revealed that 47.7% of patients treated with propinox 10 mg were free from pain vs. 68.8% and 73.5% of those receiving 20 mg and 30 mg, respectively. These percentages were considerably higher than the 15% found with placebo. Statistical analysis revealed significant differences between the 10 mg vs. the 20 mg and 30 mg groups with not differences between the latter doses. No differences in blood pressure or heart rate were found among treatments. The incidence of mouth dryness was significantly more frequent with the 20 mg and 30 mg doses of propinox than with the placebo or the 10 mg dose.
[Neurogenic factors of gallbladder contraction as a basis for the clinical interpretation of various aspects of hepatic colic; cholecystodyskinesis of diencephalic origin and a painless type of hepatic colic].
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[The genesis of recurrent intestinal pain resembling colic in children; so-called umbilical colic].
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[High pathological fixations of right colic angle; images of a bulbo-colic communication followed fluoroscopically].
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[Mechanism of the ileo-ceco-colic valve in a living person with exteriorized ileo-ceco-colic papilla].
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[Medical therapy of ureteral colic and biliary colic with rociverin and a rociverin-lysine acetylsalicylate combination. Clinical study].
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[The colic urogram. (Elimination urography during the kidney colic)].
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Ileo-colic intussusception with an unusual retrograde colo-colic intussusception.
An interesting case with both antegrade and retrograde intussusception in an infant is reported. There was no apparent predisposing cause.
Reno-colic and reno-colic-cutaneous fistula: report of 3 cases.
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Anastomoses between the colic branch of the ileocolic artery and the right colic artery.
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