Prevalance, Risk Factors, Treatment and Outcomes of Colic in Horses in Nairobi County, Kenya

Abstract

Colic is simply the manifestation of abdominal pain, mainly originating from a gastrointestinal tract problems, but could also involve organs of other systems within the abdominal cavity. The aetiology can be multifactorial and the condition impacts negatively on the welfare of the horse besides having a negative economic effect owing to inefficient performance and occasional deaths. The prevalence, risk factors and outcomes of colic in horses in Kenya is unknown. Therefore, this study was carried out in horse stables and Equine Practices in Nairobi County with the following objectives: 1. to determine the prevalence of colic in horses, 2. to determine the risk factors for colic in horses, 3. to determine haematological and biochemical parameters in horses with colic, and 4. to determine the treatment and outcomes of horses with colic. The first and second objectives were determined by administering a questionnaire to horse owners or trainers in 21 stables within Nairobi County. The questionnaire consisted of simple non-subjective questions that were easy for horse owners and trainers to answer. The questionnaire was administered by the investigator (interviewer) who asked the horse owners or trainers (respondents) questions and filled it. The third objective was determined through a prospective study, which involved following-up cases of horses with colic from which blood samples for haematology and serum for biochemical analysis were collected. The haematological parameters measured were Total Leucocyte Count (TLC), Haemoglobin Concentration (Hb), Haematocrit (hct), Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Haemoglobin Concentartion (MCHC), Platelet Count, and Leucocyte Differential Count. The biochemical parameters measured were Alkaline Phosphatase (ALP), Aspartate Aminotransferase (AST), Total Proteins, Serum Albumin, Serum Globulin, Blood Glucose and Serum Lactate. The fourth objective was determined through a retrospective study from records in six Equine Practices in Nairobi xv County, covering 11-year period. This mainly focused on data relating to pain management, treatment and outcomes of colic. There was 70% response rate from the questionnaire survey. The prevalence of colic from the questionnaire responses was 13.5%. But the incidence of colic from the retrospective study for the 11 years was 3.1%. Occurrence of spasmodic colic was 68%, impaction colic 27.8% and displacement colic 4.3%. The main risk factors found to be significantly associated with the occurrence of colic included: lack of activity of the horse (χ2 = 10.8, p < 0.01), overfeeding of grains (χ2 = 4.54, p = 0.03) and frequency of deworming (χ2 = 4.07, p = 0.04). Those that are likely to reduce incidences of colic include regular dental care (β-estimate = -0. 456, O.R. = 0.6), changing stabling conditions (β-estimate = -0. 142, O.R. = 0.9) and regular deworming at every 3 months (β-estimate = -0.301, O.R. = 0.7) and at every 12 months (β-estimate = -0. 947, O.R. = 0.4). Mean Corpuscular Haemoglobin (MCH) was significantly higher (p = 0.03) in horses with spamodic colic (916.8±1.3 pg) than in those with impaction colic (15.6±1.2 pg). The Mean Leucocyte Count (109/L) was significantly higher (p = 0.02) in horses with impaction colic (12.9±5.9 ) than in those with spasmodic colic (9.0±1.5)). Similarly, Mean Neutrophil Count (109/L) was significantly higher (p = 0.02) in horses with impaction colic (9.1±5.6) than in those with spasmodic colic (5.4±1.7). The mean values of blood glucose were significantly higher (p = 0.02) in horses with impaction colic (5.7±2.0 mmol/l) than in those with spasmodic colic (3.7±1.4 mmol/l). The only blood biochemical parameters that were significantly lower in horses that died than in those that survived were Total Protein (p = 0.002), albumin (p < 0.01) and globulin (P = 0.04). The most common pain management protocols used were the administration of single non-steroidal anti inflammatory drugs (NSAID) at 85.3%, which consisted mainly Flunixin Meglumine; followed by use of NSAID-OPIOID combinations at 6.4%, consisting mainly flunixin meglumine and butorphanol. Use of anti-spasmodics particularly buscopan was recorded in only 5.9% of the xvi cases. Type of colic seemed to significantly influence choice of analgesic protocol (χ2 = 22.5, p < 0.001), and the most significant protocol was analgesic combinations (χ2 = 18.3, p < 0.001). The type of colic strongly influenced the decision to perform nasogastric intubation (χ2 = 265, p < 0.001), but the intubation was weakly (χ2 = 4.9, p = 0.03) related to horse recovery from colic. Type of colic also strongly determined the need for use of metabolic stimulants particularly vitamin B complex ((χ2 = 99.3, p < 0.001). Also strongly associated with the type of colic (χ2 = 250, p < 0.001), was recovery or death as outcomes of the affected horse. The possibility of recurrence of colic was weakly influenced (χ2 = 4.6, p = 0.04) by the type of colic. The study concluded that the “perceived prevalence” of colic over a one year period, and the eleven year incidence of colic in horses in Nairobi County, Kenya, is fairly low. The perceived management risk factors are generally related to feeding practices, lack of activity, dental care and deworming practices. Spasmodic colic is common and displacement colic rare. The most common protocol for pain management is use of NSAIDs, particularly flunixin meglumine but combinations of analgesics may be more effective. Apart from Mean Corpuscular Haemoglobin (MCH), and slight leucocyte count and netrophil count changes, there were no major significant haematological changes in horses with colic. Total blood proteins including albumin and globulin levels could serve as possible guide to prognosis of colic in horses. The general prognosis of spasmodic colic in horses was fair or good, but poor for impaction and displacement colic. Further research should be carried out on more specific prognostic indicators of various types of colic as well as systematic study on physiological responses to various pain management protocols.