A Colic is something no horse owner wants to face, but if you have horses, you’ll likely have to deal with a Colic at some point. It is the most common reason that horses require emergency veterinarian care and affects horses of all ages and breeds.
A Colic can vary from a mild bout of discomfort that resolves itself, to something more serious that requires medical management, or worst of all a serious abdominal crisis requiring emergency colic surgery. It is known to be the deadliest condition of horses, although most colic cases are successfully cured medically, 5-10% will require surgery.
It is difficult to know which colic case fits into which category, as in the early stages the clinical signs are very similar. Therefore, it is vital that a vet is called promptly, so they can give expert advice and differentiate whether the problem is medical or surgical as early as possible. The aim is to start appropriate treatment as quickly as possible.
A major concern for horse owners is being able to identify colic symptoms. That’s because signs can vary greatly between individuals and may also depend on the severity of the pain. However, among the more common signs are
Early signs:
Or more visually:
Colics can be caused by several different factors, here are 5 of them.
This is certainly the most common type of colic. Spasmodic colic occurs when the bowel is contracting in an abnormal manner, creating painful spasms and somewhat of an “over-active” gastrointestinal tract. Spasmodic colics usually respond very well to anti-spasmodic drugs along with other therapeutic treatments. Idiopathic is a veterinary term for “unknown origin”. Despite the best veterinary investigation, there are still plenty of instances where we are not sure about the exact cause of abdominal pain. The good news, however, is that the vast majority of these colics respond to on-farm medical treatment.
This term describes when the bowel, typically the large intestine, is blocked by a firm mass of food. This is a fairly common type of colic and can often be resolved at the stable with the administration of fluids via a stomach tube. Occasionally, larger and more persistent impactions may require surgical intervention.
Displacements occur when one section of the bowel moves to an abnormal location within the abdomen.
Strangulating colics occur when the blood supply to a piece of gut gets cut off.
Torsions occur when the bowel twists on itself, cutting off the blood supply.
Some displacements can be treated by starvation and medical therapy, but severe displacements and all strangulations and torsions require immediate surgery to correct the problem.
The early stages of strangulating or displacement colics typically present in a very similar manner to the more common, less life-threatening forms of colic – the major reason to take all colic episodes seriously and call the vet at the earliest signs of abdominal pain.
Unfortunately, not all cases of colic fit easily into one of the above categories. Certain types of colic can be managed medically in the initial stages but may need surgery if they do not improve. These cases will require repeat examinations and careful management.
When calling your veterinarian, relate your horse’s vital signs and describe his clinical signs. The vet can ask questions over the phone to better assess whether a veterinarian needs to examine the animal at that time, or if the owner can just monitor the horse and summon the veterinarian if signs worsen.
As you wait for your veterinarian:
After assessing all the different factors involved in your horse’s colic, your vet will decide on the appropriate course of treatment. This may include the administration of fluids/electrolytes down a nasogastric tube if impaction is suspected.
Pain relief is one of the cornerstones of colic therapy, and your vet will decide what drug and how much is appropriate. Once pain-relieving drugs are given, we want to see a good response and the disappearance of all colic signs.
If colic signs recur, it is vital that you contact your veterinarian, as a horse that is still in pain despite pain-relieving drugs may need to be referred to an equine clinic for further investigation and possible surgery.
Once your veterinarian has communicated his findings from the horse’s physical examination and diagnostic procedures and there is an indication the horse should be referred to pursue further diagnostic tests and treatment at a referral clinic, there should be a discussion on estimated costs. If the referring veterinarian is unsure about the estimated costs for referral, they should call the clinic to collect this information prior to referral.
Ultimately, the most significant factor influencing the decision to refer is intractable pain. Postponed referral of a horse in pain can lead to gastrointestinal rupture, further systemic compromise, and death.
This decision allows further diagnostics to be performed along with around-the-clock monitoring to determine if advanced medical or surgical intervention is required. Exploratory celiotomy is the priority treatment for a horse in uncontrollable pain.
Once the decision is made, it is important to stabilise the horse before loading it into the trailer. Call the referral clinic prior to the horse’s departure to give an estimated time of arrival.
Abdominal exploratory surgery is a diagnostic as well as a therapeutic procedure for colic and is performed at a surgical referral clinic by a board-certified veterinary surgeon, and is necessary on an emergency basis in horses with persistent or severe pain. A definitive diagnosis can often not be made prior to the surgery. Early referral and surgical treatment are major contributors to better survival chances. The survival prognosis following a colic surgery is good to excellent for most horses.
Once back at the stable, horses must be put on box rest for about 8 weeks in a small stable, and hand walked several times per day. The horse is not allowed to trot, canter or move rapidly until the incision gains sufficient strength to take the weight of the intestines and organs during movement—which are hundreds of lbs/kg. The diet may need to be modified, and other specific treatment instructions may be given by the vet.
Unfortunately, there are not many absolutes when it comes to the complete prevention of colic. However, good management and routine health care can certainly help reduce the incidence of colic in horses. The establishment of a set routine, regular exercise and/or turnout, and a high-quality forage diet are all important management steps. Any concentrate feed should ideally be divided into two or three feedings, and grain based feeds should be limited when possible. Horses should have annual dental care, and older horses may need dental evaluations every 6 months. Routine faecal examination and deworming for tapeworms are also critical for good herd health.
Medical myths often get started with reasonable observations. However, whether those observations reflect anything that’s actually going on with the horse is a different question entirely. In fact, nonsensical information has a remarkable ability to stick around, even after there’s good proof that the information is nonsensical. Many myths about equine colic still persist today:
MYTH: If the horse has passed manure, the colic problem has been resolved.
FACT: Faecal material can still be passed from the latter portions of the intestinal tract, even if the horse has an obstruction further forward which has not resolved. Passing faeces is, in general, a good indication of gut motility, but your horse will still require a full examination regardless of whether he has or has not passed any droppings.
MYTH: If a horse is referred to a specialist clinic, they will always operate.
FACT: The referral clinic will re-examine the horse and can usually carry out more extensive examinations than in the field. Surgical intervention will only be proposed if it is necessary to save your horse’s life. Medical treatments are also available which may assist in certain cases. Importantly, your horse will be under constant observation.
MYTH: My horse is too old for surgery.
FACT: Researchers have concluded that age alone is not associated with outcome and is not a reason to decline colic surgery. An owner may be less willing to put an older horse through surgery because they feel it’s not fair to do so, or for purely economic reasons. In addition, older horses may no longer be insured, so the finances for surgery may not be available.
MYTH: If a horse has colic, keep him moving and don’t let him lie down or roll.
FACT: If the horse is lying or standing quietly, let him be. If the horse is restless and repeatedly getting up, lying down and attempting to roll, then walking may help to distract and settle him. In some instances, short periods of intermittent walking can increase intestinal motility and help resolve an impaction or colon displacement. Hours of endless walking, however, can leave a horse exhausted and a poor candidate for surgery.
However, if the horse is so violently agitated that he’s thrashing dangerously, do not risk injury to yourself. Leave the horse alone until help arrives. If you aren’t walking him, be sure to keep a close eye on him.
MYTH: Paraffin oil will clear the abdominal impaction.
FACT: While paraffin oil can be used in certain cases as a marker for gastrointestinal motility, it is not beneficial in any other way. It will not assist in dissolving impacted faecal material. Studies have shown that nasogastric intubation (inserting a tube through the nose and into the stomach) with an isotonic solution (water and salts) is the best method of softening the impacted material to enable it to be passed. The aspiration of paraffin oil into the lungs can result in pneumonia, which can be fatal. Nasogastric treatments should be administered only by a vet.
Occasionally the colic may be so severe that the prognosis with any treatment, be it medical or surgical, is hopeless. In such cases, it is in the horse’s best interest to be put down immediately.
Indications for euthanasia are abdominal pain that is unresponsive to analgesia, abdominal pain that persists and recurs following repeated doses of analgesia, cardiovascular deterioration (increasing heart rate, development of injected or toxic mucous membranes, coolness of extremities), and severe or increasing abdominal distension. Abdominal ultrasonographic examination can be used to identify an increase in peritoneal fluid volume or distended loops of small intestine. Abdominocentesis can also be performed; serosanguineous fluids may indicate intestinal ischemia and ingesta may indicate intestinal rupture/enterocentsis.
All insurance companies will require confirmation that a horse has been euthanised and the reasons for doing so. Most policies ask for a veterinary certificate, and some for a post-mortem.
– Do not administer any medications, unless your veterinarian specifically asks you to do so before he arrives. The drugs may mask the pain and fever, making diagnosis more difficult.
– Do not give more than one dose of pain medication without consulting your veterinarian.
– Do not walk the horse or yourself to exhaustion.
– Absolutely, do not try to pass a tube or force-feed mineral oil. Mineral oil in the lungs can result in fatal pneumonitis.
– It is also not recommended to insert a hose or anything rectally into a horse to give an enema.
Horse owners need to be able to recognise the symptoms of colic and early veterinary intervention should be sought. Although colic is probably the most feared disease by the horse-owning community, the vast majority of cases have a good outcome with appropriate treatment and care. Following a few simple guidelines to help prevent colic and seeking attention if a horse shows signs of being affected are the cornerstone of good horse management as far as colic is concerned.
My advice is to think about your horses before anything occurs and what you would be willing to put into each of them if forced to make a decision. This is easier said than done. Ultimately you will only know when you are faced with a crisis, but the best policy is always to “hope for the best, and plan for the worst”.
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