So what is colic? Simply put colic is any type of gastro-intestinal discomfort, so why all the fear and panic? I am sure you probably can count on two hands the amount of times you felt GI pain over the past six months to a year. I am sure over Christmas alone you experienced more than a handful of GI discomforts from too many treats, too much turkey, or drinking the questionable eggnog in the back of your refrigerator. Most fear for horse owners comes in the not knowing if this colic is medical, meaning it can be fixed with some supportive therapy and time, or surgical. Unfortunately, the equine GI tract is not perfect in design and has several areas of imperfection which can lead to a surgical colic. Rest assured, however, most colic situations are medical and can be treated with supportive therapy. Before we dive more into the various types of colic let’s examine the symptoms.
The symptoms of colic have many appearances. Typically, we will first see an unwillingness to eat (anorexia), agitation (pacing or pawing), continual looking at the sides, depression, stretching out, lying down, rolling (excessively), sweating, and severe discomfort thrashing. In many cases, the symptoms can be so mild that we as owners don’t necessarily notice any difference until the colic progresses to more obvious stages. I am sure if we were to observe our horses every second of every day for several months we would see some mild signs of colic that we may not have ever noticed. Again, very similar to ourselves when we feel mild indigestion or discomfort your horse may walk away from food for a while or lay down until the discomfort passes, then return to their normal routine no worse for wear. But what do you do when the colic does not go away on its own or becomes worse?
The first thing to do is not panic, assess the situation and observe the symptoms. I know many of us want to jump straight to the Banamine (NSAID) but my suggestion would be to hold off and monitor the situation. When given orally Banamine, will take up to one hour before having any relief on symptoms and in many situations if mild, the symptoms may be gone in 20 minutes. So, again, first don’t panic, assess the situation and symptoms and monitor the progress. Simply walking your horse for 10 to 20 minutes can help the gas and ingesta move through the GI resolving all discomfort. All food can be removed during the onset of colic signs until no symptoms remain. If symptoms do not subside or become worse, then your veterinarian should be contacted, if anything for further advice or possible examination. In the case of surgical colics, the sooner they are examined and sent the surgery the better the prognosis. Giving oral banamine and walking your horse around for several hours prior to contacting your veterinarian is not recommended especially if signs are severe (sweating, thrashing, rolling) or are becoming worse. In many situations your veterinarian may recommend giving oral banamine and allowing it to work over the next hour prior to making any judgements on whether the horse needs to be examined or not.
As veterinarians our main goal with any colic is first to make them comfortable and secondly assess if the colic is medical or surgical. This can be easier said than done, and all colics are not created equal. NSAIDs such a Banamine or Equioxx can be given IV along with sedatives such as dormosedan or xylazine. This will allow for a window of comfort which will allow us to better examine the horse perform a rectal examination to see if surgery is needed. The assessment of discomfort (degree of colic), physical examination (heart rate, respiration rate, GI sounds, temperature), and rectal examination will help paint a picture for your veterinarian what is going on with your horse. Lower heart rates with mild colic signs and a normal rectal exam will be treated more as a medical colic, where as an increased heart rate, more severe colic signs, and an abnormal rectal may prompt your veterinarian to send your horse in for surgery or further diagnostic testing and monitoring which cannot be done on the farm.
So what are medical colics? Gastric ulcerations, mild indigestion, and mild to moderate impactions are colics which are treated medically. In the case of gastric ulcers, a gastroscopy (stomach scope) would be needed at a separate time to confirm the ulcerations, severity, and location, however, they can be treated in the short term prior to a follow up examination. With medical colics IV sedation and a NSAID are often times enough to provide comfort. Naso-gastric intubation (stomach tube) placement will allow the veterinarian to not only assess how much fluid/ingesta is in the stomach, but will also allow them to give a large bolus (drink) of water (plus or minus electrolytes) as well as mineral oil. This will help keep the horse hydrated as well as provide a marker (the oil) which, once it comes out the hind end, will let us know there are no obstructions throughout the entire GI tract. In some instances further medical treatment such as IV fluids may be warranted to “over hydrate” the system further increasing the activity of the GI and removal of the ingesta/feces. In house diagnostics such as abdominal ultrasound, abdominocentesis (belly tap), and bloodwork can further help your veterinarian gain more information regarding your horses colic status and prognosis.
Surgical colics are colics which can only be helped with surgical intervention. This would include physical blockage of the intestines, such as a severe impaction, intussusceptions, entrapments, large colon displacements, large colon torsions, etc. Surgical colics are very important to examine, diagnose, and treat as soon as possible. With these types of situations, the sooner the physical displacement or lesion can be removed or repaired the better the prognosis for recovery. Horses who experience surgical colics oftentimes display the worst symptoms. They are continuously uncomfortable and will burn through pain medication quickly. They are the typical colics you may hear of who are down rolling, sweating, pawing, and thrashing. Rectal examination of surgical colics are often abnormal with either large solid impactions or severe gas distension and tight bands. In the case of small intestinal lesions passage of an NG tube may produce a large amount of GI content and liquid which was backed up into the stomach. Since horses do not have the ability to vomit, removal of the stomach content from horses with small intestinal lesions is imperative, as the stomach can rupture from increased pressure ultimately resulting in death. Surgical colics are the reason most horse owners begin to panic and fret the worst when their horse begins to show colic signs.
Is there a way to prevent colic? Unfortunately, there is not a way to prevent colic, however, you can reduce the incidence of colic with appropriate management and veterinary management. Yearly dental examination plus or minus floating will help with appropriate chewing and breakdown of feed material. Feeding a good quality forage and the appropriate amount of ration balancer or grain for your specific horse will also help reduce the chances of colic. I would suggest talking with your veterinarian to set up an appropriate feeding program for your farm and for your individual horses. Reduction of stressors and illness again will help reduce the development of colic. Appropriate vaccination programs along with deworming programs are vital in keeping your horse healthy, active, eating, and drinking. Again, setting up a program for you and your horses with your veterinarian is important in the reduction of colic. As stated before, all colic cannot and will not be prevented, however, a healthy horse with low stress and an appropriate diet has a far greater chance of never developing colic compared to a sickly, high stressed, malnourished horse.
But, as with life, even the best prepared can always be caught off guard. The important take home points to remember are:
If signs persist or worsen, call your veterinarian and make a plan. If they feel that banamine can be given and your horse monitored then you can do so. If they feel that the symptoms are too strong or the colic is going on too long, then an examination may be needed. If surgery is an option for your horse or your horse is insured and would be required to go to surgery if necessary, then preparing your trailer or lining a trailer up if you don’t have one can be done while the veterinarian is on their way. Remember in surgical situations, every minute can count, and if your veterinarian determines surgery is needed the sooner your horse is on the road the better.
Call 920-779-4444 at the first signs of colic.